WorldWideScience

Sample records for sub-concussive head impacts

  1. Significance of ubiquitin carboxy-terminal hydrolase L1 elevations in athletes after sub-concussive head hits.

    Directory of Open Access Journals (Sweden)

    Vikram Puvenna

    Full Text Available The impact of sub-concussive head hits (sub-CHIs has been recently investigated in American football players, a population at risk for varying degrees of post-traumatic sequelae. Results show how sub-CHIs in athletes translate in serum as the appearance of reporters of blood-brain barrier disruption (BBBD, how the number and severity of sub-CHIs correlate with elevations of putative markers of brain injury is unknown. Serum brain injury markers such as UCH-L1 depend on BBBD. We investigated the effects of sub-CHIs in collegiate football players on markers of BBBD, markers of cerebrospinal fluid leakage (serum beta 2-transferrin and markers of brain damage. Emergency room patients admitted for a clinically-diagnosed mild traumatic brain injury (mTBI were used as positive controls. Healthy volunteers were used as negative controls. Specifically this study was designed to determine the use of UCH-L1 as an aid in the diagnosis of sub-concussive head injury in athletes. The extent and intensity of head impacts and serum values of S100B, UCH-L1, and beta-2 transferrin were measured pre- and post-game from 15 college football players who did not experience a concussion after a game. S100B was elevated in players experiencing the most sub-CHIs; UCH-L1 levels were also elevated but did not correlate with S100B or sub-CHIs. Beta-2 transferrin levels remained unchanged. No correlation between UCH-L1 levels and mTBI were measured in patients. Low levels of S100B were able to rule out mTBI and high S100B levels correlated with TBI severity. UCH-L1 did not display any interpretable change in football players or in individuals with mild TBI. The significance of UCH-L1 changes in sub-concussions or mTBI needs to be further elucidated.

  2. Effects of repetitive sub-concussive brain injury on the functional connectivity of Default Mode Network in high school football athletes.

    Science.gov (United States)

    Abbas, Kausar; Shenk, Trey E; Poole, Victoria N; Robinson, Meghan E; Leverenz, Larry J; Nauman, Eric A; Talavage, Thomas M

    2015-01-01

    Sub-concussive head impacts are identified as a source of accrued damage. Football athletes experience hundreds of such blows each season. Resting state functional magnetic resonance imaging was used to prospectively study changes in Default Mode Network connectivity for clinically asymptomatic high school football athletes. Athletes exhibited short-term changes relative to baseline and across sessions.

  3. Sub-concussive hit characteristics predict deviant brain metabolism in football athletes.

    Science.gov (United States)

    Poole, Victoria N; Breedlove, Evan L; Shenk, Trey E; Abbas, Kausar; Robinson, Meghan E; Leverenz, Larry J; Nauman, Eric A; Dydak, Ulrike; Talavage, Thomas M

    2015-01-01

    Magnetic resonance spectroscopy and helmet telemetry were used to monitor the neural metabolic response to repetitive head collisions in 25 high school American football athletes. Specific hit characteristics were determined highly predictive of metabolic alterations, suggesting that sub-concussive blows can produce biochemical changes and potentially lead to neurological problems.

  4. Cumulative head impact burden in high school football.

    Science.gov (United States)

    Broglio, Steven P; Eckner, James T; Martini, Douglas; Sosnoff, Jacob J; Kutcher, Jeffrey S; Randolph, Christopher

    2011-10-01

    Impacts to the head are common in collision sports such as football. Emerging research has begun to elucidate concussion tolerance levels, but sub-concussive impacts that do not result in clinical signs or symptoms of concussion are much more common, and are speculated to lead to alterations in cerebral structure and function later in life. We investigated the cumulative number of head impacts and their associated acceleration burden in 95 high school football players across four seasons of play using the Head Impact Telemetry System (HITS). The 4-year investigation resulted in 101,994 impacts collected across 190 practice sessions and 50 games. The number of impacts per 14-week season varied by playing position and starting status, with the average player sustaining 652 impacts. Linemen sustained the highest number of impacts per season (868); followed by tight ends, running backs, and linebackers (619); then quarterbacks (467); and receivers, cornerbacks, and safeties (372). Post-impact accelerations of the head also varied by playing position and starting status, with a seasonal linear acceleration burden of 16,746.1g, while the rotational acceleration and HIT severity profile burdens were 1,090,697.7 rad/sec(2) and 10,021, respectively. The adolescent athletes in this study clearly sustained a large number of impacts to the head, with an impressive associated acceleration burden as a direct result of football participation. These findings raise concern about the relationship between sub-concussive head impacts incurred during football participation and late-life cerebral pathogenesis, and justify consideration of ways to best minimize impacts and mitigate cognitive declines.

  5. Head impact exposure in collegiate football players.

    Science.gov (United States)

    Crisco, Joseph J; Wilcox, Bethany J; Beckwith, Jonathan G; Chu, Jeffrey J; Duhaime, Ann-Christine; Rowson, Steven; Duma, Stefan M; Maerlender, Arthur C; McAllister, Thomas W; Greenwald, Richard M

    2011-10-13

    In American football, impacts to the helmet and the resulting head accelerations are the primary cause of concussion injury and potentially chronic brain injury. The purpose of this study was to quantify exposures to impacts to the head (frequency, location and magnitude) for individual collegiate football players and to investigate differences in head impact exposure by player position. A total of 314 players were enrolled at three institutions and 286,636 head impacts were recorded over three seasons. The 95th percentile peak linear and rotational acceleration and HITsp (a composite severity measure) were 62.7g, 4378rad/s(2) and 32.6, respectively. These exposure measures as well as the frequency of impacts varied significantly by player position and by helmet impact location. Running backs (RB) and quarter backs (QB) received the greatest magnitude head impacts, while defensive line (DL), offensive line (OL) and line backers (LB) received the most frequent head impacts (more than twice as many than any other position). Impacts to the top of the helmet had the lowest peak rotational acceleration (2387rad/s(2)), but the greatest peak linear acceleration (72.4g), and were the least frequent of all locations (13.7%) among all positions. OL and QB had the highest (49.2%) and the lowest (23.7%) frequency, respectively, of front impacts. QB received the greatest magnitude (70.8g and 5428rad/s(2)) and the most frequent (44% and 38.9%) impacts to the back of the helmet. This study quantified head impact exposure in collegiate football, providing data that is critical to advancing the understanding of the biomechanics of concussive injuries and sub-concussive head impacts. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Evidence for Acute Electrophysiological and Cognitive Changes Following Routine Soccer Heading

    Directory of Open Access Journals (Sweden)

    Thomas G. Di Virgilio

    2016-11-01

    Discussion: Sub-concussive head impacts routine in soccer heading are associated with immediate, measurable electrophysiological and cognitive impairments. Although these changes in brain function were transient, these effects may signal direct consequences of routine soccer heading on (long-term brain health which requires further study.

  7. Head Impact Laboratory (HIL)

    Data.gov (United States)

    Federal Laboratory Consortium — The HIL uses testing devices to evaluate vehicle interior energy attenuating (EA) technologies for mitigating head injuries resulting from head impacts during mine/...

  8. Altered Blood Biomarker Profiles in Athletes with a History of Repetitive Head Impacts.

    Directory of Open Access Journals (Sweden)

    Alex P Di Battista

    Full Text Available The long-term health effects of concussion and sub-concussive impacts in sport are unknown. Growing evidence suggests both inflammation and neurodegeneration are pivotal to secondary injury processes and the etiology of neurodegenerative diseases. In the present study we characterized circulating brain injury and inflammatory mediators in healthy male and female athletes according to concussion history and collision sport participation. Eighty-seven university level athletes (male, n = 60; female, n = 27 were recruited before the start of the competitive season. Athletes were healthy at the time of the study (no medications, illness, concussion or musculoskeletal injuries. Dependent variables included 29 inflammatory and 10 neurological injury analytes assessed in the peripheral blood by immunoassay. Biomarkers were statistically evaluated using partial least squares multivariate analysis to identify possible relationships to self-reported previous concussion history, number of previous concussions and collision sport participation in male and female athletes. Multiple concussions were associated with increases in peripheral MCP-1 in females, and MCP-4 in males. Collision sport participation was associated with increases in tau levels in males. These results are consistent with previous experimental and clinical findings that suggest ongoing inflammatory and cerebral injury processes after repetitive mild head trauma. However, further validation is needed to correlate systemic biomarkers to repetitive brain impacts, as opposed to the extracranial effects common to an athletic population such as exercise and muscle damage.

  9. Head Start Impact Study

    Data.gov (United States)

    U.S. Department of Health & Human Services — Nationally representative, longitudinal information from an evaluation where children were randomly assigned to Head Start or community services as usual;direct...

  10. Head Impact Exposure in Collegiate Football Players

    OpenAIRE

    Crisco, Joseph J.; Wilcox, Bethany J.; Beckwith, Jonathan G.; Chu, Jeffrey J.; Duhaime, Ann-Christine; Rowson, Steve; Duma, Stefan M.; Maerlender, Arthur C.; McAllister, Thomas W.; Greenwald, Richard M.

    2011-01-01

    In American football, impacts to the helmet and the resulting head accelerations are the primary cause of concussion injury and potentially chronic brain injury. The purpose of this study was to quantify exposures to impacts to the head (frequency, location and magnitude) for individual collegiate football players and to investigate differences in head impact exposure by player position. A total of 314 players were enrolled at three institutions and 286,636 head impacts were recorded over thr...

  11. Head impact in a snowboarding accident.

    Science.gov (United States)

    Bailly, N; Llari, M; Donnadieu, T; Masson, C; Arnoux, P J

    2017-09-01

    To effectively prevent sport traumatic brain injury (TBI), means of protection need to be designed and tested in relation to the reality of head impact. This study quantifies head impacts during a typical snowboarding accident to evaluate helmet standards. A snowboarder numerical model was proposed, validated against experimental data, and used to quantify the influence of accident conditions (speed, snow stiffness, morphology, and position) on head impacts (locations, velocities, and accelerations) and injury risk during snowboarding backward falls. Three hundred twenty-four scenarios were simulated: 70% presented a high risk of mild TBI (head peak acceleration >80 g) and 15% presented a high risk of severe TBI (head injury criterion >1000). Snow stiffness, speed, and snowboarder morphology were the main factors influencing head impact metrics. Mean normal head impact speed (28 ± 6 km/h) was higher than equivalent impact speed used in American standard helmet test (ASTM F2040), and mean tangential impact speed, not included in standard tests, was 13.8 (±7 km/h). In 97% of simulated impacts, the peak head acceleration was below 300 g, which is the pass/fail criteria used in standard tests. Results suggest that initial speed, impacted surface, and pass/fail criteria used in helmet standard performance tests do not fully reflect magnitude and variability of snowboarding backward-fall impacts. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Head Impact Biomechanics in Women's College Soccer.

    Science.gov (United States)

    Lynall, Robert C; Clark, Michael D; Grand, Erin E; Stucker, Jaclyn C; Littleton, Ashley C; Aguilar, Alain J; Petschauer, Meredith A; Teel, Elizabeth F; Mihalik, Jason P

    2016-09-01

    There are limited nonlaboratory soccer head impact biomechanics data. This is surprising given soccer's global popularity. Epidemiological data suggest that female college soccer players are at a greater concussion injury risk than their male counterparts. Therefore, the purposes of our study were to quantify head impact frequency and magnitude during women's soccer practices and games in the National Collegiate Athletic Association and to characterize these data across event type, playing position, year on the team, and segment of game (first and second halves). Head impact biomechanics were collected from female college soccer players (n = 22; mean ± SD age = 19.1 ± 0.1 yr, height = 168.0 ± 3.5 cm, mass = 63.7 ± 6.0 kg). We employed a helmetless head impact measurement device (X2 Biosystems xPatch) before each competition and practice across a single season. Peak linear and rotational accelerations were categorized based on impact magnitude and subsequently analyzed using appropriate nonparametric analyses. Overall, women's college soccer players experience approximately seven impacts per 90 min of game play. The overwhelming majority (~90%) of all head impacts were categorized into our mildest linear acceleration impact classification (10g-20g). Interestingly, a higher percentage of practice impacts in the 20g-40g range compared with games (11% vs 7%) was observed. Head impact biomechanics studies have provided valuable insights into understanding collision sports and for informing evidence-based rule and policy changes. These have included changing the football kickoff, ice hockey body checking ages, and head-to-head hits in both sports. Given soccer's global popularity, and the growing public concern for the potential long-term neurological implications of collision and contact sports, studying soccer has the potential to impact many athletes and the sports medicine professionals caring for them.

  13. Finite element analyses of railroad tank car head impacts

    Science.gov (United States)

    2008-09-24

    This paper describes engineering analyses of a railroad : tank car impacted at its head by a rigid punch. This type of : collision, referred to as a head impact, is examined using : dynamic, nonlinear finite element analysis (FEA). : Commercial softw...

  14. Do Head Start Impacts Vary by Neighborhood Context?

    Science.gov (United States)

    Morris, Pamela A.; Connors, Maia C.; McCoy, Dana Charles; Gomez, Celia J.; Yoshikawa, Hiro; Aber, J. Lawrence

    2014-01-01

    This paper capitalizes on the addition of geocodes for Head Start centers in which children were randomly assigned to address questions about the role of neighborhood characteristics in moderating impacts of assignment to the Head Start program. Researchers explore the extent to which impacts of assignment to Head Start on outcomes for children…

  15. Repetitive Head Impacts and Chronic Traumatic Encephalopathy.

    Science.gov (United States)

    McKee, Ann C; Alosco, Michael L; Huber, Bertrand R

    2016-10-01

    Chronic traumatic encephalopathy (CTE) is a distinctive neurodegenerative disease that occurs as a result of repetitive head impacts. CTE can only be diagnosed by postmortem neuropathologic examination of brain tissue. CTE is a unique disorder with a pathognomonic lesion that can be reliably distinguished from other neurodegenerative diseases. CTE is associated with violent behaviors, explosivity, loss of control, depression, suicide, memory loss and cognitive changes. There is increasing evidence that CTE affects amateur athletes as well as professional athletes and military veterans. CTE has become a major public health concern. Published by Elsevier Inc.

  16. Head, neck, and body coupling in reconstructions of helmeted head impacts

    NARCIS (Netherlands)

    Lange, R. de; Cappon, H.J.; Beusenberg, C.M.; Shewchenko, N.; Newman, J.A.

    2001-01-01

    A mathematical modeling study is conducted to investigate neck coupling in helmeted head impacts. The main objective of the study is to provide direction for the experimental reconstruction of American football player impacts. Head responses are compared in MADYMO simulations of various impact

  17. Head Impact Magnitude in American High School Football.

    Science.gov (United States)

    Schmidt, Julianne D; Guskiewicz, Kevin M; Mihalik, Jason P; Blackburn, J Troy; Siegmund, Gunter P; Marshall, Stephen W

    2016-08-01

    To describe determinants of head impact magnitudes between various play aspects in high school football. Thirty-two high school American football players wore Head Impact Telemetry System instrumented helmets to capture head impact magnitude (linear acceleration, rotational acceleration, and Head Impact Technology severity profile [HITsp]). We captured and analyzed video from 13 games (n = 3888 viewable head impacts) to determine the following play aspects: quarter, impact cause, play type, closing distance, double head impact, player's stance, player's action, direction of gaze, athletic readiness, level of anticipation, player stationary, ball possession, receiving ball, and snapping ball. We conducted random intercepts general linear mixed models to assess the differences in head impact magnitude between play aspects (α = 0.05). The following aspects resulted in greater head impact magnitude: impacts during the second quarter (HITsp: P = .03); contact with another player (linear, rotational, HITsp: P high school football. Rule or coaching changes that reduce collisions after long closing distances, especially when combined with the 3-point stance or when a player is being struck in the head, should be considered. Copyright © 2016 by the American Academy of Pediatrics.

  18. Finite element modelling of helmeted head impact under frontal ...

    Indian Academy of Sciences (India)

    Abstract. Finite element models of the head and helmet were used to study contact forces during frontal impact of the head with a rigid surface. The finite element model of the head consists of skin, skull, cerebro-spinal fluid (CSF), brain, tentorium and falx. The finite element model of the helmet consists of shell and foam.

  19. Finite element modelling of helmeted head impact under frontal ...

    Indian Academy of Sciences (India)

    Finite element models of the head and helmet were used to study contact forces during frontal impact of the head with a rigid surface. The finite element model of the head consists of skin, skull, cerebro-spinal fluid (CSF), brain, tentorium and falx. The finite element model of the helmet consists of shell and foam liner.

  20. Comparative Analysis of Head Impact in Contact and Collision Sports.

    Science.gov (United States)

    Reynolds, Bryson B; Patrie, James; Henry, Erich J; Goodkin, Howard P; Broshek, Donna K; Wintermark, Max; Druzgal, T Jason

    2017-01-01

    As concerns about head impact in American football have grown, similar concerns have started to extend to other sports thought to experience less head impact, such as soccer and lacrosse. However, the amount of head impact experienced in soccer and lacrosse is relatively unknown, particularly compared with the substantial amount of data from football. This pilot study quantifies and compares head impact from four different types of sports teams: college football, high school football, college soccer, and college lacrosse. During the 2013 and 2014 seasons, 61 players wore mastoid patch accelerometers to quantify head impact during official athletic events (i.e., practices and games). In both practices and games, college football players experienced the most or second-most impacts per athletic event, highest average peak resultant linear and rotational acceleration per impact, and highest cumulative linear and rotational acceleration per athletic event. For average peak resultant linear and rotational acceleration per individual impact, college football was followed by high school football, then college lacrosse, and then college soccer, with similar trends in both practices and games. In the four teams under study, college football players experienced a categorically higher burden of head impact. However, for cumulative impact burden, the high school football cohort was not significantly different from the college soccer cohort. The results suggest that head impact in sport substantially varies by both the type of sport (football vs. soccer vs. lacrosse) and level of play (college vs. high school).

  1. Head-Impact-Measurement Devices: A Systematic Review.

    Science.gov (United States)

    O'Connor, Kathryn L; Rowson, Steven; Duma, Stefan M; Broglio, Steven P

    2017-03-01

    With an estimated 3.8 million sport- and recreation-related concussions occurring annually, targeted prevention and diagnostic methods are needed. Biomechanical analysis of head impacts may provide quantitative information that can inform both prevention and diagnostic strategies. To assess available head-impact devices and their clinical utility. We performed a systematic search of the electronic database PubMed for peer-reviewed publications, using the following phrases: accelerometer and concussion, head impact telemetry, head impacts and concussion and sensor, head impacts and sensor, impact sensor and concussion, linear acceleration and concussion, rotational acceleration and concussion, and xpatch concussion. In addition to the literature review, a Google search for head impact monitor and concussion monitor yielded 15 more devices. Included studies were performed in vivo, used commercially available devices, and focused on sport-related concussion. One author reviewed the title and abstract of each study for inclusion and exclusion criteria and then reviewed each full-text article to confirm inclusion criteria. Controversial articles were reviewed by all authors to reach consensus. In total, 61 peer-reviewed articles involving 4 head-impact devices were included. Participants in boxing, football, ice hockey, soccer, or snow sports ranged in age from 6 to 24 years; 18% (n = 11) of the studies included female athletes. The Head Impact Telemetry System was the most widely used device (n = 53). Fourteen additional commercially available devices were presented. Measurements collected by impact monitors provided real-time data to estimate player exposure but did not have the requisite sensitivity to concussion. Proper interpretation of previously reported head-impact kinematics across age, sport, and position may inform future research and enable staff clinicians working on the sidelines to monitor athletes. However, head-impact-monitoring systems have limited

  2. Head Start Impact Study. Final Report. Executive Summary

    Science.gov (United States)

    Puma, Michael; Bell, Stephen; Cook, Ronna; Heid, Camilla; Shapiro, Gary; Broene, Pam; Jenkins, Frank; Fletcher, Philip; Quinn, Liz; Friedman, Janet; Ciarico, Janet; Rohacek, Monica; Adams, Gina; Spier, Elizabeth

    2010-01-01

    This report summarizes the findings from a study on the impacts of Head Start on children and families during the children's preschool, kindergarten, and 1st grade years. Its study goals were to: (1) Determine the impact of Head Start on children's school readiness, and on parental practices that support children's development; and to (2)…

  3. High-magnitude head impact exposure in youth football

    Science.gov (United States)

    Campolettano, Eamon T.; Gellner, Ryan A.; Rowson, Steven

    2018-01-01

    OBJECTIVE Even in the absence of a clinically diagnosed concussion, research suggests that neurocognitive changes may develop in football players as a result of frequent head impacts that occur during football games and practices. The objectives of this study were to determine the specific situations in which high-magnitude impacts (accelerations exceeding 40g) occur in youth football games and practices and to assess how representative practice activities are of games with regard to high-magnitude head impact exposure. METHODS A total of 45 players (mean age 10.7 ± 1.1 years) on 2 youth teams (Juniors [mean age 9.9 ± 0.6 years; mean body mass 38.9 ± 9.9 kg] and Seniors [mean age 11.9 ± 0.6 years; mean body mass 51.4 ± 11.8 kg]) wore helmets instrumented with accelerometer arrays to record head impact accelerations for all practices and games. Video recordings from practices and games were used to verify all high-magnitude head impacts, identify specific impact characteristics, and determine the amount of time spent in each activity. RESULTS A total of 7590 impacts were recorded, of which 571 resulted in high-magnitude head impact accelerations exceeding 40g (8%). Impacts were characterized based on the position played by the team member who received the impact, the part of the field where the impact occurred, whether the impact occurred during a game or practice play, and the cause of the impact. High-magnitude impacts occurred most frequently in the open field in both games (59.4%) and practices (67.5%). “Back” position players experienced a greater proportion of high-magnitude head impacts than players at other positions. The 2 teams in this study structured their practice sessions similarly with respect to time spent in each drill, but impact rates differed for each drill between the teams. CONCLUSIONS High-magnitude head impact exposure in games and practice drills was quantified and used as the basis for comparison of exposure in the 2 settings. In

  4. Treatment of femoral head osteonecrosis using bone impaction grafting.

    NARCIS (Netherlands)

    Rijnen, W.H.C.; Gardeniers, J.W.M.; Buma, P.; Yamano, K.; Slooff, T.J.J.H.; Schreurs, B.W.

    2003-01-01

    Even in extensive osteonecrosis of the femoral head in younger patients, a femoral head-preserving method is preferable. We developed a new technique using the lateral approach as used in traditional core biopsy; the osteonecrotic lesion was removed and impacted bone grafts were used to regain

  5. Practice type effects on head impact in collegiate football.

    Science.gov (United States)

    Reynolds, Bryson B; Patrie, James; Henry, Erich J; Goodkin, Howard P; Broshek, Donna K; Wintermark, Max; Druzgal, T Jason

    2016-02-01

    OBJECT IVE: This study directly compares the number and severity of subconcussive head impacts sustained during helmet-only practices, shell practices, full-pad practices, and competitive games in a National Collegiate Athletic Association (NCAA) Division I-A football team. The goal of the study was to determine whether subconcussive head impact in collegiate athletes varies with practice type, which is currently unregulated by the NCAA. Over an entire season, a cohort of 20 collegiate football players wore impact-sensing mastoid patches that measured the linear and rotational acceleration of all head impacts during a total of 890 athletic exposures. Data were analyzed to compare the number of head impacts, head impact burden, and average impact severity during helmet-only, shell, and full-pad practices, and games. Helmet-only, shell, and full-pad practices and games all significantly differed from each other (p ≤ 0.05) in the mean number of impacts for each event, with the number of impacts being greatest for games, then full-pad practices, then shell practices, and then helmet-only practices. The cumulative distributions for both linear and rotational acceleration differed between all event types (p football players.

  6. Head Impact Exposure and Neurologic Function of Youth Football Players.

    Science.gov (United States)

    Munce, Thayne A; Dorman, Jason C; Thompson, Paul A; Valentine, Verle D; Bergeron, Michael F

    2015-08-01

    Football players are subjected to repetitive impacts that may lead to brain injury and neurologic dysfunction. Knowledge about head impact exposure (HIE) and consequent neurologic function among youth football players is limited. This study aimed to measure and characterize HIE of youth football players throughout one season and explore associations between HIE and changes in selected clinical measures of neurologic function. Twenty-two youth football players (11-13 yr) wore helmets outfitted with a head impact telemetry (HIT) system to quantify head impact frequency, magnitude, duration, and location. Impact data were collected for each practice (27) and game (9) in a single season. Selected clinical measures of balance, oculomotor performance, reaction time, and self-reported symptoms were assessed before and after the season. The median individual head impacts per practice, per game, and throughout the entire season were 9, 12, and 252, respectively. Approximately 50% of all head impacts (6183) had a linear acceleration between 10g and 20g, but nearly 2% were greater than 80g. Overall, the head impact frequency distributions in this study population were similar in magnitude and location as in high school and collegiate football, but total impact frequency was lower. Individual changes in neurologic function were not associated with cumulative HIE. This study provides a novel examination of HIE and associations with short-term neurologic function in youth football and notably contributes to the limited HIE data currently available for this population. Whereas youth football players can experience remarkably similar head impact forces as high school players, cumulative subconcussive HIE throughout one youth football season may not be detrimental to short-term clinical measures of neurologic function.

  7. On Impact: Students with Head Injuries

    Science.gov (United States)

    Canto, Angela I.; Chesire, David J.; Buckley, Valerie A.

    2011-01-01

    Students with head injuries may not be as "low incidence" as previously believed. Recent efforts from the American Academy of Pediatrics (2010), the National Football League, and other agencies are attempting to raise awareness of traumatic brain injury (TBI) among students. Along with awareness, there has been an increased publicity effort via…

  8. Reconstruction of head impacts in FIS World Cup alpine skiing.

    Science.gov (United States)

    Steenstrup, Sophie Elspeth; Mok, Kam-Ming; McIntosh, Andrew S; Bahr, Roald; Krosshaug, Tron

    2017-11-25

    Prior to the 2013/2014 season, the International Ski Federation (FIS) increased the helmet testing speed from 5.4 to 6.8 m/s for alpine downhill, super-G and giant slalom. Whether this increased testing speed reflects head impact velocities in real head injury situations on snow is unclear. We therefore investigated the injury mechanisms and gross head impact biomechanics in seven real head injury situations among World Cup (WC) alpine skiers. We analysed nine head impacts from seven head injury videos from the FIS Injury Surveillance System, throughout nine WC seasons (2006-2015) in detail. We used commercial video-based motion analysis software to estimate head impact kinematics in two dimensions, including directly preimpact and postimpact, from broadcast video. The sagittal plane angular movement of the head was also measured using angle measurement software. In seven of nine head impacts, the estimated normal to slope preimpact velocity was higher than the current FIS helmet rule of 6.8 m/s (mean 8.1 (±SD 0.6) m/s, range 1.9±0.8 to 12.1±0.4 m/s). The nine head impacts had a mean normal to slope velocity change of 9.3±1.0 m/s, range 5.2±1.1 to 13.5±1.3 m/s. There was a large change in sagittal plane angular velocity (mean 43.3±2.9 rad/s (range 21.2±1.5 to 64.2±3.0 rad/s)) during impact. The estimated normal to slope preimpact velocity was higher than the current FIS helmet rule of 6.8 m/s in seven of nine head impacts. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Drill-specific head impact exposure in youth football practice.

    Science.gov (United States)

    Campolettano, Eamon T; Rowson, Steven; Duma, Stefan M

    2016-11-01

    OBJECTIVE Although 70% of football players in the United States are youth players (6-14 years old), most research on head impacts in football has focused on high school, collegiate, or professional populations. The objective of this study was to identify the specific activities associated with high-magnitude (acceleration > 40g) head impacts in youth football practices. METHODS A total of 34 players (mean age 9.9 ± 0.6 years) on 2 youth teams were equipped with helmet-mounted accelerometer arrays that recorded head accelerations associated with impacts in practices and games. Videos of practices and games were used to verify all head impacts and identify specific drills associated with each head impact. RESULTS A total of 6813 impacts were recorded, of which 408 had accelerations exceeding 40g (6.0%). For each type of practice drill, impact rates were computed that accounted for the length of time that teams spent on each drill. The tackling drill King of the Circle had the highest impact rate (95% CI 25.6-68.3 impacts/hr). Impact rates for tackling drills (those conducted without a blocker [95% CI 14.7-21.9 impacts/hr] and those with a blocker [95% CI 10.5-23.1 impacts/hr]) did not differ from game impact rates (95% CI 14.2-21.6 impacts/hr). Tackling drills were observed to have a greater proportion (between 40% and 50%) of impacts exceeding 60g than games (25%). The teams in this study participated in tackling or blocking drills for only 22% of their overall practice times, but these drills were responsible for 86% of all practice impacts exceeding 40g. CONCLUSIONS In youth football, high-magnitude impacts occur more often in practices than games, and some practice drills are associated with higher impact rates and accelerations than others. To mitigate high-magnitude head impact exposure in youth football, practices should be modified to decrease the time spent in drills with high impact rates, potentially eliminating a drill such as King of the Circle

  10. Severe-to-fatal head injuries in motor vehicle impacts.

    Science.gov (United States)

    Yoganandan, Narayan; Baisden, Jamie L; Maiman, Dennis J; Gennarelli, Thomas A; Guan, Yabo; Pintar, Frank A; Laud, Prakash; Ridella, Stephen A

    2010-07-01

    Severe-to-fatal head injuries in motor vehicle environments were analyzed using the United States Crash Injury Research and Engineering Network database for the years 1997-2006. Medical evaluations included details and photographs of injury, and on-scene, trauma bay, emergency room, intensive care unit, radiological, operating room, in-patient, and rehabilitation records. Data were synthesized on a case-by-case basis. X-rays, computed tomography scans, and magnetic resonance images were reviewed along with field evaluations of scene and photographs for the analyses of brain injuries and skull fractures. Injuries to the parenchyma, arteries, brainstem, cerebellum, cerebrum, and loss of consciousness were included. In addition to the analyses of severe-to-fatal (AIS4+) injuries, cervical spine, face, and scalp trauma were used to determine the potential for head contact. Fatalities and survivors were compared using nonparametric tests and confidence intervals for medians. Results were categorized based on the mode of impact with a focus on head contact. Out of the 3178 medical cases and 169 occupants sustaining head injuries, 132 adults were in frontal (54), side (75), and rear (3) crashes. Head contact locations are presented for each mode. A majority of cases clustered around the mid-size anthropometry and normal body mass index (BMI). Injuries occurred at change in velocities (DeltaV) representative of US regulations. Statistically significant differences in DeltaV between fatalities and survivors were found for side but not for frontal impacts. Independent of the impact mode and survivorship, contact locations were found to be superior to the center of gravity of the head, suggesting a greater role for angular than translational head kinematics. However, contact locations were biased to the impact mode: anterior aspects of the frontal bone and face were involved in frontal impacts while temporal-parietal regions were involved in side impacts. Because head

  11. The importance of rotational kinematics in pedestrian head to windshield impacts

    NARCIS (Netherlands)

    Mordaka, J.; Kleiven, S.; Schijndel-de Nooij, M. van; Lange, R. de; Casanova, L.J.G.; Carter, E.L.; Holst, H. von

    2007-01-01

    The objective of the present study was to analyze the effect of angular kinematics on head injury in pedestrian head-to-windshield impacts. Three cases of pedestrian head impacts were simulated with FE head and windshield models. The initial impact conditions were obtained from pedestrian accident

  12. Environmental and Physiological Factors Affect Football Head Impact Biomechanics.

    Science.gov (United States)

    Mihalik, Jason P; Sumrall, Adam Z; Yeargin, Susan W; Guskiewicz, Kevin M; King, Kevin B; Trulock, Scott C; Shields, Edgar W

    2017-10-01

    Recent anecdotal trends suggest a disproportionate number of head injuries in collegiate football players occur during preseason football camp. In warmer climates, this season also represents the highest risk for heat-related illness among collegiate football players. Because concussion and heat illnesses share many common symptoms, we need 1) to understand if environmental conditions, body temperature, and hydration status affect head impact biomechanics; and 2) to determine if an in-helmet thermistor could provide a valid measure of gastrointestinal temperature. A prospective cohort of 18 Division I college football players (age, 21.1 ± 1.4 yr; height, 187.7 ± 6.6 cm; mass, 114.5 ± 23.4 kg). Data were collected during one control and three experimental sessions. During each session, the Head Impact Telemetry System recorded head impact biomechanics (linear acceleration, rotational acceleration, and severity profile) and in-helmet temperature. A wet bulb globe device recorded environmental conditions, and CorTemp™ Ingestible Core Body Temperature Sensors recorded gastrointestinal temperature. Our findings suggest that linear acceleration (P = 0.57), rotational acceleration (P = 0.16), and Head Impact Technology severity profile (P = 0.33) are not influenced by environmental or physiological conditions. We did not find any single or combination of predictors for impact severity. Rotational acceleration was approaching significance between our early experimental sessions when compared with our control session. More research should be conducted to better understand if rotational accelerations are a component of impact magnitudes that are affected due to changes in environmental conditions, body temperature, and hydration status.

  13. The impact of gravity during head-up tilt

    DEFF Research Database (Denmark)

    Ottesen, Johnny T.; Olufsen, Mette; Smith, Brittany

    The impact of gravity during head-up tilt, a test often used in the clinic to diagnose patients who suffer from dizziness or frequent episodes of syncope, is not well described. This study uses mathematical modeling to analyze experimental blood pressure data measured at the level of the aorta...

  14. The impact of gravity during head-up tilt

    DEFF Research Database (Denmark)

    Olufsen, Mette; Smith, Brittany; Mehlsen, Jesper

    2011-01-01

    The impact of gravity during head-up tilt, a test often used in the clinic to diagnose patients who suffer from dizziness or frequent episodes of syncope, is not well described. This study uses mathematical modeling to analyze experimental blood pressure data measured at the level of the aorta...

  15. Injury risk assessment of non-lethal projectile head impacts.

    Science.gov (United States)

    Oukara, Amar; Nsiampa, Nestor; Robbe, Cyril; Papy, Alexandre

    2014-01-01

    Kinetic energy non-lethal projectiles are used to impart sufficient effect onto a person in order to deter uncivil or hazardous behavior with a low probability of permanent injury. Since their first use, real cases indicate that the injuries inflicted by such projectiles may be irreversible and sometimes lead to death, especially for the head impacts. Given the high velocities and the low masses involved in such impacts, the assessment approaches proposed in automotive crash tests and sports may not be appropriate. Therefore, there is a need of a specific approach to assess the lethality of these projectiles. In this framework, some recent research data referred in this article as "force wall approach" suggest the use of three lesional thresholds (unconsciousness, meningeal damages and bone damages) that depend on the intracranial pressure. Three corresponding critical impact forces are determined for a reference projectile. Based on the principle that equal rigid wall maximal impact forces will produce equal damage on the head, these limits can be determined for any other projectile. In order to validate the consistence of this innovative method, it is necessary to compare the results with other existing assessment methods. This paper proposes a comparison between the "force wall approach" and two different head models. The first one is a numerical model (Strasbourg University Finite Element Head Model-SUFEHM) from Strasbourg University; the second one is a mechanical surrogate (Ballistics Load Sensing Headform-BLSH) from Biokinetics.

  16. Human volunteer head-Tl response for oblique impact conditions

    NARCIS (Netherlands)

    Philippens, M.M.G.M.; Cappon, H.J.; Ratingen, M.R. van

    2004-01-01

    The development of modern smart restraint systems requires access to human surrogates with a biofidelic performance, which includes details on timing and local deformations. Therefore volunteer head neck responses for oblique impacts from the Naval BioDynamics Laboratory are re-analysed using a

  17. Head impacts during high school football: a biomechanical assessment.

    Science.gov (United States)

    Broglio, Steven P; Sosnoff, Jacob J; Shin, SungHoon; He, Xuming; Alcaraz, Christopher; Zimmerman, Jerrad

    2009-01-01

    Little is known about the impact biomechanics sustained by players during interscholastic football. To characterize the location and magnitude of impacts sustained by players during an interscholastic football season. Observational design. On the field. High school varsity football team (n = 35; age = 16.85 +/- 0.75 years, height = 183.49 +/- 5.31 cm, mass = 89.42 +/- 12.88 kg). Biomechanical variables (linear acceleration, rotational acceleration, jerk, force, impulse, and impact duration) related to head impacts were categorized by session type, player position, and helmet impact location. Differences in grouping variables were found for each impact descriptor. Impacts occurred more frequently and with greater intensity during games. Linear acceleration was greatest in defensive linemen and offensive skill players and when the impact occurred at the top of the helmet. The largest rotational acceleration occurred in defensive linemen and with impacts to the front of the helmet. Impacts with the highest-magnitude jerk, force, and impulse and shortest duration occurred in the offensive skill, defensive line, offensive line, and defensive skill players, respectively. Top-of-the-helmet impacts yielded the greatest magnitude for the same variables. We are the first to provide a biomechanical characterization of head impacts in an interscholastic football team across a season of play. The intensity of game play manifested with more frequent and intense impacts. The highest-magnitude variables were distributed across all player groups, but impacts to the top of the helmet yielded the highest values. These high school football athletes appeared to sustain greater accelerations after impact than their older counterparts did. How this finding relates to concussion occurrence has yet to be elucidated.

  18. Characterization of Closed Head Impact Injury in Rat

    Directory of Open Access Journals (Sweden)

    Yi Hua

    2015-01-01

    Full Text Available The closed head impact (CHI rat models are commonly used for studying the traumatic brain injury. The impact parameters vary considerably among different laboratories, making the comparison of research findings difficult. In this work, numerical CHI experiments were conducted to investigate the sensitivities of intracranial responses to various impact parameters (e.g., impact depth, velocity, and position; impactor diameter, material, and shape. A three-dimensional finite element rat head model with anatomical details was subjected to impact loadings. Results revealed that impact depth and impactor shape were the two leading factors affecting intracranial responses. The influence of impactor diameter was region-specific and an increase in impactor diameter could substantially increase tissue strains in the region which located directly beneath the impactor. The lateral impact could induce higher strains in the brain than the central impact. An indentation depth instead of impact depth would be appropriate to characterize the influence of a large deformed rubber impactor. The experimentally observed velocity-dependent injury severity could be attributed to the “overshoot” phenomenon. This work could be used to better design or compare CHI experiments.

  19. Multiscale Analysis of Head Impacts in Contact Sports

    Science.gov (United States)

    Guttag, Mark; Sett, Subham; Franck, Jennifer; McNamara, Kyle; Bar-Kochba, Eyal; Crisco, Joseph; Blume, Janet; Franck, Christian

    2012-02-01

    Traumatic brain injury (TBI) is one of the world's major causes of death and disability. To aid companies in designing safer and improved protective gear and to aid the medical community in producing improved quantitative TBI diagnosis and assessment tools, a multiscale finite element model of the human brain, head and neck is being developed. Recorded impact data from football and hockey helmets instrumented with accelerometers are compared to simulated impact data in the laboratory. Using data from these carefully constructed laboratory experiments, we can quantify impact location, magnitude, and linear and angular accelerations of the head. The resultant forces and accelerations are applied to a fully meshed head-form created from MRI data by Simpleware. With appropriate material properties for each region of the head-form, the Abaqus finite element model can determine the stresses, strains, and deformations in the brain. Simultaneously, an in-vitro cellular TBI criterion is being developed to be incorporated into Abaqus models for the brain. The cell-based injury criterion functions the same way that damage criteria for metals and other materials are used to predict failure in structural materials.

  20. Validation of an "Intelligent Mouthguard" Single Event Head Impact Dosimeter.

    Science.gov (United States)

    Bartsch, Adam; Samorezov, Sergey; Benzel, Edward; Miele, Vincent; Brett, Daniel

    2014-11-01

    Dating to Colonel John Paul Stapp MD in 1975, scientists have desired to measure live human head impacts with accuracy and precision. But no instrument exists to accurately and precisely quantify single head impact events. Our goal is to develop a practical single event head impact dosimeter known as "Intelligent Mouthguard" and quantify its performance on the benchtop, in vitro and in vivo. In the Intelligent Mouthguard hardware, limited gyroscope bandwidth requires an algorithm-based correction as a function of impact duration. After we apply gyroscope correction algorithm, Intelligent Mouthguard results at time of CG linear acceleration peak correlate to the Reference Hybrid III within our tested range of pulse durations and impact acceleration profiles in American football and Boxing in vitro tests: American football, IMG=1.00REF-1.1g, R2=0.99; maximum time of peak XYZ component imprecision 3.6g and 370 rad/s2; maximum time of peak azimuth and elevation imprecision 4.8° and 2.9°; maximum average XYZ component temporal imprecision 3.3g and 390 rad/s2. Boxing, IMG=1.00REF-0.9 g, R2=0.99, R2=0.98; maximum time of peak XYZ component imprecision 3.9 g and 390 rad/s2, maximum time of peak azimuth and elevation imprecision 2.9° and 2.1°; average XYZ component temporal imprecision 4.0 g and 440 rad/s2. In vivo Intelligent Mouthguard true positive head impacts from American football players and amateur boxers have temporal characteristics (first harmonic frequency from 35 Hz to 79 Hz) within our tested benchtop (first harmonic frequencyIntelligent Mouthguard qualifies as a single event dosimeter in American football and Boxing.

  1. A Review of Instrumented Equipment to Investigate Head Impacts in Sport

    OpenAIRE

    PATTON, Declan A.

    2016-01-01

    Contact, collision, and combat sports have more head impacts as compared to noncontact sports; therefore, such sports are uniquely suited to the investigation of head impact biomechanics. Recent advances in technology have enabled the development of instrumented equipment, which can estimate the head impact kinematics of human subjects in vivo. Literature pertaining to head impact measurement devices was reviewed and usage, in terms of validation and field studies, of such devices was discuss...

  2. Effects of Sex and Event Type on Head Impact in Collegiate Soccer

    OpenAIRE

    Reynolds, Bryson B.; Patrie, James; Henry, Erich J.; Goodkin, Howard P.; Broshek, Donna K.; Wintermark, Max; Druzgal, T. Jason

    2017-01-01

    Background: The effects of head impact in sports are of growing interest for clinicians, scientists, and athletes. Soccer is the most popular sport worldwide, but the burden of head impact in collegiate soccer is still unknown. Purpose: To quantify head impact associated with practicing and playing collegiate soccer using wearable accelerometers. Study Design: Descriptive epidemiological study. Methods: Mastoid patch accelerometers were used to quantify head impact in soccer, examining differ...

  3. Bandwidth and sample rate requirements for wearable head impact sensors.

    Science.gov (United States)

    Wu, Lyndia C; Laksari, Kaveh; Kuo, Calvin; Luck, Jason F; Kleiven, Svein; 'Dale' Bass, Cameron R; Camarillo, David B

    2016-09-06

    Wearable inertial sensors measure human head impact kinematics important to the on-going development and validation of head injury criteria. However, sensor specifications have not been scientifically justified in the context of the anticipated field impact dynamics. The objective of our study is to determine the minimum bandwidth and sample rate required to capture the impact frequency response relevant to injury. We used high-bandwidth head impact data as ground-truth measurements, and investigated the attenuation of various injury criteria at lower bandwidths. Given a 10% attenuation threshold, we determined the minimum bandwidths required to study injury criteria based on skull kinematics and brain deformation in three different model systems: helmeted cadaver (no neck), unhelmeted cadaver (no neck), and helmeted dummy impacts (with neck). We found that higher bandwidths are required for unhelmeted impacts in general and for studying strain rate injury criteria. Minimum gyroscope bandwidths of 300Hz in helmeted sports and 500Hz in unhelmeted sports are necessary to study strain rate based injury criteria. A minimum accelerometer bandwidth of 500Hz in unhelmeted sports is necessary to study most injury criteria. Current devices typically sample at 1000Hz, with gyroscope bandwidths below 200Hz, which are not always sufficient according to these requirements. With hard contact test conditions, the identified requirements may be higher than most soft contacts on the field, but should be satisfied to capture the worst contact, and often higher risk, scenarios relative to the specific sport or activity. Our findings will help establish standard guidelines for sensor choice and design in traumatic brain injury research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Cavitation/boundary effects in a simple head impact model.

    Science.gov (United States)

    Nusholtz, G S; Wylie, B; Glascoe, L G

    1995-07-01

    An experimental and numerical analysis of the impact response of a simple model of the human head is presented. A water-filled 14-cm diameter cylinder was struck by a 10 kg free flying mass. Rigid-body acceleration-time-history and the pressure at the fluid-cylinder interface were monitored during the impact event. Comparisons between the experimental results and the results of a computational model were made. The computational model used is a two-dimensional finite difference code simulating the physical experiment. The code incorporates a thin layer of air and the potential for vaporization along the inside of the cylinder. The study indicates that during a severe impact to the human head, the stresses generated within the brain can result in cavitation on the far side of impact followed by a sudden cavity collapse which can be quite violent. The study identifies how a skull-brain interface and cavitation can potentially affect the internal pressure response of the brain when subjected to a sudden impact.

  5. School Readiness in Children Living in Non-Parental Care: Impacts of Head Start

    Science.gov (United States)

    Lipscomb, Shannon T.; Pratt, Megan E.; Schmitt, Sara A.; Pears, Katherine C.; Kim, Hyoun K.

    2013-01-01

    The current study examines the effects of Head Start on the development of school readiness outcomes for children living in non-parental care. Data were obtained from the Head Start Impact Study, a randomized controlled trial of Head Start conducted with a nationally representative sample of Head Start programs and families. The sample included…

  6. The Influence of Heavier Football Helmet Faceguards on Head Impact Location and Severity.

    Science.gov (United States)

    Schmidt, Julianne D; Phan, Tracy T; Courson, Ron W; Reifsteck, Fred; Merritt, Eric D; Brown, Cathleen N

    2017-07-21

    To determine whether players with heavier faceguards have increased odds of sustaining top of the head impacts and head impacts of higher severity. Cohort study. On-field. Thirty-five division I collegiate football players. Faceguard mass was measured. Head impact location and severity (linear acceleration [gravity], rotational acceleration [radian per square second], and Head Impact Technology severity profile [unitless]) were captured for 19 379 total head impacts at practices using the Head Impact Telemetry System. Players' faceguards were categorized as either heavier (>480 g) or lighter (≤480 g) using a median split. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed for sustaining top of the head impacts between faceguard groups using a random intercepts generalized logit model. We compared head impact severity between groups using random intercepts general linear models (α = 0.05). Player position was included in all models. Overall, the 4 head impact locations were equally distributed across faceguard groups (F(3,26) = 2.16, P = 0.117). Football players with heavier faceguards sustained a higher proportion impacts to the top of the head (24.7% vs 17.5%) and had slightly increased odds of sustaining top (OR, 1.72; 95% CI, 1.01-2.94) head impacts rather than front of the head impacts. Football players wearing heavier faceguards might be slightly more prone to sustaining a higher proportion of top of the head impacts, suggesting that greater faceguard mass may make players more likely to lower their head before collision. Individuals involved with equipment selection should consider the potential influence of faceguard design on head impact biomechanics when recommending the use of a heavier faceguard.

  7. Effects of Sex and Event Type on Head Impact in Collegiate Soccer

    Science.gov (United States)

    Reynolds, Bryson B.; Patrie, James; Henry, Erich J.; Goodkin, Howard P.; Broshek, Donna K.; Wintermark, Max; Druzgal, T. Jason

    2017-01-01

    Background: The effects of head impact in sports are of growing interest for clinicians, scientists, and athletes. Soccer is the most popular sport worldwide, but the burden of head impact in collegiate soccer is still unknown. Purpose: To quantify head impact associated with practicing and playing collegiate soccer using wearable accelerometers. Study Design: Descriptive epidemiological study. Methods: Mastoid patch accelerometers were used to quantify head impact in soccer, examining differences in head impact as a function of sex and event type (practice vs game). Seven female and 14 male collegiate soccer players wore mastoid patch accelerometers that measured head impacts during team events. Data were summarized for each athletic exposure, and statistical analyses evaluated the mean number of impacts, mean peak linear acceleration, mean peak rotational acceleration, and cumulative linear and rotational acceleration, each grouped by sex and event type. Results: There were no differences in the frequency or severity of head impacts between men’s and women’s soccer practices. For men’s soccer, games resulted in 285% more head impacts than practices, but there were no event-type differences in mean impact severity. Men’s soccer games resulted in more head impacts than practices across nearly all measured impact severities, which also resulted in men’s soccer games producing a greater cumulative impact burden. Conclusion: Similar to other sports, men’s soccer games have a greater impact burden when compared with practices, and this effect is driven by the quantity rather than severity of head impacts. In contrast, there were no differences in the quantity or severity of head impacts in men’s and women’s soccer practices. These data could prompt discussions of practical concern to collegiate soccer, such as understanding sex differences in head impact and whether games disproportionately contribute to an athlete’s head impact burden. PMID:28491885

  8. Head impacts in a junior rugby league team measured with a wireless head impact sensor: an exploratory analysis.

    Science.gov (United States)

    King, Doug; Hume, Patria; Gissane, Conor; Clark, Trevor

    2017-01-01

    OBJECTIVE The aim of this study was to investigate the frequency, magnitude, and distribution of head impacts sustained by players in a junior rugby league over a season of matches. METHODS The authors performed a prospective cohort analysis of impact magnitude, frequency, and distribution on data collected with instrumented XPatches worn behind the ear of players in an "under-11" junior rugby league team (players under 11 years old). RESULTS A total of 1977 impacts were recorded. Over the course of the study, players sustained an average of 116 impacts (average of 13 impacts per player per match). The measured linear acceleration ranged from 10g to 123g (mean 22g, median 16g, and 95th percentile 57g). The rotational acceleration ranged from 89 rad/sec 2 to 22,928 rad/sec 2 (mean 4041 rad/sec 2 , median 2773 rad/sec 2 , and 95th percentile 11,384 rad/sec 2 ). CONCLUSIONS The level of impact severity based on the magnitude of impacts for linear and rotational accelerations recorded was similar to the impacts reported in studies of American junior and high school football, collegiate football, and youth ice hockey players, but the players in the rugby league cohort were younger, had less body mass, and played at a slower speed than the American players. Junior rugby league players are required to tackle the player to the ground and use a different tackle technique than that used in American football, likely increasing the rotational accelerations recorded at the head.

  9. A Modified Hybrid III 6-Year-Old Dummy Head Model for Lateral Impact Assessment

    Directory of Open Access Journals (Sweden)

    I. A. Rafukka

    2016-01-01

    Full Text Available Hybrid III six-year-old (6YO child dummy head model was developed and validated for frontal impact assessment according to the specifications contained in Code of Federal Regulations, Title 49, Part 572.122, Subpart N by Livermore Software Technology Corporation (LSTC. This work is aimed at improving biofidelity of the head for frontal impact and also extending its application to lateral impact assessment by modifying the head skin viscoelastic properties and validating the head response using the scaled nine-year-old (9YO child cadaver head response recently published in the literature. The modified head model was validated for two drop heights for frontal, right, and left parietal impact locations. Peak resultant acceleration of the modified head model appeared to have good correlation with scaled 9YO child cadaver head response for frontal impact on dropping from 302 mm height and fair correlation with 12.3% difference for 151 mm drop height. Right parietal peak resultant acceleration values correlate well with scaled 9YO head experimental data for 153 mm drop height, while fair correlation with 16.4% difference was noticed for 302 mm drop height. Left parietal, however, shows low biofidelity for the two drop heights as the difference in head acceleration response was within 30%. The modified head model could therefore be used to estimate injuries in vehicle crash for head parietal impact locations which cannot be measured by the current hybrid III dummy head model.

  10. Head Start's Impact Is Contingent on Alternative Type of Care in Comparison Group

    Science.gov (United States)

    Zhai, Fuhua; Brooks-Gunn, Jeanne; Waldfogel, Jane

    2014-01-01

    Using data ("n" = 3,790 with 2,119 in the 3-year-old cohort and 1,671 in the 4-year-old cohort) from 353 Head Start centers in the Head Start Impact Study, the only large-scale randomized experiment in Head Start history, this article examined the impact of Head Start on children's cognitive and parent-reported social-behavioral outcomes…

  11. The influence of cervical muscle characteristics on head impact biomechanics in football.

    Science.gov (United States)

    Schmidt, Julianne D; Guskiewicz, Kevin M; Blackburn, J Troy; Mihalik, Jason P; Siegmund, Gunter P; Marshall, Stephen W

    2014-09-01

    An athlete is thought to reduce head acceleration after impact by contracting the cervical musculature, which increases the effective mass of the head. To compare the odds of sustaining higher magnitude in-season head impacts between athletes with higher and lower preseason performance on cervical muscle characteristics. Cohort study; Level of evidence, 2. Forty-nine high school and collegiate American football players completed a preseason cervical testing protocol that included measures of cervical isometric strength, muscle size, and response to cervical perturbation. Head impact biomechanics were captured for each player using the Head Impact Telemetry System. A median split was used to categorize players as either high or low performers for each of the following outcome measures: isometric strength (peak torque, rate of torque development), muscle size (cross-sectional area), and response to cervical perturbation (stiffness, angular displacement, muscle onset latency). The odds of sustaining moderate and severe head impacts were computed against the reference odds of sustaining mild head impacts across cervical characteristic categorizations. Linemen with stronger lateral flexors and composite cervical strength had about 1.75 times' increased odds of sustaining moderate linear head impacts rather than mild impacts compared with weaker linemen. Players who developed extensor torque more quickly had 2 times the increased odds of sustaining severe linear head impacts (odds ratio [OR], 2.10; 95% CI, 1.08-4.05) rather than mild head impacts. However, players with greater cervical stiffness had reduced odds of sustaining both moderate (OR, 0.77; 95% CI, 0.61-0.96) and severe (OR, 0.64; 95% CI, 0.46-0.89) head impacts compared with players with less cervical stiffness. The study findings showed that greater cervical stiffness and less angular displacement after perturbation reduced the odds of sustaining higher magnitude head impacts; however, the findings did not

  12. Head kinematics and shoulder biomechanics in shoulder impacts similar to pedestrian crashes--a THUMS study.

    Science.gov (United States)

    Paas, Ruth; Davidsson, Johan; Brolin, Karin

    2015-01-01

    Head injuries account for the largest percentage of fatalities among pedestrians in car crashes. To prevent or mitigate such injuries, safety systems that reduce head linear and rotational acceleration should be introduced. Human body models (HBMs) are valuable safety system evaluation tools for assessing both head injury risk and head kinematics prior to head contact. This article aims to evaluate the suitability of the Total Human Model for Safety (THUMS) version 4.0 for studying shoulder impacts, similar to pedestrian crashes, investigating head, spine, and shoulder kinematics as well as shoulder biomechanics. Shoulder impact experiments including volunteers and postmortem human subjects (PMHSs) were simulated with THUMS. Head linear and angular and vertebral linear displacements of THUMS were compared with volunteers and shoulder deflections with both volunteers and PMHSs. A parameter variation study was conducted to assess head response to shoulder impacts, by varying shoulder posture and impact directions mimicking shoulder-to-vehicle contacts. Functional biomechanics literature was compared with THUMS responses in view of pedestrian-like shoulder impacts. THUMS head linear displacement compared better with tensed than with relaxed volunteers. Head lateral rotation was comparable with volunteer responses up to 120 ms; head twist was greater in THUMS than in the volunteers. The THUMS spine appeared to be stiffer than in the volunteers. Shoulder deflections were smaller than in the relaxed volunteers but matched the PMHSs. Raised shoulder postures decreased the THUMS shoulder deflections and increased head lateral displacements. When the impactor surface orientation or the impact velocity angle was changed from lateral to superolateral, THUMS head lateral displacement decreased. THUMS scapula and clavicle kinematics compared well with previous experimental studies. The shoulder impact conditions influenced the scapula motion over the thorax, which had

  13. Symptoms from repeated intentional and unintentional head impact in soccer players.

    Science.gov (United States)

    Stewart, Walter F; Kim, Namhee; Ifrah, Chloe S; Lipton, Richard B; Bachrach, Tamar A; Zimmerman, Molly E; Kim, Mimi; Lipton, Michael L

    2017-02-28

    To determine the rate and differential contribution of heading vs unintentional head impacts (e.g., head to head, goal post) to CNS symptoms in adult amateur soccer players. Amateur soccer players completed baseline and serial on-line 2-week recall questionnaires (HeadCount) and reported (1) soccer practice and games, (2) heading and unintentional soccer head trauma, and (3) frequency and severity (mild to very severe) of CNS symptoms. For analysis, CNS symptoms were affirmed if one or more moderate, severe, or very severe episodes were reported in a 2-week period. Repeated measures logistic regression was used to assess if 2-week heading exposure (i.e., 4 quartiles) or unintentional head impacts (i.e., 0, 1, 2+) were associated with CNS symptoms. A total of 222 soccer players (79% male) completed 470 HeadCount questionnaires. Mean (median) heading/2 weeks was 44 (18) for men and 27 (9.5) for women. One or more unintentional head impacts were reported by 37% of men and 43% of women. Heading-related symptoms were reported in 20% (93 out of 470) of the HeadCounts. Heading in the highest quartile was significantly associated with CNS symptoms (odds ratio [OR] 3.17, 95% confidence interval [CI] 1.57-6.37) when controlling for unintentional exposure. Those with 2+ unintentional exposures were at increased risk for CNS symptoms (OR 6.09, 95% CI 3.33-11.17) as were those with a single exposure (OR 2.98, 95% CI 1.69-5.26) when controlling for heading. Intentional (i.e., heading) and unintentional head impacts are each independently associated with moderate to very severe CNS symptoms. © 2017 American Academy of Neurology.

  14. A Review of Instrumented Equipment to Investigate Head Impacts in Sport

    Science.gov (United States)

    2016-01-01

    Contact, collision, and combat sports have more head impacts as compared to noncontact sports; therefore, such sports are uniquely suited to the investigation of head impact biomechanics. Recent advances in technology have enabled the development of instrumented equipment, which can estimate the head impact kinematics of human subjects in vivo. Literature pertaining to head impact measurement devices was reviewed and usage, in terms of validation and field studies, of such devices was discussed. Over the past decade, instrumented equipment has recorded millions of impacts in the laboratory, on the field, in the ring, and on the ice. Instrumented equipment is not without limitations; however, in vivo head impact data is crucial to investigate head injury mechanisms and further the understanding of concussion. PMID:27594780

  15. A Review of Instrumented Equipment to Investigate Head Impacts in Sport

    Directory of Open Access Journals (Sweden)

    Declan A. Patton

    2016-01-01

    Full Text Available Contact, collision, and combat sports have more head impacts as compared to noncontact sports; therefore, such sports are uniquely suited to the investigation of head impact biomechanics. Recent advances in technology have enabled the development of instrumented equipment, which can estimate the head impact kinematics of human subjects in vivo. Literature pertaining to head impact measurement devices was reviewed and usage, in terms of validation and field studies, of such devices was discussed. Over the past decade, instrumented equipment has recorded millions of impacts in the laboratory, on the field, in the ring, and on the ice. Instrumented equipment is not without limitations; however, in vivo head impact data is crucial to investigate head injury mechanisms and further the understanding of concussion.

  16. Development of a Finite Element Head Model for the Study of Impact Head Injury

    Directory of Open Access Journals (Sweden)

    Bin Yang

    2014-01-01

    Full Text Available This study is aimed at developing a high quality, validated finite element (FE human head model for traumatic brain injuries (TBI prediction and prevention during vehicle collisions. The geometry of the FE model was based on computed tomography (CT and magnetic resonance imaging (MRI scans of a volunteer close to the anthropometry of a 50th percentile male. The material and structural properties were selected based on a synthesis of current knowledge of the constitutive models for each tissue. The cerebrospinal fluid (CSF was simulated explicitly as a hydrostatic fluid by using a surface-based fluid modeling method. The model was validated in the loading condition observed in frontal impact vehicle collision. These validations include the intracranial pressure (ICP, brain motion, impact force and intracranial acceleration response, maximum von Mises stress in the brain, and maximum principal stress in the skull. Overall results obtained in the validation indicated improved biofidelity relative to previous FE models, and the change in the maximum von Mises in the brain is mainly caused by the improvement of the CSF simulation. The model may be used for improving the current injury criteria of the brain and anthropometric test devices.

  17. Development of a finite element head model for the study of impact head injury.

    Science.gov (United States)

    Yang, Bin; Tse, Kwong-Ming; Chen, Ning; Tan, Long-Bin; Zheng, Qing-Qian; Yang, Hui-Min; Hu, Min; Pan, Gang; Lee, Heow-Pueh

    2014-01-01

    This study is aimed at developing a high quality, validated finite element (FE) human head model for traumatic brain injuries (TBI) prediction and prevention during vehicle collisions. The geometry of the FE model was based on computed tomography (CT) and magnetic resonance imaging (MRI) scans of a volunteer close to the anthropometry of a 50th percentile male. The material and structural properties were selected based on a synthesis of current knowledge of the constitutive models for each tissue. The cerebrospinal fluid (CSF) was simulated explicitly as a hydrostatic fluid by using a surface-based fluid modeling method. The model was validated in the loading condition observed in frontal impact vehicle collision. These validations include the intracranial pressure (ICP), brain motion, impact force and intracranial acceleration response, maximum von Mises stress in the brain, and maximum principal stress in the skull. Overall results obtained in the validation indicated improved biofidelity relative to previous FE models, and the change in the maximum von Mises in the brain is mainly caused by the improvement of the CSF simulation. The model may be used for improving the current injury criteria of the brain and anthropometric test devices.

  18. Player and Game Characteristics and Head Impacts in Female Youth Ice Hockey Players.

    Science.gov (United States)

    Reed, Nick; Taha, Tim; Greenwald, Richard; Keightley, Michelle

    2017-08-01

      Despite the growing popularity of ice hockey among female youth and interest in the biomechanics of head impacts in sport, the head impacts sustained by this population have yet to be characterized.   To describe the number of, biomechanical characteristics of, and exposure to head impacts of female youth ice hockey players during competition and to investigate the influences of player and game characteristics on head impacts.   Cohort study.   Twenty-seven female youth ice hockey players (mean age = 12.5 ± 0.52 years) wore instrumented ice hockey helmets during 66 ice hockey games over a 3-year period. Data specific to player, game, and biomechanical head impact characteristics were recorded. A multiple regression analysis identified factors most associated with head impacts of greater frequency and severity.   A total of 436 total head impacts were sustained during 6924 minutes of active ice hockey participation (0.9 ± 0.6 impacts per player per game; range, 0-2.1). A higher body mass index (BMI) significantly predicted a higher number of head impacts sustained per game (P = .008). Linear acceleration of head impacts was greater in older players and those who played the forward position, had a greater BMI, and spent more time on the ice (P = .008), whereas greater rotational acceleration was present in older players who had a greater BMI and played the forward position (P = .008). During tournament games, increased ice time predicted increased severity of head impacts (P = .03).   This study reveals for the first time that head impacts are occurring in female youth ice hockey players, albeit at a lower rate and severity than in male youth ice hockey players, despite the lack of intentional body checking.

  19. A Comparison of dynamic impact response and brain deformation metrics within the cerebrum of head impact reconstructions representing three mechanisms of head injury in ice hockey

    OpenAIRE

    Kendall, Marshall; Post, Andrew; Gilchrist, M. D.

    2012-01-01

    Ice hockey has been identified as having one of the highest concussion rates. The three most likely causes of concussive injury are; falls to the ice, shoulder to head impacts and punches to the head. The purpose of this study was to examine how these three mechanisms of injury in the sport of ice hockey influence the dynamic response of the head form and the magnitude and distribution of maximum principal strain in the cerebrum. The three impact mechanisms were simulated using a Hybrid III h...

  20. Head Start Impact on Social-Emotional Outcomes for Children with Disabilities

    Science.gov (United States)

    Lee, Kyunghee; Calkins, Andrea; Shin, Tae Seob

    2016-01-01

    Objective: Using the Head Start Impact Study data, this study examines Head Start's impacts on social-emotional outcomes for children with disabilities. Method: Among 4,442 children, 570 children were reported to have disabilities. Ordinary least squares regression was used to determine whether the number of disabilities, having an individualized…

  1. Frequency, magnitude, and distribution of head impacts in Pop Warner football: the cumulative burden.

    Science.gov (United States)

    Wong, Ricky H; Wong, Andrew K; Bailes, Julian E

    2014-03-01

    A growing body of research suggests that subconcussive head impacts or repetitive mild Traumatic Brain Injury (mTBI) can have cumulative and deleterious effects. Several studies have investigated head impacts in football at the professional, collegiate, and high school levels, in an attempt to elucidate the biomechanics of head impacts among football players. Youth football players, generally from 7 to 14 years of age, constitute 70% of all football players, yet burden of, and susceptibility to, head injury in this population is not well known. A novel impact sensor utilizing binary force switches (Shockbox(®)) was used to follow an entire Pop Warner football team consisting of twenty-two players for six games and five practices. The impact sensor was designed to record impacts with linear accelerations over 30g. In addition, video recording of games and practices were used to further characterize the head impacts by type of position (skilled versus unskilled), field location of impact (open field versus line of scrimmage), type of hit (tackling, tackled, or hold/push), and whether the impact was a head-to-head impact or not. We recorded a total of 480 head impacts. An average of 21.8 head impacts occurred per practice, while 61.8 occurred per game. Players had an average of 3.7 head impacts per game and 1.5 impacts per practice (p80g) was 11. Two concussions were diagnosed over the course of the season. However, due to technical reasons the biomechanics of those hits resulting in concussions were not captured. Despite smaller players and slower play when compared to high school, collegiate or professional players, those involved in youth football sustain a moderate number of head impacts per season with several high magnitude impacts. Our results suggest that players involved in open-field, tackling plays that have head-to-head contact sustain impacts with the highest linear accelerations. Our data supports previously published data that suggests changes to the

  2. Abusive head trauma: differentiation between impact and non-impact cases based on neuroimaging findings and skeletal surveys

    NARCIS (Netherlands)

    Sieswerda-Hoogendoorn, T.; Robben, S. G. F.; Karst, W. A.; Moesker, F. M.; van Aalderen, W. M.; Laméris, J. S.; van Rijn, R. R.

    2014-01-01

    To determine whether imaging findings can be used to differentiate between impact and non-impact head trauma in a group of fatal and non-fatal abusive head trauma (AHT) victims. We included all AHT cases in the Netherlands in the period 2005-2012 for which a forensic report was written for a court

  3. Head Start’s Impact is Contingent on Alternative Type of Care in Comparison Group

    Science.gov (United States)

    Brooks-Gunn, Jeanne; Waldfogel, Jane

    2014-01-01

    Using data (n = 3,790 with 2,119 in the 3-year-old cohort and 1,671 in the 4-year-old cohort) from 353 Head Start centers in the Head Start Impact Study, the only large-scale randomized experiment in Head Start history, this paper examined the impact of Head Start on children’s cognitive and parent-reported social-behavioral outcomes through first grade contingent on the child care arrangements used by children who were randomly assigned to the control group (i.e., parental care, relative/non-relative care, another Head Start program, or other center-based care). A principal score matching approach was adopted to identify children assigned to Head Start who were similar to children in the control group with a specific care arrangement. Overall, the results showed that the effects of Head Start varied substantially contingent on the alternative child care arrangements. Compared to children in parental care and relative/non-relative care, Head Start participants generally had better cognitive and parent-reported behavioral development, with some benefits of Head Start persisting through first grade; in contrast, few differences were found between Head Start and other center-based care. The results have implications regarding the children for whom Head Start is most beneficial as well as how well Head Start compares to other center-based programs. PMID:25329552

  4. Head-impact mechanisms in men's and women's collegiate ice hockey.

    Science.gov (United States)

    Wilcox, Bethany J; Machan, Jason T; Beckwith, Jonathan G; Greenwald, Richard M; Burmeister, Emily; Crisco, Joseph J

    2014-01-01

    Concussion injury rates in men's and women's ice hockey are reported to be among the highest of all collegiate sports. Quantification of the frequency of head impacts and the magnitude of head acceleration as a function of the different impact mechanisms (eg, head contact with the ice) that occur in ice hockey could provide a better understanding of this high injury rate. To quantify and compare the per-game frequency and magnitude of head impacts associated with various impact mechanisms in men's and women's collegiate ice hockey players. Cohort study. Collegiate ice hockey rink. Twenty-three men and 31 women from 2 National Collegiate Athletic Association Division I ice hockey teams. We analyzed magnitude and frequency (per game) of head impacts per player among impact mechanisms and between sexes using generalized mixed linear models and generalized estimating equations to account for repeated measures within players. Participants wore helmets instrumented with accelerometers to allow us to collect biomechanical measures of head impacts sustained during play. Video footage from 53 games was synchronized with the biomechanical data. Head impacts were classified into 8 categories: contact with another player; the ice, boards or glass, stick, puck, or goal; indirect contact; and contact from celebrating. For men and women, contact with another player was the most frequent impact mechanism, and contact with the ice generated the greatest-magnitude head accelerations. The men had higher per-game frequencies of head impacts from contact with another player and contact with the boards than did the women (P ice hockey that result in frequent and high-magnitude head impacts will provide us with data that may improve our understanding of the high rate of concussion in the sport and inform injury-prevention strategies.

  5. Head impact exposure measured in a single youth football team during practice drills.

    Science.gov (United States)

    Kelley, Mireille E; Kane, Joeline M; Espeland, Mark A; Miller, Logan E; Powers, Alexander K; Stitzel, Joel D; Urban, Jillian E

    2017-11-01

    OBJECTIVE This study evaluated the frequency, magnitude, and location of head impacts in practice drills within a youth football team to determine how head impact exposure varies among different types of drills. METHODS On-field head impact data were collected from athletes participating in a youth football team for a single season. Each athlete wore a helmet instrumented with a Head Impact Telemetry (HIT) System head acceleration measurement device during all preseason, regular season, and playoff practices. Video was recorded for all practices, and video analysis was performed to verify head impacts and assign each head impact to a specific drill. Eleven drills were identified: dummy/sled tackling, install, special teams, Oklahoma, one-on-one, open-field tackling, passing, position skill work, multiplayer tackle, scrimmage, and tackling drill stations. Generalized linear models were fitted to log-transformed data, and Wald tests were used to assess differences in head accelerations and impact rates. RESULTS A total of 2125 impacts were measured during 30 contact practices in 9 athletes (mean age 11.1 ± 0.6 years, mean mass 44.9 ± 4.1 kg). Open-field tackling had the highest median and 95th percentile linear accelerations (24.7 g and 97.8 g, respectively) and resulted in significantly higher mean head accelerations than several other drills. The multiplayer tackle drill resulted in the highest head impact frequency, with an average of 0.59 impacts per minute per athlete, but the lowest 95th percentile linear accelerations of all drills. The front of the head was the most common impact location for all drills except dummy/sled tackling. CONCLUSIONS Head impact exposure varies significantly in youth football practice drills, with several drills exposing athletes to high-magnitude and/or high-frequency head impacts. These data suggest that further study of practice drills is an important step in developing evidence-based recommendations for modifying or eliminating

  6. Analysis of right anterolateral impacts: the effect of head rotation on the cervical muscle whiplash response

    Directory of Open Access Journals (Sweden)

    Narayan Yogesh

    2005-05-01

    Full Text Available Abstract Background The cervical muscles are considered a potential site of whiplash injury, and there are many impact scenarios for whiplash injury. There is a need to understand the cervical muscle response under non-conventional whiplash impact scenarios, including variable head position and impact direction. Methods Twenty healthy volunteers underwent right anterolateral impacts of 4.0, 7.6, 10.7, and 13.0 m/s2 peak acceleration, each with the head rotated to the left, then the head rotated to the right in a random order of impact severities. Bilateral electromyograms of the sternocleidomastoids, trapezii, and splenii capitis following impact were measured. Results At a peak acceleration of 13.0 m/s2, with the head rotated to the right, the right trapezius generated 61% of its maximal voluntary contraction electromyogram (MVC EMG, while all other muscles generated 31% or less of this variable (31% for the left trapezius, 13% for the right spleinus. capitis, and 16% for the left splenius capitis. The sternocleidomastoids muscles also tended to show an asymmetric EMG response, with the left sternocleidomastoid (the one responsible for head rotation to the right generating a higher percentage (26% of its MVC EMG than the left sternocleidomastoid (4% (p Conclusion The EMG response to a right anterolateral impact is highly dependent on the head position. The sternocleidomastoid responsible for the direction of head rotation and the trapezius ipsilateral to the direction of head rotation generate the most EMG activity.

  7. Does Visual Performance Influence Head Impact Severity Among High School Football Athletes?

    Science.gov (United States)

    Schmidt, Julianne D; Guskiewicz, Kevin M; Mihalik, Jason P; Blackburn, J Troy; Siegmund, Gunter P; Marshall, Stephen W

    2015-11-01

    To compare the odds of sustaining moderate and severe head impacts, rather than mild, between high school football players with high and low visual performance. Prospective quasi-experimental. Clinical Research Center/On-field. Thirty-seven high school varsity football players. Athletes completed the Nike SPARQ Sensory Station visual assessment before the season. Head impact biomechanics were captured at all practices and games using the Head Impact Telemetry System. Each player was classified as either a high or low performer using a median split for each of the following visual performance measures: visual clarity, contrast sensitivity, depth perception, near-far quickness, target capture, perception span, eye-hand coordination, go/no go, and reaction time. We computed the odds of sustaining moderate and severe head impacts against the reference odds of sustaining mild head impacts across groups of high and low performers for each of the visual performance measures. Players with better near-far quickness had increased odds of sustaining moderate [odds ratios (ORs), 1.27; 95% confidence intervals (CIs), 1.04-1.56] and severe head impacts (OR, 1.45; 95% CI, 1.05-2.01) as measured by Head Impact Technology severity profile. High and low performers were at equal odds on all other measures. Better visual performance did not reduce the odds of sustaining higher magnitude head impacts. Visual performance may play less of a role than expected for protecting against higher magnitude head impacts among high school football players. Further research is needed to determine whether visual performance influences concussion risk. Based on our results, we do not recommend using visual training programs at the high school level for the purpose of reducing the odds of sustaining higher magnitude head impacts.

  8. Abusive head trauma: Differentiation between impact and non-impact cases based on neuroimaging findings and skeletal surveys

    Energy Technology Data Exchange (ETDEWEB)

    Sieswerda-Hoogendoorn, T., E-mail: t.sieswerda@amc.nl [Department of Forensic Medicine, Netherlands Forensic Institute, The Hague (Netherlands); Department of Radiology, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Robben, S.G.F., E-mail: s.robben@maastrichtuniversity.nl [Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht (Netherlands); Karst, W.A., E-mail: w.karst@nfi.minvenj.nl [Department of Forensic Medicine, Netherlands Forensic Institute, P.O. Box 24044, 2490 AA The Hague (Netherlands); Moesker, F.M., E-mail: f.moesker@erasmusmc.nl [Faculty of Medicine, Academic Medical Center, Amsterdam (Netherlands); Aalderen, W.M. van, E-mail: w.m.vanaalderen@amc.nl [Department of Paediatrics, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Laméris, J.S., E-mail: j.s.lameris@amc.nl [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Rijn, R.R. van, E-mail: r.r.vanrijn@amc.nl [Department of Forensic Medicine, Netherlands Forensic Institute, The Hague (Netherlands); Department of Radiology, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2014-03-15

    Objectives: To determine whether imaging findings can be used to differentiate between impact and non-impact head trauma in a group of fatal and non-fatal abusive head trauma (AHT) victims. Methods: We included all AHT cases in the Netherlands in the period 2005–2012 for which a forensic report was written for a court of law, and for which imaging was available for reassessment. Neuroradiological and musculoskeletal findings were scored by an experienced paediatric radiologist. Results: We identified 124 AHT cases; data for 104 cases (84%) were available for radiological reassessment. The AHT victims with a skull fracture had fewer hypoxic ischaemic injuries than AHT victims without a skull fracture (p = 0.03), but the relative difference was small (33% vs. 57%). There were no significant differences in neuroradiological and musculoskeletal findings between impact and non-impact head trauma cases if the distinction between impact and non-impact head trauma was based on visible head injuries, as determined by clinical examination, as well as on the presence of skull fractures. Conclusions: Neuroradiological and skeletal findings cannot discriminate between impact and non-impact head trauma in abusive head trauma victims.

  9. Estimation of head impact exposure in high school football: implications for regulating contact practices.

    Science.gov (United States)

    Broglio, Steven P; Martini, Douglas; Kasper, Luke; Eckner, James T; Kutcher, Jeffery S

    2013-12-01

    Increased attention is being placed on the role of subconcussive impacts to the head during football participation and long-term cognitive health. Some have suggested that mitigating impacts to the head can be achieved by reducing or eliminating contact football practices. The effect that this might have on the number and magnitude of impacts is unknown. To estimate the effect of limiting contact practices on the frequency and magnitude of head impacts through the retrospective assessment of in vivo head impact data. Cross-sectional study; Level of evidence, 3. Data on impact magnitude and frequency were collected with the Head Impact Telemetry System during the 2009 football season among 42 varsity high school football athletes (mean age, 16.2 ± 0.6 years; mean height, 180.9 ± 7.2 cm; mean weight, 89.8 ± 20.1 kg). Head impacts were compared between player positions and session types (noncontact practice, contact practice, and game). These results were used to estimate the frequency and magnitude of head impacts when contact sessions were restricted. The participants collectively sustained 32,510 impacts over the 15-week season. The typical athlete sustained a mean of 774 ± 502 impacts during the season, with linemen (center, guard, and offensive or defensive tackle positions) sustaining the highest number of impacts per athlete (1076 ± 541), followed by tight ends, running backs, and linebackers (779 ± 286); wide receivers, cornerbacks, and safeties (417 ± 266); and quarterbacks (356 ± 433). When viewed by session type, noncontact practices (n = 21) accounted for 1998 total impacts (2.4 ± 1.4 per athlete per session), contact practices (n = 36) accounted for 16,346 impacts (10.5 ± 7.7 per athlete per session), and games (n = 14) accounted for 14,166 impacts (24.1 ± 19.1 per athlete per session). Significantly more impacts occurred during games when compared with contact (P = .02) and noncontact practices (P result in a 18% reduction in impacts for the

  10. The Influence of Neck Muscle Tonus and Posture on Brain Tissue Strain in Pedestrian Head Impacts.

    Science.gov (United States)

    Alvarez, Victor S; Halldin, Peter; Kleiven, Svein

    2014-11-01

    Pedestrians are one of the least protected groups in urban traffic and frequently suffer fatal head injuries. An important boundary condition for the head is the cervical spine, and it has previously been demonstrated that neck muscle activation is important for head kinematics during inertial loading. It has also been shown in a recent numerical study that a tensed neck musculature also has some influence on head kinematics during a pedestrian impact situation. The aim of this study was to analyze the influence on head kinematics and injury metrics during the isolated time of head impact by comparing a pedestrian with relaxed neck and a pedestrian with increased tonus. The human body Finite Element model THUMS Version 1.4 was connected to head and neck models developed at KTH and used in pedestrian-to-vehicle impact simulations with a generalized hood, so that the head would impact a surface with an identical impact response in all simulations. In order to isolate the influence of muscle tonus, the model was activated shortly before head impact so the head would have the same initial position prior to impact among different tonus. A symmetric and asymmetric muscle activation scheme that used high level of activation was used in order to create two extremes to investigate. It was found that for the muscle tones used in this study, the influence on the strain in the brain was very minor, in general about 1-14% change. A relatively large increase was observed in a secondary peak in maximum strains in only one of the simulated cases.

  11. Elemental Water Impact Test: Phase 2 36-Inch Aluminum Tank Head

    Science.gov (United States)

    Vassilakos, Gregory J.

    2014-01-01

    Spacecraft are being designed based on LS-DYNA simulations of water landing impacts. The Elemental Water Impact Test (EWIT) series was undertaken to assess the accuracy of LS-DYNA water impact simulations. EWIT Phase 2 featured a 36-inch aluminum tank head. The tank head was outfitted with one accelerometer, twelve pressure transducers, three string potentiometers, and four strain gages. The tank head was dropped from heights of 1 foot and 2 feet. The focus of this report is the correlation of analytical models against test data. As a measure of prediction accuracy, peak responses from the baseline LS-DYNA model were compared to peak responses from the tests.

  12. Simulation of Head Impact Leading to Traumatic Brain Injury

    National Research Council Canada - National Science Library

    Taylor, Paul A; Ford, Corey C

    2006-01-01

    ... to insipient conditions necessary for the onset of TBI. Our simulation results demonstrate that wave interactions within the head generate significant levels of stress at localized regions within the brain on an early time...

  13. Impact of MLC properties and IMRT technique in meningioma and head-and-neck treatments

    DEFF Research Database (Denmark)

    Kantz, Steffi; Söhn, Matthias; Troeller, Almut

    2015-01-01

    PURPOSE: The impact of multileaf collimator (MLC) design and IMRT technique on plan quality and delivery improvements for head-and-neck and meningioma patients is compared in a planning study. MATERIAL AND METHODS: Ten previously treated patients (5 head-and-neck, 5 meningioma) were re...

  14. Effect of vehicle front end profiles leading to pedestrian secondary head impact to ground.

    Science.gov (United States)

    Gupta, Vishal; Yang, King H

    2013-11-01

    Most studies of pedestrian injuries focus on reducing traumatic injuries due to the primary impact between the vehicle and the pedestrian. However, based on the Pedestrian Crash Data Study (PCDS), some researchers concluded that one of the leading causes of head injury for pedestrian crashes can be attributed to the secondary impact, defined as the impact of the pedestrian with the ground after the primary impact of the pedestrian with the vehicle. The purpose of this study is to understand if different vehicle front-end profiles can affect the risk of pedestrian secondary head impact with the ground and thus help in reducing the risk of head injury during secondary head impact with ground. Pedestrian responses were studied using several front-end profiles based off a mid-size vehicle and a SUV that have been validated previously along with several MADYMO pedestrian models. Mesh morphing is used to explore changes to the bumper height, bonnet leading-edge height, and bonnet rear reference-line height. Simulations leading up to pedestrian secondary impact with ground are conducted at impact speeds of 40 and 30 km/h. In addition, three pedestrian sizes (50th, 5th and 6yr old child) are used to enable us to search for a front-end profile that performs well for multiple sizes of pedestrians, not just one particular size. In most of the simulations, secondary ground impact with pedestrian head/neck/shoulder region occurred. However, there were some front-end profiles that promoted secondary ground impact with pedestrian lower extremities, thus avoiding pedestrian secondary head impact with ground. Previous pedestrian safety research work has suggested the use of active safety methods, such as 'pop up hood', to reduce pedestrian head injury during primary impact. Accordingly, we also conducted simulations using a model with the hood raised to capture the effect of a pop-up hood. These simulations indicated that even though pop-up hood helped reducing the head injury

  15. The amount of humeral head impaction of proximal humeral fractures fixed with the Humerusblock device.

    Science.gov (United States)

    Carbone, Stefano; Moroder, Philipp; Arceri, Valerio; Postacchini, Roberto; Gumina, Stefano

    2014-07-01

    The Humerusblock is a minimally invasive device allowing fixation of proximal humeral fractures. A drawback of the device is possible K-wire perforation of the head with the need for early removal of the implant. We assessed the amount of humeral head impaction and its role in the postoperative varus/valgus deviation of the humeral head in fractures of the upper humerus treated with Humerusblock. Fractures were classified according to the Codman-Lego system. The length of the posteromedial metaphyseal extension and integrity of medial hinge were measured; metaphyseal comminution was assessed. Accuracy of fracture reduction was classified as excellent to poor. An original method of measurement of amount of postoperative impaction of the humeral head was developed. The impaction and varus/valgus inclination of the heads were measured comparing postoperative and three-month follow-up radiographs. Constant score and its relation to sintering was calculated at 12-month follow-up. Forty-three fractures were available for follow-up. The amount of humeral head impaction was 3.9 mm on average and was directly correlated with patient's age, sex, Codman-Lego classification, varus inclination and mataphyseal comminution. The postoperative cervico-diaphyseal angle was restored in 35 cases, with 81 % good results. The Humerusblock was removed in 41 % of cases because of K-wire perforation of the humeral head. A negative correlation was found between impaction and Constant score. The amount of humeral head impaction is related to patients' age, sex, and fracture patterns, being the most prone to compaction those with metaphyseal comminution. Humeral head impaction negatively affects final Constant score.

  16. Video Analysis Verification of Head Impact Events Measured by Wearable Sensors.

    Science.gov (United States)

    Cortes, Nelson; Lincoln, Andrew E; Myer, Gregory D; Hepburn, Lisa; Higgins, Michael; Putukian, Margot; Caswell, Shane V

    2017-08-01

    Wearable sensors are increasingly used to quantify the frequency and magnitude of head impact events in multiple sports. There is a paucity of evidence that verifies head impact events recorded by wearable sensors. To utilize video analysis to verify head impact events recorded by wearable sensors and describe the respective frequency and magnitude. Cohort study (diagnosis); Level of evidence, 2. Thirty male (mean age, 16.6 ± 1.2 years; mean height, 1.77 ± 0.06 m; mean weight, 73.4 ± 12.2 kg) and 35 female (mean age, 16.2 ± 1.3 years; mean height, 1.66 ± 0.05 m; mean weight, 61.2 ± 6.4 kg) players volunteered to participate in this study during the 2014 and 2015 lacrosse seasons. Participants were instrumented with GForceTracker (GFT; boys) and X-Patch sensors (girls). Simultaneous game video was recorded by a trained videographer using a single camera located at the highest midfield location. One-third of the field was framed and panned to follow the ball during games. Videographic and accelerometer data were time synchronized. Head impact counts were compared with video recordings and were deemed valid if (1) the linear acceleration was ≥20 g, (2) the player was identified on the field, (3) the player was in camera view, and (4) the head impact mechanism could be clearly identified. Descriptive statistics of peak linear acceleration (PLA) and peak rotational velocity (PRV) for all verified head impacts ≥20 g were calculated. For the boys, a total recorded 1063 impacts (2014: n = 545; 2015: n = 518) were logged by the GFT between game start and end times (mean PLA, 46 ± 31 g; mean PRV, 1093 ± 661 deg/s) during 368 player-games. Of these impacts, 690 were verified via video analysis (65%; mean PLA, 48 ± 34 g; mean PRV, 1242 ± 617 deg/s). The X-Patch sensors, worn by the girls, recorded a total 180 impacts during the course of the games, and 58 (2014: n = 33; 2015: n = 25) were verified via video analysis (32%; mean PLA, 39 ± 21 g; mean PRV, 1664

  17. Interior Head Impact Protective Components and Materials for Use in US Army Vehicles

    Science.gov (United States)

    2015-08-01

    MODELING & SIMULATION, TESTING AND VALIDATION (MSTV) TECHNICAL SESSION AUGUST 4-6, 2015 – NOVI, MICHIGAN INTERIOR HEAD IMPACT PROTECTIVE COMPONENTS...rollover and blast events. TARDEC used the knowledge gained from this project to create performance specification requirements for interior head impact...displacement of the underside of the vehicle. U.S. Army vehicle interior structures are typically made of rigid, thick armor and angular

  18. Head impact exposure in youth football: middle school ages 12-14 years.

    Science.gov (United States)

    Daniel, Ray W; Rowson, Steven; Duma, Stefan M

    2014-09-01

    The head impact exposure experienced by football players at the college and high school levels has been well documented; however, there are limited data regarding youth football despite its dramatically larger population. The objective of this study was to investigate head impact exposure in middle school football. Impacts were monitored using a commercially available accelerometer array installed inside the helmets of 17 players aged 12-14 years. A total of 4678 impacts were measured, with an average (±standard deviation) of 275 ± 190 impacts per player. The average of impact distributions for each player had a median impact of 22 ± 2 g and 954 ± 122 rad/s², and a 95th percentile impact of 54 ± 9 g and 2525 ± 450 rad/s². Similar to the head impact exposure experienced by high school and collegiate players, these data show that middle school football players experience a greater number of head impacts during games than practices. There were no significant differences between median and 95th percentile head acceleration magnitudes experienced during games and practices; however, a larger number of impacts greater than 80 g occurred during games than during practices. Impacts to the front and back of the helmet were most common. Overall, these data are similar to high school and college data that have been collected using similar methods. These data have applications toward youth football helmet design, the development of strategies designed to limit head impact exposure, and child-specific brain injury criteria.

  19. On Impact: A Case of a Student with Head Injuries

    Science.gov (United States)

    Buckley, Valerie A.; Chesire, David J.; Canto, Angela I.

    2011-01-01

    This article describes a case of a student with head injuries. While the symptom presentation for students with traumatic brain injury (TBI) can be vastly different, this case represents common symptoms seen in students who are recovering from a concussion. The authors suggest that school psychologists query the teacher and parents about their…

  20. Gender Differences in Head Impacts Sustained by Collegiate Ice Hockey Players

    Science.gov (United States)

    Brainard, Lindley L.; Beckwith, Jonathan G.; Chu, Jeffrey J.; Crisco, Joseph J.; McAllister, Thomas W.; Duhaime, Ann-Christine; Maerlender, Arthur C.; Greenwald, Richard M.

    2013-01-01

    Purpose This study aims to quantify the frequency, magnitude, and location of head impacts sustained by male and female collegiate ice hockey players over two seasons of play. Methods Over two seasons, 88 collegiate athletes (51 female, 37 male) on two female and male NCAA varsity ice hockey teams wore instrumented helmets. Each helmet was equipped with 6 single-axis accelerometers and a miniature data acquisition system to capture and record head impacts sustained during play. Data collected from the helmets were post-processed to compute linear and rotational acceleration of the head as well as impact location. The head impact exposure data (frequency, location, and magnitude) were then compared across gender. Results Female hockey players experienced a significantly lower (p 0.278) for all locations except the right side of the head, where males received fewer impacts than females (p = 0.031). Female hockey players were 1.1 times more likely than males to sustain an impact less than 50 g while males were 1.3 times more likely to sustain an impact greater than 100 g. Similarly, males were 1.9 times more likely to sustain an impact with peak rotational acceleration greater than 5,000 rad/s2 and 3.5 times more likely to sustain an impact greater than 10,000 rad/s2. Conclusions Although the incidence of concussion has typically been higher for female hockey players than male hockey players, female players sustain fewer impacts and impacts resulting in lower head acceleration than males. Further study is required to better understand the intrinsic and extrinsic risk factors that lead to higher rates of concussion for females that have been previously reported. PMID:21716150

  1. Does aquatic foraging impact head shape evolution in snakes?

    Science.gov (United States)

    Segall, Marion; Cornette, Raphaël; Fabre, Anne-Claire; Godoy-Diana, Ramiro; Herrel, Anthony

    2016-08-31

    Evolutionary trajectories are often biased by developmental and historical factors. However, environmental factors can also impose constraints on the evolutionary trajectories of organisms leading to convergence of morphology in similar ecological contexts. The physical properties of water impose strong constraints on aquatic feeding animals by generating pressure waves that can alert prey and potentially push them away from the mouth. These hydrodynamic constraints have resulted in the independent evolution of suction feeding in most groups of secondarily aquatic tetrapods. Despite the fact that snakes cannot use suction, they have invaded the aquatic milieu many times independently. Here, we test whether the aquatic environment has constrained head shape evolution in snakes and whether shape converges on that predicted by biomechanical models. To do so, we used three-dimensional geometric morphometrics and comparative, phylogenetically informed analyses on a large sample of aquatic snake species. Our results show that aquatic snakes partially conform to our predictions and have a narrower anterior part of the head and dorsally positioned eyes and nostrils. This morphology is observed, irrespective of the phylogenetic relationships among species, suggesting that the aquatic environment does indeed drive the evolution of head shape in snakes, thus biasing the evolutionary trajectory of this group of animals. © 2016 The Author(s).

  2. Head Impact Exposure in Male and Female Collegiate Ice Hockey Players

    Science.gov (United States)

    Wilcox, Bethany J.; Beckwith, Jonathan G.; Greenwald, Richard M.; Chu, Jeffrey J.; McAllister, Thomas W.; Flashman, Laura A.; Maerlender, Arthur C.; Duhaime, Ann-Christine; Crisco, Joseph J.

    2014-01-01

    The purpose of this study was to quantify head impact exposure (frequency, location and magnitude of head impacts) for individual male and female collegiate ice hockey players and to investigate differences in exposure by sex, player position, session type, and team. Ninety-nine (41 male, 58 female) players were enrolled and 37,411 impacts were recorded over three seasons. Frequency of impacts varied significantly by sex (males: 287 per season, females: 170, p<0.001) and helmet impact location (p<0.001), but not by player position (p=0.088). Head impact frequency also varied by session type; both male and female players sustained more impacts in games than in practices (p<0.001), however the magnitude of impacts did not differ between session types. There was no difference in 95th percentile peak linear acceleration between sexes (males: 41.6g, females: 40.8g), but 95th percentile peak rotational acceleration and HITsp (a composite severity measure) were greater for males than females (4424, 3409 rad/s2, and 25.6, 22.3, respectively). Impacts to the back of the helmet resulted in the greatest 95th percentile peak linear accelerations for males (45.2g) and females (50.4g), while impacts to the side and back of the head were associated with the greatest 95th percentile peak rotational accelerations (males: 4719, 4256 rad/sec2, females: 3567, 3784 rad/sec2 respectively). It has been proposed that reducing an individual’s head impact exposure is a practical approach for reducing the risk of brain injuries. Strategies to decrease an individual athlete’s exposure need to be sport and gender specific, with considerations for team and session type. PMID:24210478

  3. Measuring the Impact of Femoral Head Size on Dislocation Rates Following Total Hip Arthroplasty

    Science.gov (United States)

    Kim, Min-Wook; Lee, Ji-Won; Kim, Chel-Hwan

    2017-01-01

    Purpose The purpose of this study was to evaluate if the femoral head's size has an impact on dislocation rates following total hip arthroplasty (THA). Materials and Methods Five hundreds forty-three THA performed using a posterolateral approach in our hospital and followed up more than 6 months were included in this study. We evaluated dislocation rates based on the size of femoral head (28 mm vs. over 32 mm) and further investigated the dislocation rates classified into primary and revision surgery. Patient-related and surgical factors were reviewed to evaluate risk factors impacting dislocation rates. Results Dislocation occurred in 9.6% of cases (n=52; 32 males and 20 females). Of this dislocation group, 36 were treated with femoral heads 28 mm in diameter (9.8% of all patients treated with 28 mm femoral heads) and 16 were treated with femoral heads 32 mm and over (9.1% of all patients treated with femoral heads of at least 32 mm). The percentages of patients experiencing dislocation were not significantly different among the two groups (i.e., 28 mm vs. ≥32 mm). However, after revision surgery, the dislocation rate in the 28-mm group was significantly higher than the ≥32-mm group (Pdislocation and non-dislocation groups, the risk of dislocation was 6 times higher in patients with habitual alcohol intake, and 9.2 times higher in patients with a neuropsychiatric disorder (Pdislocation rates following THA than the size of femoral head. PMID:28611959

  4. Scaling head-neck response data and derivation of 5th percentile female side-impact dummy head-neck response requirements in NBDL test conditions

    NARCIS (Netherlands)

    Meijer, R.; Wisgerhof, R.P.; Wismans, J.S.H.M.; Been, B.W.

    2009-01-01

    The head-neck biofidelity of side-impact dummies can be assessed according to the response requirements for the head-neck system based on mid-size male human subjects as published in ISO TR9790. These criteria are largely based on volunteer tests performed at the Naval Biodynamics Laboratory (NBDL)

  5. Sensitivity of head and cervical spine injury measures to impact factors relevant to rollover crashes.

    Science.gov (United States)

    Mattos, G A; Mcintosh, A S; Grzebieta, R H; Yoganandan, N; Pintar, F A

    2015-01-01

    Serious head and cervical spine injuries have been shown to occur mostly independent of one another in pure rollover crashes. In an attempt to define a dynamic rollover crash test protocol that can replicate serious injuries to the head and cervical spine, it is important to understand the conditions that are likely to produce serious injuries to these 2 body regions. The objective of this research is to analyze the effect that impact factors relevant to a rollover crash have on the injury metrics of the head and cervical spine, with a specific interest in the differentiation between independent injuries and those that are predicted to occur concomitantly. A series of head impacts was simulated using a detailed finite element model of the human body, the Total HUman Model for Safety (THUMS), in which the impactor velocity, displacement, and direction were varied. The performance of the model was assessed against available experimental tests performed under comparable conditions. Indirect, kinematic-based, and direct, tissue-level, injury metrics were used to assess the likelihood of serious injuries to the head and cervical spine. The performance of the THUMS head and spine in reconstructed experimental impacts compared well to reported values. All impact factors were significantly associated with injury measures for both the head and cervical spine. Increases in impact velocity and displacement resulted in increases in nearly all injury measures, whereas impactor orientation had opposite effects on brain and cervical spine injury metrics. The greatest cervical spine injury measures were recorded in an impact with a 15° anterior orientation. The greatest brain injury measures occurred when the impactor was at its maximum (45°) angle. The overall kinetic and kinematic response of the THUMS head and cervical spine in reconstructed experiment conditions compare well with reported values, although the occurrence of fractures was overpredicted. The trends in predicted

  6. Football Players' Head-Impact Exposure After Limiting of Full-Contact Practices.

    Science.gov (United States)

    Broglio, Steven P; Williams, Richelle M; O'Connor, Kathryn L; Goldstick, Jason

    2016-07-01

    Sporting organizations limit full-contact football practices to reduce concussion risk and based on speculation that repeated head impacts may result in long-term neurodegeneration. To directly compare head-impact exposure in high school football players before and after a statewide restriction on full-contact practices. Cross-sectional study. High school football field. Participants were varsity football athletes from a single high school. Before the rule change, 26 athletes (age = 16.2 ± 0.8 years, height = 179.6 ± 6.4 cm, weight = 81.9 ± 13.1 kg) participated. After the rule change, 24 athletes (age = 15.9 ± 0.8 years, height = 178.3 ± 6.5 cm, weight = 76.2 ± 11.6 kg) participated. Nine athletes participated in both years of the investigation. Head-impact exposure was monitored using the Head Impact Telemetry System while the athletes participated in football games and practices in the seasons before and after the rule change. Head-impact frequency, location, and magnitude (ie, linear acceleration, rotational acceleration, and Head Impact Telemetry severity profile [HITsp], respectively) were measured. A total of 15 398 impacts (592 impacts per player per season) were captured before the rule change and 8269 impacts (345 impacts per player per season) after the change. An average 42% decline in impact exposure occurred across all players, with practice-exposure declines occurring among linemen (46% decline); receivers, cornerbacks, and safeties (41% decline); and tight ends, running backs (including fullbacks), and linebackers (39% decline). Impact magnitudes remained largely unchanged between the years. A rule change limiting full-contact high school football practices appears to have been effective in reducing head-impact exposure across all players, with the largest reduction occurring among linemen. This finding is likely associated with the rule modification, particularly because the coaching staff and offensive scheme remained consistent, yet how

  7. Long-Term Cognitive and Neuropsychiatric Consequences of Repetitive Concussion and Head-Impact Exposure.

    Science.gov (United States)

    McAllister, Thomas; McCrea, Michael

    2017-03-01

    Initially, interest in sport-related concussion arose from the premise that the study of athletes engaged in sports associated with high rates of concussion could provide insight into the mechanisms, phenomenology, and recovery from mild traumatic brain injury. Over the last decade, concerns have focused on the possibility that, for some athletes, repetitive concussions may raise the long-term risk for cognitive decline, neurobehavioral changes, and neurodegenerative disease. First conceptualized as a discrete event with variable recovery trajectories, concussion is now viewed by some as a trigger of neurobiological events that may influence neurobehavioral function over the course of the life span. Furthermore, advances in technology now permit us to gain a detailed understanding of the frequency and intensity of repetitive head impacts associated with contact sports (eg, football, ice hockey). Helmet-based sensors can be used to characterize the kinematic features of concussive impacts, as well as the profiles of typical head-impact exposures experienced by athletes in routine sport participation. Many large-magnitude impacts are not associated with diagnosed concussions, whereas many diagnosed concussions are associated with more modest impacts. Therefore, a full understanding of this topic requires attention to not only the effects of repetitive concussions but also overall exposure to repetitive head impacts. This article is a review of the current state of the science on the long-term neurocognitive and neurobehavioral effects of repetitive concussion and head-impact exposure in contact sports.

  8. Head impact exposure in youth football: high school ages 14 to 18 years and cumulative impact analysis.

    Science.gov (United States)

    Urban, Jillian E; Davenport, Elizabeth M; Golman, Adam J; Maldjian, Joseph A; Whitlow, Christopher T; Powers, Alexander K; Stitzel, Joel D

    2013-12-01

    Sports-related concussion is the most common athletic head injury with football having the highest rate among high school athletes. Traditionally, research on the biomechanics of football-related head impact has been focused at the collegiate level. Less research has been performed at the high school level, despite the incidence of concussion among high school football players. The objective of this study is to twofold: to quantify the head impact exposure in high school football, and to develop a cumulative impact analysis method. Head impact exposure was measured by instrumenting the helmets of 40 high school football players with helmet mounted accelerometer arrays to measure linear and rotational acceleration. A total of 16,502 head impacts were collected over the course of the season. Biomechanical data were analyzed by team and by player. The median impact for each player ranged from 15.2 to 27.0 g with an average value of 21.7 (±2.4) g. The 95th percentile impact for each player ranged from 38.8 to 72.9 g with an average value of 56.4 (±10.5) g. Next, an impact exposure metric utilizing concussion injury risk curves was created to quantify cumulative exposure for each participating player over the course of the season. Impacts were weighted according to the associated risk due to linear acceleration and rotational acceleration alone, as well as the combined probability (CP) of injury associated with both. These risks were summed over the course of a season to generate risk weighted cumulative exposure. The impact frequency was found to be greater during games compared to practices with an average number of impacts per session of 15.5 and 9.4, respectively. However, the median cumulative risk weighted exposure based on combined probability was found to be greater for practices vs. games. These data will provide a metric that may be used to better understand the cumulative effects of repetitive head impacts, injury mechanisms, and head impact exposure of

  9. Association of Football Subconcussive Head Impacts With Ocular Near Point of Convergence.

    Science.gov (United States)

    Kawata, Keisuke; Rubin, Leah H; Lee, Jong Hyun; Sim, Thomas; Takahagi, Masahiro; Szwanki, Victor; Bellamy, Al; Darvish, Kurosh; Assari, Soroush; Henderer, Jeffrey D; Tierney, Ryan; Langford, Dianne

    2016-07-01

    An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). Near point of convergence measures and symptom scores. A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. There were significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95% CI, 21-51; P radian/s2 vs 65 016 radian/s2 [lower impact minus higher impact= 57 427; 95% CI , 31 123-80 498; P < .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1, 238 = 12.14, P < .001 and F for group × quadratic trend1, 238 = 12.97, P < .001). In the higher-impact group, there was a linear increase in NPC over time (B for linear trend, unstandardized coefficient [SE]:  0.76 [0.12], P < .001) that plateaued and resolved by postseason follow-up (B for quadratic trend [SE]: -0

  10. Passenger head in impact with frontal airbag in OOP postures

    Science.gov (United States)

    Ovidiu Soica, Adrian; Toganel, George-Radu

    2017-10-01

    Road accidents represent an aspect of road traffic that may lead negative consequences. In order to solve the problems associated with such events, interdisciplinary knowledge is called for, complex teams of engineers, doctors, lawyers, experts working together in order to reduce the severity of such events. Road safety is a continuous concern for both experts and various government organizations with the aim of protecting the lives of the participants in traffic. It has been estimated that the costs of traffic accidents account for 1-3% of a country GDP, depending on the level of country development [26]. In this paper we analyze a particular class of cases of injuries caused to passengers caused by the inflation of the frontal airbag when they are with the passenger out of position. Head kinematics, accelerations, as well as the severity of injuries expressed by HIC, as related to the AIS scale have been analysed.

  11. Impact of targeting insulin-like growth factor signaling in head and neck cancers.

    Science.gov (United States)

    Limesand, Kirsten H; Chibly, Alejandro Martinez; Fribley, Andrew

    2013-10-01

    The IGF system has been shown to have either negative or negligible impact on clinical outcomes of tumor development depending on specific tumor sites or stages. This review focuses on the clinical impact of IGF signaling in head and neck cancer, the effects of IGF targeted therapies, and the multi-dimensional role of IRS 1/2 signaling as a potential mechanism in resistance to targeted therapies. Similar to other tumor sites, both negative and positive correlations between levels of IGF-1/IGF-1-R and clinical outcomes in head and neck cancer have been reported. In addition, utilization of IGF targeted therapies has not demonstrated significant clinical benefit; therefore the prognostic impact of the IGF system on head and neck cancer remains uncertain. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Effect of neck flexor muscle activation on impact velocity of the head during backward falls in young adults.

    Science.gov (United States)

    Choi, W J; Robinovitch, S N; Ross, S A; Phan, J; Cipriani, D

    2017-11-01

    Falls are a common cause of traumatic brain injuries (TBI) across the lifespan. A proposed but untested hypothesis is that neck muscle activation influences impact severity and risk for TBI during a fall. We conducted backward falling experiments to test whether activation of the neck flexor muscles facilitates the avoidance of head impact, and reduces impact velocity if the head contacts the ground. Young adults (n=8) fell from standing onto a 30cm thick gymnastics mat while wearing a helmet. Participants were instructed to fall backward and (a) prevent their head from impacting the mat ("no head impact" trials); (b) allow their head to impact the mat, but with minimal impact severity ("soft impact" trials); and (c) allow their head to impact the mat, while inhibiting efforts to reduce impact severity ("hard impact" trials). Trial type associated with peak magnitude of electromyographic activity of the sternocleidomastoid (SCM) muscles (p<0.017), and with the vertical and horizontal velocity of the head at impact (p<0.001). Peak SCM activations, expressed as percent maximal voluntary isometric contraction (%MVIC), averaged 75.3, 67.5, and 44.5%MVIC in "no head impact", "soft impact", and "hard impact" trials, respectively. When compared to "soft impact" trials, vertical impact velocities in "hard impact" trials averaged 87% greater (3.23 versus 1.73m/s) and horizontal velocities averaged 83% greater (2.74 versus 1.50m/s). For every 10% increase in SCM %MVIC, vertical impact velocity decreased 0.24m/s and horizontal velocity decreased 0.22m/s. We conclude that SCM activation contributes to the prevention and modulation of head impact severity during backward falls. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Quantifying the biotribological properties of forehead skin to enhance head impact simulations

    Directory of Open Access Journals (Sweden)

    M.D. Jones

    2016-06-01

    Full Text Available Head injury severity is dependent on the loading and accelerations experienced during, and immediately after, impact. In England and Wales alone, for example, 700,000 head injury cases are reported annually within Emergency Departments; however, there remains a lack of data that quantifies the fundamental interaction of the head with an impacting surface. The consequence of impact depends upon a precise understanding of the head–surface interaction; hence, there is a need to appreciate the magnitude of, and variation in, frictional coefficient between the head and a range of possible surfaces. This study develops and validates a novel protocol for quantifying friction between the forehead skin and some potential surfaces. Thirteen participants were recruited and four materials tested, with the lowest (0.11 and highest (1.64 dynamic frictional coefficients measured between skin, and expanded polystyrene and laminate flooring, respectively. Preliminary computational simulation identified that a modest variation in head–surface frictional coefficient (0.6 & 0.7 increases rotational accelerations by 23–33%. Hence, this study highlights the significance of the head–surface interaction, whilst providing some data that will assist investigators evaluating head impacts within both a domestic and sporting environment.

  14. Field Data on Head Injuries in Side Airbag Vehicles in Lateral Impact

    Science.gov (United States)

    Yoganandan, Narayan; Pintar, Frank A.; Gennarelli, Thomas A.

    2005-01-01

    Field data on side airbag deployments in lateral crashes and head injuries have largely remained anecdotal. Consequently, the purpose of this research was to report head injuries in lateral motor vehicle impacts. Data from the National Automotive Sampling System files were extracted from side impacts associated with side airbag deployments. Matched pairs with similar vehicle characteristics but without side airbags were also extracted. All data were limited to the United States Federal Motor vehicle Safety Standards FMVSS 214 compliant vehicles so that the information may be more effectively used in the future. In this study, some fundamental analyses are presented regarding occupant- and vehicle-related parameters. PMID:16179147

  15. The development of a method to measure head acceleration and motion in high-impact crashes.

    Science.gov (United States)

    Olvey, Stephen E; Knox, Ted; Cohn, Kelly A

    2004-03-01

    To establish a mechanism to obtain precise measurements of the accelerations of the head in the high-speed racing environment and during crash impacts. The long-term goal is to apply this system to the assessment of head injury in automobile racing drivers and then in participants in other helmeted sports. A multidisciplinary team conceptualized, designed, and successfully tested a triaxial accelerometer system capable of measuring head acceleration and motion in high-impact crashes. The system has been implemented successfully in the professional racing environment. Accurate and reproducible data have been obtained from the accelerometer system in tests on manikins and cadavers and in actual racing events. The system has been implemented in two professional racing series in 2003. Information gained from the accelerometer system is currently being entered into a database. Eventually, the data should aid in the development of improved cockpit head protection in racing cars. Improved helmet design not only in motor sports but also in other helmeted sports should benefit from the data collected. These data will also aid the development of improved head injury protection in military aircraft and passenger vehicles. Although there has been a significant decrease in the overall rate of injury during the past 25 years, head injury remains a serious safety concern in motor sports and the greatest cause of death. Sports-related head injuries are also of great concern because repeated mild head injury has become an important health issue with potential long-term disability. True human tolerance to brain injury has yet to be established. Our scientific knowledge of brain injury is currently based on results derived from manikin, cadaver, and human volunteer testing, along with animal and computer models. The racing environment represents a venue to ethically measure and evaluate the forces involved in human brain injury.

  16. Development and validation of a physical model to investigate the biomechanics of infant head impact.

    Science.gov (United States)

    Jones, M; Darwall, D; Khalid, G; Prabhu, R; Kemp, A; Arthurs, Owen J; Theobald, P

    2017-07-01

    Head injury in childhood is the single most common cause of death or permanent disability from injury. However, despite its frequency and significance, there is little understanding of the response of a child's head to injurious loading. This is a significant limitation when making early diagnoses, informing clinical and/or forensic management or injury prevention strategies. With respect to impact vulnerability, current understanding is predominantly based on a few post-mortem-human-surrogate (PMHS) experiments. Researchers, out of experimental necessity, typically derive acceleration data, currently an established measure for head impact vulnerability, by calculation. Impact force is divided by the head mass, to produce a "global approximation", a single-generalised head response acceleration value. A need exists for a new experimental methodology, which can provide specific regional or localised response data. A surrogate infant head, was created from high resolution computer tomography scans with properties closely matched to tissue response data and validated against PMHS head impact acceleration data. The skull was 3D-printed from co-polymer materials. The brain, represented as a lumped mass, comprised of an injected gelatin/water mix. High-Speed Digital-Image-Correlation optically measured linear and angular velocities and accelerations, strains and strain rates. The "global approximation" was challenged by comparison with regional and local acceleration data. During impacts, perpendicular (at 90°) to a surface, regional and local accelerations were up to three times greater than the concomitant "global" accelerations. Differential acceleration patterns were very sensitive to impact location. Suture and fontanelle regions demonstrated ten times more strain (103%/s) than bone, resulting in skull deformations similar in magnitude to those observed during child birth, but at much higher rates. Surprisingly, perpendicular impacts produced significantly greater

  17. Safe-Play Knowledge, Aggression, and Head-Impact Biomechanics in Adolescent Ice Hockey Players.

    Science.gov (United States)

    Schmidt, Julianne D; Pierce, Alice F; Guskiewicz, Kevin M; Register-Mihalik, Johna K; Pamukoff, Derek N; Mihalik, Jason P

    2016-05-01

    Addressing safe-play knowledge and player aggression could potentially improve ice hockey sport safety. To compare (1) safe-play knowledge and aggression between male and female adolescent ice hockey players and (2) head-impact frequency and severity between players with high and low levels of safe-play knowledge and aggression during practices and games. Cohort study. On field. Forty-one male (n = 29) and female (n = 12) adolescent ice hockey players. Players completed the Safe Play Questionnaire (0 = less knowledge, 7 = most knowledge) and Competitive Aggressiveness and Anger Scale (12 = less aggressive, 60 = most aggressive) at midseason. Aggressive penalty minutes were recorded throughout the season. The Head Impact Telemetry System was used to capture head-impact frequency and severity (linear acceleration [g], rotational acceleration [rad/s(2)], Head Impact Technology severity profile) at practices and games. One-way analyses of variance were used to compare safe play knowledge and aggression between sexes. Players were categorized as having high or low safe-play knowledge and aggression using a median split. A 2 × 2 mixed-model analysis of variance was used to compare head-impact frequency, and random-intercept general linear models were used to compare head-impact severity between groups (high, low) and event types (practice, game). Boys (5.8 of 7 total; 95% confidence interval [CI] = 5.3, 6.3) had a trend toward better safe-play knowledge compared with girls (4.9 of 7 total; 95% CI = 3.9, 5.9; F1,36 = 3.40, P = .073). Less aggressive male players sustained significantly lower head rotational accelerations during practices (1512.8 rad/s (2) , 95% CI = 1397.3, 1637.6 rad/s(2)) versus games (1754.8 rad/s (2) , 95% CI = 1623.9, 1896.2 rad/s(2)) and versus high-aggression players during practices (1773.5 rad/s (2) , 95% CI = 1607.9, 1956.3 rad/s (2) ; F1,26 = 6.04, P = .021). Coaches and sports medicine professionals should ensure that athletes of all levels

  18. Influence of impact speed on head and brain injury outcome in vulnerable road user impacts to the car hood.

    Science.gov (United States)

    Fredriksson, Rikard; Zhang, Liying; Boström, Ola; Yang, King

    2007-10-01

    EuroNCAP and regulations in Europe and Japan evaluate the pedestrian protection performance of cars. The test methods are similar and they all have requirements for the passive protection of the hood area at a pedestrian to car impact speed of 40 km/h. In Europe, a proposal for a second phase of the regulation mandates a brake-assist system along with passive requirements. The system assists the driver in optimizing the braking performance during panic braking, resulting in activation only when the driver brakes sufficiently. In a European study this was estimated to occur in about 50% of pedestrian accidents. A future system for brake assistance will likely include automatic braking, in response to a pre-crash sensor, to avoid or mitigate injuries of vulnerable road users. An important question is whether these systems will provide sufficient protection, or if a parallel, passive pedestrian protection system will be necessary. This study investigated the influence of impact speed on head and brain injury risk, in impacts to the carhood. One car model was chosen and a rigid adjustable plate was mounted under the hood. Free-flying headform impacts were carried out at 20 and 30 km/h head impact velocities at different under-hood distances, 20 to 100 mm; and were compared to earlier tests at 40 km/h. The EEVC WG17 adult pedestrian headform was used for non-rotating tests and a Hybrid III adult 50th percentile head was used for rotational tests where linear and rotational acceleration was measured. Data from the rotational tests was used as input to a validated finite element model of the human head, the Wayne State University Head Injury Model (WSUHIM). The model was utilized to assess brain injury risk and potential injury mechanism in a pedestrian-hood impact. Although this study showed that it was not necessarily true that a lower HIC value reduced the risk for brain injury, it appeared, for the tested car model, under-hood distances of 60 mm in 20 km/h and 80 mm

  19. Cleveland Clinic intelligent mouthguard: a new technology to accurately measure head impact in athletes and soldiers

    Science.gov (United States)

    Bartsch, Adam; Samorezov, Sergey

    2013-05-01

    Nearly 2 million Traumatic Brain Injuries (TBI) occur in the U.S. each year, with societal costs approaching $60 billion. Including mild TBI and concussion, TBI's are prevalent in soldiers returning from Iraq and Afghanistan as well as in domestic athletes. Long-term risks of single and cumulative head impact dosage may present in the form of post traumatic stress disorder (PTSD), depression, suicide, Chronic Traumatic Encephalopathy (CTE), dementia, Alzheimer's and Parkinson's diseases. Quantifying head impact dosage and understanding associated risk factors for the development of long-term sequelae is critical toward developing guidelines for TBI exposure and post-exposure management. The current knowledge gap between head impact exposure and clinical outcomes limits the understanding of underlying TBI mechanisms, including effective treatment protocols and prevention methods for soldiers and athletes. In order to begin addressing this knowledge gap, Cleveland Clinic is developing the "Intelligent Mouthguard" head impact dosimeter. Current testing indicates the Intelligent Mouthguard can quantify linear acceleration with 3% error and angular acceleration with 17% error during impacts ranging from 10g to 174g and 850rad/s2 to 10000rad/s2, respectively. Correlation was high (R2 > 0.99, R2 = 0.98, respectively). Near-term development will be geared towards quantifying head impact dosages in vitro, longitudinally in athletes and to test new sensors for possible improved accuracy and reduced bias. Long-term, the IMG may be useful to soldiers to be paired with neurocognitive clinical data quantifying resultant TBI functional deficits.

  20. Impact of Terrorism on Managerial Efficiency of Heads of Secondary Schools in Khyber Pakhtunkhwa, Pakistan

    Science.gov (United States)

    Khattak, Usman Ghani; Iqba, Javed

    2015-01-01

    Terrorism has adversely affected the educational environment in Khyber Pakhtoon Khwa Province. This study was conducted to know the impact of Terrorism on managerial efficiency of heads of secondary schools in Khyber Pakhtoon Khwa that included Malakand, Mangawara, Dir, Hangu , Bannu and D I Khan which are the highly affected areas of terrorism.…

  1. Effect of head impacts on diffusivity measures in a cohort of collegiate contact sport athletes.

    Science.gov (United States)

    McAllister, Thomas W; Ford, James C; Flashman, Laura A; Maerlender, Arthur; Greenwald, Richard M; Beckwith, Jonathan G; Bolander, Richard P; Tosteson, Tor D; Turco, John H; Raman, Rema; Jain, Sonia

    2014-01-07

    To determine whether exposure to repetitive head impacts over a single season affects white matter diffusion measures in collegiate contact sport athletes. A prospective cohort study at a Division I NCAA athletic program of 80 nonconcussed varsity football and ice hockey players who wore instrumented helmets that recorded the acceleration-time history of the head following impact, and 79 non-contact sport athletes. Assessment occurred preseason and shortly after the season with diffusion tensor imaging and neurocognitive measures. There was a significant (p = 0.011) athlete-group difference for mean diffusivity (MD) in the corpus callosum. Postseason fractional anisotropy (FA) differed (p = 0.001) in the amygdala (0.238 vs 0.233). Measures of head impact exposure correlated with white matter diffusivity measures in several brain regions, including the corpus callosum, amygdala, cerebellar white matter, hippocampus, and thalamus. The magnitude of change in corpus callosum MD postseason was associated with poorer performance on a measure of verbal learning and memory. This study suggests a relationship between head impact exposure, white matter diffusion measures, and cognition over the course of a single season, even in the absence of diagnosed concussion, in a cohort of college athletes. Further work is needed to assess whether such effects are short term or persistent.

  2. Assessment of model-based image-matching for future reconstruction of unhelmeted sport head impact kinematics.

    Science.gov (United States)

    Tierney, Gregory J; Joodaki, Hamed; Krosshaug, Tron; Forman, Jason L; Crandall, Jeff R; Simms, Ciaran K

    2017-02-28

    Player-to-player contact inherent in many unhelmeted sports means that head impacts are a frequent occurrence. Model-Based Image-Matching (MBIM) provides a technique for the assessment of three-dimensional linear and rotational motion patterns from multiple camera views of a head impact event, but the accuracy is unknown for this application. The goal of this study is to assess the accuracy of the MBIM method relative to reflective marker-based motion analysis data for estimating six degree of freedom head displacements and velocities in a staged pedestrian impact scenario at 40 km/h. Results showed RMS error was under 20 mm for all linear head displacements and 0.01-0.04 rad for head rotations. For velocities, the MBIM method yielded RMS errors between 0.42 and 1.29 m/s for head linear velocities and 3.53-5.38 rad/s for angular velocities. This method is thus beneficial as a tool to directly measure six degree of freedom head positional data from video of sporting head impacts, but velocity data is less reliable. MBIM data, combined in future with velocity/acceleration data from wearable sensors could be used to provide input conditions and evaluate the outputs of multibody and finite element head models for brain injury assessment of sporting head impacts.

  3. The Effect of Shoulder Pad Design on Head Impact Severity during Checking.

    Science.gov (United States)

    Virani, Shane; Russell, Colin N; Bruschetta, Megan L; Hua, Kevin Ngoc; Potvin, Brigitte M; Cox, David N; Robinovitch, Stephen N

    2017-03-01

    Shoulder-to-head contact is the most common cause of concussions in ice hockey, accounting for 42% of cases in the National Hockey League. The goal of this project was to determine how shoulder pad stiffness, modified by adding foam padding over the shoulder cap of existing shoulder pads, affected head impact severity when participants delivered checks to an instrumented dummy. Fifteen participants administered "the hardest shoulder checks they were comfortable delivering" to the head of a dummy equipped with triaxial accelerometers and gyros mounted in its helmet. Trials were conducted with participants wearing two common types of shoulder pads, with and without a 2-cm-thick layer of polyurethane foam over the shoulder pad cap. When participants delivered checks with foam-modified pads versus unmodified pads, there was a decrease of 25.0% in the average peak linear head acceleration (28.73g vs 38.31g, mean difference = 9.58g, 95% confidence interval = 6.35-12.81, P impact severity to the head and warrants further examination as a method for contributing to the prevention of brain injuries in ice hockey.

  4. Effect of ice surface size on collision rates and head impacts at the World Junior Hockey Championships, 2002 to 2004.

    Science.gov (United States)

    Wennberg, Richard

    2005-03-01

    To determine if collision rates and head impacts in elite junior hockey differed between games played on the small North American ice surface (85 ft wide), an intermediate-size Finnish ice surface (94 ft wide), and the large standard international ice surface (100 ft wide). Videotape analysis of all games involving Team Canada from the 2002 (large ice, Czech Republic), 2003 (small ice, Canada), and 2004 (intermediate ice, Finland) World Junior Championships. All collisions were counted and separated into various categories (volitional player/player bodychecks, into boards or open ice, plus accidental/incidental player/boards, player/ice, head/stick, head/puck). Further subdivisions included collisions involving the head directly or indirectly and notably severe head impacts. Small, intermediate, and large ice surface mean collisions/game, respectively, were 295, 258, 222, total collisions; 251, 220, 181, volitional bodychecks; 126, 115, 88, into boards; 125, 106, 93, open ice; 71, 52, 44, total head; 44, 36, 30, indirect head; 26, 16, 13, direct head; and 1.3, 0.5, 0.3, severe head (P ice and intermediate-large ice differences in total collisions; P ice difference; P ice differences in head impacts; P ice differences in total and severe head impacts). There is a significant inverse correlation between ice size and collision rates in elite hockey, including direct, indirect, and severe head impacts. These findings suggest that uniform usage of the larger international rinks could reduce the risk of injury, and specifically, concussions in elite hockey by decreasing the occurrence of collisions and head impacts.

  5. Persistent, long-term cerebral white matter changes after sports-related repetitive head impacts.

    Directory of Open Access Journals (Sweden)

    Jeffrey J Bazarian

    Full Text Available Repetitive head impacts (RHI sustained in contact sports are thought to be necessary for the long-term development of chronic traumatic encephalopathy (CTE. Our objectives were to: 1 characterize the magnitude and persistence of RHI-induced white matter (WM changes; 2 determine their relationship to kinematic measures of RHI; and 3 explore their clinical relevance.Prospective, observational study of 10 Division III college football players and 5 non-athlete controls during the 2011-12 season. All subjects underwent diffusion tensor imaging (DTI, physiologic, cognitive, and balance testing at pre-season (Time 1, post-season (Time 2, and after 6-months of no-contact rest (Time 3. Head impact measures were recorded using helmet-mounted accelerometers. The percentage of whole-brain WM voxels with significant changes in fractional anisotropy (FA and mean diffusivity (MD from Time 1 to 2, and Time 1 to 3 was determined for each subject and correlated to head impacts and clinical measures.Total head impacts for the season ranged from 431-1,850. No athlete suffered a clinically evident concussion. Compared to controls, athletes experienced greater changes in FA and MD from Time 1 to 2 as well as Time 1 to 3; most differences at Time 2 persisted to Time 3. Among athletes, the percentage of voxels with decreased FA from Time 1 to 2 was positively correlated with several helmet impact measures. The persistence of WM changes from Time 1 to 3 was also associated with changes in serum ApoA1 and S100B autoantibodies. WM changes were not consistently associated with cognition or balance.A single football season of RHIs without clinically-evident concussion resulted in WM changes that correlated with multiple helmet impact measures and persisted following 6 months of no-contact rest. This lack of WM recovery could potentially contribute to cumulative WM changes with subsequent RHI exposures.

  6. Persistent, long-term cerebral white matter changes after sports-related repetitive head impacts.

    Science.gov (United States)

    Bazarian, Jeffrey J; Zhu, Tong; Zhong, Jianhui; Janigro, Damir; Rozen, Eric; Roberts, Andrew; Javien, Hannah; Merchant-Borna, Kian; Abar, Beau; Blackman, Eric G

    2014-01-01

    Repetitive head impacts (RHI) sustained in contact sports are thought to be necessary for the long-term development of chronic traumatic encephalopathy (CTE). Our objectives were to: 1) characterize the magnitude and persistence of RHI-induced white matter (WM) changes; 2) determine their relationship to kinematic measures of RHI; and 3) explore their clinical relevance. Prospective, observational study of 10 Division III college football players and 5 non-athlete controls during the 2011-12 season. All subjects underwent diffusion tensor imaging (DTI), physiologic, cognitive, and balance testing at pre-season (Time 1), post-season (Time 2), and after 6-months of no-contact rest (Time 3). Head impact measures were recorded using helmet-mounted accelerometers. The percentage of whole-brain WM voxels with significant changes in fractional anisotropy (FA) and mean diffusivity (MD) from Time 1 to 2, and Time 1 to 3 was determined for each subject and correlated to head impacts and clinical measures. Total head impacts for the season ranged from 431-1,850. No athlete suffered a clinically evident concussion. Compared to controls, athletes experienced greater changes in FA and MD from Time 1 to 2 as well as Time 1 to 3; most differences at Time 2 persisted to Time 3. Among athletes, the percentage of voxels with decreased FA from Time 1 to 2 was positively correlated with several helmet impact measures. The persistence of WM changes from Time 1 to 3 was also associated with changes in serum ApoA1 and S100B autoantibodies. WM changes were not consistently associated with cognition or balance. A single football season of RHIs without clinically-evident concussion resulted in WM changes that correlated with multiple helmet impact measures and persisted following 6 months of no-contact rest. This lack of WM recovery could potentially contribute to cumulative WM changes with subsequent RHI exposures.

  7. Cross-sectional evaluation of visuomotor tracking performance following subconcussive head impacts.

    Science.gov (United States)

    Brokaw, E B; Fine, M S; Kindschi, K E; Santago Ii, A C; Lum, P S; Higgins, M

    2017-11-03

    Repeated mild traumatic brain injury (mTBI) has been associated with increased risk of degenerative neurological disorders. While the effects of mTBI and repeated injury are known, studies have only recently started examining repeated subconcussive impacts, impacts that do not result in a clinically diagnosed mTBI. In these studies, repeated subconcussive impacts have been connected to cognitive performance and brain imaging changes. Recent research suggests that performance on a visuomotor tracking (VMT) task may help improve the identification of mTBI. The goal of this study was to investigate if VMT performance is sensitive to the cumulative effect of repeated subconcussive head impacts in collegiate men's lacrosse players. A cross-sectional, prospective study was completed with eleven collegiate men's lacrosse players. Participants wore helmet-mounted sensors and completed VMT and reaction time assessments. The relationship between cumulative impact metrics and VMT metrics were investigated. In this study, VMT performance correlated with repeated subconcussive head impacts; individuals approached clinically diagnosed mTBI-like performance as the cumulative rotational velocity they experienced increased. This suggests that repeated subconcussive impacts can result in measurable impairments and indicates that visuomotor tracking performance may be a useful tool for monitoring the effects of repeated subconcussive impacts.

  8. The Influence of Head Impact Threshold for Reporting Data in Contact and Collision Sports: Systematic Review and Original Data Analysis.

    Science.gov (United States)

    King, D; Hume, P; Gissane, C; Brughelli, M; Clark, T

    2016-02-01

    Head impacts and resulting head accelerations cause concussive injuries. There is no standard for reporting head impact data in sports to enable comparison between studies. The aim was to outline methods for reporting head impact acceleration data in sport and the effect of the acceleration thresholds on the number of impacts reported. A systematic review of accelerometer systems utilised to report head impact data in sport was conducted. The effect of using different thresholds on a set of impact data from 38 amateur senior rugby players in New Zealand over a competition season was calculated. Of the 52 studies identified, 42% reported impacts using a >10-g threshold, where g is the acceleration of gravity. Studies reported descriptive statistics as mean ± standard deviation, median, 25th to 75th interquartile range, and 95th percentile. Application of the varied impact thresholds to the New Zealand data set resulted in 20,687 impacts of >10 g, 11,459 (45% less) impacts of >15 g, and 4024 (81% less) impacts of >30 g. Linear and angular raw data were most frequently reported. Metrics combining raw data may be more useful; however, validity of the metrics has not been adequately addressed for sport. Differing data collection methods and descriptive statistics for reporting head impacts in sports limit inter-study comparisons. Consensus on data analysis methods for sports impact assessment is needed, including thresholds. Based on the available data, the 10-g threshold is the most commonly reported impact threshold and should be reported as the median with 25th and 75th interquartile ranges as the data are non-normally distributed. Validation studies are required to determine the best threshold and metrics for impact acceleration data collection in sport. Until in-field validation studies are completed, it is recommended that head impact data should be reported as median and interquartile ranges using the 10-g impact threshold.

  9. Frequency of head-impact-related outcomes by position in NCAA division I collegiate football players.

    Science.gov (United States)

    Baugh, Christine M; Kiernan, Patrick T; Kroshus, Emily; Daneshvar, Daniel H; Montenigro, Philip H; McKee, Ann C; Stern, Robert A

    2015-03-01

    Concussions and subconcussive impacts sustained in American football have been associated with short- and long-term neurological impairment, but differences in head impact outcomes across playing positions are not well understood. The American Medical Society for Sports Medicine has identified playing position as a key risk factor for concussion in football and one for which additional research is needed. This study examined variation in head impact outcomes across primary football playing positions in a group of 730 National Collegiate Athletic Association Division I Football Championship Series athletes, using a self-report questionnaire. Although there were no significant differences between position groups in the number of diagnosed concussions during the 2012 football season, there were significant differences between groups in undiagnosed concussions (p=0.008) and "dings" (pfootball season, with offensive linemen reporting significantly more symptoms compared to most other groups. There were also positional differences in frequency of returning to play while symptomatic (p<0.001) and frequency of participating in full-contact practice (p<0.001). Offensive linemen reported having returned to play while experiencing symptoms more frequently and participating in more full-contact practices than other groups. These findings suggest that offensive linemen, a position group that experiences frequent, but low-magnitude, head impacts, develop more postimpact symptoms than other playing positions, but do not report these symptoms as a concussion.

  10. The influence of headform orientation and flooring systems on impact dynamics during simulated fall-related head impacts.

    Science.gov (United States)

    Wright, Alexander D; Laing, Andrew C

    2012-10-01

    Novel compliant flooring systems are a promising approach for reducing fall-related injuries in seniors, as they may provide up to 50% attenuation in peak force during simulated hip impacts while eliciting only minimal influences on balance. This study aimed to determine the protective capacity of novel compliant floors during simulated 'high severity' head impacts compared to common flooring systems. A headform was impacted onto a common Commercial-Carpet at 1.5, 2.5, and 3.5 m/s in front, back, and side orientations using a mechanical drop tower. Peak impact force applied to the headform (F(max)), peak linear acceleration of the headform (g(max)) and Head Injury Criterion (HIC) were determined. For the 3.5 m/s trials, backwards-oriented impacts were associated with the highest F(max) and HIC values (pfloors (Resilient Rubber, Residential-Loop Carpet, Berber Carpet) and six novel compliant floors at each impact velocity. ANOVAs indicated that flooring type was associated with all parameters at each impact velocity (pfloors (pfloors can substantially reduce the forces and accelerations applied to a headform compared to common floors including carpet and resilient rubber. In combination with reports of minimal balance impairments, these findings support the promise of novel compliant floors as a biomechanically effective strategy for reducing fall-related injuries including traumatic brain injuries and skull fractures. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

  11. Elemental Water Impact Test: Phase 3 Plunge Depth of a 36-Inch Aluminum Tank Head

    Science.gov (United States)

    Vassilakos, Gregory J.

    2014-01-01

    Spacecraft are being designed based on LS-DYNA water landing simulations. The Elemental Water Impact Test (EWIT) series was undertaken to assess the accuracy of LS-DYNA water impact simulations. Phase 3 featured a composite tank head that was tested at a range of heights to verify the ability to predict structural failure of composites. To support planning for Phase 3, a test series was conducted with an aluminum tank head dropped from heights of 2, 6, 10, and 12 feet to verify that the test article would not impact the bottom of the test pool. This report focuses on the comparisons of the measured plunge depths to LS-DYNA predictions. The results for the tank head model demonstrated the following. 1. LS-DYNA provides accurate predictions for peak accelerations. 2. LS-DYNA consistently under-predicts plunge depth. An allowance of at least 20% should be added to the LS-DYNA predictions. 3. The LS-DYNA predictions for plunge depth are relatively insensitive to the fluid-structure coupling stiffness.

  12. Methods That Examine the Extent to Which the Quality of Children's Experiences in Elementary School Moderate the Long-Term Impacts of Head Start

    Science.gov (United States)

    Mashburn, Andrew J.; Downer, Jason T.

    2013-01-01

    The goals of the Head Start Impact Study (HSIS) are to: (1) determine the impacts of Head Start on children's school readiness and parental practices that support children's development; and (2) to determine under what circumstances Head Start achieves its greatest impacts and for which children (US Department of Health and Human Services, 2010).…

  13. Impaired Cognitive Performance in Youth Athletes Exposed to Repetitive Head Impacts.

    Science.gov (United States)

    Koerte, Inga K; Nichols, Elizabeth; Tripodis, Yorghos; Schultz, Vivian; Lehner, Stefan; Igbinoba, Randy; Chuang, Alice Z; Mayinger, Michael; Klier, Eliana M; Muehlmann, Marc; Kaufmann, David; Lepage, Christian; Heinen, Florian; Schulte-Körne, Gerd; Zafonte, Ross; Shenton, Martha E; Sereno, Anne B

    2017-08-15

    Worldwide, more than 22 million children and adolescents are exposed to repetitive head impacts (RHI) in soccer. Evidence indicates cumulative effects on brain structure, but it is not known whether exposure to RHI affects cognitive improvement in adolescents. The aim of the study was to determine whether exposure to RHI while heading the ball in soccer affects improvement in cognitive performance in adolescents over time. The study group consisted of a convenience sample of 16 male soccer players (mean age 15.7 ± 0.7 years). A comparison cohort of 14 male non-contact sports athletes (mean age 14.9 ± 1.1 years) was recruited from competitive athletic clubs and group-matched in age. Using the ProPoint and AntiPoint tasks, sensorimotor and cognitive functions were measured over both immediate (pre- vs. post-training) as well as across multiple time points within a play season. The number and type of head impacts that occurred during the training were counted. The main outcome measure was the change in response time (RT) in the ProPoint and AntiPoint tasks. The immediate (pre- vs. post-training) and longer-term (across a play season) change in RT was analyzed, and the effect of the number and type of head impacts was tested. Thirty athletes with and without exposure to RHI demonstrated a decrease in RT in both tasks immediately after training. Over the play season, both groups showed improvement in sensorimotor function. While the control group also improved in cognitive performance, the soccer players did not, however. Further, the more long headers performed, the slower the improvement in RT over the season. Youth athletes experience an immediate cognitive improvement after training most likely because of physical exercise. Results of this study also suggest an association between exposure to specific RHI (long headers) and lack of improvement in cognitive performance in youth athletes over time.

  14. Finite element analysis of occupant head injuries: parametric effects of the side curtain airbag deployment interaction with a dummy head in a side impact crash.

    Science.gov (United States)

    Deng, Xingqiao; Potula, S; Grewal, H; Solanki, K N; Tschopp, M A; Horstemeyer, M F

    2013-06-01

    In this study, we investigated and assessed the dependence of dummy head injury mitigation on the side curtain airbag and occupant distance under a side impact of a Dodge Neon. Full-scale finite element vehicle simulations of a Dodge Neon with a side curtain airbag were performed to simulate the side impact. Owing to the wide range of parameters, an optimal matrix of finite element calculations was generated using the design method of experiments (DOE); the DOE method was performed to independently screen the finite element results and yield the desired parametric influences as outputs. Also, analysis of variance (ANOVA) techniques were used to analyze the finite element results data. The results clearly show that the influence of moving deformable barrier (MDB) strike velocity was the strongest influence parameter on both cases for the head injury criteria (HIC36) and the peak head acceleration, followed by the initial airbag inlet temperature. Interestingly, the initial airbag inlet temperature was only a ~30% smaller influence than the MDB velocity; also, the trigger time was a ~54% smaller influence than the MDB velocity when considering the peak head accelerations. Considering the wide range in MDB velocities used in this study, results of the study present an opportunity for design optimization using the different parameters to help mitigate occupant injury. As such, the initial airbag inlet temperature, the trigger time, and the airbag pressure should be incorporated into vehicular design process when optimizing for the head injury criteria. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Predicting multiplanar cervical spine injury due to head-turned rear impacts using IV-NIC.

    Science.gov (United States)

    Ivancic, Paul C; Panjabi, Manohar M; Tominaga, Yasuhiro; Malcolmson, George F

    2006-09-01

    Intervertebral Neck Injury Criterion (IV-NIC) hypothesizes that dynamic three-dimensional intervertebral motion beyond physiological limit may cause multiplanar soft-tissue injury. Present goals, using biofidelic whole human cervical spine model with muscle force replication and surrogate head in head-turned rear impacts, were to: (1) correlate IV-NIC with multiplanar injury, (2) determine IV-NIC injury threshold at each intervertebral level, and (3) determine time and mode of dynamic intervertebral motion that caused injury. Impacts were simulated at 3.5, 5, 6.5, and 8 g horizontal accelerations of T1 vertebra (n = 6; average age: 80.2 years; four male, two female donors). IV-NIC was defined at each intervertebral level and in each motion plane as dynamic intervertebral rotation divided by physiological limit. Three-plane pre- and post-impact flexibility testing measured soft-tissue injury; that is significant increase in neutral zone (NZ) or range of motion (RoM) at any intervertebral level, above baseline. IV-NIC injury threshold was average IV-NIC peak at injury onset. IV-NIC extension peaks correlated best with multiplanar injuries (P NIC injury thresholds ranged between 1.1 at C0-C1 and C3-C4 to 2.9 at C7-T1. IV-NIC injury threshold times were attained between 83.4 and 150.1 ms following impact. Correlation between IV-NIC and multiplanar injuries demonstrated that three-plane intervertebral instability was primarily caused by dynamic extension beyond the physiological limit during head-turned rear impacts.

  16. Estimating Contact Exposure in Football Using the Head Impact Exposure Estimate.

    Science.gov (United States)

    Kerr, Zachary Y; Littleton, Ashley C; Cox, Leah M; DeFreese, J D; Varangis, Eleanna; Lynall, Robert C; Schmidt, Julianne D; Marshall, Stephen W; Guskiewicz, Kevin M

    2015-07-15

    Over the past decade, there has been significant debate regarding the effect of cumulative subconcussive head impacts on short and long-term neurological impairment. This debate remains unresolved, because valid epidemiological estimates of athletes' total contact exposure are lacking. We present a measure to estimate the total hours of contact exposure in football over the majority of an athlete's lifespan. Through a structured oral interview, former football players provided information related to primary position played and participation in games and practice contacts during the pre-season, regular season, and post-season of each year of their high school, college, and professional football careers. Spring football for college was also included. We calculated contact exposure estimates for 64 former football players (n = 32 college football only, n = 32 professional and college football). The head impact exposure estimate (HIEE) discriminated between individuals who stopped after college football, and individuals who played professional football (p < 0.001). The HIEE measure was independent of concussion history (p = 0.82). Estimating total hours of contact exposure may allow for the detection of differences between individuals with variation in subconcussive impacts, regardless of concussion history. This measure is valuable for the surveillance of subconcussive impacts and their associated potential negative effects.

  17. Development of a multimodal blast sensor for measurement of head impact and over-pressurization exposure.

    Science.gov (United States)

    Chu, Jeffrey J; Beckwith, Jonathan G; Leonard, Daniel S; Paye, Corey M; Greenwald, Richard M

    2012-01-01

    It is estimated that 10-20% of United States soldiers returning from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) have suffered at least one instance of blast-induced traumatic brain injury (bTBI) with many reporting persistent symptomology and long-term effects. This variation in blast response may be related to the complexity of blast waves and the many mechanisms of injury, including over-pressurization due to the shock wave and potential for blunt impacts to the head from shrapnel or from other indirect impacts (e.g., building, ground, and vehicle). To help differentiate the effects of primary, secondary, and tertiary effects of blast, a custom sensor was developed to simultaneously measure over-pressurization and blunt impact. Moreover, a custom, complementary filter was designed to differentiate the measurements of blunt (low-frequency bandwidth) from over-pressurization (high-frequency bandwidth). The custom sensor was evaluated in the laboratory using a shock tube to simulate shock waves and a drop fixture to simulate head impacts. Both bare sensors and sensor embedded within an ACH helmet coupon were compared to laboratory reference transducers under multiple loading conditions (n = 5) and trials at each condition (n = 3). For all comparative measures, peak magnitude, peak impulse, and cross-correlation measures, R (2) values, were greater than 0.900 indicating excellent agreement of peak measurements and time-series comparisons with laboratory measures.

  18. A multiscale analysis of blast impact mitigation on the human head

    Science.gov (United States)

    Jenson, Daniel Bryan

    The effectiveness of helmets in preventing shrapnel wounds and internal damage due to blast shock waves has been studied. Carbon nanotubes and similar nanostructures have also recently generated heightened interest due to their strength-to-weight ratio and other unique properties. Therefore, to understand and develop a helmet with improved protection, it is necessary to develop computational procedures that will enable the accurate modeling of traumatic head injuries as well as the precise measurement of the mechanical properties of nanostructures and how these characteristics behave when embedded as an advanced composite structure into a helmet. In this study, a multiscale simulation strategy is used to estimate the mechanical characteristics of advanced composite structures with embedded nanostructures. In most of the previous theoretical works, an analysis dedicated to improving the design of the helmet using composite structures was not included due to a lack of understanding of the interactions of the nanostructures with the matrix materials. In this work, the role of the helmet on the over pressurization and impulse experienced by the head during blast shock wave and blunt force trauma due to shrapnel impacts is studied. In addition, the properties of nanocomposite structures are estimated using molecular dynamics (MD) simulations and then scaled to the macroscopic level using continuum mechanic formulations. This modeling is further developed using Finite Element (FE) analysis to demonstrate the effectiveness of various types of nanostructures in energy absorption. An analysis is carried out on a model of an unprotected head to compare the results to those obtained when protected by a helmet containing different nanostructures. The developed multiscale model is used to improve the composition of helmets and the general understanding of the effects of blast shock wave and shrapnel impacts thereby leading to the mitigation and prevention of traumatic head

  19. Head impact velocities in FIS World Cup snowboarders and freestyle skiers: Do real-life impacts exceed helmet testing standards?

    Science.gov (United States)

    Steenstrup, Sophie E; Mok, Kam-Ming; McIntosh, Andrew S; Bahr, Roald; Krosshaug, Tron

    2018-01-01

    Prior to the 2013-2014 season, the International Ski Federation (FIS) increased the helmet testing speed from a minimum requirement of 5.4 to 6.8 m/s for alpine downhill, super-G and giant slalom and for freestyle ski cross, but not for the other freestyle disciplines or snowboarding. Whether this increased testing speed reflects impact velocities in real head injury situations on snow is unclear. We therefore investigated the injury mechanisms and gross head impact biomechanics in four real head injury situations among World Cup (WC) snowboard and freestyle athletes and compared these with helmet homologation laboratory test requirements. The helmets in the four cases complied with at least European Standards (EN) 1077 (Class B) or American Society for Testing and Materials (ASTM) F2040. We analysed four head injury videos from the FIS Injury Surveillance System throughout eight WC seasons (2006-2014) in detail. We used motion analysis software to digitize the helmet's trajectory and estimated the head's kinematics in two dimensions, including directly preimpact and postimpact. All four impacts were to the occiput. In the four cases, the normal-to-slope preimpact velocity ranged from 7.0(±SD 0.2) m/s to 10.5±0.5 m/s and the normal-to-slope velocity change ranged from 8.4±0.6 m/s to 11.7±0.7 m/s. The sagittal plane helmet angular velocity estimates indicated a large change in angular velocity (25.0±2.9 rad/s to 49.1±0.3 rad/s). The estimated normal-to-slope preimpact velocity was higher than the current strictest helmet testing rule of 6.8 m/s in all four cases. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. A Novel Instrumented Human Head Surrogate for the Impact Evaluation of Helmets

    Directory of Open Access Journals (Sweden)

    Nicola Petrone

    2018-02-01

    Full Text Available A novel Human Head Surrogate was obtained from available MRI scans of a 50th percentile male human head. Addictive manufacturing was used to produce the skull, the brain and the skin. All original MRI geometries were partially smoothed and adjusted to provide the best biofidelity compatible with printing and molding technology. The skull was 3D-printed in ABS and ten pressure sensors were placed into it. The brain surrogate was cast from silicon rubber in the 3D-printed plastic molds. Nine tri-axial accelerometers (placed at the tops of the lobes, at the sides of the lobes, in the cerebellum and in the center of mass and a three-axis gyroscope (at the center of mass were inserted into the silicon brain during casting. The cranium, after assembly with brain, was filled with silicon oil mimicking the cerebral fluid. Silicon rubber was cast in additional 3D-printed molds to form the skin surrounding the cranium. The skull base was adapted to be compatible with the Hybrid-III neck and allow the exit of brain sensors cabling. Preliminary experiments were carried out proving the functionality of the surrogate. Results showed how multiple accelerometers and pressure sensors allowed a better comprehension of the head complex motion during impacts.

  1. Impact of head modeling and sensor types in localizing human gamma-band oscillations.

    Science.gov (United States)

    Mideksa, K G; Hoogenboom, N; Hellriegel, H; Krause, H; Schnitzler, A; Deuschl, G; Raethjen, J; Heute, U; Muthuraman, M

    2014-01-01

    An effective mechanism in neuronal communication is oscillatory neuronal synchronization. The neuronal gamma-band (30-100 Hz) synchronization is associated with attention which is induced by a certain visual stimuli. Numerous studies have shown that the gamma-band activity is observed in the visual cortex. However, impact of different head modeling techniques and sensor types to localize gamma-band activity have not yet been reported. To do this, the brain activity was recorded using 306 magnetoencephalography (MEG) sensors, consisting of 102 magnetometers and 102 pairs of planar gradiometers (one measuring the derivative of the magnetic field along the latitude and the other along the longitude), and the data were analyzed with respect to time, frequency, and location of the strongest response. The spherical head models with a single-shell and overlapping spheres (local sphere) have been used as a forward model for calculating the external magnetic fields generated from the gamma-band activity. For each sensor type, the subject-specific frequency range of the gamma-band activity was obtained from the spectral analysis. The identified frequency range of interest with the highest gamma-band activity is then localized using a spatial-filtering technique known as dynamic imaging of coherent sources (DICS). The source analysis for all the subjects revealed that the gradiometer sensors which measure the derivative along the longitude, showed sources close to the visual cortex (cuneus) as compared to the other gradiometer sensors which measure the derivative along the latitude. However, using the magnetometer sensors, it was not possible to localize the sources in the region of interest. When comparing the two head models, the local-sphere model helps in localizing the source more focally as compared to the single-shell head model.

  2. Repetitive head impacts do not affect postural control following a competitive athletic season.

    Science.gov (United States)

    Murray, Nicholas G; Grimes, Katelyn E; Shiflett, Eric D; Munkasy, Barry A; D'Amico, Nathan R; Mormile, Megan E; Powell, Douglas W; Buckley, Thomas A

    2017-10-03

    Evidence suggests that Repetitive Head Impacts (RHI) directly influence the brain over the course of a single contact collision season yet do not significantly impact a player's performance on the standard clinical concussion assessment battery. The purpose of this study was to investigate changes in static postural control after a season of RHI in Division I football athletes using more sensitive measures of postural control as compared to a non-head contact sports. Fourteen Division I football players (CON) (age=20.4±1.12years) and fourteen non-contact athletes (NON) (2 male, 11 female; age=19.85±1.21years) completed a single trial of two minutes of eyes open quiet upright stance on a force platform (1000Hz) prior to athletic participation (PRE) and at the end of the athletic season (POST). All CON athletes wore helmets outfitted with Head Impact Telemetry (HIT) sensors and total number of RHI and linear accelerations forces of each RHI were recorded. Center of pressure root mean square (RMS), peak excursion velocity (PEV), and sample entropy (SampEn) in the anteroposterior (AP) and mediolateral (ML) directions were calculated. CON group experienced 649.5±496.8 mean number of impacts, 27.1±3.0 mean linear accelerations, with ≈1% of total player impacts exceeded 98g over the course of the season. There were no significant interactions for group x time RMS in the AP (p=0.434) and ML (p=0.114) directions, PEV in the AP (p=0.262) and ML (p=0.977) directions, and SampEn in the AP (p=0.499) and ML (p=0.984) directions. In addition, no significant interactions for group were observed for RMS in the AP (p=0.105) and ML (p=0.272) directions, PEV in the AP (p=0.081) and ML (p=0.143) directions, and SampEn in the AP (p=0.583) and ML (p=0.129) directions. These results suggest that over the course of a single competitive season, RHI do not negatively impact postural control even when measured with sensitive non-linear metrics. Copyright © 2017 Elsevier B.V. All rights

  3. 76 FR 73010 - Technical Report Evaluating the 1999-2003 Head Impact Upgrade of FMVSS No. 201, Upper-Interior...

    Science.gov (United States)

    2011-11-28

    ... Upgrade of FMVSS No. 201, Upper-Interior Components AGENCY: National Highway Traffic Safety Administration... Standard 201, Occupant Protection in Interior Impact. The report's title is: Evaluation of the 1999-2003 Head Impact Upgrade of FMVSS No. 201-- Upper-Interior Components: Effectiveness of Energy-Absorbing...

  4. IMPACT OF MANAGERIAL SKILLS LEARNT THROUGH MA EDUCATIONAL PLANNING MANAGEMENT PROGRAMME OF AIOU ON THE PERFORMANCE OF INSTITUTIONAL HEADS

    Directory of Open Access Journals (Sweden)

    Muhammad Asif CHUADHRY

    2012-04-01

    Full Text Available Management provides formal coordination in an organization for achieving pre-determined goals. The educational manager particulary performs his duties by using different planning and management techniques. These techniques are equally important for the manager of other sectors. The present study was focused on the impact of managerial skills learnt through MA EPM programme on the performance of the heads. Following were the objectives of the study .to assess the contribution of the programme towards the learning of the heads of educational institutions. Ø To identify the managerial skills and competencies of Educational Managers and heads trained through EPPSL Department of the Allama Iqbal Open University. Ø (ii To evaluate the effectiveness of the programme and its impact on the skills of the MA EPM graduates. Ø (iii To analyze the performance of EPM graduates working as heads in their respective institutions.A questionnaire for graduates was developed for those working as institutional heads in Rawalpindi and Islamabad. There were 58 educational institutionl heads who have their master degree in EPM .The data obtained was organized, tabulated, and analyzed by using descriptive statistics means of percentage method in numbers of tables in order to find out the impact of the skills of the MA EPM programme. The finding and conclusions of the data indicated that the impact of the skills on their performance. Majority of the heads were agreed that the programme was beneficial for them. It was recommended on the basis of the conclusions that the selection of the resource person should be on merit; quality of books might be improved; and there should be a separate course for educational budgeting. It was also recommended that this programme should be compulsory for the institutional heads. There might be upgradation of the course.

  5. Exploring the mechanisms of vehicle front-end shape on pedestrian head injuries caused by ground impact.

    Science.gov (United States)

    Yin, Sha; Li, Jiani; Xu, Jun

    2017-09-01

    In pedestrian-vehicle accidents, pedestrians typically suffer from secondary impact with the ground after the primary contact with vehicles. However, information about the fundamental mechanism of pedestrian head injury from ground impact remains minimal, thereby hindering further improvement in pedestrian safety. This study addresses this issue by using multi-body modeling and computation to investigate the influence of vehicle front-end shape on pedestrian safety. Accordingly, a simulation matrix is constructed to vary bonnet leading-edge height, bonnet length, bonnet angle, and windshield angle. Subsequently, a set of 315 pedestrian-vehicle crash simulations are conducted using the multi-body simulation software MADYMO. Three vehicle velocities, i.e., 20, 30, and 40km/h, are set as the scenarios. Results show that the top governing factor is bonnet leading-edge height. The posture and head injury at the instant of head ground impact vary dramatically with increasing height because of the significant rise of the body bending point and the movement of the collision point. The bonnet angle is the second dominant factor that affects head-ground injury, followed by bonnet length and windshield angle. The results may elucidate one of the critical barriers to understanding head injury caused by ground impact and provide a solid theoretical guideline for considering pedestrian safety in vehicle design. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. No impact of early intervention on late outcome after minimal, mild and moderate head injury

    DEFF Research Database (Denmark)

    Heskestad, Ben; Waterloo, Knut; Baardsen, Roald

    2010-01-01

    To evaluate the effect of an educational intervention on outcome after minimal, mild and moderate head injury.......To evaluate the effect of an educational intervention on outcome after minimal, mild and moderate head injury....

  7. Instrumented mouthguard acceleration analyses for head impacts in amateur rugby union players over a season of matches.

    Science.gov (United States)

    King, Doug; Hume, Patria A; Brughelli, Matt; Gissane, Conor

    2015-03-01

    Direct impacts with the head (linear acceleration or pressure) and inertial loading of the head (rotational acceleration or strain) have been postulated as the 2 major mechanisms of head-related injuries such as concussion. Although data are accumulating for soccer and American football, there are no published data for nonhelmeted collision sports such as rugby union. To quantify head impacts via instrumented mouthguard acceleration analyses for rugby union players over a season of matches. Descriptive epidemiology study. Data on impact magnitude and frequency were collected with molded instrumented mouthguards worn by 38 premier amateur senior rugby players participating in the 2013 domestic season of matches. A total of 20,687 impacts >10g (range, 10.0-164.9g) were recorded over the duration of the study. The mean ± SD number of impacts per player over the duration of the season of matches was 564 ± 618, resulting in a mean ± SD of 95 ± 133 impacts to the head per player, per match over the duration of the season of matches. The impact magnitudes for linear accelerations were skewed to the lower values (Sp = 3.7 ± 0.02; P rugby union players over a season of matches, measured via instrumented mouthguard accelerations, were higher than for most sports previously reported. Mean linear acceleration measured over a season of matches was similar to the mean linear accelerations previously reported for youth, high school, and collegiate American football players but lower than that for female youth soccer players. Mean rotational acceleration measured over a season of matches was similar to mean rotational accelerations for youth, high school, and collegiate American football players but less than those for female youth soccer players, concussed American collegiate players, collegiate American football players, and professional American football players. © 2014 The Author(s).

  8. Do crash helmets retain their position on the head in case of an impact ?

    NARCIS (Netherlands)

    Beusenberg, M.C.

    1989-01-01

    This report gives the description and results of three sled tests with each four dummy heads, to record the behaviour of the head and neck of the dummy and the helmet in case of a simulated accident. The simulated accident resulted in a motions of the head, neck and helmet owing to the effects of

  9. Investing in Head Start: Impacts and Cost Effectiveness of America's Comprehensive Child Development Program

    Science.gov (United States)

    University of Pittsburgh Office of Child Development, 2009

    2009-01-01

    As part of The American Recovery and Reinvestment Act of 2009, the federal Head Start and Early Head Start programs received a significant increase in funding. Head Start is the longest-running program to address systemic poverty in the United States. It is also one of the most heavily researched programs in the nation. Still, debate continues…

  10. Head size may modify the impact of white matter lesions on dementia.

    Science.gov (United States)

    Skoog, Ingmar; Olesen, Pernille J; Blennow, Kaj; Palmertz, Bo; Johnson, Sterling C; Bigler, Erin D

    2012-07-01

    We aimed to examine whether total intracranial volume (TICV), a marker of premorbid brain size, modified the impact of the apolipoprotein E (apoE) e4 phenotype and ischemic white matter lesions (WMLs) on odds for dementia. The study comprised a population-based sample of 104 demented and 135 nondemented 85-year-olds, and included physical and neuropsychiatric examinations, and head computerized tomography (CT). Dementia disorders were defined according to standard criteria. TICV and WMLs were rated on computerized tomography. Using the highest group as reference, the risk for dementia, Alzheimer's disease (AD), and vascular dementia (VaD) was increased in those with the smallest half, tertile, and quartile of TICV. Smaller TICV increased the odds of dementia, Alzheimer's disease, and vascular dementia in participants with WMLs. WMLs were not associated with increased odds of dementia in those with the largest TICV. The interaction term WMLs*TICV was also significant. TICV did not modify the odds of dementia in those with the apolipoprotein e4 phenotype. Our results suggest that the impact of brain pathology on the risk of dementia is modified by premorbid brain size. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Impact of sentinel node status and other risk factors on the clinical outcome of head and neck melanoma patients

    NARCIS (Netherlands)

    Leong, SPL; Accortt, NA; Essner, R; Ross, M; Gershenwald, JE; Pockaj, B; Hoekstra, HJ; Garberoglio, C; White, RL; Biel, M; Charney, K; Wanebo, H; Avisar, E; Vetto, J; Soong, SJ

    Objective: To determine the impact of sentinel lymph node (SLN) status and other risk factors on recurrence and overall survival in head and neck melanoma patients. Design: The SLN Working Group, based in San Francisco, Calif, with its 11 member centers, the John Wayne Cancer Institute, and The

  12. The Impact of Radiation Treatment Time on Survival in Patients With Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shaikh, Talha [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Handorf, Elizabeth A. [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Murphy, Colin T. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Mehra, Ranee [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Ridge, John A. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Galloway, Thomas J., E-mail: Thomas.Galloway@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)

    2016-12-01

    Purpose: To assess the impact of radiation treatment time (RTT) in head and neck cancers on overall survival (OS) in the era of chemoradiation. Methods and Materials: Patients with diagnoses of tongue, hypopharynx, larynx, oropharynx, or tonsil cancer were identified by use of the National Cancer Database. RTT was defined as date of first radiation treatment to date of last radiation treatment. In the definitive setting, prolonged RTT was defined as >56 days, accelerated RTT was defined as <47 days, and standard RTT was defined as 47 to 56 days. In the postoperative setting, prolonged RTT was defined as >49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ{sup 2} tests to identify predictors of RTT. The Kaplan-Meier method was used to compare OS among groups. Cox proportional hazards model was used for OS analysis in patients with known comorbidity status. Results: 19,531 patients were included; 12,987 (67%) had a standard RTT, 4,369 (34%) had an accelerated RTT, and 2,165 (11%) had a prolonged RTT. On multivariable analysis, accelerated RTT (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.73-0.97) was associated with an improved OS, and prolonged RTT (HR 1.25; 95% CI 1.14-1.37) was associated with a worse OS relative to standard RTT. When the 9,200 (47%) patients receiving definitive concurrent chemoradiation were examined, prolonged RTT (HR 1.29; 95% CI 1.11-1.50) was associated with a worse OS relative to standard RTT, whereas there was no significant association between accelerated RTT and OS (HR 0.76; 95% CI 0.57-1.01). Conclusion: Prolonged RTT is associated with worse OS in patients receiving radiation therapy for head and neck cancer, even in the setting of chemoradiation. Expeditious completion of radiation should continue to be a quality metric for the management of head and neck malignancies.

  13. Response of an Impact Test Apparatus for Fall Protective Headgear Testing Using a Hybrid-III Head/Neck Assembly.

    Science.gov (United States)

    Caccese, V; Ferguson, J; Lloyd, J; Edgecomb, M; Seidi, M; Hajiaghamemar, M

    2016-02-01

    A test method based upon a Hybrid-III head and neck assembly that includes measurement of both linear and angular acceleration is investigated for potential use in impact testing of protective headgear. The test apparatus is based upon a twin wire drop test system modified with the head/neck assembly and associated flyarm components. This study represents a preliminary assessment of the test apparatus for use in the development of protective headgear designed to prevent injury due to falls. By including angular acceleration in the test protocol it becomes possible to assess and intentionally reduce this component of acceleration. Comparisons of standard and reduced durometer necks, various anvils, front, rear, and side drop orientations, and response data on performance of the apparatus are provided. Injury measures summarized for an unprotected drop include maximum linear and angular acceleration, head injury criteria (HIC), rotational injury criteria (RIC), and power rotational head injury criteria (PRHIC). Coefficient of variation for multiple drops ranged from 0.4 to 6.7% for linear acceleration. Angular acceleration recorded in a side drop orientation resulted in highest coefficient of variation of 16.3%. The drop test apparatus results in a reasonably repeatable test method that has potential to be used in studies of headgear designed to reduce head impact injury.

  14. Impact of Full-Day Head Start Prekindergarten Class Model on Student Academic Performance, Cognitive Skills, and Learning Behaviors by the End of Grade 2. Evaluation Brief

    Science.gov (United States)

    Zhao, Huafang; Modarresi, Shahpar

    2013-01-01

    This brief describes the impact of the Montgomery County (Maryland) Public Schools (MCPS) 2007-2008 full-day Head Start prekindergarten (pre-K) class model on student academic performance, cognitive skills, and learning behaviors by the end of Grade 2. This is the fourth impact study of the MCPS full-day Head Start pre-K class model. The following…

  15. The six degrees of freedom motion of the human head, spine, and pelvis in a frontal impact.

    Science.gov (United States)

    Lopez-Valdes, F J; Riley, P O; Lessley, D J; Arbogast, K B; Seacrist, T; Balasubramanian, S; Maltese, M; Kent, R

    2014-01-01

    The goal of this study is to characterize the in situ 6-degree-of-freedom kinematics of the head, 3 vertebrae (T1, T8, and L2), and the pelvis in a 40 km/h frontal impact. Three postmortem human surrogates (PMHS) were exposed to a deceleration of 15 g over 125 ms and the motion of selected anatomical structures (head, T1, T8, L2, and pelvis) was tracked at 1000 Hz using an optoelectric stereophotogrammetric system. Displacements of the analyzed structures are reported in the sagittal and the transverse planes. Rotations of the structures are described using the finite helical axis of the motion. Anterior displacements were 530.5 ± 39.4 mm (head), 434.7 ± 20.0 mm (T1), 353.3 ± 29.6 mm (T8), 219.9 ± 19.3 mm (L2), and 78.9 ± 22.1 mm (pelvis). The ratio between peak anterior and lateral displacement was up to 19 percent (T1) and 26 percent (head). Magnitudes of the rotation of the head (69.9 ± 1.5°), lumbar (66.5 ± 9.1°), and pelvis (63.8 ± 11.8°) were greater than that of the thoracic vertebrae (T1: 49.1 ± 7.8°; T8: 47.7 ± 6.3°). Thoracic vertebrae exhibited a complex rotation behavior caused by the asymmetric loading of the shoulder belt. Rotation of the lumbar vertebra and pelvis occurred primarily within the sagittal plane (flexion). Despite the predominance of the sagittal motion of the occupant in a pure (12 o'clock) frontal impact, the asymmetry of belt loading induced other relevant displacements and rotations of the head and thoracic spine. Attempts to model occupant kinematics in a frontal impact should consider these results to biofidelically describe the interaction of the torso with the belt.

  16. A Test Bed to Examine Helmet Fit and Retention and Biomechanical Measures of Head and Neck Injury in Simulated Impact.

    Science.gov (United States)

    Yu, Henry Y; Knowles, Brooklynn M; Dennison, Christopher R

    2017-09-21

    Conventional wisdom and the language in international helmet testing and certification standards suggest that appropriate helmet fit and retention during an impact are important factors in protecting the helmet wearer from impact-induced injury. This manuscript aims to investigate impact-induced injury mechanisms in different helmet fit scenarios through analysis of simulated helmeted impacts with an anthropometric test device (ATD), an array of headform acceleration transducers and neck force/moment transducers, a dual high speed camera system, and helmet-fit force sensors developed in our research group based on Bragg gratings in optical fiber. To simulate impacts, an instrumented headform and flexible neck fall along a linear guide rail onto an anvil. The test bed allows simulation of head impact at speeds up to 8.3 m/s, onto impact surfaces that are both flat and angled. The headform is fit with a crash helmet and several fit scenarios can be simulated by making context specific adjustments to the helmet position index and/or helmet size. To quantify helmet retention, the movement of the helmet on the head is quantified using post-hoc image analysis. To quantify head and neck injury potential, biomechanical measures based on headform acceleration and neck force/moment are measured. These biomechanical measures, through comparison with established human tolerance curves, can estimate the risk of severe life threatening and/or mild diffuse brain injury and osteoligamentous neck injury. To our knowledge, the presented test-bed is the first developed specifically to assess biomechanical effects on head and neck injury relative to helmet fit and retention.

  17. Neuropsychological development in preschool children born with asymmetrical intrauterine growth restriction and impact of postnatal head growth.

    Science.gov (United States)

    Klaric, Andrea Simić; Galić, Slavka; Kolundzić, Zdravko; Bosnjak, Vlatka Mejaski

    2013-07-01

    Neuropsychological development and the impact of postnatal head growth were studied in preschool children with asymmetrical intrauterine growth restriction. Examinees born at term with a birth weight below the 10th percentile were matched to the control group according to chronological and gestational age, gender, and maternal education. Fifty children were in each group, with a mean age of 6 years, 4 months. The Touwen neurological examination, the Čuturić developmental test, an imitative hand positions test, and a visual attention test were performed. There were significant differences (Pimpact on neurocognitive development. Slow postnatal head growth is correlated with a poorer neuropsychological outcome.

  18. The biomechanical determinants of concussion: finite element simulations to investigate brain tissue deformations during sporting impacts to the unprotected head.

    Science.gov (United States)

    Patton, Declan A; McIntosh, Andrew S; Kleiven, Svein

    2013-12-01

    Concussion is an injury of specific interest in collision and contact sports, resulting in a need to develop effective preventive strategies. A detailed finite element model of the human head was used to approximate the regional distribution of tissue deformations in the brain by simulating reconstructions of unhelmeted concussion and no-injury head impacts. The results were evaluated using logistic regression analysis and it was found that angular kinematics, in the coronal plane, and maximum principal strains, in all regions of the brain, were significantly associated with concussion. The results suggested that impacts to the temporal region of the head cause coronal rotations, which render injurious strain levels in the brain. Tentative strain tolerance levels of 0.13, 0.15, and 0.26 in the thalamus, corpus callosum, and white matter, respectively, for a 50% likelihood of concussion were determined by logistic regression. The tentative strain tolerance levels compared well with previously reported results from reconstruction studies of American football and single axon, optic nerve, and brain slice culture model studies. The methods used in the current study provide an opportunity to collect unique kinematic data of sporting impacts to the unprotected head, which can be employed in various ways to broaden the understanding of concussion.

  19. Biomechanism of impact resistance in the woodpecker's head and its application

    National Research Council Canada - National Science Library

    Wang, LiZhen; Lu, Shan; Liu, XiaoYu; Niu, XuFeng; Wang, Chao; Ni, YiKun; Zhao, MeiYa; Feng, ChengLong; Zhang, Ming; Fan, YuBo

    2013-01-01

    .... The mechanism that protects the woodpecker's head has aroused the interest of ornithologists, biologists and scientists in the areas of mechanical engineering, material science and electronics engineering...

  20. Impact of scalp location on survival in head and neck melanoma: A retrospective cohort study.

    Science.gov (United States)

    Xie, Charles; Pan, Yan; McLean, Catriona; Mar, Victoria; Wolfe, Rory; Kelly, John

    2017-03-01

    Scalp melanomas have more aggressive clinicopathological features than other melanomas and mortality rates more than twice that of melanoma located elsewhere. We sought to describe the survival of patients with scalp melanoma versus other cutaneous head and neck melanoma (CHNM), and explore a possible independent negative impact of scalp location on CHNM survival. A retrospective cohort study was performed of all invasive primary CHNM cases seen at a tertiary referral center over a 20-year period. Melanoma-specific survival (MSS) was compared between scalp melanoma and other invasive CHNM. Multivariable Cox proportional hazards regression was performed to determine associations with survival. On univariate analysis, patients with scalp melanoma had worse MSS than other CHNM (hazard ratio 2.22, 95% confidence interval 1.59-3.11). Scalp location was not associated with MSS in CHNM on multivariable analysis (hazard ratio 1.11, 95% confidence interval 0.77-1.61) for all tumors together, but remained independently associated with MSS for the 0.76- to 1.50-mm thickness stratum (hazard ratio 5.51, 95% confidence interval 1.55-19.59). Disease recurrence was not assessed because of unavailable data. The poorer survival of scalp melanoma is largely explained by greater Breslow thickness and a higher proportion of male patients. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Impact force and time analysis influenced by execution distance in a roundhouse kick to the head in taekwondo.

    Science.gov (United States)

    Estevan, Isaac; Alvarez, Octavio; Falco, Coral; Molina-García, Javier; Castillo, Isabel

    2011-10-01

    The execution distance is a tactic factor that affects mechanical performance and execution technique in taekwondo. This study analyzes the roundhouse kick to the head by comparing the maximum impact force, execution time, and impact time in 3 distances according to the athletes' competition level. It also analyzes the relationship between impact force and weight in each group. It examines whether the execution distance affects the maximum impact force, execution time, and impact time, in each level group or 2 different competition levels. Participants were 27 male taekwondo players (13 medallists and 14 nonmedallists). The medallists executed the roundhouse kick to the head with greater impact force and in a shorter execution time than did the nonmedallists when they kicked from any distance different to their combat distance. However, the results showed that the execution distance is influential in the execution time and impact time in the nonmedallist group. It is considered appropriate to orientate the high-level competitors to train for offensive actions from any distance similar to the long execution distance because it offers equally effectiveness and a greater security against the opponent. Also, practitioners should focus their training to improve time performance because it is more affected by distance than impact force.

  2. The impact of reorienting cone-beam computed tomographic images in varied head positions on the coordinates of anatomical landmarks

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Hun; Jeong, Ho Gul; Hwang, Jae Joon; Lee, Jung Hee; Han, Sang Sun [Dept. of Oral and Maxillofacial Radiology, Yonsei University, College of Dentistry, Seoul (Korea, Republic of)

    2016-06-15

    The aim of this study was to compare the coordinates of anatomical landmarks on cone-beam computed tomographic (CBCT) images in varied head positions before and after reorientation using image analysis software. CBCT images were taken in a normal position and four varied head positions using a dry skull marked with 3 points where gutta percha was fixed. In each of the five radiographic images, reference points were set, 20 anatomical landmarks were identified, and each set of coordinates was calculated. Coordinates in the images from the normally positioned head were compared with those in the images obtained from varied head positions using statistical methods. Post-reorientation coordinates calculated using a three-dimensional image analysis program were also compared to the reference coordinates. In the original images, statistically significant differences were found between coordinates in the normal-position and varied-position images. However, post-reorientation, no statistically significant differences were found between coordinates in the normal-position and varied-position images. The changes in head position impacted the coordinates of the anatomical landmarks in three-dimensional images. However, reorientation using image analysis software allowed accurate superimposition onto the reference positions.

  3. Impact of Malaysian Polytechnics' Head of Department Multi-Dimensional Leadership Orientation towards Lecturers Work Commitment

    Science.gov (United States)

    Ibrahim, Mohammed Sani; Mujir, Siti Junaidah Mohd

    2012-01-01

    The purpose of this study is to determine if the multi-dimensional leadership orientation of the heads of departments in Malaysian polytechnics affects their leadership effectiveness and the lecturers' commitment to work as perceived by the lecturers. The departmental heads' leadership orientation was determined by five leadership dimensions…

  4. Impact of chemotherapy on the outcome of osteosarcoma of the head and neck in adults

    NARCIS (Netherlands)

    Boon, E.; Graaf, W.T. van der; Gelderblom, H.; Tesselaar, M.E.; Es, R.J. van; Oosting, S.F.; Bree, R. de; Meerten, E. van; Hoeben, A.; Smeele, L.E.; Willems, S.M.; Witjes, M.J.; Buter, J.; Jong, R.J.; Flucke, U.E.; Peer, P.G.M.; Bovee, J.V.; Herpen, C.M. van

    2017-01-01

    BACKGROUND: There is an ongoing debate about the value of (neo-)adjuvant chemotherapy in high- and intermediate-grade osteosarcoma of the head and neck. METHODS: All records of patients older than 16 years diagnosed with osteosarcoma of the head and neck in the Netherlands between 1993 and 2013 were

  5. Impact of chemotherapy on the outcome of osteosarcoma of the head and neck in adults

    NARCIS (Netherlands)

    Boon, Eline; van der Graaf, Winette T. A.; Gelderblom, Hans; Tesselaar, Margot E. T.; Van Es, Robert J. J.; Oosting, Sjoukje F.; de Bree, Remco; van Meerten, Esther; Hoeben, Ann; Smeele, Ludi E.; Willems, Stefan M.; Witjes, Max J. H.; Buter, Jan; Baatenburg de Jong, Robert J.; Flucke, Uta E.; Peer, Petronella G. M.; Bovee, Judith V. M. G.; Van Herpen, Carla M. L.

    Background. There is an ongoing debate about the value of (neo-)adjuvant chemotherapy in high- and intermediate-grade osteosarcoma of the head and neck. Methods. All records of patients older than 16 years diagnosed with osteosarcoma of the head and neck in the Netherlands between 1993 and 2013 were

  6. Impact of chemotherapy on the outcome of osteosarcoma of the head and neck in adults

    NARCIS (Netherlands)

    Boon, Eline; van der Graaf, Winette T A; Gelderblom, Hans; Tesselaar, Margot E T; van Es, Robert J.J.|info:eu-repo/dai/nl/216460646; Oosting, Sjoukje F; de Bree, Remco; van Meerten, Esther; Hoeben, Ann; Smeele, Ludi E.; Willems, Stefan M.; Witjes, Max J H; Buter, Jan; Baatenburg de Jong, Robert J; Flucke, Uta E.; Peer, Petronella G.M.; Bovée, Judith V.M.G.; Van Herpen, Carla M L

    2017-01-01

    Background: There is an ongoing debate about the value of (neo-)adjuvant chemotherapy in high- and intermediate-grade osteosarcoma of the head and neck. Methods: All records of patients older than 16 years diagnosed with osteosarcoma of the head and neck in the Netherlands between 1993 and 2013 were

  7. Understanding how a sport-helmet protects the head from closed injury by virtual impact tests.

    Science.gov (United States)

    Luo, Yunhua; Liang, Zhaoyang

    2017-01-01

    Understanding how a helmet protects the head, especially the soft brain tissues, is the prerequisite for improving helmet design. Intracranial pressure and stresses/strains in the brain tissues are the direct indicators of traumatic brain injury and they can be used to measure helmet performance. In this study, the effects of helmet design parameters such as the helmet shell stiffness, liner compliance and thickness on the brain injury indicators were investigated by virtual impact tests. A finite element head model (FEHM) was first constructed from medical images; a personally-fitted helmet made of composite material and foam was virtually prototyped using geometric information extracted from the FEHM; a helmet-head finite element model was then assembled. Virtual impact tests were conducted using the resulting helmet-head model. The obtained results suggested that, if the helmet shell already has adequate strength to resist excessive deformation and fracture, further increasing shell stiffness and strength would not considerably reduce intracranial pressure and brain strains; to reach the maximum protection with the available materials, the key is to effectively use the second stage in the stress-strain history of the liner foam material.

  8. Rotational Acceleration during Head Impact Resulting from Different Judo Throwing Techniques

    Science.gov (United States)

    MURAYAMA, Haruo; HITOSUGI, Masahito; MOTOZAWA, Yasuki; OGINO, Masahiro; KOYAMA, Katsuhiro

    2014-01-01

    Most severe head injuries in judo are reported as acute subdural hematoma. It is thus necessary to examine the rotational acceleration of the head to clarify the mechanism of head injuries. We determined the rotational acceleration of the head when the subject is thrown by judo techniques. One Japanese male judo expert threw an anthropomorphic test device using two throwing techniques, Osoto-gari and Ouchigari. Rotational and translational head accelerations were measured with and without an under-mat. For Osoto-gari, peak resultant rotational acceleration ranged from 4,284.2 rad/s2 to 5,525.9 rad/s2 and peak resultant translational acceleration ranged from 64.3 g to 87.2 g; for Ouchi-gari, the accelerations respectively ranged from 1,708.0 rad/s2 to 2,104.1 rad/s2 and from 120.2 g to 149.4 g. The resultant rotational acceleration did not decrease with installation of an under-mat for both Ouchi-gari and Osoto-gari. We found that head contact with the tatami could result in the peak values of translational and rotational accelerations, respectively. In general, because kinematics of the body strongly affects translational and rotational accelerations of the head, both accelerations should be measured to analyze the underlying mechanism of head injury. As a primary preventative measure, throwing techniques should be restricted to participants demonstrating ability in ukemi techniques to avoid head contact with the tatami. PMID:24477065

  9. Capabilities of Helmets for Preventing Head Injuries Induced by Ballistic Impacts

    Directory of Open Access Journals (Sweden)

    D.V. Balandin

    2004-01-01

    Full Text Available The limiting performance of ballistically loaded helmets designed to reduce head injuries is studied analytically. The projectile does not penetrate the helmet. This analysis evaluates the absolute minimum of the peak displacement of the helmet shell relative to the head, provided that criteria measuring the severity of head injuries lie within prescribed limits. Rather than optimize a specific design configuration, e.g. a viscoelastic foam liner, characteristics of a time-dependent force representing the helmet liner are calculated. The formulation reduces the limiting performance analysis to an optimal control problem.

  10. Impact of yellow head virus outbreaks in the whiteleg shrimp, Penaeus vannamei (Boone), in Thailand.

    Science.gov (United States)

    Senapin, S; Thaowbut, Y; Gangnonngiw, W; Chuchird, N; Sriurairatana, S; Flegel, T W

    2010-05-01

    Yellow head virus (YHV) is known as a major pathogen in the black tiger shrimp, Penaeus (Penaeus) monodon. It can also cause serious mortality in farmed whiteleg shrimp, Penaeus (Litopenaeus) vannamei. However, there is no published information on the economic and/or production impact of the disease in P. vannamei. Shrimp with gross signs of YHV disease (faded body colour and 60-70% mortality) were observed in 20 study farms rearing P. vannamei in the central part of Thailand from the end of 2007 through early 2008. The estimated economic loss for these farms according to the Thai Animal Aquaculture Association was approximately US$3 million. Detailed sequence analysis of RT-PCR amplicons from shrimp in all the study ponds revealed the presence of YHV Type 1b (YHV-1b) alone (characterized by a 162-bp deletion in the ORF3 region encoding the structural gene for gp116) and the absence of YHV Type 1a (YHV-1a), the original YHV type reported from Thailand. Despite the large 162-bp deletion (= 54 deduced amino acids) in the gp116 structural gene, histopathology of YHV-1b infections was identical to that of YHV-1a infections, and electron microscopy revealed that YHV-1b virions were morphologically indistinguishable from those previously reported for YHV-1a. In addition, an existing commercial RT-PCR detection kit and an immunochromatographic test strip for the detection of YHV were proven to have been valid tests for both YHV-1b and YHV-1a. The source of the virus for these outbreaks was unlikely to have been the post-larvae used to stock the ponds, as they were derived from domesticated specific pathogen-free stocks free of YHV. Thus, it is possible that they originated from an unknown, natural reservoir.

  11. Finite element analysis of the effectiveness of bicycle helmets in head impacts against roads

    National Research Council Canada - National Science Library

    OIKAWA, Shoko; NAKADATE, Hiromichi; ZHANG, Yuelin; UENO, Takahiro; AOMURA, Shigeru; MATSUI, Yasuhiro

    2017-01-01

    ...% of cyclist fatalities in 2015 (ITARDA, 2016). The purpose of this study is to estimate head injuries for cyclists and quantify the effectiveness of a bicycle helmet by performing finite element (FE...

  12. Oncogenic impact of human papilloma virus in head and neck cancer.

    LENUS (Irish Health Repository)

    Heffernan, C B

    2012-02-01

    There is considerable debate within the literature about the significance of human papilloma virus in head and neck squamous cell carcinoma, and its potential influence on the prevention, diagnosis, grading, treatment and prognosis of these cancers. Cigarette smoking and alcohol consumption have traditionally been cited as the main risk factors for head and neck cancers. However, human papilloma virus, normally associated with cervical and other genital carcinomas, has emerged as a possible key aetiological factor in head and neck squamous cell carcinoma, especially oropharyngeal cancers. These cancers pose a significant financial burden on health resources and are increasing in incidence. The recent introduction of vaccines targeted against human papilloma virus types 16 and 18, to prevent cervical cancer, has highlighted the need for ongoing research into the importance of human papilloma virus in head and neck squamous cell carcinoma.

  13. Fast calculating surrogate models for leg and head impact in vehicle-pedestrian collision simulations.

    Science.gov (United States)

    Wimmer, Peter; Benedikt, Martin; Huber, Philipp; Ferenczi, Izabella

    2015-01-01

    In previous research, a tool chain to simulate vehicle-pedestrian accidents from ordinary driving state to in-crash has been developed. This tool chain allows for injury criteria-based, vehicle-specific (geometry, stiffness, active safety systems, etc.) assessments. Due to the complex nature of the included finite element analysis (FEA) models, calculation times are very high. This is a major drawback for using FEA models in large-scale effectiveness assessment studies. Therefore, fast calculating surrogate models to approximate the relevant injury criteria as a function of pedestrian vehicle collision constellations have to be developed. The development of surrogate models for head and leg injury criteria to overcome the problem of long calculation times while preserving high detail level of results for effectiveness analysis is shown in this article. These surrogate models are then used in the tool chain as time-efficient replacements for the FEA model to approximate the injury criteria values. The method consists of the following steps: Selection of suitable training data sets out of a large number of given collision constellations, detailed FEA calculations with the training data sets as input, and training of the surrogate models with the FEA model's input and output values. A separate surrogate model was created for each injury criterion, consisting of a response surface that maps the input parameters (i.e., leg impactor position and velocity) to the output value. In addition, a performance test comparing surrogate model predictions of additional collision constellations to the results of respective FEA calculations was carried out. The developed method allows for prediction of injury criteria based on impact constellation for a given vehicle. Because the surrogate models are specific to a certain vehicle, training has to be redone for a new vehicle. Still, there is a large benefit regarding calculation time when doing large-scale studies. The method can be

  14. Similar head impact acceleration measured using instrumented ear patches in a junior rugby union team during matches in comparison with other sports.

    Science.gov (United States)

    King, Doug A; Hume, Patria A; Gissane, Conor; Clark, Trevor N

    2016-07-01

    OBJECTIVE Direct impact with the head and the inertial loading of the head have been postulated as major mechanisms of head-related injuries, such as concussion. METHODS This descriptive observational study was conducted to quantify the head impact acceleration characteristics in under-9-year-old junior rugby union players in New Zealand. The impact magnitude, frequency, and location were collected with a wireless head impact sensor that was worn by 14 junior rugby players who participated in 4 matches. RESULTS A total of 721 impacts > 10g were recorded. The median (interquartile range [IQR]) number of impacts per player was 46 (IQR 37-58), resulting in 10 (IQR 4-18) impacts to the head per player per match. The median impact magnitudes recorded were 15g (IQR 12g-21g) for linear acceleration and 2296 rad/sec(2) (IQR 1352-4152 rad/sec(2)) for rotational acceleration. CONCLUSIONS There were 121 impacts (16.8%) above the rotational injury risk limit and 1 (0.1%) impact above the linear injury risk limit. The acceleration magnitude and number of head impacts in junior rugby union players were higher than those previously reported in similar age-group sports participants. The median linear acceleration for the under-9-year-old rugby players were similar to 7- to 8-year-old American football players, but lower than 9- to 12-year-old youth American football players. The median rotational accelerations measured were higher than the median and 95th percentiles in youth, high school, and collegiate American football players.

  15. Measurement of Hybrid III Head Impact Kinematics Using an Accelerometer and Gyroscope System in Ice Hockey Helmets.

    Science.gov (United States)

    Allison, Mari A; Kang, Yun Seok; Maltese, Matthew R; Bolte, John H; Arbogast, Kristy B

    2015-08-01

    Helmet-based instrumentation is used to study the biomechanics of concussion. The most extensively used systems estimate rotational acceleration from linear acceleration, but new instrumentation measures rotational velocity using gyroscopes, potentially reducing error. This study compared kinematics from an accelerometer and gyroscope-containing system to reference measures. A Hybrid III (HIII) adult male anthropometric test device head and neck was fit with two helmet brands, each instrumented with gForce Tracker (GFT) sensor systems in four locations. Helmets were impacted at various speeds and directions. Regression relationships between GFT-measured and reference peak kinematics were quantified, and influence of impact direction, sensor location, and helmet brand was evaluated. The relationship between the sensor output and the reference acceleration/velocity experienced by the head was strong. Coefficients of determination for data stratified by individual impact directions ranged from 0.77 to 0.99 for peak linear acceleration and from 0.78 to 1.0 for peak rotational velocity. For the data from all impact directions combined, coefficients of determination ranged from 0.60 to 0.80 for peak resultant linear acceleration and 0.83 to 0.91 for peak resultant rotational velocity. As expected, raw peak resultant linear acceleration measures exhibited large percent differences from reference measures. Adjustment using regressions resulted in average absolute errors of 10-15% if regression adjustments were done by impact direction or 25-40% if regressions incorporating data from all impact directions were used. Average absolute percent differences in raw peak resultant rotational velocity were much lower, around 10-15%. It is important to define system accuracy for a particular helmet brand, sensor location, and impact direction in order to interpret real-world data.

  16. Estimation of heading gyrocompass error using a GPS 3DF system: Impact on ADCP measurements

    Directory of Open Access Journals (Sweden)

    Simón Ruiz

    2002-12-01

    Full Text Available Traditionally the horizontal orientation in a ship (heading has been obtained from a gyrocompass. This instrument is still used on research vessels but has an estimated error of about 2-3 degrees, inducing a systematic error in the cross-track velocity measured by an Acoustic Doppler Current Profiler (ADCP. The three-dimensional positioning system (GPS 3DF provides an independent heading measurement with accuracy better than 0.1 degree. The Spanish research vessel BIO Hespérides has been operating with this new system since 1996. For the first time on this vessel, the data from this new instrument are used to estimate gyrocompass error. The methodology we use follows the scheme developed by Griffiths (1994, which compares data from the gyrocompass and the GPS system in order to obtain an interpolated error function. In the present work we apply this methodology on mesoscale surveys performed during the observational phase of the OMEGA project, in the Alboran Sea. The heading-dependent gyrocompass error dominated. Errors in gyrocompass heading of 1.4-3.4 degrees have been found, which give a maximum error in measured cross-track ADCP velocity of 24 cm s-1.

  17. Survival Prediction in Head and Neck Cancer: Impact of Tumor and Patient Specific Characteristics

    NARCIS (Netherlands)

    F.R. Datema (Frank)

    2012-01-01

    textabstractHead and neck cancer accounts for almost 5% of all malignant tumors in the Netherlands. The most up‐todate Dutch Cancer Registry (NCR) database from 2009 reported 2878 new patients with an invasive carcinoma of the lip, oral cavity, pharynx and larynx (general incidence 17:100.000). In

  18. Population dynamics and impacts of the red-headed leafy spurge stem borer on leafy spurge

    Science.gov (United States)

    R. A. Progar; G. P. Markin; J. Milan; T. Barbouletos; M. J. Rinella

    2013-01-01

    We evaluated the efficacy of the biological control agent, red-headed leafy spurge stem borer (Oberea erythrocephala Schrank.) against the nonnative invasive plant leafy spurge (Euphorbia esula L.). Our three treatments were release of the biological control agent into uncaged plots, release of the biological control agent into plots caged to prevent agent escape and...

  19. Survival Prediction in Head and Neck Cancer: Impact of Tumor and Patient Specific Characteristics

    NARCIS (Netherlands)

    F.R. Datema (Frank)

    2012-01-01

    textabstractHead and neck cancer accounts for almost 5% of all malignant tumors in the Netherlands. The most up‐todate Dutch Cancer Registry (NCR) database from 2009 reported 2878 new patients with an invasive carcinoma of the lip, oral cavity, pharynx and larynx (general incidence 17:100.000).

  20. Abnormal white matter integrity related to head impact exposure in a season of high school varsity football.

    Science.gov (United States)

    Davenport, Elizabeth M; Whitlow, Christopher T; Urban, Jillian E; Espeland, Mark A; Jung, Youngkyoo; Rosenbaum, Daryl A; Gioia, Gerard A; Powers, Alexander K; Stitzel, Joel D; Maldjian, Joseph A

    2014-10-01

    The aim of this study was to determine whether the cumulative effects of head impacts from a season of high school football produce magnetic resonance imaging (MRI) measureable changes in the brain in the absence of clinically diagnosed concussion. Players from a local high school football team were instrumented with the Head Impact Telemetry System (HITS™) during all practices and games. All players received pre- and postseason MRI, including diffusion tensor imaging (DTI). Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) was also conducted. Total impacts and risk-weighted cumulative exposure (RWE), including linear (RWELinear), rotational (RWERotational), and combined components (RWECP), were computed from the sensor data. Fractional, linear, planar, and spherical anisotropies (FA, CL, CP, and CS, respectively), as well as mean diffusivity (MD), were used to determine total number of abnormal white matter voxels defined as 2 standard deviations above or below the group mean. Delta (post-preseason) ImPACT scores for each individual were computed and compared to the DTI measures using Spearman's rank correlation coefficient. None of the players analyzed experienced clinical concussion (N=24). Regression analysis revealed a statistically significant linear relationship between RWECP and FA. Secondary analyses demonstrated additional statistically significant linear associations between RWE (RWECP and RWELinear) and all DTI measures. There was also a strong correlation between DTI measures and change in Verbal Memory subscore of the ImPACT. We demonstrate that a single season of football can produce brain MRI changes in the absence of clinical concussion. Similar brain MRI changes have been previously associated with mild traumatic brain injury.

  1. Long-term prevalence of oropharyngeal dysphagia in head and neck cancer patients: Impact on quality of life.

    Science.gov (United States)

    García-Peris, P; Parón, L; Velasco, C; de la Cuerda, C; Camblor, M; Bretón, I; Herencia, H; Verdaguer, J; Navarro, C; Clave, P

    2007-12-01

    To determine the prevalence of dysphagia in head and neck cancer patients treated with surgery and radiotherapy or chemoradiotherapy. To study the impact of dysphagia on food habits, nutritional status, and quality of life. Retrospective cross-sectional study of 87 head and neck cancer patients treated with surgery and radiotherapy or chemoradiotherapy from January 2000 through May 2005. Time since surgery was 28.5+/-17.8 months. A clinical test was used to detect dysphagia. A nutritional assessment was performed in all patients. A questionnaire was used to evaluate quality of life. Oropharyngeal dysphagia was present in 50.6% of patients, mostly to solid foods (72.4%). Patients with total glossectomy and chemoradiotherapy had the highest rate of dysphagia. Nutritional support was necessary in 57.1% of patients. Malnutrition was present in 20.3% of patients, mainly marasmus (81%). Fifty-one percent of patients reported a decrease in their quality of life due to dysphagia. We found a high prevalence of dysphagia in head and neck cancer patients treated with surgery and coadjuvant treatment. This problem negatively affects their quality of life. It is important that nutritional surveillance be provided to detect it and to prevent malnutrition.

  2. Prognostic impact of p53, c-erbB-2 and epidermal growth factor receptor on head and neck carcinoma

    Directory of Open Access Journals (Sweden)

    Orlando Parise Junior

    Full Text Available CONTEXT: p53, c-erbB-2 and epidermal growth factor receptor (EGFR are cancer-related proteins that are usually expressed in head and neck squamous cell carcinoma (SCC. Their prognostic value remains controversial. OBJECTIVE: To evaluate the prognostic impact of p53, c-erbB-2 and EGFR expression in head and neck SCC. TYPE OF STUDY: Prospective. SETTING: Head and Neck Surgery Department, Hospital AC Camargo, São Paulo. METHODS: Fifty-four patients were studied for p53, c-erbB-2 and EGFR expression in head and neck SCC and adjacent mucosa, via immunohistochemistry. These data were correlated with histoclinical data and survival. RESULTS: There was a direct association of p53 expression in SCC and mucosa (p = 0.001; loss of c-erbB-2 expression (- from normal mucosa to SCC (p = 0.04; lower frequency of association of c-erbB-2 (+ with EGFR (- in SCC (p = 0.02; and a direct association of EGFR (+ expression in SCC and mitotic index (p = 0.03. The 60-month actuarial survival rates for patients presenting lymph node metastasis were higher when there was no capsule rupture by SCC (48.3%; p = 0.02, no more than one positive lymph node (52.3%; p = 0.004 or clear surgical margins (47.0%; p = 0.01, in comparison with patients presenting capsule rupture (20.2%, two or more positive lymph nodes (18.7% or compromised surgical margins (0.0%, respectively. Patients presenting SCC p53 (+ and EGFR (- demonstrated greater survival (75.0%; p = 0.03 than for the remaining group (33.1%. Multivariate analysis confirmed the positive impact of p53 (+ and EGFR (- on survival (p = 0.02. DISCUSSION: Associations were found for p53, c-erbB-2 and EGFR expression with histoclinical data and prognosis. Interestingly, these results suggest that loss of mucosal c-erbB-2 expression could be involved in SCC carcinogenesis; EGFR expression in SCC is related to tumor mitotic index; and presence of p53 with absence of EGFR expression in head and neck SCC may be a prognostic factor for

  3. Impact of HPV infection on the development of head and neck cancer

    Science.gov (United States)

    Betiol, J.; Villa, L.L.; Sichero, L.

    2013-01-01

    Human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC) is considered to be a distinct clinical entity with better prognosis than the classical tobacco- and alcohol-associated tumors. The increasing incidence of this neoplasia during the last decades highlights the need to better understand the role of HPV in the development of these cancers. Although the proportion of HNSCC attributed to HPV varies considerably according to anatomical site, overall approximately 25% of all HNSCC are HPV-DNA positive, and HPV-16 is by far the most prevalent type. In this review we discuss the existing evidence for a causal association between HPV infection and HNSCC at diverse anatomical head and neck subsites. PMID:23532264

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

    Science.gov (United States)

    2015-02-01

    in additional experiments where the top of the head is allowed to strike the surface of the cylinder ( cockpit ), which models a combined insult...the bottom of the lower plate that would give a peak acceleration of the top hull of 2800G in the absence of the compressible cylinders. As shown in...acceleration experienced by a blast loaded vehicle. To do these tests we used two round plates and kept the distance between them constant. The

  5. [Displacement of a stapes piston as a consequence of whiplash injury with head impact].

    Science.gov (United States)

    Träger, V; Seidl, R O; Ernst, A

    2005-02-01

    We report the case of a 60 year old patient suffering from a displacement of her stapes piston after a rear-end collision with whiplash injury. Immediately after the accident she complained hearing loss and tinnitus. During the following days, the patient developed vertigo with lateropulsion. Diagnostic tympanoscopy showed a piston dislocation with migration into the vestibulum as a result of the blunt head trauma.

  6. Postradiation trismus and its impact on quality of life in patients with head and neck cancer.

    Science.gov (United States)

    Lee, Li-Yun; Chen, Shu-Ching; Chen, Wen-Cheng; Huang, Bing-Shen; Lin, Chien-Yu

    2015-02-01

    The aims of this study were to investigate the following in patients with head and neck cancer (HNC): (1) factors related to trismus that predict the development of trismus, (2) factors affecting quality of life and measurements of these factors, and (3) comparison of these findings in patients with and without trismus to evaluate the effects of trismus on quality of life. This cross-sectional study included the questionnaires: the Hospital Anxiety and Depression Scale (HADS) - Depression Subscale, the Chewing Function Questionnaire (CFQ), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Head and Neck Cancer Module (EORTC QLQ-HN35). A scaled ruler was used to measure maximal intercisal opening (MIO). Of the 104 patients in the study, 8.7% had clinical depression. The average MIO was 35.81 mm, and 47.1% of patients had trismus. Moderate levels of chewing dysfunction with regard to different types of food were noted. Lower body mass index, chemoradiotherapy treatment, longer time since treatment completion, and higher radiation dose were significantly associated with trismus. Such patients had significantly lower head and neck-specific quality of life in terms of social contact, sexuality, teeth, mouth opening, dry mouth, feeling ill, nutritional supplement, and weight loss. Patients with trismus should be provided mouth opening exercises after treatment and programs to improve trismus and quality of life. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Impact of genetic targets on therapy in head and neck squamous cell carcinoma.

    Science.gov (United States)

    Chaikhoutdinov, Irina; Goldenberg, David

    2013-01-01

    Despite advances in surgical technique, radiation therapy and chemotherapy, the mortality from head and neck squamous cell carcinoma (HNSCC) has not improved significantly. Squamous cell carcinoma is caused by tobacco use, alcohol consumption and infection with high-risk types of human papillomavirus. It is the 6th most common cancer in the world, with upwards of 45,000 new cases reported yearly in the United States alone.In recent years, there has been a significant increase in the understanding of the molecular and genetic pathogenesis of head and neck cancer, shedding light on the unexpected heterogeneity of the disease. Genetic analysis has led to new classification schemes for HNSCC, with different subgroups exhibiting different prognoses. In addition, multiple targets in aberrant signaling pathways have been identified using increasingly sophisticated bio-informatics tools. Advances in technology have allowed for novel delivery mechanisms to introduce genetic material into cells to produce a therapeutic effect by targeting cancer cells via a number of different approaches.A pressing need to develop novel therapies to augment current treatment modalities has led to a number of translational studies involving gene therapy in the treatment of HNSCC. This article will focus on a review of the most recent developments in molecular biology of head and neck squamous cell carcinoma in regards to possible targets for gene therapy, as well as the array of novel therapeutic strategies directed at these targets.

  8. Does a multidisciplinary team approach in a tertiary referral centre impact on the initial management of head and neck cancer?

    Science.gov (United States)

    Bergamini, Cristiana; Locati, Laura; Bossi, Paolo; Granata, Roberta; Alfieri, Salvatore; Resteghini, Carlo; Imbimbo, Martina; Fallai, Carlo; Orlandi, Ester; Tana, Silvia; Iacovelli, Nicola Alessandro; Guzzo, Marco; Ibba, Tullio; Colombo, Sarah; Bianchi, Roberto; Pizzi, Natalia; Fontanella, Walter; Licitra, Lisa

    2016-03-01

    A multi-disciplinary team (MDT) is essential in the management of cancer. Head and neck cancer (HNC) is a rare, complex and heterogeneous group of malignancies for which different treatment options are available. However, the potential impact of MDT on the management of HNC has been only poorly evaluated to date. This study evaluates the impact of MDT on the management of HNC in a tertiary centre. We retrospectively analysed records of HNC patients referred to a MDT evaluation at the Istituto Nazionale Tumori of Milan, Italy, from May 2007 to January 2012. All cases were reviewed by a MDT consisting of a head and neck surgeon, a radiation oncologist, and a medical oncologist. Data from 781 HNC patients were analysed. Approximately 70% of patients were referred to our Institution for a second opinion consultation. Following MDT evaluation, new staging examinations were requested in 49% of patients, and treatment plan was modified in 10%. A MDT approach in a tertiary referral hospital leads to staging refinement of disease or changes in treatment plan in about 60% of patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Repetitive head impact exposure and later-life plasma total tau in former National Football League players.

    Science.gov (United States)

    Alosco, Michael L; Tripodis, Yorghos; Jarnagin, Johnny; Baugh, Christine M; Martin, Brett; Chaisson, Christine E; Estochen, Nate; Song, Linan; Cantu, Robert C; Jeromin, Andreas; Stern, Robert A

    2017-01-01

    Blood protein analysis of total tau (t-tau) may be a practical screening biomarker for chronic traumatic encephalopathy (CTE), a neurodegenerative tauopathy associated with repetitive head impact (RHI) exposure. We examined plasma t-tau in symptomatic former National Football League (NFL) players compared with controls and the relationship between RHI exposure and later-life plasma t-tau. Ninety-six former NFL players (age 40-69) and 25 same-age controls underwent blood draw to determine plasma t-tau levels. The cumulative head impact index (CHII) quantified RHI exposure. Subjects completed measures of clinical function. A higher CHII predicted greater plasma t-tau in the former NFL players (P = .0137). No group differences in plasma t-tau emerged, but a concentration ≥3.56 pg/mL was 100% specific to former NFL players. Plasma t-tau did not predict clinical function. Greater RHI exposure predicted higher later-life plasma t-tau concentrations, and further study on plasma t-tau as a candidate screening biomarker for CTE is warranted.

  10. Recombinant human bone morphogenetic protein-2 in debridement and impacted bone graft for the treatment of femoral head osteonecrosis.

    Directory of Open Access Journals (Sweden)

    Wei Sun

    Full Text Available The purpose of this study was to compare the clinical outcomes of impacted bone graft with or without recombinant human bone morphogenetic protein-2 (rhBMP-2 for osteonecrosis of the femoral head (ONFH. We examined the effect of bone-grafting through a window at the femoral head-neck junction, known as the "light bulb" approach, for the treatment of ONFH with a combination of artificial bone (Novobone mixed with or without rhBMP-2. A total of 42 patients (72 hips were followed-up from 5 to 7.67 years (average of 6.1 years. The patients with and without BMP were the first group (IBG+rhBMP-2 and the second group (IBG, respectively. The clinical effectiveness was evaluated by Harris hip score (HHS. The radiographic follow-up was evaluated by pre-and postoperative X-ray and CT scan. Excellent, good, and fair functions were obtained in 36, 12, and 7 hips, respectively. The survival rate was 81.8% and 71.8% in the first and second group, respectively. However, the survival rate was 90.3% in ARCO stage IIb, c, and only 34.6% in ARCO stage IIIa (P<0.05. It was concluded that good and excellent mid-term follow-up could be achieved in selected patients with ONFH treated with impacted bone graft operation. The rhBMP-2 might improve the clinical efficacy and quality of bone repair.

  11. Impact of initial FDG PET/CT in the management plan of patients with locally advanced head and neck cancer.

    Science.gov (United States)

    Arias, F; Chicata, V; García-Velloso, M J; Asín, G; Uzcanga, M; Eito, C; Quilez, I; Viudez, A; Saenz, J; Hernández, I; Caicedo, C; Errasti, M; Barrado, M; García-Bragado, F

    2015-02-01

    To determine the impact of initial FDG PET/CT staging on clinical stage and the management plan in patients with locally advanced head and neck cancer (LAHNC). We retrospectively reviewed the records of 72 consecutive patients (2007-2010) staged with PET/CT and conventional CT with tumours of hypopharynx/larynx (26 patients, 36 %), oral cavity (17 patients, 24 %), oropharynx (16 patients, 22 %), nasopharynx (12 patients, 17 %), and others (2 %). The impact of PET/CT on management plans was considered high when PET/CT changed the planned treatment modality or treatment intent, and intramodality changes were considered as minor changes with low impact. FDG PET/CT changed the stage in 27 patients and had high impact on the management plan in 12 % of patients (detection of distant metastases in 6 patients and stage II in 2 patients). Intramodality changes were more frequent: FDG PET/CT altered the TNM stage in 18/72 (25 %) of patients, upstaging N stage in 90 % of patients with low impact. Initial FDG PET/CT staging not only improves stage but also affects the management plan in LAHNC patients.

  12. Impact of warm ischemia on phosphorylated biomarkers in head and neck squamous cell carcinoma.

    Science.gov (United States)

    Tower, Jacob I; Lingen, Mark W; Seiwert, Tanguy Y; Langerman, Alexander

    2014-01-01

    To quantitatively and visually characterize changes in phosphorylated biomarker expression in head and neck squamous cell carcinoma specimens from excision through 90 minutes of warm ischemia. Tissue biospecimens were procured prospectively. Head and neck squamous cell carcinoma specimens from 5 patients were subdivided into three parts upon excision, exposed to warm ischemia of 15, 30, or 90 minutes, and routinely biobanked. Relative change in biomarker expression of p-Akt, p-ERK, and p-Stat3 was measured by immunoblot densitometry. Immunofluorescent stains were performed to visually supplement the quantitative analysis. From 15 to 30 minutes of ex vivo ischemia, there was a significant decrease in p-Akt (p = 0.045) as the mean intensity fell by 44.9%. This decrease in p-Akt remained significant at the 90 minute time point (p = 0.015). From 15 to 30 minutes of ischemia, there was a trend toward a decline in p-ERK, which became significant by 90 minutes of ex vivo warm ischemia (p = 0.008). These changes were supported by qualitative differences in p-ERK fluorescence at 0 and 90 minutes warm ischemia. Some phosphorylated biomarkers of HNSCC remain highly dynamic during the period of ex vivo warm ischemia after surgical excision but before biobanking. These findings have critical implications for studies that attempt to correlate protein phosphorylation with clinical outcome. We conclude that ex vivo warm ischemia time is a major determinant of tissue quality that may explain inconsistent results from biomarker research in head and neck squamous cell carcinoma.

  13. The impacts of climate change on a Norwegian high-head hydropower plant

    Energy Technology Data Exchange (ETDEWEB)

    Chernet, Haregewoin Haile; Alfredsen, Knut; Killintveit, Aanund

    2010-07-01

    Full text: Norway relies on hydropower for 99 percent of the electricity production and thus Hydropower is important for Norway today and in the future energy system. The work presented in this paper shows how a high-head hydropower system in Norway will be affected in the future climate. The Aurland Hydropower system, operated by E-Co Vannkraft, Norway is the test case for the study. The Aurland hydropower system has many reservoirs and transfer systems and is considered to be one of the complex systems in Norway, but also a typical example of a Norwegian high head system. The nMAG Hydropower simulation model, which has been developed at the Norwegian Hydro technical Laboratory, is used to simulate the hydropower system. Historical and future inflow series were transposed from the neighbouring catchment Flaamselvi using scaling based on area and specific runoff, as there is no discharge station in Aurland catchment with long unregulated inflow series to set up the model and to be used for developing future climate scenarios. To generate the future inflow series for the analysis, the HBV hydrological model is calibrated for the Flaamselvi catchment. The model is then used to generate future inflow series of using the Hadley GCM (HADAm3) and A2, B2 climate scenarios. The operation of the hydropower system is then simulated for the period 2071 -2100 to see how future power production is affected by the change in the inflow conditions. The HBV model is also used to see how snow accumulation will be affected in the future as snow melt is important for Norwegian reservoir and hydropower systems. The Hydrologic scenarios under climate change imply an average increase in runoff for the system. Snow accumulation will decrease with sooner snow melt and more winter precipitation as rain. The hydropower simulation results show that associated with the increase in runoff there is an increase in energy generation with 10-20% under the current reservoir operation strategies

  14. Dysphagia. Impact on quality of life after radio(chemo)therapy of head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, Julia; Hipp, Matthias; Koelbl, Oliver [Regensburg Univ. Medical Center (Germany). Dept. of Radiotherapy; Schaefer, Christof [Hospital St. Elisabeth Straubing (Germany). Dept. of Radiotherapy

    2011-11-15

    In the past, xerostomia was considered one of the most important determining factors of quality of life (QoL) after radiotherapy (RT) of the head and neck region. In addition, more recent studies have shown that RT-induced dysphagia has an essential influence on the QoL. Between September 2005 and August 2007, 35 patients with locally advanced squamous cell carcinoma of the head and neck region were included in the prospective study. Patients were treated by IMAT (intensity-modulated arc therapy) or IMRT (intensity-modulated radiotherapy) planned on 3D imaging. A total of 28 patients (80%) received concomitant chemotherapy. The evaluation of QoL (EORTC QLQ - C30, H and N C-35) and toxicities (CTC 2.0) were assessed at the beginning of, during, and after RT as well as up to 12 months after the end of therapy. At the end of therapy, 86% of the patients experienced difficulties in swallowing (62% CTC II-III ). Twelve months after the end of treatment, 15% still suffered from dysphagia CTC II-III . Concomitant chemotherapy exacerbated the incidence and gravity of dysphagia, resulting in increasing dietary problems. QoL (EORTC) was significantly affected by dysphagia. In particular, the global state of health and QoL were influenced at the end of treatment (p = 0.033) and at a later stage (p = 0.050). The findings of this study suggest that more emphasis should be placed on structured clinical diagnostics, therapy, and rehabilitation of deglutition problems. This means in particular to not only spare the parotids while planning the irradiation, but also to take into consideration the important structures for deglutition, like the retropharyngeal muscles. (orig.)

  15. An improved finite element modeling of the cerebrospinal fluid layer in the head impact analysis.

    Science.gov (United States)

    Wu, John Z; Pan, Christopher S; Wimer, Bryan M; Rosen, Charles L

    2017-01-01

    The finite element (FE) method has been widely used to investigate the mechanism of traumatic brain injuries (TBIs), because it is technically difficult to quantify the responses of the brain tissues to the impact in experiments. One of technical challenges to build a FE model of a human head is the modeling of the cerebrospinal fluid (CSF) of the brain. In the current study, we propose to use membrane elements to construct the CSF layer. Using the proposed approach, we demonstrate that a head model can be built by using existing meshes available in commercial databases, without using any advanced meshing software tool, and with the sole use of native functions of the FE package Abaqus. The calculated time histories of the intracranial pressures at frontal, posterior fossa, parietal, and occipital positions agree well with the experimental data and the simulations in the literature, indicating that the physical effects of the CSF layer have been accounted for in the proposed modeling approach. The proposed modeling approach would be useful for bioengineers to solve practical problems.

  16. Impact of head models in N170 component source imaging: results in control subjects and ADHD patients

    Science.gov (United States)

    Beltrachini, L.; Blenkmann, A.; von Ellenrieder, N.; Petroni, A.; Urquina, H.; Manes, F.; Ibáñez, A.; Muravchik, C. H.

    2011-12-01

    The major goal of evoked related potential studies arise in source localization techniques to identify the loci of neural activity that give rise to a particular voltage distribution measured on the surface of the scalp. In this paper we evaluate the effect of the head model adopted in order to estimate the N170 component source in attention deficit hyperactivity disorder (ADHD) patients and control subjects, considering faces and words stimuli. The standardized low resolution brain electromagnetic tomography algorithm (sLORETA) is used to compare between the three shell spherical head model and a fully realistic model based on the ICBM-152 atlas. We compare their variance on source estimation and analyze the impact on the N170 source localization. Results show that the often used three shell spherical model may lead to erroneous solutions, specially on ADHD patients, so its use is not recommended. Our results also suggest that N170 sources are mainly located in the right occipital fusiform gyrus for faces stimuli and in the left occipital fusiform gyrus for words stimuli, for both control subjects and ADHD patients. We also found a notable decrease on the N170 estimated source amplitude on ADHD patients, resulting in a plausible marker of the disease.

  17. The impact of pediatric-specific dose modulation curves on radiation dose and image quality in head computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Joana; Paulo, Graciano [Instituto Politecnico de Coimbra, ESTESC, DMIR, Coimbra (Portugal); Foley, Shane; Rainford, Louise [University College Dublin, School of Medicine and Medical Science, Health Science Centre, Dublin 4 (Ireland); McEntee, Mark F. [The University of Sydney, Faculty of Health Sciences, Cumberland Campus, Sydney (Australia)

    2015-11-15

    The volume of CT examinations has increased with resultant increases in collective dose values over the last decade. To analyze the impact of the tube current and voltage modulation for dose values and image quality of pediatric head CT examinations. Head CT examinations were performed on anthropomorphic phantoms and four pediatric age categories before and after the introduction of dedicated pediatric curves for tube voltage and current modulation. Local diagnostic reference levels were calculated. Visual grading characteristic image quality evaluation was performed by four pediatric neuroradiologists and image noise comparisons were performed. Pediatric-specific modulation curves demonstrated a 49% decrease in mean radiation dose for phantom examinations. The local diagnostic reference levels (CTDIvol) for clinical examinations decreased by 52%, 41%, 46% and 40% for newborn, 5-, 10- and 15-year-old patients, respectively. Visual grading characteristic image quality was maintained for the majority of age categorizations (area under the curve = 0.5) and image noise measurements did not change (P = 0.693). Pediatric-specific dose modulation curves resulted in an overall mean dose reduction of 45% with no significant differences in subjective or objective image quality findings. (orig.)

  18. An Investigation of Head Accelerometry, Cognitive Function, and Brain Blood Flow During Intercollegiate Boxing and its Impact Regarding Head Injury Assessment In Combat

    Science.gov (United States)

    2010-09-06

    Brininger ,Teresa, Kryskow, Elizabeth 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) AND...ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER HQ USAFA/ADPH 2169 Fieldhouse Drive USAFA, CO 80840 USARIEM Natick, MA 01760 9...Injury, Head Acceleration, MBTI Diagnostics, Cognitive Testing, Brain Acoustic Monitoring, Boxing, Neuropsychology 16. SECURITY CLASSIFICATION OF

  19. Impact of copper toxicity on stone-head cabbage (Brassica oleracea var. capitata) in hydroponics.

    Science.gov (United States)

    Ali, Sajid; Shahbaz, Muhammad; Shahzad, Ahmad Naeem; Khan, Hafiz Azhar Ali; Anees, Moazzam; Haider, Muhammad Saleem; Fatima, Ammara

    2015-01-01

    Arable soils are frequently subjected to contamination with copper as the consequence of imbalanced fertilization with manure and organic fertilizers and/or extensive use of copper-containing fungicides. In the present study, the exposure of stone-head cabbage (Brassica oleracea var. capitata) to elevated Cu(2+) levels resulted in leaf chlorosis and lesser biomass yield at ≥2 µ M. Root nitrate content was not statistically affected by Cu(2+) levels, although it was substantially decreased at ≥5 µ M Cu(2+) in the shoot. The decrease in nitrate contents can be related to lower nitrate uptake rates because of growth inhibition by Cu-toxicity. Shoot sulfate content increased strongly at ≥2 µ M Cu(2+) indicating an increase in demand for sulfur under Cu stress. Furthermore, at ≥2 µM concentration, concentration of water-soluble non-protein thiol increased markedly in the roots and to a smaller level in the shoot. When exposed to elevated concentrations of Cu(2+) the improved sulfate and water-soluble non-protein thiols need further studies for the evaluation of their direct relation with the synthesis of metal-chelating compounds (i.e., phytochelatins).

  20. Impact of copper toxicity on stone-head cabbage (Brassica oleracea var. capitata in hydroponics

    Directory of Open Access Journals (Sweden)

    Sajid Ali

    2015-08-01

    Full Text Available Arable soils are frequently subjected to contamination with copper as the consequence of imbalanced fertilization with manure and organic fertilizers and/or extensive use of copper-containing fungicides. In the present study, the exposure of stone-head cabbage (Brassica oleracea var. capitata to elevated Cu2+ levels resulted in leaf chlorosis and lesser biomass yield at ≥2 µ M. Root nitrate content was not statistically affected by Cu2+ levels, although it was substantially decreased at ≥5 µ M Cu2+ in the shoot. The decrease in nitrate contents can be related to lower nitrate uptake rates because of growth inhibition by Cu-toxicity. Shoot sulfate content increased strongly at ≥2 µ M Cu2+ indicating an increase in demand for sulfur under Cu stress. Furthermore, at ≥2 µM concentration, concentration of water-soluble non-protein thiol increased markedly in the roots and to a smaller level in the shoot. When exposed to elevated concentrations of Cu2+ the improved sulfate and water-soluble non-protein thiols need further studies for the evaluation of their direct relation with the synthesis of metal-chelating compounds (i.e., phytochelatins.

  1. The Impact of Ocular Pressures, Material Properties and Geometry on Optic Nerve Head Deformation

    Science.gov (United States)

    Feola, Andrew J.; Myers, Jerry G.; Raykin, Julia; Nelson, Emily S.; Samuels, Brian C.; Ethier C. Ross

    2017-01-01

    Alteration in intracranial pressure (ICP) has been associated with various diseases that cause visual impairment, including glaucoma, idiopathic intracranial hypertension and Visual Impairment and Intracranial Pressure (VIIP) syndrome. However, how changes in ICP lead to vision loss is unclear, although it is hypothesized to involve deformations of the tissues in the optic nerve head (ONH). Recently, understanding the effect of ICP alterations on ocular tissues has become a major concern for NASA, where 42 of astronauts that partake in long duration space missions suffer from VIIP syndrome. Astronauts with VIIP syndrome suffer from visual impairment and changes in ocular anatomy that persist after returning to earth (1). It is hypothesized that the cephalad fluid shift that occurs upon entering microgravity increases ICP, which leads to an altered biomechanical environment in the posterior globe and optic nerve sheath, and subsequently VIIP syndrome. Our goal was to develop a finite element (FE) model to simulate the acute effects of elevated ICP on the posterior eye. Here, we simulated how inter-individual differences affect the deformation of ONH tissues. Further, we examined how several different geometries influenced deformations when exposed to elevated ICP.

  2. Active Head Restraints Used to Improve the Car Seats Safety in a Rear Impact Situation, in Accordance with the Requirements of EURO NCAP

    Directory of Open Access Journals (Sweden)

    D. Yu. Solopov

    2014-01-01

    Full Text Available This article is devoted to the urgent, presently, problem that is to ensure the best level of the passive safety of car seats with active head restraints, as well as to assess the effectiveness of such constructional designs. This is an impact-related task, to be, as a consequence, essentially nonlinear with large deformations, strains and accelerations.To solve this problem finite element models of three types of seat designs with active head restraints have been developed. When creating the simulation FEM a number of CAD (Computer Aided Design/CAE (Computer Aided Engineering software was used.This work was performed within the framework of the developed technique, which allows an efficient creation of the car seat designs with passive and active head restraints that meet requirements of the passive safety.The results of calculations and experiments allowed us to find that the active head restraint significantly reduced a NIC (Neck Injury Criterion value, namely up to 36.92 (4% when using the active headrest with articulated tilting couch, 29.23 (per 24% when using the active headrest with sliding pad, and 26.15 (31% when using the active head restraint, which is provided with an airbag. We have also managed to achieve significantly reduced head acceleration under impact.It was found that FEM seats with active head restraint, which is provided with an airbag, are the most secure because of the least NIC value under the impact (26.15.Presented in the article materials are used in teaching students at the department “Wheeled vehicles” of scientific and educational complex "Special engineering" in BMSTU.

  3. Unpacking the Treatment Contrast in the Head Start Impact Study: To What Extent Does Assignment to Treatment Affect Quality of Care?

    Science.gov (United States)

    Friedman-Krauss, Allison H.; Connors, Maia C.; Morris, Pamela A.

    2017-01-01

    Attending high-quality early childhood care and education (ECCE) is associated with higher cognitive and social-emotional skills, especially for children growing up in poverty, but access to high-quality ECCE is limited. This study capitalizes on the random assignment design of the Head Start Impact Study to better understand whether the…

  4. Outcome impact and cost-effectiveness of quality assurance for radiotherapy planned for the EORTC 22071-24071 prospective study for head and neck cancer

    NARCIS (Netherlands)

    Weber, Damien C.; Hurkmans, Coen W.; Melidis, Christos; Budach, Wilfried; Langendijk, Johannes H.; Peters, Lester J.; Gregoire, Vincent; Maingon, Philippe; Combescure, Christophe

    Introduction: One of the goals of Quality Assurance in Radiotherapy (QART) is to reduce the variability and uncertainties related to treatment planning and beam delivery. The purpose of this study was to assess the outcome impact and cost-effectiveness (CE) of various QART levels for a head and neck

  5. The impact of late treatment-toxicity on generic health-related quality of life in head and neck cancer patients after radiotherapy

    NARCIS (Netherlands)

    Ramaekers, Bram L. T.; Joore, Manuela A.; Grutters, Janneke P. C.; van den Ende, Piet; de Jong, Jos; Houben, Ruud; Lambin, Philippe; Christianen, Miranda; Beetz, Ivo; Pijls-Johannesma, Madelon; Langendijk, Johannes A.

    To examine the impact of late treatment-related xerostomia and dysphagia on health-related quality of life (HRQOL) in head and neck cancer (HNC) patients after radiotherapy. A multi-center cross-sectional survey was performed. Patients with a follow-up of at least 6 months after curative

  6. Premedication with meloxicam exacerbates intracranial hemorrhage in an immature swine model of non-impact inertial head injury

    Science.gov (United States)

    Friess, SH; Naim, MY; Kilbaugh, TJ; Ralston, J; Margulies, SS

    2014-01-01

    Meloxicam is a cyclo-oxgenase-2 preferential non-steroid anti-inflammatory drug with very effective analgesic and anti-inflammatory effects in swine. Previous reports in piglets have demonstrated that meloxicam also inhibits cyclo-oxgenase-1 and reduces production of thromboxane significantly. We use pre-injury analgesia in our immature swine (3–5 day old piglets) model of brain injury using rapid head rotations without impact. In 23 consecutive subjects we found that premedication with meloxicam (N=6) produced a significantly higher mortality rate (5/6 or 83%) than buprenorphine (N =17, 1/17 or 6%, p meloxicam-treated swine, we observed massive subdural and subarachnoid bleeding which were not present in buprenorphine-premedicated animals. To our knowledge there are no previous reports in swine of increased bleeding or platelet inhibition associated with meloxicam administration and further research is needed to define mechanisms of action in piglets. We caution the use of meloxicam in swine when inhibition of platelet aggregation might adversely affect refinement of experimental research protocols, such as in stroke, trauma, and cardiac arrest models. PMID:22238292

  7. Strain relief from the cerebral ventricles during head impact: experimental studies on natural protection of the brain.

    Science.gov (United States)

    Ivarsson, J; Viano, D C; Lövsund, P; Aldman, B

    2000-02-01

    Physical models of the parasagittal human skull/brain have been tested to investigate whether the cerebral ventricles provide natural protection of the brain by relieving strain during head rotation. A sophisticated model included anatomical structures, and a semicircular model consisted of a cylinder divided into two semicircles. Silicone gel simulated the brain and was detached from the vessel by a layer of liquid paraffin simulating the cerebrospinal fluid. Both models were run with and without an elliptical inclusion filled with liquid paraffin simulating a cerebral ventricle. The 2D models were exposed to angular acceleration by a pendulum impact causing 7600 rad/s2 peak rotational acceleration with 6 ms pulse duration. After rotating 100 degrees, the models were decelerated during 30 ms. The trajectory of grid markers was analyzed from high-speed video (1000 frames/s). Rigid-body displacement, shear strain and principal strain were determined from the displacement of three-point sets inferior and superior to the ventricle. For the subventricular (inferior) region in the sophisticated model, approximately 40% lower peak strain values were obtained in the model with ventricle than in the one without. Subcortical displacement was reduced by 12%. Corresponding strain reduction in the subcortical (superior) region was approximately 40% following the acceleration and 25% following the deceleration. Similar but less pronounced effects were found for the semicircular model. The lateral ventricles play an important role as strain relievers and provide natural protection against brain injury.

  8. The prevalence and impact of Fusarium head blight pathogens and mycotoxins on malting barley quality in UK

    Science.gov (United States)

    Nielsen, L.K.; Cook, D.J.; Edwards, S.G.; Ray, R.V.

    2014-01-01

    Fusarium head blight (FHB) caused by Fusarium and Microdochium species can significantly affect the yield of barley grain as well as the quality and safety of malt and beer. The present study provides new knowledge on the impacts of the FHB pathogen complex on the malting and brewing quality parameters of naturally infected barley. Quantitative real-time PCR and liquid chromatography double mass spectrometry were used to quantify the predominant FHB pathogens and Fusarium mycotoxins, respectively, in commercially grown UK malting barley samples collected between 2007 and 2011. The predominant Fusarium species identified across the years were F. poae, F. tricinctum and F. avenaceum. Microdochium majus was the predominant Microdochium species in 2007, 2008, 2010 and 2011 whilst Microdochium nivale predominated in 2009. Deoxynivalenol and zearalenone quantified in samples collected between 2007 and 2009 were associated with F. graminearum and F. culmorum, whilst HT-2 and T-2, and nivalenol in samples collected between 2010 and 2011 correlated positively with F. langsethiae and F. poae, respectively. Analysis of the regional distribution and yearly variation in samples from 2010 to 2011 showed significant differences in the composition of the FHB species complex. In most regions (Scotland, the South and North of England) the harvest in 2010 had higher concentrations of Fusarium spp. than in 2011, although no significant difference was observed in the Midlands between the two years. Microdochium DNA was significantly higher in 2011 and in the North of England and Scotland compared to the South or Midlands regions. Pathogens of the FHB complex impacted negatively on grain yield and quality parameters. Thousand grain weight of malting barley was affected significantly by M. nivale and M. majus whilst specific weight correlated negatively with F. avenaceum and F. graminearum. To determine the impact of sub-acute infections of the identified Fusarium and Microdochium

  9. Impact of Parent Practices of Infant Positioning on Head Orientation Profile and Development of Positional Plagiocephaly in Healthy Term Infants.

    Science.gov (United States)

    Leung, Amy; Mandrusiak, Allison; Watter, Pauline; Gavranich, John; Johnston, Leanne M

    2017-04-04

    The influence of infant positioning on the development of head orientation and plagiocephaly is not clear. This study explored the relationship between infant body and head positioning, with the development of asymmetrical head orientation and/or positional plagiocephaly. Methods: Clinician measurement of head orientation profile and parent-reported infant positioning data were collected for 94 healthy term infants at 3, 6, and 9 weeks of age. Plagiocephaly was measured at 9 weeks with the modified Cranial Vault Asymmetry Index. More severe plagiocephaly was associated with longer supine-sleep-maximum (p = 0.001) and longer supine-lying-total (p = 0.014) at 6 weeks. Prone positioning was not associated with plagiocephaly. Parent-reported head asymmetry during awake and sleep time at 3 weeks identified infants with clinician-measured head asymmetry at 9 weeks. Better symmetry in head turning was associated with more side-lying-total time by 9 weeks (p = 0.013). Our results showed that infant positioning is associated with early head orientation and plagiocephaly development. Early parent-reported asymmetry during awake and sleep time is an important indicator for the need for professional assessment and advice. A Plagiocephaly Prevention Strategy and Plagiocephaly Screening Pathway are provided for clinicians and parents.

  10. The psychological impact of annual chest X-ray follow-up in head and neck cancer

    NARCIS (Netherlands)

    Geurts, T. W.; Ackerstaff, A. H.; van Zandwijk, N.; Hart, A. A. M.; Hilgers, F. J. M.; Balm, A. J. M.

    2006-01-01

    CONCLUSION: Annual post-treatment screening of head and neck squamous cell carcinoma (HNSCC) patients for second primary lung cancer and metastatic recurrence appeared to form no major burden for head and neck cancer patients. A majority of patients regard the annual chest X-ray as a reassurance.

  11. Pediatric head and neck dynamics in frontal impact: analysis of important mechanical factors and proposed neck performance corridors for 6- and 10-year-old ATDs.

    Science.gov (United States)

    Dibb, Alan T; Cutcliffe, Hattie C; Luck, Jason F; Cox, Courtney A; Myers, Barry S; Bass, Cameron R; Arbogast, Kristy B; Seacrist, Thomas; Nightingale, Roger W

    2014-01-01

    Traumatic injuries are the leading cause of death of children aged 1-19 in the United States and are principally caused by motor vehicle collisions, with the head being the primary region injured. The neck, though not commonly injured, governs head kinematics and thus influences head injury. Vehicle improvements necessary to reduce these injuries are evaluated using anthropomorphic testing devices (ATDs). Current pediatric ATD head and neck properties were established by scaling adult properties using the size differences between adults and children. Due to the limitations of pediatric biomechanical research, computational models are the only available methods that combine all existing data to produce injury-relevant biofidelity specifications for ATDs. The purpose of this study is to provide the first frontal impact biofidelity corridors for neck flexion response of 6- and 10-year-olds using validated computational models, which are compared to the Hybrid III (HIII) ATD neck responses and the Mertz flexion corridors. Our virtual 6- and 10-year-old head and neck multibody models incorporate pediatric biomechanical properties obtained from pediatric cadaveric and radiological studies, include the effect of passive and active musculature, and are validated with data including pediatric volunteer 3 g dynamic frontal impact responses. We simulate ATD pendulum tests-used to calibrate HIII neck bending stiffness-to compare the pediatric model and HIII ATD neck bending stiffness and to compare the model flexion bending responses with the Mertz scaled neck flexion corridors. Additionally, pediatric response corridors for pendulum calibration tests and high-speed (15 g) frontal impacts are estimated through uncertainty analyses on primary model variables, with response corridors calculated from the average ± SD response over 650 simulations. The models are less stiff in dynamic anterioposterior bending than the ATDs; the secant stiffness of the 6- and 10-year-old models is

  12. Analysis of head impact exposure and brain microstructure response in a season-long application of a jugular vein compression collar: a prospective, neuroimaging investigation in American football

    Science.gov (United States)

    Myer, Gregory D; Yuan, Weihong; Barber Foss, Kim D; Thomas, Staci; Smith, David; Leach, James; Kiefer, Adam W; Dicesare, Chris; Adams, Janet; Gubanich, Paul J; Kitchen, Katie; Schneider, Daniel K; Braswell, Daniel; Krueger, Darcy; Altaye, Mekibib

    2016-01-01

    Background Historical approaches to protect the brain from outside the skull (eg, helmets and mouthpieces) have been ineffective in reducing internal injury to the brain that arises from energy absorption during sports-related collisions. We aimed to evaluate the effects of a neck collar, which applies gentle bilateral jugular vein compression, resulting in cerebral venous engorgement to reduce head impact energy absorption during collision. Specifically, we investigated the effect of collar wearing during head impact exposure on brain microstructure integrity following a competitive high school American football season. Methods A prospective longitudinal controlled trial was employed to evaluate the effects of collar wearing (n=32) relative to controls (CTRL; n=30) during one competitive football season (age: 17.04±0.67 years). Impact exposure was collected using helmet sensors and white matter (WM) integrity was quantified based on diffusion tensor imaging (DTI) serving as the primary outcome. Results With similar overall g-forces and total head impact exposure experienced in the two study groups during the season (p>0.05), significant preseason to postseason changes in mean diffusivity, axial diffusivity and radial diffusivity in the WM integrity were noted in the CTRL group (corrected p0.05). The CTRL group demonstrated significantly larger preseason to postseason DTI change in multiple WM regions compared with the collar group (corrected p<0.05). Discussion Reduced WM diffusivity alteration was noted in participants wearing a neck collar after a season of competitive football. Collar wearing may have provided a protective effect against brain microstructural changes after repetitive head impacts. Trial registration number NCT02696200. PMID:27307271

  13. Head injuries, heading, and the use of headgear in soccer.

    Science.gov (United States)

    Niedfeldt, Mark W

    2011-01-01

    Soccer has more than 265 million players around the world and is the only contact sport with purposeful use of the head for controlling and advancing the ball. Head contact in soccer has the potential to cause acute traumatic brain injury including concussion or, potentially, a pattern of chronic brain injury. Although early retrospective research on the effects of soccer heading seemed to suggest that purposeful heading may contribute to long-term cognitive impairment, prospective controlled studies do not support this and, in fact, suggest that purposeful heading may not be a risk factor for cognitive impairment. Headgear has not been shown to be effective in reducing ball impact but may be helpful in reducing the force of non-ball-related impacts to the head. There are concerns that universal use of headgear may cause more aggressive heading and head challenges, leading to increased risk of injury.

  14. Sex differences in head acceleration during heading while wearing soccer headgear

    National Research Council Canada - National Science Library

    Tierney, Ryan T; Higgins, Michael; Caswell, Shane V; Brady, Jessica; McHardy, Krista; Driban, Jeffrey B; Darvish, Kurosh

    2008-01-01

    .... Soccer headgear is marketed for reducing head acceleration and risk of concussion. To determine the effect of sex and soccer headgear on head impact kinematics and dynamic stabilization during soccer heading...

  15. Smoking has a negative impact upon health related quality of life after treatment for head and neck cancer

    DEFF Research Database (Denmark)

    Jensen, Kenneth; Jensen, Anders Bonde; Grau, Cai

    2006-01-01

    To examine the influence of smoking on observer based morbidity scores and patient assessed health related quality of life after treatment for head and neck cancer. The results of EORTC C30 and H&N35 questionnaires and DAHANCA morbidity scores were studied according to smoking status in 114...... recurrence free head and neck cancer patients. In contrast to observer based toxicity scoring, smoking had a significantly negative influence on 20 of the 33 quality of life scales. Previous smokers had quality of life scores in between never smokers and continuous smokers. Smoking after treatment of head...

  16. The impact of comorbidity on outcome in 12 623 Danish head and neck cancer patients: a population based study from the DAHANCA database

    DEFF Research Database (Denmark)

    Bøje, Charlotte Rotbøl; Dalton, Susanne Oksbjerg; Grønborg, Therese Koops

    2013-01-01

    Head and neck squamous cell carcinoma (HNSCC) is primarily caused by smoking and alcohol. Besides having a carcinogenic effect, smoking also leads to other diseases and thus contributes to a high prevalence of comorbidities among HNSCC patients. Furthermore, the world population is becoming older...... resulting in more elderly patients with HNSCC. The aim of this study was to investigate the prevalence and impact of comorbidity in a retrospective nationwide population-based study of all Danish HNSCC patients diagnosed from 1992 to 2008....

  17. Age at First Exposure to Repetitive Head Impacts Is Associated with Smaller Thalamic Volumes in Former Professional American Football Players.

    Science.gov (United States)

    Schultz, Vivian; Stern, Robert A; Tripodis, Yorghos; Stamm, Julie; Wrobel, Pawel; Lepage, Christian; Weir, Isabelle; Guenette, Jeffrey P; Chua, Alicia; Alosco, Michael L; Baugh, Christine M; Fritts, Nathan G; Martin, Brett M; Chaisson, Christine E; Coleman, Michael J; Lin, Alexander P; Pasternak, Ofer; Shenton, Martha E; Koerte, Inga K

    2017-11-17

    Thalamic atrophy has been associated with exposure to repetitive head impacts (RHI) in professional fighters. The aim of this study is to investigate whether or not age at first exposure (AFE) to RHI is associated with thalamic volume in symptomatic former National Football League (NFL) players at risk for chronic traumatic encephalopathy (CTE). Eighty-six symptomatic former NFL players (mean age = 54.9 ± 7.9 years) were included. T1-weighted data were acquired on a 3T magnetic resonance imager, and thalamic volumes were derived using FreeSurfer. Mood and behavior, psychomotor speed, and visual and verbal memory were assessed. The association between thalamic volume and AFE to playing football and to number of years playing was calculated. Decreased thalamic volume was associated with more years of play (left: p = 0.03; right: p = 0.03). Younger AFE was associated with decreased right thalamic volume (p = 0.014). This association remained significant after adjusting for total years of play. Decreased left thalamic volume was associated with worse visual memory (p = 0.014), whereas increased right thalamic volume was associated with fewer mood and behavior symptoms (p = 0.003). In our sample of symptomatic former NFL players at risk for CTE, total years of play and AFE were associated with decreased thalamic volume. The effect of AFE on right thalamic volume was almost twice as strong as the effect of total years of play. Our findings confirm previous reports of an association between thalamic volume and exposure to RHI. They suggest further that younger AFE may result in smaller thalamic volume later in life.

  18. The Impact of Secondary Lymphedema after Head and Neck Cancer Treatment on Symptoms, Functional Status, and Quality Of Life

    Science.gov (United States)

    Deng, Jie; Murphy, Barbara A.; Dietrich, Mary S.; Wells, Nancy; Wallston, Kenneth A.; Sinard, Robert J.; Cmelak, Anthony J.; Gilbert, Jill; Ridner, Sheila H.

    2014-01-01

    Background Lymphedema may disrupt local function and affect quality of life (QOL) in patients with head and neck cancer. The study aim was to examine the associations among severity of internal and external lymphedema, symptoms, functional status, and QOL in patients with head and neck cancer. Methods The sample included 103 patients who were ≥3 months post head and neck cancer treatment. Variables assessed included severity of internal and external lymphedema, physical/psychological symptoms, functional status, and QOL. Results Severity of internal and external lymphedema was associated with physical symptoms and psychological symptoms. Patients with more severe external lymphedema were more likely to have a decrease in neck left/right rotation. The combined effects of external and internal lymphedema severity were associated with hearing impairment and decreased QOL. Conclusions Lymphedema severity correlates with symptom burden, functional status, and QOL in patients post head and neck cancer treatment. PMID:22791550

  19. Finite element simulations of the head-brain responses to the top impacts of a construction helmet: Effects of the neck and body mass.

    Science.gov (United States)

    Wu, John Z; Pan, Christopher S; Wimer, Bryan M; Rosen, Charles L

    2017-01-01

    Traumatic brain injuries are among the most common severely disabling injuries in the United States. Construction helmets are considered essential personal protective equipment for reducing traumatic brain injury risks at work sites. In this study, we proposed a practical finite element modeling approach that would be suitable for engineers to optimize construction helmet design. The finite element model includes all essential anatomical structures of a human head (i.e. skin, scalp, skull, cerebrospinal fluid, brain, medulla, spinal cord, cervical vertebrae, and discs) and all major engineering components of a construction helmet (i.e. shell and suspension system). The head finite element model has been calibrated using the experimental data in the literature. It is technically difficult to precisely account for the effects of the neck and body mass on the dynamic responses, because the finite element model does not include the entire human body. An approximation approach has been developed to account for the effects of the neck and body mass on the dynamic responses of the head-brain. Using the proposed model, we have calculated the responses of the head-brain during a top impact when wearing a construction helmet. The proposed modeling approach would provide a tool to improve the helmet design on a biomechanical basis.

  20. Impact of Referral Protocols on the Dental Management of Patients Undergoing Treatment for Head and Neck Oncology in Northern Ireland.

    Science.gov (United States)

    Moore, Ciaran; Killough, Simon; Markey, Neill; McLister, Conor; McKenna, Gerald

    2016-03-01

    Management of head and neck oncology necessitates an extensive multidisciplinary approach. Throughout Northern Ireland all oral care for Head and Neck Oncology patients is overseen within the Centre for Dentistry, Queens University Belfast via referral from the Head and Neck Multidisciplinary Team. The aim of this study was to develop and introduce a referral pro-forma to improve communication between members of the multidisciplinary team and ultimately expedite provision of oral care prior to patients undergoing treatment for Head and Neck Oncology. The study period ran from June 2013 until November 2014. All patients undergoing treatment for Head and Neck Oncology in Northern Ireland were included in the study. A referral pro-forma was introduced in June 2014 in an attempt to streamline the referral process. Data was gathered on patient waiting times, extraction protocols with comparisons made between the period before and after introduction of the pro-forma. In total 137 patients were included in the study: 96 patients were referred to the service using referral letters, confidential emails and via telephone; 41 patients were referred using the pro-forma. The introduction of the referral pro-forma resulted in a significant decrease in the mean number of days from referral to assessment (12 to 7 days) (p dental assessment and having extractions completed in a more timely manner therefore expediting the commencement of their oncology treatment.

  1. The use of accident reconstruction for the analysis of traumatic brain injury due to head impacts arising from falls.

    Science.gov (United States)

    Doorly, M C; Gilchrist, M D

    2006-12-01

    Brain injury is the leading cause of death in those aged under 45 years in both Europe and the USA. The objective of this research is to reconstruct and analyse real world cases of accidental head injury, thereby providing accurate data, which can be used subsequently to develop clinical tolerance levels associated with particular traumatic injuries and brain lesions. This paper looks at using numerical modelling techniques, namely multibody body dynamics and finite element methods, to reconstruct two real-life accident cases arising from falls. Preliminary results show the levels of acceleration of the head and deformation of brain tissue correspond well to those found by other researchers, suggesting that this method is suitable for modeling head-injury accidents.

  2. How Big of an Effect Do Small Dams Have? Using Geomorphological Footprints to Quantify Spatial Impact of Low-Head Dams and Identify Patterns of Across-Dam Variation

    Science.gov (United States)

    Costigan, Katie H.; Daniels, Melinda D.

    2015-01-01

    Longitudinal connectivity is a fundamental characteristic of rivers that can be disrupted by natural and anthropogenic processes. Dams are significant disruptions to streams. Over 2,000,000 low-head dams (ecology are largely untested. Progress for research and conservation is impaired by not knowing the magnitude of low-head dam impacts. Based on the geomorphic literature, we refined a methodology that allowed us to quantify the spatial extent of low-head dam impacts (herein dam footprint), assessed variation in dam footprints across low-head dams within a river network, and identified select aspects of the context of this variation. Wetted width, depth, and substrate size distributions upstream and downstream of six low-head dams within the Upper Neosho River, Kansas, United States of America were measured. Total dam footprints averaged 7.9 km (3.0–15.3 km) or 287 wetted widths (136–437 wetted widths). Estimates included both upstream (mean: 6.7 km or 243 wetted widths) and downstream footprints (mean: 1.2 km or 44 wetted widths). Altogether the six low-head dams impacted 47.3 km (about 17%) of the mainstem in the river network. Despite differences in age, size, location, and primary function, the sizes of geomorphic footprints of individual low-head dams in the Upper Neosho river network were relatively similar. The number of upstream dams and distance to upstream dams, but not dam height, affected the spatial extent of dam footprints. In summary, ubiquitous low-head dams individually and cumulatively altered lotic ecosystems. Both characteristics of individual dams and the context of neighboring dams affected low-head dam impacts within the river network. For these reasons, low-head dams require a different, more integrative, approach for research and management than the individualistic approach that has been applied to larger dams. PMID:26540105

  3. The Impact of Supplemental Antioxidants on Visual Function in Nonadvanced Age-Related Macular Degeneration: A Head-to-Head Randomized Clinical Trial.

    Science.gov (United States)

    Akuffo, Kwadwo Owusu; Beatty, Stephen; Peto, Tunde; Stack, Jim; Stringham, Jim; Kelly, David; Leung, Irene; Corcoran, Laura; Nolan, John M

    2017-10-01

    The purpose of this study was to evaluate the impact of supplemental macular carotenoids (including versus not including meso-zeaxanthin) in combination with coantioxidants on visual function in patients with nonadvanced age-related macular degeneration. In this study, 121 participants were randomly assigned to group 1 (Age-Related Eye Disease Study 2 formulation with a low dose [25 mg] of zinc and an addition of 10 mg meso-zeaxanthin; n = 60) or group 2 (Age-Related Eye Disease Study 2 formulation with a low dose [25 mg] of zinc; n = 61). Visual function was assessed using best-corrected visual acuity, contrast sensitivity (CS), glare disability, retinal straylight, photostress recovery time, reading performance, and the National Eye Institute Visual Function Questionnaire-25. Macular pigment was measured using customized heterochromatic flicker photometry. There was a statistically significant improvement in the primary outcome measure (letter CS at 6 cycles per degree [6 cpd]) over time (P = 0.013), and this observed improvement was statistically comparable between interventions (P = 0.881). Statistically significant improvements in several secondary outcome visual function measures (letter CS at 1.2 and 2.4 cpd; mesopic and photopic CS at all spatial frequencies; mesopic glare disability at 1.5, 3, and 6 cpd; photopic glare disability at 1.5, 3, 6, and 12 cpd; photostress recovery time; retinal straylight; mean and maximum reading speed) were also observed over time (P 0.05, for all). Statistically significant increases in macular pigment at all eccentricities were observed over time (P 0.05). Antioxidant supplementation in patients with nonadvanced age-related macular degeneration results in significant increases in macular pigment and improvements in CS and other measures of visual function. (Clinical trial, http://www.isrctn.com/ISRCTN13894787).

  4. An assessment of the potential for neck injury due to padding of aircraft interior walls for head impact protection.

    Science.gov (United States)

    1993-08-01

    This report describes a short test program to assess the potential for neck injury induced by placing padding on the interior walls of an aircraft cabin to reduce the possibility of a head injury during a crash. Such padding is a possible mechanism o...

  5. Population dynamics and impacts of the red-headed leafy spurge stem borer on leafy spurge (Euphorbia esula)

    Science.gov (United States)

    Robert A. Progar; George Markin; Joseph Milan; Tom Barbouletos; Matthew J. Rinella

    2011-01-01

    We evaluated the efficacy of the biological control agent, red-headed leafy spurge stem borer, against the nonnative invasive plant leafy spurge. Our three treatments were release of the biological control agent into uncaged plots, release of the biological control agent into plots caged to prevent agent escape, and control plots caged to prevent agent entry. These...

  6. The Impact of the Chile Intervention on the Food Served in Head Start Centers in Rural New Mexico

    Science.gov (United States)

    Morshed, Alexandra B.; Davis, Sally M.; Keane, Patricia C.; Myers, Orrin B.; Mishra, Shiraz I.

    2016-01-01

    Background: The Child Health Initiative for Lifelong Eating and Exercise is a multicomponent obesity-prevention intervention, which was evaluated among Head Start (HS) centers in American Indian and predominantly Hispanic communities in rural New Mexico. This study examines the intervention's foodservice outcomes: fruits, vegetables, whole grains,…

  7. Head Injuries

    Science.gov (United States)

    ... ATV) Safety Balance Disorders Knowing Your Child's Medical History First Aid: Falls First Aid: Head Injuries Preventing Children's Sports Injuries Getting Help: Know the Numbers Concussions Stay ...

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

    OpenAIRE

    Case, D.; Richer, E.

    2016-01-01

    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...

  9. Quasi-Static Compression and Low-Velocity Impact Behavior of Tri-Axial Bio-Composite Structural Panels Using a Spherical Head

    Science.gov (United States)

    Li, Jinghao; Hunt, John F; Gong, Shaoqin; Cai, Zhiyong

    2017-01-01

    This paper presents experimental results of both quasi-static compression and low-velocity impact behavior for tri-axial bio-composite structural panels using a spherical load head. Panels were made having different core and face configurations. The results showed that panels made having either carbon fiber fabric composite faces or a foam-filled core had significantly improved impact and compressive performance over panels without either. Different localized impact responses were observed based on the location of the compression or impact relative to the tri-axial structural core; the core with a smaller structural element had better impact performance. Furthermore, during the early contact phase for both quasi-static compression and low-velocity impact tests, the panels with the same configuration had similar load-displacement responses. The experimental results show basic compression data could be used for the future design and optimization of tri-axial bio-composite structural panels for potential impact applications. PMID:28772542

  10. Quasi-Static Compression and Low-Velocity Impact Behavior of Tri-Axial Bio-Composite Structural Panels Using a Spherical Head

    Directory of Open Access Journals (Sweden)

    Jinghao Li

    2017-02-01

    Full Text Available This paper presents experimental results of both quasi-static compression and low-velocity impact behavior for tri-axial bio-composite structural panels using a spherical load head. Panels were made having different core and face configurations. The results showed that panels made having either carbon fiber fabric composite faces or a foam-filled core had significantly improved impact and compressive performance over panels without either. Different localized impact responses were observed based on the location of the compression or impact relative to the tri-axial structural core; the core with a smaller structural element had better impact performance. Furthermore, during the early contact phase for both quasi-static compression and low-velocity impact tests, the panels with the same configuration had similar load-displacement responses. The experimental results show basic compression data could be used for the future design and optimization of tri-axial bio-composite structural panels for potential impact applications.

  11. Do stigma and its psychosocial impact differ between Asian-born Chinese immigrants and Western-born Caucasians with head and neck cancer?

    Science.gov (United States)

    Lebel, Sophie; Payne, Ada Y M; Mah, Kenneth; Irish, Jonathan; Rodin, Gary; Devins, Gerald M

    2016-07-01

    Stigma appears to influence emotional distress and well-being in cancer survivors, but cross-cultural differences have been ignored. Previous studies suggest that stigma may be especially relevant for survivors of Asian origin. However, their study designs (e.g. focused on female cancers, qualitative designs, and an absence of comparison groups) limit the strength of this conclusion. We hypothesized that (1) Asian-born Chinese immigrants (AI) would report more perceived cancer-related stigma than Western-born Caucasians (WBC); and (2) the impact of stigma on emotional distress and well-being would be greater in AI as compared to WBC. Head and neck cancer survivors (n = 118 AI and n = 404 WBC) completed measures of well-being, emotional distress, and a three-item indicator of stigma in structured interviews. The majority of respondents (59%) reported one or more indicators of stigma. Stigma correlated significantly with emotional distress (r = .13, p = .004) and well-being (r = -.09, p = .032). Contrary to our hypotheses, WBCs and AIs did not differ in reported stigma nor did we detect differences in its psychosocial impact. Stigma exerts a deleterious psychosocial impact on head and neck cancer survivors. It did not differ significantly between AI and WBC survivors.

  12. A randomized clinical trial to evaluate the impact of a dental care program in the quality of life of head and neck cancer patients.

    Science.gov (United States)

    Funk, Camila Samara; Warmling, Cristine Maria; Baldisserotto, Julio

    2014-05-01

    A randomized clinical trial (RCT) to evaluate the impact of dental care program on the quality of life (QOL) of head and neck cancer patients under oncological treatment. The study design was a parallel RCT where 46 subjects with a diagnosis of head and neck primary neoplasy were randomly allocated to the control (CG) or test group (TG). Both groups received basic dental care but the TG received a complimentary care before and during, oncological therapy. Data related to general (WHOQOL-BREF) and specific (EORTC QLQ H&N 35) QOL were assessed before and 15 days after the conclusion of the oncological therapy. The TG showed an improvement in the general and specific QOL, while the CG showed a worsening in these indexes but without significant difference. The variation between the initial and final measures in the TG shows a tendency of significant improvement along the time. A reduction in candidiasis (p dental care was able to reduce damage from the oncological therapy especially related to muccositis and candidiasis, although the QOL was not significantly improved. However, a longer follow-up to measure the late side effects over the QOL of these patients is necessary. Provision of continuous dental care for head and neck cancer patients can reduce deleterious side effects of the oncological treatment.

  13. Crush characteristics and HIC values in front windshield areas in pedestrian head impacts; Joyosha zenmen mado garasu oyobi sono shuhenbu no shogeki tokusei to tobu shogaich

    Energy Technology Data Exchange (ETDEWEB)

    Matsui, Y.; Ishikawa, H. [Japan Automobile Research Institute Inc., Tsukuba (Japan)

    2000-04-01

    An experimental research was conducted to grasp pedestrian head protective performance in pedestrian-vehicle accident. In the recent accidents, pedestrian head collided with vehicle more at the front windshield than at the bonnet top. In the experiment, by colliding headform with the vehicle standstill, head injury coefficients (HIC) in impacts to front windshield and the periphery were measured. As to the headform, the main body made of phenol resin is covered by rubber skin with 7.5mm thickness. The diameter is 165mm, and the total weight is 4.8kg. HIC was obtained by a triaxial accelerator installed around the gravity center of the sphere. As a result of the experiment, the following were found out. The HIC value of the front windshield becomes 1000 or below when the headform is more than the radius of the headform away from the window frame. At the window frame, HIC in all the pillar area is high, but HIC at the central part of the roof rail becomes 1000 or below. The relation between HIC and dynamic displacement is almost the same both in the bonnet top and the front windshield. (translated by NEDO)

  14. Impact of low-level laser therapy on hyposalivation, salivary pH, and quality of life in head and neck cancer patients post-radiotherapy.

    Science.gov (United States)

    Palma, Luiz Felipe; Gonnelli, Fernanda Aurora Stabile; Marcucci, Marcelo; Dias, Rodrigo Souza; Giordani, Adelmo José; Segreto, Roberto Araújo; Segreto, Helena Regina Comodo

    2017-05-01

    Late effects of radiotherapy for head and neck cancer treatment have been increasingly investigated due to its impact on patients' quality of life. The purpose of this study was to evaluate the effect of low-level laser therapy on hyposalivation, low salivary pH, and quality of life in head and neck cancer patients post-radiotherapy. Twenty-nine patients with radiation-induced xerostomia received laser sessions twice a week, during 3 months (24 sessions). For this, a continuous wave Indium-Gallium-Aluminium-Phosphorus diode laser device was used punctually on the major salivary glands (808 nm, 0.75 W/cm 2 , 30 mW, illuminated area 0.04 cm 2 , 7.5 J/cm 2 , 10 s, 0.3 J). Six extraoral points were illuminated on each parotid gland and three on each submandibular gland, as well as two intraoral points on each sublingual gland. Stimulated and unstimulated salivary flow rate, pH (two scales with different gradations), and quality of life (University Of Washington Quality of Life Questionnaire for Patients with Head and Neck Cancer) were assessed at baseline and at the end of the treatment. There were significant increases in both mean salivary flow rates (unstimulated: p = 0.0012; stimulated: p cancer, thereby leading to an improvement in quality of life.

  15. Scatter radiation breast exposure during head CT: impact of scanning conditions and anthropometric parameters on shielded and unshielded breast dose

    Energy Technology Data Exchange (ETDEWEB)

    Klasic, B. [Hospital for pulmonary diseases, Zagreb (Croatia); Knezevic, Z.; Vekic, B. [Rudjer Boskovic Institute, Zagreb (Croatia); Brnic, Z.; Novacic, K. [Merkur Univ. Hospital, Zagreb (Croatia)

    2006-07-01

    Constantly increasing clinical requests for CT scanning of the head on our facility continue to raise concern regarding radiation exposure of patients, especially radiosensitive tissues positioned close to the scanning plane. The aim of our prospective study was to estimate scatter radiation doses to the breast from routine head CT scans, both with and without use of lead shielding, and to establish influence of various technical and anthropometric factors on doses using statistical data analysis. In 85 patient referred to head CT for objective medical reasons, one breast was covered with lead apron during CT scanning. Radiation doses were measured at skin of both breasts and over the apron simultaneously, by the use of thermo luminescent dosimeters. The doses showed a mean reduction by 37% due to lead shielding. After we statistically analyzed our data, we observed significant correlation between under-the-shield dose and values of technical parameters. We used multiple linear regression model to describe the relationships of doses to unshielded and shielded breast respectively, with anthropometric and technical factors. Our study proved lead shielding of the breast to be effective, easy to use and leading to a significant reduction in scatter dose. (author)

  16. The impact of treatment for head and neck cancer on positive psychological change within a year of completing treatment.

    Science.gov (United States)

    Harding, S; Moss, T P

    2018-03-01

    Head and neck cancer carries a high level of morbidity and mortality. So why could anyone find having such a disease a positive event? The adversity hypothesis of "what doesn't kill you makes you stronger" suggests that people can use adversity to develop as human beings. This positive psychological change has received little attention in relation to head and neck cancer. Responses to the Silver Lining Questionnaire, University of Washington Quality of Life Questionnaire, and Short-Form 12 were collected from a postal survey, 3 to 12 months after the completion of treatment for head and neck cancer. Fifty-two (63%) people returned the survey and were included in the analysis. Time since completion of therapy did not show any relationship with positive psychological change. Tumour stage and treatment regimen both had a relationship with positive change. Participants with lower stage tumours had higher levels of positive change than those with tumours of higher stages. Participants who had surgery alone reported more positive change than those who had surgery with radiotherapy. A social factor related to greater change was being married or living with a partner when compared to living alone. Further research would aid the identification of bio-psychosocial factors that influence the development of positive psychological change and inform the development of rehabilitation interventions. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. The impact of a community-based oral, head and neck cancer screening for reducing tobacco consumption.

    Science.gov (United States)

    Hapner, Edie R; Bauer, Kellie L; Wise, Justin C

    2011-11-01

    Examine the usefulness of large-scale community-based head and neck cancer screening for reducing tobacco use in an at-risk population. Questions answered: (1) Is participating in a community-based head and neck cancer screening related to a reduction in tobacco usage? (2) Do differing factors between participants predict behavior change? Survey based with a longitudinal follow-up component. Atlanta Motor Speedway during a National Association of Stock Car Auto Racing (NASCAR) race event. Recruited NASCAR fans (n = 620). Initial screening and 11-question survey for 6-month telephone follow-up. One hundred fifty-six participants (25%) required medical follow-up. Chi-square analysis indicated a significantly higher proportion of smokers (13%) evidenced positive findings compared to nonsmokers (8%) or past smokers (6%). Kruskal-Wallis analysis followed by Dunn's multiple comparison post hoc test indicated smokers were from a significantly lower socioeconomic status background compared to nonsmokers. Analysis of variance indicated contacted participants reported smoking significantly fewer cigarettes per day 6 months postscreening compared to the number of cigarettes smoked at the baseline. Forty-four (59%) participants reported reducing the number of cigarettes smoked per day, and 11 participants reported quitting smoking. The authors have demonstrated that large-scale community-based head and neck cancer screenings can be effectively implemented in nonmedical venues. This study demonstrated that targeting education for reduction of risk factors in the NASCAR population positively affected tobacco cessation.

  18. The impact of CBCT reconstruction and calibration for radiotherapy planning in the head and neck region - a phantom study.

    Science.gov (United States)

    Elstrøm, Ulrik V; Olsen, Sune R K; Muren, Ludvig P; Petersen, Jørgen B B; Grau, Cai

    2014-08-01

    The applicability of cone-beam computed tomography (CBCT) image sets for dose calculation purposes relies on high image quality and CT number accuracy. In this study we have investigated the use of stoichiometric calibration for transforming CT numbers into physical parameters, in combination with a new CBCT scatter correction algorithm, focusing on head and neck geometries. CBCT projections were acquired using an On-Board-Imager (OBI v1.4; Varian Medical Systems) using both low- and high-dose clinical image acquisition protocols. The CBCT projections were reconstructed twice, using both the standard method (OBI) as well as an experimental pre-clinical reconstruction algorithm (Full Fan Experimental - FFE). Stoichiometric calibration was performed using both a phantom from CIRS with nine tissue equivalent inserts (ranging from lung to dense bone) as well as with a custom made cylindrical PMMA head and neck phantom with variable 'head' diameter and with cavities designed to fit the inserts from a Gammex RMI phantom. To benchmark the CBCT performance, the same calibration procedures were performed using two conventional CT scanners. For assessment of influence on dose-volume parameters, the head part of the anthropomorphic Alderson phantom was scanned, reconstructed with both CT and CBCT using the stoichiometric calibration curves, and finally used to compare IMRT dose calculations. The stoichiometric CBCT calibrations with the CIRS phantom resulted in an excellent fit between calculated and measured CT numbers (R = 1.000 for all combinations tested), equivalent to the results for the conventional scanners. Using the PMMA phantom, the stoichiometric calibration curves again showed excellent agreement, although the OBI reconstruction showed marginally increasing deviation from the unity line as the phantom size decreased. For the dose-volume parameters, deviations well within 1% were seen between the different reconstruction methods and acquisition modes. This study

  19. Indirect Measurement of Head Orientation During Gy Acceleration

    National Research Council Canada - National Science Library

    Brungart, Douglas

    1995-01-01

    .... A retroactive study of data from +Gy impacts of instrumented human volunteers and manikins attempted to determine head position during peak head acceleration from the direction of the head acceleration vector...

  20. The Residual Setup Errors of Different IGRT Alignment Procedures for Head and Neck IMRT and the Resulting Dosimetric Impact

    Energy Technology Data Exchange (ETDEWEB)

    Graff, Pierre [Department of Radiation-Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California (United States); Radiation-Oncology, Alexis Vautrin Cancer Center, Vandoeuvre-Les-Nancy (France); Doctoral School BioSE (EA4360), Nancy (France); Kirby, Neil [Department of Radiation-Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California (United States); Weinberg, Vivian [Department of Radiation-Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California (United States); Department of Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California (United States); Chen, Josephine; Yom, Sue S. [Department of Radiation-Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California (United States); Lambert, Louise [Department of Radiation-Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California (United States); Radiation-Oncology, Montreal University Centre, Montreal (Canada); Pouliot, Jean, E-mail: jpouliot@radonc.ucsf.edu [Department of Radiation-Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California (United States)

    2013-05-01

    Purpose: To assess residual setup errors during head and neck radiation therapy and the resulting consequences for the delivered dose for various patient alignment procedures. Methods and Materials: Megavoltage cone beam computed tomography (MVCBCT) scans from 11 head and neck patients who underwent intensity modulated radiation therapy were used to assess setup errors. Each MVCBCT scan was registered to its reference planning kVCT, with seven different alignment procedures: automatic alignment and manual registration to 6 separate bony landmarks (sphenoid, left/right maxillary sinuses, mandible, cervical 1 [C1]-C2, and C7-thoracic 1 [T1] vertebrae). Shifts in the different alignments were compared with each other to determine whether there were any statistically significant differences. Then, the dose distribution was recalculated on 3 MVCBCT images per patient for every alignment procedure. The resulting dose-volume histograms for targets and organs at risk (OARs) were compared to those from the planning kVCTs. Results: The registration procedures produced statistically significant global differences in patient alignment and actual dose distribution, calling for a need for standardization of patient positioning. Vertically, the automatic, sphenoid, and maxillary sinuses alignments mainly generated posterior shifts and resulted in mean increases in maximal dose to OARs of >3% of the planned dose. The suggested choice of C1-C2 as a reference landmark appears valid, combining both OAR sparing and target coverage. Assuming this choice, relevant margins to apply around volumes of interest at the time of planning to take into account for the relative mobility of other regions are discussed. Conclusions: Use of different alignment procedures for treating head and neck patients produced variations in patient setup and dose distribution. With concern for standardizing practice, C1-C2 reference alignment with relevant margins around planning volumes seems to be a valid

  1. The residual setup errors of different IGRT alignment procedures for head and neck IMRT and the resulting dosimetric impact.

    Science.gov (United States)

    Graff, Pierre; Kirby, Neil; Weinberg, Vivian; Chen, Josephine; Yom, Sue S; Lambert, Louise; Pouliot, Jean

    2013-05-01

    To assess residual setup errors during head and neck radiation therapy and the resulting consequences for the delivered dose for various patient alignment procedures. Megavoltage cone beam computed tomography (MVCBCT) scans from 11 head and neck patients who underwent intensity modulated radiation therapy were used to assess setup errors. Each MVCBCT scan was registered to its reference planning kVCT, with seven different alignment procedures: automatic alignment and manual registration to 6 separate bony landmarks (sphenoid, left/right maxillary sinuses, mandible, cervical 1 [C1]-C2, and C7-thoracic 1 [T1] vertebrae). Shifts in the different alignments were compared with each other to determine whether there were any statistically significant differences. Then, the dose distribution was recalculated on 3 MVCBCT images per patient for every alignment procedure. The resulting dose-volume histograms for targets and organs at risk (OARs) were compared to those from the planning kVCTs. The registration procedures produced statistically significant global differences in patient alignment and actual dose distribution, calling for a need for standardization of patient positioning. Vertically, the automatic, sphenoid, and maxillary sinuses alignments mainly generated posterior shifts and resulted in mean increases in maximal dose to OARs of >3% of the planned dose. The suggested choice of C1-C2 as a reference landmark appears valid, combining both OAR sparing and target coverage. Assuming this choice, relevant margins to apply around volumes of interest at the time of planning to take into account for the relative mobility of other regions are discussed. Use of different alignment procedures for treating head and neck patients produced variations in patient setup and dose distribution. With concern for standardizing practice, C1-C2 reference alignment with relevant margins around planning volumes seems to be a valid option. Copyright © 2013 Elsevier Inc. All rights

  2. Head Lice

    Science.gov (United States)

    ... 1044-1047. Canyon, DV, Speare R, et al . “Spatial and kinetic factors for the transfer of head ... for children. Natural products can give parents false sense of safety If using a natural product or ...

  3. Analytical modelling of soccer heading

    Indian Academy of Sciences (India)

    Heading occur frequently in soccer games and studies have shown that repetitive heading of the soccer ball could result in degeneration of brain cells and lead to mild traumatic brain injury. This study proposes a two degree-of-freedom linear mathematical model to study the impact of the soccer ball on the brain. The model ...

  4. Impact of leadership styles adopted by head nurses on job satisfaction: a comparative study between governmental and private hospitals in Jordan.

    Science.gov (United States)

    Abdelhafiz, Ibrahim Mbarak; Alloubani, Aladeen Mah'D; Almatari, Mohammad

    2016-04-01

    Previous studies demonstrated that leadership styles are the basis of daily interactions between leaders and employees and facilitate and enhance work processes. This study aimed to explore how the leadership styles of nurse leaders affect job satisfaction among working nurses. Quantitative, descriptive and comparative methods were used. Three main Ministry of Health hospitals in different areas of Jordan and three private hospitals in Amman were selected. Among the leadership styles measured by the Multi-factor Leadership Questionnaire 5X, transformational leadership had been used by head nurse managers in both settings more than transactional leadership and passive-avoidant leadership. The level of job satisfaction among nursing staff was higher in public hospitals than in private hospitals in this study. A positive relationship was found between the overall score for transformational leadership and job satisfaction (r = 0.374**). The overall transactional leadership score correlated positively with job satisfaction (r = 0.391**). Conversely, the overall correlation between passive-avoidant leadership and job satisfaction was negative (r = -0.240). The increased development of transformational leadership behaviours increases nurses' job satisfaction and thus contributes to an increased retention of nurses. The ability of hospitals to address the leadership styles of head nurses and their impacts on job satisfaction will be strengthened. © 2015 John Wiley & Sons Ltd.

  5. Pediatric head injury.

    Science.gov (United States)

    Tulipan, N

    1998-01-01

    Pediatric head injury is a public health problem that exacts a high price from patients, their families and society alike. While much of the brain damage in head-injured patients occurs at the moment of impact, secondary injuries can be prevented by aggressive medical and surgical intervention. Modern imaging devices have simplified the task of diagnosing intracranial injuries. Recent advances in monitoring technology have made it easier to assess the effectiveness of medical therapy. These include intracranial pressure monitoring devices that are accurate and safe, and jugular bulb monitoring which provides a continuous, qualitative measure of cerebral blood flow. The cornerstones of treatment remain hyperventilation and osmotherapy. Despite maximal treatment, however, the mortality and morbidity associated with pediatric head injury remains high. Reduction of this mortality and morbidity will likely depend upon prevention rather than treatment.

  6. The impact of direct aperture optimization on plan quality and efficiency in complex head and neck IMRT

    Directory of Open Access Journals (Sweden)

    Sabatino Marcello

    2012-01-01

    Full Text Available Abstract Background Conventional step&shoot intensity modulated radio therapy (IMRT approaches potentially lead to treatment plans with high numbers of segments and monitor units (MU and, therefore, could be time consuming at the linear accelerator. Direct optimization methods are able to reduce the complexity without degrading the quality of the plan. The aim of this study is the evaluation of different IMRT approaches at standardized conditions for head and neck tumors. Method For 27 patients with carcinomas in the head and neck region a planning study with a 2-step-IMRT system (KonRad, a direct optimization system (Panther DAO and a mixture of both approaches (MasterPlan DSS was created. In order to avoid different prescription doses for boost volumes a simple standardization was realized. The dose was downscaled to 50 Gy to the planning target volume (PTV which included the primary tumor as well as the bilateral lymphatic drainage (cervical and supraclavicular. Dose restrictions for the organs at risk (OAR were downscaled to this prescription from high dose concepts up to 72 Gy. Those limits were defined as planning objectives while reaching definable PTV coverage with a standardized field setup. The parameters were evaluated from the corresponding dose volume histogram (DVH. Special attention was paid to the efficiency of the method, measured by means of calculated MU and required segments. Statistical tests of significance were applied to quantify the differences between the evaluated systems. Results PTV coverage for all systems in terms of V90% and V95% fell short of the requested 100% and 95%, respectively, but were still acceptable (range: 98.7% to 99.1% and 94.2% to 94.7%. Overall for OAR sparing and the burden of healthy tissue with low doses no technique was superior for all evaluated parameters. Differences were found for the number of segments where the direct optimization systems generated less segments. Lowest average numbers of

  7. Impact of concomitant chemoradiation on survival for patients with T1-2N1 head and neck cancer.

    Science.gov (United States)

    Zumsteg, Zachary S; Kim, Sungjin; David, John M; Yoshida, Emi J; Tighiouart, Mourad; Shiao, Stephen L; Scher, Kevin; Mita, Alain; Sherman, Eric J; Lee, Nancy Y; Ho, Allen S

    2017-05-01

    Single-modality radiotherapy is considered a standard-of-care option for certain stage III, T1-2N1 head and neck squamous cell carcinomas (HNSCCs). The role of concomitant chemoradiation is not well established because there have been no studies comparing chemoradiation with radiation alone in this population. This study analyzed patients in the National Cancer Data Base with cT1-2N1M0 invasive squamous cell carcinomas of the oropharynx, larynx, and hypopharynx who were diagnosed between 2004 and 2012 and were undergoing definitive radiation. Patients who were undergoing surgery before radiation with unknown follow-up or for whom either the receipt or timing of chemotherapy was unknown were excluded. In all, 5030 patients with T1-2N1 oropharyngeal, laryngeal, or hypopharyngeal cancer were included. The median follow-up was 56.8 months (95% confidence interval [CI], 55.7-58.6 months). Overall, 68% of the patients received concomitant chemoradiation (CCRT). The use of CCRT significantly increased during the time period of this study from 53% in 2004 to 78% in 2012 (P cancer (HR, 0.74; 95% CI, 0.65-0.85; P Cancer 2017;123:1555-1565. © 2017 American Cancer Society. © 2016 American Cancer Society.

  8. Evaluation of the impact of water harvesting techniques on the evolution of piezometric head of Ain El Bidha groundwater in Kairouan at the Central part of Tunisia

    Science.gov (United States)

    Mechergui, M. Mohamed; Henda Saoudi, Mme

    2016-04-01

    This study aims to assess the impact of water harvesting constructed hydraulic structures (big and small dams, terraces, seuils for recharge…) on the evolution of piezometric head of Ain El Beidha groundwater table. The measurements of depth of water table, taken at the end of rain season and at the end of irrigation season, in many piezometers and monitoring wells, for a long period of observation before and after implementation of all the hydraulic structures, were used with the cumulative rain to the highest water table to diagnostic the effect of natural recharge and constructed hydraulic structures. According to the analysis of curves illustrating the evolution of piezometric head and rainfall over time, it was shown that despite the fact that the same amount of rain fall on the total area in the limits of Ain El Beidha groundwater table, the piezometers respond differently. This is because there are many sources of recharge and many factors affecting the recharge. First of all, the aquifer is divided in four compartments (the calcareous formation of Djebel El Houyareb, the plio-quaternary formation, the Miocene formation: Baglia and Saouaf). All those respond differently to the recharge by their capacity of infiltration and their hydrodynamic characteristics. The recharge of the groundwater table was increased by the implementation of small soil and water conservation structures, artificial lakes, El Haouareb Dam, run off in the natural Oued bads and seuils for recharge installed in the bads of oueds. The different piezometric drown maps were used to determine the flow direction and hydraulic gradient in order to identify the recharge areas, while tracking maps for three equal piezometric heads 210 m 300 m and 370 m established over different years made it possible to assess the impact of hydraulic structures, namely the effect of SWC and Ben Zitoun Lake. To illustrate the impact of El Houareb dam on the groundwater, the piezometric maps and local values

  9. Head Start.

    Science.gov (United States)

    Greenman, Geri

    2000-01-01

    Discusses an art project in which students created drawings of mop heads. Explains that the approach of drawing was more important than the subject. States that the students used the chiaroscuro technique, used by Rembrandt and Caravaggio, in which light appears out of the darkness. (CMK)

  10. Impact of radiation-induced xerostomia on quality of life after primary radiotherapy among patients with head and neck cancer

    NARCIS (Netherlands)

    Jellema, Anke Petra; Slotman, Ben J.; Doornaert, Patricia; Leemans, C. Rene; Langendijk, Johannes A.

    2007-01-01

    Purpose: To investigate the impact of xerostomia on overall quality of life (QoL) outcome and related dimensions among bead and neck cancer patients treated with primary radiotherapy. Methods and Materials: A total of 288 patients with Stage I-IV disease without distant metastases were included.

  11. The impact of viewing a video with and without head phones on snack intake: A pilot study.

    Science.gov (United States)

    Dieze, Anastasia; Stephan, Theodora; Hilzendegen, Carolin; Stroebele-Benschop, Nanette

    2017-01-01

    Research shows that many small changes to the environment impact one's eating behavior. The aim of this study was to examine whether the type of audio transmission would affect snack intake depending on the degree of immersion. A sample of 174 university students were randomized to either viewing a movie wearing headphones or listening over loud speakers while consuming a snack of their choice. Significant differences were found with more snacks consumed in the group without headphones compared to the group wearing headphones. Particularly women tend to eat less (about 10% of the offered snack less) when wearing headphones while viewing a movie. The results seem to indicate that audio transmission mode might impact eating behavior.

  12. The impact of viewing a video with and without head phones on snack intake: A pilot study.

    Directory of Open Access Journals (Sweden)

    Anastasia Dieze

    Full Text Available Research shows that many small changes to the environment impact one's eating behavior. The aim of this study was to examine whether the type of audio transmission would affect snack intake depending on the degree of immersion. A sample of 174 university students were randomized to either viewing a movie wearing headphones or listening over loud speakers while consuming a snack of their choice. Significant differences were found with more snacks consumed in the group without headphones compared to the group wearing headphones. Particularly women tend to eat less (about 10% of the offered snack less when wearing headphones while viewing a movie. The results seem to indicate that audio transmission mode might impact eating behavior.

  13. The impact of taste and smell alterations on quality of life in head and neck cancer patients.

    Science.gov (United States)

    Alvarez-Camacho, M; Gonella, S; Ghosh, S; Kubrak, C; Scrimger, R A; Chu, K P; Wismer, W V

    2016-06-01

    Taste and smell alterations (TSAs) are among the most frequent and troublesome symptoms reported by head and neck cancer (HNC) patients after treatment. Little is known about the relationship between TSAs and quality of life (QoL) among HNC patients. The aim of this study was to determine the effect of TSAs on overall QoL among tube-fed and orally fed HNC patients before treatment, at end of treatment and at 2.5-month follow-up. Data were collected in a longitudinal study prior to treatment (n = 126), at end of treatment (n = 100) and at 2.5-month follow-up (n = 85). Chemosensory Complaint Score (CCS) and the University of Washington Quality of Life Questionnaire version 3 were used to assess TSAs and QoL, respectively. Generalized estimated equation modeling was used to estimate the effect of CCS on QoL. At end of treatment, QoL and CCS had declined for both tube-fed and orally fed patients and thereafter improved, but not to pre-treatment levels. Neither QoL nor CCS mean scores were different between the two groups at any time point. CCS was a significant predictor of overall QoL (β = -1.82, p < 0.0001), social-emotional (β = -1.76, p < 0.0001), physical (β = -1.12, p < 0.0001) and overall functions (β = -1.15, p < 0.0001) at a multivariate level. Taste was reported as an important symptom for both tube-fed and orally fed groups at end of treatment and follow-up. TSAs are an important symptom and an independent predictor of QoL for both tube-fed and orally fed HNC patients. HNC patients need support to manage TSAs, regardless of the method of nutritional intake.

  14. Evaluating the impact of an integrated multidisciplinary head & neck competency-based anatomy & radiology teaching approach in radiation oncology: a prospective cohort study

    Science.gov (United States)

    2014-01-01

    Background Modern radiation oncology demands a thorough understanding of gross and cross-sectional anatomy for diagnostic and therapeutic applications. Complex anatomic sites present challenges for learners and are not well-addressed in traditional postgraduate curricula. A multidisciplinary team (MDT) based head-and-neck gross and radiologic anatomy program for radiation oncology trainees was developed, piloted, and empirically assessed for efficacy and learning outcomes. Methods Four site-specific MDT head-and-neck seminars were implemented, each involving a MDT delivering didactic and case-based instruction, supplemented by cadaveric presentations. There was no dedicated contouring instruction. Pre- and post-testing were performed to assess knowledge, and ability to apply knowledge to the clinical setting as defined by accuracy of contouring. Paired analyses of knowledge pretests and posttests were performed by Wilcoxon matched-pair signed-rank test. Results Fifteen post-graduate trainees participated. A statistically significant (p comparing spatial overlap of participants’ pretest and posttest contours with a gold standard through the dice similarity coefficient. A statistically significant improvement in contouring accuracy was observed for 3 out of 20 anatomical structures. Qualitative and quantitative feedback revealed that participants were more confident at contouring and were enthusiastic towards the seminars. Conclusions MDT seminars were associated with improved knowledge scores and resident satisfaction; however, increased gross and cross-sectional anatomic knowledge did not translate into improvements in contouring accuracy. Further research should evaluate the impact of hands-on contouring sessions in addition to dedicated instructional sessions to develop competencies. PMID:24969509

  15. Single, Divorced, or Separated? Factors That Impact the Lives of Women Who Are Heads of Household in Lima, Peru

    Directory of Open Access Journals (Sweden)

    Beatriz Alvarado

    2015-10-01

    Full Text Available The rupture of a conjugal relationship has both a positive and negative impact on the lives of immediate family members. Although for many women terminating marriage may signal freedom from an oppressive, even violent conjugal relationship, it is undeniable that this separation also results in strong social pressure and discrimination in certain contexts, a situation which limits the woman’s freedom of action in and outside of the home. The purpose of this descriptive, phenomenological study is to explore the experiences of 15 Peruvian, urban-based mothers, all of whom made the decision to exchange marriage for single parenthood within the confines of a strong patriarchal system. The study follows the actions of the women as they seek to overcome obstacles related to parenting and the management of their respective households. Three emerging themes are identified in this study: (a the development of the woman’s relationship as wife and mother, (b impact of the separation/divorce on the maternal role, and (c experiences in the single parent household. Implications for social research studies and practice are discussed.

  16. Is HEADS in our heads?

    DEFF Research Database (Denmark)

    Boisen, Kirsten A; Hertz, Pernille Grarup; Blix, Charlotte

    2016-01-01

    BACKGROUND: Outpatient clinic visits are a window of opportunity to address health risk behaviors and promote a healthier lifestyle among young people. The HEADS (Home, Education, Eating, Activities, Drugs [i.e. substance use including tobacco, alcohol, and illegal drugs], Sexuality [including...... contraception], Safety, Self-harm) interview is a feasible way of exploring health risk behaviors and resilience. OBJECTIVE: The purpose of this study was to evaluate how often HEADS topics were addressed according to young patients and staff in pediatric and adult outpatient clinics. METHODS: We conducted...... care professionals participated. We found only small reported differences between staff and young patients regarding whether home, education, and activity were addressed. However, staff reported twice the rate of addressing smoking, alcohol, illegal drugs, sexuality, and contraception compared to young...

  17. Impact of Compliance on Dysphagia Rehabilitation in Head and Neck Cancer Patients: Results from a Multi-center Clinical Trial.

    Science.gov (United States)

    Krisciunas, Gintas P; Castellano, Kerlly; McCulloch, Timothy M; Lazarus, Cathy L; Pauloski, Barbara R; Meyer, Tanya K; Graner, Darlene; Van Daele, Douglas J; Silbergleit, Alice K; Crujido, Lisa R; Rybin, Denis; Doros, Gheorghe; Kotz, Tamar; Langmore, Susan E

    2017-04-01

    A 5-year, 16-site, randomized controlled trial enrolled 170 HNC survivors into active (estim + swallow exercise) or control (sham estim + swallowing exercise) arms. Primary analyses showed that estim did not enhance swallowing exercises. This secondary analysis determined if/how patient compliance impacted outcomes. A home program, performed 2 times/day, 6 days/week, for 12 weeks included stretches and 60 swallows paired with real or sham estim. Regular clinic visits ensured proper exercise execution, and detailed therapy checklists tracked patient compliance which was defined by mean number of sessions performed per week (0-12 times) over the 12-week intervention period. "Compliant" was defined as performing 10-12 sessions/week. Outcomes were changes in PAS, HNCI, PSS, OPSE, and hyoid excursion. ANCOVA analyses determined if outcomes differed between real/sham and compliant/noncompliant groups after 12 weeks of therapy. Of the 170 patients enrolled, 153 patients had compliance data. The mean number of sessions performed was 8.57/week (median = 10.25). Fifty-four percent of patients (n = 83) were considered "compliant." After 12 weeks of therapy, compliant patients in the sham estim group realized significantly better PAS scores than compliant patients in the active estim group (p = 0.0074). When pooling all patients together, there were no significant differences in outcomes between compliant and non-compliant patients. The addition of estim to swallowing exercises resulted in worse swallowing outcomes than exercises alone, which was more pronounced in compliant patients. Since neither compliant nor non-compliant patients benefitted from swallowing exercises, the proper dose and/or efficacy of swallowing exercises must also be questioned in this patient population.

  18. The Impact of Gender, Partner Status, and Race on Locoregional Failure and Overall Survival in Head and Neck Cancer Patients in Three Radiation Therapy Oncology Group (RTOG) Trials

    Science.gov (United States)

    Dilling, Thomas J.; Bae, Kyounghwa; Paulus, Rebecca; Watkins-Bruner, Deborah; Garden, Adam S.; Forastiere, Arlene; Ang, K. Kian; Movsas, Benjamin

    2011-01-01

    PURPOSE We investigated the impact of race, in conjunction with gender and partner status, on both locoregional control (LRC) and overall survival (OS) in three head and neck trials conducted by the Radiation Therapy Oncology Group (RTOG). METHODS AND MATERIALS Patients from RTOG 9003, 9111, and 9703 were included. Patients were stratified by treatment arms. Covariates of interest were partner status (partnered/non-partnered), race (white/non-white), and sex (female/male). Chi-square testing demonstrated homogeneity across treatment arms. Hazards ratio (HR) was used to estimate time to event outcome. Unadjusted and adjusted HRs were calculated for all covariates with associated 95% confidence intervals (CIs) and p-values. RESULTS 1736 patients were analyzed. Unpartnered males had inferior OS to partnered females (adjusted HR=1.22, 95% CI=(1.09, 1.36)), partnered males (adjusted HR=1.20, 95% CI=(1.09, 1.28)), and unpartnered females (adjusted HR=1.20, 95% CI=(1.09, 1.32)). White females had superior OS compared with white males, non-white females, and non-white males. Non-white males had inferior OS compared to white males. Partnered whites had improved OS relative to partnered non-white, unpartnered white, and unpartnered non-white patients. Unpartnered males had inferior LRC than partnered males (adjusted HR=1.26, 95% CI=(1.09, 1.46)) and unpartnered females (adjusted HR=1.30, 95% CI=(1.05, 1.62)). White females had superior LRC to non-white males and females. White males had improved LRC than non-white males. Partnered whites had improved LRC than partnered and unpartnered non-white patients. Unpartnered whites had improved LRC than unpartnered non-whites. CONCLUSIONS Race, gender, and partner status impacted on both overall survival and locoregional failure, both singly and in combination. PMID:21549515

  19. Feasibility and impact of a dedicated multidisciplinary rehabilitation program on health-related quality of life in advanced head and neck cancer patients.

    Science.gov (United States)

    Passchier, Ellen; Stuiver, Martijn M; van der Molen, Lisette; Kerkhof, Stefanie I C; van den Brekel, Michiel W M; Hilgers, Frans J M

    2016-06-01

    In an observational prospective study, feasibility and outcomes of a dedicated multidisciplinary rehabilitation program (HNR) for head and neck cancer (HNC) patients were evaluated. HRQoL was assessed before and after HNR with EORTC C30 and H&N-35 QoL questionnaires in 52 consecutive patients. Initial HRQoL scores were compared with EORTC reference scores for HNC patients and post-HNR with those available for the general healthy population. Distress was assessed before and after HNR with the distress thermometer (DT). At completion of HNR with a mean duration of 7 months, overall HRQoL was significantly improved (p < 0.001). Role, Emotional, and Social function scales and most EORTC C30 and H&N35 symptom scale items showed a statistically significant (p < 0.01) and clinically relevant improvement. Mean distress score before HNR was above the cutoff value of 5, suggesting the need for referral to rehabilitation. After completing HNR, distress decreased significantly to 3.0 (p < 0.001). HRQoL pretreatment was poorer than that of the EORTC reference HNC population, whereas at the completion of the HNR program, the HRQoL was comparable to that of the general population reference level. We conclude that a dedicated multidisciplinary HNR program is feasible and suggest that it has a positive impact on HRQoL. The multidisciplinary approach may have added value over mono-disciplinary interventions. However, our results should be judged cautiously due to the observational nature of the study.

  20. The incidence of trismus and long-term impact on health-related quality of life in patients with head and neck cancer.

    Science.gov (United States)

    Pauli, Nina; Johnson, Joakim; Finizia, Caterina; Andréll, Paulin

    2013-08-01

    Trismus is a common symptom related to the treatment of head and neck (H&N) cancer. To date there are few prospective studies regarding the incidence of trismus and the patients' experience of trismus in daily life activities. The aim of the study was to assess the incidence of trismus in H&N cancer patients and the impact on health-related quality of life (HRQL), by evaluating the patients before and after oncological treatment. We used the criteria for trismus of maximum interincisal opening (MIO) ≤ 35 mm and measured the patients at several occasions before and after treatment during one year. The patients answered the HRQL questionnaires EORTC QLQ C30, EORTC QLQ H&N 35, Gothenburg Trismus Questionnaire (GTQ) and the Hospital Anxiety and Depression Scale (HADS). The incidence of trismus was 9% pre-treatment and 28% at the one-year follow-up post-treatment. The highest incidence, 38%, was found six months post-treatment. Patients with tumours of the tonsils were most prone to develop trismus. Patients with trismus reported greater HRQL impairments with regard to the GTQ domains; mouth opening (p trismus, 6-12 months post-treatment. Furthermore, all patients reported pain, anxiety and depression pre- and post-treatment. The incidence of trismus in patients with H&N cancer is non-negligible. Trismus severely impairs HRQL and negatively affects daily life activities in patients with H&N cancer. Further studies regarding symptomatic treatment of patients with trismus are highly warranted. The symptom-specific questionnaire GTQ is useful to identify the problems in this group of patients given it is responsive to showing change over time.

  1. A Prediction of Response of the Head and Neck of the U.S. Adult Military Population to Dynamic Impact Acceleration from Selected Dynamic Test Subjects.

    Science.gov (United States)

    1976-05-01

    It noceeawy and )Aettfi O haack mombe) Dynamic Response of Head and Neck Physical Characteristics of Head and NecK Mathematical Model Simulationj...response of these volunteers to -Gx sled acca’eratioa at 6 and 15 G’s. Procedures used for comuting the various prameter vilues w-4 coeprisons between...may be used with . mathematical modeling techniques in order to extend and project the NAMRL dynamic response results to the general adult U.S

  2. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... of the Head? What is CT Scanning of the Head? Computed tomography, more commonly known as a ... of page What are some common uses of the procedure? CT scanning of the head is typically ...

  3. Sex differences in head acceleration during heading while wearing soccer headgear.

    Science.gov (United States)

    Tierney, Ryan T; Higgins, Michael; Caswell, Shane V; Brady, Jessica; McHardy, Krista; Driban, Jeffrey B; Darvish, Kurosh

    2008-01-01

    Researchers have indicated that female soccer players may be at greater risk of concussion compared with their male counterparts. Soccer headgear is marketed for reducing head acceleration and risk of concussion. To determine the effect of sex and soccer headgear on head impact kinematics and dynamic stabilization during soccer heading. Cross-sectional design. Research laboratory. Forty-four college-aged soccer players (29 women, 15 men). Using a head impact model, participants performed 4 soccer headers under 3 headgear conditions (control, Head Blast Soccer Band, and Full90 Select Performance Headguard). Dependent variables assessed before soccer heading were head-neck anthropometrics and isometric neck muscle strength, and those assessed during soccer headers were resultant linear head acceleration, Head Injury Criteria (HIC(36)), and superficial neck muscle electromyography. Statistical analyses included multivariate and univariate analyses of variance with repeated measures, independent-samples t tests, appropriate follow-up analyses of variance and post hoc t tests, and Pearson product moment correlations (alpha = .05). Head acceleration in women was 32% and 44% greater than in men when wearing the Head Blast (21.5 g versus 16.3 g) and Full90 Select (21.8 g versus 15.2 g), respectively (P headgear. Our results are important clinically because they indicate that soccer headgear may not be an appropriate head injury prevention tool for all athletes.

  4. Impact of communicative head movements on the quality of functional near-infrared spectroscopy signals: negligible effects for affirmative and negative gestures and consistent artifacts related to raising eyebrows

    Science.gov (United States)

    Balardin, Joana Bisol; Morais, Guilherme Augusto Zimeo; Furucho, Rogério Akira; Trambaiolli, Lucas Romualdo; Sato, João Ricardo

    2017-04-01

    Functional near-infrared spectroscopy (fNIRS) is currently one of the most promising tools in the neuroscientific research to study brain hemodynamics during naturalistic social communication. The application of fNIRS by studies in this field of knowledge has been widely justified by its strong resilience to motion artifacts, including those that might be generated by communicative head and facial movements. Previous studies have focused on the identification and correction of these artifacts, but a quantification of the differential contribution of common communicative movements on the quality of fNIRS signals is still missing. We assessed the impact of four movements (nodding head up and down, reading aloud, nodding head sideways, and raising eyebrows) performed during rest and task conditions on two metrics of signal quality control: an estimative of signal-to-noise performance and the negative correlation between oxygenated and deoxygenated hemoglobin (oxy-Hb and deoxy-Hb). Channel-wise group analysis confirmed the robustness of the fNIRS technique to head nodding movements but showed a large effect of raising eyebrows in both signal quality control metrics, both during task and rest conditions. Reading aloud did not disrupt the expected anticorrelation between oxy-Hb and deoxy-Hb but had a relatively large effect on signal-to-noise performance. These findings may have implications to the interpretation of fNIRS studies examining communicative processes.

  5. SU-F-R-38: Impact of Smoothing and Noise On Robustness of CBCT Textural Features for Prediction of Response to Radiotherapy Treatment of Head and Neck Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Bagher-Ebadian, H; Chetty, I; Liu, C; Movsas, B; Siddiqui, F [Henry Ford Health System, Detroit, MI (United States)

    2016-06-15

    Purpose: To examine the impact of image smoothing and noise on the robustness of textural information extracted from CBCT images for prediction of radiotherapy response for patients with head/neck (H/N) cancers. Methods: CBCT image datasets for 14 patients with H/N cancer treated with radiation (70 Gy in 35 fractions) were investigated. A deformable registration algorithm was used to fuse planning CT’s to CBCT’s. Tumor volume was automatically segmented on each CBCT image dataset. Local control at 1-year was used to classify 8 patients as responders (R), and 6 as non-responders (NR). A smoothing filter [2D Adaptive Weiner (2DAW) with 3 different windows (ψ=3, 5, and 7)], and two noise models (Poisson and Gaussian, SNR=25) were implemented, and independently applied to CBCT images. Twenty-two textural features, describing the spatial arrangement of voxel intensities calculated from gray-level co-occurrence matrices, were extracted for all tumor volumes. Results: Relative to CBCT images without smoothing, none of 22 textural features extracted showed any significant differences when smoothing was applied (using the 2DAW with filtering parameters of ψ=3 and 5), in the responder and non-responder groups. When smoothing, 2DAW with ψ=7 was applied, one textural feature, Information Measure of Correlation, was significantly different relative to no smoothing. Only 4 features (Energy, Entropy, Homogeneity, and Maximum-Probability) were found to be statistically different between the R and NR groups (Table 1). These features remained statistically significant discriminators for R and NR groups in presence of noise and smoothing. Conclusion: This preliminary work suggests that textural classifiers for response prediction, extracted from H&N CBCT images, are robust to low-power noise and low-pass filtering. While other types of filters will alter the spatial frequencies differently, these results are promising. The current study is subject to Type II errors. A much

  6. Computed tomography of head: impact of the use of automatic exposure control; Doses em tomografia computadorizada de crânio: impacto do uso do controle automático de exposição

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Giordana Salvi de Souza; Froner, Ana Paula Pastre; Silva, Ana Maria Marques da, E-mail: giordana.souza@acad.pucrs.br [Pontificia Universidade catolica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS (Brazil). Núcleo de Pesquisa em Imagens Médicas

    2017-07-01

    The use of dose reduction systems in computed tomography is particularly important for pediatric patients, who have a high radiosensitivity, since they are in the growing phase. The aim of this study was to evaluate the impact of Siemens AEC Care Dose system use on dose estimation in head computed tomography scans in pediatric patients. A retrospective study was conducted with 199 computed tomography head scans of pediatric patients, divided in different age groups, on a 16-channel Siemens Emotion scanner. It was possible to observe, for all age groups, that the use of AEC Care Dose system, not only reduced CTDI{sub vol}, but also the interquartile range, reducing the total dose in the investigated population. Concluding, AEC Care Dose system models the tube current according to the patient's dimensions, reducing individual and collective dose without affecting the diagnostic quality . (author)

  7. Mechanisms of head injuries in elite football.

    Science.gov (United States)

    Andersen, T E; Arnason, A; Engebretsen, L; Bahr, R

    2004-12-01

    The aim of this study was to describe, using video analysis, the mechanisms of head injuries and of incidents with a high risk of head injury in elite football. Videotapes and injury information were collected prospectively for 313 of the 409 matches played in the Norwegian (2000 season) and Icelandic (1999 and 2000 season) professional leagues. Video recordings of incidents where a player appeared to be hit in the head and the match was consequently interrupted by the referee were analysed and cross referenced with reports of acute time loss injuries from the team medical staff. The video analysis revealed 192 incidents (18.8 per 1000 player hours). Of the 297 acute injuries reported, 17 (6%) were head injuries, which corresponds to an incidence of 1.7 per 1000 player hours (concussion incidence 0.5 per 1000 player hours). The most common playing action was a heading duel with 112 cases (58%). The body part that hit the injured player's head was the elbow/arm/hand in 79 cases (41%), the head in 62 cases (32%), and the foot in 25 cases (13%). In 67 of the elbow/arm/hand impacts, the upper arm of the player causing the incident was at or above shoulder level, and the arm use was considered to be active in 61 incidents (77%) and intentional in 16 incidents (20%). This study suggests that video analysis provides detailed information about the mechanisms for head injuries in football. The most frequent injury mechanism was elbow to head contact, followed by head to head contact in heading duels. In the majority of the elbow to head incidents, the elbow was used actively at or above shoulder level, and stricter rule enforcement or even changes in the laws of the game concerning elbow use should perhaps be considered, in order to reduce the risk of head injury.

  8. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head Computed tomography (CT) of the head uses special x-ray ... Head? What is CT Scanning of the Head? Computed tomography, more commonly known as a CT or CAT ...

  9. Color, Capital, and the Climb to the Headship: The Impact of Social Capital on People of Color when Applying to Become a Head of an Independent School

    Science.gov (United States)

    Brown, Ara Carlos

    2012-01-01

    The literature on social networks, homophily, and educational backgrounds indicates that people of color have less access to the social capital that would be necessary to be considered for the position of head of an independent school in the United States. Furthermore, research indicates that people of color receive decreased returns on their…

  10. The impact of vasoactive substances on intraosseous pressure and blood flow alterations in the femoral head: a study based on magnetic resonance imaging

    NARCIS (Netherlands)

    Schneider, T.; Drescher, W.; Becker, C.; Schlack, W.; Sager, M.; Assheuer, J.; Rüther, W.

    1998-01-01

    In beagle dogs, the alterations of intraosseous pressure and blood supply in the femoral head that result from the administration of vasoactive substances were examined, and the changes were documented by magnetic resonance imaging (MRI). Vasoactive substance were infused into the medial and lateral

  11. Climate change impacts on the ecology of Fusarium graminearum species complex and susceptibility of wheat to Fusarium head blight: a review

    Science.gov (United States)

    Fusarium head blight (FHB) of wheat caused mainly by members of the Fusarium graminearum species complex (FGSC) is a major threat to agricultural grain production, food safety, and animal health. The severity of disease epidemics and accumulation of associated trichothecene mycotoxins in wheat kerne...

  12. Impact Findings from the Head Start CARES Demonstration: National Evaluation of Three Approaches to Improving Preschoolers' Social and Emotional Competence. Executive Summary. OPRE Report 2014-44

    Science.gov (United States)

    Morris, Pamela; Mattera, Shira K.; Castells, Nina; Bangser, Michael; Bierman, Karen; Raver, Cybele

    2014-01-01

    Low-income preschool children face risks to their social-emotional development that can affect them later on. Although there are promising approaches to promoting preschoolers' social-emotional skills, the evidence base is limited, particularly on their effectiveness when implemented at scale. The Head Start CARES demonstration evaluated the…

  13. Could the biological robustness of low level laser therapy (Photobiomodulation) impact its use in the management of mucositis in head and neck cancer patients

    NARCIS (Netherlands)

    Sonis, Stephen T.; Hashemi, Sepehr; Epstein, Joel B.; Nair, Raj G.; Raber-Durlacher, Judith E.

    2016-01-01

    Low level laser therapy (LLLT) has been noted to be effective in mitigating the development of oral mucositis among patients being treated with chemoradiation for cancers of the head and neck. To explain the biological basis for this observation we performed a comprehensive literature search. Our

  14. The impact of Chinese cultural values on Taiwan nursing leadership styles: comparing the self-assessments of staff nurses and head nurses.

    Science.gov (United States)

    Chang, Yuanmay

    2008-06-01

    The purpose of this study was to investigate the influence of Chinese culture on nursing leadership behavior in Taiwan nurses. A descriptive study compared staff nurses' assessment of Chinese value in the leadership behavior of their head nurses. Data analysis was made on a convenience sample in Taiwan of 214 head nurses and 2,127 staff nurses who had worked with their head nurse for at least one year. Six medical centers and regional hospitals in northern (Taipei), central (Taichung) and southern (Kaohsiung) Taiwan were recruited for this study. Instruments included the demographic questionnaire, Chinese Value Survey, and Kang's Chinese Leadership Behaviors Module Scale. Results indicated that head nurses scored significantly higher than staff nurses in terms of all cultural values and leadership behaviors. Both staff nurses and head nurses scored the highest mean scores in personal integrity (Yi) and human connectedness (Ren) and the lowest in moral discipline (Li). Staff nurse perceptions of leadership behavior indicated the role of parent to be higher than either the role of director or mentor. Head nurses perceptions of leadership behavior emphasized the role of the director more than either parent or mentor. There were no significant differences between the staff nurses and head nurses in terms of expectative leadership behavior, which gave the role of director higher mean scores than those of either the parent or mentor. Positive and significant associations (r = .266 to r = .334) were found between cultural values and perceptions of leadership behavior. Cultural values predicted 10.6% of leadership behavior variance. The three demographic characteristics of location in northern Taiwan (beta = .09), intention to leave (beta = -.14), and general unit (beta = .10) and the two cultural values of human connectedness (Ren) (beta = .16) and personal integrity (Yi) (beta = .16) together reported a cumulative R2 of 14.6% to explain variance in leadership behavior

  15. The impact of use of Glutamine on patients with head and neck tumors in radiotherapy and chemotherapy treatment; O Impacto do uso de Glutamina em pacientes com tumores de cabeca e pescoco em tratamento radioterapico e quimioterapico

    Energy Technology Data Exchange (ETDEWEB)

    Boligon, Caroline Schardong, E-mail: caronut@bol.com.b [Hospital de Caridade de Ijui, RS (Brazil); Huth, Adriane, E-mail: adriane.huth@unijui.edu.b [UNIJUI, RS (Brazil). Dept. Ciencias da Saude

    2011-07-01

    Introduction: patients with head and neck neoplasia usually show malnutrition or a nutritional risk, because of common symptoms like: dysphagia, odynophagia and xerostomia. Objective: this study aimed to verify the impact of using amino glutamine in patients with head and neck neoplasia and under radiotherapy and chemotherapy treatment concomitantly. Methods: the research was quantitative, cross-sectional, descriptive and exploratory. The data was collected from nutritional evaluation, and patients chart consultation. The patients were divided in a control group (without use of glutamine) and a test group (with use of glutamine). 16 patients, 13 of which were men and three were women, participated in the research. Results: The control group presented mucositis grades I to IV while patients who used the amino glutamine showed mucositis grades I to II only. It could be observed that the Nutritional Risk Index decreased, which represents higher nutritional risk in patients from the control group only. In patients who used glutamine, this decrease was not significant. Conclusion: these results suggest that the use of glutamine in patients with head and neck tumors and under antineoplastic therapy helps to maintain their nutritional stage and to prevent mucositis throughout their treatment, mainly grades III and IV, which prevents adequate and regular eating and nourishment. (author)

  16. The impact of 8 weeks selected corrective exercises on neck pain, range of motion in the shoulder and neck of lifesaver women who suffering from forward head posture and myofascial pain syndrome

    Directory of Open Access Journals (Sweden)

    Melody Tabatabaei

    2017-06-01

    Full Text Available Background: The purpose of this research was studying the impact of 8 weeks selected corrective exercises on neck pain, range of motion in the shoulder and neck of lifesaver women who suffering from forward head posture and myofascial pain syndrome. Methods: The method of research is semi-experimental. The population consists of 30 lifesaver women who suffering from forward head posture and myofascial pain syndrome who they placed randomly in two groups of experimental (33±2.2 and control (33±2.5. Research plan was as the pre-test and post-test with control group. The exercise protocol was carried out by experimental groups for 8 weeks, 3 sessions per week, each session lasting 45 minutes. Studied variables include myofascial pain in the neck, shoulder and neck range of motion. The mean and standard deviation were used as descriptive statistics and in the section of inferential statistics analysis of covariance was used. Results: Results of research indicated that, the protocol on the reform exercise of neck pain (P=0.001, range of motion of shoulder joint (P=0.001 and neck range of motion (P=0.001 has significant difference. Conclusion: Therefore, lifesavers women can benefit from it as a training program to improve and prevent damage caused by head forward and myofascial pain syndrome.

  17. Force, Frequency of Head Hits Jump as Young Football Players Get Older

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_166906.html Force, Frequency of Head Hits Jump as Young Football Players ... is based on a comparison of head impact frequency and impact force among groups of kids between ...

  18. The impact of oral rehabilitation on oral health-related quality of life in patients receiving radiotherapy for the treatment of head and neck cancer.

    Science.gov (United States)

    Schweyen, Ramona; Kuhnt, Thomas; Wienke, Andreas; Eckert, Alexander; Hey, Jeremias

    2017-05-01

    To analyze the influence of dental treatment on oral health-related quality of life (OHRQoL) in head and neck cancer patients. This study included the data of 116 patients who underwent radiotherapy (RT) because of head and neck cancer. For each patient, the variables age, sex, tumor site, irradiation technique, dose on the spared parotid gland, concomitant chemotherapy, and denture status were documented. OHRQoL was determined using the OHIP-G14 questionnaire. Patients were divided into subgroups according to denture status: none or fixed partial dentures (none/FPD), removable partial dentures (RPD), and full dentures (CD). OHIP summary scores were determined and tested for clinical relevant differences with respect to the different variables. The association between OHRQol and the variables was assessed using linear regression. No clinically relevant influence on OHRQoL was found for gender, irradiation technique, and chemotherapy. Patients with tumors located in the oral cavity had a significantly higher OHIP score than patients with other tumor sites (p < 0.001). None/FPD and RPD patients had higher values than those found in a normal population, but did not differ significantly from each other (p = 0.387). In contrast to tumor site, teeth and type of denture seem to have a limited effect on OHRQoL in head and neck cancer patients. Prosthetic treatment in head and neck cancer patients do not lead to the same improvement in OHRQoL as found in the normal population. This might be taken into account especially if extensive dental treatment is intended.

  19. Multigenerational Head Start Participation: An Unexpected Marker of Progress

    Science.gov (United States)

    Chor, Elise

    2018-01-01

    One-quarter of the Head Start population has a mother who participated in the program as a child. This study uses experimental Head Start Impact Study (HSIS) data on 3- and 4-year-olds (N = 2,849) to describe multigenerational Head Start families and their program experiences. In sharp contrast to full-sample HSIS findings, Head Start has large,…

  20. Head injury - first aid

    Science.gov (United States)

    ... medlineplus.gov/ency/article/000028.htm Head injury - first aid To use the sharing features on this page, ... a concussion can range from mild to severe. First Aid Learning to recognize a serious head injury and ...

  1. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... the head is typically used to detect: bleeding, brain injury and skull fractures in patients with head injuries. ... hard time staying still, are claustrophobic or have chronic pain, you may find a CT exam to ...

  2. Head and face reconstruction

    Science.gov (United States)

    ... medlineplus.gov/ency/article/002980.htm Head and face reconstruction To use the sharing features on this page, please enable JavaScript. Head and face reconstruction is surgery to repair or reshape deformities ...

  3. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... the limitations of CT Scanning of the Head? What is CT Scanning of the Head? Computed tomography, ... than regular radiographs (x-rays). top of page What are some common uses of the procedure? CT ...

  4. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... for Brain Tumors Radiation Therapy for Head and Neck Cancer Others American Stroke Association National Stroke Association ... Computer Tomography (CT) Safety During Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine ...

  5. Newborn head molding

    Science.gov (United States)

    Newborn cranial deformation; Molding of the newborn's head; Neonatal care - head molding ... The bones of a newborn baby's skull are soft and flexible, with gaps between the plates of bone. The spaces between the bony plates of ...

  6. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... limitations of CT Scanning of the Head? What is CT Scanning of the Head? Computed tomography, more commonly known as a ... top of page What are some common uses of the procedure? CT scanning of the head is ...

  7. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Computed tomography (CT) of the head uses special x-ray equipment to help assess head injuries, severe headaches, dizziness, and other symptoms of ... content. Related Articles and Media Radiation Dose in X-Ray and CT ... Perfusion of the Head CT Angiography (CTA) Stroke Brain Tumors Computer Tomography ( ...

  8. The Impact Of Oral Vitamin E In Preventing Mucositis (Bucal Mucous Inflammation Resulting From The Radiotherapy In Tumors Of Head And Neck

    Directory of Open Access Journals (Sweden)

    Bahador M

    2004-07-01

    Full Text Available Background: Mucositis [bucal Mucous inflamation] is the most common complication resulting from the radiotherapy in tumors of head and neck. These malignancies are often curable through radiotherapy. This complication, however, may impair the treatment process and cause malnutrition. So far no medicine has been Known to prevent this complication. Vitamin E is a stabilizer of cell membrane and is also used in mucositis treatment. The survey of oral vitamin E effect on mucositis prophylaxis in radiotherapy of head and neck malignancies. Materials and Methods: Seventy patients afflicted with head and neck malignancies referring to Imam Khomeini Hospital were randomly divided into 2groups, two of whom died during treatment process. The first group (The case group consisting of 34 patients Consumed oral vitamin E 200 mg daily for seven days. The second group (The control group did not use any medicine at all. The two group underwent radiotherapy. They were compared and contrasted as to mucositis severity and dysphagia during treatment. Results: In the first group, since the fourth week up to the end of the treatment, there was a lower frequency and grade of mucositis in contrast with the control group. In the fourth week, the grade two mucositis in the first group (Case group was 20.6% and 47.5% in the control group the difference was statistically significant (P=0.024. There was also a lower frequency and grade of dysphagia in the case group since the fourth week versus the control group. In the fourth week, moderate dysphagia was 29.4% in the case group and 55.9% in the control group. The difference was statistically significant (P=0.023. Conclusion: Oral vitamin E has Proved to be effective in the Prophylaxis of Moderate and severe mucositis and dysphagia resulting from radiotherapy. It is advisable to conduct more research with more cases, lengthier duration and heavier doses.

  9. Mechanical properties and anthropometry of the human infant head.

    Science.gov (United States)

    Prange, Michael T; Luck, Jason F; Dibb, Alan; Van Ee, Chris A; Nightingale, Roger W; Myers, Barry S

    2004-11-01

    The adult head has been studied extensively and computationally modeled for impact, however there have been few studies that attempt to quantify the mechanical properties of the pediatric skull. Likewise, little documentation of pediatric anthropometry exists. We hypothesize that the properties of the human pediatric skull differ from the human adult skull and exhibit viscoelastic structural properties. Quasi-static and dynamic compression tests were performed using the whole head of three human neonate specimens (ages 1 to 11 days old). Whole head compression tests were performed in a MTS servo-hydraulic actuator. Testing was conducted using nondestructive quasi-static, and constant velocity protocols in the anterior-posterior and right-left directions. In addition, the pediatric head specimens were dropped from 15cm and 30cm and impact force-time histories were measured for five different locations: vertex, occiput, forehead, right and left parietal region. The compression stiffness values increased with an increase in velocity but were not significantly different between the anterior-posterior and right-left directions. Peak head acceleration during the head impact tests did not significantly vary between the five different impact locations. A three parameter model that included damping represented the pediatric head impact data more accurately than a simple mass-spring system. The compressive and impact stiffness of the pediatric heads were significantly more compliant than published adult values. Also, infant head dimensions, center of gravity and moment of inertia (Iyy) were determined. The CRABI 6-month dummy impact response was similar to the infant cadaver for impacts to the vertex, occiput, and forehead but dramatically stiffer in lateral impacts. These pediatric head anthropomorphic, compression, and impact data will provide a basis to validate whole head models and compare with ATD performance in similar exposures.

  10. Magnetic Resonance Imaging (MRI) -- Head

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head ... limitations of MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is ...

  11. The impact of tumour volume and other characteristics on uptake of radiolabelled monoclonal antibodies in tumour tissue of head and neck cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Bree, R. de; Quak, J.J.; Brekel, M.W.M. van den; Snow, G.B.; Dongen, G.A.M.S. van [Department of Otolaryngology/Head and Neck Surgery, University Hospital Vrije Universiteit, Amsterdam (Netherlands); Kuik, D.J. [Department of Medical Statistics, University Hospital Vrije Universiteit, Amsterdam (Netherlands); Roos, J.C.; Greuter, H. [Department of Nuclear Medicine, University Hospital Vrije Universiteit, Amsterdam (Netherlands); Castelijns, J.A.; Wagtendonk, F.W. van [Department of Radiology, University Hospital Vrije Universiteit, Amsterdam (Netherlands)

    1998-11-01

    Radioimmunotherapy (RIT) seems to be a realistic option for eradication of minimal residual squamous cell carcinoma of the head and neck (HNSCC), although uptake levels of radiolabelled monoclonal antibodies (MAbs) in tumour tissue vary strongly. The aim of this study was to obtain greater insight into the factors influencing the accumulation of MAbs in HNSCC. Twenty-seven HNSCC patients were injected with radiolabelled MAb E48 or U36 and underwent surgery 2 days after injection. Radioactivity was measured in tumour biopsies taken from the surgical specimen. Uptake levels were correlated with various patient, tumour and MAb characteristics, including age, sex, site, TNM stage, volume as assesssed by computed tomography or magnetic resonance imaging, degree of differentiation, antigen expression of the tumour, the particular MAb that had been injected and the MAb dose. A stepwise regression multivariate analysis showed that tumour volume is the most significant prognostic factor (P=0.01) for MAb uptake. In conclusion, a significantly higher MAb uptake is found in small tumours as compared to larger tumours. Therefore, RIT may be particularly effective in head and neck cancer patients when used in an adjuvant setting. (orig.) With 1 fig., 1 tab., 10 refs.

  12. Impact of Salinity on the Incubation Rate and the Performance during the Nursery Phase of Square Head Climbing Perch (Anabas testudineus Bloch, 1792

    Directory of Open Access Journals (Sweden)

    Le, DV.

    2016-01-01

    Full Text Available Square head climbing perch (Anabas testudineus Bloch, 1792 is a high quality fish without small bones. It grows in a wide range of temperatures (10-42 oC, pH (3.5-9.5 and salinity (up to 16%. As regards climate change, this species may become important for aquaculture in the Tam Giang-Cau Hai lagoon near Hue city. To optimise the quality of fingerlings, we analyzed the effect of salinity levels on hatching and nursing in three subsequent experiments. Fertilization, hatching, survival and growth rates for 30 days were determined at salinity levels 0%, 5%, 7%, 13% and 15%. Water temperature and pH varied between 22-29.5 oC and 7.3-7.8, respectively. Between 0-5%, fertilization ratio was 77% to 83% and highest at 5%, but this dropped to 0% when salinity increased; hatching ratio was larger than 90%, but decreased to 0% at 13-15%. Between 0-11%, hatching time of fertilized eggs was not affected by salinity levels. The ratio of deformation gradually increased above 5%. After hatching at either 0 or 5%, survival ratios for square head climbing perch were above 13% up to 5%, but dropped to 0% at 9%. The growth after 30 days of nursing was higher at 5 and 7% compared with that of 0 and 3%.

  13. Effects of Soccer Heading on Brain Structure and Function

    Science.gov (United States)

    Rodrigues, Ana Carolina; Lasmar, Rodrigo Pace; Caramelli, Paulo

    2016-01-01

    Soccer is the most popular sport in the world, with more than 265 million players worldwide, including professional and amateur ones. Soccer is unique in comparison to other sports, as it is the only sport in which participants purposely use their head to hit the ball. Heading is considered as an offensive or defensive move whereby the player’s unprotected head is used to deliberately impact the ball and direct it during play. A soccer player can be subjected to an average of 6–12 incidents of heading the ball per competitive game, where the ball reaches high velocities. Moreover, in practice sessions, heading training, which involves heading the ball repeatedly at low velocities, is common. Although the scientific community, as well as the media, has focused on the effects of concussions in contact sports, the role of subconcussive impacts, as it can occur during heading, has recently gained attention, considering that it may represent an additional mechanism of cumulative brain injury. The purpose of this study is to review the existing literature regarding the effects of soccer heading on brain structure and function. Only in the last years, some investigations have addressed the impact of heading on brain structure, by using neuroimaging techniques. Similarly, there have been some recent studies investigating biochemical markers of brain injury in soccer players. There is evidence of association between heading and abnormal brain structure, but the data are still preliminary. Also, some studies have suggested that subconcussive head impacts, as heading, could cause cognitive impairment, whereas others have not corroborated this finding. Questions persist as to whether or not heading is deleterious to cognitive functioning. Further studies, especially with longitudinal designs, are needed to clarify the clinical significance of heading as a cause of brain injury and to identify risk factors. Such investigations might contribute to the establishment of safety

  14. Effects of soccer heading on brain structure and function

    Directory of Open Access Journals (Sweden)

    Ana Carolina Oliveira Rodrigues

    2016-03-01

    Full Text Available Soccer is the most popular sport in the world, with more than 265 million players worldwide, including professional and amateur ones. Soccer is unique in comparison to other sports, as it is the only sport in which participants purposely use their head to hit the ball. Heading is considered an offensive or defensive move whereby the player’s unprotected head is used to deliberately impact the ball and direct it during play. A soccer player can be subjected to an average of six to twelve incidents of heading the ball per competitive game, where the ball reaches high velocities. Moreover, in practice sessions, heading training, which involves heading the ball repeatedly at low velocities, is common. Although the scientific community, as well as the media, has focused on the effects of concussions in contact sports, the role of subconcussive impacts, as it can occur during heading, has recently gained attention, considering that it may represent an additional mechanism of cumulative brain injury. The purpose of this study is to review the existing literature regarding the effects of soccer heading on brain structure and function. Only in the last years some investigations have addressed the impact of heading on brain structure, by using neuroimaging techniques. Similarly, there have been some recent studies investigating biochemical markers of brain injury in soccer players. There is evidence of association between heading and abnormal brain structure, but the data are still preliminary. Also, some studies have suggested that subconcussive head impacts, as heading, could cause cognitive impairment, whereas others have not corroborated this finding. Questions persist as to whether or not heading is deleterious to cognitive functioning. Further studies, especially with longitudinal designs, are needed to clarify the clinical significance of heading as a cause of brain injury and to identify risk factors. Such investigations might contribute to the

  15. Could the biological robustness of low level laser therapy (Photobiomodulation) impact its use in the management of mucositis in head and neck cancer patients.

    Science.gov (United States)

    Sonis, Stephen T; Hashemi, Sepehr; Epstein, Joel B; Nair, Raj G; Raber-Durlacher, Judith E

    2016-03-01

    Low level laser therapy (LLLT) has been noted to be effective in mitigating the development of oral mucositis among patients being treated with chemoradiation for cancers of the head and neck. To explain the biological basis for this observation we performed a comprehensive literature search. Our investigation identified a substantial number of LLLT-activated pathways that have been strongly associated with negative tumor outcomes including proliferation, invasion, angiogenesis, metastases and cancer-treatment resistance. In light of these findings, we suggest an investigational strategy to assure that LLLT's anti-mucositis efficacy is independent of its possible potential to enhance threatening tumor behaviors. Included are appropriate pre-clinical modeling, short- and long-term follow-up of LLLT-treated patients, and the requirement for consistency of LLLT parameters. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Pretreatment microRNA Expression Impacting on Epithelial-to-Mesenchymal Transition Predicts Intrinsic Radiosensitivity in Head and Neck Cancer Cell Lines and Patients.

    Science.gov (United States)

    de Jong, Monique C; Ten Hoeve, Jelle J; Grénman, Reidar; Wessels, Lodewyk F; Kerkhoven, Ron; Te Riele, Hein; van den Brekel, Michiel W M; Verheij, Marcel; Begg, Adrian C

    2015-12-15

    Predominant causes of head and neck cancer recurrence after radiotherapy are rapid repopulation, hypoxia, fraction of cancer stem cells, and intrinsic radioresistance. Currently, intrinsic radioresistance can only be assessed by ex vivo colony assays. Besides being time-consuming, colony assays do not identify causes of intrinsic resistance. We aimed to identify a biomarker for intrinsic radioresistance to be used before start of treatment and to reveal biologic processes that could be targeted to overcome intrinsic resistance. We analyzed both microRNA and mRNA expression in a large panel of head and neck squamous cell carcinoma (HNSCC) cell lines. Expression was measured on both irradiated and unirradiated samples. Results were validated using modified cell lines and a series of patients with laryngeal cancer. miRs, mRNAs, and gene sets that correlated with resistance could be identified from expression data of unirradiated cells. The presence of epithelial-to-mesenchymal transition (EMT) and low expression of miRs involved in the inhibition of EMT were important radioresistance determinants. This finding was validated in two independent cell line pairs, in which the induction of EMT reduced radiosensitivity. Moreover, low expression of the most important miR (miR-203) was shown to correlate with local disease recurrence after radiotherapy in a series of patients with laryngeal cancer. These findings indicate that EMT and low expression of EMT-inhibiting miRs, especially miR-203, measured in pretreatment material, causes intrinsic radioresistance of HNSCC, which could enable identification and treatment modification of radioresistant tumors. Clin Cancer Res; 21(24); 5630-8. ©2015 AACR. ©2015 American Association for Cancer Research.

  17. Head Injuries in Soccer.

    Science.gov (United States)

    Myrick, Karen M

    2016-07-01

    Soccer is currently the most popular and fastest growing sport worldwide, with approximately 265 million registered soccer players existing around the world. The popularity of the sport, coupled with the high incidence of 18.8-21.5 head injuries per 1,000 player hours reported, make it essential that clinicians, coaches, and the athletes, have a solid understanding of head injuries. The successful rehabilitation of athletes with head injuries relies upon early and accurate identification strategies and implementation of appropriate return to play measures across all areas in the continuum of care. Soccer is a frequently played sport, and head injuries are common. Therefore, it is imperative that clinicians, coaches, and the athletes themselves have a solid understanding of head injury prevention, diagnosis, and treatment options. The purpose of this article was to provide rehabilitation nurses with current information regarding frequently occurring head injuries in the widespread sport of soccer. © 2015 Association of Rehabilitation Nurses.

  18. Head and Neck

    DEFF Research Database (Denmark)

    Højgaard, Liselotte; Berthelsen, Anne Kiil; Loft, Annika

    2014-01-01

    Positron emission tomography (PET)/computed tomography with FDG of the head and neck region is mainly used for the diagnosis of head and neck cancer, for staging, treatment evaluation, relapse, and planning of surgery and radio therapy. This article is a practical guide of imaging techniques......, including a detailed protocol for FDG PET in head and neck imaging, physiologic findings, and pitfalls in selected case stories....

  19. Prognostic Impact of Expression of Bcl-2 and Bax Genes in Circulating Immune Cells Derived from Patients with Head and Neck Carcinoma

    Directory of Open Access Journals (Sweden)

    Tomoyuki Tano

    2013-03-01

    Full Text Available Antitumor functions of the host immune system are frequently compromised in patients with malignancies. In the current study, we evaluated the relationship between expression ratio of mRNAs for the antiapoptotic protein Bcl-2 and the proapoptotic protein Bax (the Bcl-2/Bax ratio in peripheral blood mononuclear cells and clinical outcomes in patients with head and neck carcinomas. The overall survival (OS time of patients with Bcl-2/Bax ratios ≥ 1.2 tended to be longer than that of patients with Bcl-2/Bax ratios < 1.2 but not significantly so (P = .084, n = 61. Disease-free survival (DFS of patients with Bcl-2/Bax ratios ≥ 1.2 was statistically significantly longer than that of patients with Bcl-2/Bax ratios < 1.2 (P = .001, n = 76. All of the patients whose Bcl-2/Bax ratio is ≥ 2.0 were alive after 36 months and survived without any evidence of disease for 24 months (Bcl-2/Bax ≥ 2.0 versus Bcl-2/Bax < 2.0; P = .035, n = 61 in OS, P < .001, n = 76 in DFS, respectively. In 56 patients who received immunochemoradiotherapy using UFT and OK-432 in combination with radiotherapy, a statistically significant relationship between the Bcl-2/Bax ratio and the therapeutic effect estimated using Response Evaluation Criteria in Solid Tumors was observed, as well as a relation with interferon-γ (IFN-γ induction in response to the therapy [P = .002 in complete response versus partial response + stable disease; P = .046 in IFN-γ(+ versus IFN-γ(-]. In addition, there were significant correlations of the Bcl-2/Bax ratio with both the absolute number of CD4+ T cells and the rate of CD4+ T cell and natural killer cell activity. These findings strongly suggest that the balance of expression of Bcl-2 and Bax genes in circulating immune cells has a high prognostic value in head and neck cancer patients.

  20. Different impact of heat-inactivated and viable lactic acid bacteria of aquatic origin on turbot (Scophthalmus maximus L.) head-kidney leucocytes.

    Science.gov (United States)

    Muñoz-Atienza, Estefanía; Araújo, Carlos; Lluch, Nuria; Hernández, Pablo E; Herranz, Carmen; Cintas, Luis M; Magadán, Susana

    2015-05-01

    In aquaculture, several criteria should be considered to select an appropriate probiotic, including the aquatic origin and safety of the strain and its ability to modulate the host immune response. The properties and effects of probiotics are strain-specific and some factors such as viability, dose and duration of diet supplementation may regulate their immunomodulatory activities. In this study, we assessed the in vitro effect of eight heat-inactivated and viable lactic acid bacteria (LAB) of aquatic origin belonging to the genera Enterococcus, Lactobacillus, Lactococcus, Leuconostoc, Pediococcus and Weissella on the viability and innate immune response of turbot (Scophthalmus maximus L.) leucocytes. Head-kidney leucocytes were incubated with viable and heat-inactivated LAB at different concentrations. After incubation, the viability of leucocytes was evaluated using colorimetric assays (MTT and LDH) and flow cytometry (annexin V/propidium iodide). Heat-inactivated LAB showed no cytotoxic effect while viable LAB exerted variable influence on apoptosis of turbot phagocytes and lymphocytes. Leucocyte respiratory burst activity and phagocytosis were also differentially activated, as viable LAB stimulated leucocytes more efficiently than the heat-inactivated LAB. Our results suggest diverse strain-specific mechanisms of interaction between the evaluated LAB and turbot leucocytes. Furthermore, our work sets up in vitro systems to evaluate the effect of LAB as potential probiotics, which will be useful to develop efficient screening. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Reverse breech extraction versus the standard approach of pushing the impacted fetal head up through the vagina in caesarean section for obstructed labour: A randomised controlled trial.

    Science.gov (United States)

    Nooh, Ahmed Mohamed; Abdeldayem, Hussein Mohammed; Ben-Affan, Othman

    2017-05-01

    The objective of this study was to assess effectiveness and safety of the reverse breech extraction approach in Caesarean section for obstructed labour, and compare it with the standard approach of pushing the fetal head up through the vagina. This randomised controlled trial included 192 women. In 96, the baby was delivered by the 'reverse breech extraction approach', and in the remaining 96, by the 'standard approach'. Extension of uterine incision occurred in 18 participants (18.8%) in the reverse breech extraction approach group, and 46 (47.9%) in the standard approach group (p = .0003). Two women (2.1%) in the reverse breech extraction approach group needed blood transfusion and 11 (11.5%) in the standard approach group (p = .012). Pyrexia developed in 3 participants (3.1%) in the reverse breech extraction approach group, and 19 (19.8%) in the standard approach group (p = .0006). Wound infection occurred in 2 women (2.1%) in the reverse breech extraction approach group, and 12 (12.5%) in the standard approach group (p = .007). Apgar score vagina.

  2. Impact of interfractional changes in head and neck cancer patients on the delivered dose in intensity modulated radiotherapy with protons and photons.

    Science.gov (United States)

    Müller, Birgit Sabine; Duma, Marciana Nona; Kampfer, Severin; Nill, Simeon; Oelfke, Uwe; Geinitz, Hans; Wilkens, Jan Jakob

    2015-05-01

    To investigate the influence of interfractional changes on the delivered dose of intensity modulated proton (IMPT) and photon plans (IMXT). Five postoperative head and neck cancer patients, previously treated with tomotherapy at our institute, were analyzed. The planning study is based on megavoltage (MV) control images. For each patient one IMPT plan and one IMXT plan were generated on the first MV-CT and recalculated on weekly control MV-CTs in the actual treatment position. Dose criteria for evaluation were coverage and conformity of the planning target volume (PTV), as well as mean dose to parotids and maximum dose to spinal cord. Considerable dosimetric changes were observed for IMPT and IMXT plans. Proton plans showed a more pronounced increase of maximum dose and decrease of minimum dose with local underdosage occurring even in the center of the PTV (worst IMPT vs. IMXT coverage: 66.7% vs. 85.0%). The doses to organs at risk (OARs) increased during the treatment period. However, the OAR doses of IMPT stayed below corresponding IMXT values at any time. For both modalities treatment plans did not necessarily worsen monotonically throughout the treatment. Although absolute differences between planned and reconstructed doses were larger in IMPT plans, doses to OARs were higher in IMXT plans. Tumor coverage was more stable in IMXT plans; IMPT dose distributions indicated a high risk for local underdosage during the treatment course. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  3. We Look More, Listen More, Notice More: Impact of Sustained Professional Development on Head Start Teachers' Inquiry-Based and Culturally-Relevant Science Teaching Practices

    Science.gov (United States)

    Roehrig, Gillian H.; Dubosarsky, Mia; Mason, Annie; Carlson, Stephan; Murphy, Barbara

    2011-10-01

    Despite many scholars' recommendations, science is often avoided during early childhood education. Among the reasons provided by early childhood teachers for the exclusion of science from their daily routines included science anxiety, low self-efficacy with respect to teaching science, lack of experience participating in science activities as students, or the notion that literacy and language are more important during the early years. In minority populations the problem is even greater due to identification of science with the `culture of. This article presents results from Ah Neen Dush, a sustained and transformative professional development program for Head Start teachers on an American Indian Reservation. The goal of the program is to support early childhood teachers in developing inquiry-based and culturally-relevant teaching practices. Through analysis of teachers' classroom practices, surveys and interviews, we explore changes in teachers' attitudes toward science and inquiry-based practices. Classroom observations were conducted using CLASS (Classroom assessment Scoring System), a tool used to evaluate the quality of classroom interactions. After 1 year of professional development teachers' attitudes were found to improve and after 2 years teachers classroom practices were more inquiry-based with statistically significant increases in CLASS observation scores.

  4. Monte Carlo based investigations of electron contamination from telecobalt unit head in build up region and its impact on surface dose.

    Science.gov (United States)

    Jagtap, A S; Palani Selvam, T; Patil, B J; Chavan, S T; Pethe, S N; Kulkarni, Gauri; Dahiwale, S S; Bhoraskar, V N; Dhole, S D

    2016-12-01

    A Telecobalt unit has wide range of applications in cancer treatments and is used widely in many countries all around the world. Estimation of surface dose in Cobalt-60 teletherapy machine becomes important since clinically useful photon beam consist of contaminated electrons during the patient treatment. EGSnrc along with the BEAMnrc user code was used to model the Theratron 780E telecobalt unit. Central axis depth dose profiles including surface doses have been estimated for the field sizes of 0×0, 6×6, 10×10, 15×15, 20×20, 25×25, 30×30cm(2) and at Source-to-surface distance (SSD) of 60 and 80cm. Surface dose was measured experimentally by the Gafchromic RTQA2 films and are in good agreement with the simulation results. The central axis depth dose data are compared with the data available from the British Journal of Radiology report no. 25. Contribution of contaminated electrons has also been calculated using Monte Carlo simulation by the different parts of the Cobalt-60 head for different field size and SSD's. Moreover, depth dose curve in zero area field size is calculated by extrapolation method and compared with the already published data. They are found in good agreement. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Computed tomography (CT) of the head uses special x-ray equipment to help assess head injuries, severe headaches, ... is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside ...

  6. Head Injuries in Children

    Science.gov (United States)

    Pennington, Nicole

    2010-01-01

    School nurses play a crucial role in injury prevention and initial treatment when injuries occur at school. The role of school nurses includes being knowledgeable about the management of head injuries, including assessment and initial treatment. The school nurse must be familiar with the outcomes of a head injury and know when further evaluation…

  7. Abnormal Head Position

    Science.gov (United States)

    ... non-ocular causes of an abnormal head position? Congenital shortening of the neck muscles (sternocleidomastoid) can cause a head tilt. This is ... amblyopia) are other treatment alternatives. Physical therapy helps congenital torticollis from tight neck muscles. Updated ... Terms & Conditions Most Common ...

  8. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... the limitations of CT Scanning of the Head? What is CT Scanning of the Head? Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside of ...

  9. Head Start in Action.

    Science.gov (United States)

    Riley, Clara M. D.; Epps, Frances M. J.

    Records and observations from a summer Head Start program, conducted in Los Angeles by Delta Sigma Theta, are delineated in this book. It relates firsthand experiences of the participating personnel as they developed and implemented a Head Start program for some 300 children. The book is divided into three sections. Section I,…

  10. Fear of Cancer Recurrence and Its Impacts on Quality of Life in Family Caregivers of Patients With Head and Neck Cancers.

    Science.gov (United States)

    Lin, Ching-Rong; Chen, Shu-Ching; Chang, Joseph Tung-Chien; Fang, Yuan-Yuan; Lai, Yeur-Hur

    2016-09-01

    Fear of cancer recurrence (FCR) is a major concern for family caregivers (FCs) caring for patients with head and neck cancers (HNCs). This study (a) investigated the FCR experience of HNC FCs, (b) compared the differences in the FCR levels of FCs while taking care of patients with different lengths of time since completing major treatments (posttreatment durations), and (c) examined the correlation between FCR and quality of life (QOL) in these FCs. A cross-sectional study was conducted in the radiation outpatient department of a medical center in northern Taiwan. A set of questionnaires, including the Fear of Cancer Recurrence Inventory-Caregiver version and the Medical Outcomes Short-Form Health Survey, and a background information form were employed. One-way analysis of variance was used to examine the differences in the FCR and QOL among groups of FCs taking care of patients with different posttreatment durations (typically concurrent chemoradiotherapy). Pearson's correlation was used to identify the relationship between FCR and QOL. Two hundred fifty FCs were recruited in this study. The FCs used several coping and reassurance strategies to address their FCR experiences. Those FCs who cared for patients with short posttreatment durations (3-6 and 6-12 months) showed significantly higher overall FCR levels and higher FCR severity levels than those who cared for patients with long posttreatment durations (more than 5 years). High FCR was negatively correlated with physical and mental QOL. The results suggest that FCs caring for patients with a relatively short posttreatment duration experience higher levels of FCR than those caring for patients with a longer posttreatment duration. In clinical settings, healthcare providers should use posttreatment duration as an indicator of risk of FCR in caregivers to address FCR and provide appropriate support. Future research should develop and examine interventions to help HNC FCs cope effectively with their FCR and

  11. Baseline head in Olkiluoto

    Energy Technology Data Exchange (ETDEWEB)

    Ahokas, H.; Tammisto, E.; Lehtimaeki, T. (Poeyry Environment Oy, Vantaa (Finland))

    2008-11-15

    As part of the programme for the final disposal of the spent nuclear fuel, Posiva Oy investigates the prevailing hydrological conditions on Olkiluoto island. The hydrological investigations have included several kinds of hydrological tests such as measurements of hydraulic conductivity by flow logging and a double-packer tool as well as interference tests by pumping, in order to study the hydraulic connections between the drillholes. In addition, long-term monitoring of groundwater level and groundwater head as well as measurements of flow conditions in open drillholes, groundwater salinity (in situ EC), precipitation (including snow), sea-water level, surface flow (runoff) etc. have been part of the investigation programme aiming at the characterization of the bedrock. The data have been used in the compilation of deterministic hydro-zones and hydraulic properties for numerical flow modelling to study the flow pattern on Olkiluoto island. In addition, the compiled bedrock models have been used in the planning of the repository layout and in the analyses of the transport of radionuclides and the functionality of engineered barriers. This report focuses on the measurements of groundwater head by means of multi-packers and in connection with flow loggings. The determination of the undisturbed groundwater head (baseline head) in terms of the in situ fresh water head is the main goal of this report. The density of groundwater is strongly dependent on salinity and due to the saline groundwater deep in the bedrock in Olkiluoto the term fresh water head is used instead of hydraulic head. Taking the density of groundwater into account, the gradient of the residual pressure, which actually causes groundwater flow can be calculated. The measured and calculated heads are converted into corresponding in situ fresh water heads, which correspond to the water level (metres above sea level) in the hose that runs from the packed-off section to the ground surface. This means that

  12. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... the limitations of MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive ... top of page What are some common uses of the procedure? MR imaging of the head is ...

  13. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive ... of page What are some common uses of the procedure? MR imaging of the head is performed ...

  14. Ulnar head replacement.

    Science.gov (United States)

    Herbert, Timothy J; van Schoonhoven, Joerg

    2007-03-01

    Recent years have seen an increasing awareness of the anatomical and biomechanical significance of the distal radioulnar joint (DRUJ). With this has come a more critical approach to surgical management of DRUJ disorders and a realization that all forms of "excision arthroplasty" can only restore forearm rotation at the expense of forearm stability. This, in turn, has led to renewed interest in prosthetic replacement of the ulnar head, a procedure that had previously fallen into disrepute because of material failures with early implants, in particular, the Swanson silicone ulnar head replacement. In response to these early failures, a new prosthesis was developed in the early 1990s, using materials designed to withstand the loads across the DRUJ associated with normal functional use of the upper limb. Released onto the market in 1995 (Herbert ulnar head prosthesis), clinical experience during the last 10 years has shown that this prosthesis is able to restore forearm function after ulnar head excision and that the materials (ceramic head and noncemented titanium stem), even with normal use of the limb, are showing no signs of failure in the medium to long term. As experience with the use of an ulnar head prosthesis grows, so does its acceptance as a viable and attractive alternative to more traditional operations, such as the Darrach and Sauve-Kapandji procedures. This article discusses the current indications and contraindications for ulnar head replacement and details the surgical procedure, rehabilitation, and likely outcomes.

  15. Tolerance of the Head and Neck to -Gx Inertial Loading of the Head

    Science.gov (United States)

    1981-03-09

    cervical muscles reduced the inci- dence of "concussion" symptons produced in this animal, Collars on monkeys subjected to flexion producing occipital...muscles reduced the incidence of "concussion" symptoms produced in this animal. Collars on monkeys subjected to flexion producing occipital impacts, were...4 In a repeat run to determine what caused the losA of un- consciousness in Run 133, Stapp, with head held down to aviod amplification of head

  16. Car Accident Reconstruction and Head Injury Correlation

    Science.gov (United States)

    Chawla, A.; Grover, V.; Mukherjee, S.; Hassan, A. M.

    2013-04-01

    Estimation of brain damage remains an elusive issue and controlled tests leading to brain damage cannot be carried out on volunteers. This study reconstructs real-world car accidents to estimate the kinematics of the head impact. This data is to be used to estimate the head injury measures through computer simulations and then correlate reported skull as well as brain damage to impact measures; whence validating the head FE model (Willinger, IJCrash 8:605-617, 2003). In this study, two crash cases were reconstructed. Injury correlation was successful in one of these cases in that the injuries to the brain of one of the car drivers could be correlated in terms of type, location and severity when compared with the tolerance limits of relevant injury parameters (Willinger, IJCrash 8:605-617, 2003).

  17. SU-E-T-365: Dosimetric Impact of Dental Amalgam CT Image Artifacts On IMRT and VMAT Head and Neck Plans

    Energy Technology Data Exchange (ETDEWEB)

    Cao, N; Young, L; Parvathaneni, U; Liao, J; Richard, P; Ford, E; Sandison, G [University of Washington, Department of Radiation Oncology, Seattle, WA (United States)

    2014-06-01

    Purpose: The presence of high density dental amalgam in patient CT image data sets causes dose calculation errors for head and neck (HN) treatment planning. This study assesses and compares dosimetric variations in IMRT and VMAT treatment plans due to dental artifacts. Methods: Sixteen HN patients with similar treatment sites (oropharynx), tumor volume and extensive dental artifacts were divided into two groups: IMRT (n=8, 6 to 9 beams) and VMAT (n=8, 2 arcs with 352° rotation). All cases were planned with the Pinnacle 9.2 treatment planning software using the collapsed cone convolution superposition algorithm and a range of prescription dose from 60 to 72Gy. Two different treatment plans were produced, each based on one of two image sets: (a)uncorrected; (b)dental artifacts density overridden (set to 1.0g/cm{sup 3}). Differences between the two treatment plans for each of the IMRT and VMAT techniques were quantified by the following dosimetric parameters: maximum point dose, maximum spinal cord and brainstem dose, mean left and right parotid dose, and PTV coverage (V95%Rx). Average differences generated for these dosimetric parameters were compared between IMRT and VMAT plans. Results: The average absolute dose differences (plan a minus plan b) for the VMAT and IMRT techniques, respectively, caused by dental artifacts were: 2.2±3.3cGy vs. 37.6±57.5cGy (maximum point dose, P=0.15); 1.2±0.9cGy vs. 7.9±6.7cGy (maximum spinal cord dose, P=0.026); 2.2±2.4cGy vs. 12.1±13.0cGy (maximum brainstem dose, P=0.077); 0.9±1.1cGy vs. 4.1±3.5cGy (mean left parotid dose, P=0.038); 0.9±0.8cGy vs. 7.8±11.9cGy (mean right parotid dose, P=0.136); 0.021%±0.014% vs. 0.803%±1.44% (PTV coverage, P=0.17). Conclusion: For the HN plans studied, dental artifacts demonstrated a greater dose calculation error for IMRT plans compared to VMAT plans. Rotational arcs appear on the average to compensate dose calculation errors induced by dental artifacts. Thus, compared to VMAT, density

  18. Fusarium graminearum Possesses Virulence Factors Common to Fusarium Head Blight of Wheat and Seedling Rot of Soybean but Differing in Their Impact on Disease Severity.

    Science.gov (United States)

    Sella, Luca; Gazzetti, Katia; Castiglioni, Carla; Schäfer, Wilhelm; Favaron, Francesco

    2014-11-01

    Fusarium graminearum is a toxigenic fungal pathogen that causes Fusarium head blight (FHB) and crown rot on cereal crops worldwide. This fungus also causes damping-off and crown and root rots at the early stage of crop development in soybean cultivated in North and South America. Several F. graminearum genes were investigated for their contribution to FHB in cereals but no inherent study is reported for the dicotyledonous soybean host. In this study we determined the disease severity on soybean seedlings of five single gene disrupted mutants of F. graminearum, previously characterized in wheat spike infection. Three of these mutants are impaired on a specific function as the production of deoxynivalenol (DON, Δtri5), lipase (ΔFgl1), and xylanase (Δxyl03624), while the remaining two are MAP kinase mutants (ΔFgOS-2, Δgpmk1), which are altered in signaling pathways. The mutants that were reduced in virulence (Δtri5, ΔFgl1, and ΔFgOS-2) or are avirulent (Δgpmk1) on wheat were correspondently less virulent or avirulent in soybean seedlings, as shown by the extension of lesions and seedling lengths. The Δxyl03624 mutant was as virulent as the wild type mirroring the behavior observed in wheat. However, a different ranking of symptom severity occurred in the two hosts: the ΔFgOS-2 mutant, that infects wheat spikelets similarly to Δtri5 and ΔFgl1 mutants, provided much reduced symptoms in soybean. Differently from the other mutants, we observed that the ΔFgOS-2 mutant was several fold more sensitive to the glyceollin phytoalexin suggesting that its reduced virulence may be due to its hypersensitivity to this phytoalexin. In conclusion, lipase and DON seem important for full disease symptom development in soybean seedlings, OS-2 and Gpmk1 MAP kinases are essential for virulence, and OS-2 is involved in conferring resistance to the soybean phytoalexin.

  19. Parental Book Reading and Social-Emotional Outcomes for Head Start Children in Foster Care.

    Science.gov (United States)

    Lee, Kyunghee; Lee, Jung-Sook

    2016-01-01

    This study examines the associations between parental book reading and social-emotional outcomes for Head Start children in foster care. Despite no main Head Start impact on parental book reading, subgroup effects were found. Foster parents in Head Start provided more book reading for children with disabilities but less for children with low preacademic scores. Head Start enhanced social-emotional outcomes for children in foster care. The positive impacts of Head Start on children's social-emotional outcomes were greater when parents read books frequently. Head Start should include more foster families and provided parenting skills to enhance social-emotional outcomes for children in foster care.

  20. The Impact of Sports Cardiology on the Practice of Primary Care Sports Medicine: Where Were We, Where Are We, Where Are We Headed?

    Science.gov (United States)

    Statuta, Siobhan; Mistry, Dilaawar J; Battle, Robert W

    2015-07-01

    This article is a commentary on the role of sports cardiologists in the athletic arena and the beneficial impact they offer sports medicine in the comprehensive care of competitive athletes. The focus is a dialogue on current recommendations for primary prevention of sudden cardiac arrest (SCA), incorporating elements of the preparticipation evaluation and continuing care of athletes with diagnosed heart disease (HD). The feasibility and potential advantages of implementing well-designed preparticipation cardiovascular screening programs and the role of sports cardiologists to educate primary care team physicians on secondary prevention of SCA and proper treatment of underlying HD are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. 49 CFR 214.113 - Head protection.

    Science.gov (United States)

    2010-10-01

    ... impact, or from falling or flying objects, or from electrical shock and burns, shall be provided and... and penetration of falling and flying objects, or from high voltage electrical shock and burns shall conform to the national consensus standards for industrial head protection (American National Standards...

  2. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... you! Do you have a personal story about radiology? Share your patient story here Images × Image Gallery ... Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to ...

  3. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Tomography (CT) Safety During Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear ... or other physician. To locate a medical imaging or radiation oncology provider in your community, you can search the ...

  4. Overview of Head Injuries

    Science.gov (United States)

    ... brain. If the head injury is very severe, mechanical ventilation may be used. Doctors control blood pressure and minimize the amount of brain swelling by adjusting the amount of intravenous fluids given and sometimes by giving intravenous drugs that ...

  5. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... headaches, dizziness, and other symptoms of aneurysm, bleeding, stroke and brain tumors. It also helps your doctor ... scanning provides more detailed information on head injuries, stroke , brain tumors and other brain diseases than regular ...

  6. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... be necessary. Your doctor will explain the exact reason why another exam is requested. Sometimes a follow- ... limitations of CT Scanning of the Head? A person who is very large may not fit into ...

  7. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... medically necessary because of potential risk to the baby. This risk is, however, minimal with head CT ... intravenous contrast indicate mothers should not breastfeed their babies for 24-48 hours after contrast medium is ...

  8. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... assess head injuries, severe headaches, dizziness, and other symptoms of aneurysm, bleeding, stroke and brain tumors. It ... within the brain shortly after a patient exhibits symptoms of a stroke. a stroke, especially with a ...

  9. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... scans in children should always be done with low-dose technique. top of page What are the ... page Additional Information and Resources RTAnswers.org Radiation Therapy for Brain Tumors Radiation Therapy for Head and ...

  10. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... this tunnel. Rotating around you, the x-ray tube and electronic x-ray detectors are located opposite ... medically necessary because of potential risk to the baby. This risk is, however, minimal with head CT ...

  11. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much ... head CT scanning. Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 ...

  12. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... special x-ray equipment to help assess head injuries, severe headaches, dizziness, and other symptoms of aneurysm, ... cancer. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. ...

  13. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... traditional x-rays, particularly of soft tissues and blood vessels. CT scanning provides more detailed information on head injuries, stroke , brain tumors and other brain diseases than regular radiographs (x-rays). top of page ...

  14. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... used to detect: bleeding, brain injury and skull fractures in patients with head injuries. bleeding caused by ... a few seconds, and even faster in small children. Such speed is beneficial for all patients but ...

  15. TCGA head Neck

    Science.gov (United States)

    Investigators with The Cancer Genome Atlas (TCGA) Research Network have discovered genomic differences – with potentially important clinical implications – in head and neck cancers caused by infection with the human papillomavirus (HPV).

  16. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much ... for Head and Neck Cancer Others American Stroke Association National Stroke Association top of page This page ...

  17. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels. CT scanning provides more detailed information on head ...

  18. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. When ... for Brain Tumors Radiation Therapy for Head and Neck Cancer Others American Stroke Association National Stroke Association ...

  19. Early Head Start Evaluation

    Data.gov (United States)

    U.S. Department of Health & Human Services — Longitudinal information from an evaluation where children were randomly assigned to Early Head Start or community services as usual;direct assessments and...

  20. Head CT scan

    Science.gov (United States)

    ... be: Stored Viewed on a monitor Printed on film Three-dimensional models of the head area can ... when you have certain other signs or symptoms Hearing loss (in some people) Symptoms of damage to ...

  1. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... and other symptoms of aneurysm, bleeding, stroke and brain tumors. It also helps your doctor to evaluate your ... provides more detailed information on head injuries, stroke , brain tumors and other brain diseases than regular radiographs (x- ...

  2. Head and Neck Cancer

    Science.gov (United States)

    ... increase the risk of head and neck cancer. Environmental or occupational inhalants. Inhaling asbestos, wood dust, paint ... from the American Society of Clinical Oncology. Review dictionary articles to help understand medical phrases and terms ...

  3. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... used to detect: bleeding, brain injury and skull fractures in patients with head injuries. bleeding caused by ... are present in the paranasal sinuses. plan radiation therapy for cancer of the brain or other tissues. ...

  4. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... used to detect: bleeding, brain injury and skull fractures in patients with head injuries. bleeding caused by ... is also performed to: evaluate the extent of bone and soft tissue damage in patients with facial ...

  5. The impact of interpreted flow regimes during constant head injection tests on the estimated transmissivity from injection tests and difference flow logging

    Energy Technology Data Exchange (ETDEWEB)

    Hjerne, Calle; Ludvigsson, Jan-Erik; Harrstroem, Johan [Geosigma AB, Uppsala (Sweden)

    2013-04-15

    A large number of constant head injection tests were carried out in the site investigation at Forsmark using the Pipe String System, PSS3. During the original evaluation of the tests the dominating transient flow regimes during both the injection and recovery period were interpreted together with estimation of hydraulic parameters. The flow regimes represent different flow and boundary conditions during the tests. Different boreholes or borehole intervals may display different distributions of flow regimes. In some boreholes good agreement was obtained between the results of the injection tests and difference flow logging with Posiva flow log (PFL) but in other boreholes significant discrepancies were found. The main objective of this project is to study the correlation between transient flow regimes from the injection tests and other borehole features such as transmissivity, depth, geology, fracturing etc. Another subject studied is whether observed discrepancies between estimated transmissivity from difference flow logging and injection tests can be correlated to interpreted flow regimes. Finally, a detailed comparison between transient and stationary evaluation of transmissivity from the injection tests in relation to estimated transmissivity from PFL tests in corresponding sections is made. Results from previous injection tests in 5 m sections in boreholes KFM04, KFM08A and KFM10A were used. Only injection tests above the (test-specific) measurement limit regarding flow rate are included in the analyses. For all of these tests transient flow regimes were interpreted. In addition, results from difference flow logging in the corresponding 5 m test sections were used. Finally, geological data of fractures together with rock and fracture zone properties have been used in the correlations. Flow regimes interpreted from the injection period of the tests are generally used in the correlations but deviations between the interpreted flow regimes from the injection and

  6. Análise do colapso segmentar da cabeça femoral nas fraturas do acetábulo tratadas cirurgicamente Analysis of the segmental impaction of femoral head following an acetabular fracture surgically managed

    Directory of Open Access Journals (Sweden)

    Rodrigo Pereira Guimarães

    2009-10-01

    Full Text Available OBJETIVO: Correlacionar a evolução radiográfica pós-operatória com as variáveis que acompanham as fraturas do acetábulo, a fim de definir o que tem valor preditivo no aparecimento do colapso segmentar da cabeça femoral. MÉTODOS: Realizada análise retrospectiva de prontuários de pacientes submetidos à cirurgia de redução aberta e fixação interna do acetábulo. Em aproximadamente 35 anos, 596 pacientes foram tratados por fratura do acetábulo; 267 foram acompanhados pelo menos por dois anos. Os demais foram excluídos por não ter sido acompanhados pelo tempo mínimo, não haver dados suficientes no prontuário ou ter sido submetidos a tratamento não operatório. O acompanhamento dos pacientes foi feito por um de três cirurgiões do grupo, utilizando a escala clínica de Merle d'Aubigné e Postel e estudos radiológicos. RESULTADOS: Somente duas variáveis estudadas, idade e qualidade da redução pós-operatória, apresentaram correlação estatisticamente significante com o colapso da cabeça femoral. CONCLUSÕES: A qualidade da redução, anatômica ou com desvio residual de até dois milímetros, apresenta evolução radiográfica satisfatória, diminuindo a probabilidade do colapso segmentar da cabeça femoral, achado que tem significância estatística.OBJECTIVE: Correlate the postoperative radiographic evaluation with variables accompanying acetabular fractures in order to determine the predictive factors for segmental impaction of femoral head. METHODS: Retrospective analysis of medial files of patients submitted to open reduction surgery with internal acetabular fixation. Within approximately 35 years, 596 patients were treated for acetabular fractures; 267 were followed up for at least two years. The others were excluded either because their follow up was shorter than the minimum time, or as a result of the lack of sufficient data reported on files, or because they had been submitted to non-surgical treatment. The

  7. Learning toward practical head pose estimation

    Science.gov (United States)

    Sang, Gaoli; He, Feixiang; Zhu, Rong; Xuan, Shibin

    2017-08-01

    Head pose is useful information for many face-related tasks, such as face recognition, behavior analysis, human-computer interfaces, etc. Existing head pose estimation methods usually assume that the face images have been well aligned or that sufficient and precise training data are available. In practical applications, however, these assumptions are very likely to be invalid. This paper first investigates the impact of the failure of these assumptions, i.e., misalignment of face images, uncertainty and undersampling of training data, on head pose estimation accuracy of state-of-the-art methods. A learning-based approach is then designed to enhance the robustness of head pose estimation to these factors. To cope with misalignment, instead of using hand-crafted features, it seeks suitable features by learning from a set of training data with a deep convolutional neural network (DCNN), such that the training data can be best classified into the correct head pose categories. To handle uncertainty and undersampling, it employs multivariate labeling distributions (MLDs) with dense sampling intervals to represent the head pose attributes of face images. The correlation between the features and the dense MLD representations of face images is approximated by a maximum entropy model, whose parameters are optimized on the given training data. To estimate the head pose of a face image, its MLD representation is first computed according to the model based on the features extracted from the image by the trained DCNN, and its head pose is then assumed to be the one corresponding to the peak in its MLD. Evaluation experiments on the Pointing'04, FacePix, Multi-PIE, and CASIA-PEAL databases prove the effectiveness and efficiency of the proposed method.

  8. Do Spin-Offs Make the Academics' Heads Spin?: The Impacts of Spin-Off Companies on Their Parent Research Organisation.

    Science.gov (United States)

    Zomer, Arend H; Jongbloed, Ben W A; Enders, Jürgen

    2010-09-01

    As public research organisations are increasingly driven by their national and regional governments to engage in knowledge transfer, they have started to support the creation of companies. These research based spin-off companies (RBSOs) often keep contacts with the research institutes they originate from. In this paper we present the results of a study of four research institutes within two universities and two non-university public research organisations (PROs) in the Netherlands. We show that research organisations have distinct motivations to support the creation of spin-off companies. In terms of resources RBSOs contribute, mostly in a modest way, to research activities by providing information, equipment and monetary resources. In particular, RBSOs are helpful for researchers competing for research grants that demand participation of industry. Furthermore, RBSOs may be seen as a proactive response by Dutch public research organisations to demands of economic relevance from their institutional environment. RBSOs enhance the prestige of their parent organisations and create legitimacy for public funds invested in PROs. At the same time, most RBSOs do not have a significant impact on the direction of the research conducted at the PROs.

  9. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head ... limitations of MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is ...

  10. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful ... Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

  11. Head and Tibial Acceleration as a Function of Stride Frequency and Visual Feedback during Running.

    Directory of Open Access Journals (Sweden)

    Michael A Busa

    Full Text Available Individuals regulate the transmission of shock to the head during running at different stride frequencies although the consequences of this on head-gaze stability remain unclear. The purpose of this study was to examine if providing individuals with visual feedback of their head-gaze orientation impacts tibial and head accelerations, shock attenuation and head-gaze motion during preferred speed running at different stride frequencies. Fifteen strides from twelve recreational runners running on a treadmill at their preferred speed were collected during five stride frequencies (preferred, ±10% and ±20% of preferred in two visual task conditions (with and without real-time visual feedback of head-gaze orientation. The main outcome measures were tibial and head peak accelerations assessed in the time and frequency domains, shock attenuation from tibia to head, and the magnitude and velocity of head-gaze motion. Decreasing stride frequency resulted in greater vertical accelerations of the tibia (p<0.01 during early stance and at the head (p<0.01 during early and late stance; however, for the impact portion the increase in head acceleration was only observed for the slowest stride frequency condition. Visual feedback resulted in reduced head acceleration magnitude (p<0.01 and integrated power spectral density in the frequency domain (p<0.01 in late stance, as well as overall of head-gaze motion (p<0.01. When running at preferred speed individuals were able to stabilize head acceleration within a wide range of stride frequencies; only at a stride frequency 20% below preferred did head acceleration increase. Furthermore, impact accelerations of the head and tibia appear to be solely a function of stride frequency as no differences were observed between feedback conditions. Increased visual task demands through head gaze feedback resulted in reductions in head accelerations in the active portion of stance and increased head-gaze stability.

  12. Impact and sustainability of low-head drip irrigation kits, in the semi-arid Gwanda and Beitbridge Districts, Mzingwane Catchment, Limpopo Basin, Zimbabwe

    Science.gov (United States)

    Moyo, Richard; Love, David; Mul, Marloes; Mupangwa, Walter; Twomlow, Steve

    Resource-poor smallholder farmers in the semi-arid Gwanda and Beitbridge districts face food insecurity on an annual basis due to a combination of poor and erratic rainfall (average 500 mm/a and 345 mm/a, respectively, for the period 1970-2003) and technologies inappropriate to their resource status. This impacts on both household livelihoods and food security. In an attempt to improve food security in the catchment a number of drip kit distribution programmes have been initiated since 2003 as part of an on-going global initiative aimed at 2 million poor households per year. A number of recent studies have assessed the technical performance of the drip kits in-lab and in-field. In early 2005 a study was undertaken to assess the impacts and sustainability of the drip kit programme. Representatives of the NGOs, local government, traditional leadership and agricultural extension officers were interviewed. Focus group discussions with beneficiaries and other villagers were held at village level. A survey of 114 households was then conducted in two districts, using a questionnaire developed from the output of the interviews and focus group discussions. The results from the study showed that the NGOs did not specifically target the distribution of the drip kits to poor members of the community (defined for the purpose of the study as those not owning cattle). Poor households made up 54% of the beneficiaries. This poor targeting of vulnerable households could have been a result of conditions set by some implementing NGOs that beneficiaries must have an assured water source. On the other hand, only 2% of the beneficiaries had used the kit to produce the expected 5 harvests over the 2 years, owing to problems related to water shortage, access to water and also pests and diseases. About 51% of the respondents had produced at least 3 harvests and 86% produced at least 2 harvests. Due to water shortages during the dry season 61% of production with the drip kit occurred during

  13. On-the-field management of athletic head injuries.

    Science.gov (United States)

    Durand, Pierre; Adamson, Gregory J

    2004-01-01

    Head injuries are prevalent in collision sports. Concussions represent the relatively benign end of the spectrum of injuries. Severe closed head injuries include epidural hematomas, acute subdural hematomas, intracerebral hematomas, intraventricular hematomas, subarachnoid hemorrhages, and diffuse axonal injuries. Second impact syndrome represents a severe cerebral autoregulatory dysfunction that can lead to death in an athlete who sustains a second (often minor) closed head trauma while still symptomatic from a previous head injury. Generally, athletes who have suffered a severe closed head injury should not return to play. Exceptions include athletes asymptomatic for 1 year who return to a noncontact sport and those who recover completely from an epidural hematoma without underlying brain injury. Several guidelines for returning athletes to play have been proposed and are commonly used. The team physician has the responsibility of on-the-field evaluation and management of athletes with head injuries, as well as of advising them when it is safe to return to play.

  14. Biomechanics of Heading a Soccer Ball: Implications for Player Safety

    Directory of Open Access Journals (Sweden)

    Charles F. Babbs

    2001-01-01

    Full Text Available To better understand the risk and safety of heading a soccer ball, the author created a set of simple mathematical models based upon Newton�s second law of motion to describe the physics of heading. These models describe the player, the ball, the flight of the ball before impact, the motion of the head and ball during impact, and the effects of all of these upon the intensity and the duration of acceleration of the head. The calculated head accelerations were compared to those during presumably safe daily activities of jumping, dancing, and head nodding and also were related to established criteria for serious head injury from the motor vehicle crash literature. The results suggest heading is usually safe but occasionally dangerous, depending on key characteristics of both the player and the ball. Safety is greatly improved when players head the ball with greater effective body mass, which is determined by a player�s size, strength, and technique. Smaller youth players, because of their lesser body mass, are more at risk of potentially dangerous headers than are adults, even when using current youth size balls. Lower ball inflation pressure reduces risk of dangerous head accelerations. Lower pressure balls also have greater “touch” and “playability”, measured in terms of contact time and contact area between foot and ball during a kick. Focus on teaching proper technique, the re-design of age-appropriate balls for young players with reduced weight and inflation pressure, and avoidance of head contact with fast, rising balls kicked at close range can substantially reduce risk of subtle brain injury in players who head soccer balls.

  15. Impact of salivary gland dosimetry on post-IMRT recovery of saliva output and xerostomia grade for head-and-neck cancer patients treated with or without contralateral submandibular gland sparing: a longitudinal study.

    Science.gov (United States)

    Wang, Zhong-He; Yan, Chao; Zhang, Zhi-Yuan; Zhang, Chen-Ping; Hu, Hai-Sheng; Tu, Wen-Yong; Kirwan, Jessica; Mendenhall, William M

    2011-12-01

    To observe the recovery of saliva output and effect on xerostomia grade after intensity-modulated radiotherapy (IMRT) with or without contralateral submandibular gland (cSMG) sparing and to assess the impact of salivary gland dosimetry on this recovery among patients with head-and-neck cancer. Between May 2007 and May 2008, 52 patients with head-and-neck cancer received definitive (n=5 patients) and postoperative (n=47 patients) IMRT at our institution, with at least one parotid gland spared. Of these patients, 26 patients with a low risk of recurrence in the cSMG region underwent IMRT and had their cSMGs spared (cSMG-sparing group). The remaining 26 high-risk patients had no cSMGs spared (cSMG-unspared group). Xerostomia grades and salivary flow rates were monitored at five time points (before IMRT and at 2, 6, 12, and 18 months after IMRT). Average mean doses and mean volumes receiving 30 Gy (V30) of the cSMGs were lower in the cSMG-sparing group than in the cSMG-unspared group (mean dose, 20.4 Gy vs. 57.4 Gy; mean V30, 14.7% vs. 99.8%, respectively). Xerostomia grades at 2 and 6 months post-IMRT were also significantly lower among patients in the cSMG-sparing group than in the cSMG-unspared group, but differences were not significant at 12 and 18 months after IMRT. Patients in the cSMG-sparing group had significantly better mean unstimulated salivary flow rates at each time point post- IMRT as well as better mean stimulated salivary flow rates at 2 months post-IMRT. Recovery of saliva output and grade of xerostomia post-IMRT in patients whose cSMGs were spared were much better than in patients whose cSMGs were not spared. The influence of the mean doses to the cSMG and parotid gland on the recovery of saliva output was equivalent to that of the mean V30 to the glands. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Impact of Salivary Gland Dosimetry on Post-IMRT Recovery of Saliva Output and Xerostomia Grade for Head-and-Neck Cancer Patients Treated With or Without Contralateral Submandibular Gland Sparing: A Longitudinal Study

    Energy Technology Data Exchange (ETDEWEB)

    Wang Zhonghe; Yan Chao [Division of Radiation Oncology, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Zhang Zhiyuan; Zhang Chenping [Department of Oral and Maxillofacial Surgery, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Hu Haisheng; Tu Wenyong [Division of Radiation Oncology, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Kirwan, Jessica [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); Mendenhall, William M., E-mail: mendwm@shands.ufl.edu [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States)

    2011-12-01

    Purpose: To observe the recovery of saliva output and effect on xerostomia grade after intensity-modulated radiotherapy (IMRT) with or without contralateral submandibular gland (cSMG) sparing and to assess the impact of salivary gland dosimetry on this recovery among patients with head-and-neck cancer. Methods and Materials: Between May 2007 and May 2008, 52 patients with head-and-neck cancer received definitive (n = 5 patients) and postoperative (n = 47 patients) IMRT at our institution, with at least one parotid gland spared. Of these patients, 26 patients with a low risk of recurrence in the cSMG region underwent IMRT and had their cSMGs spared (cSMG-sparing group). The remaining 26 high-risk patients had no cSMGs spared (cSMG-unspared group). Xerostomia grades and salivary flow rates were monitored at five time points (before IMRT and at 2, 6, 12, and 18 months after IMRT). Results: Average mean doses and mean volumes receiving 30 Gy (V30) of the cSMGs were lower in the cSMG-sparing group than in the cSMG-unspared group (mean dose, 20.4 Gy vs. 57.4 Gy; mean V30, 14.7% vs. 99.8%, respectively). Xerostomia grades at 2 and 6 months post-IMRT were also significantly lower among patients in the cSMG-sparing group than in the cSMG-unspared group, but differences were not significant at 12 and 18 months after IMRT. Patients in the cSMG-sparing group had significantly better mean unstimulated salivary flow rates at each time point post- IMRT as well as better mean stimulated salivary flow rates at 2 months post-IMRT. Conclusions: Recovery of saliva output and grade of xerostomia post-IMRT in patients whose cSMGs were spared were much better than in patients whose cSMGs were not spared. The influence of the mean doses to the cSMG and parotid gland on the recovery of saliva output was equivalent to that of the mean V30 to the glands.

  17. Head First Statistics

    CERN Document Server

    Griffiths, Dawn

    2009-01-01

    Wouldn't it be great if there were a statistics book that made histograms, probability distributions, and chi square analysis more enjoyable than going to the dentist? Head First Statistics brings this typically dry subject to life, teaching you everything you want and need to know about statistics through engaging, interactive, and thought-provoking material, full of puzzles, stories, quizzes, visual aids, and real-world examples. Whether you're a student, a professional, or just curious about statistical analysis, Head First's brain-friendly formula helps you get a firm grasp of statistics

  18. Head and Neck Reconstruction.

    Science.gov (United States)

    Wong, Shannon; Melin, Alyson; Reilly, Debra

    2017-10-01

    Management of head and neck burns involves acute and intermediate phases. Acutely, the goals are establish a secure airway and treat life-threatening injuries. Then, optimize nutrition, assess extent of the burn, perform local wound care, and provide eye protection. Management depends on the degree of the head and neck burn. Postinjury splinting and rehabilitation are vital to healing. After the acute inflammation has resolved and the scars have matured, reconstruction begins with the goals of restoring both function and aesthetics. Reconstruction ranges from simple scar release, to skin grafting, and possibly free flap reconstruction. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Head first Ajax

    CERN Document Server

    Riordan, Rebecca M

    2008-01-01

    Ajax is no longer an experimental approach to website development, but the key to building browser-based applications that form the cornerstone of Web 2.0. Head First Ajax gives you an up-to-date perspective that lets you see exactly what you can do -- and has been done -- with Ajax. With it, you get a highly practical, in-depth, and mature view of what is now a mature development approach. Using the unique and highly effective visual format that has turned Head First titles into runaway bestsellers, this book offers a big picture overview to introduce Ajax, and then explores the use of ind

  20. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos ... head injuries, stroke , brain tumors and other brain diseases than regular radiographs (x-rays). top of page ...

  1. Lubricating the swordfish head

    NARCIS (Netherlands)

    Videler, John J.; Haydar, Deniz; Snoek, Roelant; Hoving, Henk-Jan T.; Szabo, Ben G.

    The swordfish is reputedly the fastest swimmer on Earth. The concave head and iconic sword are unique characteristics, but how they contribute to its speed is still unknown. Recent computed tomography scans revealed a poorly mineralised area near the base of the rostrum. Here we report, using

  2. Waco Head Start Program.

    Science.gov (United States)

    Porter, Para

    The Economic Opportunity Act of 1964 led to the formation of three separate Head Start Programs in Waco, Texas. The first year, 1,500 children were involved. Of these, 40 percent were Negro, 30 percent Latin American, and 30 percent white. All teachers received a week of preparatory study at the University of Texas. The program involved four areas…

  3. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head ...

  4. Ultrasound: Head (For Parents)

    Science.gov (United States)

    ... a safe and painless test that uses sound waves to make images of the brain. During the examination, an ultrasound machine sends sound ... The fontanel provides an opening for the sound waves to get through and reach the brain. Why It's Done Doctors order head ultrasounds when ...

  5. Silva as the Head

    DEFF Research Database (Denmark)

    Svabo, Connie

    2015-01-01

    The head of the performance design programme is substituted by a sister's academy delegate. this performance situation formed part of a week of semesterstart where the students and professors visited Sister's Academy, Malmø. I participated in the Sister's Academy as visiting researcher and here...

  6. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Radiation Dose in X-Ray and CT Exams Blood Clots CT Perfusion of the Head CT Angiography ( ...

  7. Head nurses as middle managers.

    Science.gov (United States)

    Johnston, P F

    1983-11-01

    The relationship between head nurses and their staff nurses influences staff turnover rates and job satisfaction. In this article the author describes the measures taken by the management of Greater Southeast Community Hospital in response to an increasing turnover rate among staff RNs. In recognition of the head nurse role vis-d-vis attrition rates and job satisfaction, head nurses were upgraded to department head status and rigorous head nurse performance standards were developed. These standards required clinical expertise, managerial competence, and accountability. It is the author's contention that clinical practice and staff morale are directly related to a clearly defined head nurse role.

  8. Radial Head Fractures

    Science.gov (United States)

    Jordan, Robert W.; Jones, Alistair DR.

    2017-01-01

    Background: Radial head fractures are common elbow injuries in adults and are frequently associated with additional soft tissue and bone injuries. Methods: A literature search was performed and the authors’ personal experiences are reported. Results: Mason type I fractures are treated non-operatively with splinting and early mobilisation. The management of Mason type II injuries is less clear with evidence supporting both non-operative treatment and internal fixation. The degree of intra-articular displacement and angulation acceptable for non-operative management has yet to be conclusively defined. Similarly the treatment of type III and IV fractures remain controversial. Traditional radial head excision is associated with valgus instability and should be considered only for patients with low functional demands. Comparative studies have shown improved results from internal fixation over excision. Internal fixation should only be attempted when anatomic reduction and initiation of early motion can be achieved. Authors have reported that results from fixation are poorer and complication rates are higher if more than three fragments are present. Radial head arthroplasty aims to reconstruct the native head and is indicated when internal fixation is not feasible and in the presence of complex elbow injuries. Overstuffing of the radiocapitellar joint is a frequent technical fault and has significant adverse effects on elbow biomechanics. Modular design improves the surgeon’s ability to reconstruct the native joint. Two randomised controlled trials have shown improved clinical outcomes and lower complication rate following arthroplasty when compared to internal fixation. Conclusion: We have presented details regarding the treatment of various types of radial head fractures - further evidence, however, is still required to provide clarity over the role of these different management strategies. PMID:29290880

  9. Head and neck position sense.

    Science.gov (United States)

    Armstrong, Bridget; McNair, Peter; Taylor, Denise

    2008-01-01

    Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or

  10. Does Head Start differentially benefit children with risks targeted by the program's service model?

    Science.gov (United States)

    Miller, Elizabeth B; Farkas, George; Duncan, Greg J

    Data from the Head Start Impact Study ( N = 3540) were used to test for differential benefits of Head Start after one program year and after kindergarten on pre-academic and behavior outcomes for children at risk in the domains targeted by the program's comprehensive services. Although random assignment to Head Start produced positive treatment main effects on children's pre-academic skills and behavior problems, residualized growth models showed that random assignment to Head Start did not differentially benefit the pre-academic skills of children with risk factors targeted by the Head Start service model. The models showed detrimental impacts of Head Start for maternal-reported behavior problems of high-risk children, but slightly more positive impacts for teacher-reported behavior. Policy implications for Head Start are discussed.

  11. Femoral head reduction osteoplasty for fracture dislocation: A surgical technique.

    Science.gov (United States)

    Bartlett, Craig Scott; Birch, Christopher Erik

    2015-08-01

    Femoral head fractures with subchondral impaction and cartilage loss are difficult to treat successfully. Although multiple surgical management options have been described, no one technique has proven superior, particularly in the young high-demand population. A femoral head reduction osteoplasty was performed following a surgical dislocation of the hip. A peripherally based wedge of bone was resected off the damaged central third of the head followed by reduction and fixation of the remaining fragments. This technique resulted in a smaller yet congruent femoral head. A healthy 40-year old labourer sustained a traumatic crush injury while at work, resulting in a left femoral head fracture dislocation with an associated posterior wall acetabular fracture. Significant femoral head impaction and cartilage loss limited the treatment options. Intraoperative reduction and postoperative imaging demonstrated near anatomic reconstruction of femoral head with a congruent hip joint. Superiorly at the level of resection, the medial-lateral diameter was reduced by 5-6mm (approximately 12-15% the diameter of the original head) by the osteoplasty. At five years, Harris Hip Score was 86, Oxford Hip Score 36, and UCLA score 89. Hip abductor strength was full, range of motion near normal, and the patient ambulated without antalgia. Radiographs demonstrate a congruent joint and patchy avascular necrosis without collapse. The patient maintained full employment as a labourer. Femoral head reduction osteoplasty is a viable option that may produce durable intermediate-term results for complex femoral head fracture with superior impaction and chondral damage. Level V. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Evaluation of femoral head perfusion by dynamic MRI

    Energy Technology Data Exchange (ETDEWEB)

    Tago, Hiroyuki [Okayama Univ. (Japan). School of Medicine

    1998-05-01

    The purpose of this study was to evaluate the usefulness of dynamic MRI for femoral head perfusion. Objects were 64 femoral heads of 44 normal cases (20-95 years old), 10 cases (33-90 y) of femoral neck fracture and 8 cases (61-86 y) using steroid due to articular rheumatism, nephrosis and other diseases. Siemens 1.0 T Magneton Impact with body array coil was used for dynamic MRI by the fast low-angle shot 2D method for every 17 sec interval. Gd-DTPA was injected intravenously. ROI was defined in the center of femur head and of trochanter to monitor their values for the dynamic curve. Evaluation was done on the ratio of enhancement ratio (ER) in the head/trochanter and on the curve in both heads. In normal cases, the head ER was significantly lower in >60 years old cases. There was neither significant correlation between their head/trochanter ER ratios nor significant difference between their dynamic curves. In fracture cases, there were dynamic curves showing no increase. In steroid cases, there were cases showing low values in the head ER and in ER ratio. Dynamic MRI was shown to be a useful method for evaluation of femoral head perfusion. (K.H.)

  13. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful magnetic field, radio waves and a computer to produce ...

  14. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... content. Related Articles and Media MR Angiography (MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain ...

  15. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... Articles and Media MR Angiography (MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to ...

  16. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... are the limitations of MRI of the Head? What is MRI of the Head? Magnetic resonance imaging ( ... brain) in routine clinical practice. top of page What are some common uses of the procedure? MR ...

  17. Childhood Head and Neck Irradiation

    Science.gov (United States)

    ... Thyroid Association ® www.thyroid.org Childhood Head & Neck Irradiation What is the thyroid gland? The thyroid gland ... Thyroid Association ® www.thyroid.org Childhood Head & Neck Irradiation Thyroid nodules (see Thyroid Nodule brochure) • Thyroid nodules ...

  18. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... for Brain Tumors Radiation Therapy for Head and Neck Cancer Others : American Stroke Association National Stroke Association ... MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging ( ...

  19. 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.

  20. Radiation dose reduction using 100-kVp and a sinogram-affirmed iterative reconstruction algorithm in adolescent head CT: Impact on grey-white matter contrast and image noise.

    Science.gov (United States)

    Nagayama, Yasunori; Nakaura, Takeshi; Tsuji, Akinori; Urata, Joji; Furusawa, Mitsuhiro; Yuki, Hideaki; Hirarta, Kenichiro; Kidoh, Masafumi; Oda, Seitaro; Utsunomiya, Daisuke; Yamashita, Yasuyuki

    2017-07-01

    To retrospectively evaluate the image quality and radiation dose of 100-kVp scans with sinogram-affirmed iterative reconstruction (IR) for unenhanced head CT in adolescents. Sixty-nine patients aged 12-17 years underwent head CT under 120- (n = 34) or 100-kVp (n = 35) protocols. The 120-kVp images were reconstructed with filtered back-projection (FBP), 100-kVp images with FBP (100-kVp-F) and sinogram-affirmed IR (100-kVp-S). We compared the effective dose (ED), grey-white matter (GM-WM) contrast, image noise, and contrast-to-noise ratio (CNR) between protocols in supratentorial (ST) and posterior fossa (PS). We also assessed GM-WM contrast, image noise, sharpness, artifacts, and overall image quality on a four-point scale. ED was 46% lower with 100- than 120-kVp (p noise was lower, on 100-kVp-S than 120-kVp at ST (p noise in adolescent head CT. • 100-kVp head CT provides 46% radiation dose reduction compared with 120-kVp. • 100-kVp scanning improves subjective and objective GM-WM contrast. • Sinogram-affirmed IR decreases head CT image noise, especially in supratentorial region. • 100-kVp protocol with sinogram-affirmed IR is suited for adolescent head CT.

  1. Where are we heading

    Energy Technology Data Exchange (ETDEWEB)

    Noto, L.A. [Mobil Corporation, (United States)

    1996-12-31

    The present paper deals with different aspects connected to the global petroleum industry by discussing the way of heading. The aspects cover themes like new frontiers, new relationships, sanctions, global climate change, new alliances and new technology. New frontiers and relationships concern domestic policy affecting the industry, and sanctions are discussed in connection with trade. The author discusses the industry`s participation in the global environmental policy and new alliances to provide greater opportunity for developing new technology

  2. Radial Head Fractures

    OpenAIRE

    Jordan, Robert W.; Jones, Alistair DR.

    2017-01-01

    Background: Radial head fractures are common elbow injuries in adults and are frequently associated with additional soft tissue and bone injuries. Methods: A literature search was performed and the authors’ personal experiences are reported. Results: Mason type I fractures are treated non-operatively with splinting and early mobilisation. The management of Mason type II injuries is less clear with evidence supporting both non-operative treatment and internal fixation. The degree of intra-arti...

  3. Head Trauma in Mixed Martial Arts.

    Science.gov (United States)

    Hutchison, Michael G; Lawrence, David W; Cusimano, Michael D; Schweizer, Tom A

    2014-06-01

    Mixed martial arts (MMA) is a full combative sport with a recent global increase in popularity despite significant scrutiny from medical associations. To date, the empirical research of the risk of head injuries associated with this sport is limited. Youth and amateur participation is growing, warranting investigation into the burden and mechanism of injuries associated with this sport. (1) To determine the incidence, risk factors, and characteristics of knockouts (KOs) and technical knockouts (TKOs) from repetitive strikes in professional MMA; and (2) to identify the mechanisms of head trauma and the situational factors that lead to KOs and TKOs secondary to repetitive strikes through video analysis. Descriptive epidemiology study. Competition data and video records for all KOs and TKOs from numbered Ultimate Fighting Championship MMA events (n = 844) between 2006 to 2012. Analyses included (1) multivariate logistic regression to investigate factors associated with an increased risk of sustaining a KO or TKO secondary to repetitive strikes and (2) video analysis of all KOs and TKOs secondary to repetitive strikes with descriptive statistics. During the study period, the KO rate was 6.4 per 100 athlete-exposures (AEs) (12.7% of matches), and the rate of TKOs secondary to repetitive strikes was 9.5 per 100 AEs (19.1% of matches), for a combined incidence of match-ending head trauma of 15.9 per 100 AEs (31.9% of matches). Logistic regression identified that weight class, earlier time in a round, earlier round in a match, and older age were risk factors for both KOs and TKOs secondary to repetitive strikes. Match significance and previously sustained KOs or TKOs were also risk factors for KOs. Video analysis identified that all KOs were the result of direct impact to the head, most frequently a strike to the mandibular region (53.9%). The average time between the KO-strike and match stoppage was 3.5 seconds (range, 0-20 seconds), with losers sustaining an average of 2

  4. Who Benefits Most from Head Start? Using Latent Class Moderation to Examine Differential Treatment Effects

    Science.gov (United States)

    Cooper, Brittany Rhoades; Lanza, Stephanie T.

    2014-01-01

    Head Start (HS) is the largest federally funded preschool program for disadvantaged children. Research has shown relatively small impacts on cognitive and social skills; therefore, some have questioned its effectiveness. Using data from the Head Start Impact Study (3-year-old cohort; N = 2,449), latent class analysis was used to (a) identify…

  5. Head injuries in helmeted child bicyclists.

    Science.gov (United States)

    Grimard, G.; Nolan, T.; Carlin, J. B.

    1995-01-01

    OBJECTIVE: To determine the characteristics and the severity of head and facial injuries to helmeted child bicyclists, and whether the helmet contributed to the injury, and to study factors related to bicycle accidents. DESIGN: Retrospective review of two case series. Children sustaining head injury while not wearing helmets were studied as a form of reference group. SETTING: Large paediatric teaching hospital. SUBJECTS: 34 helmeted child bicyclists and 155 non-helmeted bicyclists, aged 5-14 years. MAIN OUTCOME MEASURES: Number of injuries, type of injuries, injury severity score, deaths, and accident circumstances. RESULTS: 79% of the head injuries of the helmeted child group were mild and two thirds of these had facial injuries. Children in the helmet group were in a greater proportion of bike-car collisions than the no helmet group and at least 15% of the helmets were lost on impact. There were no injuries secondary to the helmet. CONCLUSIONS: Most of the head injuries sustained by the helmeted children were of mild severity and there was no evidence to suggest that the helmet contributed to injury. Nevertheless, consideration should be given to designing a facial protector for the bicycle helmet and to improvement of the fastening device. PMID:9345988

  6. Conservation of water for washing beef heads at harvest.

    Science.gov (United States)

    DeOtte, R E; Spivey, K S; Galloway, H O; Lawrence, T E

    2010-03-01

    The objective of this research was to develop methods to conserve water necessary to cleanse beef heads prior to USDA-FSIS inspection. This was to be accomplished by establishing a baseline for the minimum amount of water necessary to adequately wash a head and application of image analysis to provide an objective measure of head cleaning. Twenty-one beef heads were manually washed during the harvest process. An average 18.75 L (2.49 SD) and a maximum of 23.88 L were required to cleanse the heads to USDA-FSIS standards. Digital images were captured before and after manual washing then evaluated for percentage red saturation using commercially available image analysis software. A decaying exponential curve extracted from these data indicated that as wash water increased beyond 20 L the impact on red saturation decreased. At 4 sigma from the mean of 18.75 L, red saturation is 16.0 percent, at which logistic regression analysis indicates 99.994 percent of heads would be accepted for inspection, or less than 1 head in 15,000 would be rejected. Reducing to 3 sigma would increase red saturation to 27.6 percent, for which 99.730 percent of heads likely would be accepted (less than 1 in 370 would be rejected). Copyright 2009 Elsevier Ltd. All rights reserved.

  7. Impact of comprehensive geriatric assessment on survival, function, and nutritional status in elderly patients with head and neck cancer: protocol for a multicentre randomised controlled trial (EGeSOR).

    Science.gov (United States)

    Brugel, Lydia; Laurent, Marie; Caillet, Philippe; Radenne, Anne; Durand-Zaleski, Isabelle; Martin, Michel; Baron, Melany; de Kermadec, Héloïse; Bastuji-Garin, Sylvie; Canouï-Poitrine, Florence; Paillaud, Elena

    2014-06-13

    Survival is poorer in elderly patients with head and neck squamous cell carcinomas [HNSCCs] than in younger patients. Possible explanations include a contribution of co-morbidities to mortality, frequent refusal of standard therapy, and the use of suboptimal treatments due to concern about toxicities. The Comprehensive Geriatric Assessment [CGA] is a multidimensional assessment of general health that can help to customise treatment and follow-up plans. The CGA has been proven effective in several health settings but has not been evaluated in randomised studies of patients with cancer. Our aim here was to assess the impact of the CGA on overall survival, function, and nutritional status of elderly patients with HNSCC. EGeSOR is an open-label, multicentre, randomised, controlled, parallel-group trial in patients aged 70 years or older and receiving standard care for HNSCC. The intervention includes four components: the CGA conducted by a geriatrician before cancer treatment, participation of the same geriatrician in cancer treatment selection, a standardised geriatric therapeutic intervention designed by the same geriatrician; and geriatric follow-up for 24 months. The primary endpoint, assessed after 6 months, is a composite criterion including death, functional impairment [Activities of Daily Living score decrease ≥ 2], and weight loss ≥ 10%. Secondary endpoints include progression-free survival, unscheduled admissions, quality of life, treatment toxicities, costs, and completion of the planned cancer treatment. A centralised online system is used to perform 1:1 randomisation with a minimisation algorithm for centre, age, T and N stages, and tumour site [oral, oropharyngeal, hypopharyngeal, or laryngeal]. The estimated sample size is 704 patients, who are being recruited by 14 centres in 9 French cities. EGeSOR is the first randomised trial of the CGA in elderly cancer patients. We expect the CGA to have direct clinical benefits on the management of elderly

  8. Head First Web Design

    CERN Document Server

    Watrall, Ethan

    2008-01-01

    Want to know how to make your pages look beautiful, communicate your message effectively, guide visitors through your website with ease, and get everything approved by the accessibility and usability police at the same time? Head First Web Design is your ticket to mastering all of these complex topics, and understanding what's really going on in the world of web design. Whether you're building a personal blog or a corporate website, there's a lot more to web design than div's and CSS selectors, but what do you really need to know? With this book, you'll learn the secrets of designing effecti

  9. "E" Heating Head

    Science.gov (United States)

    Fox, Robert L.; Swaim, Robert J.; Johnson, Samuel D.; Coultrip, Robert H.; Phillips, W. Morris; Copeland, Carl E.

    1994-01-01

    Two separate areas heated inductively for adhesive bonding in single operation. "E" heating head developed to satisfy need for fast-acting and reliable induction heating device. Used in attaching "high-hat" stiffeners to aircraft panels. Incorporates principles and circuitry of toroid joining gun. Width and length configured to provide variously sized heat zones, depending on bonding requirements. Lightweight, portable and provides rapid, reliable heating of dual areas in any environment. Well suited for flight-line and depot maintenance, and battlefield repair. Also useful in automotive assembly lines to strengthen automobile panels.

  10. Head First Python

    CERN Document Server

    Barry, Paul

    2010-01-01

    Ever wished you could learn Python from a book? Head First Python is a complete learning experience for Python that helps you learn the language through a unique method that goes beyond syntax and how-to manuals, helping you understand how to be a great Python programmer. You'll quickly learn the language's fundamentals, then move onto persistence, exception handling, web development, SQLite, data wrangling, and Google App Engine. You'll also learn how to write mobile apps for Android, all thanks to the power that Python gives you. We think your time is too valuable to waste struggling with

  11. Head first C#

    CERN Document Server

    Stellman, Andrew

    2010-01-01

    You want to learn C# programming, but you're not sure you want to suffer through another tedious technical book. You're in luck: Head First C# introduces this language in a fun, visual way. You'll quickly learn everything from creating your first program to learning sophisticated coding skills with C# 4.0, Visual Studio 2010 and .NET 4, while avoiding common errors that frustrate many students. The second edition offers several hands-on labs along the way to help you build and test programs using skills you've learned up to that point. In the final lab, you'll put everything together. From o

  12. Head first C#

    CERN Document Server

    Stellman, Andrew

    2008-01-01

    Head First C# is a complete learning experience for object-oriented programming, C#, and the Visual Studio IDE. Built for your brain, this book covers C# 3.0 and Visual Studio 2008, and teaches everything from language fundamentals to advanced topics including garbage collection, extension methods, and double-buffered animation. You'll also master C#'s hottest and newest syntax, LINQ, for querying SQL databases, .NET collections, and XML documents. By the time you're through, you'll be a proficient C# programmer, designing and coding large-scale applications. Every few chapters you will come

  13. Head First Mobile Web

    CERN Document Server

    Gardner, Lyza; Grigsby, Jason

    2011-01-01

    Despite the huge number of mobile devices and apps in use today, your business still needs a website. You just need it to be mobile. Head First Mobile Web walks you through the process of making a conventional website work on a variety smartphones and tablets. Put your JavaScript, CSS media query, and HTML5 skills to work-then optimize your site to perform its best in the demanding mobile market. Along the way, you'll discover how to adapt your business strategy to target specific devices. Navigate the increasingly complex mobile landscapeTake both technical and strategic approaches to mobile

  14. Impacts

    NARCIS (Netherlands)

    Hellmuth, M.; Kabat, P.

    2003-01-01

    Even without the impacts of climate change, water managers face prodigious challenges in meeting sustainable development goals. Growing populations need affordable food, water and energy. Industrial development demands a growing share of water resources and contaminates those same resources with its

  15. Evaluation of the impact of tumor HPV status on outcome in patients with locally advanced unresectable head and neck squamous cell carcinoma (HNSCC) receiving cisplatin, 5-fluorouracil with or without docetaxel: a subset analysis of EORTC 24971 study

    NARCIS (Netherlands)

    Psyrri, A.; Fortpied, C.; Koutsodontis, G.; Avgeris, M.; Kroupis, C.; Goutas, N.; Menis, J.; Herman, L.; Giurgea, L.; Remenar, E.; Degardin, M.; Pateras, I.S.; Langendijk, J.A.; Herpen, C.M.L. van; Awada, A.; Germa-Lluch, J.R.; Kienzer, H.R.; Licitra, L.; Vermorken, J.B.

    2017-01-01

    Background: EORTC 24971 was a phase III trial demonstrating superiority of induction regimen TPF (docetaxel, cisplatin, 5-fluorouracil) over PF (cisplatin/5-fluorouracil), in terms of progression-free (PFS) and overall survival (OS) in locoregionally advanced unresectable head and neck squamous cell

  16. Prediction of outcome after moderate and severe traumatic brain injury: External validation of the International Mission on Prognosis and Analysis of Clinical Trials (IMPACT) and Corticoid Randomisation after Significant Head injury (CRASH) prognostic models

    NARCIS (Netherlands)

    B. Roozenbeek (Bob); H.F. Lingsma (Hester); F.E. Lecky (Fiona); J. Lu (Juan); J. Weir (James); I. Butcher (Isabella); G.S. McHugh (Gillian); G.D. Murray (Gordon); P. Perel (Pablo); A.I.R. Maas (Andrew); E.W. Steyerberg (Ewout)

    2012-01-01

    textabstractObjective: The International Mission on Prognosis and Analysis of Clinical Trials and Corticoid Randomisation After Significant Head injury prognostic models predict outcome after traumatic brain injury but have not been compared in large datasets. The objective of this is study is to

  17. Patient-reported Measurements of Oral Mucositis in Head and Neck Cancer Patients Treated With Radiotherapy With or Without Chemotherapy Demonstration of Increased Frequency, Severity, Resistance to Palliation, and Impact on Quality of Life

    NARCIS (Netherlands)

    Elting, Linda S.; Keefe, Dorothy M.; Sonis, Stephen T.; Garden, Adam S.; Spijkervet, F. K. L.; Barasch, Andrei; Tishler, Roy B.; Canty, Thomas P.; Kudrimoti, Mahesh K.; Vera-Lionch, Montserrat

    2008-01-01

    BACKGROUND. I-lie risk, severity, and patient-reported outcomes of radiation-induced mucositis among head and neck cancer patients were prospectively estimated. METHODS. A validated, patient-reported questionnaire (OMDQ), the FACT quality of life (QOL), and the Functional Assessment of Chronic

  18. IMPACTS !

    CERN Multimedia

    2008-01-01

    (Photo courtesy of Don Davis / NASA)The University of Geneva (UNIGE) and the Ecole Polytechnique Fédérale of Lausanne (EPFL) are organising the 4th series of public lectures on astronomy, on the theme of "Impacts". The schedule is as follows: Il y a 100 ans : une explosion dans la Tunguska – Dr. Frédéric COURBIN, EPFL Les impacts sur Terre – Prof. Didier Queloz, UNIGE La fin des dinosaures – Dr. Stéphane Paltani, UNIGE Wednesday 7 May 2008, from 7.00 p.m. to 9.00 p.m. Auditoire CO1, EPFL, Ecublens Thursday 08 May 2008, from 7.00 p.m. to 9.00 p.m. Auditoire Rouiller, Uni-Dufour, Genève All 3 lectures will be givent each evening! Admission free Information: 022 379 22 00

  19. HEADS UP : Sensorimotor control of the head-neck system

    NARCIS (Netherlands)

    Forbes, P.A.

    2014-01-01

    Head-neck stabilization is inherently challenging even when stationary, requiring constant vigilance to counter the downward pull of gravity. It involves a highly complex biomechanical system comprised of a large mass (the head) balanced on top of seven vertebrae (the neck), that are in turn

  20. Comparison of multibody and finite element human body models in pedestrian accidents with the focus on head kinematics.

    Science.gov (United States)

    Fahlstedt, Madelen; Halldin, Peter; Kleiven, Svein

    2016-01-01

    The objective of this study was to compare and evaluate the difference in head kinematics between the TNO and THUMS models in pedestrian accident situations. The TNO pedestrian model (version 7.4.2) and the THUMS pedestrian model (version 1.4) were compared in one experiment setup and 14 different accident scenarios where the vehicle velocity, leg posture, pedestrian velocity, and pedestrian's initial orientation were altered. In all simulations, the pedestrian model was impacted by a sedan. The head trajectory, head rotation, and head impact velocity were compared, as was the trend when various different parameters were altered. The multibody model had a larger head wrap-around distance for all accident scenarios. The maximum differences of the head's center of gravity between the models in the global x-, y-, and z-directions at impact were 13.9, 5.8, and 5.6 cm, respectively. The maximum difference between the models in head rotation around the head's inferior-superior axis at head impact was 36°. The head impact velocity differed up to 2.4 m/s between the models. The 2 models showed similar trends for the head trajectory when the various parameters were altered. There are differences in kinematics between the THUMS and TNO pedestrian models. However, these model differences are of the same magnitude as those induced by other uncertainties in the accident reconstructions, such as initial leg posture and pedestrian velocity.

  1. Womanhood in Bessie Head's fiction

    African Journals Online (AJOL)

    confronted with gender discrimination in addition ;to the racial and ethnic marginality she had suffered since childhood. When the discovery of. Margaret's Basarwa origins culminate in the decision to get rid of her, Head points to the multiplicity of her problems. Head demonstrates that Margaret's womanhood comes into ...

  2. The head-mounted microscope.

    Science.gov (United States)

    Chen, Ting; Dailey, Seth H; Naze, Sawyer A; Jiang, Jack J

    2012-04-01

    Microsurgical equipment has greatly advanced since the inception of the microscope into the operating room. These advancements have allowed for superior surgical precision and better post-operative results. This study focuses on the use of the Leica HM500 head-mounted microscope for the operating phonosurgeon. The head-mounted microscope has an optical zoom from 2× to 9× and provides a working distance from 300 mm to 700 mm. The headpiece, with its articulated eyepieces, adjusts easily to head shape and circumference, and offers a focus function, which is either automatic or manually controlled. We performed five microlaryngoscopic operations utilizing the head-mounted microscope with successful results. By creating a more ergonomically favorable operating posture, a surgeon may be able to obtain greater precision and success in phonomicrosurgery. Phonomicrosurgery requires the precise manipulation of long-handled cantilevered instruments through the narrow bore of a laryngoscope. The head-mounted microscope shortens the working distance compared with a stand microscope, thereby increasing arm stability, which may improve surgical precision. Also, the head-mounted design permits flexibility in head position, enabling operator comfort, and delaying musculoskeletal fatigue. A head-mounted microscope decreases the working distance and provides better ergonomics in laryngoscopic microsurgery. These advances provide the potential to promote precision in phonomicrosurgery. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  3. Advances in otolaryngology-Head and neck surgery. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Myers, E.N. (Univ. of Pittsburgh School of Medicine, Pittsburgh, PA (US)); Bluestone, C.D. (Univ. of Pittsburgh, Pittsburgh, PA (US))

    1987-01-01

    This book consists of 14 sections. The section titles are: The impact of AIDS on otolaryngology--head and neck surgery; The management of sleep apneas and snoring; Antimicrobial agents for infections in the ear, nose, and throat--head and neck; Nasal allergy: Medical and surgical treatment; Uses of computerized tomography and magnetic resonance imaging in temporal bone imaging; Surgical management of otitis media with effusion; middle ear reconstruction: Current status; Cochlear implants: an overview; Diagnosis and management of acute facial paralysis; The use of the laser in head and neck surgery; The management and prevention of subglottic stenosis in infants and children; Management of the mass in the thyroid; Suction-assisted lipectomy of the head and neck area; and Ambulatory surgery.

  4. 49 CFR 572.112 - Head assembly.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Head assembly. 572.112 Section 572.112... 50th Percentile Male § 572.112 Head assembly. The head assembly consists of the head (drawing 78051-61X...) accelerometers that are mounted in conformance to § 572.36 (c). (a) Test procedure. (1) Soak the head assembly in...

  5. 49 CFR 572.192 - Head assembly.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Head assembly. 572.192 Section 572.192... Dummy, Small Adult Female § 572.192 Head assembly. (a) The head assembly consists of the head (180-1000...) of this section, the head assembly shall meet performance requirements specified in paragraph (c) of...

  6. Impact of additional cervical dedicated {sup 18}FDG-PET-CT on the management of head and neck squamous cell carcinoma; Impact therapeutique de l'acquisition cervicale dediee en [{sup 18}F]-FDG-TEP-TDM sur la prise en charge des carcinomes epidermoides de la tete et du cou

    Energy Technology Data Exchange (ETDEWEB)

    Queneau, M.; Tourdias, T.; Guyot, M.; Allard, M.; Fernandez, P. [CHU Pellegrin-Tripode, Service de Medecine Nucleaire, 33 - Bordeaux (France); Houliat, H. [CHU Pellegrin-Tripode, Service d' Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale du Pr Bebear, 33 - Bordeaux (France)

    2008-09-15

    Aim of the study: To investigate the therapeutic impact of additional cervical dedicated {sup 18}F.D.G.-PET-CT on the management of head and neck squamous cell carcinoma (H.N.S.C.C.). Materials and methods: Thirty patients with H.N.S.C.C. underwent a [{sup 18}F]-F.D.G.-PET-CT standard, whole-body scan completed by a cervical dedicated protocol. Two physicians blindly reviewed the exams and the results were discussed with surgeons to determine the therapeutic impact of the dedicated protocol. Result: Among 30 patients, only four (13%) discordant results were registered by the both observers, and two more by only one observer (k = 0.75, S.D. = 0.08). As to the four patients: 1) a N0 staged patient on whole body (W.B.) exam was upstaged to N2b in cervical PET (obese patient, whole-body exam with poor quality), 2) for a second patient, no node was described on whole-body scan, but one lymph node in each cervical chain was observed in focused PET, with low standardized uptake value (S.U.V. value), 3) in the other two cases, cervical PET scan upstaged from N2a to N2b and from N2a to N2c (S.U.V. < 3), without any influence on treatment management. Conclusion: Our results show that additional cervical dedicated PET-CT does not modify the management of patients with H.N.S.C.C. when compared to whole-body PET-CT, except for particular obese or N0 patients, allowing to reduce patient CT radiation dose and time-consuming PET acquisition. (authors)

  7. Research study on neck injury lessening with active head restraint using human body FE model.

    Science.gov (United States)

    Kitagawa, Yuichi; Yasuki, Tsuyoshi; Hasegawa, Junji

    2008-12-01

    The objective of this study is to examine the effectiveness of the active head restraint system in reducing neck injury risk of car occupants in low-speed rear impacts. A human body FE model "THUMS" was used to simulate head and neck kinematics of the occupant and to evaluate loading to the neck. Joint capsule strain was calculated to predict neck injury risk as well as NIC. The validity of the model was confirmed comparing its mechanical responses to those in human subjects in the literatures. Seat FE models were also prepared representing one with a fixed head restraint and the other one with an active head restraint system. The active head restraint system was designed to move the head restraint forward and upward when the lower unit was lower unit was loaded by the pelvis. Rear impact simulations were performed assuming a triangular acceleration pulse at a delta-V of 25 km/h. The model reproduced similar head and neck motions to those measured in the human volunteer test, except for active muscular responses. The calculated joint capsule strain also showed a good match with those of PMHS tests in the literature. A rear-impact simulation was conducted using the model with the fixed head restraint. The result revealed that NIC was strongly correlated with the relative acceleration between the head and the torso and that its maximum peak appeared when the head contacted the head restraint. It was also found that joint capsule strain grew in later timing synchronizing with the relative displacement. Another simulation with the active head restraint system showed that both NIC and joint capsule strain were lowered owing to the forward and upward motion of the head restraint. A close investigation of the vertebral motion indicated that the active head restraint reduced the magnitude of shear deformation in the facet joint, which contributed to the strain growth in the fixed head restraint case. Rear-impact simulations were conducted using a human body FE model, THUMS

  8. Does Head Start differentially benefit children with risks targeted by the program’s service model?☆

    Science.gov (United States)

    Miller, Elizabeth B.; Farkas, George; Duncan, Greg J.

    2015-01-01

    Data from the Head Start Impact Study (N = 3540) were used to test for differential benefits of Head Start after one program year and after kindergarten on pre-academic and behavior outcomes for children at risk in the domains targeted by the program’s comprehensive services. Although random assignment to Head Start produced positive treatment main effects on children’s pre-academic skills and behavior problems, residualized growth models showed that random assignment to Head Start did not differentially benefit the pre-academic skills of children with risk factors targeted by the Head Start service model. The models showed detrimental impacts of Head Start for maternal-reported behavior problems of high-risk children, but slightly more positive impacts for teacher-reported behavior. Policy implications for Head Start are discussed. PMID:26379369

  9. A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy

    Directory of Open Access Journals (Sweden)

    Ryosuke Desaki

    2014-01-01

    Full Text Available For pancreatic ductal adenocarcinoma (PDAC of the head and/or body invading the splenic artery (SA, we developed a new surgical technique of proximal subtotal pancreatectomy with splenic artery and vein resection, so-called pancreaticoduodenectomy with splenic artery resection (PD-SAR. We retrospectively reviewed a total of 84 patients with curative intent pancreaticoduodenectomy (PD for PDAC of the head and/or body. These 84 patients were classified into the two groups: conventional PD (n=66 and PD-SAR (n=18. Most patients were treated by preoperative chemoradiotherapy (CRT. Postoperative MDCT clearly demonstrated enhancement of the remnant pancreas at 1 and 6 months in all patients examined. Overall survival rates were very similar between PD and PD-SAR (3-year OS: 23.7% versus 23.1%, P=0.538, despite the fact that the tumor size and the percentages of UICC-T4 determined before treatment were higher in PD-SAR. Total daily insulin dose was significantly higher in PD-SAR than in PD at 1 month, while showing no significant differences between the two groups thereafter. PD-SAR with preoperative CRT seems to be promising surgical strategy for PDAC of head and/or body with invasion of the splenic artery, in regard to the balance between operative radicality and postoperative QOL.

  10. Will New Metal Heads Restore Mechanical Integrity of Corroded Trunnions?

    Science.gov (United States)

    Derasari, Aditya; Gold, Jonathan E; Ismaily, Sabir; Noble, Philip C; Incavo, Stephen J

    2017-04-01

    Metal wear and corrosion from modular junctions in total hip arthroplasty can lead to further unwanted surgery. Trunnion tribocorrosion is recognized as an important contributor to failure. This study was performed to determine if new metal heads restore mechanical integrity of the original modular junction after impaction on corroded trunnions, and assess which variables affect stability of the new interface created at revision total hip arthroplasty. Twenty-two trunnions, cobalt-chromium (CoCr) and titanium alloy (TiAIV), (CoCr, n = 12; TiAIV, n = 10) and new metal heads were used, 10 trunnions in pristine condition and 12 with corrosion damage. Test states were performed using an MTS Machine and included the following: 1, Assembly; 2, Disassembly; 3, Assembly; 4, Toggling; and 5, Disassembly. During loading, three-dimensional motion of the head-trunnion junction was measured using a custom jig. There were no statistical differences in the tested mechanical properties between corroded and pristine trunnions implanted with a new metal femoral head. Average micromotion of the head versus trunnion interface was greatest at the start of loading, stabilizing after approximately 50 loading cycles at an average of 30.6 ± 3.2 μm. Corrosion at the trunnion does not disrupt mechanical integrity of the junction when a CoCr head is replaced with a CoCr trunnion. However, increased interface motion of a new metal head on a corroded titanium trunnion requires additional study. The evaluation of ball head size on mechanical integrity of trunnions would also be a potential subject of future investigation, as increasing the ball head size at the time of revision is not uncommon in revisions today. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Impact of (18)f-fluorodeoxyglucose positron emission tomography/computed tomography scan on initial evaluation of head and neck squamous cell carcinoma: our experience at a tertiary care center in India.

    Science.gov (United States)

    Nair, Satish; Mohan, Sharad; Nilakantan, Ajith; Gupta, Atul; Malik, Akshat; Gupta, Abhishek

    2015-01-01

    The efficacy of the whole body (WB) (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography-computed tomography (PET-CT) as a part of conventional initial staging in all cases of head and neck squamous cell carcinoma (HNSCC) is still controversial with various studies in literature giving contradictory reports. We conducted this study at a government tertiary care oncology center in India to identify the impact of WB (18)F-FDG PET-CT scan on HNSCC staging and treatment. A prospective clinical study of patients of HNSCC who were evaluated and treated at our center was performed. The patients included in the study were HNSCC of the oral cavity, oropharynx, hypopharynx, larynx, nasopharynx, and carcinoma of unknown primary site (CUPS) with cervical metastasis. The study design was to evaluate the cases of HNSCC initially by staging with conventional investigations followed by staging with the information derived from WB (18)F-FDG PET-CT scan. At the end of the conventional investigations, a tumor, node, metastasis (TNM) staging as per AJCC 7(th) edition, and a detailed treatment plan as per NCCN 2012 guidelines was decided in consultation with the multidisciplinary oncology team of the hospital. WB (18)F-FDG PET-CT scan was carried out in all these patients. The findings of WB (18)F-FDG PET-CT were then interpreted with the staging with conventional investigations to identify the cases with change in staging and also those in whom the treatment protocol would be affected. Descriptive analysis of demographic data and analytical analysis of the sensitivity and specificity of WB (18)F-FDG PET-CT scan and also the change in staging and treatment plan after WB (18)F-FDG PET-CT scan was analyzed using SPSS version 18. A total of 131 patients met the inclusion criteria, which included 123 males and 8 females. The various sites involved among the study group are oral cavity 11 (8.3%), oropharyn × 39 (29.7%), hypopharyn × 31 (23.6%), laryn × 34 (25.9%), nasopharyn

  12. HEAD AND NECK SURGERY

    African Journals Online (AJOL)

    and the Control through Salt Iodization. Geneva: WHO/. NUT/94.6,World Health Organisation 1994;1-55. 16. Bron LP, O' Brien CJ. Total thyroidectomy for clinically benign disease of the thyroid gland. Br J Surg. 2004;91:569-74. 17. Phillips AW, Fenwick JD, Mallick UK, Perros P. The impact of clinical guidelines on surgical ...

  13. Landslides at Beachy Head, Sussex

    OpenAIRE

    Pennington, Catherine

    2007-01-01

    Beachy Head (Figures 1 and 2) is a famous natural and historic site and tourist attraction on the south coast. The cliff top area is part of the Downland Country Park managed by Eastbourne District Council. The section of cliff surveyed at Beachy Head is situated to the east of the modern lighthouse. The survey spans a 400 m south-facing stretch of beach with a cliff height of between 120 and 160 m. Cliffs and lighthouse at Beachy Head As part of a programme of work monitoring coast...

  14. Return of the talking heads

    DEFF Research Database (Denmark)

    Reinecke Hansen, Kenneth; Bro, Peter; Andersson, Ralf

    2016-01-01

    . In order to analyze the latest development entering the third wave, we propose a theoretically based dramaturgical model for the television news item. The analysis concludes that, with the current ‘return’ of the talking heads format, the pre-produced and pre-packaged bulletin program about past events......The present article suggests that the brief history of Western television news dramaturgy can be expounded as three major waves: from the early days of the talking heads in the studio, over the narrativization of the field report to a (re-)current studio- and field-based talking heads format...

  15. A Season of American Football Is Not Associated with Changes in Plasma Tau.

    Science.gov (United States)

    Oliver, Jonathan M; Jones, Margaret T; Anzalone, Anthony J; Kirk, K Michele; Gable, David A; Repshas, Justin T; Johnson, Torie A; Höglund, Kina; Blennow, Kaj; Zetterberg, Henrik

    2017-08-18

    American football athletes are routinely exposed to sub-concussive impacts over the course of the season. This study sought to examine the effect of a season of American football on plasma tau, a potential marker of axonal damage. Nineteen National Collegiate Athletic Association (NCAA) football athletes underwent serial blood sampling over the course of the 2014-2015 season at those times in which the number and magnitude of head impacts likely changed. Non-contact sport controls (NCAA men's swim athletes; n = 19) provided a single plasma sample for comparison. No significant differences were observed between control swim athletes and football athletes following a period of non-contact (p = 0.569) or a period of contact (p = 0.076). Football athletes categorized as starters (n = 11) had higher tau concentrations than non-starters (n = 8) following a period of non-contact (p = 0.039) and contact (p = 0.036), but not higher than swimmers (p = 1.000 and p = 1.000, respectively). No difference was noted over the course of the season in football athletes, irrespective of starter status. Despite routine head impacts common to the sport of American football, no changes were observed over the course of the season in football athletes, irrespective of starter status. Further, no difference was observed between football athletes and non-contact control swim athletes following a period of non-contact or contact. These data suggest that plasma tau is not sensitive enough to detect damage associated with repetitive sub-concussive impacts sustained by collegiate-level football athletes.

  16. Counting heads in Cairo.

    Science.gov (United States)

    1994-09-14

    Representatives of 182 nations gathered in Cairo in September, 1994, at the Un Conference on Population and Development. The resulting 113-page Draft Program of Action contains sober discussions on demographic issues, including projections of population increase in the decades ahead. It focuses on the potential growth of famine, disease, warfare, environmental degradation, and general human misery if the world's population cannot be stabilized at around 8 billion in the next 20 years. The 1994 figure stands at about 5.7 billion, and there will be 12.5 billion people if no action is taken. Previous conferences hosted under the UN helped spark a remarkable decline in fertility rates, especially in Indonesia and Thailand. Even in populous Bangladesh, some 40% of women now use contraceptives, while the fertility rate has dropped from 7 to 4.2 in 2 decades. The proposals debated in Cairo include sustainable development, gender equality, and the empowerment of women. Whatever the country or culture, fertility rates tend to fall dramatically as women become more educated. This has been borne out almost everywhere, most notably in Japan and Singapore. The conference has been criticized by the Vatican as advocating an international standard for easy abortion, encouraging sex education for teenagers, and sanctioning marriages other than between a man and a woman. Some conservative Muslim thinkers have also complained that it promotes Western values and fosters illicit sex. Many supporters of population planning have argued that the empowerment of women will reduce the incidence of abortion. The Cairo document will alienate many across Asia with its references to the plurality of family forms, including the large number of households headed by single parents. The one goal on which everyone can agree is the need to promote policies that will stabilize the global headcount.

  17. Impact of geometric uncertainties on dose distribution during intensity modulated radiotherapy of head-and-neck cancer: the need for a planning target volume and a planning organ-at-risk volume.

    Science.gov (United States)

    Ballivy, O; Parker, W; Vuong, T; Shenouda, G; Patrocinio, H

    2006-06-01

    We assessed the effect of geometric uncertainties on target coverage and on dose to the organs at risk (OARS) during intensity-modulated radiotherapy (IMRT) for head-and-neck cancer, and we estimated the required margins for the planning target volume (PTV) and the planning organ-at-risk volume (PRV). For eight head-and-neck cancer patients, we generated IMRT plans with localization uncertainty margins of 0 mm, 2.5 mm, and 5.0 mm. The beam intensities were then applied on repeat computed tomography (CT) scans obtained weekly during treatment, and dose distributions were recalculated.The dose-volume histogram analysis for the repeat ct scans showed that target coverage was adequate (V(100) >/= 95%) for only 12.5% of the gross tumour volumes, 54.3% of the upper-neck clinical target volumes (CTVS), and 27.4% of the lower-neck CTVS when no margins were added for PTV. The use of 2.5-mm and 5.0-mm margins significantly improved target coverage, but the mean dose to the contralateral parotid increased from 25.9 Gy to 29.2 Gy. Maximum dose to the spinal cord was above limit in 57.7%, 34.6%, and 15.4% of cases when 0-mm, 2.5-mm, and 5.0-mm margins (respectively) were used for prv.Significant deviations from the prescribed dose can occur during IMRT treatment delivery for head-and-neck cancer. The use of 2.5-mm to 5.0-mm margins for PTV and PRV greatly reduces the risk of underdosing targets and of overdosing the spinal cord.

  18. Radiation dose reduction using 100-kVp and a sinogram-affirmed iterative reconstruction algorithm in adolescent head CT: Impact on grey-white matter contrast and image noise

    Energy Technology Data Exchange (ETDEWEB)

    Nagayama, Yasunori [Kumamoto City Hospital, Department of Radiology, Kumamoto (Japan); Kumamoto University, Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto (Japan); Nakaura, Takeshi; Yuki, Hideaki; Hirarta, Kenichiro; Kidoh, Masafumi; Oda, Seitaro; Utsunomiya, Daisuke; Yamashita, Yasuyuki [Kumamoto University, Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto (Japan); Tsuji, Akinori; Urata, Joji; Furusawa, Mitsuhiro [Kumamoto City Hospital, Department of Radiology, Kumamoto (Japan)

    2017-07-15

    To retrospectively evaluate the image quality and radiation dose of 100-kVp scans with sinogram-affirmed iterative reconstruction (IR) for unenhanced head CT in adolescents. Sixty-nine patients aged 12-17 years underwent head CT under 120- (n = 34) or 100-kVp (n = 35) protocols. The 120-kVp images were reconstructed with filtered back-projection (FBP), 100-kVp images with FBP (100-kVp-F) and sinogram-affirmed IR (100-kVp-S). We compared the effective dose (ED), grey-white matter (GM-WM) contrast, image noise, and contrast-to-noise ratio (CNR) between protocols in supratentorial (ST) and posterior fossa (PS). We also assessed GM-WM contrast, image noise, sharpness, artifacts, and overall image quality on a four-point scale. ED was 46% lower with 100- than 120-kVp (p < 0.001). GM-WM contrast was higher, and image noise was lower, on 100-kVp-S than 120-kVp at ST (p < 0.001). CNR of 100-kVp-S was higher than of 120-kVp (p < 0.001). GM-WM contrast of 100-kVp-S was subjectively rated as better than of 120-kVp (p < 0.001). There were no significant differences in the other criteria between 100-kVp-S and 120-kVp (p = 0.072-0.966). The 100-kVp with sinogram-affirmed IR facilitated dramatic radiation reduction and better GM-WM contrast without increasing image noise in adolescent head CT. (orig.)

  19. Simple Strategy to Prevent Severe Head Trauma in Judo

    National Research Council Canada - National Science Library

    MURAYAMA, Haruo; HITOSUGI, Masahito; MOTOZAWA, Yasuki; OGINO, Masahiro; KOYAMA, Katsuhiro

    2013-01-01

    To determine whether the use of an under-mat has an effect on impact forces to the head in Judo, a Judo expert threw an anthropomorphic test device using the Osoto-gari and Ouchi-gari techniques onto a tatami (judo mat...

  20. Prophylactic Swallowing Exercises in Head and Neck Cancer Radiotherapy

    DEFF Research Database (Denmark)

    Mortensen, H R; Jensen, Kenneth; Aksglæde, K

    2015-01-01

    Many head and neck cancer (HNC) survivors experience reduced quality of life due to radiotherapy (RT)-related dysphagia. The aim of this prospective randomized trial was to evaluate the impact of prophylactic swallowing exercises on swallowing-related outcomes in HNC patients treated with curativ...

  1. Food safety on the slaughterline: inspection of pig heads

    DEFF Research Database (Denmark)

    Petersen, J.V.; Andersen, Jens Kirk; Sorensen, F.

    2002-01-01

    This paper summarises information on the current inspection procedures for pig heads on the slaughterline and their impact on food safety, and considers the implications for food safety of certain lesions. It is argued that although a modified slaughter and inspection technique would decrease...

  2. Predicting brain acceleration during heading of soccer ball

    Science.gov (United States)

    Taha, Zahari; Hasnun Arif Hassan, Mohd; Azri Aris, Mohd; Anuar, Zulfika

    2013-12-01

    There has been a long debate whether purposeful heading could cause harm to the brain. Studies have shown that repetitive heading could lead to degeneration of brain cells, which is similarly found in patients with mild traumatic brain injury. A two-degree of freedom linear mathematical model was developed to study the impact of soccer ball to the brain during ball-to-head impact in soccer. From the model, the acceleration of the brain upon impact can be obtained. The model is a mass-spring-damper system, in which the skull is modelled as a mass and the neck is modelled as a spring-damper system. The brain is a mass with suspension characteristics that are also defined by a spring and a damper. The model was validated by experiment, in which a ball was dropped from different heights onto an instrumented dummy skull. The validation shows that the results obtained from the model are in a good agreement with the brain acceleration measured from the experiment. This findings show that a simple linear mathematical model can be useful in giving a preliminary insight on what human brain endures during a ball-to-head impact.

  3. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... digital cloud server. Currently, MRI is the most sensitive imaging test of the head (particularly the brain) ... Society of Urogenital Radiology note that the available data suggest that it is safe to continue breastfeeding ...

  4. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... medically necessary. MRI may not always distinguish between cancer tissue and fluid, known as edema . MRI typically ... Brain Tumors Radiation Therapy for Head and Neck Cancer Others : American Stroke Association National Stroke Association top ...

  5. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... a computer to produce detailed pictures of the brain and other cranial structures that are clearer and ... sensitive imaging test of the head (particularly the brain) in routine clinical practice. top of page What ...

  6. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... of the head (particularly the brain) in routine clinical practice. top of page What are some common ... acutely injured; however, this decision is based on clinical judgment. This is because traction devices and many ...

  7. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... page Additional Information and Resources RTAnswers.org : Radiation Therapy for Brain Tumors Radiation Therapy for Head and ...

  8. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... an IV line, into a vein in your hand or arm. A saline solution may be used ... Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to Magnetic ...

  9. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... Videos About Us News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic ... very early stage by mapping the motion of water molecules in the tissue. This water motion, known ...

  10. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... practice. top of page What are some common uses of the procedure? MR imaging of the head ... gadolinium contrast, it may still be possible to use it after appropriate pre-medication. Patient consent will ...

  11. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... MRI) of the head uses a powerful magnetic field, radio waves and a computer to produce detailed ... there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some ...

  12. Head, Neck, and Oral Cancer

    Science.gov (United States)

    ... cancer of the head, neck and mouth. The Oral Cancer Foundation estimates that close to 42,000 Americans ... diagnosed with oral or pharyngeal cancer this year. Oral cancer’s mortality is particularly high, not because it is ...

  13. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... have a personal story about radiology? Share your patient story here Images ... (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging (MRI) ...

  14. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no ... Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose medical conditions. ...

  15. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... the same effect. A very irregular heartbeat may affect the quality of images obtained using techniques that ... Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to Magnetic ...

  16. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... test of the head (particularly the brain) in routine clinical practice. top of page What are some ... told otherwise, you may follow your regular daily routine and take food and medications as usual. Some ...

  17. Eye-based head gestures

    DEFF Research Database (Denmark)

    Mardanbegi, Diako; Witzner Hansen, Dan; Pederson, Thomas

    2012-01-01

    A novel method for video-based head gesture recognition using eye information by an eye tracker has been proposed. The method uses a combination of gaze and eye movement to infer head gestures. Compared to other gesture-based methods a major advantage of the method is that the user keeps the gaze...... on the interaction object while interacting. This method has been implemented on a head-mounted eye tracker for detecting a set of predefined head gestures. The accuracy of the gesture classifier is evaluated and verified for gaze-based interaction in applications intended for both large public displays and small...... mobile phone screens. The user study shows that the method detects a set of defined gestures reliably....

  18. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... the same effect. A very irregular heartbeat may affect the quality of images obtained using techniques that ... Information and Resources RTAnswers.org : Radiation Therapy for Brain Tumors Radiation Therapy for Head and Neck Cancer ...

  19. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... a CD or uploaded to a digital cloud server. Currently, MRI is the most sensitive imaging test ... Brain Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to Magnetic ...

  20. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... the same effect. A very irregular heartbeat may affect the quality of images obtained using techniques that ... Brain Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to ...

  1. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... Radiation Therapy for Head and Neck Cancer Others : American Stroke Association National Stroke Association top of page ... and is further reviewed by committees from the American College of Radiology (ACR) and the Radiological Society ...

  2. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... the head uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of ... the body being imaged, send and receive radio waves, producing signals that are detected by the coils. ...

  3. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... data suggest that it is safe to continue breastfeeding after receiving intravenous contrast. For further information please ... Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to Magnetic Resonance Imaging ( ...

  4. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... scanner. top of page How does the procedure work? Unlike conventional x-ray examinations and computed tomography ( ... for Head and Neck Cancer Others : American Stroke Association National Stroke Association top of page This page ...

  5. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... copied to a CD or uploaded to a digital cloud server. Currently, MRI is the most sensitive ... Brain Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to Magnetic ...

  6. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... of the head uses a powerful magnetic field, radio waves and a computer to produce detailed pictures ... medical conditions. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed ...

  7. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... or headphones during the exam. MRI scanners are air-conditioned and well-lit. Music may be played ... the limitations of MRI of the Head? High-quality images are assured only if you are able ...

  8. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... may sense a temporary metallic taste in their mouth after the contrast injection. If you do not ... Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to Magnetic Resonance Imaging ( ...

  9. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... and may add approximately 15 minutes to the total exam time. top of page What will I ... the limitations of MRI of the Head? High-quality images are assured only if you are able ...

  10. A Success Story: The Evaluation of Four Head Start Bilingual Multicultural Curriculum Models.

    Science.gov (United States)

    Arenas, Soledad; Trujillo, Lorenzo A.

    An evaluation was made of four Head Start bilingual/ multicultural curriculum models to assess their effectiveness and impact on children, staff, and parents. Intended as a pre-post design (with 90 children at each of eight Head Start replication sites and with treatment and control groups stratified on the basis of Spanish or English language…

  11. Head and Neck Cancer Pain.

    Science.gov (United States)

    Ing, Jakun W

    2017-08-01

    Pain is a significant morbidity resulting from head and neck cancer. Pain may also be the result of the treatments directed against head and neck cancer. An experienced practitioner may manage this pain by understanding the multifactorial mechanisms of pain and the various pharmacotherapies available. Pain should be managed with multiple medications in a multimodal approach, and nonpharmacologic therapies should be considered as well. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. 49 CFR 572.182 - Head assembly.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Head assembly. 572.182 Section 572.182... Dummy, 50th Percentile Adult Male § 572.182 Head assembly. (a) The head assembly consists of the head... assembly shall meet performance requirements specified in paragraph (c) of this section. (b) Test procedure...

  13. Catastrophic head injuries in high school and college football players.

    Science.gov (United States)

    Boden, Barry P; Tacchetti, Robin L; Cantu, Robert C; Knowles, Sarah B; Mueller, Frederick O

    2007-07-01

    Catastrophic head injuries in football are rare but tragic events. To update the profile of catastrophic head injuries in high school and college football players and to describe relevant risk factors. Case series; Level of evidence, 4. We reviewed 94 incidents of severe football head injuries reported to the National Center for Catastrophic Sports Injury Research during 13 academic years (September 1989 through June 2002). In the study period there were an average of 7.23 (standard deviation = 2.05) direct high school and college catastrophic head injuries in scholastic football participants per year. There were 0.67 injuries per 100 000 (95% confidence interval: 0.54, 0.81 per 100 000) high school and 0.21 injuries per 100 000 (95% confidence interval: 0.0, 0.49 per 100 000) college participants for a risk ratio of 3.28 (95% confidence interval: 0.81, 13.3). The injuries resulted in subdural hematoma in 75 athletes, subdural hematoma with diffuse brain edema in 10 athletes, diffuse brain edema in 5 athletes, and arteriovenous malformation or aneurysm in 4 athletes. Fifty-nine percent of the contacts reported that the athlete had a history of a previous head injury, of which 71% occurred within the same season as the catastrophic event. Thirty-nine percent of the athletes (21 of 54) were playing with residual neurologic symptoms from the prior head injury. There were 8 (9%) deaths as a result of the injury, 46 (51%) permanent neurologic injuries, and 36 (40%) serious injuries with full recovery. Most players sustained a major impact to the head either from tackling or being tackled. The incidence of catastrophic head injuries in football has remained low since the advent of the modern day football helmet in the early 1970s. The incidence of catastrophic head injuries in football is dramatically higher at the high school level than at the college level. Although the reason for this discrepancy is unclear, an unacceptably high percentage of high school players were

  14. Head injury potential and the effectiveness of headgear in women's lacrosse.

    Science.gov (United States)

    Rodowicz, Kathleen Allen; Olberding, Joseph E; Rau, Andrew C

    2015-04-01

    Over the past 10 years, lacrosse has grown increasingly popular, making it one of the fastest growing team sports in the country. Similar to other sporting activities, head injuries in lacrosse can and do occur, and the number of lacrosse-related head injuries has increased in recent years. In women's lacrosse, protective headgear is not required, but U.S. Lacrosse and the American Society for Testing and Materials are currently working to develop a headgear standard for the women's game. In the interim, some female lacrosse programs and individual players are wearing soft headgear during play. The effectiveness of this headgear is unknown. Testing was conducted to better understand the material properties of various types of headgear that may be used in lacrosse and the effect of this headgear on head impact response and head injury potential. For the evaluation of head impact response, an instrumented Hybrid III anthropomorphic test device (ATD) was impacted on the side of the head with lacrosse balls and the front and side of the head with a lacrosse stick. The linear and rotational impact response of the head and corresponding acceleration-based injury metrics are reported. Testing was then repeated with the ATD wearing different types of headgear. Tested headgear included a men's lacrosse helmet and two brands of commercially-available soft headgear. For the higher velocity ball impacts, there was no statistically-significant difference in the measured linear and rotational response of the head for the no headgear and soft headgear test conditions. For the lower velocity ball impacts, there was a small, yet statistically-significant, reduction in head linear acceleration for one of the soft headgears tested in comparison to the no headgear test condition, but there was not a statistically-significant difference in the rotational impact response with this headgear. These results indicate that the soft headgear would not be effective in reducing head injury

  15. Heading for a fall? Management of head injury in infants.

    LENUS (Irish Health Repository)

    Williamson, M

    2010-09-01

    Head injury is one of the commonest reasons for infants (< 1 year) to attend the Emergency Department (ED). Clinical management varies considerably and concern about non accidental injury results in a high admission rate in some hospitals. Information was obtained on 103 children under one year of age presenting to the ED with head injury in a prospective study. The average age was 6.7 months and 57% of patients were male. Twenty eight babies had skull x rays with 1 skull fracture diagnosed. None required CT brain scan. Ninety eight (94%) were discharged home from the ED. There were no unplanned returns, readmissions or adverse events. The incidence of traumatic brain injury in children under one year of age presenting with head injury is low and the majority can be safely discharged home.

  16. Oral microbiome, periodontitis and risk of head and neck cancer.

    Science.gov (United States)

    Galvão-Moreira, Leonardo Victor; da Cruz, Maria Carmen Fontoura Nogueira

    2016-02-01

    A wide range of studies has been successfully exploring the association between the human microenvironment, sustained inflammation, and cancer. Growing evidence has then emerged in this field over the past few years. Nevertheless, reliable data addressing the impact of the oral microbiome and periodontitis on the pathogenesis and risk of head and neck malignancies remain scarce. Hence, this communication focuses on briefly discuss the relationship between the oral microbiome, periodontitis and head and neck cancer based on the current understanding of such a disease-associated scenario. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Sex Differences in Anthropometrics and Heading Kinematics Among Division I Soccer Athletes.

    Science.gov (United States)

    Bretzin, Abigail C; Mansell, Jamie L; Tierney, Ryan T; McDevitt, Jane K

    Soccer players head the ball repetitively throughout their careers; this is also a potential mechanism for a concussion. Although not all soccer headers result in a concussion, these subconcussive impacts may impart acceleration, deceleration, and rotational forces on the brain, leaving structural and functional deficits. Stronger neck musculature may reduce head-neck segment kinematics. The relationship between anthropometrics and soccer heading kinematics will not differ between sexes. The relationship between anthropometrics and soccer heading kinematics will not differ between ball speeds. Pilot, cross-sectional design. Level 3. Division I soccer athletes (5 male, 8 female) were assessed for head-neck anthropometric and neck strength measurements in 6 directions (ie, flexion, extension, right and left lateral flexions and rotations). Participants headed the ball 10 times (25 or 40 mph) while wearing an accelerometer secured to their head. Kinematic measurements (ie, linear acceleration and rotational velocity) were recorded at 2 ball speeds. Sex differences were observed in neck girth ( t = 5.09, P soccer heading kinematics for sex and ball speeds. Neck girth and neck strength are factors that may limit head impact kinematics.

  18. Spanish Instruction in Head Start and Dual Language Learners' Academic Achievement.

    Science.gov (United States)

    Miller, Elizabeth B

    2017-09-01

    Data from the Head Start Impact Study ( N = 1,141) and the Head Start Family and Child Experiences Survey, 2009 Cohort ( N = 825) were used to investigate whether Spanish instruction in Head Start differentially increased Spanish-speaking Dual Language Learners' (DLLs) academic achievement. Although hypothesized that Spanish instruction would be beneficial for DLLs' early literacy and math skills, results from residualized growth models showed there were no such positive associations. Somewhat surprisingly, DLL children instructed in Spanish had higher English receptive vocabulary skills at the end of the Head Start year than those not instructed, with children randomly assigned to Head Start and instructed in Spanish having the highest scores. Policy implications for Head Start-eligible Spanish-speaking DLLs are discussed.

  19. Magnetic head having a wear-resistant layer, and method of manufacturing such a magnetic head

    NARCIS (Netherlands)

    Dirne, F.W.A.; Zieren, V.; Broese van Groenou, A.; Oorschot, L.F.M. van; Lasinski, P.; Jongh, M. de; Roozeboom, F.

    2002-01-01

    Magnetic head having a head face (5) and comprising a head structure composed of thin layers and provided with a transducing element (E11), in which different materials occurring in different areas are present in the head face. The head face is provided with a first layer (31) of a material which is

  20. Wheelchair control by head motion

    Directory of Open Access Journals (Sweden)

    Pajkanović Aleksandar

    2013-01-01

    Full Text Available Electric wheelchairs are designed to aid paraplegics. Unfortunately, these can not be used by persons with higher degree of impairment, such as quadriplegics, i.e. persons that, due to age or illness, can not move any of the body parts, except of the head. Medical devices designed to help them are very complicated, rare and expensive. In this paper a microcontroller system that enables standard electric wheelchair control by head motion is presented. The system comprises electronic and mechanic components. A novel head motion recognition technique based on accelerometer data processing is designed. The wheelchair joystick is controlled by the system’s mechanical actuator. The system can be used with several different types of standard electric wheelchairs. It is tested and verified through an experiment performed within this paper.

  1. OCULAR MANIFESTATIONS OF HEAD INJURIES

    Directory of Open Access Journals (Sweden)

    Kanukollu Venkata Madusudana Rao

    2016-12-01

    Full Text Available BACKGROUND This prospective study aimed to evaluate the incidence of ocular manifestations in head injury and their correlation with the intracranial lesions. MATERIALS AND METHODS A total of 108 consecutive cases of closed head injury admitted in the neurosurgical ward of a tertiary teaching hospital underwent a thorough ophthalmic assessment. Clinical examination, radiological imaging and Glasgow Coma Scale (GCS were applied to grade the severity of injury. RESULTS Total number of 108 patients of head injury were examined of which 38 patients had ocular manifestations (35.18%. Of these, 85.18% were males, 84% of injuries were due to road traffic accidents and 16% were due to fall from a height. The ocular manifestations were as follows- Orbital complications were seen in 6 patients (15.8%. Anterior segment manifestations included black eyes seen in 10 patients (26.3%, subconjunctival haemorrhage in 10.5% of patients (4 patients, corneal involvement in 21% of patients (8 patients and pupillary involvement in 50% of patients (19 patients. Posterior segment manifestations were seen in 26.3% of patients (10 patients and were as follows- Purtscher’s retinopathy in 2 patients and optic atrophy in 5 patients. Cranial nerve palsies were seen in 15 patients (39.47% and supranuclear movement disorders were seen in 3 patients (8%. CONCLUSION Even though, neurosurgeons perform comprehensive clinical examination including eye examination, the main purpose is limited to aid topical diagnosis of neurological lesions. This study emphasises the importance of a detailed eye examination by an ophthalmologist to prevent irreversible visual loss in addition to aiding in the neurological diagnosis. Pupillary involvement, papilloedema and ocular motor paresis pointed to a more severe head injury. This observational prospective study helped us to correlate the severity of head injuries in association with ocular findings in patients admitted in neurosurgical ward

  2. Predictive Compensator Optimization for Head Tracking Lag in Virtual Environments

    Science.gov (United States)

    Adelstein, Barnard D.; Jung, Jae Y.; Ellis, Stephen R.

    2001-01-01

    We examined the perceptual impact of plant noise parameterization for Kalman Filter predictive compensation of time delays intrinsic to head tracked virtual environments (VEs). Subjects were tested in their ability to discriminate between the VE system's minimum latency and conditions in which artificially added latency was then predictively compensated back to the system minimum. Two head tracking predictors were parameterized off-line according to cost functions that minimized prediction errors in (1) rotation, and (2) rotation projected into translational displacement with emphasis on higher frequency human operator noise. These predictors were compared with a parameterization obtained from the VE literature for cost function (1). Results from 12 subjects showed that both parameterization type and amount of compensated latency affected discrimination. Analysis of the head motion used in the parameterizations and the subsequent discriminability results suggest that higher frequency predictor artifacts are contributory cues for discriminating the presence of predictive compensation.

  3. Development of Head Injury Assessment Reference Values Based on NASA Injury Modeling

    Science.gov (United States)

    Somers, Jeffrey T.; Melvin, John W.; Tabiei, Ala; Lawrence, Charles; Ploutz-Snyder, Robert; Granderson, Bradley; Feiveson, Alan; Gernhardt, Michael; Patalak, John

    2011-01-01

    NASA is developing a new capsule-based, crewed vehicle that will land in the ocean, and the space agency desires to reduce the risk of injury from impact during these landings. Because landing impact occurs for each flight and the crew might need to perform egress tasks, current injury assessment reference values (IARV) were deemed insufficient. Because NASCAR occupant restraint systems are more effective than the systems used to determine the current IARVs and are similar to NASA s proposed restraint system, an analysis of NASCAR impacts was performed to develop new IARVs that may be more relevant to NASA s context of vehicle landing operations. Head IARVs associated with race car impacts were investigated by completing a detailed analysis of all of the 2002-2008 NASCAR impact data. Specific inclusion and exclusion criteria were used to select 4071 impacts from the 4015 recorder files provided (each file could contain multiple impact events). Of the 4071 accepted impacts, 274 were selected for numerical simulation using a custom NASCAR restraint system and Humanetics Hybrid-III 50th percentile numerical dummy model in LS-DYNA. Injury had occurred in 32 of the 274 selected impacts, and 27 of those injuries involved the head. A majority of the head injuries were mild concussions with or without brief loss of consciousness. The 242 non-injury impacts were randomly selected and representative of the range of crash dynamics present in the total set of 4071 impacts. Head dynamics data (head translational acceleration, translational change in velocity, rotational acceleration, rotational velocity, HIC-15, HIC-36, and the Head 3ms clip) were filtered according to SAE J211 specifications and then transformed to a log scale. The probability of head injury was estimated using a separate logistic regression analysis for each log-transformed predictor candidate. Using the log transformation constrains the estimated probability of injury to become negligible as IARVs approach

  4. The Video Head Impulse Test

    Science.gov (United States)

    Halmagyi, G. M.; Chen, Luke; MacDougall, Hamish G.; Weber, Konrad P.; McGarvie, Leigh A.; Curthoys, Ian S.

    2017-01-01

    In 1988, we introduced impulsive testing of semicircular canal (SCC) function measured with scleral search coils and showed that it could accurately and reliably detect impaired function even of a single lateral canal. Later we showed that it was also possible to test individual vertical canal function in peripheral and also in central vestibular disorders and proposed a physiological mechanism for why this might be so. For the next 20 years, between 1988 and 2008, impulsive testing of individual SCC function could only be accurately done by a few aficionados with the time and money to support scleral search-coil systems—an expensive, complicated and cumbersome, semi-invasive technique that never made the transition from the research lab to the dizzy clinic. Then, in 2009 and 2013, we introduced a video method of testing function of each of the six canals individually. Since 2009, the method has been taken up by most dizzy clinics around the world, with now close to 100 refereed articles in PubMed. In many dizzy clinics around the world, video Head Impulse Testing has supplanted caloric testing as the initial and in some cases the final test of choice in patients with suspected vestibular disorders. Here, we consider seven current, interesting, and controversial aspects of video Head Impulse Testing: (1) introduction to the test; (2) the progress from the head impulse protocol (HIMPs) to the new variant—suppression head impulse protocol (SHIMPs); (3) the physiological basis for head impulse testing; (4) practical aspects and potential pitfalls of video head impulse testing; (5) problems of vestibulo-ocular reflex gain calculations; (6) head impulse testing in central vestibular disorders; and (7) to stay right up-to-date—new clinical disease patterns emerging from video head impulse testing. With thanks and appreciation we dedicate this article to our friend, colleague, and mentor, Dr Bernard Cohen of Mount Sinai Medical School, New York, who since his

  5. The Video Head Impulse Test

    Directory of Open Access Journals (Sweden)

    G. M. Halmagyi

    2017-06-01

    Full Text Available In 1988, we introduced impulsive testing of semicircular canal (SCC function measured with scleral search coils and showed that it could accurately and reliably detect impaired function even of a single lateral canal. Later we showed that it was also possible to test individual vertical canal function in peripheral and also in central vestibular disorders and proposed a physiological mechanism for why this might be so. For the next 20 years, between 1988 and 2008, impulsive testing of individual SCC function could only be accurately done by a few aficionados with the time and money to support scleral search-coil systems—an expensive, complicated and cumbersome, semi-invasive technique that never made the transition from the research lab to the dizzy clinic. Then, in 2009 and 2013, we introduced a video method of testing function of each of the six canals individually. Since 2009, the method has been taken up by most dizzy clinics around the world, with now close to 100 refereed articles in PubMed. In many dizzy clinics around the world, video Head Impulse Testing has supplanted caloric testing as the initial and in some cases the final test of choice in patients with suspected vestibular disorders. Here, we consider seven current, interesting, and controversial aspects of video Head Impulse Testing: (1 introduction to the test; (2 the progress from the head impulse protocol (HIMPs to the new variant—suppression head impulse protocol (SHIMPs; (3 the physiological basis for head impulse testing; (4 practical aspects and potential pitfalls of video head impulse testing; (5 problems of vestibulo-ocular reflex gain calculations; (6 head impulse testing in central vestibular disorders; and (7 to stay right up-to-date—new clinical disease patterns emerging from video head impulse testing. With thanks and appreciation we dedicate this article to our friend, colleague, and mentor, Dr Bernard Cohen of Mount Sinai Medical School, New York, who

  6. Femoral Head and Neck Excision.

    Science.gov (United States)

    Harper, Tisha A M

    2017-07-01

    Femoral head and neck excision is a surgical procedure that is commonly performed in small animal patients. It is a salvage procedure that is done to relieve pain in the coxofemoral joint and restore acceptable function of the limb. Femoral head and neck excision is most commonly used to treat severe osteoarthritis in the coxofemoral joint and can be done in dogs and cats of any size or age. The procedure should not be overused and ideally should not be done when the integrity of the coxofemoral joint can be restored. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Head First 2D Geometry

    CERN Document Server

    Fallow), Stray

    2009-01-01

    Having trouble with geometry? Do Pi, The Pythagorean Theorem, and angle calculations just make your head spin? Relax. With Head First 2D Geometry, you'll master everything from triangles, quads and polygons to the time-saving secrets of similar and congruent angles -- and it'll be quick, painless, and fun. Through entertaining stories and practical examples from the world around you, this book takes you beyond boring problems. You'll actually use what you learn to make real-life decisions, like using angles and parallel lines to crack a mysterious CSI case. Put geometry to work for you, and

  8. Head injury mechanisms in FIS World Cup alpine and freestyle skiers and snowboarders.

    Science.gov (United States)

    Steenstrup, Sophie Elspeth; Bakken, Arnhild; Bere, Tone; Patton, Declan Alexander; Bahr, Roald

    2018-01-01

    Head injuries represent a concern in skiing and snowboarding, with traumatic brain injuries being the most common cause of death. To describe the mechanisms of head and face injuries among World Cup alpine and freestyle skiers and snowboarders. We performed a qualitative analysis of videos obtained of head and face injuries reported through the International Ski Federation Injury Surveillance System during 10 World Cup seasons (2006-2016). We analysed 57 head impact injury videos (alpine n=29, snowboard n=13, freestyle n=15), first independently and subsequently in a consensus meeting. During the crash sequence, most athletes (84%) impacted the snow with the skis or board first, followed by the upper or lower extremities, buttocks/pelvis, back and, finally, the head. Alpine skiers had sideways (45%) and backwards pitching falls (35%), with impacts to the rear (38%) and side (35%) of the helmet. Freestyle skiers and snowboarders had backwards pitching falls (snowboard 77%, freestyle 53%), mainly with impacts to the rear of the helmet (snowboard 69%, freestyle 40%). There were three helmet ejections among alpine skiers (10% of cases), and 41% of alpine skiing injuries occurred due to inappropriate gate contact prior to falling. Athletes had one (47%) or two (28%) head impacts, and the first impact was the most severe (71%). Head impacts were mainly on snow (83%) on a downward slope (63%). This study has identified several characteristics of the mechanisms of head injuries, which may be addressed to reduce risk. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... very early stage by mapping the motion of water molecules in the tissue. This water motion, known as diffusion, is impaired by most ... page Additional Information and Resources RTAnswers.org : Radiation Therapy for Brain Tumors Radiation Therapy for Head and ...

  10. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... data suggest that it is safe to continue breastfeeding after receiving intravenous contrast. For further information please consult the ACR Manual on Contrast Media and its references. top of page What are the limitations of MRI of the Head? High-quality images are assured only if you are able ...

  11. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... very early stage by mapping the motion of water molecules in the tissue. This water motion, known as diffusion, is impaired by most ... the limitations of MRI of the Head? High-quality images are assured only if you are able ...

  12. The head organizer in Hydra.

    Science.gov (United States)

    Bode, Hans R

    2012-01-01

    Organizers and organizing centers play critical roles in axis formation and patterning during the early stages of embryogenesis in many bilaterians. The presence and activity of an organizer was first described in adult Hydra about 100 years ago, and in the following decades organizer regions were identified in a number of bilaterian embryos. In an adult Hydra, the cells of the body column are constantly in the mitotic cycle resulting in continuous displacement of the tissue to the extremities where it is sloughed. In this context, the head organizer located in the hypostome is continuously active sending out signals to maintain the structure and morphology of the head, body column and foot of the animal. The molecular basis of the head organizer involves the canonical Wnt pathway, which acts in a self-renewing manner to maintain itself in the context of the tissue dynamics of Hydra. During bud formation, Hydra's mode of asexual reproduction, a head organizer based on the canonical Wnt pathway is set up to initiate and control the development of a new Hydra. As this pathway plays a central role in vertebrate embryonic organizers, its presence and activity in Hydra indicate that the molecular basis of the organizer arose early in metazoan evolution.

  13. Blunt Head Trauma and Headache

    Directory of Open Access Journals (Sweden)

    Ana B Chelse

    2015-04-01

    Full Text Available Investigators from New York Presbyterian Morgan Stanley Children’s Hospital examined whether having an isolated headache following minor blunt head trauma was suggestive of traumatic brain injury (TBI among a large cohort of children 2-18 years of age.

  14. challenges facing child headed households

    African Journals Online (AJOL)

    Mugumbate

    care approaches on psychosocial wellbeing of orphans and other vulnerable children (OVC) in Zimbabwe, ... related stigma, poverty or anomie, are insufficient for understanding the isolation of the child-headed ..... organisation was failing to cope with the problems of these families. This was so because it did not have.

  15. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media MR Angiography (MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging (MRI) ...

  16. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... the head uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the brain and other cranial structures that are clearer and more detailed than other imaging methods. This exam does not use ionizing radiation and may require an injection of a ...

  17. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... examination poses almost no risk to the average patient when appropriate safety guidelines are followed. If sedation is used, there ... have a personal story about radiology? Share your patient story here Images ... Disease Head Injury Brain Tumors Images related ...

  18. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... of which shows a thin slice of the body. The images can then be studied from different angles by ... information please consult the ACR Manual on Contrast Media and its references. top of page What are the limitations of MRI of the Head? High-quality images are assured only if you are able to ...

  19. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... symptoms. It can help diagnose conditions such as: brain tumors stroke infections developmental anomalies hydrocephalus — dilatation of fluid ... Information and Resources RTAnswers.org : Radiation Therapy for Brain Tumors Radiation Therapy for Head and Neck Cancer Others : ...

  20. Femoral head cartilage disarticulation disorder

    Science.gov (United States)

    Femoral head cartilage disarticulation disorder and necrosis is a major skeletal problem in broiler breeders since they are maintained for a long time in the farm. The etiology of this disease is not well understood. A field study was conducted to understand the basis of this metabolic disease. Six ...

  1. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... structures of the brain and can also provide functional information (fMRI) in selected cases. MR images of ... Articles and Media MR Angiography (MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain ...

  2. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... imaging (MRI) of the head uses a powerful magnetic field, radio waves and a computer to produce detailed ... whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some ...

  3. Humeral head size in shoulder arthroplasty

    DEFF Research Database (Denmark)

    Vaesel, M T; Olsen, Bo Sanderhoff; Søjbjerg, Jens Ole

    1998-01-01

    Changes in kinematics after hemiarthroplasty of the glenohumeral joint were investigated in nine cadaveric specimens. During experiments the influence of the humeral head size on glenohumeral kinematics was evaluated. A modular prosthesis with five different head sizes and press-fit stems was used....... Three-dimensional kinematic measurements during abduction and adduction from 0 degree to 70 degrees showed increased external rotation with increasing head size. Small prosthetic heads translated inferiorly and large prosthetic heads superiorly compared with the intact humeral head. During forced...

  4. Radial head prosthesis: results overview.

    Science.gov (United States)

    Carità, E; Donadelli, A; Cugola, L; Perazzini, P

    2017-12-01

    Radial head replacement is frequently used in treatment of radial head fractures or sequela. Impossibility to restore a correct anatomy, acute elbow traumatic instability and failure of osteosynthesis hardware are the most common indications. The authors describe their case studies and results on the implantation of various radial head prostheses. Between June 2005 and June 2016, 28 radial head prostheses were implanted in the same number of patients with an average follow-up of 49 months (6-104). Indications for implantation were: Mason type III and IV radial head fractures and post-traumatic arthritis due to failure of previous treatments. Monopolar prostheses were used and were press-fit implanted via Kaplan's lateral access and Kocher's anconeus approach to the humeroradial joint. At the follow-up, assessments were made of the pain, according to the visual analogic scale, range of motion (ROM), stability and functionality according to the Mayo Elbow Performance Score, presence of osteolysis and mobilization during radiography tests, personal satisfaction of the patients, Disabilities of the Arm, Shoulder and Hand and Patient-Rated Wrist Evaluation outcomes measurements. At the follow-up, we recorded an average level of pain of 1.8 in patients under acute treatments for radial head fractures and a marked reduction in the remaining cases from 6.7 to 2.1. ROM was found on average to be 107° of flexion-extension and 159° of pronosupination. Personal satisfaction was good-excellent in 23 cases. There was no case of infection; removal of the implant was necessary in three cases due to mobilization of the stem and oversized implants. In six cases, bone resorption was seen at the level of the prosthetic collar and it was in all cases asymptomatic. The results of this study suggest that the use of prostheses, if well positioned, is a valid solution in the treatment of secondary arthritis and fractures of the radial head with poor prognosis, with good results in the

  5. Head Start at ages 3 and 4 versus Head Start followed by state pre-k: Which is more effective?

    Science.gov (United States)

    Jenkins, Jade Marcus; Farkas, George; Duncan, Greg J; Burchinal, Margaret; Vandell, Deborah Lowe

    2016-03-01

    As policy-makers contemplate expanding preschool opportunities for low-income children, one possibility is to fund two, rather than one year of Head Start for children at ages 3 and 4. Another option is to offer one year of Head Start followed by one year of pre-k. We ask which of these options is more effective. We use data from the Oklahoma pre-k study to examine these two 'pathways' into kindergarten using regression discontinuity to estimate the effects of each age-4 program, and propensity score weighting to address selection. We find that children attending Head Start at age 3 develop stronger pre-reading skills in a high quality pre-kindergarten at age 4 compared with attending Head Start at age 4. Pre-k and Head Start were not differentially linked to improvements in children's pre-writing skills or pre-math skills. This suggests that some impacts of early learning programs may be related to the sequencing of learning experiences to more academic programming.

  6. Porcine head response to blast

    Directory of Open Access Journals (Sweden)

    Jay eShridharani

    2012-05-01

    Full Text Available Recent studies have shown an increase in the frequency of traumatic brain injuries related to blast exposure. However, the mechanisms that cause blast neurotrauma are unknown. Blast neurotrauma research using computational models has been one method to elucidate that response of the brain in blast, and to identify possible mechanical correlates of injury. However, model validation against experimental data is required to ensure that the model output is representative of in vivo biomechanical response. This study exposed porcine subjects to primary blast overpressures generated using a compressed-gas shock tube. Shock tube blasts were directed to the unprotected head of each animal while the lungs and thorax were protected using ballistic protective vests similar to those employed in theater. The test conditions ranged from 110-740 kPa peak incident overpressure with scaled durations from 1.3-6.9 ms and correspond approximately with a 50% injury risk for brain bleeding and apnea in a ferret model scaled to porcine exposure. The bulk head acceleration and the pressure at the surface of the head and in the cranial cavity were measured. Immediately after the blast, 5 of the 20 animals tested were apneic. Three subjects recovered without intervention within thirty seconds and the remaining two recovered within 8 minutes following bagging and administration of the respiratory stimulant doxapram. Gross examination of the brain revealed no indication of bleeding. Intracranial pressures ranged from 80-685 kPa as a result of the blast and were notably lower than the shock tube reflected pressures of 300-2830 kPa, indicating pressure attenuation by the skull up to a factor of 8.4. Peak head accelerations were measured from 385-3845 G’s and were well correlated with peak incident overpressure (R2=0.90. One standard deviation corridors for the surface pressure, intracranial pressure, and head acceleration are presented to provide experimental data for

  7. Head injury predictors in sports trauma--a state-of-the-art review.

    Science.gov (United States)

    Fernandes, Fábio A O; de Sousa, Ricardo J Alves

    2015-08-01

    Head injuries occur in a great variety of sports. Many of these have been associated with neurological injuries, affecting the central nervous system. Some examples are motorsports, cycling, skiing, horse riding, mountaineering and most contact sports such as football, ice and field hockey, soccer, lacrosse, etc. The outcome of head impacts in these sports can be very severe. The worst-case scenarios of permanent disability or even death are possibilities. Over recent decades, many In recent decades, a great number of head injury criteria and respective thresholds have been proposed. However, the available information is much dispersed and a consensus has still not been achieved regarding the best injury criteria or even their thresholds. This review paper gives a thorough overview of the work carried out by the scientific community in the field of impact biomechanics about head injuries sustained during sports activity. The main goal is to review the head injury criteria, as well as their thresholds. Several are reviewed, from the predictors based on kinematics to the ones based on human tissue thresholds. In this work, we start to briefly introduce the head injuries and their mechanisms commonly seen as a result of head trauma in sports. Then, we present and summarize the head injury criteria and their respective thresholds. © IMechE 2015.

  8. Preschool Facilities - MDC_HeadStart

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — A label (point) feature class of Head Start / Early Head Start/ Delegate Agencies/ Child Care Partnership & Family Day Care Homes Programs location in Miami-Dade...

  9. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... What's this? Submit What's this? Submit Button Concussion in Youth Sports Training course: This page has moved ... What's this? Submit What's this? Submit Button Connect with HEADS UP & CDC's Injury Center HEADS UP Resources ...

  10. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... this? Submit Button Connect with HEADS UP & CDC's Injury Center HEADS UP Resources File Formats Help: How ... for Disease Control and Prevention , National Center for Injury Prevention and Control , Division of Unintentional Injury Prevention ...

  11. Heads Up to High School Sports

    Science.gov (United States)

    ... submit" value="Submit" /> HEADS UP to School Sports Recommend on Facebook Tweet Share Compartir To help ... organizations, developed the HEADS UP: Concussion in School Sports initiative and materials. Specific Concussion Information for... Coaches ...

  12. Adjustment of saccade characteristics during head movements.

    Science.gov (United States)

    Morasso, P.; Bizzi, E.; Dichgans, J.

    1973-01-01

    Saccade characteristics have been studied during coordinated eye-head movements in monkeys. Amplitude, duration, and peak velocity of saccades with head turning were compared with saccades executed while the head was artificially restrained. The results indicate that the saccade characteristics are modulated as a function of head movement, hence the gaze movement (eye+head) exactly matches saccades with head fixed. Saccade modulation is achieved by way of negative vestibulo-ocular feedback. The neck proprioceptors, because of their longer latency, are effective only if the head starts moving prior to the onset of saccade. It is concluded that saccades make with head turning are not 'ballistic' movements because their trajectory is not entirely predetermined by a central command.

  13. Head stabilization in whooping cranes

    Science.gov (United States)

    Kinloch, M.R.; Cronin, T.W.; Olsen, G.H.; Chavez-Ramirez, Felipe

    2005-01-01

    The whooping crane (Grus americana) is the tallest bird in North America, yet not much is known about its visual ecology. How these birds overcome their unusual height to identify, locate, track, and capture prey items is not well understood. There have been many studies on head and eye stabilization in large wading birds (herons and egrets), but the pattern of head movement and stabilization during foraging is unclear. Patterns of head movement and stabilization during walking were examined in whooping cranes at Patuxent Wildlife Research Center, Laurel, Maryland USA. Four whooping cranes (1 male and 3 females) were videotaped for this study. All birds were already acclimated to the presence of people and to food rewards. Whooping cranes were videotaped using both digital and Hi-8 Sony video cameras (Sony Corporation, 7-35 Kitashinagawa, 6-Chome, Shinagawa-ku, Tokyo, Japan), placed on a tripod and set at bird height in the cranes' home pens. The cranes were videotaped repeatedly, at different locations in the pens and while walking (or running) at different speeds. Rewards (meal worms, smelt, crickets and corn) were used to entice the cranes to walk across the camera's view plane. The resulting videotape was analyzed at the University of Maryland at Baltimore County. Briefly, we used a computerized reduced graphic model of a crane superimposed over each frame of analyzed tape segments by means of a custom written program (T. W. Cronin, using C++) with the ability to combine video and computer graphic input. The speed of the birds in analyzed segments ranged from 0.30 m/s to 2.64 m/s, and the proportion of time the head was stabilized ranged from 79% to 0%, respectively. The speed at which the proportion reached 0% was 1.83 m/s. The analyses suggest that the proportion of time the head is stable decreases as speed of the bird increases. In all cases, birds were able to reach their target prey with little difficulty. Thus when cranes are walking searching for food

  14. Head movements while steering around bends

    NARCIS (Netherlands)

    Erp, J.B.F. van; Oving, A.B.

    2012-01-01

    In this study, the determinants of head motions (rotations) when driving around bends were investigated when drivers viewed the scene through a head-mounted display. The scene camera was either fixed or coupled to head motions along 2 or 3 axes of rotation. Eight participants drove around a

  15. Head and neck mycetoma: the mycetoma research centre experience.

    OpenAIRE

    Ahmed Fahal; El Sheikh Mahgoub; Ahmed Mohamed El Hassan; Angom Osman Jacoub; Doaa Hassan

    2015-01-01

    Mycetoma is a unique neglected tropical disease which is endemic in what is known as the ?mycetoma belt?. The disease has many devastating impacts on patients and communities in endemic area and is characterised by massive deformity, destruction and disability. Mycetoma is commonly seen in the foot and hand and less frequent in other parts of the body. Mycetoma of the head and neck is a rarity and is associated with high morbidity and even mortality if not treated early. In this communication...

  16. Heads in Grammatical Theory. Introduction.

    OpenAIRE

    Corbett, Greville G.; Fraser, Norman M.; McGlashan, Scott

    1993-01-01

    Contemporary linguistic theories distinguish the principal element of a phrase - the ‘head’ - from the subordinate elements it dominates. This pervasive grammatical concept has been used to describe and account for linguistic phenomena ranging from agreement and government to word order universals, but opinions differ widely on its precise definition. A key question is whether the head is not already identified by some other, more basic notion or interacting set of notions in linguistics. Hea...

  17. Supernumerary head of biceps brachii

    Directory of Open Access Journals (Sweden)

    Balasubramanian A

    2010-12-01

    Full Text Available The biceps brachii muscle and the musculocutaneous nerve of arm are frequent in their variations. A third head of biceps brachii was noted unilaterally during routine anatomy dissection. Variation in musculocutaneous nerve was also seen on the same arm. The evolutionary and functional basis of such variations are discussed. Such variations become relevant during surgical intervention of the arm, especially after humeral fracture with subsequent unusual bone displacements.

  18. Optical Head Design Using HOE's

    Science.gov (United States)

    Ih, Charles S.; Xiang, Lian-Qin; Zhuang, B. H.; Yang, C. W.; Lu, K. Q.; Tian, Rongsheng; Wang, Z. M.

    1989-05-01

    We describe an optical head design using two spherical lenses and two HOE's. This study was intended to show the feasibility of using HOE's to improve the performance of optical head for Read/Write optical disc drives. The two HOE's correct the spherical aberrations of the lens, change the elliptical beam to a circular one and compensate for wavelength shift up to +, - 5 nm. Experiments have been performed to confirm these concepts. The HOE's were made optically in the visible wavelength using an intermediate CGH. Ideally the HOE's are to be generated by a computer and preferably written directly by an e-beam machine. Since at that time all the commercially available e-beam shops we contacted lacked the confidence in making such high resolution CGH, we decided to use the Optical-CGH approach. Actually this approach offers several advantages. First we can make large and high resolution ir HOE immediately. Secondly we can even make Bragg (or volume) ir hologram using visible light. Basically we create a pre-distorted CGH from which the final HOE can be made using visible light. The final HOE can then be reconstruct at the ir wavelength without aberrations. The techniques used here can be extended to optical head designs using aspherical lenses. The HOE's function can then be, in addition to beam shaping, to achieve a larger wavelength compensation, to correct the residual chromatic and aspherical aberrations of the aspherical lenses. The astigmatism of the laser diode can also be corrected by the HOE's. The possibility of an optical head using only HOE's (no lenses) will be discussed. Computer simulations and experimental results are shown.

  19. Cranial surgery without head shaving.

    Science.gov (United States)

    Tokimura, Hiroshi; Tajitsu, Kenichiro; Tsuchiya, Masahiro; Yamahata, Hitoshi; Taniguchi, Ayumi; Takayama, Kenji; Kaji, Masatomo; Hirabaru, Masashi; Hirayama, Takahisa; Shinsato, Tomomi; Arita, Kazunori

    2009-12-01

    Based on a series of 632 patients who underwent craniotomy without head shaving, we report the efficacy and safety of our simplified procedure and document the usefulness of the electrosurgical scalpel. After brushing a chlorhexidine-alcohol solution onto the craniotomy site, the hair was parted from the incision line and fixed with adhesive paper drapes. In recent cases, electrosurgical scalpels were used for scalp- and subcutaneous dissection. At the end of surgery, the wound was closed in the usual manner, taking care that no hair was in the wound and the hair and wound were rinsed with clean water in the operating room. We did not apply disinfectant for postoperative wound care, rather, the hair was shampooed on the 2nd, 4th, and 6th postoperative day. Among 632 patients who underwent cranial surgery without head shaving, only 7 (1.1%) developed postoperative wound infections. None of the 34 patients who underwent craniotomy using the electrosurgical scalpel developed wound infections. Our simplified cranial surgery without head shaving does not increase the risk of wound infection. Because the use of the electrosurgical scalpel for skin and soft tissue dissection minimizes bleeding, the probability of wound infection appears to be reduced.

  20. Is Heading in Youth Soccer Dangerous Play?

    Science.gov (United States)

    O'Kane, John W

    2016-01-01

    Soccer is among the most popular youth sports with over 3 million youth players registered in the U.S. Soccer is unique in that players intentionally use their head to strike the ball, leading to concerns that heading could cause acute or chronic brain injury, especially in the immature brains of children. Pub Med search without date restriction was conducted in November 2014 and August 2015 using the terms soccer and concussion, heading and concussion, and youth soccer and concussion. 310 articles were identified and reviewed for applicable content specifically relating to youth athletes, heading, and/or acute or chronic brain injury from soccer. Soccer is a low-risk sport for catastrophic head injury, but concussions are relatively common and heading often plays a role. At all levels of play, concussions are more likely to occur in the act of heading than with other facets of the game. While concussion from heading the ball without other contact to the head appears rare in adult players, some data suggests children are more susceptible to concussion from heading primarily in game situations. Contributing factors include biomechanical forces, less developed technique, and the immature brain's susceptibility to injury. There is no evidence that heading in youth soccer causes any permanent brain injury and there is limited evidence that heading in youth soccer can cause concussion. A reasonable approach based on U.S. Youth Soccer recommendations is to teach heading after age 10 in controlled settings, and heading in games should be delayed until skill acquisition and physical maturity allow the youth player to head correctly with confidence.

  1. Porcine head response to blast.

    Science.gov (United States)

    Shridharani, Jay K; Wood, Garrett W; Panzer, Matthew B; Capehart, Bruce P; Nyein, Michelle K; Radovitzky, Raul A; Bass, Cameron R 'dale'

    2012-01-01

    Recent studies have shown an increase in the frequency of traumatic brain injuries related to blast exposure. However, the mechanisms that cause blast neurotrauma are unknown. Blast neurotrauma research using computational models has been one method to elucidate that response of the brain in blast, and to identify possible mechanical correlates of injury. However, model validation against experimental data is required to ensure that the model output is representative of in vivo biomechanical response. This study exposes porcine subjects to primary blast overpressures generated using a compressed-gas shock tube. Shock tube blasts were directed to the unprotected head of each animal while the lungs and thorax were protected using ballistic protective vests similar to those employed in theater. The test conditions ranged from 110 to 740 kPa peak incident overpressure with scaled durations from 1.3 to 6.9 ms and correspond approximately with a 50% injury risk for brain bleeding and apnea in a ferret model scaled to porcine exposure. Instrumentation was placed on the porcine head to measure bulk acceleration, pressure at the surface of the head, and pressure inside the cranial cavity. Immediately after the blast, 5 of the 20 animals tested were apneic. Three subjects recovered without intervention within 30 s and the remaining two recovered within 8 min following respiratory assistance and administration of the respiratory stimulant doxapram. Gross examination of the brain revealed no indication of bleeding. Intracranial pressures ranged from 80 to 390 kPa as a result of the blast and were notably lower than the shock tube reflected pressures of 300-2830 kPa, indicating pressure attenuation by the skull up to a factor of 8.4. Peak head accelerations were measured from 385 to 3845 G's and were well correlated with peak incident overpressure (R(2) = 0.90). One SD corridors for the surface pressure, intracranial pressure (ICP), and head acceleration are

  2. First Class Call Stacks: Exploring Head Reduction

    Directory of Open Access Journals (Sweden)

    Philip Johnson-Freyd

    2016-06-01

    Full Text Available Weak-head normalization is inconsistent with functional extensionality in the call-by-name λ-calculus. We explore this problem from a new angle via the conflict between extensionality and effects. Leveraging ideas from work on the λ-calculus with control, we derive and justify alternative operational semantics and a sequence of abstract machines for performing head reduction. Head reduction avoids the problems with weak-head reduction and extensionality, while our operational semantics and associated abstract machines show us how to retain weak-head reduction's ease of implementation.

  3. Rehabilitation interventions after mild head injury.

    Science.gov (United States)

    Ponsford, Jennie

    2005-12-01

    This review examines current management and rehabilitation strategies for mild traumatic brain injury, with emphasis on the need to address multiple potential causative factors in order to enhance outcomes and to conduct more controlled efficacy studies. Whilst most individuals who sustain mild traumatic brain injury make a good recovery, a proportion experience significant ongoing disability. In some cases this is due to diffuse axonal injury and cognitive impairment, but in others symptoms are exacerbated by factors such as pain, stress, personality issues or litigation, or in children, previous head injury, behavioural or learning difficulties. Provision of information early after injury results in reduced symptom reporting in adults and children. There is also a need, however, to address these other factors in treatment. Psychological therapy using a cognitive behavioural approach may be helpful, but controlled evaluations of such interventions have been lacking. Recent uncontrolled studies have examined the impact of computer-mediated interventions to remediate visual and verbal processing and oculomotor problems and the impact of quantitative electroencephalography. More rigorous efficacy studies of these approaches are needed. Guidelines for management of sports-related concussion and timing of return to play also require a more solid scientific basis. The evidence base for management of mild traumatic brain injury is still very limited. There is a need to conduct more carefully controlled prospective studies and examine the influence of factors not directly related to the brain injury as a basis for formulating more uniform management guidelines.

  4. Very Low Head Turbine Deployment in Canada

    Science.gov (United States)

    Kemp, P.; Williams, C.; Sasseville, Remi; Anderson, N.

    2014-03-01

    The Very Low Head (VLH) turbine is a recent turbine technology developed in Europe for low head sites in the 1.4 - 4.2 m range. The VLH turbine is primarily targeted for installation at existing hydraulic structures to provide a low impact, low cost, yet highly efficient solution. Over 35 VLH turbines have been successfully installed in Europe and the first VLH deployment for North America is underway at Wasdell Falls in Ontario, Canada. Deployment opportunities abound in Canada with an estimated 80,000 existing structures within North America for possible low-head hydro development. There are several new considerations and challenges for the deployment of the VLH turbine technology in Canada in adapting to the hydraulic, environmental, electrical and social requirements. Several studies were completed to determine suitable approaches and design modifications to mitigate risk and confirm turbine performance. Diverse types of existing weirs and spillways pose certain hydraulic design challenges. Physical and numerical modelling of the VLH deployment alternatives provided for performance optimization. For this application, studies characterizing the influence of upstream obstacles using water tunnel model testing as well as full-scale prototype flow dynamics testing were completed. A Cold Climate Adaptation Package (CCA) was developed to allow year-round turbine operation in ice covered rivers. The CCA package facilitates turbine extraction and accommodates ice forces, frazil ice, ad-freezing and cold temperatures that are not present at the European sites. The Permanent Magnet Generator (PMG) presents some unique challenges in meeting Canadian utility interconnection requirements. Specific attention to the frequency driver control and protection requirements resulted in a driver design with greater over-voltage capability for the PMG as well as other key attributes. Environmental studies in Europe included fish friendliness testing comprised of multiple in

  5. Facility Head | Center for Cancer Research

    Science.gov (United States)

    Facility HeadConfocal Microscopy Core FacilityLaboratory of Cancer Biology and Genetics The Laboratory of Cancer Biology and Genetics (LCBG), Center for Cancer Research (CCR), NCI, NIH, HHS is looking for a motivated and skilled microscopist to fill a Facility Head position to lead its Confocal Microscopy Core Facility. The CCR Microscopy Core provides microscopy equipment and support to approximately 150 active users representing over 20 NCI laboratories. The Core places an emphasis on training independent users, but the staff is available to assist in all phases of experiments. This includes experimental design, data acquisition, and data analysis. The Core provides state-of-the-art microscopic analyses to better understand critical biological structures and cellular processes involved in cancer. The Facility Head will also be expected to participate in the CCR Microscopy Core meetings and to interact extensively with the other microscopy facilities in CCR. Light microscopic techniques and analytic methods currently used in this facility include, but are not limited to: 1) co-localization of fluorescent fusion proteins with organelles; 2) demonstration of membrane ruffling, cytoskeletal organization, focal adhesions and other cell morphology; 3) live time-lapse translocation of fluorescent fusion proteins; 4) fluorescent indicators of oxidative stress in live cells; 5) 4D imaging of cell division; 6) Super-Resolution imaging; 7) tiling; 8) Fluorescent Recovery After Photobleaching (FRAP) and Fluorescent Resonance Energy Transfer (FRET); 9) Fluorescence Correlation Spectroscopy (FCS); 10) Fluorescence Lifetime Imaging (FLIM); and, 11) Second Harmonic Generation imaging (SHG) of whole live tissue/organ. The Facility's equipment includes a Zeiss LSM 710 NLO for two-photon imaging, a Zeiss LSM 780 for higher sensitivity imaging, a Zeiss LSM 780/ELYRA for super-resolution imaging of fixed cells, and the Zeiss LSM 880/Airyscan for super-resolution imaging of live and

  6. Best practice guidelines in the psychosocial management of HPV-related head and neck cancer: recommendations from the European Head and Neck Cancer Society's Make Sense Campaign.

    Science.gov (United States)

    Reich, M; Licitra, L; Vermorken, J B; Bernier, J; Parmar, S; Golusinski, W; Castellsagué, X; Leemans, C R

    2016-10-01

    Over the past three decades, oral human papillomavirus (HPV) has been associated with an increase in the incidence of oropharyngeal squamous cell carcinoma (OPSCC) in several countries. Specialist oncologists in head and neck cancer are observing a wider range of demographics, sexual behaviours, and survival outcomes with their patients. Additionally, there are fewer smokers, consumers of alcohol, or people of lower socioeconomic status than in previous decades. In order to support patients, the European Head and Neck Society's Make Sense Campaign aims to promote best practice in the management of head and neck cancer through the delivery of counselling, psychological assessment, support with the patient experience following HPV-related cancer diagnosis, sexual impact (in terms of communication, behaviour and prevention), facilitating access to educational resources about HPV in head and neck squamous cell carcinoma and OPSCC, and early referral if necessary. New concerns about psychosocial distress and unmet psychosocial needs following diagnosis, therefore, exist throughout the disease and treatment periods. Oncologists treating patients with HPV-related head and neck cancer must integrate new parameters focused on infection risk transmission and sexual topics. The development and dissemination of best practice guidelines through The European Head and Neck Cancer Society Make Sense Campaign will help healthcare professionals to be more confident and resourceful in supporting patients with HPV-related head and neck cancer. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. A Head-to-head Comparison between SurgiMend and Epiflex in 127 Breast Reconstructions.

    Science.gov (United States)

    Eichler, Christian; Vogt, Nadine; Brunnert, Klaus; Sauerwald, Axel; Puppe, Julian; Warm, Mathias

    2015-06-01

    The use of acellular dermal matrices (ADM) has become a widely used option in breast reconstruction. A great deal of literature is available, totaling over 2400 ADM reconstructions. Nonetheless, head-to-head comparisons between SurgiMend and Epiflex are not yet reported. In fact, this is the first clinical data report on the use of Epiflex. This work will, therefore, compare postoperative complication rates and costs for these ADMs. This analysis is a retrospective review of a single surgeon's 6-year experience with both SurgiMend-an acellular bovine dermal collagen matrix for soft-tissue reconstruction and Epiflex-a decellularized human skin tissue from 2008 to 2013. One hundred patients had a total of 127 implant-based reconstructions using SurgiMend (64 cases; 50.4%) or Epiflex (63 cases; 49.6%). Gross complication rates were 11.1% for SurgiMend and 40.6% for Epiflex including hematoma, postoperative skin irritation, infection, necrosis, and revision surgery. The most common complication was postoperative red breast syndrome. Severe complications requiring revision surgery were significantly increased in patients treated with Epiflex (12.5%) compared with SurgiMend (4.8%). This retrospective analysis favors the use of SurgiMend over Epiflex because of significantly lower gross complication rates. Severe complication rates are comparable with those reported in literature for both products. Although results promote the use of SurgiMend, the single surgeon retrospective nature of this work limits its clinical impact.

  8. Head First jQuery

    CERN Document Server

    Benedetti, Ryan

    2011-01-01

    Want to add more interactivity and polish to your websites? Discover how jQuery can help you build complex scripting functionality in just a few lines of code. With Head First jQuery, you'll quickly get up to speed on this amazing JavaScript library by learning how to navigate HTML documents while handling events, effects, callbacks, and animations. By the time you've completed the book, you'll be incorporating Ajax apps, working seamlessly with HTML and CSS, and handling data with PHP, MySQL and JSON. If you want to learn-and understand-how to create interactive web pages, unobtrusive scrip

  9. Head Access Piping System Desing

    OpenAIRE

    中大路 道彦; 一宮 正和; 向坊 隆一; 前田 清彦; 永田 敬

    1994-01-01

    PNC made design studies on loop type FBR plants:a 600 MWe class in '91, and a 1300 MWe class in '93 both with the "head access" primary piping system. This paper focuses on the features of the smaller plant at first and afterwards on the extension to the larger one. The contents of the paper consist of R/V wall protection mechanism, primary piping circuit, secondary piping circuit, plant layout and then, discusses the extension of the applicability of the wall protection mechanism, primary pi...

  10. Prolonged Repetitive Head Trauma Induces a Singular Chronic Traumatic Encephalopathy-Like Pathology in White Matter Despite Transient Behavioral Abnormalities.

    Science.gov (United States)

    Briggs, Denise I; Angoa-Pérez, Mariana; Kuhn, Donald M

    2016-11-01

    Repetitive mild traumatic brain injury (rmTBI), resulting from insults caused by an external mechanical force that disrupts normal brain function, has been linked to the development of neurodegenerative diseases, such as chronic traumatic encephalopathy and Alzheimer disease; however, neither the severity nor frequency of head injury required to trigger adverse behavioral outcomes is well understood. In this study, the administration of 30 head impacts using two different weights to lightly anesthetized, completely unrestrained mice established a paradigm that simulates the highly repetitive nature of sports- and military-related head injury. As the number of head impacts increases, the time to recover consciousness diminishes; however, both the sensorimotor function and behavioral outcomes of impacted mice evolve during the ensuing weeks. Postmortem analyses reveal robust Alzheimer disease and chronic traumatic encephalopathy-like conditions that manifest in a singular manner throughout the white matter concomitant with evidence of chronic oligodendrogenesis. Our data suggest that latency to recover the righting reflex may be an inadequate measure of injury severity and imply that exposure to repeated head impacts may mask the severity of an underlying and developing neuropathologic condition that does not manifest itself until long after head collisions cease. In addition, our data indicate that there is a cumulative and dose-dependent effect of repetitive head impacts that induces the neurobehavioral and neuropathologic outcomes seen in humans with a history of rmTBI. Copyright © 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  11. Penetrating head injury from angle grinder: A cautionary tale

    Directory of Open Access Journals (Sweden)

    S Senthilkumaran

    2010-01-01

    Full Text Available Penetrating cranial injury is a potentially life-threatening condition. Injuries resulting from the use of angle grinders are numerous and cause high-velocity penetrating cranial injuries. We present a series of two penetrating head injuries associated with improper use of angle grinder, which resulted in shattering of disc into high velocity missiles with reference to management and prevention. One of those hit on the forehead of the operator and the other on the occipital region of the co-worker at a distance of five meters. The pathophysiological consequence of penetrating head injuries depends on the kinetic energy and trajectory of the object. In the nearby healthcare center the impacted broken disc was removed without realising the consequences and the wound was packed. As the conscious level declined in both, they were referred. CT brain revealed fracture in skull and changes in the brain in both. Expeditious removal of the penetrating foreign body and focal debridement of the scalp, skull, dura, and involved parenchyma and Watertight dural closure were carried out. The most important thing is not to remove the impacted foreign body at the site of accident. Craniectomy around the foreign body, debridement and removal of foreign body without zigzag motion are needed. Removal should be done following original direction of projectile injury. The neurological sequelae following the non missile penetrating head injuries are determined by the severity and location of initial injury as well as the rapidity of the exploration and fastidious debridement.

  12. Penetrating head injury from angle grinder: A cautionary tale.

    Science.gov (United States)

    Senthilkumaran, S; Balamurgan, N; Arthanari, K; Thirumalaikolundusubramanian, P

    2010-01-01

    Penetrating cranial injury is a potentially life-threatening condition. Injuries resulting from the use of angle grinders are numerous and cause high-velocity penetrating cranial injuries. We present a series of two penetrating head injuries associated with improper use of angle grinder, which resulted in shattering of disc into high velocity missiles with reference to management and prevention. One of those hit on the forehead of the operator and the other on the occipital region of the co-worker at a distance of five meters. The pathophysiological consequence of penetrating head injuries depends on the kinetic energy and trajectory of the object. In the nearby healthcare center the impacted broken disc was removed without realising the consequences and the wound was packed. As the conscious level declined in both, they were referred. CT brain revealed fracture in skull and changes in the brain in both. Expeditious removal of the penetrating foreign body and focal debridement of the scalp, skull, dura, and involved parenchyma and Watertight dural closure were carried out. The most important thing is not to remove the impacted foreign body at the site of accident. Craniectomy around the foreign body, debridement and removal of foreign body without zigzag motion are needed. Removal should be done following original direction of projectile injury. The neurological sequelae following the non missile penetrating head injuries are determined by the severity and location of initial injury as well as the rapidity of the exploration and fastidious debridement.

  13. A Pre-Hispanic Head

    Science.gov (United States)

    Bianucci, Raffaella; Jeziorska, Maria; Lallo, Rudy; Mattutino, Grazia; Massimelli, Massimo; Phillips, Genevieve; Appenzeller, Otto

    2008-01-01

    This report on a male head revealed biologic rhythms, as gleaned from hydrogen isotope ratios in hair, consistent with a South-American origin and Atomic Mass Spectrometry radiocarbon dating (AMS) compatible with the last pre-Hispanic period (1418–1491 AD, 95.4% probability). Biopsies showed exceptionally well-preserved tissues. The hair contained high levels of toxic elements (lead, arsenic and mercury) incompatible with life. There was no evidence for lead deposition in bone consistent with post-mortem accumulation of this toxic element in the hair. We propose that the high content of metals in hair was the result of metabolic activity of bacteria leading to metal complexation in extra cellular polymeric substances (EPS). This is a recognized protective mechanism for bacteria that thrive in toxic environments. This mechanism may account for the tissues preservation and gives a hint at soil composition where the head was presumably buried. Our results have implications for forensic toxicology which has, hitherto, relied on hair analyses as one means to reconstruct pre-mortem metabolism and for detecting toxic elements accumulated during life. Our finding also has implications for other archaeological specimens where similar circumstances may distort the results of toxicological studies. PMID:18446229

  14. Effective selective head cooling during posthypoxic hypothermia in newborn piglets.

    Science.gov (United States)

    Thoresen, M; Simmonds, M; Satas, S; Tooley, J; Silver, I A

    2001-04-01

    Selective head cooling has been proposed as a neuroprotective intervention after hypoxia-ischemia in which the brain is cooled without subjecting the rest of the body to significant hypothermia, thus minimizing adverse systemic effects. There are little data showing it is possible to cool the brain more than the body. We have therefore applied selective head cooling to our hypoxia-ischemia piglet model to establish whether it is possible. Nine piglets were anesthetized, and brain temperature was measured at the surface and in the superficial (0.2 cm) and deep (1.7-2.0 cm) gray matter. Rectal (6-cm depth), skin, and scalp temperatures (T) were recorded continuously. Lowering T-rectal from normothermia (39 degrees C) to hypothermia (33.5-33.8 degrees C) using a head cap perfused with cold (6-24 degrees C) water was undertaken for up to 6 h. To assess the impact of the 45-min hypoxia-ischemia insult on the effectiveness of selective head cooling, four piglets were cooled both before and after the insult, and four, only afterward. During selective head cooling, it was possible to achieve a lower T-deep brain than T-rectal in all animals both before and after hypoxia. However, this was only possible when overhead body heating was used. The T-rectal to T-deep brain gradient was significantly smaller after the insult (median, 5.3 degrees C; range, 4.2-8.5 degrees C versus 3.0 degrees C; 1.7-7.4 degrees C; p = 0.008). During rewarming to normothermia, the gradient was maintained at 4.5 degrees C. We report for the first time a study, which by direct measurement of deep intracerebral temperatures, validates the cooling cap as an effective method of selective brain cooling in a newborn animal hypoxia-ischemia model.

  15. Peripheral refraction with eye and head rotation with contact lenses.

    Science.gov (United States)

    Lopes-Ferreira, Daniela P; Neves, Helena I F; Faria-Ribeiro, Miguel; Queirós, António; Fernandes, Paulo R B; González-Méijome, José M

    2015-04-01

    To evaluate the impact of eye and head rotation in the measurement of peripheral refraction with an open-field autorefractometer in myopic eyes wearing two different center-distance designs of multifocal contact lenses (MFCLs). Nineteen right eyes from 19 myopic patients (average central M ± SD = -2.67 ± 1.66 D) aged 20-27 years (mean ± SD = 23.2 ± 3.3 years) were evaluated using a Grand-Seiko autorefractometer. Patients were fitted with one multifocal aspheric center-distance contact lens (Biofinity Multifocal D(®)) and with one multi-concentric MFCL (Acuvue Oasys for Presbyopia). Axial and peripheral refraction were evaluated by eye rotation and by head rotation under naked eye condition and with each MFCL fitted randomly and in independent sessions. For the naked eye, refractive pattern (M, J0 and J45) across the central 60° of the horizontal visual field values did not show significant changes measured by rotating the eye or rotating the head (p > 0.05). Similar results were obtained wearing the Biofinity D, for both testing methods, no obtaining significant differences to M, J0 and J45 values (p > 0.05). For Acuvue Oasys for presbyopia, also no differences were found when comparing measurements obtained by eye and head rotation (p > 0.05). Multivariate analysis did not showed a significant interaction between testing method and lens type neither with measuring locations (MANOVA, p > 0.05). There were significant differences in M and J0 values between naked eyes and each MFCL. Measurements of peripheral refraction by rotating the eye or rotating the head in myopic patients wearing dominant design or multi-concentric multifocal silicone hydrogel contact lens are comparable. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  16. Experimental Injury Biomechanics of the Pediatric Head and Brain

    Science.gov (United States)

    Margulies, Susan; Coats, Brittany

    Traumatic brain injury (TBI) is a leading cause of death and disability among children and young adults in the United States and results in over 2,500 childhood deaths, 37,000 hospitalizations, and 435,000 emergency department visits each year (Langlois et al. 2004). Computational models of the head have proven to be powerful tools to help us understand mechanisms of adult TBI and to determine load thresholds for injuries specific to adult TBI. Similar models need to be developed for children and young adults to identify age-specific mechanisms and injury tolerances appropriate for children and young adults. The reliability of these tools, however, depends heavily on the availability of pediatric tissue material property data. To date the majority of material and structural properties used in pediatric computer models have been scaled from adult human data. Studies have shown significant age-related differences in brain and skull properties (Prange and Margulies 2002; Coats and Margulies 2006a, b), indicating that the pediatric head cannot be modeled as a miniature adult head, and pediatric computer models incorporating age-specific data are necessary to accurately mimic the pediatric head response to impact or rotation. This chapter details the developmental changes of the pediatric head and summarizes human pediatric properties currently available in the literature. Because there is a paucity of human pediatric data, material properties derived from animal tissue are also presented to demonstrate possible age-related differences in the heterogeneity and rate dependence of tissue properties. The chapter is divided into three main sections: (1) brain, meninges, and cerebral spinal fluid (CSF); (2) skull; and (3) scalp.

  17. Novel Technique for Femoral Head Reconstruction using Allograft following Obturator Hip Dislocation.

    Science.gov (United States)

    Church, Dane J; Merrill, Haley M; Kotwal, Suhel; Dubin, Jonathan R

    2016-01-01

    Obturator hip dislocations with an associated osteochondral fracture of the femoral head are uncommon. The treatment of these injuries is challenging and the functional outcomes are poor. Though the injury pattern has been described previously in literature, there are few published reports regarding treatment options. This case report illustrates a novel technique for fixation and stabilization for an unusual injury involving an obturator hip dislocation and an osteochondral impaction fracture of the femoral head. A 30-years old African American male, involved in a motor vehicle collision, sustained an obturator dislocation of the left hip with a large posterior osteochondral fracture of the femoral head. An emergency closed reduction procedure was performed followed by a computed tomography (CT) scan of the hip joint which demonstrated a large osteochondral defect (25 x 10 mm, depth: 5 mm) of the femoral head, visualized within the weight-bearing area. Surgical intervention was planned as a fracture of the femoral head with a defect deeper than four millimeters has been shown to be a risk factor for the development of post-traumatic arthritis, often with onset of symptoms within 5 years of the date of injury. Following surgical hip dislocation, the defect of the femoral head was reconstructed with implantation of a femoral head allograft and internal fixation. At the six months follow-up, the patient could ambulate with minimal pain and without assistive devices. Radiographs demonstrated maintenance of articular congruity with no evidence of implant failure, post-traumatic arthritis or avascular necrosis. Surgical hip dislocation and reconstruction using femoral head allograft used to treat obturator hip dislocations with concomitant femoral head impaction fractures can lead to satisfactory short term functional outcomes.

  18. AHP 47: YELLOW-HEAD HORSE

    Directory of Open Access Journals (Sweden)

    Sangs rgyas bkra shis སངས་རྒྱས་བཀྲ་ཤིས།

    2017-04-01

    Full Text Available My family had a stallion we called Rta mgo ser 'Yellow-Head Horse'. Father and two of his brothers occasionally rode it. Father said that Yellow-Head was very wild when it was taken to join local horseraces. I didn't believe that because Yellow-Head was very gentle when Mother rode it to the local monastery and also when I rode it.

  19. Vascular lesions of head and neck: A literature review

    Directory of Open Access Journals (Sweden)

    Nazia Masoom Syed

    2016-01-01

    Full Text Available Vascular lesions are among the most common congenital and neonatal abnormalities. These anomalies can occur throughout the whole body, with 60%, however, being located in the head and neck region probably due to its intricate vascular anatomy of region. There is a significant confusion in the literature because of the use of confusing descriptive terminology for the same vascular entity and eponyms. Correct naming of lesion, appropriate classification, and clinical appearance of vascular lesions have a direct impact on understanding of etiologies of these complex lesions, diagnosis, and in treating patients. Thus, the aim of this article is to provide comprehensive knowledge about classifications and to have an insight of various important vascular lesions affecting head and neck region based on its pathogenesis, clinical presentation, and management.

  20. Femoral head diameter in the Malaysian population.

    Science.gov (United States)

    Lee, Chee Kean; Kwan, Mun Keong; Merican, Azhar Mahmood; Ng, Wuey Min; Saw, Lim Beng; Teh, Kok Kheng; Krishnan, Manoharan; Ramiah, Ramanathan

    2014-08-01

    Hip arthroplasty is commonly performed worldwide. The objective of this study was to determine the diameter of the femoral head in the Malaysian population in relation to gender and race (i.e. among Malay, Chinese and Indian patients). This was a retrospective cross-sectional study performed between January 1995 and December 2006, evaluating the femoral head diameters of all patients aged 50 years and above who underwent hemiarthroplasty at two major hospitals in Malaysia. A total of 945 femoral heads (663 women, 282 men) were evaluated. The mean age of the patients in our cohort was 75.2 ± 9.4 (range 50-101) years. The mean femoral head diameter (with intact articular cartilage) was 44.9 ± 3.2 (range 38-54) mm. In our study, men had a significantly larger mean femoral head diameter than women (47.7 ± 2.8 mm vs. 43.7 ± 2.4 mm; p Chinese ethnicity were also found to have significantly larger femoral head diameters, when compared among the three races studied (p Malaysians have a mean femoral head diameter of 44.9 ± 3.2 mm. Among our patients, Chinese patients had a significantly larger femoral head size than Malay and Indian patients. We also found that, in our cohort, men had significantly larger femoral head diameters than women.