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Sample records for sub-concussive head impacts

  1. Correlating cumulative sub-concussive head impacts in football with player performance - biomed 2009.

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    Rowson, Steven; Goforth, Mike W; Dietter, Dave; Brolinson, P Gunnar; Duma, Stefanan M

    2009-01-01

    The objective of this study was to investigate the effect of cumulative sub-concussive head impacts on football player performance. The helmets of three Virginia Tech football players were instrumented with a six accelerometer sensor capable of measuring head acceleration. Helmets were instrumented for every game during the 2006 and 2007 football seasons. Each time the head was impacted during a game, the sensor recorded the impact and wirelessly transmitted the data to a sideline computer. Furthermore, the coaching staff at Virginia Tech reviewed post-game film and evaluated each player's performance based on strict criteria. Players were awarded positive points for good plays and negative points for bad plays. Their performance scores were then normalized to a per play basis. Correlations of player performance with cumulative peak linear acceleration and cumulative head injury criterion (HIC) were evaluated. No consistent head acceleration-based measure showed a strong correlation with significance. In addition, relationship trends varied on a position basis. There are many factors other than head impacts that can affect a player's performance and more research is needed to further quantify such effects.

  2. Novel Method of Weighting Cumulative Helmet Impacts Improves Correlation with Brain White Matter Changes After One Football Season of Sub-concussive Head Blows.

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    Merchant-Borna, Kian; Asselin, Patrick; Narayan, Darren; Abar, Beau; Jones, Courtney M C; Bazarian, Jeffrey J

    2016-12-01

    One football season of sub-concussive head blows has been shown to be associated with subclinical white matter (WM) changes on diffusion tensor imaging (DTI). Prior research analyses of helmet-based impact metrics using mean and peak linear and rotational acceleration showed relatively weak correlations to these WM changes; however, these analyses failed to account for the emerging concept that neuronal vulnerability to successive hits is inversely related to the time between hits (TBH). To develop a novel method for quantifying the cumulative effects of sub-concussive head blows during a single season of collegiate football by weighting helmet-based impact measures for time between helmet impacts. We further aim to compare correlations to changes in DTI after one season of collegiate football using weighted cumulative helmet-based impact measures to correlations using non-weighted cumulative helmet-based impact measures and non-cumulative measures. We performed a secondary analysis of DTI and helmet impact data collected on ten Division III collegiate football players during the 2011 season. All subjects underwent diffusion MR imaging before the start of the football season and within 1 week of the end of the football season. Helmet impacts were recorded at each practice and game using helmet-mounted accelerometers, which computed five helmet-based impact measures for each hit: linear acceleration (LA), rotational acceleration (RA), Gadd Severity Index (GSI), Head Injury Criterion (HIC 15 ), and Head Impact Technology severity profile (HITsp). All helmet-based impact measures were analyzed using five methods of summary: peak and mean (non-cumulative measures), season sum-totals (cumulative unweighted measures), and season sum-totals weighted for time between hits (TBH), the interval of time from hit to post-season DTI assessment (TUA), and both TBH and TUA combined. Summarized helmet-based impact measures were correlated to statistically significant changes in

  3. 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.

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

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    Puvenna, Vikram; Brennan, Chanda; Shaw, Gerald; Yang, Cui; Marchi, Nicola; Bazarian, Jeffrey J; Merchant-Borna, Kian; Janigro, Damir

    2014-01-01

    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.

  5. Exposure to sub-concussive head injury in boxing and other sports.

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    Erlanger, David M

    2015-01-01

    Current characterizations of chronic traumatic brain injury (CTBI) in boxing, football and other sports are reviewed in the context of the history of research on sub-concussive brain trauma in athletes. The utility of exposure models for understanding CTBI in boxers is examined and concerns regarding the paucity of findings supportive of an exposure model for CTBI in football players are discussed. Recommendations for development of exposure models for sport-specific phenotypic characterizations of CTBI are presented.

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

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    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)

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    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

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    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. Single season changes in resting state network power and the connectivity between regions distinguish head impact exposure level in high school and youth football players

    Science.gov (United States)

    Murugesan, Gowtham; Saghafi, Behrouz; Davenport, Elizabeth; Wagner, Ben; Urban, Jillian; Kelley, Mireille; Jones, Derek; Powers, Alex; Whitlow, Christopher; Stitzel, Joel; Maldjian, Joseph; Montillo, Albert

    2018-02-01

    The effect of repetitive sub-concussive head impact exposure in contact sports like American football on brain health is poorly understood, especially in the understudied populations of youth and high school players. These players, aged 9-18 years old may be particularly susceptible to impact exposure as their brains are undergoing rapid maturation. This study helps fill the void by quantifying the association between head impact exposure and functional connectivity, an important aspect of brain health measurable via resting-state fMRI (rs-fMRI). The contributions of this paper are three fold. First, the data from two separate studies (youth and high school) are combined to form a high-powered analysis with 60 players. These players experience head acceleration within overlapping impact exposure making their combination particularly appropriate. Second, multiple features are extracted from rs-fMRI and tested for their association with impact exposure. One type of feature is the power spectral density decomposition of intrinsic, spatially distributed networks extracted via independent components analysis (ICA). Another feature type is the functional connectivity between brain regions known often associated with mild traumatic brain injury (mTBI). Third, multiple supervised machine learning algorithms are evaluated for their stability and predictive accuracy in a low bias, nested cross-validation modeling framework. Each classifier predicts whether a player sustained low or high levels of head impact exposure. The nested cross validation reveals similarly high classification performance across the feature types, and the Support Vector, Extremely randomized trees, and Gradboost classifiers achieve F1-score up to 75%.

  11. Head impact in a snowboarding accident.

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    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 Start Impact Study. Technical Report

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    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 Technical Report is designed to provide technical detail to support the analysis and findings presented in the "Head Start Impact Study Final Report" (U.S. Department of Health and Human Services, January 2010). Chapter 1 provides an overview of the Head Start Impact Study and its findings. Chapter 2 provides technical information on the…

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

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    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.

  14. The Role of Classroom Quality in Explaining Head Start Impacts

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    Connors, Maia C.; Friedman-Krauss, Allison H.; Morris, Pamela A.; Page, Lindsay C.; Feller, Avi

    2014-01-01

    This study seeks to answer the following question: Are impacts on Head Start classroom quality associated with impacts of Head Start on children's learning and development? This study employs a variety of descriptive and quasi-experimental methods to explore the role of classroom quality as a mediator or mechanism of Head Start impacts. This…

  15. Do Head Start Impacts Vary by Neighborhood Context?

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    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…

  16. Analysis of linear head accelerations from collegiate football impacts.

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    Brolinson, P Gunnar; Manoogian, Sarah; McNeely, David; Goforth, Mike; Greenwald, Richard; Duma, Stefan

    2006-02-01

    Sports-related concussions result in 300,000 brain injuries in the United States each year. We conducted a study utilizing an in-helmet system that measures and records linear head accelerations to analyze head impacts in collegiate football. The Head Impact Telemetry (HIT) System is an in-helmet system with six spring-mounted accelerometers and an antenna that transmits data via radio frequency to a sideline receiver and laptop computer system. A total of 11,604 head impacts were recorded from the Virginia Tech football team throughout the 2003 and 2004 football seasons during 22 games and 62 practices from a total of 52 players. Although the incidence of injury data are limited, this study presents an extremely large data set from human head impacts that provides valuable insight into the lower limits of head acceleration that cause mild traumatic brain injuries.

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

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    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)…

  18. High-magnitude head impact exposure in youth football

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    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

  19. Evaluating the "Threshold Theory": Can Head Impact Indicators Help?

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    Mihalik, Jason P; Lynall, Robert C; Wasserman, Erin B; Guskiewicz, Kevin M; Marshall, Stephen W

    2017-02-01

    This study aimed to determine the clinical utility of biomechanical head impact indicators by measuring the sensitivity, specificity, positive predictive value (PV+), and negative predictive value (PV-) of multiple thresholds. Head impact biomechanics (n = 283,348) from 185 football players in one Division I program were collected. A multidisciplinary clinical team independently made concussion diagnoses (n = 24). We dichotomized each impact using diagnosis (yes = 24, no = 283,324) and across a range of plausible impact indicator thresholds (10g increments beginning with a resultant linear head acceleration of 50g and ending with 120g). Some thresholds had adequate sensitivity, specificity, and PV-. All thresholds had low PV+, with the best recorded PV+ less than 0.4% when accounting for all head impacts sustained by our sample. Even when conservatively adjusting the frequency of diagnosed concussions by a factor of 5 to account for unreported/undiagnosed injuries, the PV+ of head impact indicators at any threshold was no greater than 1.94%. Although specificity and PV- appear high, the low PV+ would generate many unnecessary evaluations if these indicators were the sole diagnostic criteria. The clinical diagnostic value of head impact indicators is considerably questioned by these data. Notwithstanding, valid sensor technologies continue to offer objective data that have been used to improve player safety and reduce injury risk.

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

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    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.

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

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    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.

  2. Head Impact Exposure in Junior and Adult Australian Football Players

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    Mark Hecimovich

    2018-01-01

    Full Text Available This study measured and compared the frequency, magnitude, and distribution of head impacts sustained by junior and adult Australian football players, respectively, and between player positions over a season of games. Twelve junior and twelve adult players were tracked using a skin-mounted impact sensor. Head impact exposure, including frequency, magnitude, and location of impacts, was quantified using previously established methods. Over the collection period, there were no significant differences in the impact frequency between junior and adult players. However, there was a significant increase in the frequency of head impacts for midfielders in both grades once we accounted for player position. A comparable amount of head impacts in both junior and adult players has implications for Australian football regarding player safety and medical coverage as younger players sustained similar impact levels as adult players. The other implication of a higher impact profile within midfielders is that, by targeting education and prevention strategies, a decrease in the incidence of sports-related concussion may result.

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

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    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

  4. Effect of head rotation in whiplash-type rear impacts.

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    Kumar, Shrawan; Ferrari, Robert; Narayan, Yogesh

    2005-01-01

    Knowledge is increasing about the electromyographic and kinematic response of the neck muscles to rear impact, and also recent information is available on the effect of a rear impact offset to the left (posterolateral). The effect of head rotation, however, at the time of rear impact is not known. The purpose of this study was to examine the effects of head rotation to the left and right on the cervical muscle response to increasing low-velocity posterolateral impacts. Twenty healthy volunteers were subjected to rear impacts of 4.7, 8.3, 10.9 and 13.7 m/s2 acceleration, offset by 45 degrees to the subject's left, with head rotation to right and left. Bilateral electromyograms of the sternocleidomastoids, trapezii and splenii capitis were recorded. Triaxial accelerometers recorded the acceleration of the sled, torso at the shoulder level, and head of the participant. With the head rotated to the right, at an acceleration of 13.7 m/s2, the left sternocleidomastoid generated 59% and the right sternocleidomastoid 20% of their maximal voluntary contraction (MVC) electromyogram (EMG). Under these conditions, the remaining muscles (both splenii capitis and trapezius) generated 25% or less of their MVC. With the head rotated to the left, at an acceleration of 13.7 m/s2, the right sternocleidomastoid generated 65% and the left sternocleidomastoid only 11% of the MVC EMG. Under these conditions, again the remaining muscles had low EMG activity (27% or less) with the exception of the left trapezius which generated 47% of its MVC. Electromyographic variables were significantly affected by the levels of acceleration (pfactor in determining the muscle response to whiplash, but head rotation at the time of impact is also important in this regard. More specifically, when a rear impact is left posterolateral, it results in increased EMG generation mainly in the contralateral sternocleidomastoid, as expected, but head rotation at the same time in this type of impact reduces the EMG

  5. Heading Frequency Is More Strongly Related to Cognitive Performance Than Unintentional Head Impacts in Amateur Soccer Players

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    Walter F. Stewart

    2018-04-01

    Full Text Available ObjectiveCompared to heading, unintentional head impacts (e.g., elbow to head, head to head, head to goalpost in soccer are more strongly related to risk of moderate to very severe Central Nervous System (CNS symptoms. But, most head impacts associated with CNS symptoms that occur in soccer are mild and are more strongly related to heading. We tested for a differential relation of heading and unintentional head impacts with neuropsychological (NP test performance.MethodActive adult amateur soccer players were recruited in New York City and the surrounding areas for this repeated measures longitudinal study of individuals who were enrolled if they had 5+ years of soccer play and were active playing soccer 6+ months/year. All participants completed a baseline validated questionnaire (“HeadCount-2w”, reporting 2-week recall of soccer activity, heading and unintentional head impacts. In addition, participants also completed NP tests of verbal learning, verbal memory, psychomotor speed, attention, and working memory. Most participants also completed one or more identical follow-up protocols (i.e., HeadCount-2w and NP tests at 3- to 6-month intervals over a 2-year period. Repeated measures General Estimating Equations (GEE linear models were used to determine if variation in NP tests at each visit was related to variation in either heading or unintentional head impacts in the 2-week period before testing.Results308 players (78% male completed 741 HeadCount-2w. Mean (median heading/2-weeks was 50 (17 for men and 26 (7 for women. Heading was significantly associated with poorer performance on psychomotor speed (p < 0.001 and attention (p = 0.02 tasks and was borderline significant with poorer performance on the working memory (p = 0.06 task. Unintentional head impacts were not significantly associated with any NP test. Results did not differ after excluding 22 HeadCount-2w with reported concussive or borderline concussive symptoms

  6. Characterizing Verified Head Impacts in High School Girls' Lacrosse.

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    Caswell, Shane V; Lincoln, Andrew E; Stone, Hannah; Kelshaw, Patricia; Putukian, Margot; Hepburn, Lisa; Higgins, Michael; Cortes, Nelson

    2017-12-01

    Girls' high school lacrosse players have higher rates of head and facial injuries than boys. Research indicates that these injuries are caused by stick, player, and ball contacts. Yet, no studies have characterized head impacts in girls' high school lacrosse. To characterize girls' high school lacrosse game-related impacts by frequency, magnitude, mechanism, player position, and game situation. Descriptive epidemiology study. Thirty-five female participants (mean age, 16.2 ± 1.2 years; mean height, 1.66 ± 0.05 m; mean weight, 61.2 ± 6.4 kg) volunteered during 28 games in the 2014 and 2015 lacrosse seasons. Participants wore impact sensors affixed to the right mastoid process before each game. All game-related impacts recorded by the sensors were verified using game video. Data were summarized for all verified impacts in terms of frequency, peak linear acceleration (PLA), and peak rotational acceleration (PRA). Descriptive statistics and impact rates were calculated. Fifty-eight verified game-related impacts ≥20 g were recorded (median PLA, 33.8 g; median PRA, 6151.1 rad/s 2 ) during 467 player-games. The impact rate for all game-related verified impacts was 0.12 per athlete-exposure (AE) (95% CI, 0.09-0.16), equivalent to 2.1 impacts per team game, indicating that each athlete suffered fewer than 2 head impacts per season ≥20 g. Of these impacts, 28 (48.3%) were confirmed to directly strike the head, corresponding with an impact rate of 0.05 per AE (95% CI, 0.00-0.10). Overall, midfielders (n = 28, 48.3%) sustained the most impacts, followed by defenders (n = 12, 20.7%), attackers (n = 11, 19.0%), and goalies (n = 7, 12.1%). Goalies demonstrated the highest median PLA and PRA (38.8 g and 8535.0 rad/s 2 , respectively). The most common impact mechanisms were contact with a stick (n = 25, 43.1%) and a player (n = 17, 29.3%), followed by the ball (n = 7, 12.1%) and the ground (n = 7, 12.1%). One hundred percent of ball impacts occurred to goalies. Most impacts

  7. 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

  8. Heading Frequency Is More Strongly Related to Cognitive Performance Than Unintentional Head Impacts in Amateur Soccer Players.

    Science.gov (United States)

    Stewart, Walter F; Kim, Namhee; Ifrah, Chloe; Sliwinski, Martin; Zimmerman, Molly E; Kim, Mimi; Lipton, Richard B; Lipton, Michael L

    2018-01-01

    Compared to heading, unintentional head impacts (e.g., elbow to head, head to head, head to goalpost) in soccer are more strongly related to risk of moderate to very severe Central Nervous System (CNS) symptoms. But, most head impacts associated with CNS symptoms that occur in soccer are mild and are more strongly related to heading. We tested for a differential relation of heading and unintentional head impacts with neuropsychological (NP) test performance. Active adult amateur soccer players were recruited in New York City and the surrounding areas for this repeated measures longitudinal study of individuals who were enrolled if they had 5+ years of soccer play and were active playing soccer 6+ months/year. All participants completed a baseline validated questionnaire ("HeadCount-2w"), reporting 2-week recall of soccer activity, heading and unintentional head impacts. In addition, participants also completed NP tests of verbal learning, verbal memory, psychomotor speed, attention, and working memory. Most participants also completed one or more identical follow-up protocols (i.e., HeadCount-2w and NP tests) at 3- to 6-month intervals over a 2-year period. Repeated measures General Estimating Equations (GEE) linear models were used to determine if variation in NP tests at each visit was related to variation in either heading or unintentional head impacts in the 2-week period before testing. 308 players (78% male) completed 741 HeadCount-2w. Mean (median) heading/2-weeks was 50 (17) for men and 26 (7) for women. Heading was significantly associated with poorer performance on psychomotor speed ( p  impacts were not significantly associated with any NP test. Results did not differ after excluding 22 HeadCount-2w with reported concussive or borderline concussive symptoms. Poorer NP test performance was consistently related to frequent heading during soccer practice and competition in the 2 weeks before testing. In contrast, unintentional head impacts incurred

  9. 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.

  10. The impact of gravity during head-up tilt

    DEFF Research Database (Denmark)

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

    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 an...

  11. 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.

  12. 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.

  13. Assessing women's lacrosse head impacts using finite element modelling.

    Science.gov (United States)

    Clark, J Michio; Hoshizaki, T Blaine; Gilchrist, Michael D

    2018-04-01

    Recently studies have assessed the ability of helmets to reduce peak linear and rotational acceleration for women's lacrosse head impacts. However, such measures have had low correlation with injury. Maximum principal strain interprets loading curves which provide better injury prediction than peak linear and rotational acceleration, especially in compliant situations which create low magnitude accelerations but long impact durations. The purpose of this study was to assess head and helmet impacts in women's lacrosse using finite element modelling. Linear and rotational acceleration loading curves from women's lacrosse impacts to a helmeted and an unhelmeted Hybrid III headform were input into the University College Dublin Brain Trauma Model. The finite element model was used to calculate maximum principal strain in the cerebrum. The results demonstrated for unhelmeted impacts, falls and ball impacts produce higher maximum principal strain values than stick and shoulder collisions. The strain values for falls and ball impacts were found to be within the range of concussion and traumatic brain injury. The results also showed that men's lacrosse helmets reduced maximum principal strain for follow-through slashing, falls and ball impacts. These findings are novel and demonstrate that for high risk events, maximum principal strain can be reduced by implementing the use of helmets if the rules of the sport do not effectively manage such situations. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Evaluation of possible head injuries ensuing a cricket ball impact.

    Science.gov (United States)

    Mohotti, Damith; Fernando, P L N; Zaghloul, Amir

    2018-05-01

    The aim of this research is to study the behaviour of a human head during the event of an impact of a cricket ball. While many recent incidents were reported in relation to head injuries caused by the impact of cricket balls, there is no clear information available in the published literature about the possible threat levels and the protection level of the current protective equipment. This research investigates the effects of an impact of a cricket ball on a human head and the level of protection offered by the existing standard cricket helmet. An experimental program was carried out to measure the localised pressure caused by the impact of standard cricket balls. The balls were directed at a speed of 110 km/h on a 3D printed head model, with and without a standard cricket helmet. Numerical simulations were carried out using advanced finite element package LS-DYNA to validate the experimental results. The experimental and numerical results showed approximately a 60% reduction in the pressure on the head model when the helmet was used. Both frontal and side impact resulted in head acceleration values in the range of 225-250 g at a ball speed of 110 km/h. There was a 36% reduction observed in the peak acceleration of the brain when wearing a helmet. Furthermore, numerical simulations showed a 67% reduction in the force on the skull and a 95% reduction in the skull internal energy when introducing the helmet. (1) Upon impact, high localised pressure could cause concussion for a player without helmet. (2) When a helmet was used, the acceleration of the brain observed in the numerical results was at non-critical levels according to existing standards. (3) A significant increase in the threat levels was observed for a player without helmet, based on force, pressure, acceleration and energy criteria, which resulted in recommending the compulsory use of the cricket helmet. (4) Numerical results showed a good correlation with experimental results and hence, the

  15. 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…

  16. 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

  17. 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.

  18. 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…

  19. Development and field performance of indy race car head impact padding.

    Science.gov (United States)

    Melvin, J W; Bock, H; Anderson, K; Gideon, T

    2001-11-01

    The close-fitting cockpit of the modern Indy car single seat race car has the potential to provide a high level of head and neck impact protection in rear and side impacts. Crash investigation has shown that a wide variety of materials have been used as the padding for these cockpits and, as a result, produced varying outcomes in crashes. Additionally, these pads have not always been positioned for optimal performance. The purpose of this study was to investigate the head impact performance of a variety of energy-absorbing padding materials under impact conditions typical of Indy car rear impacts and to identify superior materials and methods of improving their performance as race car head pads. An extensive series of tests with the helmeted Hybrid III test dummy head and neck on an impact mini-sled was conducted to explore head padding concepts. Following this, a performance specification for a simplified impact test using a rigid headform that simulates the helmeted head was developed and recommendations for performance levels of head padding based on biomechanical data on helmeted head impacts were made. In 1997, during the time that the head pad research was being performed, the Indy Racing League introduced a new chassis specification for their cars. There were a number of rear- and side-impact crashes during that season that resulted in seven severe head injuries. Examples of the head padding in those cars were included in the experimental study. The results of the head pad research were used to specify new padding materials that met the new biomechanical criteria. The placement of the head pads was also changed for better location of the padding. These changes instituted in 1998 have reduced the number of head injuries in crashes similar to or more severe than those of 1997 and have resulted in only occasional moderate head injuries (concussions) in the 1998 and 1999 seasons.

  20. Comparative analyses of bicyclists and motorcyclists in vehicle collisions focusing on head impact responses.

    Science.gov (United States)

    Wang, Xinghua; Peng, Yong; Yi, Shengen

    2017-11-01

    To investigate the differences of the head impact responses between bicyclists and motorcyclists in vehicle collisions. A series of vehicle-bicycle and vehicle-motorcycle lateral impact simulations on four vehicle types at seven vehicle speeds (30, 35, 40, 45, 50, 55 and 60 km/h) and three two-wheeler moving speeds (5, 7.5 and 10 km/h for bicycle, 10, 12.5 and 15 km/h for motorcycle) were established based on PC-Crash software. To further comprehensively explore the differences, additional impact scenes with other initial conditions, such as impact angle (0, π/3, 2π/3 and π) and impact position (left, middle and right part of vehicle front-end), also were supplemented. And then, extensive comparisons were accomplished with regard to average head peak linear acceleration, average head impact speed, average head peak angular acceleration, average head peak angular speed and head injury severity. The results showed there were prominent differences of kinematics and body postures for bicyclists and motorcyclists even under same impact conditions. The variations of bicyclist head impact responses with the changing of impact conditions were a far cry from that of motorcyclists. The average head peak linear acceleration, average head impact speed and average head peak angular acceleration values were higher for motorcyclists than for bicyclists in most cases, while the bicyclists received greater average head peak angular speed values. And the head injuries of motorcyclists worsened faster with increased vehicle speed. The results may provide even deeper understanding of two-wheeler safety and contribute to improve the public health affected by road traffic accidents.

  1. An experimental and numerical investigation of head dynamics due to stick impacts in girls' lacrosse.

    Science.gov (United States)

    Morse, Justin D; Franck, Jennifer A; Wilcox, Bethany J; Crisco, Joseph J; Franck, Christian

    2014-12-01

    A method of investigating head acceleration and intracranial dynamics from stick impacts in girls' and women's lacrosse was developed using headform impact experiments and a finite element head model. Assessing the likelihood of head injury due to stick-head impacts is of interest in girls' and women's lacrosse due to the current lack of head protection during play. Experimental and simulation data were compared to characterize the head acceleration caused by stick-head impacts. Validation against cadaver head impact experiments ensures that the finite element model, with its relatively simple material properties, can provide means to develop a better understanding of the intracranial dynamics during lacrosse stick impacts. Our numerical results showed the peak acceleration at the center of gravity increased linearly with impact force, and was generally in agreement with the experimental data. von Mises stresses and peak principal strains, two common literature injury indicators, were examined within the finite element model, and peak values were below the previously reported thresholds for mild traumatic brain injury. By reconstructing typical in-game, unprotected stick-head impacts, this investigation lays the foundation for a quantitative methodology of injury prediction in girls' and womens' lacrosse.

  2. 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.

  3. 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 < .001), and these impacts were greater in peak rotational acceleration (P = .027). Identifying the impact mechanisms in collegiate 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.

  4. Assessment of head injury of children due to golf ball impact.

    Science.gov (United States)

    Lee, Heow Pueh; Wang, Fang

    2010-10-01

    Head trauma injury due to impact by a flying golf ball is one of the most severe possible injury accidents on the golf course. Numerical simulations based on the finite element method are presented to investigate head injury in children due to impact by a flying golf ball. The stress and energy flow patterns in a head model during the golf ball impact are computed for various combinations of striking speed, falling angle of the golf ball before impact, and impact location. It is found that a child is more prone to head injury due to golf ball impact on the frontal and side/temporal areas. The simulated results are found to conform to the clinical reports on children's head injuries from flying golf balls.

  5. 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…

  6. 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

  7. 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

  8. 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.

  9. The Impact of Head Start on Children, Families and Communities. Final Report of the Head Start Evaluation, Synthesis and Utilization Project.

    Science.gov (United States)

    McKey, Ruth Hubbell; And Others

    Including all Head Start research (both published and unpublished) and using, when possible, the statistical technique of meta-analysis, this final report of the Head Start Evaluation, Synthesis, and Utilization Project presents findings on the impact of Head Start on children's cognitive and socioemotional development, on child health and health…

  10. 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.

  11. 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

  12. Relationship Between Neck Strength, Anthropometric Parameters, and Gender with Head Motion under Impact Acceleration

    National Research Council Canada - National Science Library

    Morris, Charles

    1996-01-01

    .... Since women tend to have less upper-body strength than men, it was hypothesized that they may not be able to brace their heads as effectively against the loads which occur during impact and escape...

  13. Economic impact of a head and neck oncologic surgeon: the case mix index.

    Science.gov (United States)

    Jalisi, Scharukh; Sanan, Akshay; Mcdonough, Katie; Hussein, Khalil; Platt, Michael; Truong, Minh Tam; Couch, Marion; Burkey, Brian B

    2014-10-01

    Head and neck oncologic surgery is a time-consuming specialty that requires extensive resources and manpower. Case mix index (CMI) is used in evaluating the complexity and economic impact of surgeons. Head and neck oncologic surgeons generate significant revenue for hospitals, yet compensation is relatively low. Retrospective review of a tertiary hospital's case mix data for 605 otolaryngology admissions from 2009 to 2011 was performed. CMI comparison for head and neck oncologic surgeons versus general otolaryngology was performed. In an otolaryngology department of 9 surgeons; there was a significant difference (p 1) favoring head and neck oncologic surgeons. Head and neck oncologic surgeons increase the CMI for hospitals and ultimately influence the hospital's reimbursement. There is a need for increased collaboration between hospitals and departments in fostering and furthering their head and neck surgical oncology programs by taking CMI into consideration. © 2013 Wiley Periodicals, Inc.

  14. Clinical Risk Factors for Head Impact During Falls in Older Adults: A Prospective Cohort Study in Long-Term Care.

    Science.gov (United States)

    Yang, Yijian; Mackey, Dawn C; Liu-Ambrose, Teresa; Leung, Pet-Ming; Feldman, Fabio; Robinovitch, Stephen N

    To examine risk factors associated with head impact during falls in older adults in long-term care (LTC). Two LTC facilities in British Columbia, Canada. 160 LTC residents. Prospective cohort study. Between 2007 and 2014, we video captured 520 falls experienced by participants. Each fall video was analyzed to determine whether impact occurred to the head. Using generalized estimating equation models, we examined how head impact was associated with other fall characteristics and health status prior to the fall. Head impact occurred in 33% of falls. Individuals with mild cognitive impairment were at higher risk for head impact (odds ratio = 2.8; 95% confidence interval, 1.5-5.0) than those with more severe cognitive impairment. Impaired vision was associated with 2.0-fold (1.3-3.0) higher odds of head impact. Women were 2.2 times (1.4-3.3) more likely than men to impact their head during a fall. Head impact is common during falls in LTC, with less cognitively impaired, female residents who suffered from visual impairment, being most likely to impact their head. Future research should focus on improving our ability to detect neural consequences of head impact and evaluating the effect of interventions for reducing the risk for fall-related head injuries in LTC.

  15. Motion of the head and neck of female and male volunteers in rear impact car-to-car impacts.

    Science.gov (United States)

    Carlsson, Anna; Siegmund, Gunter P; Linder, Astrid; Svensson, Mats Y

    2012-01-01

    The objectives of this study were to quantify and compare dynamic motion responses between 50th percentile female and male volunteers in rear impact tests. These data are fundamental for developing future occupant models for crash safety development and assessment. High-speed video data from a rear impact test series with 21 male and 21 female volunteers at 4 and 8 km/h, originally presented in Siegmund et al. (1997), were used for further analysis. Data from a subset of female volunteers, 12 at 4 km/h and 9 at 8 km/h, were extracted from the original data set to represent the 50th percentile female. Their average height was 163 cm and their average weight was 62 kg. Among the male volunteers, 11 were selected, with an average height of 175 cm and an average weight of 73 kg, to represent the 50th percentile male. Response corridors were generated for the horizontal and angular displacements of the head, T1 (first thoracic vertebra), and the head relative to T1. T-tests were performed with the statistical significance level of .05 to quantify the significance of the differences in parameter values for the males and females. Several differences were found in the average motion response of the male and female volunteers at 4 and 8 km/h. Generally, females had smaller rearward horizontal and angular motions of the head and T1 compared to the males. This was mainly due to shorter initial head-to-head restraint distance and earlier head-to-head restraint contact for the females. At 8 km/h, the female volunteers showed 12 percent lower horizontal peak rearward head displacement (P = .018); 22 percent lower horizontal peak rearward head relative to T1 displacement (P = .018); and 30 percent lower peak head extension angle (P = .001). The females also had more pronounced rebound motion. This study indicates that there may be characteristic differences in the head-neck motion response between 50th percentile males and females in rear impacts. The exclusive use of 50th

  16. 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).

  17. Hybrid III anthropomorphic test device (ATD) response to head impacts and potential implications for athletic headgear testing.

    Science.gov (United States)

    Bartsch, Adam; Benzel, Edward; Miele, Vincent; Morr, Douglas; Prakash, Vikas

    2012-09-01

    The Hybrid III 50th percentile male anthropomorphic test device (ATD) is the most widely used human impact testing surrogate and has historically been used in automotive or military testing. More recently, this ATD is finding use in applications evaluating athletic helmet protectivity, quantifying head impact dosage and estimating injury risk. But ATD head-neck response has not been quantified in omnidirectional athletic-type head impacts absent axial preload. It is probable that headgear injury reduction that can be quantified in a laboratory, including in American football, boxing, hockey, lacrosse and soccer, is related to a number of interrelated kinetic and kinematic factors, such as head center of gravity linear acceleration, head angular acceleration, head angular velocity, occipito-cervical mechanics and neck stiffness. Therefore, we characterized ATD head-neck dynamic response to direct head impacts in a series of front, oblique front and lateral head impacts. Key findings were: (1) impacts producing highest ATD resultant center of gravity linear acceleration resulted in the lowest resultant occipito-cervical spine bending moment/force. (2) Resultant ATD head angular velocity and angular acceleration did not appear coupled to impact direction at lower impact energy levels; these parameters were coupled at higher energy levels. (3) The ATD had progressively increasing occipito-cervical stiffness in extension, torsion and lateral bending, respectively. Because the ATD neck influenced head and neck impact dosage parameters, testing agencies, manufacturers and researchers should consider using the Hybrid III head form attached to a neck as a means to quantify head and neck injury risks as opposed to systems that do not utilize a neck. This heightened understanding of Hybrid III ATD head-neck response, and consideration of order of stiffest axes in the lateral, oblique and extension directions, respectively, should aid in the development of head and neck injury

  18. Changes in parents' spanking and reading as mechanisms for Head Start impacts on children.

    Science.gov (United States)

    Gershoff, Elizabeth T; Ansari, Arya; Purtell, Kelly M; Sexton, Holly R

    2016-06-01

    This study examined whether Head Start, the nation's main two-generation program for low-income families, benefits children in part through positive changes in parents' use of spanking and reading to children. Data were drawn from the 3-year-old cohort of the national evaluation of the Head Start program known as the Head Start Impact Study (N = 2,063). Results indicated that Head Start had small, indirect effects on children's spelling ability at Age 4 and their aggression at Age 4 through an increase in parents' reading to their children. Taken together, the results suggest that parents play a role in sustaining positive benefits of the Head Start program for children's behavior and literacy skills, one that could be enhanced with a greater emphasis on parent involvement and education. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. Comprehensive Coach Education Reduces Head Impact Exposure in American Youth Football

    Science.gov (United States)

    Kerr, Zachary Y.; Yeargin, Susan W.; Valovich McLeod, Tamara C.; Mensch, James; Hayden, Ross; Dompier, Thomas P.

    2015-01-01

    Background: Despite little evidence that defines a threshold of head impact exposure or that participation in youth sports leads to long-term cognitive impairments, it is prudent to identify methods of reducing the frequency of head impacts. Purpose: To compare the mean number of head impacts between youth football players in practice and games between leagues that implemented the Heads Up Football (HUF) educational program and those that did not (NHUF). Study Design: Cohort study; Level of evidence, 2. Methods: During the 2014 season, head impact exposure was measured using xPatch accelerometers from 70 youth football players aged 8 to 15 years from 5 leagues. Data were collected during both games and practices. The NHUF group comprised 32 players from 8 teams within 3 leagues. The HUF group comprised 38 players from 7 teams within 2 leagues. Independent-sample t tests evaluated differences in head impact exposure across groups (ie, HUF and NHUF). Results: Players (mean ± SD: age, 11.7 ± 1.4 years; height, 152.2 ± 10.5 cm; weight, 51.6 ± 9.6 kg) experienced a total of 7478 impacts over 10g, of which 4250 (56.8%) and 3228 (43.2%) occurred in practices and games, respectively. The majority of impacts occurred within the NHUF group (62.0%), followed by the HUF group (38.0%). With a 10g impact threshold, the mean number of impacts during practice per individual event was lower in the HUF group (mean ± SD, 5.6 ± 2.9) than in the NHUF group (mean ± SD, 8.9 ± 3.1; difference, 3.4; 95% CI, 2.9-3.9). This difference was attenuated when the threshold was changed to 20g but remained significant (difference, 1.0; 95% CI, 0.7-1.3). At both the 10g and 20g impact thresholds, no differences were found in games. Conclusion: Players who participated in HUF leagues accumulated fewer head impacts per practice at both the 10g and 20g thresholds. Youth football leagues should consider the HUF educational program, while exploring additional interventions, to help reduce the

  20. Quantifying Variation in Head Start Effects on Young Children's Cognitive and Socio-Emotional Skills Using Data from the National Head Start Impact Study

    Science.gov (United States)

    Bloom, Howard S.; Weiland, Christina

    2015-01-01

    This paper uses data from the Head Start Impact Study (HSIS), a nationally representative multisite randomized trial, to quantify variation in effects of Head Start during 2002-2003 on children's cognitive and socio-emotional outcomes relative to the effects of other local alternatives, including parent care. We find that (1) treatment and control…

  1. The Impact of Head Start on Children, Families and Communities. Final Report of the Head Start Evaluation, Synthesis and Utilization Project. Executive Summary.

    Science.gov (United States)

    McKey, Ruth Hubbell; And Others

    This report summarizes the results of a study on the impact of Head Start on children's cognitive and socioemotional development, on child health and health institutions in the community, on enrollees' families, and on communities where Head Start programs operate. After discussing the background and methodology of the study, the report concludes…

  2. 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

  3. 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.

  4. Low-head hydropower impacts on steam dissolved oxygen

    International Nuclear Information System (INIS)

    Thene, J.R.; Stefan, H.G.; Daniil, E.I.

    1989-01-01

    A method to evaluate the effect of hydropower development on downstream dissolved oxygen (DO) is presented for a low head dam. Water, previously aerated during release over spillways and under gates, is diverted through the hydropower facility without further aeration. The oxygen transfer that occurs as a result of air entrainment at the various release points of a dam is measured. Oxygen transfer efficiencies are calculated and incorporated into an oxygen transfer model to predict average release DO concentrations. This model is used to systematically determine the effect of hydropower operation on downstream DO. Operational alternatives are investigated and a simple operational guide is developed to mitigate the effects of hydropower operation. Combinations of reduced generation and optimal releases from the dam allow the hydropower facility to operate within DO standards

  5. Post-heading heat stress and yield impact in winter wheat of China.

    Science.gov (United States)

    Liu, Bing; Liu, Leilei; Tian, Liying; Cao, Weixing; Zhu, Yan; Asseng, Senthold

    2014-02-01

    Wheat is sensitive to high temperatures, but the spatial and temporal variability of high temperature and its impact on yield are often not known. An analysis of historical climate and yield data was undertaken to characterize the spatial and temporal variability of heat stress between heading and maturity and its impact on wheat grain yield in China. Several heat stress indices were developed to quantify heat intensity, frequency, and duration between heading and maturity based on measured maximum temperature records of the last 50 years from 166 stations in the main wheat-growing region of China. Surprisingly, heat stress between heading and maturity was more severe in the generally cooler northern wheat-growing regions than the generally warmer southern regions of China, because of the delayed time of heading with low temperatures during the earlier growing season and the exposure of the post-heading phase into the warmer part of the year. Heat stress between heading and maturity has increased in the last decades in most of the main winter wheat production areas of China, but the rate was higher in the south than in the north. The correlation between measured grain yields and post-heading heat stress and average temperature were statistically significant in the entire wheat-producing region, and explained about 29% of the observed spatial and temporal yield variability. A heat stress index considering the duration and intensity of heat between heading and maturity was required to describe the correlation of heat stress and yield variability. Because heat stress is a major cause of yield loss and the number of heat events is projected to increase in the future, quantifying the future impact of heat stress on wheat production and developing appropriate adaptation and mitigation strategies are critical for developing food security policies in China and elsewhere. © 2013 John Wiley & Sons Ltd.

  6. Sensing Passive Eye Response to Impact Induced Head Acceleration Using MEMS IMUs.

    Science.gov (United States)

    Meng, Yuan; Bottenfield, Brent; Bolding, Mark; Liu, Lei; Adams, Mark L

    2018-02-01

    The eye may act as a surrogate for the brain in response to head acceleration during an impact. Passive eye movements in a dynamic system are sensed by microelectromechanical systems (MEMS) inertial measurement units (IMU) in this paper. The technique is validated using a three-dimensional printed scaled human skull model and on human volunteers by performing drop-and-impact experiments with ribbon-style flexible printed circuit board IMUs inserted in the eyes and reference IMUs on the heads. Data are captured by a microcontroller unit and processed using data fusion. Displacements are thus estimated and match the measured parameters. Relative accelerations and displacements of the eye to the head are computed indicating the influence of the concussion causing impacts.

  7. Head injury causation scenarios for belted, rear-seated children in frontal impacts.

    Science.gov (United States)

    Bohman, Katarina; Arbogast, Kristy B; Bostrom, Ola

    2011-02-01

    Head injuries are the most common serious injuries sustained by children in motor vehicle crashes and are of critical importance with regard to long-term disability. There is a lack of understanding of how seat belt-restrained children sustain head injuries in frontal impacts. The aim of the study was to identify the AIS2+ head injury causation scenarios for rear-seated, belt-restrained children in frontal impacts, including the set of parameters contributing to the injury. In-depth crash investigations from two National Highway Traffic Safety Administration (NHTSA) databases, the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS; 1997-2008) and the Crash Injury Research and Engineering Network (CIREN; 1996-2009), were collected and analyzed in detail. Selection criteria were all frontal impacts with principal direction of force (PDOF) of 11, 12, and 1 o'clock involving rear-seated, three-point belt-restrained, with or without booster cushion, children from 3 to 13 years with an AIS2+ head injury. Cases were analyzed using the BioTab method of injury causation assessment in order to systematically analyze the injury causation scenario for each case. There were 27 cases meeting the inclusion criteria, 19 cases with MAIS2 head injuries and 8 cases with MAIS3+ head injuries, including 2 fatalities. Three major injury causation scenarios were identified, including head contact with seatback (10 cases), head contact with side interior (7 cases,) and no evidence of head contact (9 cases). Head injuries with seatback or side interior contact typically included a PDOF greater than 10 degree (similar to the Insurance Institute for Highway Safety [IIHS] and EuroNCAP offset frontal testing) and vehicle maneuvers. For seatback contact, the vehicle's movements contributed to occupant kinematics inboard the vehicle, causing a less than optimal restraint of the torso and/or torso roll out of the shoulder belt. For side interior contact, the PDOF and

  8. 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

  9. Analysis of head impacts during sub-elite hurling practice sessions.

    Science.gov (United States)

    O'Sullivan, D; Roe, M; Blake, C

    2018-06-01

    The reported incidence of head and neck injuries in hurling is 0.12 per 1000 hours, but no previous research has quantified head impact characteristics in this sport. Here, a wireless accelerometer and gyroscope captured head impacts, in 20 senior club level hurling players. Peak linear and rotational acceleration and impact location were recorded during three hurling training sessions, each player participating once. A mean of 27.9 impacts (linear acceleration >10g) per player, per session were recorded; 1314 impacts during a total exposure time of 247 minutes. Only 2.6% impacts had peak linear acceleration of >70g and 6.2% had peak rotational acceleration >7900 rad/s 2 . There were significant differences in the number and magnitude of impacts, quantified by the accelerometer, between three training sessions of differing intensity (ŋ2 0.03-0.09, p impacts during hurling, demonstrating the feasibility of this technology in the field. The sensors were able to discriminate between sessions of varying intensity. These data can be used to develop athlete monitoring protocols and may be useful in developing innovative helmet-testing standards for hurling. The potential for this technology to provide feedback has clinical utility for team medical personnel.

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

    Indian Academy of Sciences (India)

    helmets in direct impact are well documented and helmets have been found to ... conditions during a drop test and studied the influence of shell stiffness and liner ... the latter authors use a SI (Structural Intensity) approach to study power flow ...

  11. Laboratory Evaluation of Low-Cost Wearable Sensors for Measuring Head Impacts in Sports.

    Science.gov (United States)

    Tyson, Abigail M; Duma, Stefan M; Rowson, Steven

    2018-04-03

    Advances in low-cost wearable head impact sensor technology provide potential benefits regarding sports safety for both consumers and researchers. However, previous laboratory evaluations are not directly comparable and don't incorporate test conditions representative of unhelmeted impacts. This study addresses those limitations. The xPatch by X2 Biosystems and the SIM-G by Triax Technologies were placed on a NOCSAE headform with a Hybrid III neck which underwent impacts tests using a pendulum. Impact conditions included helmeted, padded impactor to bare head, and rigid impactor to bare head to represent long and short-duration impacts seen in helmeted and unhelmeted sports. The wearable sensors were evaluated on their kinematic accuracy by comparing results to reference sensors located at the headform center of gravity. Statistical tests for equivalence were performed on the slope of the linear regression between wearable sensors and reference. The xPatch gave equivalent measurements to the reference in select longer-duration impacts whereas the SIM-G had large variance leading to no equivalence. For the short-duration impacts, both wearable sensors underpredicted the reference. This error can be improved with increases in sampling rate from 1 to 1.5 kHz. Follow-up evaluations should be performed on the field to identify error in vivo. (197/200).

  12. 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.

  13. 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.…

  14. Analysis of two colliding fractionally damped spherical shells in modelling blunt human head impacts

    Science.gov (United States)

    Rossikhin, Yury A.; Shitikova, Marina V.

    2013-06-01

    The collision of two elastic or viscoelastic spherical shells is investigated as a model for the dynamic response of a human head impacted by another head or by some spherical object. Determination of the impact force that is actually being transmitted to bone will require the model for the shock interaction of the impactor and human head. This model is indended to be used in simulating crash scenarios in frontal impacts, and provide an effective tool to estimate the severity of effect on the human head and to estimate brain injury risks. The model developed here suggests that after the moment of impact quasi-longitudinal and quasi-transverse shock waves are generated, which then propagate along the spherical shells. The solution behind the wave fronts is constructed with the help of the theory of discontinuities. It is assumed that the viscoelastic features of the shells are exhibited only in the contact domain, while the remaining parts retain their elastic properties. In this case, the contact spot is assumed to be a plane disk with constant radius, and the viscoelastic features of the shells are described by the fractional derivative standard linear solid model. In the case under consideration, the governing differential equations are solved analytically by the Laplace transform technique. It is shown that the fractional parameter of the fractional derivative model plays very important role, since its variation allows one to take into account the age-related changes in the mechanical properties of bone.

  15. 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 < 0.05 for small-intermediate ice and intermediate-large ice differences in total collisions; P < 0.005 for small-large ice difference; P < 0.05 for small-intermediate ice differences in head impacts; P < 0.01 for small-large 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.

  16. The role of Human papillomavirus in head and neck cancer and the impact on radiotherapy outcome

    International Nuclear Information System (INIS)

    Lassen, Pernille

    2010-01-01

    The profound influence of Human papillomavirus (HPV) on the epidemiological pattern and clinical course of head and neck cancer (HNSCC) has led to a change in the traditional understanding of this disease entity. Separate therapeutic strategies based on tumour HPV status are under consideration and in this light provision of knowledge concerning the influence of tumour HPV on the radiation response in HNSCC appears highly relevant. This review provides a summary of the current understanding of the role of HPV in head and neck cancer with specific focus on the viral impact on radiotherapy outcome of HNSCC.

  17. 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

    Introduction 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. Methods 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. Results 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. Conclusions 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. PMID:24740265

  18. 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

    2018-01-01

    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.

  19. Head Impact Exposure in Youth Football: Comparing Age- and Weight-Based Levels of Play.

    Science.gov (United States)

    Kelley, Mireille E; Urban, Jillian E; Miller, Logan E; Jones, Derek A; Espeland, Mark A; Davenport, Elizabeth M; Whitlow, Christopher T; Maldjian, Joseph A; Stitzel, Joel D

    2017-06-01

    Approximately 5,000,000 athletes play organized football in the United States, and youth athletes constitute the largest proportion with ∼3,500,000 participants. Investigations of head impact exposure (HIE) in youth football have been limited in size and duration. The objective of this study was to evaluate HIE of athletes participating in three age- and weight-based levels of play within a single youth football organization over four seasons. Head impact data were collected using the Head Impact Telemetry (HIT) System. Mixed effects linear models were fitted, and Wald tests were used to assess differences in head accelerations and number of impacts among levels and session type (competitions vs. practices). The three levels studied were levels A (n = 39, age = 10.8 ± 0.7 years, weight = 97.5 ± 11.8 lb), B (n = 48, age = 11.9 ± 0.5 years, weight = 106.1 ± 13.8 lb), and C (n = 32, age = 13.0 ± 0.5 years, weight = 126.5 ± 18.6 lb). A total of 40,538 head impacts were measured. The median/95th percentile linear head acceleration for levels A, B, and C was 19.8/49.4g, 20.6/51.0g, and 22.0/57.9g, respectively. Level C had significantly greater mean linear acceleration than both levels A (p = 0.005) and B (p = 0.02). There were a significantly greater number of impacts per player in a competition than in a practice session for all levels (A, p = 0.0005, B, p = 0.0019, and C, p football and are an important step in making evidence-based decisions to reduce HIE.

  20. 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.

  1. 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.

  2. Channel heads in mountain catchments subject to human impact - The Skrzyczne range in Southern Poland

    Science.gov (United States)

    Wrońska-Wałach, Dominika; Żelazny, Mirosław; Małek, Stanisław; Krakowian, Katarzyna; Dąbek, Natalia

    2018-05-01

    Channel heads in mountain catchments are increasingly influenced by human activity. The disturbance of mountain headwater areas in moderate latitudes by the clearing of trees and the associated logging, road building and hydrotechnical constructions contribute to changes in the water cycle and consequently may induce a change in channel head development. Here we examine channel heads in the Beskid Śląski Mts., one of the areas most affected by ecological disaster in the Polish Flysch Carpathians. An ecological disaster associated with the decline of spruce trees in the 1980s and 1990s caused a substantial decrease (of about 50%) in the land area occupied by spruce forest in the Beskid Śląski Mts. As a result, headwater areas were subject to multidirectional changes in the environment. The purpose of this paper is to determine the detailed characteristics of channel heads currently developing in the analyzed headwater areas, as well as to identify independent factors that affect the evolution of channel heads. Geomorphological mapping was conducted in 2012 in the vicinity of springs in the study area. One-way ANOVA was used to determine the significance of differences between mean values calculated for groups identified based on: i) geomorphologic processes (hollows with rock veneer - h, spring niches - sn, gullies - g), ii) location vs. transformation of channel heads (forested areas vs., deforested areas with road constructions). Principal component analysis (PCA) was used to determine the structure and general patterns associated with relationships between the parameters of a channel head and its contribution area, as well as to identify and interpret new (orthogonal) spaces defined using distinct factors. As far as we know, this kind of approach has been never applied before. A total of 80 channel heads surrounding 104 springs were surveyed close to the main ridge in the study area. A total of 14 morphometric parameters were taken into account in this study

  3. The effect of motorcycle helmet fit on estimating head impact kinematics from residual liner crush.

    Science.gov (United States)

    Bonin, Stephanie J; Gardiner, John C; Onar-Thomas, Arzu; Asfour, Shihab S; Siegmund, Gunter P

    2017-09-01

    Proper helmet fit is important for optimizing head protection during an impact, yet many motorcyclists wear helmets that do not properly fit their heads. The goals of this study are i) to quantify how a mismatch in headform size and motorcycle helmet size affects headform peak acceleration and head injury criteria (HIC), and ii) to determine if peak acceleration, HIC, and impact speed can be estimated from the foam liner's maximum residual crush depth or residual crush volume. Shorty-style helmets (4 sizes of a single model) were tested on instrumented headforms (4 sizes) during linear impacts between 2.0 and 10.5m/s to the forehead region. Helmets were CT scanned to quantify residual crush depth and volume. Separate linear regression models were used to quantify how the response variables (peak acceleration (g), HIC, and impact speed (m/s)) were related to the predictor variables (maximum crush depth (mm), crush volume (cm 3 ), and the difference in circumference between the helmet and headform (cm)). Overall, we found that increasingly oversized helmets reduced peak headform acceleration and HIC for a given impact speed for maximum residual crush depths less than 7.9mm and residual crush volume less than 40cm 3 . Below these levels of residual crush, we found that peak headform acceleration, HIC, and impact speed can be estimated from a helmet's residual crush. Above these crush thresholds, large variations in headform kinematics are present, possibly related to densification of the foam liner during the impact. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    OpenAIRE

    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.

    2015-01-01

    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 rel...

  5. Role of awareness in head-neck acceleration in low velocity rear-end impacts.

    Science.gov (United States)

    Kumar, S; Narayan, Y; Amell, T

    2000-03-01

    Fourteen normal healthy seated and restrained young adults were delivered rear-end impacts of four intensities of acceleration. The chair was delivered a regulated and controlled pneumatic blow using a 30 cm cylinder to cause an acceleration of 0.5, 0.9, 1.1 and 1.4g. The accelerated chair was stopped suddenly by impacting the stopper at the other end of the 2 m long friction reduced track. In one set of trials, subjects were informed about the impending impact and in the other they were blindfolded and provided with loud auditory input to eliminate cues of the impact. The accelerations of the chair, shoulder and head of the participating subjects were measured triaxially and compared between levels of acceleration and expectation. The multiple analyses of variance revealed that the peak acceleration was significantly affected by the gender (P < 0.01), intensity of impact (P < 0.001), and expectation (P < 0.0001). The accelerations were significantly different in different axes (P < 0.001). A significant two-way interaction between acceleration and expectation (P < 0.03), and expectation and axes of acceleration (P < 0.02) would imply that awareness of the impending impact serves to significantly reduce the level of accelerations of head and neck.

  6. 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.

  7. Analysis of impact noise induced by hitting of titanium head golf driver.

    Science.gov (United States)

    Kim, Young Ho; Kim, Young Chul; Lee, Jun Hee; An, Yong-Hwi; Park, Kyung Tae; Kang, Kyung Min; Kang, Yeon June

    2014-11-01

    The hitting of titanium head golf driver against golf ball creates a short duration, high frequency impact noise. We analyzed the spectra of these impact noises and evaluated the auditory hazards from exposure to the noises. Noises made by 10 titanium head golf drivers with five maximum hits were collected, and the spectra of the pure impact sounds were studied using a noise analysis program. The noise was measured at 1.7 m (position A) and 3.4 m (position B) from the hitting point in front of the hitter and at 3.4 m (position C) behind the hitting point. Average time duration was measured and auditory risk units (ARUs) at position A were calculated using the Auditory Hazard Assessment Algorithm for Humans. The average peak levels at position A were 119.9 dBA at the sound pressure level (SPL) peak and 100.0 dBA at the overall octave level. The average peak levels (SPL and overall octave level) at position B were 111.6 and 96.5 dBA, respectively, and at position C were 111.5 and 96.7 dBA, respectively. The average time duration and ARUs measured at position A were 120.6 ms and 194.9 units, respectively. Although impact noises made by titanium head golf drivers showed relatively low ARUs, individuals enjoying golf frequently may be susceptible to hearing loss due to the repeated exposure of this intense impact noise with short duration and high frequency. Unprotected exposure to impact noises should be limited to prevent cochleovestibular disorders.

  8. 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).…

  9. Training programme impact on thermoplastic immobilization for head and neck radiation therapy

    International Nuclear Information System (INIS)

    Outhwaite, Julie-Anne; McDowall, W. Robert; Marquart, Louise; Rattray, Gregory; Fielding, Andrew; Hargrave, Catriona

    2013-01-01

    Purpose: To determine whether uniform guidelines and training in the stabilization and formation of thermoplastic shells can improve the reproducibility of set-up for Head and Neck cancer patients. Methods and materials: Image based measurements of the planning and treatment positions for 35 head and neck cancer patients undergoing radical radiotherapy were analysed to provide a baseline of the reproducibility of thermoplastic immobilization. Radiation therapists (RT) were surveyed to establish a perception of their confidence in thermoplastic procedures. An evidence based staff training programme was created and implemented. Set-up reproduction and staff perception were reviewed to measure the impact of the training programme. Results: The mean (SD) 3D vectors of anatomical displacement, measured on the patient images, improved from 4.64 (2.03) for the baseline group compared to 3.02 (1.65) following training (p < 0.01). The proportion of 3D displacements of patient data exceeding 5 mm 3D vector was decreased from 37.1% to 5.7% (p < 0.001) and the 3 mm vector from 85.7% to 42.9% (p < 0.001). The post-training survey scores demonstrated improved confidence in reproducibility of set-up for head and neck patients. Conclusion: The Thermoplastic Shells Training Program has been found to improve the treatment reproducibility for head and neck radiation therapy patients. Uniform guidelines have increased RT confidence in thermoplastic procedures.

  10. Computed tomography of head: impact of the use of automatic exposure control

    International Nuclear Information System (INIS)

    Souza, Giordana Salvi de Souza; Froner, Ana Paula Pastre; Silva, Ana Maria Marques da

    2017-01-01

    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 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)

  11. 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.

  12. Management and outcome of low velocity penetrating head injury caused by impacted foreign bodies.

    Science.gov (United States)

    Moussa, Wael Mohamed Mohamed; Abbas, Mohamed

    2016-05-01

    Penetrating head injuries with impacted foreign bodies are rare, associated with a high incidence of morbidity and potentially life-threatening. In this study, we aimed at investigating the outcome of these cases as well as analyzing the factors affecting the prognosis. A retrospective study in which the records of 16 patients who had penetrating head injuries caused by low-velocity impacted foreign bodies were revised. All patients were males with a mean age of 28.9 years (range, 18 to 50 years). The follow-up period ranged from 4 to 13 months with a mean of 8.1 months. Causes of injury were construction accidents in 6 (37.5 %) patients, assault in 6 (37.5 %) and road traffic accidents in 4 (25 %). The impacted objects included a bar of iron, a piece of wood, a nail, a sickle and a piece of glass. Diagnostic computerized tomography (CT) of the brain was carried out on admission in all patients. Thirteen (81.3 %) patients were submitted to surgery, and all had the appropriate management in the form of antibiotics and dehydrating measures as required. The primary outcome measure was the Glasgow Outcome Scale (GOS) at the end of follow-up. At the end of follow-up, ten (62.5 %) patients had a GOS score of 5, two (12.5 %) patients had a score of 4, and four (25 %) patients had a score of 1. Low-velocity penetrating head injuries are most common in young adult males. With the appropriate management, a majority of even the most severe cases can have a favorable outcome.

  13. 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.

  14. 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

  15. Correlation of Head Impacts to Change in Balance Error Scoring System Scores in Division I Men's Lacrosse Players.

    Science.gov (United States)

    Miyashita, Theresa L; Diakogeorgiou, Eleni; Marrie, Kaitlyn

    Investigation into the effect of cumulative subconcussive head impacts has yielded various results in the literature, with many supporting a link to neurological deficits. Little research has been conducted on men's lacrosse and associated balance deficits from head impacts. (1) Athletes will commit more errors on the postseason Balance Error Scoring System (BESS) test. (2) There will be a positive correlation to change in BESS scores and head impact exposure data. Prospective longitudinal study. Level 3. Thirty-four Division I men's lacrosse players (age, 19.59 ± 1.42 years) wore helmets instrumented with a sensor to collect head impact exposure data over the course of a competitive season. Players completed a BESS test at the start and end of the competitive season. The number of errors from pre- to postseason increased during the double-leg stance on foam ( P impacts sustained over the course of 1 lacrosse season, as measured by average linear acceleration, head injury criteria, and Gadd Severity Index scores. If there is microtrauma to the vestibular system due to repetitive subconcussive impacts, only an assessment that highly stresses the vestibular system may be able to detect these changes. Cumulative subconcussive impacts may result in neurocognitive dysfunction, including balance deficits, which are associated with an increased risk for injury. The development of a strategy to reduce total number of head impacts may curb the associated sequelae. Incorporation of a modified BESS test, firm surface only, may not be recommended as it may not detect changes due to repetitive impacts over the course of a competitive season.

  16. Survival of patients with head and neck cancer. Impact of physical status and comorbidities

    Energy Technology Data Exchange (ETDEWEB)

    Sadat, F. [Friedrich Alexander Univ., Erlangen (Germany). Clinic of Radiotherapy; Wienke, A. [Martin Luther Univ. Halle-Wittenberg, Halle/Saale (Germany). Inst. of Medical Epidemiology; Dunst, J. [Schleswig-Holstein Univ., Luebeck (Germany). Clinic of Radiotherapy; Kuhnt, T. [Rostock Univ. (Germany). Dept. of Radiation Oncology

    2012-01-15

    Prognostic factors (e.g., gender, tumor stage, and hypoxia) have an impact on survival in patients with head and neck cancer. Thus, the impact of physical status and comorbidities on treatment decision and survival were evaluated. Patients and methods A total of 169 primary, inoperable patients with squamous cell cancer of the head and neck were retrospectively investigated. Patients were treated with hyperfractionated accelerated radio(chemo)therapy (HARcT) or hypofractionated radio(chemo)therapy (HypoRcT). Depending on the individual patient's situation (Karnofsky Performance Index, KPI), treatment for patients with a KPI of 80-100% was generally radiochemotherapy and for patients with a KPI {<=} 70% treatment was radiotherapy alone. In addition, all comorbidities were evaluated. Uni- and multivariate proportional hazards model were used, and overall survival (OS) was estimated by the Kaplan-Meier method. Results Treatment consisted of HARcT for 76 patients (45%), HART for 28 patients (17%), HypoRcT for 14 patients(8%), and HypoRT for 51 patients (30%). Of the patients, 107 patients (63%) presented with a KPI of 80-100%. OS (20%) was significantly better for patients with a KPI of 80-100%, while the OS for patients with a KPI {<=} 70% was 8% (p < 0.001). Good KPI, total irradiation dose (> 70 Gy), and chemotherapy were significant prognostic factors for better OS. Conclusion Our retrospective analysis shows that performance status with dependency on comorbidities was an independent risk factor for OS. (orig.)

  17. Survival of patients with head and neck cancer. Impact of physical status and comorbidities

    International Nuclear Information System (INIS)

    Sadat, F.; Wienke, A.; Dunst, J.; Kuhnt, T.

    2012-01-01

    Prognostic factors (e.g., gender, tumor stage, and hypoxia) have an impact on survival in patients with head and neck cancer. Thus, the impact of physical status and comorbidities on treatment decision and survival were evaluated. Patients and methods A total of 169 primary, inoperable patients with squamous cell cancer of the head and neck were retrospectively investigated. Patients were treated with hyperfractionated accelerated radio(chemo)therapy (HARcT) or hypofractionated radio(chemo)therapy (HypoRcT). Depending on the individual patient's situation (Karnofsky Performance Index, KPI), treatment for patients with a KPI of 80-100% was generally radiochemotherapy and for patients with a KPI ≤ 70% treatment was radiotherapy alone. In addition, all comorbidities were evaluated. Uni- and multivariate proportional hazards model were used, and overall survival (OS) was estimated by the Kaplan-Meier method. Results Treatment consisted of HARcT for 76 patients (45%), HART for 28 patients (17%), HypoRcT for 14 patients(8%), and HypoRT for 51 patients (30%). Of the patients, 107 patients (63%) presented with a KPI of 80-100%. OS (20%) was significantly better for patients with a KPI of 80-100%, while the OS for patients with a KPI ≤ 70% was 8% (p 70 Gy), and chemotherapy were significant prognostic factors for better OS. Conclusion Our retrospective analysis shows that performance status with dependency on comorbidities was an independent risk factor for OS. (orig.)

  18. Injuries of the head from backface deformation of ballistic protective helmets under ballistic impact.

    Science.gov (United States)

    Rafaels, Karin A; Cutcliffe, Hattie C; Salzar, Robert S; Davis, Martin; Boggess, Brian; Bush, Bryan; Harris, Robert; Rountree, Mark Steve; Sanderson, Ellory; Campman, Steven; Koch, Spencer; Dale Bass, Cameron R

    2015-01-01

    Modern ballistic helmets defeat penetrating bullets by energy transfer from the projectile to the helmet, producing helmet deformation. This deformation may cause severe injuries without completely perforating the helmet, termed "behind armor blunt trauma" (BABT). As helmets become lighter, the likelihood of larger helmet backface deformation under ballistic impact increases. To characterize the potential for BABT, seven postmortem human head/neck specimens wearing a ballistic protective helmet were exposed to nonperforating impact, using a 9 mm, full metal jacket, 124 grain bullet with velocities of 400-460 m/s. An increasing trend of injury severity was observed, ranging from simple linear fractures to combinations of linear and depressed fractures. Overall, the ability to identify skull fractures resulting from BABT can be used in forensic investigations. Our results demonstrate a high risk of skull fracture due to BABT and necessitate the prevention of BABT as a design factor in future generations of protective gear. © 2014 American Academy of Forensic Sciences.

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

    OpenAIRE

    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 ...

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

    International Nuclear Information System (INIS)

    Shaikh, Talha; Handorf, Elizabeth A.; Murphy, Colin T.; Mehra, Ranee; Ridge, John A.; Galloway, Thomas J.

    2016-01-01

    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 49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ"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.

  1. The impact of virus in N3 node dissection for head and neck cancer.

    Science.gov (United States)

    Armas, Gian Luca; Su, Chih-Ying; Huang, Chao-Cheng; Fang, Fu-Min; Chen, Ching-Mei; Chien, Chih-Yen

    2008-11-01

    This study is to determine the impact of virus in surgical outcomes among patients of head and neck cancer with N3 lymph node metastasis. A retrospective analysis was conducted for 32 patients with operable N3 neck metastasis undergoing surgical treatment between January 1987 and October 2006. The nuclei of the tumor cells were investigated for the presence of human papillomavirus (HPV) and Epstein-Barr virus (EBV) DNAs and were taken into account as the variable for survival analysis. The primary sites were oropharynx in 11 patients, tongue in 3, buccal mucosa in 1, hypopharynx in 8 and unknown primary in 9. The five-year cumulative overall survival rate was 40.7% and 5-year cumulative regional control rate was 55.8%. The 5-year cumulative overall survival rate of patients with unknown primary site (72.9%) and HPV or EBV positive in the tumor (77.8%) were significantly higher than those patients with known primary site (31.3%) and HPV or EBV negative in the tumor (27.4%), respectively (P = 0.0335 and P = 0.0348, log rank test). In conclusion, surgery with adjuvant therapy offers reasonable outcomes for operable N3 node in head and neck cancer in our cohort. In addition, patients with HPV or EBV positive in the tumor have a better survival.

  2. The Effect of Soil Type and Moisture Content on Head Impacts on Natural Grass Athletic Fields

    Directory of Open Access Journals (Sweden)

    Kyley Dickson

    2018-02-01

    Full Text Available Studies are warranted to evaluate head injury criterion (HIC on athletic fields to determine baseline numbers and compare those findings to current critical thresholds for impact attenuation. A two year (2016 and 2017 study was conducted on University of Tennessee athletic fields (Knoxville, TN, USA to determine the effect of soil type (cohesive soil, United States Golf Association sand specifications and grass species (Poa pratensis and Cynodon dactylon × C. transvaalensis on HIC. Additionally soil moisture conditions monitored were: dry (0.06–0.16 m3/m3, acceptable (0.17–0.29 m3/m3, and wet (0.30–0.40 m3/m3. A linear relationship (r = 0.91 was identified between drop height (0.5–2.9 M and HIC value (35-1423 HIC on granular root zones of both grass types. However, HIC on cohesive soil is a function of soil water content in addition to drop height. These results demonstrate to aid in head injury prevention on cohesive soil athletic fields the HIC can be lowered by managing soil water content.

  3. Relative brain displacement and deformation during constrained mild frontal head impact.

    Science.gov (United States)

    Feng, Y; Abney, T M; Okamoto, R J; Pless, R B; Genin, G M; Bayly, P V

    2010-12-06

    This study describes the measurement of fields of relative displacement between the brain and the skull in vivo by tagged magnetic resonance imaging and digital image analysis. Motion of the brain relative to the skull occurs during normal activity, but if the head undergoes high accelerations, the resulting large and rapid deformation of neuronal and axonal tissue can lead to long-term disability or death. Mathematical modelling and computer simulation of acceleration-induced traumatic brain injury promise to illuminate the mechanisms of axonal and neuronal pathology, but numerical studies require knowledge of boundary conditions at the brain-skull interface, material properties and experimental data for validation. The current study provides a dense set of displacement measurements in the human brain during mild frontal skull impact constrained to the sagittal plane. Although head motion is dominated by translation, these data show that the brain rotates relative to the skull. For these mild events, characterized by linear decelerations near 1.5g (g = 9.81 m s⁻²) and angular accelerations of 120-140 rad s⁻², relative brain-skull displacements of 2-3 mm are typical; regions of smaller displacements reflect the tethering effects of brain-skull connections. Strain fields exhibit significant areas with maximal principal strains of 5 per cent or greater. These displacement and strain fields illuminate the skull-brain boundary conditions, and can be used to validate simulations of brain biomechanics.

  4. 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.

  5. Survival of patients with head and neck cancer. Impact of physical status and comorbidities.

    Science.gov (United States)

    Sadat, F; Wienke, A; Dunst, J; Kuhnt, T

    2012-01-01

    Prognostic factors (e.g., gender, tumor stage, and hypoxia) have an impact on survival in patients with head and neck cancer. Thus, the impact of physical status and comorbidities on treatment decision and survival were evaluated. A total of 169 primary, inoperable patients with squamous cell cancer of the head and neck were retrospectively investigated. Patients were treated with hyperfractionated accelerated radio(chemo)therapy (HARcT) or hypofractionated radio(chemo)therapy (HypoRcT). Depending on the individual patient's situation (Karnofsky Performance Index, KPI), treatment for patients with a KPI of 80-100% was generally radiochemotherapy and for patients with a KPI ≤ 70% treatment was radiotherapy alone. In addition, all comorbidities were evaluated. Uni- and multivariate proportional hazards model were used, and overall survival (OS) was estimated by the Kaplan-Meier method. Treatment consisted of HARcT for 76 patients (45%), HART for 28 patients (17%), HypoRcT for 14 patients(8%), and HypoRT for 51 patients (30%). Of the patients, 107 patients (63%) presented with a KPI of 80-100%. OS (20%) was significantly better for patients with a KPI of 80-100%, while the OS for patients with a KPI ≤ 70% was 8% (p KPI, total irradiation dose (> 70 Gy), and chemotherapy were significant prognostic factors for better OS. Our retrospective analysis shows that performance status with dependency on comorbidities was an independent risk factor for OS.

  6. The Role of Interface on the Impact Characteristics and Cranial Fracture Patterns Using the Immature Porcine Head Model.

    Science.gov (United States)

    Deland, Trevor S; Niespodziewanski, Emily; Fenton, Todd W; Haut, Roger C

    2016-01-01

    The role of impact interface characteristics on the biomechanics and patterns of cranial fracture has not been investigated in detail, and especially for the pediatric head. In this study, infant porcine skulls aged 2-19 days were dropped with an energy to cause fracturing onto four surfaces varying in stiffness from a rigid plate to one covered with plush carpeting. Results showed that heads dropped onto the rigid surface produced more extensive cranial fracturing than onto carpeted surfaces. Contact forces generated at fracture initiation and the overall maximum contact forces were generally lower for the rigid than carpeted impacts. While the degree of cranial fracturing from impacts onto the heavy carpeted surface was comparable to that of lower-energy rigid surface impacts, there were fewer diastatic fractures. This suggests that characteristics of the cranial fracture patterns may be used to differentiate energy level from impact interface in pediatric forensic cases. © 2015 American Academy of Forensic Sciences.

  7. The dosimetric impact of dental implants on head-and-neck volumetric modulated arc therapy

    International Nuclear Information System (INIS)

    Lin, Mu-Han; Li Jinsheng; Price, Robert A Jr; Wang Lu; Ma, C-M; Lee, Chung-Chi

    2013-01-01

    This work aims to investigate the dosimetric impact of dental implants on volumetric modulated arc therapy (VMAT) for head-and-neck patients and to evaluate the effectiveness of using the material's electron-density ratio for the correction. An in-house Monte Carlo (MC) code was utilized for the dose calculation to account for the scattering and attenuation caused by the high-Z implant material. Three different dental implant materials were studied in this work: titanium, Degubond®4 and gold. The dose perturbations caused by the dental implant materials were first investigated in a water phantom with a 1 cm 3 insert. The per cent depth dose distributions of a 3 × 3 cm 2 photon field were compared with the insert material as water and the three selected dental implant materials. To evaluate the impact of the dental implant on VMAT patient dose calculation, four head-and-neck cases were selected. For each case, the VMAT plan was designed based on the artifact-corrected patient geometry using a treatment planning system (TPS) that was typically utilized for routine patient treatment. The plans were re-calculated using the MC code for five situations: uncorrected geometry, artifact-corrected geometry and artifact-corrected geometry with one of the three different implant materials. The isodose distributions and the dose–volume histograms were cross-compared with each other. To evaluate the effectiveness of using the material's electron-density ratio for dental implant correction, the implant region was set as water with the material's electron-density ratio and the calculated dose was compared with the MC simulation with the real material. The main effect of the dental implant was the severe attenuation in the downstream. The 1 cm 3 dental implant can lower the downstream dose by 10% (Ti) to 51% (Au) for a 3 × 3 cm 2 field. The TPS failed to account for the dose perturbation if the dental implant material was not precisely defined. For the VMAT patient dose

  8. 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).

  9. The impact of a head and neck microvascular fellowship program on otolaryngology resident training.

    Science.gov (United States)

    Zender, Chad A; Clancy, Kate; Melki, Sami; Li, Shawn; Fowler, Nicole

    2018-01-01

    To assess the impact of a microvascular head and neck (H&N) fellowship on senior residents' surgical experience. Retrospective review of Accreditation Council for Graduate Medical Education-generated operative case log reports, retrospective chart review, and electronic survey. A retrospective review of one institution's residents' H&N operative case logs and free flap operative reports was performed to determine changes in key indicator cases (KICs) after the addition of a H&N fellowship. An electronic survey was distributed to senior residents at all U.S. otolaryngology residency programs to determine residents' perceptions of a H&N fellow's impact on their surgical experience. An electronic survey was distributed to senior medical students applying to surgical residencies to explore the perceived impact that a fellowship has on the desirability of a residency program. The average number of each postgraduate year (PGY)5's H&N KIC before and after the addition of the fellowship were: parotidectomy, 19 versus 17.8; neck dissection, 33.2 versus 40.6; oral cavity resection, 15.3 versus 12.6; thyroid/parathyroid, 45.5 versus 45.6; and flaps/grafts, 56.7 versus 42. PGY5 participation as first assistant in free flaps dropped from 78% to 17%; however, residents still participated in some aspect of 45% of the cases. Seventy percent of senior residents reported a positive perception of the H&N fellow on their H&N operative experience. Eighty-nine percent of senior medical student respondents reported a nonnegative perception of a fellowship in their applied field. The addition of a H&N fellowship did not decrease senior residents' H&N KIC, and most senior residents at programs with fellowships report that the fellow has a positive impact on their H&N operative experience. 4. Laryngoscope, 128:52-56, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  10. 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.

  11. SU-F-T-396: Impact of Shoulder Deformation for Head and Neck VMAT

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, Y; Tachibana, H [National Cancer Center, Kashiwa, Chiba (Japan)

    2016-06-15

    Purpose: For head and neck VMAT (HN-VMAT), variations of position and deformation of patient’s shoulders is a concern to affect inaccuracy of dose distribution. It has been reported that the setup error of the shoulders was variable from 5 mm – 1 cm. The beams of the HN-VMAT pass through the shoulders. We assessed the impact of shoulder deformation to dose distribution for HN-VMAT. Methods: One HN-VMAT plan was generated using a patient’s CT. The patient’s CT was deformed using ImSimQA (Oncology Systems Limited, Shrewsbury, Shropshire, UK) to generate several patterns of the shoulders’ deformations when the right and left humeral heads were shifted with 3, 6, and 15 mm in the superior and inferior directions (SI), 3, 5, and 15 mm in the anterior and posterior directions (AP), and 5 and 15 mm in the right or left direction (LR). DVH comparison was performed in the different deformation patterns. The dosimetric parameters of D95% for CTV70Gy, CTV60Gy and CTV54Gy and dmax for Spinal cord were also measured. Gamma index evaluation (Criteria: 3%/2mm) was performed to exhibit clinically tolerable area in the comparison. Results: DVH comparison shows similar for all structures. As the comparison for the dosimetric parameters, the variations of D95% in the LR and AP were within 1%. There were larger variations in the SI than those in the other directions, however were within 1.5%. In gamma index evaluation, the small spots with higher gamma index values were appeared when the shift was 6 mm, however the pass ratio was 99.13%. Conclusion: HN-VMAT should be robust for shoulder deformation and geometric accuracy within 6 mm from patient’s setup and image-guided radiotherapy may be clinically acceptable for target dose coverage or normal tissue dose sparing.

  12. 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.

  13. 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 (Pmotor variables, the developmental quotient, and the imitative hand positions test. Fine motor skills had the most discriminative power. Relative growth of the head in relation to weight gain was positively correlated to neurocognitive outcome. Intrauterine growth-restricted children with a current head circumference ≤10th percentile had poorer outcomes. Conclusively, intrauterine growth restriction has a negative impact on neurocognitive development. Slow postnatal head growth is correlated with a poorer neuropsychological outcome.

  14. 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 Ouchi-gari. 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/s(2) to 5,525.9 rad/s(2) 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/s(2) to 2,104.1 rad/s(2) 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.

  15. 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.

  16. 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.

  17. Impact of conventional radiotherapy on health-related quality of life and critical functions of the head and neck

    International Nuclear Information System (INIS)

    Connor, Nadine P.; Cohen, Stacy B. M.A.; Kammer, Rachael E.; Sullivan, Paula A.; Brewer, Kathryn A.; Hong, Theodore S.; Chappell, Richard J.; Harari, Paul M.

    2006-01-01

    Purpose: Head-and-neck radiotherapy is associated with significant morbidities. Our purpose was to document impact of morbidities by use of multiple objective measures and health-related quality of life (HR-QOL). Methods and Materials: Ten head-and-neck cancer patients were evaluated before receiving conventional head-and-neck radiotherapy and at 1 month and 6 months after treatment. We evaluated weight, saliva production, diet, swallow function, auditory function, and HR-QOL. Results: After radiotherapy, weight was reduced in 89% of subjects. Salivary function was significantly reduced and did not resolve by 6 months. Diet impairment and abnormalities in swallowing function persisted at 6 months. Perception of physical functioning was reduced after treatment, and swallowing, coughing, and dry-mouth symptoms increased. Very few changes were observed in auditory function. Conclusions: Conventional head-and-neck radiotherapy is associated with substantial functional deficits and diminished HR-QOL. Deficits reported here can serve as a baseline for comparison with results derived from new radiotherapy-treatment techniques

  18. Influence of stiffness and shape of contact surface on skull fractures and biomechanical metrics of the human head of different population underlateral impacts.

    Science.gov (United States)

    Shaoo, Debasis; Deck, Caroline; Yoganandan, Narayan; Willinger, Rémy

    2015-07-01

    The objective of this study was to determine the responses of 5th-percentile female, and 50th- and 95th-percentile male human heads during lateral impacts at different velocities and determine the role of the stiffness and shape of the impacting surface on peak forces and derived skull fracture metrics. A state-of-the-art validated finite element (FE) head model was used to study the influence of different population human heads on skull fracture for lateral impacts. The mass of the FE head model was altered to match the adult size dummies. Numerical simulations of lateral head impacts for 45 cases (15 experiments×3 different population human heads) were performed at velocities ranging from 2.4 to 6.5m/s and three impacting conditions (flat and cylindrical 90D; and flat 40D padding). The entire force-time signals from simulations were compared with experimental mean and upper/lower corridors at each velocity, stiffness (40 and 90 durometer) and shapes (flat and cylindrical) of the impacting surfaces. Average deviation of peak force from the 50th male to 95th male and 5th female were 6.4% and 10.6% considering impacts on the three impactors. These results indicate hierarchy of variables which can be used in injury mitigation efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. 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.

  20. COMPARISON OF A HEAD MOUNTED IMPACT MEASUREMENT DEVICE TO THE HYBRID III ANTHROPOMORPHIC TESTING DEVICE IN A CONTROLLED LABORATORY SETTING.

    Science.gov (United States)

    Schussler, Eric; Stark, David; Bolte, John H; Kang, Yun Seok; Onate, James A

    2017-08-01

    Reports estimate that 1.6 to 3.8 million cases of concussion occur in sports and recreation each year in the United States. Despite continued efforts to reduce the occurrence of concussion, the rate of diagnosis continues to increase. The mechanisms of concussion are thought to involve linear and rotational head accelerations and velocities. One method of quantifying the kinematics experienced during sport participation is to place measurement devices into the athlete's helmet or directly on the athlete's head. The purpose of this research to determine the accuracy of a head mounted device for measuring the head accelerations experienced by the wearer. This will be accomplished by identifying the error in Peak Linear Acceleration (PLA), Peak Rotational Acceleration (PRA) and Peak Rotational Velocity (PRV) of the device. Laboratory study. A helmeted Hybrid III 50th percentile male headform was impacted via a pneumatic ram from the front, side, rear, front oblique and rear oblique at speeds from 1.5 to 5 m/s. The X2 Biosystems xPatch® (Seattle, WA) sensor was placed on the headform's right side at the approximate location of the mastoid process. Measures of PLA, PRA, PRV from the xPatch ® and Hybrid III were analyzed for Root Mean Square Error (RMSE), and Absolute and Relative Error (AE, RE). Seventy-six impacts were analyzed. All measures of correlation, fixed through the origin, were found to be strong: PLA R 2 =0.967 pstandard yet above the average error of testing devices in both PLA and PRA, but a low error in PRV. PLA measures from the xPatch® system demonstrated a high level of correlation with the PLA data from the Hybrid III mounted data collection system. 3.

  1. Less efficient oculomotor performance is associated with increased incidence of head impacts in high school ice hockey.

    Science.gov (United States)

    Kiefer, Adam W; DiCesare, Christopher; Nalepka, Patrick; Foss, Kim Barber; Thomas, Staci; Myer, Gregory D

    2018-01-01

    To evaluate associations between pre-season oculomotor performance on visual tracking tasks and in-season head impact incidence during high school boys ice hockey. Prospective observational study design. Fifteen healthy high school aged male hockey athletes (M=16.50±1.17years) performed two 30s blocks each of a prosaccade and self-paced saccade task, and two trials each of a slow, medium, and fast smooth pursuit task (90°s -1 ; 180°s -1 ; 360°s -1 ) during the pre-season. Regular season in-game collision data were collected via helmet-mounted accelerometers. Simple linear regressions were used to examine relations between oculomotor performance measures and collision incidence at various impact thresholds. The variability of prosaccade latency was positively related to total collisions for the 20g force cutoff (p=0.046, adjusted R 2 =0.28). The average self-paced saccade velocity (p=0.020, adjusted R 2 =0.37) and variability of smooth pursuit gaze velocity (p=0.012, adjusted R 2 =0.47) were also positively associated with total collisions for the 50g force cutoff. These results provide preliminary evidence that less efficient oculomotor performance on three different oculomotor tasks is associated with increased incidence of head impacts during a competitive ice hockey season. The variability of prosaccade latency, the average self-paced saccade velocity and the variability of gaze velocity during predictable smooth pursuit all related to increased head impacts. Future work is needed to further understand player initiated collisions, but this is an important first step toward understanding strategies to reduce incidence of injury risk in ice hockey, and potentially contact sports more generally. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  2. Early Head Start and African American Families: Impacts and Mechanisms of Child Outcomes

    Science.gov (United States)

    Harden, Brenda Jones; Sandstrom, Heather; Chazan-Cohen, Rachel

    2012-01-01

    Persistent disparities exist between African American children and their European American counterparts across developmental domains. Early childhood intervention may serve to promote more positive outcomes among African American children. The current study examined whether and how the Early Head Start (EHS) program benefited African American…

  3. Supporting Head Start Parents: Impact of a Text Message Intervention on Parent-Child Activity Engagement

    Science.gov (United States)

    Hurwitz, Lisa B.; Lauricella, Alexis R.; Hanson, Ann; Raden, Anthony; Wartella, Ellen

    2015-01-01

    Head Start emphasises parent engagement as a critical strategy in promoting children's long-term learning. Parents can support children's positive development by engaging them in stimulating activities. The following study assessed whether a service that delivered parenting tips via text message could prompt parents of children enrolled in Head…

  4. Predicting brain mechanics during closed head impact : numerical and constitutive aspects

    NARCIS (Netherlands)

    Brands, D.W.A.

    2002-01-01

    Annually, motor vehicle crashes world wide cause over a million fatalities and over a hundred million injuries. Of all body parts, the head is identified as the body region most frequently involved in life-threatening injury. To understand how the brain gets injured during an accident, the

  5. 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.

  6. Heading and head injuries in soccer.

    Science.gov (United States)

    Kirkendall, D T; Jordan, S E; Garrett, W E

    2001-01-01

    In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill obviously places the player at risk of head injury and the game does carry some risk. Head injury can be a result of contact of the head with another head (or other body parts), ground, goal post, other unknown objects or even the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions or even, in rare cases, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected soccer players have some degree of cognitive dysfunction. It is important to determine the reasons behind such deficits. Purposeful heading has been blamed, but a closer look at the studies that focus on heading has revealed methodological concerns that question the validity of blaming purposeful heading of the ball. The player's history and age (did they play when the ball was leather and could absorb significant amounts of water), alcohol intake, drug intake, learning disabilities, concussion definition and control group use/composition are all factors that cloud the ability to blame purposeful heading. What does seem clear is that a player's history of concussive episodes is a more likely explanation for cognitive deficits. While it is likely that the subconcussive impact of purposeful heading is a doubtful factor in the noted deficits, it is unknown whether multiple subconcussive impacts might have some lingering effects. In addition, it is unknown whether the noted deficits have any affect on daily life. Proper instruction in the technique is critical because if the ball contacts an unprepared head (as in accidental head-ball contacts), the potential for serious injury is possible. To further our understanding of the relationship of heading, head injury and cognitive deficits, we need to: learn more about the actual impact of a ball on the

  7. The impact of use of Glutamine on patients with head and neck tumors in radiotherapy and chemotherapy treatment

    International Nuclear Information System (INIS)

    Boligon, Caroline Schardong; Huth, Adriane

    2011-01-01

    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)

  8. 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

  9. 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

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

    Science.gov (United States)

    2017-10-01

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

  11. Impact of total radiotherapy dose on survival for head and neck Merkel cell carcinoma after resection.

    Science.gov (United States)

    Patel, Sagar A; Qureshi, Muhammad M; Mak, Kimberley S; Sahni, Debjani; Giacalone, Nicholas J; Ezzat, Waleed; Jalisi, Scharukh; Truong, Minh Tam

    2017-07-01

    Head and neck Merkel cell carcinoma (MCC) is commonly treated with surgery and adjuvant radiotherapy (RT) for high-risk features. The optimal radiation dose is unknown. One thousand six hundred twenty-five eligible patients with head and neck MCC were identified in the National Cancer Data Base (NCDB). Radiation dose was divided into 3 groups: 30 to 55-70 Gy. Cox regression was used to compare overall survival (OS) between groups, accounting for age, sex, stage, surgery type, margin status, comorbidities, and use of chemotherapy. With a median follow-up of 33.5 months, 3-year OS was 48.9%, 70.3%, and 58.7% for 30 to 55-70 Gy, respectively (P 55-70 Gy (adjusted HR 1.21; 95% CI 1.0-1.46; P = .06) were associated with worse survival. Adjuvant radiation doses within 50-55 Gy may be optimal for head and neck MCC. © 2017 Wiley Periodicals, Inc.

  12. Impact of dysphagia on quality of life after treatment of head-and-neck cancer

    International Nuclear Information System (INIS)

    Nguyen, Nam P.; Frank, Cheryl; Moltz, Candace C.; Vos, Paul; Smith, Herbert J.; Karlsson, Ulf; Dutta, Suresh; Midyett, Allan; Barloon, Jessica; Sallah, Sabah

    2005-01-01

    Purpose: To evaluate the quality of life (QOL) associated with dysphagia after head-and-neck cancer treatment. Methods and materials: Of a total population of 104, a retrospective analysis of 73 patients who complained of dysphagia after primary radiotherapy (RT), chemoradiotherapy, and postoperative RT for head-and-neck malignancies were evaluated. All patients underwent a modified barium swallow examination to assess the severity of dysphagia, graded on a scale of 1-7. QOL was evaluated by the University of Washington (UW) and Hospital Anxiety and Depression questionnaires. The QOL scores obtained were compared with those from the 31 patients who were free of dysphagia after treatment. The QOL scores were also graded according to the dysphagia severity. Results: The UW and Hospital Anxiety and Depression scores were reduced and elevated, respectively, in the dysphagia group compared with the no dysphagia group (p = 0.0005). The UW scores were also substantially lower among patients with moderate-to-severe (Grade 4-7) compared with no or mild (Grade 2-3) dysphagia (p = 0.0005). The corresponding Hospital Anxiety (p = 0.005) and Depression (p = 0.0001) scores were also greater for the moderate-to-severe group. The UW QOL subscale scores showed a statistically significant decrease for swallowing (p = 0.00005), speech (p = 0.0005), recreation/entertainment (p = 0.0005), disfigurement (p = 0.0006), activity (p = 0.005), eating (p = 0.002), shoulder disability (p = 0.006), and pain (p = 0.004). Conclusion: Dysphagia is a significant morbidity of head-and-neck cancer treatment, and the severity of dysphagia correlated with a compromised QOL, anxiety, and depression. Patients with moderate-to-severe dysphagia require a team approach involving nutritional support, physical therapy, speech rehabilitation, pain management, and psychological counseling

  13. Clinical and scientific impact of human papillomavirus on head and neck cancer.

    Science.gov (United States)

    Friedman, Jeffrey M; Stavas, Mark J; Cmelak, Anthony J

    2014-10-10

    Head and neck cancer (HNC) arises from the skull base to the clavicles and is the fifth most common cancer in the world by incidence. Historically, in the developed world HNC was associated with tobacco use and alcohol consumption, and the combination of the two produced a synergistic increase in risk. However, beginning in 1983, investigators have found a significant and growing proportion of HNC patients with human papillomavirus-positive (HPV) tumors who neither drank nor used tobacco. Since that time, there has been increased interest in the molecular biology of HPV-positive HNC. Multiple studies now show that HPV has shifted the epidemiological landscape and prognosis of head and neck squamous cell carcinoma (HNSCC). These studies provide strong evidence for improved survival outcomes in patients with HPV-positive HNSCC compared to those with HPV-negative HNSCC. In many reports, HPV status is the strongest predictor of locoregional control, disease specific survival and overall survival. In response to these findings, there has been significant interest in the best management of HPV-positive disease. Discussions within major cooperative groups consider new trials designed to maintain the current strong survival outcomes while reducing the long-term treatment-related toxicities. This review will highlight the epidemiological, clinical and molecular discoveries surrounding HPV-related HNSCC over the recent decades and we conclude by suggesting how these findings may guide future treatment approaches.

  14. Impact of comorbidity on treatment outcome in head and neck squamous cell carcinoma – A systematic review

    International Nuclear Information System (INIS)

    Bøje, Charlotte Rotbøl

    2014-01-01

    The significant association with tobacco and alcohol combined with advanced age at time of diagnosis predispose head and neck squamous cell carcinoma (HNSCC) patients to increased risk of comorbidities. The presence of comorbidity affects treatment, treatment selection and subsequent outcome. Multiple studies have demonstrated comorbidity to be a strong prognostic factor for survival, and therefore comorbidity can be a major confounder in clinical trials. This review provides a summary of the current literature on comorbidity in head and neck cancer, measurements of comorbidity, the impact of comorbidity on treatment, treatment selection, and survival. A systematic search was performed in six electronic databases. In all, 31 papers were selected for this review. A meta-analysis on the prognostic impact of comorbidity was performed including 10 studies. Furthermore, 21 studies concerning comorbidity were reviewed. Several valid indices to classify comorbidity were described in the literature, none proven to be superior over the other. The prevalence of comorbidity increased with age and the presence of comorbidity influenced treatment and treatment selection. Furthermore, comorbidity was associated with lower socio economic status and increased the risk of early retirement after treatment. The meta-analysis on comorbidity as a prognostic factor, including 22,932 patients, showed that overall survival was significantly worsened among patients with comorbidity (HR = 1.38 (1.32–1.43)). Increasing comorbidity-score was associated with increased risk of death. Comorbidity is important in HNSCC and significantly impacts on overall survival. Trials concerning HNSCC should always include information on comorbidity and randomized trials should stratify patients according to comorbidity in order to avoid bias in the study

  15. Impact of Radiation-Induced Xerostomia on Quality of Life After Primary Radiotherapy Among Patients With Head and Neck Cancer

    International Nuclear Information System (INIS)

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

    2007-01-01

    Purpose: To investigate the impact of xerostomia on overall quality of life (QoL) outcome and related dimensions among head 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. Late xerostomia according to the Radiation Therapy Oncology Group (RTOG-xerostomia) and QoL (European Organization for Research and Treatment of Cancer QLC-C30) were assessed at baseline and every 6th month from 6 months to 24 months after radiotherapy. Results: A significant association was found between RTOG-xerostomia and overall QoL outcome (effect size [ES] 0.07, p 65 years). An analysis of the impact of RTOG-xerostomia on overall QoL outcome over time showed an increase from 0.09 at 6 months to 0.22 at 24 months. With elapsing time, a worsening was found for these individual scales with increasing RTOG-xerostomia. Conclusions: The results of this prospective study are the first to show a significant impact of radiation-induced xerostomia on QoL. Although the incidence of Grade ≥2 RTOG-xerostomia decreases with time, its impact on QoL increases. This finding emphasizes the importance of prevention of xerostomia

  16. Heads Up

    Science.gov (United States)

    ... Connect with Us HEADS UP Apps Reshaping the Culture Around Concussion in Sports Get HEADS UP on Your Web Site Concussion ... HEADS UP on your web site! Create a culture of safety for young athletes Officials, learn how you can ... UP to Providers HEADS UP to Youth Sports HEADS UP to School Sports HEADS UP to ...

  17. 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.)

  18. 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

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

    International Nuclear Information System (INIS)

    Maurer, Julia; Hipp, Matthias; Koelbl, Oliver; Schaefer, Christof

    2011-01-01

    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.)

  20. New developments in the management of head and neck cancer – impact of pembrolizumab

    Directory of Open Access Journals (Sweden)

    Saleh K

    2018-02-01

    Full Text Available Khalil Saleh, Roland Eid, Fady GH Haddad, Nadine Khalife-Saleh, Hampig Raphaël Kourie Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon Abstract: Head and neck squamous cell carcinoma (HNSCC, a heterogeneous group of upper aerodigestive tract malignancies, is the seventh most common cancer worldwide. Tobacco use and alcohol consumption were the most identified risk factors of HNSCC. However, human papilloma virus, a sexually transmitted infection, has been determined as another primary cause of HNSCC. Early-stage disease is treated with surgery or radiotherapy. Recurrent or metastatic HNSCC is associated with poor prognosis with a median overall survival of 10 months. The EXTREME protocol is commonly used in first-line setting. Recently, pembrolizumab, an anti-programmed death-1 agent, has been approved by the US Food and Drug Administration for the treatment of patients with recurrent or metastatic squamous cell carcinoma of the head and neck with disease progression on or after a platinum-based therapy. It demonstrated a durable objective response rate with a good safety profile and quality of life. Many ongoing trials are evaluating the use of pembrolizumab for the treatment of HNSCC in various indications such as adjuvant and neoadjuvant setting, maintenance and recurrent disease, alone or in combination with chemotherapy, radiation and targeted therapy. Finding those biomarkers predictive of response to immune checkpoints inhibitors has been a major concern. However, markers have been identified, such as PD-L1 expression, human papilloma virus infection, interferon-γ signature score, microsatellite instability and neoantigen production. Keywords: epidemiology, HPV, pharmacokinetics, PD-1/PD-L1 inhibitors, immunotherapy, biomarkers

  1. 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.

  2. 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.)

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

    International Nuclear Information System (INIS)

    Santos, Joana; Paulo, Graciano; Foley, Shane; Rainford, Louise; McEntee, Mark F.

    2015-01-01

    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.)

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

    International Nuclear Information System (INIS)

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

    2011-01-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Beltrachini, L; Blenkmann, A; Ellenrieder, N von; Muravchik, C H [Laboratory of Industrial Electronics, Control and Instrumentation (LEICI), National University of La Plata (Argentina); Petroni, A [Integrative Neuroscience Laboratory, Physics Department, University of Buenos Aires, Buenos Aires (Argentina); Urquina, H; Manes, F; Ibanez, A [Institute of Cognitive Neurology (INECO) and Institute of Neuroscience, Favaloro University, Buenos Aires (Argentina)

    2011-12-23

    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.

  6. Impact of MLC leaf position errors on simple and complex IMRT plans for head and neck cancer

    International Nuclear Information System (INIS)

    Mu, G; Ludlum, E; Xia, P

    2008-01-01

    The dosimetric impact of random and systematic multi-leaf collimator (MLC) leaf position errors is relatively unknown for head and neck intensity-modulated radiotherapy (IMRT) patients. In this report we studied 17 head and neck IMRT patients, including 12 treated with simple plans ( 100 segments). Random errors (-2 to +2 mm) and systematic errors (±0.5 mm and ±1 mm) in MLC leaf positions were introduced into the clinical plans and the resultant dose distributions were analyzed based on defined endpoint doses. The dosimetric effect was insignificant for random MLC leaf position errors up to 2 mm for both simple and complex plans. However, for systematic MLC leaf position errors, we found significant dosimetric differences between the simple and complex IMRT plans. For 1 mm systematic error, the average changes in D 95% were 4% in simple plans versus 8% in complex plans. The average changes in D 0.1cc of the spinal cord and brain stem were 4% in simple plans versus 12% in complex plans. The average changes in parotid glands were 9% in simple plans versus 13% for the complex plans. Overall, simple IMRT plans are less sensitive to leaf position errors than complex IMRT plans

  7. Nutrition impact symptoms and associated outcomes in post-chemoradiotherapy head and neck cancer survivors: a systematic review.

    Science.gov (United States)

    Crowder, Sylvia L; Douglas, Katherine G; Yanina Pepino, M; Sarma, Kalika P; Arthur, Anna E

    2018-03-20

    It is estimated that more than 90% of head and neck cancer (HNC) survivors who underwent chemoradiotherapy experience one or more nutrition impact symptoms (NIS) in the months or years thereafter. Despite the high prevalence, there is limited research addressing long-term impact of NIS on outcomes such as nutrition and quality of life in HNC survivors treated with chemoradiotherapy. To conduct a systematic review of the literature pertaining to the presence of nutrition impact symptoms and their associated outcomes in post-chemoradiotherapy head and neck cancer survivors. A systematic review was conducted across three databases according to PRISMA guidelines and used to identify current literature regarding NIS in HNC survivors. A keyword search was conducted in PubMed, Scopus, and Web of Science from 2007 to 2017. Studies that met all of the following criteria were included in the review: (1) studies must include human subjects with a HNC diagnosis; (2) study participants must have received chemoradiotherapy; (3) study participants must have been post-treatment for a minimum of 3 months at the time of data collection; (4) full-text articles must have appeared in peer-reviewed journals; (5) papers must have been published in English; (6) studies must be quantitative in nature; (7) studies must have reported at least one NIS; and (8) studies must address at least one of the following outcomes: nutrition, functional status, or quality of life. Two independent reviewers assessed study quality using a predefined set of criteria. A systematic search yielded 1119 papers, of which 15 met the inclusion criteria. The study reviewed existing evidence of NIS in a variety of HNC survivors ranging from 3 months to greater than 10 years post-chemoradiotherapy treatment. Eight hundred forty-nine study participants were included in the review. Of the 15 studies, 10 were designed as prospective cohort studies, 4 were cross-sectional studies, and 1 was a retrospective cohort

  8. Integrated assessment of pedestrian head impact protection in testing secondary safety and autonomous emergency braking.

    Science.gov (United States)

    Searson, D J; Anderson, R W G; Hutchinson, T P

    2014-02-01

    Pedestrian impact testing is used to provide information to the public about the relative level of protection provided by different vehicles to a struck pedestrian. Autonomous Emergency Braking (AEB) is a relatively new technology that aims to reduce the impact speed of such crashes. It is expected that vehicles with AEB will pose less harm to pedestrians, and that the benefit will come about through reductions in the number of collisions and a change in the severity of impacts that will still occur. In this paper, an integration of the assessment of AEB performance and impact performance is proposed based on average injury risk. Average injury risk is calculated using the result of an impact test and a previously published distribution of real world crash speeds. A second published speed distribution is used that accounts for the effects of AEB, and reduced average risks are implied. This principle allows the effects of AEB systems and secondary safety performance to be integrated into a single measure of safety. The results are used to examine the effect of AEB on Euro NCAP and ANCAP assessments using previously published results on the likely effect of AEB. The results show that, given certain assumptions about AEB performance, the addition of AEB is approximately the equivalent of increasing Euro NCAP test performance by one band, which corresponds to an increase in the score of 25% of the maximum. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. 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).

  10. 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.

  11. Impact of Target Distance, Target Size, and Visual Acuity on the Video Head Impulse Test.

    Science.gov (United States)

    Judge, Paul D; Rodriguez, Amanda I; Barin, Kamran; Janky, Kristen L

    2018-05-01

    The video head impulse test (vHIT) assesses the vestibulo-ocular reflex. Few have evaluated whether environmental factors or visual acuity influence the vHIT. The purpose of this study was to evaluate the influence of target distance, target size, and visual acuity on vHIT outcomes. Thirty-eight normal controls and 8 subjects with vestibular loss (VL) participated. vHIT was completed at 3 distances and with 3 target sizes. Normal controls were subdivided on the basis of visual acuity. Corrective saccade frequency, corrective saccade amplitude, and gain were tabulated. In the normal control group, there were no significant effects of target size or visual acuity for any vHIT outcome parameters; however, gain increased as target distance decreased. The VL group demonstrated higher corrective saccade frequency and amplitude and lower gain as compared with controls. In conclusion, decreasing target distance increases gain for normal controls but not subjects with VL. Preliminarily, visual acuity does not affect vHIT outcomes.

  12. On the impact of improved dosimetric accuracy on head and neck high dose rate brachytherapy.

    Science.gov (United States)

    Peppa, Vasiliki; Pappas, Eleftherios; Major, Tibor; Takácsi-Nagy, Zoltán; Pantelis, Evaggelos; Papagiannis, Panagiotis

    2016-07-01

    To study the effect of finite patient dimensions and tissue heterogeneities in head and neck high dose rate brachytherapy. The current practice of TG-43 dosimetry was compared to patient specific dosimetry obtained using Monte Carlo simulation for a sample of 22 patient plans. The dose distributions were compared in terms of percentage dose differences as well as differences in dose volume histogram and radiobiological indices for the target and organs at risk (mandible, parotids, skin, and spinal cord). Noticeable percentage differences exist between TG-43 and patient specific dosimetry, mainly at low dose points. Expressed as fractions of the planning aim dose, percentage differences are within 2% with a general TG-43 overestimation except for the spine. These differences are consistent resulting in statistically significant differences of dose volume histogram and radiobiology indices. Absolute differences of these indices are however small to warrant clinical importance in terms of tumor control or complication probabilities. The introduction of dosimetry methods characterized by improved accuracy is a valuable advancement. It does not appear however to influence dose prescription or call for amendment of clinical recommendations for the mobile tongue, base of tongue, and floor of mouth patient cohort of this study. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Ametropia, retinal anatomy, and OCT abnormality patterns in glaucoma. 2. Impacts of optic nerve head parameters

    Science.gov (United States)

    Baniasadi, Neda; Wang, Mengyu; Wang, Hui; Jin, Qingying; Elze, Tobias

    2017-12-01

    Clinicians use retinal nerve fiber layer thickness (RNFLT) measured by optical coherence tomography (OCT) as an adjunct to glaucoma diagnosis. Ametropia is accompanied by changes to the optic nerve head (ONH), which may affect how OCT machines mark RNFLT measurements as abnormal. These changes in abnormality patterns may bias glaucoma diagnosis. Here, we investigate the relationship between OCT abnormality patterns and the following ONH-related and ametropia-associated parameters on 421 eyes of glaucoma patients: optic disc tilt and torsion, central retinal vessel trunk location (CRVTL), and nasal and temporal retinal curvature adjacent to ONH, quantified as nasal/temporal slopes of the inner limiting membrane. We applied multivariate logistic regression with abnormality marks as regressands to 40,401 locations of the peripapillary region and generated spatial maps of locations of false positive/negative abnormality marks independent of glaucoma severity. Effects of torsion and temporal slope were negligible. The effect of tilt could be explained by covariation with ametropia. For CRVTL/nasal slope, abnormality pattern shifts at 7.2%/23.5% of the peripapillary region were detected, respectively, independent of glaucoma severity and ametropia. Therefore, CRVTL and nasal curvature should be included in OCT RNFLT norms. Our spatial location maps may aid clinicians to improve diagnostic accuracy.

  14. 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.

  15. The Impact of Parent Involvement in Head Start on Parents and Children. Final Report [and] Executive Summary.

    Science.gov (United States)

    Parker, Faith Lamb; Piotrkowski, Chaya S.; Kessler-Sklar, Susan; Baker, Amy J. L.; Peay, Lenore; Clark, Beryl

    From its inception, Head Start's legislative mandate called for "maximum feasible participation" of parents in all programmatic efforts and policy decisions. Nevertheless, there has been little research done on the benefits of Head Start to parents and on the role of parents as mediators of child and family outcomes. The Head Start…

  16. 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.

  17. Brain tissue strains vary with head impact location: A possible explanation for increased concussion risk in struck versus striking football players.

    Science.gov (United States)

    Elkin, Benjamin S; Gabler, Lee F; Panzer, Matthew B; Siegmund, Gunter P

    2018-03-29

    On-field football helmet impacts over a large range of severities have caused concussions in some players but not in other players. One possible explanation for this variability is the struck player's helmet impact location. We examined the effect of impact location on regional brain tissue strain when input energy was held constant. Laboratory impacts were performed at 12 locations distributed over the helmet and the resulting head kinematics were simulated in two finite element models of the brain: the Simulated Injury Monitor and the Global Human Body Model Consortium brain model. Peak kinematics, injury metrics and brain strain varied significantly with impact location. Differences in impact location explained 33 to 37% of the total variance in brain strain for the whole brain and cerebrum, considerably more than the variance explained by impact location for the peak resultant head kinematics (8 to 23%) and slightly more than half of the variance explained by the difference in closing speed (57 to 61%). Both finite element models generated similar strain results, with minor variations for impacts that generated multi-axial rotations, larger variations in brainstem strains for some impact locations and a small bias for the cerebellum. Based on this experimental and computational simulation study, impact location on the football helmet has a large effect on regional brain tissue strain. We also found that the lowest strains consistently occurred in impacts to the crown and forehead, helmet locations commonly associated with the striking player. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Evaluation of the impact of dental artefacts on intensity-modulated radiotherapy planning for the head and neck

    International Nuclear Information System (INIS)

    Webster, Gareth J.; Rowbottom, Carl G.; Mackay, Ranald I.

    2009-01-01

    Background and purpose: High density materials create severe artefacts in the computed tomography (CT) scans used for radiotherapy dose calculations. Increased use of intensity-modulated radiotherapy (IMRT) to treat oropharyngeal cancers raises concerns over the accuracy of the resulting dose calculation. This work quantifies their impact and evaluates a simple corrective technique. Materials and methods: Fifteen oropharyngeal patients with severe artefacts were retrospectively planned with IMRT using two different CT/density look-up tables. Each plan was recalculated using a corrected CT dataset to evaluate the dose distribution delivered to the patient. Plan quality in the absence of dental artefacts was similarly assessed. A range of dosimetric and radiobiological parameters were compared pre- and post-correction. Results: Plans using a standard CT/density look-up table (density ≤1.8 g/cm 3 ) revealed inconsistent inter-patient errors, mostly within clinical acceptance, although potentially significantly reducing target coverage for individual patients. Using an extended CT/density look-up table (density ≤10.0 g/cm 3 ) greatly reduced the errors for 13/15 patients. In 2/15 patients with residual errors the CTV extended into the severely affected region and could be corrected by applying a simple manual correction. Conclusions: Use of an extended CT/density look-up table together with a simple manual bulk density correction reduces the impact of dental artefacts on head and neck IMRT planning to acceptable levels.

  19. Assessment of shoulder position variation and its impact on IMRT and VMAT doses for head and neck cancer

    Directory of Open Access Journals (Sweden)

    Neubauer Emily

    2012-02-01

    Full Text Available Abstract Background For radiotherapy of the head and neck, 5-point mask immobilization is used to stabilize the shoulders. Still, the daily position of the shoulders during treatment may be different from the position in the treatment plan despite correct isocenter setup. The purpose of this study was to determine the interfractional displacement of the shoulders relative to isocenter over the course of treatment and the associated dosimetric effect of this displacement. Methods The extent of shoulder displacements relative to isocenter was assessed for 10 patients in 5-point thermoplastic masks using image registration and daily CT-on-rails scans. Dosimetric effects on IMRT and VMAT plans were evaluated in Pinnacle based on simulation CTs modified to represent shoulder shifts between 3 and 15 mm in the superior-inferior, anterior-posterior, and right-left directions. The impact of clinically observed shoulder shifts on the low-neck dose distributions was examined. Results Shoulder motion was 2-5 mm in each direction on average but reached 20 mm. Superior shifts resulted in coverage loss, whereas inferior shifts increased the dose to the brachial plexus. These findings were generally consistent for both IMRT and VMAT plans. Over a course of observed shifts, the dose to 99% of the CTV decreased by up to 101 cGy, and the brachial plexus dose increased by up to 72 cGy. Conclusions he position of the shoulder affects target coverage and critical structure dose, and may therefore be a concern during the setup of head and neck patients, particularly those with low neck primary disease.

  20. 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

  1. Impact of oral rehabilitation on patients with head and neck cancer: A study using the Liverpool Oral Rehabilitation Questionnaire and the Oral Health Impact Profile-14.

    Science.gov (United States)

    Dholam, Kanchan P; Dugad, Jinesh A; Sadashiva, Karthik M

    2017-04-01

    The treatment of oral cancers affects oral functions and quality of life (QOL). Dental rehabilitation is a major step toward enhancing quality of life after controlling the disease. The effects of the disease, treatment, and rehabilitation need to be evaluated to assess oral health-related QOL. The Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) and Oral Health Impact Profile-14 (OHIP-14) are specific assessment questionnaires of oral rehabilitation. The purpose of this study was to assess the impact of oral rehabilitation on patients with head and neck cancer by using the LORQv3 and OHIP-14 questionnaires and to discover and document specific patient-derived problems related to the issues of oral rehabilitation. The LORQv3 and OHIP-14 questionnaires were administered to 60 participants with oral cancer, who were in need of oral rehabilitation. They were asked to rate their dental problems on a Likert scale before fabrication of their prostheses (baseline) and at the 3-month follow-up visit after prosthetic rehabilitation. Paired comparison was done using the Wilcoxon signed rank test according to the distribution, and Cronbach alpha was used to assess internal consistency. Subscale scores were determined by mean value (α=.05). For the LORQv3 questionnaire, a 10% to 27% improvement was found in the domain of oral function, and a 20% improvement in orofacial appearance, with improvement in patient satisfaction with the prosthesis. Using the OHIP-14 questionnaire, a 45% to 67% improvement was generally seen in all domains. After assessment using the LORQv3 and OHIP-14 questionnaires, prosthetic rehabilitation was seen to contribute to the betterment of patients with head and neck cancer. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  2. Development of a human head FE model for the impact analysis using VOXEL approach and simulation for the assessment on the focal brain injury

    International Nuclear Information System (INIS)

    Watanabe, Dai; Yuge, Kohei; Nishimoto, Tetsuya; Murakami, Shigeyuki; Takao, Hiroyuki

    2008-01-01

    In this paper, a three-dimensional digital human-head model was developed and several dynamic analyses on the head trauma were conducted. This model was built up by the VOXEL approach using 433 slice CT images (512 x 512 pixels) and made of 1.22 million parallelepiped finite elements with 10 anatomical tissue properties such as scalp, cerebrospinal fluid (CSF), skull, brain, dura mater and so on. The numerical analyses were conducted using a finite element code the authors have developed. The main features of the code are it is based on the explicit time integration method and it uses the one point integration method to evaluate the equivalent nodal forces with the hourglass control proposed by Flanagan and Belythcko and it utilizes the parallel computation with the Massage Passing Interface (MPI). In order to verify the developed model, the head impact experiment for a cadaver by Nahum et al. was simulated. The calculated results showed good agreement with experimental ones. A front and rear impact analyses were also performed investigate the relation between the impact direction and the positions of the high measurement of pressure and stresses in brain. The obtained results represent that brain injury has a closer relation with the Mises equivalent stress rather than the pressure. At this time, the large deformation of a frontal cranial base was observed in both frontal and occipital impact analyses. We expect that it induces the brain injury in a frontal lobe regardless of the impact positions. (author)

  3. Impact of low-head hydropower generation at Morgan Falls, LaHave River on migrating Atlantic salmon (Salmo salar)

    International Nuclear Information System (INIS)

    Amiro, P.G.; Jansen, H.

    2000-01-01

    A study was conducted to assess the impact that a low-head hydro electric power generating facility has on Atlantic salmon populations, particularly salmon smolts migrating downstream. The facility, located at Morgan Falls, LaHave River in Nova Scotia, is adjacent to a fishway and counting trap used to monitor salmon migration. Since 1972, the effects monitoring at the power facility for Atlantic salmon smolts concentrated on estimating three rates: (1) the facility use rate for downstream migrating smolts, (2) the louver efficiency rate for smolts entering the power canal, and (3) the turbine mortality rate for smolts passing through the turbine. Estimates of the number of wild smolt produced above the falls were determined and together with adult salmon data collected at the fishway, the potential impact of the facility on the salmon population was assessed. In this study, a total of 4,750 tagged smolts were released on four dates in 1997. Counts were recorded as the fish exited the bypass collection tank during louver or turbine testing periods and during daytime and evening hours. The estimated louver efficiencies of 86.3 and 88.3 per cent were higher than previously reported near-surface efficiencies of 80 per cent guidance for Atlantic salmon smolts experiencing a bypass acceleration factor of 1.26:1. Louver efficiencies of 96 per cent were estimated if fish that were recovered in the bypass holding tank after the experiments were included. Estimates of turbine mortality ranged from 15.4 per cent to 78.5 per cent, depending on the assumption about the missing fish. Mortalities in the assessment facility were due to turbulence in the bypass holding tank and impingement of fish on the incline screen fish separator. 7 refs., 10 tabs., 6 figs

  4. The impact of preload reduction with head-up tilt testing on longitudinal and transverse left ventricular mechanics.

    Science.gov (United States)

    Schneider, Caroline; Forsythe, Lynsey; Somauroo, John; George, Keith; Oxborough, David

    2018-01-03

    Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function however the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change. A focused transthoracic echocardiogram was performed on 10 healthy male participants (23 ± 3 years,) in the supine position and following 1 min and 5 min of HUT testing. Raw temporal longitudinal ε (Ls) and transverse ε (Ts) values were exported and divided into 5% increments across the cardiac cycle and corresponding LV volumes were traced at each 5% increment. This provided simultaneous LV longitudinal and transverse ε and volume-loops (deformation-volume analysis - DVA). There was a leftward- shift of the ε -volume loop from supine to 1 min and 5 min of HUT, ptransverse thickening from supine to 1min, which was further augmented at 5min (p=0.018). Preload reduction occurs within 1 minute of HUT but does not further reduce at 5 minutes. This decline is associated with a decrease in longitudinal ε and concomitant increase in transverse ε. Consequently, augmented transverse relaxation appears to be an important factor in the maintenance of LV filling in the setting of reduced preload. DVA provides information on the relative contribution of mechanics to a change in LV volume and may have a role in the assessment of clinical populations. © 2018 The authors.

  5. Impact of fast-track concept elements in the classical pancreatic head resection (Kausch-Whipple procedure).

    Science.gov (United States)

    Gastinger, Ingo; Meyer, Frank; Lembcke, Thomas; Schmidt, Uwe; Ptok, Henry; Lippert, Hans

    2012-08-01

    The aim of the study was to determine statistically significant factors with an impact on the early postoperative surgical outcome. The influence of applied fast-track components on surgical results and early postoperative outcome in 143 consecutive Kausch-Whipple procedure patients was evaluated in a single-center retrospective analysis of a prospective collection of patient-associated pre-, peri- and postoperative data from 1997-2006. The in-hospital mortality rate was 2.8% (n=4). Fast-track measures were shown to have no effect on the morbidity rate in the multi-variate analysis. Over the study period, a decrease of intraoperative infusion volume from 14.2 mL/kg body weight/h in the first year to 10.7 mL/kg body weight/h in the last year was accompanied by an increase in patients requiring intraoperative catecholamines, up from 17% to 95%. The administration of ropivacain/sufentanil via thoracic peri-dural catheter injection initiated in 2000 and now considered the leading analgesic method, was used in 95% of the cases in 2006. Early extubation rate rose from 16.6% to 57.9%. Fast-track aspects in the perioperative management have become more important in several surgical procedure even in those with a greater invasiveness such as Kausch-Whipple. However, such techniques used in peri-operative management of Kausch-Whipple pancreatic-head resections had no impact on the morbidity rate. In addition, the low in-hospital mortality rate was particularly attributed to surgical competence.

  6. 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

  7. SU-E-T-454: Impact of Calculation Grid Size On Dosimetry and Radiobiological Parameters for Head and Neck IMRT

    Energy Technology Data Exchange (ETDEWEB)

    Srivastava, S; Das, I [Purdue University, West Lafayette, IN (United States); Indiana University Health Methodist Hospital, Indianapolis, IN (United States); Indiana University- School of Medicine, Indianapolis, IN (United States); Cheng, C [Purdue University, West Lafayette, IN (United States); Indiana University Health Methodist Hospital, Indianapolis, IN (United States)

    2014-06-01

    Purpose: IMRT has become standard of care for complex treatments to optimize dose to target and spare normal tissues. However, the impact of calculation grid size is not widely known especially dose distribution, tumor control probability (TCP) and normal tissue complication probability (NTCP) which is investigated in this study. Methods: Ten head and neck IMRT patients treated with 6 MV photons were chosen for this study. Using Eclipse TPS, treatment plans were generated for different grid sizes in the range 1–5 mm for the same optimization criterion with specific dose-volume constraints. The dose volume histogram (DVH) was calculated for all IMRT plans and dosimetric data were compared. ICRU-83 dose points such as D2%, D50%, D98%, as well as the homogeneity and conformity indices (HI, CI) were calculated. In addition, TCP and NTCP were calculated from DVH data. Results: The PTV mean dose and TCP decreases with increasing grid size with an average decrease in mean dose by 2% and TCP by 3% respectively. Increasing grid size from 1–5 mm grid size, the average mean dose and NTCP for left parotid was increased by 6.0% and 8.0% respectively. Similar patterns were observed for other OARs such as cochlea, parotids and spinal cord. The HI increases up to 60% and CI decreases on average by 3.5% between 1 and 5 mm grid that resulted in decreased TCP and increased NTCP values. The number of points meeting the gamma criteria of ±3% dose difference and ±3mm DTA was higher with a 1 mm on average (97.2%) than with a 5 mm grid (91.3%). Conclusion: A smaller calculation grid provides superior dosimetry with improved TCP and reduced NTCP values. The effect is more pronounced for smaller OARs. Thus, the smallest possible grid size should be used for accurate dose calculation especially in H and N planning.

  8. Impact of head and neck radiotherapy on the mechanical behavior of composite resins and adhesive systems: A systematic review.

    Science.gov (United States)

    Madrid Troconis, Cristhian Camilo; Santos-Silva, Alan Roger; Brandão, Thaís Bianca; Lopes, Marcio Ajudarte; de Goes, Mario Fernando

    2017-11-01

    To analyze the evidence regarding the impact of head and neck radiotherapy (HNRT) on the mechanical behavior of composite resins and adhesive systems. Searches were conducted on PubMed, Embase, Scopus and ISI Web of Science databases using "Radiotherapy", "Composite resins" and "Adhesive systems" as keywords. Selected studies were written in English and assessed the mechanical behavior of composite resins and/or adhesive systems when bonding procedure was conducted before and/or after a maximum radiation dose ≥50Gy, applied under in vitro or in vivo conditions. In total, 115 studies were found but only 16 were included, from which five evaluated the effect of in vitro HNRT on microhardness, wear resistance, diametral tensile and flexural strength of composite resins, showing no significant negative effect in most of reports. Regarding bond strength of adhesive systems, 11 studies were included from which five reported no meaningful negative effect when bonding procedure was conducted before simulated HNRT. Conversely, five studies showed that bond strength diminished when adhesive procedure was done after in vitro radiation therapy. Only two studies about dental adhesion were conducted after in vivo radiotherapy but the results were not conclusive. The mechanical behavior of composite resins and adhesive systems seems not to be affected when in vitro HNRT is applied after bonding procedure. However, bond strength of adhesive systems tends to decrease when simulated radiotherapy is used immediately before bonding procedure. Studies assessing dentin bond strength after in-vivo HNRT were limited and controversial. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  9. Prognostic factors for head and neck cancer of unknown primary including the impact of human papilloma virus infection.

    Science.gov (United States)

    Axelsson, Lars; Nyman, Jan; Haugen-Cange, Hedda; Bove, Mogens; Johansson, Leif; De Lara, Shahin; Kovács, Anikó; Hammerlid, Eva

    2017-06-10

    Head and neck cancer of unknown primary (HNCUP) is rare and prospective studies are lacking. The impact of different prognostic factors such as age and N stage is not completely known, the optimal treatment is not yet established, and the reported survival rates vary. In the last decade, human papilloma virus (HPV) has been identified as a common cause of and important prognostic factor in oropharyngeal cancer, and there is now growing interest in the importance of HPV for HNCUP. The aim of the present study on curatively treated HNCUP was to investigate the prognostic importance of different factors, including HPV status, treatment, and overall survival. A search for HNCUP was performed in the Swedish Cancer Registry, Western health district, between the years 1992-2009. The medical records were reviewed, and only patients with squamous cell carcinoma or undifferentiated carcinoma treated with curative intent were included. The tumor specimens were retrospectively analyzed for HPV with p16 immunostaining. Sixty-eight patients were included. The mean age was 59 years. The majority were males, and had N2 tumors. Sixty-nine percent of the tumors were HPV positive using p16 staining. Patients who were older than 70 years, patients with N3-stage tumors, and patients with tumors that were p16 negative had a significantly worse prognosis. The overall 5-year survival rate for patients with p16-positive tumors was 88% vs 61% for p16-negative tumors. Treatment with neck dissection and postoperative radiation or (chemo) radiation had 81 and 88% 5-year survival rates, respectively. The overall and disease-free 5-year survival rates for all patients in the study were 82 and 74%. Curatively treated HNCUP had good survival. HPV infection was common. Independent prognostic factors for survival were age over 70 years, HPV status and N3 stage. We recommend that HPV analysis should be performed routinely for HNCUP. Treatment with neck dissection and postoperative radiation or

  10. The preliminary study of setup errors' impact on dose distribution of image guide radiation therapy for head and neck cancer

    International Nuclear Information System (INIS)

    Xu Luying; Pan Jianji; Wang Xiaoliang; Bai Penggang; Li Qixin; Fei Zhaodong; Chen Chuanben; Ma Liqin; Tang Tianlan

    2011-01-01

    Objective: To measure the set-up errors of patients with head and neck (H and N) cancer during the image guided intensity-modulated radiotherapy (IMRT) treatment and analyze the impact of setup errors on dose distribution; then to further investigate the necessity of adjustment online for H and N cancer during IMRT treatment. Methods: Cone-beam CT (CBCT) scanning of thirty patients with H and N cancer were acquired by once weekly with a total of 6 times during IMRT treatment. The CBCT images and the original planning CT images were matched by the bony structure and worked out the translational errors of the x, y, z axis, as well as rotational errors. The dose distributions were recalculated based on the data of each setup error. The dose of planning target volume (PTV) and organs at risk were calculated in the re-planning, and than compared with the original plan by paired t-test. Results: The mean value of x, y, z axis translational set-up errors were (1.06 ± 0.95)mm, (0.95 ± 0.77)mm and (1.31 ± 1.07)mm, respectively. The rotational error of x, y, z axis were (1.04 ±0.791), (1.06 ±0.89) and (0.81 ±0.61 ), respectively. PTV 95% volume dose (D 95 ) and PTV minimal dose of re-planning for 6 times set-up were lower than original plan (6526.6 cGy : 6630.3 cGy, t =3.98, P =0.000 and 5632.6 cGy : 5792.5 cGy, t =- 2.89, P =0.007). Brain stem received 45 Gydose volume (V 45 ) and 1% brain stem volume dose (D 01 )were higher than original plan (3.54% : 2.75%, t =3.84, P =0.001 and 5129.7 cGy : 4919.3 cGy, t =4.36, P =0.000). Conclusions: The set-up errors led to the dose of PTV D 95 obviously insufficient and significantly increased V 45 , D 01 of the brainstem. So, adjustment online is necessary for H and N cancer during IMRT treatment. (authors)

  11. 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...... and neck cancer adversely influenced a wide range of quality of life endpoints. Quitters had better quality of life than patients who continued to smoke after treatment, suggesting that smoking cessation may improve quality of life in addition to reducing the risk of new cancer. Udgivelsesdato: 2007-Feb...

  12. Intracranial Pressure Response to Non-Penetrating Ballistic Impact: An Experimental Study Using a Pig Physical Head Model and Live Pigs

    Science.gov (United States)

    Liu, Hai; Kang, Jianyi; Chen, Jing; Li, Guanhua; Li, Xiaoxia; Wang, Jianmin

    2012-01-01

    This study was conducted to characterize the intracranial pressure response to non-penetrating ballistic impact using a "scalp-skull-brain" pig physical head model and live pigs. Forty-eight ballistic tests targeting the physical head model and anesthetized pigs protected by aramid plates were conducted with standard 9 mm bullets at low (279-297 m/s), moderate (350-372 m/s), and high (409-436 m/s) velocities. Intracranial pressure responses were recorded with pressure sensors embedded in similar brain locations in the physical head model and the anesthetized pigs. Three parameters of intracranial pressure were determined from the measured data: intracranial maximum pressure (Pmax), intracranial maximum pressure impulse (PImax), and the duration of the first positive phase (PPD). The intracranial pressure waves exhibited blast-like characteristics for both the physical model and l live pigs. Of all three parameters, Pmax is most sensitive to impact velocity, with means of 126 kPa (219 kPa), 178 kPa (474 kPa), and 241 kPa (751 kPa) for the physical model (live pigs) for low, moderate, and high impact velocities, respectively. The mean PPD becomes increasingly short as the impact velocity increases, whereas PImax shows the opposite trend. Although the pressure parameters of the physical model were much lower than those of the live pigs, good correlations between the physical model and the live pigs for the three pressure parameters, especially Pmax, were found using linear regression. This investigation suggests that Pmax is a preferred parameter for predicting the severity of the brain injury resulting from behind armor blunt trauma (BABT). PMID:23055817

  13. 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)

    Fencl, Jane S.; Mather, Martha E.; 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 (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.

  14. 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).

  15. Three Approaches to Preschoolers' Social and Emotional Competence: A Summary of Impact and Implementation Findings from Head Start CARES

    Science.gov (United States)

    MDRC, 2015

    2015-01-01

    This summary describes the Head Start CARES research project, which evaluated three classroom-based approaches to enhancing children's social-emotional development: (1) The Incredible Years Teacher Training Program; (2) Preschool PATHS (Promoting Alternative Thinking Strategies); and (3) Tools of the Mind--Play. The three social-emotional…

  16. Impact of mandatory motorcycle helmet wearing legislation on head injuries in Viet Nam: results of a preliminary analysis.

    Science.gov (United States)

    Passmore, Jonathon; Tu, Nguyen Thi Hong; Luong, Mai Anh; Chinh, Nguyen Duc; Nam, Nguyen Phuong

    2010-04-01

    To compare estimated prevalence of head injuries among road traffic injury patients admitted to hospitals, before and after the introduction of a mandatory helmet law in the Socialist Republic of Viet Nam. Before and after study of all road traffic injury patients with head injuries admitted to 20 provincial and central hospitals 3 months before and after the new law came into effect on 15 December 2007. Relative risk was computed and comparison made for the periods of 3 months before and after the new law. The study found a 16 percent reduction in the risk of road traffic head injuries (4683 to 3522; relative risk [RR] 0.84; 95% confidence interval [CI] 0.81-0.87) and an 18 percent reduction in the risk of road traffic death (deaths in hospital plus injured patients discharged to die at home; 566 to 417; RR 0.82; 95% CI 0.73-0.93). Over the first 3 months of the comprehensive mandatory helmet legislation there has been a significant reduction in the risk of road traffic head injuries among patients admitted to 20 hospitals. The Viet Nam Government's decision to require all motorcycle riders and passengers to wear helmets is suspected of leading to positive road safety benefits and should be seen as a policy example for other low- and middle-income countries with a high utilization of motorcycles for transport.

  17. 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,…

  18. An investigation of the effects of sports-related concussion in youth using functional magnetic resonance imaging and the head impact telemetry system.

    Science.gov (United States)

    Keightley, Michelle; Green, Stephanie; Reed, Nick; Agnihotri, Sabrina; Wilkinson, Amy; Lobaugh, Nancy

    2011-01-12

    One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI). Children and youth involved in organized sports such as competitive hockey are nearly six times more likely to suffer a severe concussion compared to children involved in other leisure physical activities. While the most common cognitive sequelae of mTBI appear similar for children and adults, the recovery profile and breadth of consequences in children remains largely unknown, as does the influence of pre-injury characteristics (e.g. gender) and injury details (e.g. magnitude and direction of impact) on long-term outcomes. Competitive sports, such as hockey, allow the rare opportunity to utilize a pre-post design to obtain pre-injury data before concussion occurs on youth characteristics and functioning and to relate this to outcome following injury. Our primary goals are to refine pediatric concussion diagnosis and management based on research evidence that is specific to children and youth. To do this we use new, multi-modal and integrative approaches that will: 1. Evaluate the immediate effects of head trauma in youth. 2. Monitor the resolution of post-concussion symptoms (PCS) and cognitive performance during recovery. 3. Utilize new methods to verify brain injury and recovery. To achieve our goals, we have implemented the Head Impact Telemetry (HIT) System. (Simbex; Lebanon, NH, USA). This system equips commercially available Easton S9 hockey helmets (Easton-Bell Sports; Van Nuys, CA, USA) with single-axis accelerometers designed to measure real-time head accelerations during contact sport participation. By using telemetric technology, the magnitude of acceleration and location of all head impacts during sport participation can be objectively detected and recorded. We also use functional magnetic resonance imaging (fMRI) to localize and assess changes in neural activity specifically in the medial temporal and frontal lobes

  19. Simultaneous transcranial direct current stimulation (tDCS) and whole-head magnetoencephalography (MEG): assessing the impact of tDCS on slow cortical magnetic fields.

    Science.gov (United States)

    Garcia-Cossio, Eliana; Witkowski, Matthias; Robinson, Stephen E; Cohen, Leonardo G; Birbaumer, Niels; Soekadar, Surjo R

    2016-10-15

    Transcranial direct current stimulation (tDCS) can influence cognitive, affective or motor brain functions. Whereas previous imaging studies demonstrated widespread tDCS effects on brain metabolism, direct impact of tDCS on electric or magnetic source activity in task-related brain areas could not be confirmed due to the difficulty to record such activity simultaneously during tDCS. The aim of this proof-of-principal study was to demonstrate the feasibility of whole-head source localization and reconstruction of neuromagnetic brain activity during tDCS and to confirm the direct effect of tDCS on ongoing neuromagnetic activity in task-related brain areas. Here we show for the first time that tDCS has an immediate impact on slow cortical magnetic fields (SCF, 0-4Hz) of task-related areas that are identical with brain regions previously described in metabolic neuroimaging studies. 14 healthy volunteers performed a choice reaction time (RT) task while whole-head magnetoencephalography (MEG) was recorded. Task-related source-activity of SCFs was calculated using synthetic aperture magnetometry (SAM) in absence of stimulation and while anodal, cathodal or sham tDCS was delivered over the right primary motor cortex (M1). Source reconstruction revealed task-related SCF modulations in brain regions that precisely matched prior metabolic neuroimaging studies. Anodal and cathodal tDCS had a polarity-dependent impact on RT and SCF in primary sensorimotor and medial centro-parietal cortices. Combining tDCS and whole-head MEG is a powerful approach to investigate the direct effects of transcranial electric currents on ongoing neuromagnetic source activity, brain function and behavior. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. 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.

  1. Impact of the prophylactic gastrostomy for unresectable squamous cell head and neck carcinomas treated with radio-chemotherapy on quality of life: Prospective randomized trial

    International Nuclear Information System (INIS)

    Salas, Sebastien; Baumstarck-Barrau, Karine; Alfonsi, Marc; Digue, Laurence; Bagarry, Danielle; Feham, Nasreddine; Bensadoun, Rene Jean; Pignon, Thierry; Loundon, Anderson; Deville, Jean-Laurent; Zanaret, Michel; Favre, Roger; Duffaud, Florence; Auquier, Pascal

    2009-01-01

    Background and purpose: Concomitant radio-chemotherapy is the gold standard treatment for unresectable head and neck carcinomas. Placement of prophylactic gastrostomy has been proposed to provide adequate nutrition during the therapeutic sequence. The objectives of this study were to assess the impact of prophylactic gastrostomy on the 6-month quality of life, and to determine the factors related to this quality of life. Materials and methods: Design. randomized, controlled, open study ('systematic percutaneous gastrostomy' versus 'no systematic gastrostomy'). Patients. squamous cell head and neck carcinoma (stages III and IV, UICC 1997). Setting. oncological departments of French university teaching hospitals. Treatment. optimal concomitant radio-chemotherapy. Evaluations. T0 baseline evaluation, T1 during the treatment, T2 end of the treatment, and T3 6-month post-inclusion. Primary endpoint. 6-month quality of life (Qol) assessed using SF36, EORTC QLQ-C30, EORTC QLQ H and N35 questionnaires. Results: The Qol changes from baseline included a decline (T1 and T2) followed by an improvement (T3). Qol at 6 months was significantly higher in the group receiving systematic prophylactic gastrostomy (p = 10 -3 ). Higher initial BMI and lower initial Karnofsky index were significant factors related to a higher 6-month Qol. Conclusions: The study results suggest that prophylactic gastrostomy improves post-treatment quality of life for unresectable head and neck cancer patients, after adjusting for other potential predictive quality of life factors.

  2. 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 quality of life questionnaire (p patients submitted to radiotherapy for head and neck cancer, thereby leading to an improvement in quality of life.

  3. Impact of Pretreatment Body Mass Index on Patients With Head-and-Neck Cancer Treated With Radiation

    International Nuclear Information System (INIS)

    Pai, Ping-Ching; Chuang, Chi-Cheng; Tseng, Chen-Kan; Tsang, Ngan-Ming; Chang, Kai-Ping; Yen, Tzu-Chen; Liao, Chun-Ta; Hong, Ji-Hong; Chang, Joseph Tung-Chieh

    2012-01-01

    Purpose: To investigate the association of pretreatment body mass index (preT BMI) with outcomes of head-and-neck cancer in patients treated with radiotherapy (RT). Methods and Materials: All 1,562 patients diagnosed with head-and-neck cancer and treated with curative-intent RT to a dose of 60 Gy or higher were retrospectively studied. Body weight was measured both at entry and at the end of RT. Cancer-specific survival (CSS), overall survival (OS), locoregional control (LRC), and distant metastasis (DM) were analyzed by preT BMI ( 2 vs. ≥25 kg/m 2 ). The median follow-up was 8.6 years. Results: Patients with lower preT BMI were statistically significantly associated with poorer CSS and OS than those with higher preT BMI. There was no significant difference between preT BMI groups in terms of LRC and DM. Body weight loss (BWL) during radiation did not influence survival outcomes. However, in the group with higher preT BMI, CSS, OS, and DM-free survival of patients with less BWL during radiation were statistically longer when compared with greater BWL. Conclusion: This study demonstrates that higher preT BMI positively influenced survival outcomes for patients with head-and-neck cancer. Patients with higher preT BMI who were able to maintain their weight during radiation had significantly better survival than patients with greater BWL.

  4. 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)

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

    International Nuclear Information System (INIS)

    Klasic, B.; Knezevic, Z.; Vekic, B.; Brnic, Z.; Novacic, K.

    2006-01-01

    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)

  6. Head Lice

    Science.gov (United States)

    ... nits. You should also use hot water to wash any bed linens, towels, and clothing recently worn by the person who had head lice. Vacuum anything that can’t be washed, such as the couch, carpets, your child’s car seat, and any stuffed animals. Because head lice ...

  7. Impact of curved shaped energy dissipaters downstream of head structures on both water energy dissipation and irrigation water quality

    Directory of Open Access Journals (Sweden)

    Ashour Mohamed A.

    2015-03-01

    Full Text Available Using energy dissipaters on the soled aprons downstream of head structures is the main technique for accelerating hydraulic jump formation and dissipating a great amount of the residual harmful kinetic energy occurring downstream of head structures. In this paper, an experimental study was conducted to investigate some untested shapes of curved dissipaters with different angles of curvature and arrangements from two points of view. The first is to examine its efficiency in dissipating the kinetic water energy. The second is to examine the most effective shape and arrangement obtained from the aforementioned step in enriching the flow with dissolved oxygen for enhancement of the irrigation water quality. The study was held in the irrigation and hydraulic laboratory of the Civil Department, Faculty of Engineering, Assiut University, using a movable bed tilting channel 20 m long, 30 cm wide, and 50 cm high, using 21 types of curved dissipaters with different arrangements. A total of 660 runs were carried out. Results were analysed, tabulated and graphically presented, and new formulas were introduced to estimate the energy dissipation ratio, as well as the DO concentrations. Results in general showed that the dissipater performance is more tangible in dissipating the residual energy when the curvature is in the opposite direction to that of the flow. Also, the energy loss ratio increases with an increase in curvature angle (θ, until it reaches (θ = 120°, then it decreases again. The study also showed that using three rows of dissipaters give nearly the same effect as using four rows, concerning both the relative energy dissipation and dissolved oxygen content. So, it is recommended to use three rows of the curved dissipater with the angle of curvature (θ = 120° in the opposite direction to that of the flow to obtain the maximum percentage of water energy dissipation downstream of head structures, and maximum dissolved oxygen content too

  8. Impact of subject head motion on quantitative brain 15O PET and its correction by image-based registration algorithm

    International Nuclear Information System (INIS)

    Matsubara, Keisuke; Ibaraki, Masanobu; Nakamura, Kazuhiro; Yamaguchi, Hiroshi; Umetsu, Atsushi; Kinoshita, Fumiko; Kinoshita, Toshibumi

    2013-01-01

    Subject head motion during sequential 15 O positron emission tomography (PET) scans can result in artifacts in cerebral blood flow (CBF) and oxygen metabolism maps. However, to our knowledge, there are no systematic studies examining this issue. Herein, we investigated the effect of head motion on quantification of CBF and oxygen metabolism, and proposed an image-based motion correction method dedicated to 15 O PET study, correcting for transmission-emission mismatch and inter-scan mismatch of emission scans. We analyzed 15 O PET data for patients with major arterial steno-occlusive disease (n=130) to determine the occurrence frequency of head motion during 15 O PET examination. Image-based motion correction without and with realignment between transmission and emission scans, termed simple and 2-step method, respectively, was applied to the cases that showed severe inter-scan motion. Severe inter-scan motion (>3 mm translation or >5deg rotation) was observed in 27 of 520 adjacent scan pairs (5.2%). In these cases, unrealistic values of oxygen extraction fraction (OEF) or cerebrovascular reactivity (CVR) were observed without motion correction. Motion correction eliminated these artifacts. The volume-of-interest (VOI) analysis demonstrated that the motion correction changed the OEF on the middle cerebral artery territory by 17.3% at maximum. The inter-scan motion also affected cerebral blood volume (CBV), cerebral metabolism rate of oxygen (CMRO 2 ) and CBF, which were improved by the motion correction. A difference of VOI values between the simple and 2-step method was also observed. These data suggest that image-based motion correction is useful for accurate measurement of CBF and oxygen metabolism by 15 O PET. (author)

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

    International Nuclear Information System (INIS)

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

    2013-01-01

    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

  10. Defining the biomechanical and biological threshold of murine mild traumatic brain injury using CHIMERA (Closed Head Impact Model of Engineered Rotational Acceleration).

    Science.gov (United States)

    Namjoshi, Dhananjay R; Cheng, Wai Hang; Bashir, Asma; Wilkinson, Anna; Stukas, Sophie; Martens, Kris M; Whyte, Tom; Abebe, Zelalem A; McInnes, Kurt A; Cripton, Peter A; Wellington, Cheryl L

    2017-06-01

    CHIMERA (Closed Head Impact Model of Engineered Rotational Acceleration) is a recently described animal model of traumatic brain injury (TBI) that primarily produces diffuse axonal injury (DAI) characterized by white matter inflammation and axonal damage. CHIMERA was specifically designed to reliably generate a variety of TBI severities using precise and quantifiable biomechanical inputs in a nonsurgical user-friendly platform. The objective of this study was to define the lower limit of single impact mild TBI (mTBI) using CHIMERA by characterizing the dose-response relationship between biomechanical input and neurological, behavioral, neuropathological and biochemical outcomes. Wild-type male mice were subjected to a single CHIMERA TBI using six impact energies ranging from 0.1 to 0.7J, and post-TBI outcomes were assessed over an acute period of 14days. Here we report that single TBI using CHIMERA induces injury dose- and time-dependent changes in behavioral and neurological deficits, axonal damage, white matter tract microgliosis and astrogliosis. Impact energies of 0.4J or below produced no significant phenotype (subthreshold), 0.5J led to significant changes for one or more phenotypes (threshold), and 0.6 and 0.7J resulted in significant changes in all outcomes assessed (mTBI). We further show that linear head kinematics are the most robust predictors of duration of unconsciousness, severity of neurological deficits, white matter injury, and microgliosis following single TBI. Our data extend the validation of CHIMERA as a biofidelic animal model of DAI and establish working parameters to guide future investigations of the mechanisms underlying axonal pathology and inflammation induced by mechanical trauma. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  11. Detecting Large-Scale Brain Networks Using EEG: Impact of Electrode Density, Head Modeling and Source Localization

    Science.gov (United States)

    Liu, Quanying; Ganzetti, Marco; Wenderoth, Nicole; Mantini, Dante

    2018-01-01

    Resting state networks (RSNs) in the human brain were recently detected using high-density electroencephalography (hdEEG). This was done by using an advanced analysis workflow to estimate neural signals in the cortex and to assess functional connectivity (FC) between distant cortical regions. FC analyses were conducted either using temporal (tICA) or spatial independent component analysis (sICA). Notably, EEG-RSNs obtained with sICA were very similar to RSNs retrieved with sICA from functional magnetic resonance imaging data. It still remains to be clarified, however, what technological aspects of hdEEG acquisition and analysis primarily influence this correspondence. Here we examined to what extent the detection of EEG-RSN maps by sICA depends on the electrode density, the accuracy of the head model, and the source localization algorithm employed. Our analyses revealed that the collection of EEG data using a high-density montage is crucial for RSN detection by sICA, but also the use of appropriate methods for head modeling and source localization have a substantial effect on RSN reconstruction. Overall, our results confirm the potential of hdEEG for mapping the functional architecture of the human brain, and highlight at the same time the interplay between acquisition technology and innovative solutions in data analysis. PMID:29551969

  12. Head Injuries

    Science.gov (United States)

    ... a severe blow to the head can still knock the brain into the side of the skull ... following certain precautions and taking a break from sports and other activities that make symptoms worse. Playing ...

  13. Cumulative Head Impact Exposure Predicts Later-Life Depression, Apathy, Executive Dysfunction, and Cognitive Impairment in Former High School and College Football Players.

    Science.gov (United States)

    Montenigro, Philip H; Alosco, Michael L; Martin, Brett M; Daneshvar, Daniel H; Mez, Jesse; Chaisson, Christine E; Nowinski, Christopher J; Au, Rhoda; McKee, Ann C; Cantu, Robert C; McClean, Michael D; Stern, Robert A; Tripodis, Yorghos

    2017-01-15

    The term "repetitive head impacts" (RHI) refers to the cumulative exposure to concussive and subconcussive events. Although RHI are believed to increase risk for later-life neurological consequences (including chronic traumatic encephalopathy), quantitative analysis of this relationship has not yet been examined because of the lack of validated tools to quantify lifetime RHI exposure. The objectives of this study were: 1) to develop a metric to quantify cumulative RHI exposure from football, which we term the "cumulative head impact index" (CHII); 2) to use the CHII to examine the association between RHI exposure and long-term clinical outcomes; and 3) to evaluate its predictive properties relative to other exposure metrics (i.e., duration of play, age of first exposure, concussion history). Participants included 93 former high school and collegiate football players who completed objective cognitive and self-reported behavioral/mood tests as part of a larger ongoing longitudinal study. Using established cutoff scores, we transformed continuous outcomes into dichotomous variables (normal vs. impaired). The CHII was computed for each participant and derived from a combination of self-reported athletic history (i.e., number of seasons, position[s], levels played), and impact frequencies reported in helmet accelerometer studies. A bivariate probit, instrumental variable model revealed a threshold dose-response relationship between the CHII and risk for later-life cognitive impairment (p < 0.0001), self-reported executive dysfunction (p < 0.0001), depression (p < 0.0001), apathy (p = 0.0161), and behavioral dysregulation (p < 0.0001). Ultimately, the CHII demonstrated greater predictive validity than other individual exposure metrics.

  14. Changes in lateral dimensions of irradiated volume and their impact on the accuracy of dose delivery during radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Senkus-Konefka, Elzbieta; Naczk, Edmund; Borowska, Ilona; Badzio, Andrzej; Jassem, Jacek

    2006-01-01

    Background and purpose: To assess changes in lateral dimensions of irradiated volume during head and neck cancer radiotherapy and to determine their impact on the accuracy of dose delivery. Patients and methods: Lateral dimensions of irradiated volumes were measured in five predefined points prior to treatment and then bi-weekly. For each measurement, midline dose was calculated and verified using in vivo dosimetry. Early radiation reactions, patient weight changes and the need to modify radiotherapy accessories were also recorded. The study included 33 head and neck cancer patients irradiated using parallel opposed megavoltage fields. Results: Body mass changes during radiotherapy ranged from -18 to +4 kg (median -5). Lateral dimension changes >5 mm (range -37 to +16) occurred in 32 patients (97%). For axis measurements, the degree of lateral dimension changes were correlated with treatment field size (P=0.022) and degree of mucositis (P=0.017). Axis doses calculated for changed dimensions varied from those prescribed by -2.5 to +6% (median +2%). Differences larger than 5% were present in 4.8% of calculations. In 17 patients (52%), radiotherapy accessories had to be modified during treatment. The need to modify radiotherapy accessories correlated with larger treatment portals (P=0.004), more weight loss during treatment (P=0.01) and higher initial N stage (P=0.04). Conclusions: Changes of irradiated volume lateral dimensions during head and neck cancer radiotherapy may lead to considerable dose delivery inaccuracies. Watchful monitoring, corrections to calculated dose when changes observed are significant and radiotherapy accessories modification during the course of treatment are strongly recommended

  15. Impact of uncertain head tissue conductivity in the optimization of transcranial direct current stimulation for an auditory target

    Science.gov (United States)

    Schmidt, Christian; Wagner, Sven; Burger, Martin; van Rienen, Ursula; Wolters, Carsten H.

    2015-08-01

    Objective. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique to modify neural excitability. Using multi-array tDCS, we investigate the influence of inter-individually varying head tissue conductivity profiles on optimal electrode configurations for an auditory cortex stimulation. Approach. In order to quantify the uncertainty of the optimal electrode configurations, multi-variate generalized polynomial chaos expansions of the model solutions are used based on uncertain conductivity profiles of the compartments skin, skull, gray matter, and white matter. Stochastic measures, probability density functions, and sensitivity of the quantities of interest are investigated for each electrode and the current density at the target with the resulting stimulation protocols visualized on the head surface. Main results. We demonstrate that the optimized stimulation protocols are only comprised of a few active electrodes, with tolerable deviations in the stimulation amplitude of the anode. However, large deviations in the order of the uncertainty in the conductivity profiles could be noted in the stimulation protocol of the compensating cathodes. Regarding these main stimulation electrodes, the stimulation protocol was most sensitive to uncertainty in skull conductivity. Finally, the probability that the current density amplitude in the auditory cortex target region is supra-threshold was below 50%. Significance. The results suggest that an uncertain conductivity profile in computational models of tDCS can have a substantial influence on the prediction of optimal stimulation protocols for stimulation of the auditory cortex. The investigations carried out in this study present a possibility to predict the probability of providing a therapeutic effect with an optimized electrode system for future auditory clinical and experimental procedures of tDCS applications.

  16. Impact of nutrition management in patients with head and neck cancers treated with irradiation: is the nutritional intervention useful?

    International Nuclear Information System (INIS)

    Garabige, V.; Giraud, P.; Jaulerry, C.; Brunin, F.; Rycke, Y. de; Girod, A.; Jouffroy, T.; Rodriguez, J.

    2007-01-01

    Aims. The head and neck tumors are most often associated with a precarious nutritional status. Radiotherapy increases the risk of de-nutrition because of its secondary effects on the secretory and sensorial mucous membranes. The purpose of our retrospectively study was to evaluate the interest of a precocious and regular nutritional therapy on the ability to maintain the nutritional status of the patient during the radiotherapy. Patients and methods. The fifty-two patients included in the survey have been classified retrospectively in two different groups based on their observance to the nutritional therapy: group 1 'good observance', group 2 'bad observance'. Results. The 31 patients of group 1 have lost an average of 1.9 kg by the end of the irradiation, whereas the 21 patients of group 2 have lost an average of 6.1 kg (p < 0.001). The almost stability in weight of patients in group 1 was linked to a lower frequency of breaks in the radio-therapy (6 vs 33% p = 0.03) and in a decrease in grade of inflammatory, mucous membranes (10% of grade 3 in group 1 vs 52% in group 2, p = 0.006). The quantity of calories ingested in form of nutritional supplements was greater in group 1 and consequently enabled patients to stabilized their weight (1200 calories in group 1 versus 850 calories in group 2, p < 0.005). Conclusions. The given nutritional advice and the prescription of adapted nutritional supplements consequently allowed limiting efficiently the weight lost during the irradiation and the grade of mucositis. The systematization of a precocious nutritional therapy for patients irradiated for head and neck tumors seems absolutely essential. (authors)

  17. Lymphoscintigraphy with intraoperative gamma probe sentinel node detection: clinical impact in patients with head and neck melanomas

    International Nuclear Information System (INIS)

    Maccauro, M.; Villano, C.; Aliberti, G.; Ferrani, L.; Castellani, M.R.; Bombardieri, E.; Patuzzo, R.; Santinami, M.; Tshering, D.

    2005-01-01

    Aim. The aims of this paper were to evaluate the clinical relevance of lymphoscintigraphy with intraoperative gamma-probe detection in identifying sentinel nodes (SNs) and to study the prognostic value of SN biopsy in head and neck melanoma patients. Methods. Sixty-one patients had lymphoscintigraphy with intradermal injections of 99m Tc-Nanocoll (40 MBq), 24 h before surgery. Tumor-positive SNs patients underwent total lymph node dissection Postoperative histological examination was performed. Patients were followed up for 1 to 5 years (median 3 years). The tumor relapses and the overall survival were evaluated by means of statistical methods. Results. Lymphoscintigraphy showed lymphatic distribution to more than one basin in 45 patients (74%), in 15 patients one basin was visualized and no basin in 1 patient. In 41 patients the SN was negative for metastases, while in 20 was positive. In a high percentage of patients (30%), metastatic involvement occurred in more than one lymph node basin. During follow-up in the negative SN group, 40 patients remained disease free and 1 relapsed. In the positive SN group, 10 patients remained disease free and 10 relapsed. Recurrence time ranged from 6 to 11 months. The overall survival of the SNs negative group was significantly higher than the positive SN group. Conclusion. This approach was able to distinguish: a) patients with tumor-negative SNs with a favorable clinical course (98% did not relapse, P<0.001); b) patients with tumor-positive SNs with a high rate of tumor relapse (50%, P<0.001). Therefore SN biopsy may give information about prognosis in head and neck melanoma patients

  18. Impact of organ-specific dose reduction on the image quality of head and neck CT angiography

    International Nuclear Information System (INIS)

    Schimmoeller, L.; Lanzman, R.S.; Heusch, P.; Dietrich, S.; Miese, F.; Aissa, J.; Heusner, T.A.; Antoch, G.; Kroepil, P.

    2013-01-01

    Organ-specific dose reduction (OSDR) algorithms can reduce radiation on radiosensitive organs up to 59 %. This study evaluates the influence of a new OSDR algorithm on image quality of head and neck computed tomographic angiography (CTA) in clinical routine. Sixty-two consecutive patients (68 ± 13 years) were randomised into two groups and imaged using 128-row multidetector CT. Group A (n = 31) underwent conventional CTA and group B (n = 31) CTA with a novel OSDR algorithm. Subjective and objective image quality were statistically compared. Subjective image quality was rated on a five-point scale. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated with region-of-interest measurements. The SNR of the common carotid artery and middle cerebral artery was 53.6 ± 22.7 and 43.3 ± 15.3 (group A) versus 54.1 ± 20.5 and 46.2 ± 14.6 (group B). The CNR was 40.0 ± 19.3 and 29.7 ± 12.0 (group A) compared with 40.7 ± 16.8 and 32.9 ± 10.9 (group B), respectively. Subjective image quality was excellent in both groups (mean score 4.4 ± 0.7 versus 4.4 ± 0.6). Differences between the two groups were not significant. The novel OSDR algorithm does not compromise image quality of head and neck CTA. Its application can be recommended for CTA in clinical routine to protect the thyroid gland and ocular lenses from unnecessary high radiation. (orig.)

  19. Impact of weight loss on survival after chemoradiation for locally advanced head and neck Cancer: secondary results of a randomized phase III trial (SAKK 10/94)

    International Nuclear Information System (INIS)

    Ghadjar, Pirus; Hayoz, Stefanie; Zimmermann, Frank; Bodis, Stephan; Kaul, David; Badakhshi, Harun; Bernier, Jacques; Studer, Gabriela; Plasswilm, Ludwig; Budach, Volker; Aebersold, Daniel M

    2015-01-01

    To analyze the impact of weight loss before and during chemoradiation on survival outcomes in patients with locally advanced head and neck cancer. From 07/1994-07/2000 a total of 224 patients with squamous cell carcinoma of the head and neck were randomized to either hyperfractionated radiation therapy alone or the same radiation therapy combined with two cycles of concomitant cisplatin. The primary endpoint was time to any treatment failure (TTF); secondary endpoints were locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS). Patient weight was measured 6 months before treatment, at treatment start and treatment end. The proportion of patients with >5% weight loss was 32% before, and 51% during treatment, and the proportion of patients with >10% weight loss was 12% before, and 17% during treatment. After a median follow-up of 9.5 years (range, 0.1 – 15.4 years) weight loss before treatment was associated with decreased TTF, LRRFS, DMFS, cancer specific survival and OS in a multivariable analysis. However, weight loss during treatment was not associated with survival outcomes. Weight loss before and during chemoradiation was commonly observed. Weight loss before but not during treatment was associated with worse survival

  20. 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.

  1. 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

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

    International Nuclear Information System (INIS)

    Sabatino, Marcello; Kretschmer, Matthias; Zink, Klemens; Würschmidt, Florian

    2012-01-01

    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. 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. PTV coverage for all systems in terms of V 90% and V 95% 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 MU were 308 by Panther DAO calculated for

  3. [The impact of Reiki on side effects in patients with head-neck neoplasia undergoing radiotherapy: a pilot study].

    Science.gov (United States)

    Iacorossi, Laura; Di Ridolfi, Paolo; Bigiarini, Liciano; Giannarelli, Diana; Sanguineti, Giuseppe

    2017-01-01

    Cancer patients often report symptoms related to therapeutic treatment, whose management is based on traditional medicine. In recent years, however, there has been growing interest towards adopting some form of complementary medicine, among these, Reiki. The aim of this study is to evaluate how this type of discipline can contribute to managing radiotherapy-related symptoms in patients with head and neck cancer. The study was performed in the Radiotherapy Department at the Regina Elena National Cancer Institute in Rome. To assess QoL, the FACT-H N questionnaire was used, while the CTCAE Scale was adopted to evaluate mucositis, cutaneous toxicity and salivation. 10.5% of patients were reported to experience strong pain in the fifth week, compared to 21.1% of patients in the previous week; a degree of mucositis equal to G3 was also found in 15.5% of cases according to the clinical evaluation, as well as in 10.5% of patients according to the functional one. Only one case (5.3%) of grade 3 cutaneous toxicity was registered. The study shows how the Reiki treatment benefits patients in most cases, with both psychological support to help deal with the therapeutic process together with integrated support towards pain therapy.

  4. Impact of head and neck cancer adaptive radiotherapy to spare the parotid glands and decrease the risk of xerostomia.

    Science.gov (United States)

    Castelli, Joel; Simon, Antoine; Louvel, Guillaume; Henry, Olivier; Chajon, Enrique; Nassef, Mohamed; Haigron, Pascal; Cazoulat, Guillaume; Ospina, Juan David; Jegoux, Franck; Benezery, Karen; de Crevoisier, Renaud

    2015-01-09

    Large anatomical variations occur during the course of intensity-modulated radiation therapy (IMRT) for locally advanced head and neck cancer (LAHNC). The risks are therefore a parotid glands (PG) overdose and a xerostomia increase. The purposes of the study were to estimate: - the PG overdose and the xerostomia risk increase during a "standard" IMRT (IMRTstd); - the benefits of an adaptive IMRT (ART) with weekly replanning to spare the PGs and limit the risk of xerostomia. Fifteen patients received radical IMRT (70 Gy) for LAHNC. Weekly CTs were used to estimate the dose distributions delivered during the treatment, corresponding either to the initial planning (IMRTstd) or to weekly replanning (ART). PGs dose were recalculated at the fraction, from the weekly CTs. PG cumulated doses were then estimated using deformable image registration. The following PG doses were compared: pre-treatment planned dose, per-treatment IMRTstd and ART. The corresponding estimated risks of xerostomia were also compared. Correlations between anatomical markers and dose differences were searched. Compared to the initial planning, a PG overdose was observed during IMRTstd for 59% of the PGs, with an average increase of 3.7 Gy (10.0 Gy maximum) for the mean dose, and of 8.2% (23.9% maximum) for the risk of xerostomia. Compared to the initial planning, weekly replanning reduced the PG mean dose for all the patients (pxerostomia by 11% (pxerostomia risk.

  5. Impact of Early Head Start in North Carolina on Dental Care Use Among Children Younger Than 3 Years.

    Science.gov (United States)

    Burgette, Jacqueline M; Preisser, John S; Weinberger, Morris; King, Rebecca S; Lee, Jessica Y; Rozier, R Gary

    2017-04-01

    To examine the effects of North Carolina Early Head Start (EHS), an early education program for low-income children younger than 3 years and their families, on dental care use among children. We performed a quasi-experimental study in which we interviewed 479 EHS and 699 non-EHS parent-child dyads at baseline (2010-2012) and at a 24-month follow-up (2012-2014). We estimated the effects of EHS participation on the probability of having a dental care visit after controlling for baseline dental care need and use and a propensity score covariate; we included random effects to account for EHS program clustering. The odds of having a dental care visit of any type (adjusted odds ratio [OR] = 2.5; 95% confidence interval [CI] = 1.74, 3.48) and having a preventive dental visit (adjusted OR = 2.6; 95% CI = 1.84, 3.63) were higher among EHS children than among non-EHS children. In addition, the adjusted mean number of dental care visits among EHS children was 1.3 times (95% CI = 1.17, 1.55) the mean number among non-EHS children. This study is the first, to our knowledge, to demonstrate that EHS participation increases dental care use among disadvantaged young children.

  6. Impact of 3D virtual planning on reconstruction of mandibular and maxillary surgical defects in head and neck oncology.

    Science.gov (United States)

    Witjes, Max J H; Schepers, Rutger H; Kraeima, Joep

    2018-04-01

    This review describes the advances in 3D virtual planning for mandibular and maxillary reconstruction surgical defects with full prosthetic rehabilitation. The primary purpose is to provide an overview of various techniques that apply 3D technology safely in primary and secondary reconstructive cases of patients suffering from head and neck cancer. Methods have been developed to overcome the problem of control over the margin during surgery while the crucial decision with regard to resection margin and planning of osteotomies were predetermined by virtual planning. The unlimited possibilities of designing patient-specific implants can result in creative uniquely applied solutions for single cases but should be applied wisely with knowledge of biomechanical engineering principles. The high surgical accuracy of an executed 3D virtual plan provides tumor margin control during ablative surgery and the possibility of planned combined use of osseus free flaps and dental implants in the reconstruction in one surgical procedure. A thorough understanding of the effects of radiotherapy on the reconstruction, soft tissue management, and prosthetic rehabilitation is imperative in individual cases when deciding to use dental implants in patients who received radiotherapy.

  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. 29 CFR 1926.100 - Head protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Head protection. 1926.100 Section 1926.100 Labor... § 1926.100 Head protection. (a) Employees working in areas where there is a possible danger of head... protected by protective helmets. (b) Helmets for the protection of employees against impact and penetration...

  9. 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

  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. Impact of Managerial Skills Learnt through MA Educational Planning Management Programme of AIOU on the Performance of Institutional Heads

    Science.gov (United States)

    Chuadhry, Muhammad Asif; Shah, Syed Manzoor Hussain

    2012-01-01

    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…

  12. 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)

  13. Impact of head and neck cancer adaptive radiotherapy to spare the parotid glands and decrease the risk of xerostomia

    International Nuclear Information System (INIS)

    Castelli, Joel; Simon, Antoine; Louvel, Guillaume; Henry, Olivier; Chajon, Enrique; Nassef, Mohamed; Haigron, Pascal; Cazoulat, Guillaume; Ospina, Juan David; Jegoux, Franck; Benezery, Karen; Crevoisier, Renaud de

    2015-01-01

    Large anatomical variations occur during the course of intensity-modulated radiation therapy (IMRT) for locally advanced head and neck cancer (LAHNC). The risks are therefore a parotid glands (PG) overdose and a xerostomia increase. The purposes of the study were to estimate: - the PG overdose and the xerostomia risk increase during a “standard” IMRT (IMRT std ); - the benefits of an adaptive IMRT (ART) with weekly replanning to spare the PGs and limit the risk of xerostomia. Fifteen patients received radical IMRT (70 Gy) for LAHNC. Weekly CTs were used to estimate the dose distributions delivered during the treatment, corresponding either to the initial planning (IMRT std ) or to weekly replanning (ART). PGs dose were recalculated at the fraction, from the weekly CTs. PG cumulated doses were then estimated using deformable image registration. The following PG doses were compared: pre-treatment planned dose, per-treatment IMRT std and ART. The corresponding estimated risks of xerostomia were also compared. Correlations between anatomical markers and dose differences were searched. Compared to the initial planning, a PG overdose was observed during IMRT std for 59% of the PGs, with an average increase of 3.7 Gy (10.0 Gy maximum) for the mean dose, and of 8.2% (23.9% maximum) for the risk of xerostomia. Compared to the initial planning, weekly replanning reduced the PG mean dose for all the patients (p < 0.05). In the overirradiated PG group, weekly replanning reduced the mean dose by 5.1 Gy (12.2 Gy maximum) and the absolute risk of xerostomia by 11% (p < 0.01) (30% maximum). The PG overdose and the dosimetric benefit of replanning increased with the tumor shrinkage and the neck thickness reduction (p < 0.001). During the course of LAHNC IMRT, around 60% of the PGs are overdosed of 4 Gy. Weekly replanning decreased the PG mean dose by 5 Gy, and therefore by 11% the xerostomia risk

  14. Anemia During Sequential Induction Chemotherapy and Chemoradiation for Head and Neck Cancer: The Impact of Blood Transfusion on Treatment Outcome

    International Nuclear Information System (INIS)

    Bhide, Shreerang A.; Ahmed, Merina; Rengarajan, Vijayan; Powell, Ceri; Miah, Aisha; Newbold, Kate; Nutting, Christopher M.; Harrington, Kevin J.

    2009-01-01

    Purpose: Sequential treatment (chemotherapy followed by concomitant chemoradiation; CCRT) is increasingly being used for radical treatment of squamous cell cancer of the head and neck (SCCHN), which results in increased myelosuppression. In this study, we review the incidence of anemia and the effect of a policy of hemoglobin (Hb) maintenance by blood transfusion on disease outcomes in these patients. Methods and Materials: Retrospective review of the records of patients with SCCHN treated with sequential CCRT formed the basis of this study. The incidence of anemia and statistics on blood transfusion were documented. For the purpose of outcome analyses, patients were divided into four categories by (1) transfusion status, (2) nadir Hb concentration, (3) number of transfusion episodes, and (4) number of units of blood transfused (NOUT). Data on 3-year locoregional control (LRC), relapse-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were analyzed. Results: One hundred and sixty-nine patients were identified. The median follow-up was 23.6 months. The RFS (52% vs. 41%, p = 0.03), DSS (71% vs. 66%, p = 0.02), and OS (58% vs. 42% p = 0.005) were significantly better for patients who did not have a transfusion vs. those who did. The LRC, RFS, DSS, and OS were also significantly better for patients with nadir Hb level >12 vs. 4. Conclusion: Our study seems to suggest that blood transfusion during radical treatment for SCCHN might be detrimental. Further research should be undertaken into the complex interactions among tumor hypoxia, anemia, and the treatment of anemia before making treatment recommendations

  15. Anemia During Sequential Induction Chemotherapy and Chemoradiation for Head and Neck Cancer: The Impact of Blood Transfusion on Treatment Outcome

    Energy Technology Data Exchange (ETDEWEB)

    Bhide, Shreerang A; Ahmed, Merina [Institute of Cancer Research, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Rengarajan, Vijayan; Powell, Ceri; Miah, Aisha; Newbold, Kate [Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Nutting, Christopher M [Institute of Cancer Research, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Harrington, Kevin J [Institute of Cancer Research, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], E-mail: kevinh@icr.ac.uk

    2009-02-01

    Purpose: Sequential treatment (chemotherapy followed by concomitant chemoradiation; CCRT) is increasingly being used for radical treatment of squamous cell cancer of the head and neck (SCCHN), which results in increased myelosuppression. In this study, we review the incidence of anemia and the effect of a policy of hemoglobin (Hb) maintenance by blood transfusion on disease outcomes in these patients. Methods and Materials: Retrospective review of the records of patients with SCCHN treated with sequential CCRT formed the basis of this study. The incidence of anemia and statistics on blood transfusion were documented. For the purpose of outcome analyses, patients were divided into four categories by (1) transfusion status, (2) nadir Hb concentration, (3) number of transfusion episodes, and (4) number of units of blood transfused (NOUT). Data on 3-year locoregional control (LRC), relapse-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were analyzed. Results: One hundred and sixty-nine patients were identified. The median follow-up was 23.6 months. The RFS (52% vs. 41%, p = 0.03), DSS (71% vs. 66%, p = 0.02), and OS (58% vs. 42% p = 0.005) were significantly better for patients who did not have a transfusion vs. those who did. The LRC, RFS, DSS, and OS were also significantly better for patients with nadir Hb level >12 vs. <12 g/dL and NOUT 1-4 vs. >4. Conclusion: Our study seems to suggest that blood transfusion during radical treatment for SCCHN might be detrimental. Further research should be undertaken into the complex interactions among tumor hypoxia, anemia, and the treatment of anemia before making treatment recommendations.

  16. 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.

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

    OpenAIRE

    Beatriz Alvarado; Rosa del Carmen Vilchez

    2015-01-01

    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 ou...

  18. Impact of a portal/superior mesenteric vein resection during pancreatico-duodenectomy for pancreatic head adenocarcinoma.

    Science.gov (United States)

    Dumitrascu, T; Dima, S; Brasoveanu, V; Stroescu, C; Herlea, V; Moldovan, S; Ionescu, M; Popescu, I

    2014-12-01

    The impact of venous resection (VR) in pancreatico-dudenectomy (PD) for pancreatic adenocarcinoma (PDAC) is controversial. The aim of the study is to comparatively assess the postoperative outcomes after PD with and without VR for PDAC and to identify predictors of morbidity and survival in the subgroup of PD with VR. The data of 51 PD with VR were compared with those of 183 PD without VR. Binary logistic regression and Cox survival analyses were performed. Both the operative time and estimated blood loss was significantly higher in the VR group (P<0.001). A trend towards an increased 90-day mortality (9.8% vs. 5.5%) and severe morbidity (20% vs. 13%) was observed when a VR was performed (P ≥0.264). The median overall survival time after the PD with and without VR was 13 months and 17 months, respectively (P=0.845). The absence of histological tumor invasion of the VR was found as the only independent predictor for a better survival (HR=0.359; 95% CI 0.161-0.803; P=0.013). A PD with VR can be safely incorporated in a pancreatic surgeon armamentarium. However, the trend towards increased mortality and severe morbidity rates should be expected, along with higher operative time and blood loss, compared with PD without VR. Associated VR does not appear to significantly impair the prognosis after PD for PDAC; however, histological tumor invasion of the VR has a negative impact on the survival.

  19. 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.

  20. The blind men meet the elephant at the dam: Alternative spatial and taxonomic components reveal different insights about how low-head dams impact fish biodiversity

    Science.gov (United States)

    Fencl, Jane S.; Mather, Martha E.; Smith, Joseph M.; Hitchman, Sean M.

    2017-01-01

    Dams are ubiquitous environmental impacts that threaten aquatic ecosystems. The ability to compare across research studies is essential to conserve the native biodiversity that is impacted by the millions of low‐head dams that currently fragment streams and rivers. Here, we identify a previously unaddressed obstacle that impedes this generalization. Specifically, divergent spatial and taxonomic approaches that result from different conceptualizations of the dam‐biodiversity problem can produce conflicting science‐based conclusions about the same dam impact. In this research, using the same dammed and undammed sites, we evaluated the scientific generality of different conceptualizations of the dam‐biodiversity problem. We compared two different but commonly used spatial approaches—(1) above dam–below dam vs. (2) undammed–dammed comparisons—and 11 different, commonly used taxonomic approaches (three assemblage summaries, eight guilds). Sites above the dam structure had less diverse fish assemblages than sites below dams, whereas sites below the dam structure were similar to undammed sites. Thus, spatial approach 1 detected a large dam effect and spatial approach 2 detected a small dam effect. Similarly, some taxonomic responses (species richness, diversity, abundance, and number of guilds) detected large dam effects; other responses detected small (riffle specialist guild) or no dam effects (pool generalists). In summary, our results showed that how the problem was framed altered scientific conclusions and created different dam realities. The metaphor of how individual blind men disagree about the structure of an elephant, based on examinations of different body parts, reinforces the need for a coordinated, holistic perspective on dam research. Although no single approach is adequate for all problems, identifying the form, consequences of, and relationships among different research conceptualizations will set the stage for future syntheses of dam

  1. A Proposed Mechanism for Development of CTE Following Concussive Events: Head Impact, Water Hammer Injury, Neurofilament Release, and Autoimmune Processes.

    Science.gov (United States)

    Kornguth, Steven; Rutledge, Neal; Perlaza, Gabe; Bray, James; Hardin, Allen

    2017-12-19

    During the past decade, there has been an increasing interest in early diagnosis and treatment of traumatic brain injuries (TBI) that lead to chronic traumatic encephalopathy (CTE). The subjects involved range from soldiers exposed to concussive injuries from improvised explosive devices (IEDs) to a significant number of athletes involved in repetitive high force impacts. Although the forces from IEDs are much greater by a magnitude than those from contact sports, the higher frequency associated with contact sports allows for more controlled assessment of the mechanism of action. In our study, we report findings in university-level women soccer athletes followed over a period of four and a half years from accession to graduation. Parameters investigated included T1-, T2-, and susceptibility-weighted magnetic resonance images (SWI), IMPACT (Immediate Post-Concussion Assessment and Cognitive Testing), and C3 Logix behavioral and physiological assessment measures. The MRI Studies show several significant findings: first, a marked increase in the width of sulci in the frontal to occipital cortices; second, an appearance of subtle hemorrhagic changes at the base of the sulci; third was a sustained reduction in total brain volume in several soccer players at a developmental time when brain growth is generally seen. Although all of the athletes successfully completed their college degree and none exhibited long term clinical deficits at the time of graduation, the changes documented by MRI represent a clue to the pathological mechanism following an injury paradigm. The authors propose that our findings and those of prior publications support a mechanism of injury in CTE caused by an autoimmune process associated with the release of neural proteins from nerve cells at the base of the sulcus from a water hammer injury effect. As evidence accumulates to support this hypothesis, there are pharmacological treatment strategies that may be able to mitigate the development of

  2. A Proposed Mechanism for Development of CTE Following Concussive Events: Head Impact, Water Hammer Injury, Neurofilament Release, and Autoimmune Processes

    Directory of Open Access Journals (Sweden)

    Steven Kornguth

    2017-12-01

    Full Text Available During the past decade, there has been an increasing interest in early diagnosis and treatment of traumatic brain injuries (TBI that lead to chronic traumatic encephalopathy (CTE. The subjects involved range from soldiers exposed to concussive injuries from improvised explosive devices (IEDs to a significant number of athletes involved in repetitive high force impacts. Although the forces from IEDs are much greater by a magnitude than those from contact sports, the higher frequency associated with contact sports allows for more controlled assessment of the mechanism of action. In our study, we report findings in university-level women soccer athletes followed over a period of four and a half years from accession to graduation. Parameters investigated included T1-, T2-, and susceptibility-weighted magnetic resonance images (SWI, IMPACT (Immediate Post-Concussion Assessment and Cognitive Testing, and C3 Logix behavioral and physiological assessment measures. The MRI Studies show several significant findings: first, a marked increase in the width of sulci in the frontal to occipital cortices; second, an appearance of subtle hemorrhagic changes at the base of the sulci; third was a sustained reduction in total brain volume in several soccer players at a developmental time when brain growth is generally seen. Although all of the athletes successfully completed their college degree and none exhibited long term clinical deficits at the time of graduation, the changes documented by MRI represent a clue to the pathological mechanism following an injury paradigm. The authors propose that our findings and those of prior publications support a mechanism of injury in CTE caused by an autoimmune process associated with the release of neural proteins from nerve cells at the base of the sulcus from a water hammer injury effect. As evidence accumulates to support this hypothesis, there are pharmacological treatment strategies that may be able to mitigate the

  3. Flued head replacement alternatives

    International Nuclear Information System (INIS)

    Smetters, J.L.

    1987-01-01

    This paper discusses flued head replacement options. Section 2 discusses complete flued head replacement with a design that eliminates the inaccessible welds. Section 3 discusses alternate flued head support designs that can drastically reduce flued head installation costs. Section 4 describes partial flued head replacement designs. Finally, Section 5 discusses flued head analysis methods. (orig./GL)

  4. 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.

  5. Goniometer head

    International Nuclear Information System (INIS)

    Dzhazairov-Kakhramanov, V.; Berger, V.D.; Kadyrzhanov, K.K.; Zarifov, R.A.

    1994-01-01

    The goniometer head is an electromechanical instrument that performs the independent transfer of a testing sample on three coordinate axes (X, Y, Z) within limits of ±8 mm and independent rotation relative of these directions. The instrument comprises a sample holder, bellows component and three electrometer drives. The sample holder rotates around the axes X and Y, and is installed on the central arm which rotates around axis Z. One characteristic of this instrument is its independence which allows its use in any camera for researches in the field of radiation physics. 2 figs

  6. The impact of preload reduction with head-up tilt testing on longitudinal and transverse left ventricular mechanics: a study utilizing deformation volume analysis.

    Science.gov (United States)

    Schneider, Caroline; Forsythe, Lynsey; Somauroo, John; George, Keith; Oxborough, David

    2018-03-01

    Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function; however, the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change. A focused transthoracic echocardiogram was performed on 10 healthy male participants (23 ± 3 years) in the supine position and following 1 min and 5 min of HUT testing. Raw temporal longitudinal ε (Ls) and transverse ε (Ts) values were exported and divided into 5% increments across the cardiac cycle and corresponding LV volumes were traced at each 5% increment. This provided simultaneous LV longitudinal and transverse ε and volume loops (deformation volume analysis - DVA). There was a leftward shift of the ε-volume loop from supine to 1 min and 5 min of HUT ( P  transverse thickening from supine to 1 min, which was further augmented at 5 min ( P  = 0.018). Preload reduction occurs within 1 min of HUT but does not further reduce at 5 min. This decline is associated with a decrease in longitudinal ε and concomitant increase in transverse ε. Consequently, augmented transverse relaxation appears to be an important factor in the maintenance of LV filling in the setting of reduced preload. DVA provides information on the relative contribution of mechanics to a change in LV volume and may have a role in the assessment of clinical populations. © 2018 The authors.

  7. Head injury in children

    International Nuclear Information System (INIS)

    Sugiura, Makoto; Mori, Nobuhiko; Yokosuka, Reiko; Yamamoto, Masaaki; Imanaga, Hirohisa

    1981-01-01

    Findings of computerized tomography (CT) in 183 cases of head injury in children were investigated with special reference to CT findings of mild head injury. As was expected, CT findings of mild head injury fell within the normal range, in almost all cases. However, abnormal findings were noticed in 4 out of 34 cases (12%) in acute stage and 7 out of 76 cases (9%) in chronic stage. They were 3 cases of localized low density area in acute stage and 6 cases of mild cerebral atrophy in chronic stage, etc. There were some cases of mild head injury in which CT findings were normal while EEG examination revealed abnormality. Also in some cases, x-ray study demonstrated linear skull fracture which CT failed to show. These conventional techniques could be still remained as useful adjunct aid in diagnosis of head injury. CT findings of cases of cerebral contusion in their acute stage were divided as follows; normal, low density, small ventricle and ventricular and/or cisternal hemorrhage, frequency of incidence being 38, 17, 22, 11% respectively. These findings were invariably converted to cerebral atrophy from 10 days to 2 months after the impacts. In the cases with intracranial hematoma revealed by CT, only 32% of them showed clinical signs of Araki's type IV in their acute stage and 63% of them showed no neurological defects, that is Araki's type I and II. A case of extreme diffuse cerebral atrophy which followed acute subdural hematoma caused by tear of bridging veins without cortical contusion was presented. (author)

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

    International Nuclear Information System (INIS)

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

    2014-01-01

    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 (H and N) cancer study. Materials and methods: QART levels were defined as: basic QART with a dummy run (level 2), level 2 plus prospective Individual Case Reviews (ICRs) for 15% of patients (level 3) and level 2 plus prospective ICRs for all patients (level 4). The follow-up of patients was modeled using a multi-state model with parameters derived from EORTC, TROG and RTOG prospective studies. Individual patient data, linking QART results with outcome, were retrieved from the TROG database. Results for each QART level were expressed as percentage of mortality and local failure at 5 years. Results: Quality-of-life-adjusted and recurrence-free survival increased with increasing QART levels. The increase of all these metrics was more sizeable with an increased QART level from 2 or 3 to 4. The estimated quality-adjusted-life-years (QALYs) for an increase of QART levels of 3–4 and 2–4 were 0.09 and 0.15, respectively. The incremental CE ratio was €5525 and €3659 Euros per QALY for these QART levels. Compared to QART level 2 or 3, level 4 was cost-effective. Conclusions: Increasing QART levels resulted in better patient outcome in this simulated study. The increased complexity of the QART program was also cost-effective

  9. Is HEADS in our heads?

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... patients. Young patients reported that smoking, alcohol, illegal drugs, sexuality, and contraception were addressed significantly more at adult clinics in comparison to pediatric clinics. After controlling for age, gender and duration of illness, according to young patients, adjusted odds ratios...

  10. 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.

  11. 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; Zimeo Morais, Guilherme Augusto; 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.

  12. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ... more. TMJ and Facial Pain TMJ and Facial ... Teeth Management Wisdom Teeth Management An impacted wisdom tooth can ...

  13. 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

  14. 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)

  15. Head Trauma: First Aid

    Science.gov (United States)

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

  16. Quantifying the association between white matter integrity changes and subconcussive head impact exposure from a single season of youth and high school football using 3D convolutional neural networks

    Science.gov (United States)

    Saghafi, Behrouz; Murugesan, Gowtham; Davenport, Elizabeth; Wagner, Ben; Urban, Jillian; Kelley, Mireille; Jones, Derek; Powers, Alexander; Whitlow, Christopher; Stitzel, Joel; Maldjian, Joseph; Montillo, Albert

    2018-02-01

    The effect of subconcussive head impact exposure during contact sports, including American football, on brain health is poorly understood particularly in young and adolescent players, who may be more vulnerable to brain injury during periods of rapid brain maturation. This study aims to quantify the association between cumulative effects of head impact exposure from a single season of football on white matter (WM) integrity as measured with diffusion MRI. The study targets football players aged 9-18 years old. All players were imaged pre- and post-season with structural MRI and diffusion tensor MRI (DTI). Fractional Anisotropy (FA) maps, shown to be closely correlated with WM integrity, were computed for each subject, co-registered and subtracted to compute the change in FA per subject. Biomechanical metrics were collected at every practice and game using helmet mounted accelerometers. Each head impact was converted into a risk of concussion, and the risk of concussion-weighted cumulative exposure (RWE) was computed for each player for the season. Athletes with high and low RWE were selected for a two-category classification task. This task was addressed by developing a 3D Convolutional Neural Network (CNN) to automatically classify players into high and low impact exposure groups from the change in FA maps. Using the proposed model, high classification performance, including ROC Area Under Curve score of 85.71% and F1 score of 83.33% was achieved. This work adds to the growing body of evidence for the presence of detectable neuroimaging brain changes in white matter integrity from a single season of contact sports play, even in the absence of a clinically diagnosed concussion.

  17. Head and neck cancer

    International Nuclear Information System (INIS)

    Vogl, S.E.

    1988-01-01

    This book contains 10 chapters. Some of the titles are: Combined Surgical Resection and Irradiation for Head and Neck Cancers; Analysis of Radiation Therapy Oncology Group Head and Neck Database: Identification of Prognostic Factors and the Re-evaluation of American Joint Committee Stages; Combined Modality Approach to Head and Neck Cancer; Induction Combination Chemotherapy of Regionally Advanced Head and Neck Cancer; and Outcome after Complete Remission to Induction Chemotherapy in Head and Neck Cancer

  18. 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

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

    NARCIS (Netherlands)

    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.

    2015-01-01

    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

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

    NARCIS (Netherlands)

    de Jong, M.C.; ten Hoeve, J.J.; Grénman, R.; Wessels, L.F.; Kerkhoven, R.; te Riele, H.; van den Brekel, M.W.M.; Verheij, M.; Begg, A.C.

    2015-01-01

    Purpose: 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

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

    NARCIS (Netherlands)

    Jong, M.C. de; Hoeve, J.J. Ten; Grenman, R.; Wessels, L.F.; Kerkhoven, R.; Riele, H. Te; Brekel, M.W. van den; Verheij, M.; Begg, A.C.

    2015-01-01

    PURPOSE: 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

  2. 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

  3. 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)

  4. 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.

  5. Impact of intensity-modulated and image-guided radiotherapy on elderly patients undergoing chemoradiation for locally advanced head and neck cancer

    International Nuclear Information System (INIS)

    Nguyen, N.P.; Chi, A.; Vock, J.

    2012-01-01

    Purpose: In this work, the treatment tolerance of elderly patients (≥ 70 years) undergoing intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT) and chemotherapy for locally advanced head and neck cancer was assessed. Patients and methods: A retrospective review of 112 patients undergoing concurrent chemoradiation for locally advanced head and neck cancer was performed. Treatment toxicity, protocol violations, long-term complications, and survival were compared between 85 younger patients (< 70 years) and 27 older patients (≥ 70 years). Results: Grade 3-4 treatment toxicity was observed in 88.2% and 88.8% for younger and older patients, respectively. Mean weight loss and treatment break were 5.9 and 3.9 kg (p = 0.03) and 7.3 and 7.8 days (p = 0.8) for younger and older patients, respectively. Seven patients (8.2%) did not complete treatment in the younger group compared to 1 patient (3.7%) in the older group (p = 0.6). No significant differences in protocol violations and survival were found between the two groups. Conclusion: Compared to younger patients, elderly patients with locally advanced head and neck cancer tolerated chemoradiation with IMRT and IGRT well, and should not be denied curative treatment based solely on age. (orig.)

  6. Chryse 'Alien Head'

    Science.gov (United States)

    2005-01-01

    26 January 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows an impact crater in Chryse Planitia, not too far from the Viking 1 lander site, that to seems to resemble a bug-eyed head. The two odd depressions at the north end of the crater (the 'eyes') may have formed by wind or water erosion. This region has been modified by both processes, with water action occurring in the distant past via floods that poured across western Chryse Planitia from Maja Valles, and wind action common occurrence in more recent history. This crater is located near 22.5oN, 47.9oW. The 150 meter scale bar is about 164 yards long. Sunlight illuminates the scene from the left/lower left.

  7. Impact of Intensity-Modulated Radiotherapy on Health-Related Quality of Life for Head and Neck Cancer Patients: Matched-Pair Comparison with Conventional Radiotherapy

    International Nuclear Information System (INIS)

    Graff, Pierre; Lapeyre, Michel; Desandes, Emmanuel; Ortholan, Cecile; Bensadoun, Rene-Jean; Alfonsi, Marc; Maingon, Philippe; Giraud, Philippe; Bourhis, Jean; Marchesi, Vincent; Mege, Alice; Peiffert, Didier

    2007-01-01

    Purpose: To assess the benefit of intensity-modulated radiotherapy (IMRT) compared with conventional RT for the quality of life (QOL) of head and neck cancer survivors. Methods and Materials: Cross-sectional QOL measures (European Organization for Research and Treatment of Cancer QOL questionnaire C30 and head and neck cancer module) were used with a French multicenter cohort of patients cured of head and neck cancer (follow-up ≥ 1 year) who had received bilateral neck RT (≥ 45 Gy) as a part of their initial treatment. We compared the QOL mean scores regarding RT modality (conventional RT vs. IMRT). The patients of the two groups were matched (one to one) according to the delay between the end of RT and the timing of the QOL evaluation and the T stage. Each QOL item was divided into two relevant levels of severity: 'not severe' (responses, 'not at all' and 'a little') vs. 'severe' (responses 'quite a bit' and 'very much'). The association between the type of RT and the prevalence of severe symptoms was approximated, through multivariate analysis using the prevalence odds ratio. Results: Two comparable groups (67 pairs) were available. Better scores were observed on the head and neck cancer module QOL questionnaire for the IMRT group, especially for dry mouth and sticky saliva (p < 0.0001). Severe symptoms were more frequent with conventional RT concerning saliva modifications and oral discomfort. The adjusted prevalence odds ratios were 3.17 (p = 0.04) for dry mouth, 3.16 (p = 0.02) for sticky saliva, 3.58 (p = 0.02) for pain in the mouth, 3.35 (p = 0.04) for pain in the jaw, 2.60 (p = 0.02) for difficulties opening the mouth, 2.76 (p = 0.02) for difficulties with swallowing, and 2.68 (p = 0.03) for trouble with eating. Conclusion: The QOL assessment of head and neck cancer survivors demonstrated the benefit of IMRT, particularly in the areas of salivary dysfunction and oral discomfort

  8. 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,…

  9. 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 ...

  10. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... the head uses special x-ray equipment to help assess head injuries, severe headaches, dizziness, and other ... aneurysm, bleeding, stroke and brain tumors. It also helps your doctor to evaluate your face, sinuses, and ...

  11. 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 ...

  12. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... When the image slices are reassembled by computer software, the result is a very detailed multidimensional view ... Safety Images related to Computed Tomography (CT) - Head Videos related to Computed Tomography (CT) - Head Sponsored by ...

  13. 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 ...

  14. Computed Tomography (CT) -- Head

    Medline Plus

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

  15. The Impact of Positron Emission Tomography/Computed Tomography in Edge Delineation of Gross Tumor Volume for Head and Neck Cancers

    International Nuclear Information System (INIS)

    Ashamalla, Hani; Guirgius, Adel; Bieniek, Ewa; Rafla, Sameer; Evola, Alex; Goswami, Ganesh; Oldroyd, Randall; Mokhtar, Bahaa; Parikh, Kapila

    2007-01-01

    Purpose: To study anatomic biologic contouring (ABC), using a previously described distinct halo, to unify volume contouring methods in treatment planning for head and neck cancers. Methods and Materials: Twenty-five patients with head and neck cancer at various sites were planned for radiation therapy using positron emission tomography/computed tomography (PET/CT). The ABC halo was used in all PET/CT scans to contour the gross tumor volume (GTV) edge. The CT-based GTV (GTV-CT) and PET/CT-based GTV (GTV-ABC) were contoured by two independent radiation oncologists. Results: The ABC halo was observed in all patients studied. The halo had a standard unit value of 2.19 ± 0.28. The mean halo thickness was 2.02 ± 0.21 mm. Significant volume modification (≥25%) was seen in 17 of 25 patients (68%) after implementation of GTV-ABC. Concordance among observers was increased with the use of the halo as a guide for GTV determination: 6 patients (24%) had a ≤10% volume discrepancy with CT alone, compared with 22 (88%) with PET/CT (p 3 in CT-based planning to 7.2 cm 3 in PET/CT-based planning (p < 0.001). Conclusions: Using the 'anatomic biologic halo' to contour GTV in PET/CT improves consistency among observers. The distinctive appearance of the described halo and its presence in all of the studied tumors make it attractive for GTV contouring in head and neck tumors. Additional studies are needed to confirm the correlation of the halo with presence of malignant cells

  16. Impact of intra-arterial administration of boron compounds on dose-volume histograms in boron neutron capture therapy for recurrent head-and-neck tumors

    International Nuclear Information System (INIS)

    Suzuki, Minoru; Sakurai, Yoshinori; Nagata, Kenji; Kinashi, Yuko; Masunaga, Shinichiro; Ono, Koji; Maruhashi, Akira; Kato, Ituro; Fuwa, Nobukazu; Hiratsuka, Junichi; Imahori, Yoshio

    2006-01-01

    Purpose: To analyze the dose-volume histogram (DVH) of head-and-neck tumors treated with boron neutron capture therapy (BNCT) and to determine the advantage of the intra-arterial (IA) route over the intravenous (IV) route as a drug delivery system for BNCT. Methods and Materials: Fifteen BNCTs for 12 patients with recurrent head-and-neck tumors were included in the present study. Eight irradiations were done after IV administration of boronophenylalanine and seven after IA administration. The maximal, mean, and minimal doses given to the gross tumor volume were assessed using a BNCT planning system. Results: The results are reported as median values with the interquartile range. In the IA group, the maximal, mean, and minimal dose given to the gross tumor volume was 68.7 Gy-Eq (range, 38.8-79.9), 45.0 Gy-Eq (range, 25.1-51.0), and 13.8 Gy-Eq (range, 4.8-25.3), respectively. In the IV group, the maximal, mean, and minimal dose given to the gross tumor volume was 24.2 Gy-Eq (range, 21.5-29.9), 16.4 Gy-Eq (range, 14.5-20.2), and 7.8 Gy-Eq (range, 6.8-9.5), respectively. Within 1-3 months after BNCT, the responses were assessed. Of the 6 patients in the IV group, 2 had a partial response, 3 no change, and 1 had progressive disease. Of 4 patients in the IA group, 1 achieved a complete response and 3 a partial response. Conclusion: Intra-arterial administration of boronophenylalanine is a promising drug delivery system for head-and-neck BNCT

  17. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

  18. 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%.

  19. 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 pushing the fetal head up through the vagina.

  20. Locally Advanced Stage IV Squamous Cell Carcinoma of the Head and Neck: Impact of Pre-Radiotherapy Hemoglobin Level and Interruptions During Radiotherapy

    International Nuclear Information System (INIS)

    Rades, Dirk; Stoehr, Monika; Kazic, Nadja; Hakim, Samer G.; Walz, Annette; Schild, Steven E.; Dunst, Juergen

    2008-01-01

    Purpose: Stage IV head and neck cancer patients carry a poor prognosis. Clear understanding of prognostic factors can help to optimize care for the individual patient. This study investigated 11 potential prognostic factors including pre-radiotherapy hemoglobin level and interruptions during radiotherapy for overall survival (OS), metastases-free survival (MFS), and locoregional control (LC) after radiochemotherapy. Methods and Materials: Eleven factors were investigated in 153 patients receiving radiochemotherapy for Stage IV squamous cell head and neck cancer: age, gender, Karnofsky performance score (KPS), tumor site, grading, T stage, N stage, pre-radiotherapy hemoglobin level, surgery, chemotherapy type, and interruptions during radiotherapy >1 week. Results: On multivariate analysis, improved OS was associated with KPS 90-100 (relative risk [RR], 2.36; 95% confidence interval [CI], 1.20-4.93; p = .012), hemoglobin ≥12 g/dL (RR, 1.88; 95% CI, 1.01-3.53; p = .048), and no radiotherapy interruptions (RR, 2.59; 95% CI, 1.15-5.78; p = .021). Improved LC was significantly associated with lower T stage (RR, 2.17; 95% CI, 1.16-4.63; p = .013), hemoglobin ≥12 g/dL (RR, 4.12; 95% CI, 1.92-9.09; p 1 week. It appears important to avoid anemia and radiotherapy interruptions to achieve the best treatment results

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

    Science.gov (United States)

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

    2017-01-01

    Context: 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. Objective: To assess available head-impact devices and their clinical utility. Data Sources: 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. Study Selection: Included studies were performed in vivo, used commercially available devices, and focused on sport-related concussion. Data Extraction: 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. Data Synthesis: 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. Conclusions: 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

  2. 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

  3. 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

  4. Head CT scan

    Science.gov (United States)

    ... scan - orbits; CT scan - sinuses; Computed tomography - cranial; CAT scan - brain ... head size in children Changes in thinking or behavior Fainting Headache, when you have certain other signs ...

  5. Bottom head assembly

    International Nuclear Information System (INIS)

    Fife, A.B.

    1998-01-01

    A bottom head dome assembly is described which includes, in one embodiment, a bottom head dome and a liner configured to be positioned proximate the bottom head dome. The bottom head dome has a plurality of openings extending there through. The liner also has a plurality of openings extending there through, and each liner opening aligns with a respective bottom head dome opening. A seal is formed, such as by welding, between the liner and the bottom head dome to resist entry of water between the liner and the bottom head dome at the edge of the liner. In the one embodiment, a plurality of stub tubes are secured to the liner. Each stub tube has a bore extending there through, and each stub tube bore is coaxially aligned with a respective liner opening. A seat portion is formed by each liner opening for receiving a portion of the respective stub tube. The assembly also includes a plurality of support shims positioned between the bottom head dome and the liner for supporting the liner. In one embodiment, each support shim includes a support stub having a bore there through, and each support stub bore aligns with a respective bottom head dome opening. 2 figs

  6. Prevalence and impact of diffuse axonal injury in patients with moderate and severe head injury: a cohort study of early magnetic resonance imaging findings and 1-year outcome.

    Science.gov (United States)

    Skandsen, Toril; Kvistad, Kjell Arne; Solheim, Ole; Strand, Ingrid Haavde; Folvik, Mari; Vik, Anne

    2010-09-01

    In this prospective cohort study the authors examined patients with moderate to severe head injuries using MR imaging in the early phase. The objective was to explore the occurrence of diffuse axonal injury (DAI) and determine whether DAI was related to level of consciousness and patient outcome. One hundred and fifty-nine patients (age range 5-65 years) with traumatic brain injury, who survived the acute phase, and who had a Glasgow Coma Scale (GCS) score of 3-13 were admitted between October 2004 and August 2008. Of these 159 patients, 106 were examined using MR imaging within 4 weeks postinjury. Patients were classified into 1 of 3 stages of DAI: Stage 1, in which lesions were confined to the lobar white matter; Stage 2, in which there were callosal lesions; and Stage 3, in which lesions occurred in the dorsolateral brainstem. The outcome measure used 12 months postinjury was the Glasgow Outcome Scale-Extended (GOSE). Diffuse axonal injury was detected in 72% of the patients and a combination of DAI and contusions or hematomas was found in 50%. The GCS score was significantly lower in patients with "pure DAI" (median GCS Score 9) than in patients without DAI (median GCS Score 12; p GOSE score of 7, and patients without DAI had a median GOSE score of 8 (p = 0.10). Outcome was better in patients with DAI Stage 1 (median GOSE Score 8) and DAI Stage 2 (median GOSE Score 7.5) than in patients with DAI Stage 3 (median GOSE Score 4; p < 0.001). Thus, in patients without any brainstem injury, there was no difference in good recovery between patients with DAI (67%) and patients without DAI (66%). Diffuse axonal injury was found in almost three-quarters of the patients with moderate and severe head injury who survived the acute phase. Diffuse axonal injury influenced the level of consciousness, and only in patients with DAI was GCS score related to outcome. Finally, DAI was a negative prognostic sign only when located in the brainstem.

  7. 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.

  8. Impact of daily anatomical changes on EPID-based in vivo dosimetry of VMAT treatments of head-and-neck cancer

    International Nuclear Information System (INIS)

    Rozendaal, Roel A.; Mijnheer, Ben J.; Hamming-Vrieze, Olga; Mans, Anton; Herk, Marcel van

    2015-01-01

    Background and purpose: Target dose verification for VMAT treatments of head-and-neck (H&N) cancer using 3D in vivo EPID dosimetry is expected to be affected by daily anatomical changes. By including these anatomical changes through cone-beam CT (CBCT) information, the magnitude of this effect is investigated. Materials and methods: For 20 VMAT-treated H&N cancer patients, all plan-CTs (pCTs), 633 CBCTs and 1266 EPID movies were used to compare four dose distributions per fraction: treatment planning system (TPS) calculated dose and EPID reconstructed in vivo dose, both determined using the pCT and using the CBCT. D2, D50 and D98 of the planning target volume (PTV) were determined per dose distribution. Results: When including daily anatomical information, D2, D50 and D98 of the PTV change on average by 0.0 ± 0.4% according to TPS calculations; the standard deviation of the difference between EPID and TPS target dose changes from 2.5% (pCT) to 2.1% (CBCT). Small time trends are seen for both TPS and EPID dose distributions when using the pCT, which disappear when including CBCT information. Conclusions: Daily anatomical changes hardly influence the target dose distribution for H&N VMAT treatments according to TPS recalculations. Including CBCT information in EPID dose reconstructions slightly improves the agreement with TPS calculations

  9. 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.

  10. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head Computed tomography (CT) of the head uses special x-ray equipment ... story here Images × Image Gallery Patient undergoing computed tomography (CT) scan. View full size with caption Pediatric Content ...

  11. 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 ...

  12. Reactor head shielding apparatus

    International Nuclear Information System (INIS)

    Schukei, G.E.; Roebelen, G.J.

    1992-01-01

    This patent describes a nuclear reactor head shielding apparatus for mounting on spaced reactor head lifting members radially inwardly of the head bolts. It comprises a frame of sections for mounting on the lifting members and extending around the top central area of the head, mounting means for so mounting the frame sections, including downwardly projecting members on the frame sections and complementary upwardly open recessed members for fastening to the lifting members for receiving the downwardly projecting members when the frame sections are lowered thereto with lead shielding supported thereby on means for hanging lead shielding on the frame to minimize radiation exposure or personnel working with the head bolts or in the vicinity thereof

  13. Moneyball for Head Start: Using Data, Evidence, and Evaluation to Improve Outcomes for Children and Families

    Science.gov (United States)

    Mead, Sara; Mitchel, Ashley LiBetti

    2016-01-01

    Head Start is a valuable federal program that improves the lives of our nation's most vulnerable children and their families. Research shows that Head Start programs improve children's learning at school entry and have a positive impact on long-term life outcomes. Research also suggests that Head Start could have a stronger impact on children's…

  14. Failure of misonidazole-sensitized radiotherapy to impact upon outcome among stage III-IV squamous cancers of the head and neck

    International Nuclear Information System (INIS)

    Fazekas, J.; Pajak, T.F.; Wasserman, T.; Marcial, V.; Davis, L.; Kramer, S.; Rotman, M.; Stetz, J.

    1987-01-01

    As part of the RTOG research effort in the treatment of advanced, inoperable squamous cancer of the head and neck region, the hypoxic cell sensitizer, misonidazole, was selected for investigation as an adjuvant to definitive irradiation. Based upon a pilot experience (78-02) showing a 67% complete response rate among 36 AJC Stage III-IV patients receiving full-dose irradiation and 6 weekly p.o. doses of misonidazole, a phase III trial was carried out from '79-'83. Three hundred and six patients were entered, 42% of whom had oropharyngeal primaries and with 78% of all cases representing T3 or T4 (inoperable) lesions. Only 16% of the entire series presented with N0 necks. Fractionation was altered among the misonidazole-receiving patients, in contrast to standard 5 treatments per week among control patients, such that 2 separate treatments were given on each day of p.o. misonidazole administration (2.0 gm/m2/wk X 6 doses, 2.5 Gy in a.m., 2.1 Gy in p.m.). Total tumor doses were identical among the two treatment arms except that a limitation of 40.0 Gy to spinal cord was specified for sensitized radiotherapy vs. 45.0 Gy for control patients. Primary tumor clearance was observed to be 55-60%, with minor variations according to tumor stage and site. The local regional control rate among radiotherapy-alone patients was 26% at 2 years compared to 22% (2 years) within the misonidazole-receiving group. Analysis of survival revealed no advantage to the sensitized patients, with 55 +/- 2% surviving 1 year and 22 +/- 1% living 3 years following treatment in both treatment categories. Distant metastases as first site of failure (12-13%) and the local failure among initial complete responders (46%) showed no advantage to the misonidazole group. Although a misonidazole dosage of 2.0 gm/m2/wk X 6 (12 gm/m2 total) is well tolerated, no clinical benefit was demonstrated in this randomized trial

  15. 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

  16. Locoregionally Advanced Head and Neck Cancer Treated With Primary Radiotherapy: A Comparison of the Addition of Cetuximab or Chemotherapy and the Impact of Protocol Treatment

    International Nuclear Information System (INIS)

    Caudell, Jimmy J.; Sawrie, Stephen M.; Spencer, Sharon A.; Desmond, Renee A.; Carroll, William R.; Peters, Glenn E.; Nabell, Lisle M.; Meredith, Ruby F.; Bonner, James A.

    2008-01-01

    Purpose: The addition of platinum-based chemotherapy (ChRT) or cetuximab (ExRT) to concurrent radiotherapy (RT) has resulted in improved survival in Phase III studies for locoregionally advanced head and neck cancer (LAHNC). However the optimal treatment regimen has not been defined. A retrospective study was performed to compare outcomes in patients who were treated definitively with ExRT or ChRT. Methods: Cetuximab with concurrent RT was used to treat 29 patients with LAHNC, all of whom had tumors of the oral cavity, oropharynx, or larynx. All patients were T2 to T4 and overall American Joint Committee on Cancer Stage III to IVB, with a Karnofsky Performance Status (KPS) score of 60 or greater. ChRT was used to treat 103 patients with similar characteristics. Patients were evaluated for locoregional control (LRC), distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS). Median follow-up for patients alive at last contact was 83 months for those treated with ExRT and 53 months for those treated with ChRT. Cox proportional hazard models were used to assess independent prognostic factors. Results: The LRC, DMFS, and DSS were not significantly different, with 3-year rates of 70.7%, 92.4%, and 78.6% for ExRT and 74.7%, 86.6%, and 76.5% for ChRT, respectively. The OS was significantly different between the two groups (p = 0.02), with 3-year rates of 75.9% for ExRT and 61.3% for ChRT. OS was not significant when patients who were on protocol treatments of ExRT or ChRT were compared. Also, OS was not significant when multivariate analysis was used to control for potential confounding factors. Conclusion: In our single-institution retrospective review of patients treated with ExRT or ChRT, no significant differences were found in LRC, DMFS, DSS, or OS

  17. Evaluation of the radiobiological impact of anatomic modifications during radiation therapy for head and neck cancer: Can we simply summate the dose?

    International Nuclear Information System (INIS)

    Orban de Xivry, Jonathan; Castadot, Pierre; Janssens, Guillaume; Lee, John Aldo; Geets, Xavier; Gregoire, Vincent; Macq, Benoit

    2010-01-01

    Background and purpose: Adaptive strategies in radiotherapy (RT) require the knowledge of the total dose given to every organ of the body. Because of anatomical changes and setup errors non-rigid registration is necessary to map the different dose fractions to a common reference. This study evaluates practically if the accumulation of all of these registered dose fractions must take radiobiology into account in a classical clinical setting. Materials and methods: Ten patients with head and neck tumors treated by chemo-RT were used. Contrast-enhanced CT scans were acquired prior and during RT following delivery of mean doses of 14.2, 24.5, 35.0 and 44.9 Gy and the planned pre-treatment helical tomotherapy sinograms were applied on the per-treatment CTs to create a series of per-treatment dose distributions corresponding to each per-treatment CT image. In order to calculate the cumulative dose distribution, the per-treatment dose maps were non-rigidly deformed by using the deformation map computed by a non-rigid registration. The deformed dose maps were then summed in two ways: one while taking radiobiology into account and one without. These two strategies were compared using clinical surrogates in the target volumes (TV) and in surrounding organs at risk (OAR). Results: The differences between the strategies, while statistically significant (p < 0.05), are clinically irrelevant. In the OARs, the mean differences stay in the 0.01-0.07 Gy range for the total dose. In the targets, all mean differences stay in the 0.001-0.012 Gy range. However, some local high difference spots appear leading to punctual errors as high as 2.5 Gy. Conclusion: If using current radiotherapy practices and clinical recommendations based on dose surrogates computed globally on OARs and TVs, one does not need to take radiobiological effects into account while accumulating total dose as these lead to very small differences compared to a simple accumulation technique consisting of a linear sum

  18. The impact of high total cholesterol and high low-density lipoprotein on avascular necrosis of the femoral head in low-energy femoral neck fractures.

    Science.gov (United States)

    Zeng, Xianshang; Zhan, Ke; Zhang, Lili; Zeng, Dan; Yu, Weiguang; Zhang, Xinchao; Zhao, Mingdong; Lai, Zhicheng; Chen, Runzhen

    2017-02-17

    Avascular necrosis of the femoral head (AVNFH) typically constitutes 5 to 15% of all complications of low-energy femoral neck fractures, and due to an increasingly ageing population and a rising prevalence of femoral neck fractures, the number of patients who develop AVNFH is increasing. However, there is no consensus regarding the relationship between blood lipid abnormalities and postoperative AVNFH. The purpose of this retrospective study was to investigate the relationship between blood lipid abnormalities and AVNFH following the femoral neck fracture operation among an elderly population. A retrospective, comparative study was performed at our institution. Between June 2005 and November 2009, 653 elderly patients (653 hips) with low-energy femoral neck fractures underwent closed reduction and internal fixation with cancellous screws (Smith and Nephew, Memphis, Tennessee). Follow-up occurred at 1, 6, 12, 18, 24, 30, and 36 months after surgery. Logistic multi-factor regression analysis was used to assess the risk factors of AVNFH and to determine the effect of blood lipid levels on AVNFH development. Inclusion and exclusion criteria were predetermined to focus on isolated freshly closed femoral neck fractures in the elderly population. The primary outcome was the blood lipid levels. The secondary outcome was the logistic multi-factor regression analysis. A total of 325 elderly patients with low-energy femoral neck fractures (AVNFH, n = 160; control, n = 165) were assessed. In the AVNFH group, the average TC, TG, LDL, and Apo-B values were 7.11 ± 3.16 mmol/L, 2.15 ± 0.89 mmol/L, 4.49 ± 1.38 mmol/L, and 79.69 ± 17.29 mg/dL, respectively; all of which were significantly higher than the values in the control group. Logistic multi-factor regression analysis showed that both TC and LDL were the independent factors influencing the postoperative AVNFH within femoral neck fractures. This evidence indicates that AVNFH was significantly

  19. Femoral head avascular necrosis

    International Nuclear Information System (INIS)

    Chrysikopoulos, H.; Sartoris, D.J.; Resnick, D.L.; Ashburn, W.; Pretorius, T.

    1988-01-01

    MR imaging has been shown to be more sensitive and specific than planar scintigraphy for avascular necrosis (AVN) of the femoral head. However, experience with single photon emission CT (SPECT) is limited. The authors retrospectively compared 1.5-T MR imaging with SPECT in 14 patients with suspected femoral head AVN. Agreement between MR imaging and SPECT was present in 24 femurs, 14 normal and ten with AVN. MR imaging showed changes of AVN in the remaining four femoral heads. Of these, one was normal and the other three inconclusive for AVN by SPECT. The authors conclude that MR imaging is superior to SPECT for the evaluation of AVN of the hip

  20. Protective head of sensors

    International Nuclear Information System (INIS)

    Liska, K.; Anton, P.

    1987-01-01

    The discovery concerns the protective heads of diagnostic assemblies of nuclear power plants for conductors of the sensors from the fuel and control parts of the said assemblies. A detailed description is presented of the design of the protective head which, as compared with the previous design, allows quick and simple assembly with reduced risk of damaging the sensors. The protective head may be used for diagnostic assemblies both in power and in research reactors and it will be used for WWER reactor assemblies. (A.K.). 3 figs

  1. 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.

  2. 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

  3. Do head-restraints protect the neck from whiplash injuries?

    Science.gov (United States)

    Morris, F

    1989-01-01

    Over an 11-month period a study was made of all patients presenting to an accident and emergency department who had sustained whiplash as a result of rear-bumper impacts. The patients were analysed with respect to the presence of head-restraints in their vehicles. A significant increase in the incidence of whiplash was found in patients whose vehicles did not have head-restraints fitted. Legislation requiring all passenger cars to have head-restraints fitted as standard would have a major impact in reducing the number of whiplash injuries sustained in rear bumper impacts. PMID:2712983

  4. 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 ...

  5. Exploding head syndrome.

    Science.gov (United States)

    Sharpless, Brian A

    2014-12-01

    Exploding head syndrome is characterized by the perception of abrupt, loud noises when going to sleep or waking up. They are usually painless, but associated with fear and distress. In spite of the fact that its characteristic symptomatology was first described approximately 150 y ago, exploding head syndrome has received relatively little empirical and clinical attention. Therefore, a comprehensive review of the scientific literature using Medline, PsycINFO, Google Scholar, and PubMed was undertaken. After first discussing the history, prevalence, and associated features, the available polysomnography data and five main etiological theories for exploding head syndrome are summarized. None of these theories has yet reached dominance in the field. Next, the various methods used to assess and treat exploding head syndrome are discussed, as well as the limited outcome data. Finally, recommendations for future measure construction, treatment options, and differential diagnosis are provided. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. 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 ...

  7. 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...

  8. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... top of page Additional Information and Resources RTAnswers.org Radiation Therapy for Brain Tumors Radiation Therapy for ... Tomography (CT) - Head Sponsored by Please note RadiologyInfo.org is not a medical facility. Please contact your ...

  9. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... of the Head? Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic ... white on the x-ray; soft tissue, such as organs like the heart or liver, shows up ...

  10. 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 ...

  11. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... rays). top of page What are some common uses of the procedure? CT scanning of the head ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

  12. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... rays). top of page What are some common uses of the procedure? CT scanning of the head ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  13. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Stroke Brain Tumors Computer Tomography (CT) Safety During Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Computed Tomography (CT) - ...

  14. 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).

  15. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... your doctor to evaluate your face, sinuses, and skull or to plan radiation therapy for brain cancer. ... typically used to detect: bleeding, brain injury and skull fractures in patients with head injuries. bleeding caused ...

  16. The exploding head syndrome.

    Science.gov (United States)

    Green, M W

    2001-06-01

    This article reviews the features of an uncommon malady termed "the exploding head syndrome." Sufferers describe terrorizing attacks of a painless explosion within their head. Attacks tend to occur at the onset of sleep. The etiology of attacks is unknown, although they are considered to be benign. Treatment with clomipramine has been suggested, although most sufferers require only reassurance that the spells are benign in nature.

  17. Target definition in prostate, head, and neck

    NARCIS (Netherlands)

    Rasch, Coen; Steenbakkers, Roel; van Herk, Marcel

    2005-01-01

    Target definition is a major source of errors in both prostate and head and neck external-beam radiation treatment. Delineation errors remain constant during the course of radiation and therefore have a large impact on the dose to the tumor. Major sources of delineation variation are visibility of

  18. GPK heading machine

    Energy Technology Data Exchange (ETDEWEB)

    Krmasek, J.; Novosad, K.

    1981-01-01

    This article evaluates performance tests of the Soviet made GPK heading machine carried out in 4 coal mines in Czechoslovakia (Ostrava-Karvina region and Kladno mines). GPK works in coal seams and rocks with compression strength of 40 to 50 MPa. Dimensions of the tunnel are height 1.8 to 3.8 m and width 2.6 to 4.7 m, tunnel gradient plus to minus 10 degrees. GPK weighs 16 t, its conical shaped cutting head equipped with RKS-1 cutting tools is driven by an electric motor with 55 kW capacity. Undercarriage of the GPK, gathering-arm loader, hydraulic system, electric system and dust supression system (water spraying or pneumatic section) are characterized. Specifications of GPK heading machines are compared with PK-3r and F8 heading machines. Reliability, number of failures, dust level, noise, productivity depending on compression strength of rocks, heading rate in coal and in rocks, energy consumption, performance in inclined tunnels, and cutting tool wear are evaluated. Tests show that GPK can be used to drive tunnels in coal with rock constituting up to 50% of the tunnel crosscut, as long as rock compression strength does not exceed 50 MPa. In rocks characterized by higher compression strength cutting tool wear sharply increases. GPK is characterized by higher productivity than that of the PK-3r heading machine. Among the weak points of the GPK are: unsatisfactory reliability and excessive wear of its elements. (4 refs.) (In Czech)

  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. 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 uses a powerful ... the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

  1. 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 ... the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

  2. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

  3. Head, Neck, and Oral Cancer

    Science.gov (United States)

    ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

  4. 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.; 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.

    2016-01-01

    Purpose A 5yr, 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. Methods A home program, performed 2×/day, 6d/wk, for 12wks 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 12wk intervention period. “Compliant” was defined as performing 10-12 sessions/wk. Outcomes were change in PAS, HNCI, PSS, OPSE, and hyoid excursion. ANCOVA analyses determined if outcomes differed between real/sham and compliant/noncompliant groups after 12wks of therapy. Results Of the 170 patients enrolled, 153 patients had compliance data. The mean number of sessions performed was 8.57/wk (median=10.25). Fifty four percent of patients (n=83) were considered “compliant”. After 12wks 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. Conclusions 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. PMID:27848021

  5. Effect of head restraint backset on head-neck kinematics in whiplash.

    Science.gov (United States)

    Stemper, Brian D; Yoganandan, Narayan; Pintar, Frank A

    2006-03-01

    Although head restraints were introduced in the 1960s as a countermeasure for whiplash, their limited effectiveness has been attributed to incorrect positioning. The effect of backset on cervical segmental angulations, which were previously correlated with spinal injury, has not been delineated. Therefore, the practical restraint position to minimize injury remains unclear. A parametric study of increasing head restraint backset between 0 and 140mm was conducted using a comprehensively validated computational model. Head retraction values increased with increasing backset, reaching a maximum value of 53.5mm for backsets greater than 60mm. Segmental angulation magnitudes, greatest at levels C5-C6 and C6-C7, reached maximum values during the retraction phase and increased with increasing backset. Results were compared to a previously published head restraint rating system, wherein lower cervical extension magnitudes from this study exceeded mean physiologic limits for restraint positions rated good, acceptable, marginal, and poor. As head restraint contact was the limiting factor in head retraction and segmental angulations, the present study indicates that minimizing whiplash injury may be accomplished by limiting head restraint backset to less than 60mm either passively or actively after impact.

  6. 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.

  7. 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

    International Nuclear Information System (INIS)

    Wang Zhonghe; Yan Chao; Zhang Zhiyuan; Zhang Chenping; Hu Haisheng; Tu Wenyong; Kirwan, Jessica; Mendenhall, William M.

    2011-01-01

    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.

  8. Treatment, patient and tumor characteristics impact quality of life (QOL) in patients with locally advanced head and neck cancer: Report of the radiation therapy oncology group (RTOG) trial 90-03

    International Nuclear Information System (INIS)

    Fisher, J.; Scott, C.; Fu, K.; Trotti, A.; Spencer, S.; Garden, A.; Phillips, T.; Movsas, B.; Byhardt, R.; Ang, K.

    2001-01-01

    Purpose: To determine factors that effect QOL in patients with locally advanced squamous cell cancer of the head and neck randomized to standard fractionation radiotherapy (SFX), hyperfractionation (HFX), Accelerated Fractionation with Split (AFX-S) and Accelerated Fractionation with Concomitant Boost (AFX-C). Materials and Methods: RTOG 90-03 used the Head and Neck Performance Status Scale (HNPSS) and the Functional Assessment of Cancer Therapy (FACT-H and N), version 2 to assess QOL. The HNPSS has three components Normalcy of Diet, Eating in Public, and Understandability of Speech. The FACT-H and N has two components: a global QOL questionnaire (FACT-G) consisting of 4 domains; Physical Well Being (PWB), Social Well Being (SWB), Emotional Well Being (EWB), Functional Well Being (FWB), and an additional H and N specific questionnaire (AC). Between 3/92 and 8/97, 1113 pts. were randomized; 718 completed a pretreatment FACT-H and N. Pts. completed the HNPSS and FACT-H and N; pretreatment, 4 weeks post-RT, every 3 months for 1 year. Results: Prior to the start of radiotherapy (RT) 48% of pts had normal diets, 64% had normal public eating, and 77% had normal speech. Age ( 60), KPS, tumor site (oral cavity vs. other), T-stage (T3+T4 vs. T1+T2+TX), N-stage (N0 vs. other), Race (Non-White vs. White), and marital status (single vs. married), FACT-G, PWB, EWB, FWB, AC, use of oral nutrient supplements, feeding tube, and parenteral nutrition predicted for pretreatment diet, public eating, and speech. During the acute toxicity phase diet, eating, and speech were related to the intensity of RT (HFX or AFX-C), marital status (single), tumor site (oral cavity), use of oral nutrient supplements, and feeding tube. At one-year oral cavity tumors, AFX-C, oral nutrient supplements, feeding tube, and single patients had worse diet, eating, and speech. Conclusion: Pretreatment patient and tumor characteristics impact on QOL prior to the initiation of therapy. Intensification of

  9. 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.

  10. 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

  11. 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

  12. Facial preservation following extreme mummification: Shrunken heads.

    Science.gov (United States)

    Houlton, Tobias M R; Wilkinson, Caroline

    2018-05-01

    Shrunken heads are a mummification phenomenon unique to South America. Ceremonial tsantsa are ritually reduced heads from enemy victims of the Shuar, Achuar, Awajún (Aguaruna), Wampís (Huambisa), and Candoshi-Shapra cultures. Commercial shrunken heads are comparatively modern and fraudulently produced for the curio-market, often using stolen bodies from hospital mortuaries and graves. To achieve shrinkage and desiccation, heads undergo skinning, simmering (in water) and drying. Considering the intensive treatments applied, this research aims to identify how the facial structure can alter and impact identification using post-mortem depiction. Sixty-five human shrunken heads were assessed: 6 ceremonial, 36 commercial, and 23 ambiguous. Investigations included manual inspection, multi-detector computerised tomography, infrared reflectography, ultraviolet fluorescence and microscopic hair analysis. The mummification process disfigures the outer face, cheeks, nasal root and bridge form, including brow ridge, eyes, ears, mouth, and nose projection. Melanin depletion, epidermal degeneration, and any applied staining changes the natural skin complexion. Papillary and reticular dermis separation is possible. Normal hair structure (cuticle, cortex, medulla) is retained. Hair appears longer (unless cut) and more profuse following shrinkage. Significant features retained include skin defects, facial creases, hairlines and earlobe form. Hair conditions that only affect living scalps are preserved (e.g. nits, hair casts). Ear and nose cartilage helps to retain some morphological information. Commercial heads appear less distorted than ceremonial tsantsa, often presenting a definable eyebrow shape, vermillion lip shape, lip thickness (if mouth is open), philtrum form, and palpebral slit angle. Facial identification capabilities are considered limited, and only perceived possible for commercial heads. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. 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 i...

  14. 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 ...

  15. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... are present in the paranasal sinuses. plan radiation therapy for cancer of the brain or other tissues. guide the ... RTAnswers.org Radiation Therapy for Brain Tumors Radiation Therapy for Head and Neck Cancer Others American Stroke Association National Stroke Association top ...

  16. 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 ( ...

  17. The Twente humanoid head

    NARCIS (Netherlands)

    Reilink, Rob; Visser, L.C.; Bennik, J.; Carloni, Raffaella; Brouwer, Dannis Michel; Stramigioli, Stefano

    2009-01-01

    This video shows the results of the project on the mechatronic development of the Twente humanoid head. The mechanical structure consists of a neck with four degrees of freedom (DOFs) and two eyes (a stereo pair system) which tilt on a common axis and rotate sideways freely providing a three more

  18. 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

  19. Low head hydro market assessment : main report : vol. 1

    International Nuclear Information System (INIS)

    2008-03-01

    Hydroelectric power is a predictable renewable energy source that produces no greenhouse gases (GHGs) and has low maintenance costs. In addition to river resources, low head hydro is available in sluice gates, irrigation canals, drinking water pressure release valves, and municipal wastewater outfalls. Canada's potential for low head hydro has been estimated at 5000 MW at 2000 different sites across the country. Sites of up to 50 MW have been identified in Ontario and Manitoba. This study performed a market assessment on low head hydro developments. Available and emerging technologies for developing low head hydro were identified. The economics of low head hydro in Canada were explored, and barriers to low head hydro development were identified. Strategies to promote low head hydro development were also explored, and the impact of different incentive types on the low head hydropower market were estimated using a simple economic model. It was concluded that a reduced, streamlined, and standardized environmental assessment process will significantly benefit low head hydro development in Canada. 5 refs., 14 tabs., 17 figs

  20. 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.

  1. Head and Neck Cancer Treatment

    Science.gov (United States)

    ... Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer overview What are my ... and neck cancer. For updated information on new cancer treatments that are available, you should discuss these issues ...

  2. 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 ( ...

  3. 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 ...

  4. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with ... and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with ...

  5. Head Lice: Prevention and Control

    Science.gov (United States)

    ... and General Public. Contact Us Parasites Home Prevention & Control Language: English (US) Español (Spanish) Recommend on Facebook ... that can be taken to help prevent and control the spread of head lice: Avoid head-to- ...

  6. Every Newton Hertz: a macro to micro approach to investigating brain injury.

    Science.gov (United States)

    Duma, Stefan M; Rowson, Steven

    2009-01-01

    The high incidence of concussion in contact sports provides a unique opportunity to collect data to characterize mild traumatic brain injury. This paper outlines a macro to micro approach in which the organ level response of the head is analyzed through head acceleration data from human volunteers and the tissue level response is analyzed through finite element analysis of these data. The helmets of Virginia Tech football players are instrumented with multi-accelerometer measurement devices to record linear and rotational head accelerations for every impact during a game or practice. These impacts are then modeled using the Simulated Injury Monitor (SIMon) finite element head model. Cumulative strain damage measure was investigated for the impacts resulting in the high linear and rotational accelerations. The effect of head impacts on functional performance in football players is also investigated to identify any cognitive effects from repetitive sub-concussive impacts. A better understanding of the effects of head impacts and the mechanisms of brain injury will likely result in insight to future head injury prevention methods and cellular research on brain injury.

  7. MRI in head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jin Kyo [Shin Wha Hospital, Seoul (Korea, Republic of)

    1986-02-15

    In the diagnosis of head injury, Magnetic Resonance Imaging (MRI), like CT, is an effective method of distinguishing between intracerebral and extracerebral lesions. In our experience of MRI, early hematomas are almost isointense by Saturation Recovery (SR) method, so these must be performed with Spin Echo (SE) method for better visualization of hematomas. Isodense subdural hematomas, which is a diagnostic dilemma on CT images, are clearly seen on MRI. Delayed hematomas or residual parenchymal lesions are better demonstrated on MRI than on CT. Direct cornal, sagittal images and multiplanar facility of MRI provides excellent visualization of the the location and shape of extracerebral collection of hematoma. For the screening of head traumas, SE method is a technique of choice because of its excellent sensitivity within limited time.

  8. Where is Russia heading?

    Directory of Open Access Journals (Sweden)

    Natalija Pliskevič

    1999-10-01

    Full Text Available The author examines the proceedings from the collection Where is Russia Heading? (= Куда идёт Россия?, published between 1994 and 1998 in connection with the international symposium held under this name each year in Moscow. The symposia and their proceeding, involving leading Russian and foreign experts, were significant in that they encompassed a wide range of themes – social, economic, political, legislative, cultural and other transformations that have been occurring in Russia during the past decades. The author, however, limits her review to contributions dealing with ethno-political and socio-cultural transformations in Russia. She concludes that the question – “Where is Russia heading?” – still remains open to answers.

  9. MRI in head trauma

    International Nuclear Information System (INIS)

    Hong, Jin Kyo

    1986-01-01

    In the diagnosis of head injury, Magnetic Resonance Imaging (MRI), like CT, is an effective method of distinguishing between intracerebral and extracerebral lesions. In our experience of MRI, early hematomas are almost isointense by Saturation Recovery (SR) method, so these must be performed with Spin Echo (SE) method for better visualization of hematomas. Isodense subdural hematomas, which is a diagnostic dilemma on CT images, are clearly seen on MRI. Delayed hematomas or residual parenchymal lesions are better demonstrated on MRI than on CT. Direct cornal, sagittal images and multiplanar facility of MRI provides excellent visualization of the the location and shape of extracerebral collection of hematoma. For the screening of head traumas, SE method is a technique of choice because of its excellent sensitivity within limited time.

  10. "Head versus heart"

    Directory of Open Access Journals (Sweden)

    Paul Rozin

    2007-08-01

    Full Text Available Most American respondents give ``irrational,'' magical responses in a variety of situations that exemplify the sympathetic magical laws of similarity and contagion. In most of these cases, respondents are aware that their responses (usually rejections, as of fudge crafted to look like dog feces, or a food touched by a sterilized, dead cockroach are not ``scientifically'' justified, but they are willing to avow them. We interpret this, in some sense, as ``heart over head.'' We report in this study that American adults and undergraduates are substantially less likely to acknowledge magical effects when the judgments involve money (amount willing to pay to avoid an ``unpleasant'' magical contact than they are when using preference or rating measures. We conclude that in ``head-heart'' conflicts of this type, money tips the balance towards the former, or, in other words, that money makes the mind less magical.

  11. [The exploding head syndrome].

    Science.gov (United States)

    Bongers, K M; ter Bruggen, J P; Franke, C L

    1991-04-06

    The case is reported of a 47-year old female suffering from the exploding head syndrome. This syndrome consists of a sudden awakening due to a loud noise shortly after falling asleep, sometimes accompanied by a flash of light. The patient is anxious and experiences palpitations and excessive sweating. Most patients are more than fifty years of age. Further investigations do not reveal any abnormality. The pathogenesis is unknown, and no therapy other than reassurance is necessary.

  12. Where are we heading

    International Nuclear Information System (INIS)

    Noto, L.A.

    1996-01-01

    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

  13. "Head versus heart"

    OpenAIRE

    Paul Rozin; Heidi Grant; Stephanie Weinberg; Scott Parker

    2007-01-01

    Most American respondents give ``irrational,'' magical responses in a variety of situations that exemplify the sympathetic magical laws of similarity and contagion. In most of these cases, respondents are aware that their responses (usually rejections, as of fudge crafted to look like dog feces, or a food touched by a sterilized, dead cockroach) are not ``scientifically'' justified, but they are willing to avow them. We interpret this, in some sense, as ``heart over head.'' We report in this ...

  14. Head segmentation in vertebrates

    OpenAIRE

    Kuratani, Shigeru; Schilling, Thomas

    2008-01-01

    Classic theories of vertebrate head segmentation clearly exemplify the idealistic nature of comparative embryology prior to the 20th century. Comparative embryology aimed at recognizing the basic, primary structure that is shared by all vertebrates, either as an archetype or an ancestral developmental pattern. Modern evolutionary developmental (Evo-Devo) studies are also based on comparison, and therefore have a tendency to reduce complex embryonic anatomy into overly simplified patterns. Her...

  15. Radiofrequency ablation of two femoral head chondroblastomas

    Energy Technology Data Exchange (ETDEWEB)

    Petsas, Theodore [Department of Radiology, University of Patras (Greece); Megas, Panagiotis [Department of Orthopaedic Surgery, University of Patras (Greece)]. E-mail: panmegas@med.upatras.gr; Papathanassiou, Zafiria [Department of Radiology, University of Patras (Greece)

    2007-07-15

    Chondroblastoma is a rare benign cartilaginous bone tumor. Surgical resection is the treatment of choice for pain relief and prevention of further growth. Open surgical techniques are associated with complications, particularly when the tumors are located in deep anatomical sites. The authors performed RF ablation in two cases of subarticular femoral head chondroblastomas and emphasize its positive impact. The clinical course, the radiological findings and the post treatment results are discussed.

  16. 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

  17. BIOMECHANICS OF HEAD INJURY IN OLYMPIC TAEKWONDO AND BOXING

    Science.gov (United States)

    Fife, G.P.; Pieter, W.

    2013-01-01

    Objective The purpose was to examine differences between taekwondo kicks and boxing punches in resultant linear head acceleration (RLA), head injury criterion (HIC15), peak head velocity, and peak foot and fist velocities. Data from two existing publications on boxing punches and taekwondo kicks were compared. Methods For taekwondo head impacts a Hybrid II Crash Dummy (Hybrid II) head was instrumented with a tri-axial accelerometer mounted inside the Hybrid II head. The Hybrid II was fixed to a height-adjustable frame and fitted with a protective taekwondo helmet. For boxing testing, a Hybrid III Crash Dummy head was instrumented with an array of tri-axial accelerometers mounted at the head centre of gravity. Results Differences in RLA between the roundhouse kick (130.11±51.67 g) and hook punch (71.23±32.19 g, d = 1.39) and in HIC15 (clench axe kick: 162.63±104.10; uppercut: 24.10±12.54, d = 2.29) were observed. Conclusions Taekwondo kicks demonstrated significantly larger magnitudes than boxing punches for both RLA and HIC. PMID:24744497

  18. 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

  19. 49 CFR 572.122 - Head assembly and test procedure.

    Science.gov (United States)

    2010-10-01

    ... head CG may not be less than 245 G or more than 300 G. The resultant acceleration vs. time history... and the head must be oriented to an incline of 62 ±1 deg. between the “D” plane as shown in Figure N1 and the plane of the impact surface. The 1.57 mm (0.062 in) diameter holes located on either side of...

  20. Kinematics of the AM-50 heading machine cutting head

    Energy Technology Data Exchange (ETDEWEB)

    Sikora, W; Bak, K; Klich, R [Politechnika Slaska, Gliwice (Poland). Instytut Mechanizacji Gornictwa

    1987-01-01

    Analyzes motion of the cutter head of the AM-50 heading machine. Two types of head motion are comparatively evaluated: planar motion and spatial motion. The spatial motion consists of the head rotational motion and horizontal or vertical feed motion, while planar motion consists of rotational motion and vertical feed motion. Equations that describe head motion under conditions of cutter vertical or horizontal feed motion are derived. The angle between the cutting speed direction and working speed direction is defined. On the basis of these formulae variations of cutting speed depending on the cutting tool position on a cutter head are calculated. Calculations made for 2 extreme cutting tools show that the cutting speed ranges from 1,205 m/s to 3,512 m/s. 4 refs.

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. Reactor vessel head permanent shield

    International Nuclear Information System (INIS)

    Hankinson, M.F.; Leduc, R.J.; Richard, J.W.; Malandra, L.J.

    1989-01-01

    A nuclear reactor is described comprising: a nuclear reactor pressure vessel closure head; control rod drive mechanisms (CRDMs) disposed within the closure head so as to project vertically above the closure head; cooling air baffle means surrounding the control rod drive mechanisms for defining cooling air paths relative to the control rod drive mechanisms; means defined within the periphery of the closure head for accommodating fastening means for securing the closure head to its associated pressure vessel; lifting lugs fixedly secured to the closure head for facilitating lifting and lowering movements of the closure head relative to the pressure vessel; lift rods respectively operatively associated with the plurality of lifting lugs for transmitting load forces, developed during the lifting and lowering movements of the closure head, to the lifting lugs; upstanding radiation shield means interposed between the cooling air baffle means and the periphery of the enclosure head of shielding maintenance personnel operatively working upon the closure head fastening means from the effects of radiation which may emanate from the control rod drive mechanisms and the cooling air baffle means; and connecting systems respectively associated with each one of the lifting lugs and each one of the lifting rods for connecting each one of the lifting rods to a respective one of each one of the lifting lugs, and for simultaneously connecting a lower end portion of the upstanding radiation shield means to each one of the respective lifting lugs

  7. 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

  8. 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

  9. Analysis of real-time head accelerations in collegiate football players.

    Science.gov (United States)

    Duma, Stefan M; Manoogian, Sarah J; Bussone, William R; Brolinson, P Gunnar; Goforth, Mike W; Donnenwerth, Jesse J; Greenwald, Richard M; Chu, Jeffrey J; Crisco, Joseph J

    2005-01-01

    To measure and analyze head accelerations during American collegiate football practices and games. A newly developed in-helmet 6-accelerometer system that transmits data via radio frequency to a sideline receiver and laptop computer system was implemented. From the data transfer of these accelerometer traces, the sideline staff has real-time data including the head acceleration, the head injury criteria value, the severity index value, and the impact location. Data are presented for instrumented players for the entire 2003 football season, including practices and games. American collegiate football. Thirty-eight players from Virginia Tech's varsity football team. Accelerations and pathomechanics of head impacts. : A total of 3312 impacts were recorded over 35 practices and 10 games for 38 players. The average peak head acceleration, Gadd Severity Index, and Head Injury Criteria were 32 g +/- 25 g, 36 g +/- 91 g, and 26 g +/- 64 g, respectively. One concussive event was observed with a peak acceleration of 81 g, a 267 Gadd Severity Index, and 200 Head Injury Criteria. Because the concussion was not reported until the day after of the event, a retrospective diagnosis based on his history and clinical evaluation suggested a mild concussion. The primary finding of this study is that the helmet-mounted accelerometer system proved effective at collecting thousands of head impact events and providing contemporaneous head impact parameters that can be integrated with existing clinical evaluation techniques.

  10. Small and low head pumped storage projects

    International Nuclear Information System (INIS)

    Makarechian, A.H.

    1991-01-01

    The purpose of this paper is to focus attention on small and low head pumped storage projects. These projects may be defined as having a capacity of less than 200-300 MW and down to about 20 MW, with heads of 1200 ft to about 300 ft or less. Many advantages of these smaller pumped storage projects include more flexibility in siting of a project, considerably shorter licensing and construction period, adaptability to closed system design concept to reduce adverse environmental impacts, considerably reduced risks of delays and substantial cost over-runs, better suited to meeting peaking capacity requirements for individual utilities, and much less transmission inter-connection requirements. An overall licensing and construction schedule of about 3 to 3 1/2 years is realistic for many smaller pumped storage projects, and competitive costs in terms of dollars per kW installed can be achieved

  11. Representation of heading direction in far and near head space

    NARCIS (Netherlands)

    Poljac, E.; Berg, A.V. van den

    2003-01-01

    Manipulation of objects around the head requires an accurate and stable internal representation of their locations in space, also during movements such as that of the eye or head. For far space, the representation of visual stimuli for goal-directed arm movements relies on retinal updating, if eye

  12. Head trauma and CT

    International Nuclear Information System (INIS)

    Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitoshi

    1979-01-01

    In our cases of acute and subacute subdural hematoma, the use of CT was evaluated. In our department of surgery, acute subdural hematoma was found in 46 of 388 patients of head trauma who underwent CT. Acute subdural hematoma, like epidural hematoma was usually visualized as a high-density area along the cranial inner table, and this was easily differenciated from epidural hematoma because of difference in shape from the other. The picture of acute subdural hematoma was occasionally confused with that of intracerebral hematoma or cerebral contusion. Single use of CT does not differenciate subacute subdural hematoma from chronic subdural hematoma. However, CT usually visualized acute hematoma as a high-density area, showing the extent of hematoma. Comparison of the thickness of hematoma with the axis deviation of the median part such as the 3rd cerebral ventricle suggested severity of cerebral edema. CT also revealed bilateral or multiple lesions of cerebral contusion or intracerebral hematoma. (Ueda, J.)

  13. Lower head failure analysis

    International Nuclear Information System (INIS)

    Rempe, J.L.; Thinnes, G.L.; Allison, C.M.; Cronenberg, A.W.

    1991-01-01

    The US Nuclear Regulatory Commission is sponsoring a lower vessel head research program to investigate plausible modes of reactor vessel failure in order to determine (a) which modes have the greatest likelihood of occurrence during a severe accident and (b) the range of core debris and accident conditions that lead to these failures. This paper presents the methodology and preliminary results of an investigation of reactor designs and thermodynamic conditions using analytic closed-form approximations to assess the important governing parameters in non-dimensional form. Preliminary results illustrate the importance of vessel and tube geometrical parameters, material properties, and external boundary conditions on predicting vessel failure. Thermal analyses indicate that steady-state temperature distributions will occur in the vessel within several hours, although the exact time is dependent upon vessel thickness. In-vessel tube failure is governed by the tube-to-debris mass ratio within the lower head, where most penetrations are predicted to fail if surrounded by molten debris. Melt penetration distance is dependent upon the effective flow diameter of the tube. Molten debris is predicted to penetrate through tubes with a larger effective flow diameter, such as a boiling water reactor (BWR) drain nozzle. Ex-vessel tube failure for depressurized reactor vessels is predicted to be more likely for a BWR drain nozzle penetration because of its larger effective diameter. At high pressures (between ∼0.1 MPa and ∼12 MPa) ex-vessel tube rupture becomes a dominant failure mechanism, although tube ejection dominates control rod guide tube failure at lower temperatures. However, tube ejection and tube rupture predictions are sensitive to the vessel and tube radial gap size and material coefficients of thermal expansion

  14. [Head and neck adaptive radiotherapy].

    Science.gov (United States)

    Graff, P; Huger, S; Kirby, N; Pouliot, J

    2013-10-01

    Onboard volumetric imaging systems can provide accurate data of the patient's anatomy during a course of head and neck radiotherapy making it possible to assess the actual delivered dose and to evaluate the dosimetric impact of complex daily positioning variations and gradual anatomic changes such as geometric variations of tumors and normal tissues or shrinkage of external contours. Adaptive radiotherapy is defined as the correction of a patient's treatment planning to adapt for individual variations observed during treatment. Strategies are developed to selectively identify patients that require replanning because of an intolerable dosimetric drift. Automated tools are designed to limit time consumption. Deformable image registration algorithms are the cornerstones of these strategies, but a better understanding of their limits of validity is required before adaptive radiotherapy can be safely introduced to daily practice. Moreover, strict evaluation of the clinical benefits is yet to be proven. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  15. Snowboard head injury: prospective study in Chino, Nagano, for two seasons from 1995 to 1997.

    Science.gov (United States)

    Nakaguchi, H; Fujimaki, T; Ueki, K; Takahashi, M; Yoshida, H; Kirino, T

    1999-06-01

    The popularity of snowboarding has been growing rapidly throughout the world. To date, however, the risk of head injury associated with this relatively new winter sport, especially in comparison with alpine skiing, has not been well analyzed. This study was conducted to assess the risk of head injury in snowboarding and to elucidate its features in comparison with skiing head injury. We prospectively analyzed 301 cases of head injuries related to snowboarding or skiing experienced from December of 1995 to May of 1997 at our institution, which is located close to the most popular skiing areas in Japan. Of those injuries, 143 cases were snowboard related and 158 cases were ski related. In addition to appropriate medical evaluation and medical care, detailed examination was performed on every patient to determine various factors, including sex, age, skill level, cause and mechanism of the accident, and the side of impact to the head. The data are statistically analyzed to elucidate unique features of snowboard head injury. During the study period, 2.2 million snowboarders and 4.2 million skiers visited the five skiing facilities that are covered by our hospital. Thus, the incidence of head injury was 6.5 per 100,000 visits for snowboarders and 3.8 per 100,000 visits for skiers. Beginning snowboarders more frequently sustained head injuries compared with beginning skiers (60 of 142 vs. 48 of 154, p = 0.022). Likewise, frequent causes of snowboarding head injuries were fall during jumping (43 of 139 vs. 2 of 147, pskiing head injuries (1.3%). Of 11 major head injury cases, 10 were caused by occipital impact. These results indicate that snowboarders, particularly beginners, are at higher risk for head injury, frequently involving occipital impact, and could lead to more major head injuries. We propose that measures should be taken to protect the head, especially the occiput, in snowboarding.

  16. 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 < 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. • 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.

  17. 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.

  18. Modular reactor head shielding system

    International Nuclear Information System (INIS)

    Jacobson, E. B.

    1985-01-01

    An improved modular reactor head shielding system is provided that includes a frame which is removably assembled on a reactor head such that no structural or mechanical alteration of the head is required. The shielding system also includes hanging assemblies to mount flexible shielding pads on trolleys which can be moved along the frame. The assemblies allow individual pivoting movement of the pads. The pivoting movement along with the movement allowed by the trolleys provides ease of access to any point on the reactor head. The assemblies also facilitate safe and efficient mounting of the pads directly to and from storage containers such that workers have additional shielding throughout virtually the entire installation and removal process. The flexible shielding pads are designed to interleave with one another when assembled around the reactor head for substantially improved containment of radiation leakage

  19. Advances in otolaryngology-Head and neck surgery. Volume 1

    International Nuclear Information System (INIS)

    Myers, E.N.; Bluestone, C.D.

    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

  20. 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.

  1. Stereotactic Body Radiotherapy for Head and Neck Tumors

    Science.gov (United States)

    2016-04-18

    Squamous Cell Carcinoma of the Head and Neck; Nasopharyngeal Carcinoma; Salivary Gland Cancer; Head and Neck Sarcoma; Paraganglioma of Head and Neck; Chordoma of Head and Neck; Chondrosarcoma of Head and Neck; Angiofibroma of Head and Neck

  2. Validation and calibration of HeadCount, a self-report measure for quantifying heading exposure in soccer players.

    Science.gov (United States)

    Catenaccio, E; Caccese, J; Wakschlag, N; Fleysher, R; Kim, N; Kim, M; Buckley, T A; Stewart, W F; Lipton, R B; Kaminski, T; Lipton, M L

    2016-01-01

    The long-term effects of repetitive head impacts due to heading are an area of increasing concern, and exposure must be accurately measured; however, the validity of self-report of cumulative soccer heading is not known. In order to validate HeadCount, a 2-week recall questionnaire, the number of player-reported headers was compared to the number of headers observed by trained raters for a men's and a women's collegiate soccer teams during an entire season of competitive play using Spearman's correlations and intraclass correlation coefficients (ICCs), and calibrated using a generalized estimating equation. The average Spearman's rho was 0.85 for men and 0.79 for women. The average ICC was 0.75 in men and 0.38 in women. The calibration analysis demonstrated that men tend to report heading accurately while women tend to overestimate. HeadCount is a valid instrument for tracking heading behaviour, but may have to be calibrated in women.

  3. Turbidity Current Head Mixing

    Science.gov (United States)

    Hernandez, David; Sanchez, Miguel Angel; Medina, Pablo

    2010-05-01

    A laboratory experimental set - up for studying the behaviour of sediment in presence of a turbulent field with zero mean flow is compared with the behaviour of turbidity currents [1] . Particular interest is shown on the initiation of sediment motion and in the sediment lift - off. The behaviour of the turbidity current in a flat ground is compared with the zero mean flow oscilating grid generated turbulence as when wave flow lifts off suspended sediments [2,3]. Some examples of the results obtained with this set-up relating the height of the head of the turbidity current to the equilibrium level of stirred lutoclines are shown. A turbulent velocity u' lower than that estimated by the Shield diagram is required to start sediment motion. The minimum u' required to start sediment lift - off, is a function of sediment size, cohesivity and resting time. The lutocline height depends on u', and the vorticity at the lutocline seems constant for a fixed sediment size [1,3]. Combining grid stirring and turbidty current head shapes analyzed by means of advanced image analysis, sediment vertical fluxes and settling speeds can be measured [4,5]. [1] D. Hernandez Turbulent structure of turbidity currents and sediment transport Ms Thesis ETSECCPB, UPC. Barcelona 2009. [2] A. Sánchez-Arcilla; A. Rodríguez; J.C. Santás; J.M. Redondo; V. Gracia; R. K'Osyan; S. Kuznetsov; C. Mösso. Delta'96 Surf-zone and nearshore measurements at the Ebro Delta. A: International Conference on Coastal Research through large Scale Experiments (Coastal Dynamics '97). University of Plymouth, 1997, p. 186-187. [3] P. Medina, M. A. Sánchez and J. M. Redondo. Grid stirred turbulence: applications to the initiation of sediment motion and lift-off studies Physics and Chemistry of the Earth, Part B: Hydrology, Oceans and Atmosphere. 26, Issue 4, 2001, Pages 299-304 [4] M.O. Bezerra, M. Diez, C. Medeiros, A. Rodriguez, E. Bahia., A. Sanchez-Arcilla and J.M. Redondo. Study on the influence of waves on

  4. 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

  5. Femoral head necrosis; Hueftkopfnekrose

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, J.; Scheurecker, G.; Scheurecker, A.; Stoeger, A.; Huber, A. [Roentgeninstitut am Schillerpark, Linz (Austria); Hofmann, S. [Orthopaedisches Landeskrankenhaus Stolzalpe (Austria)

    2009-05-15

    The epidemiology and pathohistogenesis of avascular femoral head necrosis has still not been clarified in detail. Because the course of the disease runs in stages and over a long time period nearly always culminates in the necessity for a total hip prosthesis, an exact radiological evaluation is of paramount importance for the treatment. There is a need for a common staging system to enable comparison of different therapy concepts and especially their long-term results. In this article the ARCO staging system is described in full detail, which includes all radiological modalities as well as histopathological alterations. (orig.) [German] Bei der avaskulaeren Femurkopfnekrose handelt es sich um ein Krankheitsbild, dessen Ursachen noch immer nicht vollstaendig geklaert sind. Da die Erkrankung stadienhaft verlaeuft und ueber einen laengeren Zeitraum betrachtet nahezu immer in einem prothetischen Hueftersatz muendet, ist eine genaue radiologische Abklaerung fuer die Behandlung von enormer Bedeutung. Um Langzeiterfolge verschiedener Therapiekonzepte vergleichen zu koennen, sind eine exakte Beschreibung und darauf basierend die Verwendung einer einheitlichen Stadieneinteilung wuenschenswert. In der vorliegenden Arbeit wird die ARCO-Stadieneinteilung im Detail beschrieben, die alle bildgebenden Methoden beruecksichtigt und histopathologische Veraenderungen mit einbezieht. (orig.)

  6. Head trauma and CT

    International Nuclear Information System (INIS)

    Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitoshi

    1979-01-01

    It has been said that chronic subdural hematoma cannot be diagnosed by CT. In our cases, CT was used, and the results were described. According to the density of the picture, CT findings of chronic subdural hematoma could be classified into 3 types, those of higher density than that of the cerebral paranchyma, those of isodensity, and those of lower density than that of the cerebral parenchyma. The difference among them appeared to be due to variation in the fluid in hematoma, especially that in hemoglobin concentration. Chronic subdural hematoma was found in 27 of 388 cases of head trauma in which CT was undertaken in our department of surgery for last 2 years. It is difficult to differenciate this disease from subdural edema or subarachnoideal retention of the cerebrospinal fluid. In many cases, use of contrast medium added no change to the CT picture. Cerebral angiography is necessary for definite diagnosis of the disease. Chronic subdural hematoma gives more varieties of findings than other intracranial hematomas. However, if the film is very carefully read, CT is still useful for diagnosing this disease in spite of initially remarked difficulties. (Ueda, J.)

  7. Anaphylaxis Due to Head Injury

    Directory of Open Access Journals (Sweden)

    Bruner, Heather C.

    2015-05-01

    Full Text Available Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury. [West J Emerg Med. 2015;16(3:435–437.

  8. Anaphylaxis due to head injury.

    Science.gov (United States)

    Bruner, Heather C; Bruner, David I

    2015-05-01

    Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury.

  9. Boxing-related head injuries.

    Science.gov (United States)

    Jayarao, Mayur; Chin, Lawrence S; Cantu, Robert C

    2010-10-01

    Fatalities in boxing are most often due to traumatic brain injury that occurs in the ring. In the past 30 years, significant improvements in ringside and medical equipment, safety, and regulations have resulted in a dramatic reduction in the fatality rate. Nonetheless, the rate of boxing-related head injuries, particularly concussions, remains unknown, due in large part to its variability in clinical presentation. Furthermore, the significance of repeat concussions sustained when boxing is just now being understood. In this article, we identify the clinical manifestations, pathophysiology, and management of boxing-related head injuries, and discuss preventive strategies to reduce head injuries sustained by boxers.

  10. Head-positioning scintillation camera and head holder therefor

    International Nuclear Information System (INIS)

    Kay, T.D.

    1976-01-01

    A holder for immobilizing the head of a patient undergoing a vertex brain scan by a Gamma Scintillation Camera is described. The holder has a uniquely designed shape capable of comfortably supporting the head. In addition, this holder can be both adjustably and removably utilized in combination with the scintillation camera so as to enable the brain scan operation to take place while the patient is in the seated position

  11. Head and Neck Cancer

    International Nuclear Information System (INIS)

    Tomita, Toshiki; Imanishi, Yorihisa

    2008-01-01

    The limitation of concurrent chemo-radiotherapy (CCRT) in head and neck cancer (HNC) as the primary treatment is described based on recent findings. Limits in the application/indication involve factors of age, performance status (PS) and renal function. The first is that, as deaths in >71 years old patients are derived from other causes (41%) than HNC, CCRT is only useful for younger population; the second, patients with PS 0-1 or Karnofsky performance score >60-70 can be indicated; and third, contraindicated are those with creatinine clearance (CCr) <60 mL/min as the key drug cisplatin in CCRT has a high renal toxicity. It should be recognized that completion rates of chemotherapy and RT are as low as 66-85% and 84-92%, respectively, in CCRT. CCRT has such limiting adverse events as mucitis, dry mouth, dysohagia, weight loss, neutropenia, sepsis, etc., which are most important in CCRT application. CCRT is recommended for the primary cancers of larynx and hypopharynx because they are significantly better conserved than middle pharyngeal, oral and upper jaw cancers. Evidence of CCRT is poor for cancers in paranasal sinuses. Planned neck dissection (PND) is for the cervical metastatic lymph nodes and conducted 6-12 weeks after CCRT regardless to its outcome. In fluorodeoxyglucose-positron emission tomography (FDG-PET) negative cases, PND can be omitted. Necessity of PND is possibly inversely proportional to CCRT intensity performed. For control of remote metastasis, CCRT has obvious limits and inductive chemotherapy before it is currently considered. Salvage surgery post CCRT does not always yield a relief because of complication. Patients with advanced laryngeal cancer can be selected either to surgery or CCRT depending on results of the inductive chemotherapy. To predict the sensitivity to CCRT, some biomarkers like HPV, EGFR and VEGF have been suggested to be useful by retrospective studies. Understanding the limitation is as important as knowing the usefulness in

  12. 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.)

  13. The impact of concurrent granulocyte macrophage-colony stimulating factor on radiation-induced mucositis in head and neck cancer patients: A double-blind placebo-controlled prospective Phase III study by Radiation Therapy Oncology Group 9901

    International Nuclear Information System (INIS)

    Ryu, Janice K.; Swann, Suzanne; LeVeque, Francis; Scarantino, Charles W.; Johnson, Darlene J.; Chen, Allan; Fortin, Andre; Pollock, JonDavid; Kim, Harold; Ang, Kian K.

    2007-01-01

    Purpose: Based on early clinical evidence of potential mucosal protection by granulocyte-macrophage colony stimulating factor (GM-CSF), the Radiation Therapy Oncology Group conducted a double-blind, placebo-controlled, randomized study to test the efficacy and safety of GM-CSF in reducing the severity and duration of mucosal injury and pain (mucositis) associated with curative radiotherapy (RT) in head-and-neck cancer patients. Methods and Materials: Eligible patients included those with head-and-neck cancer with radiation ports encompassing >50% of oral cavity and/or oropharynx. Standard RT ports were used to cover the primary tumor and regional lymphatics at risk in standard fractionation to 60-70 Gy. Concurrent cisplatin chemotherapy was allowed. Patients were randomized to receive subcutaneous injection of GM-CSF 250 μg/m 2 or placebo 3 times a week. Mucosal reaction was assessed during the course of RT using the National Cancer Institute Common Toxicity Criteria and the protocol-specific scoring system. Results: Between October 2000 and September 2002, 130 patients from 36 institutions were accrued. Nine patients (7%) were excluded from the analysis, 3 as a result of drug unavailability. More than 80% of the patients participated in the quality-of-life endpoint of this study. The GM-CSF did not cause any increase in toxicity compared with placebo. There was no statistically significant difference in the average mean mucositis score in the GM-CSF and placebo arms by a t test (p = 0.4006). Conclusion: This placebo-controlled, randomized study demonstrated no significant effect of GM-CSF given concurrently compared with placebo in reducing the severity or duration of RT-induced mucositis in patients undergoing definitive RT for head-and-neck cancer

  14. Sports-related Head Injury

    Science.gov (United States)

    ... and head gear come in many sizes and styles for many sports and must properly fit to ... to play or practice." The "Concussion Diagnosis and Management" section details circumstances in which an athlete should ...

  15. Heater head for stirling engine

    Science.gov (United States)

    Corey, John A.

    1985-07-09

    A monolithic heater head assembly which augments cast fins with ceramic inserts which narrow the flow of combustion gas and obtains high thermal effectiveness with the assembly including an improved flange design which gives greater durability and reduced conduction loss.

  16. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should ... a digital cloud server. Currently, MRI is the most sensitive imaging test of the head (particularly the ...

  17. 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 ...

  18. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... the head (particularly the brain) in routine clinical practice. top of page What are some common uses ... gadolinium contrast material except when absolutely necessary for medical treatment. See the MRI Safety page for more ...

  19. 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. ...

  20. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

  1. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... top of page Additional Information and Resources RTAnswers.org : Radiation Therapy for Brain Tumors Radiation Therapy for ... Imaging (MRI) - Head Sponsored by Please note RadiologyInfo.org is not a medical facility. Please contact your ...

  2. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... It can also invite bacteria that lead to gum disease. Click here to find out more. Who We ... It can also invite bacteria that lead to gum disease. Click here to find out more. Oral, Head ...

  3. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... the head (particularly the brain) in routine clinical practice. top of page What are some common uses ... may follow your regular daily routine and take food and medications as usual. Some MRI examinations may ...

  4. 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 ...

  5. 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 ...

  6. 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 ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

  7. American Head and Neck Society

    Science.gov (United States)

    ... research and insights. Comments This field is for validation purposes and should be left unchanged. This iframe ... and Announcements Copyright ©2016 · American Head and Neck Society · Privacy and Return Policy Managed by BSC Management, ...

  8. 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 ... for immediate assistance. Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 ...

  9. 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 ...

  10. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... by the interpreting radiologist. Frequently, the differentiation of abnormal (diseased) tissue from normal tissues is better with ... Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to Magnetic ...

  11. 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 ...

  12. 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 ...

  13. 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 ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  14. 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 ...

  15. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... teeth or become infected. It can also invite bacteria that lead to gum disease. Click here to find out ... and surgically treating cancer of the head, neck and mouth. The Oral Cancer Foundation estimates that close to ...

  16. 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...... mobile phone screens. The user study shows that the method detects a set of defined gestures reliably.......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...

  17. Environmental impacts of divorce

    OpenAIRE

    Yu, Eunice; Liu, Jianguo

    2007-01-01

    Divorce is increasingly common around the world. Its causes, dynamics, and socioeconomic impacts have been widely studied, but little research has addressed its environmental impacts. We found that average household size (number of people in a household) in divorced households (households with divorced heads) was 27–41% smaller than married households (households with married heads) in 12 countries across the world around the year 2000 (between 1998 and 2002). If divorced households had combi...

  18. Topiramate Responsive Exploding Head Syndrome

    OpenAIRE

    Palikh, Gaurang M.; Vaughn, Bradley V.

    2010-01-01

    Exploding head syndrome is a rare phenomenon but can be a significant disruption to quality of life. We describe a 39-year-old female with symptoms of a loud bang and buzz at sleep onset for 3 years. EEG monitoring confirmed these events occurred in transition from stage 1 sleep. This patient reported improvement in intensity of events with topiramate medication. Based on these results, topiramate may be an alternative method to reduce the intensity of events in exploding head syndrome.

  19. Topiramate responsive exploding head syndrome.

    Science.gov (United States)

    Palikh, Gaurang M; Vaughn, Bradley V

    2010-08-15

    Exploding head syndrome is a rare phenomenon but can be a significant disruption to quality of life. We describe a 39-year-old female with symptoms of a loud bang and buzz at sleep onset for 3 years. EEG monitoring confirmed these events occurred in transition from stage 1 sleep. This patient reported improvement in intensity of events with topiramate medication. Based on these results, topiramate may be an alternative method to reduce the intensity of events in exploding head syndrome.

  20. 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.

  1. Original Article Epidemiology and Functional Outcome of Head ...

    African Journals Online (AJOL)

    KIGZ

    As such, head injury is a public health problem that has a great impact on society, costing it the loss of ... Patient is independent as far as daily life is concerned. .... in elderly and children. Earlier .... Injury Control and Safety Promotion. 2003 ...

  2. Exploding head syndrome is common in college students.

    Science.gov (United States)

    Sharpless, Brian A

    2015-08-01

    Exploding head syndrome is characterized by the perception of loud noises during sleep-wake or wake-sleep transitions. Although episodes by themselves are relatively harmless, it is a frightening phenomenon that may result in clinical consequences. At present there are little systematic data on exploding head syndrome, and prevalence rates are unknown. It has been hypothesized to be rare and to occur primarily in older (i.e. 50+ years) individuals, females, and those suffering from isolated sleep paralysis. In order to test these hypotheses, 211 undergraduate students were assessed for both exploding head syndrome and isolated sleep paralysis using semi-structured diagnostic interviews: 18.00% of the sample experienced lifetime exploding head syndrome, this reduced to 16.60% for recurrent cases. Though not more common in females, it was found in 36.89% of those diagnosed with isolated sleep paralysis. Exploding head syndrome episodes were accompanied by clinically significant levels of fear, and a minority (2.80%) experienced it to such a degree that it was associated with clinically significant distress and/or impairment. Contrary to some earlier theorizing, exploding head syndrome was found to be a relatively common experience in younger individuals. Given the potential clinical impacts, it is recommended that it be assessed more regularly in research and clinical settings. © 2015 European Sleep Research Society.

  3. Dynamic Response and Residual Helmet Liner Crush Using Cadaver Heads and Standard Headforms.

    Science.gov (United States)

    Bonin, S J; Luck, J F; Bass, C R; Gardiner, J C; Onar-Thomas, A; Asfour, S S; Siegmund, G P

    2017-03-01

    Biomechanical headforms are used for helmet certification testing and reconstructing helmeted head impacts; however, their biofidelity and direct applicability to human head and helmet responses remain unclear. Dynamic responses of cadaver heads and three headforms and residual foam liner deformations were compared during motorcycle helmet impacts. Instrumented, helmeted heads/headforms were dropped onto the forehead region against an instrumented flat anvil at 75, 150, and 195 J. Helmets were CT scanned to quantify maximum liner crush depth and crush volume. General linear models were used to quantify the effect of head type and impact energy on linear acceleration, head injury criterion (HIC), force, maximum liner crush depth, and liner crush volume and regression models were used to quantify the relationship between acceleration and both maximum crush depth and crush volume. The cadaver heads generated larger peak accelerations than all three headforms, larger HICs than the International Organization for Standardization (ISO), larger forces than the Hybrid III and ISO, larger maximum crush depth than the ISO, and larger crush volumes than the DOT. These significant differences between the cadaver heads and headforms need to be accounted for when attempting to estimate an impact exposure using a helmet's residual crush depth or volume.

  4. Ghost Head Nebula

    Science.gov (United States)

    1999-01-01

    Looking like a colorful holiday card, a new image from NASA's Hubble Space Telescope reveals a vibrant green and red nebula far from Earth. The image of NGC 2080, taken by Hubble's Wide Field and Planetary Camera 2, designed and built by NASA's Jet Propulsion Laboratory, Pasadena, Calif., is available online at http://www.jpl.nasa.gov/images/wfpc . Images like this help astronomers investigate star formation in nebulas. NGC 2080, nicknamed 'The Ghost Head Nebula,' is one of a chain of star-forming regions lying south of the 30 Doradus nebula in the Large Magellanic Cloud. 30 Doradus is the largest star-forming complex in the local group of galaxies. This 'enhanced color' picture is composed of three narrow-band-filter images obtained by Hubble on March 28, 2000. The red and blue light come from regions of hydrogen gas heated by nearby stars. The green light on the left comes from glowing oxygen. The energy to illuminate the green light is supplied by a powerful stellar wind, a stream of high-speed particles coming from a massive star just outside the image. The central white region is a combination of all three emissions and indicates a core of hot, massive stars in this star-formation region. Intense emission from these stars has carved a bowl-shaped cavity in surrounding gas. In the white region, the two bright areas (the 'eyes of the ghost') - named A1 (left) and A2 (right) -- are very hot, glowing 'blobs' of hydrogen and oxygen. The bubble in A1 is produced by the hot, intense radiation and powerful stellar wind from one massive star. A2 contains more dust and several hidden, massive stars. The massive stars in A1 and A2 must have formed within the last 10,000 years, since their natal gas shrouds are not yet disrupted by the powerful radiation of the newborn stars. The Space Telescope Science Institute is operated by the Association of Universities for Research in Astronomy, Inc., for NASA, under contract with the Goddard Space Flight Center, Greenbelt, Md. The

  5. 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.

  6. 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.

  7. 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.

  8. Manufacturing and properties of closure head forging integrated with flange for PWR reactor pressure vessel

    International Nuclear Information System (INIS)

    Tomoharu Sasaki; Iku Kurihara; Etsuo Murai; Yasuhiko Tanaka; Koumei Suzuki

    2003-01-01

    Closure head forging (SA508, Gr.3 Cl.1) integrated with flange for PWR reactor pressure vessel has been developed. This is intended to enhance structural integrity of closure head resulted in elimination of ISI, by eliminating weld joint between closure head and flange in the conventional design. Manufacturing procedures have been established so that homogeneity and isotropy of the material properties can be assured in the closure head forging integrated with flange. Acceptance tensile and impact test specimens are taken and tested regarding the closure head forging integrated with flange as very thick and complex forgings. This paper describes the manufacturing technologies and material properties of the closure head forging integrated with flange. (orig.)

  9. In a bad place: Carers of patients with head and neck cancer experiences of travelling for cancer treatment.

    Science.gov (United States)

    Balfe, Myles; Keohane, Kieran; O' Brien, Katie; Gooberman-Hill, Rachael; Maguire, Rebecca; Hanly, Paul; O' Sullivan, Eleanor; Sharp, Linda

    2017-10-01

    To explore the effect that treatment-related commuting has on carers of patients with head and neck cancer. Semi-structured interviews, thematically analysed, with 31 carers. Treatment-related commuting had a considerable impact on carers of patients with head and neck cancer, both in practical terms (economic costs, disruption) and also in psychological terms. Many carers of patients with head and neck cancer described becoming distressed by their commute. Some carers from large urban cities appeared to have hidden commuting burdens. Some carers respond to commuting stress by 'zoning out' or becoming 'like zombies'. Treatment-related travel for head and neck cancer can have significant practical and psychological impacts. Health professionals should be aware of the impacts that commuting can have on head and neck caregivers. Health services may be able to take practical steps, such as providing subsidized parking, to address head and neck carergivers' difficulties. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Passive Cushiony Biomechanics of Head Protection in Falling Geckos

    Directory of Open Access Journals (Sweden)

    Hao Wang

    2018-01-01

    Full Text Available Gekko geckos are capable to crawl on the steep even on upside-down surfaces. Such movement, especially at great altitude, puts them at high risks of incidentally dropping down and inevitable body or head impactions, though they may trigger air-righting reaction (ARR to attenuate the landing shocks. However, the air-righting ability (ARA in Gekko geckos is not fully developed. The implementation of ARR in some geckos is quite slow; and for those without tails, the ARR is even unobservable. Since ARA is compromised in Gekko geckos, there must be some other mechanisms responsible for protecting them from head injuries during falls. In this study, we looked into a Gekko gecko’s brain to study its internal environment and structure, using the magnetic resonance imaging (MRI technique. The results showed that the brain parenchyma was fully surrounded by the cerebrospinal fluid (CSF in the skull. A succulent characteristic was presented, which meant the intracalvarium was significantly occupied by the CSF, up to 45% in volume. Then a simplified three-dimensional finite element model was built, and a dynamic simulation was conducted to evaluate the mechanical property of this succulent characteristic during the head impactions. These implied the succulent characteristic may play certain roles on the self-protection in case of head impaction, which is adaptable to the Gekko gecko’s locomotion and behavior.

  11. Neck Collar with Mild Jugular Vein Compression Ameliorates Brain Activation Changes during a Working Memory Task after a Season of High School Football.

    Science.gov (United States)

    Yuan, Weihong; Leach, James; Maloney, Thomas; Altaye, Mekibib; Smith, David; Gubanich, Paul J; Barber Foss, Kim D; Thomas, Staci; DiCesare, Christopher A; Kiefer, Adam W; Myer, Gregory D

    2017-08-15

    Emerging evidence indicates that repetitive head impacts, even at a sub-concussive level, may result in exacerbated or prolonged neurological deficits in athletes. This study aimed to: 1) quantify the effect of repetitive head impacts on the alteration of neuronal activity based on functional magnetic resonance imaging (fMRI) of working memory after a high school football season; and 2) determine whether a neck collar that applies mild jugular vein compression designed to reduce brain energy absorption in head impact through "slosh" mitigation can ameliorate the altered fMRI activation during a working memory task. Participants were recruited from local high school football teams with 27 and 25 athletes assigned to the non-collar and collar group, respectively. A standard N-Back task was used to engage working memory in the fMRI at both pre- and post-season. The two study groups experienced similar head impact frequency and magnitude during the season (all p > 0.05). fMRI blood oxygen level dependent (BOLD) signal response (a reflection of the neuronal activity level) during the working memory task increased significantly from pre- to post-season in the non-collar group (corrected p working memory related brain activity, as well as a potential protective effect that resulted from the use of the purported brain slosh reducing neck collar in contact sports.

  12. 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.

  13. 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

  14. 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

  15. Ophthalmic manifestations of head injury.

    Science.gov (United States)

    Kowal, L

    1992-02-01

    Head injuries are frequently associated with ophthalmic problems. The commonest problems seen in this series of 161 patients with head injury were problems with poor accommodation (16% of patients; 58% of these persisted), convergence (14% of patients; 35% of these persisted), pseudomyopia (19%; 55% persisted) and optic atrophy (26% of the patients; 78% of these were mild and easily missed on routine testing, and 22% were severe). Motility disorders were common, especially cranial nerve palsies. Other less frequent motility disturbances included apparent inferior oblique palsy, comitant esotropia, and exotropia which was often of the convergence insufficiency type.

  16. 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

  17. Intellectual Capital and Predefined Headings in Swedish Health Care Sector

    Directory of Open Access Journals (Sweden)

    Terner Annika

    2017-01-01

    Full Text Available The heavily decentralized Swedish health care sector is facing massive challenges, e.g. to even out differences in health care performance. Intellectual Capital can partly be used to explain these differences. In the research field it is difficult to find contributions regarding the study of intellectual capital management in the health care sector and there is also a lack of studies on semantic interoperability. It is semantic interoperability which allows the right information to be available to the right people at the right time across products and organizations. Structured and standardized headings can be a tool to enable semantic interoperability. The aim of this article is to argue for predefined headings as intellectual capital and as base for a national shared and standardized terminology in the health care sector. The study shows that there is a lack of national management of predefined headings deployed in both electronic health records and national quality registries. This lack causes multiple documentation which is time-consuming, impacts health professionals’ workloads, data quality and partly the performance of health care. We argue that predefined headings can be a base for semantic interoperability and that there is a need for the management of predefined headings on a national level.

  18. 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 ...

  19. Womanhood in Bessie Head's fiction

    African Journals Online (AJOL)

    Rain Cloud~· Gather ( 1969), Maru ( 1972) and A Question of Power ( 1974 ),. Head addresses and ... Yet as is the case in most literature by black women from Africa and the. Caribbean .... womanhood comes into play in the principal's decision to get rid of her: "she ... which tl}e principal intends to use to his advantage.

  20. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... 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 ...

  1. 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.

  2. 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 ...

  3. 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 ...

  4. 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 ...

  5. 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...

  6. Head Start Center Design Guide.

    Science.gov (United States)

    Administration for Children, Youth, and Families (DHHS), Washington, DC. Head Start Bureau.

    This guide contains suggested criteria for planning, designing, and renovating Head Start centers so that they are safe, child-oriented, developmentally appropriate, beautiful, environmentally sensitive, and functional. The content is based on the U.S. General Services Administration's Child Care Center Design Guide, PBS-P140, which was intended…

  7. Analytical modelling of soccer heading

    Indian Academy of Sciences (India)

    ... game is that the players are permitted to use their head to direct the ball during ... method in assessing the cognitive functions that can be applied not only to ... It is attached to a spring (stiffness, k1) and a dashpot (damping coefficient, c1).

  8. 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 ...

  9. 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

    2016-01-01

    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. PMID:27076692

  10. 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.

  11. Electromagnetic interference-induced instability in CPP-GMR read heads

    International Nuclear Information System (INIS)

    Khunkitti, P.; Siritaratiwat, A.; Kaewrawang, A.; Mewes, T.; Mewes, C.K.A.; Kruesubthaworn, A.

    2016-01-01

    Electromagnetic interference (EMI) has been a significant issue for the current perpendicular-to-the-plane giant magnetoresistance (CPP-GMR) read heads because it can cause magnetic failure. Furthermore, the magnetic noise induced by the spin transfer torque (STT) effect has played an important role in the CPP read heads because it can affect the stability of the heads. Accordingly, this work proposed an investigation of the magnetic instabilities induced by EMI through the STT effect in a CPP-GMR read head via micromagnetic simulations. The magnetization fluctuation caused by EMI was examined, and then, magnetic noise was evaluated by using power spectral density analysis. It was found that the magnetization orientation can be fluctuated by EMI in close proximity to the head. The results also showed a multimode spectral density. The main contributions of the spectral density were found to originate at the edges of the stripe height sides due to the characteristics of the demagnetization field inside the free layer. Hence, the magnetic instabilities produced by EMI become a significant factor that essentially impacts the reliability of the CPP-GMR read heads. - Highlights: • The instability induced by electromagnetic interference in read head is examined. • The magnetization orientation can be fluctuated by electromagnetic interference. • The electromagnetic interference can induce additional noise spectra to the system. • The noise is mainly located at stripe height of the read head. • The noise induced by electromagnetic interference is a crucial factor for the head.

  12. Electromagnetic interference-induced instability in CPP-GMR read heads

    Energy Technology Data Exchange (ETDEWEB)

    Khunkitti, P.; Siritaratiwat, A.; Kaewrawang, A. [KKU-Seagate Cooperation Research Laboratory, Department of Electrical Engineering, Faculty of Engineering, Khon Kaen University, Khon Kaen 40002 (Thailand); Mewes, T.; Mewes, C.K.A. [Department of Physics and Astronomy, MINT Center, University of Alabama, Tuscaloosa, AL 35487 (United States); Kruesubthaworn, A., E-mail: anankr@kku.ac.th [KKU-Seagate Cooperation Research Laboratory, Department of Electrical Engineering, Faculty of Engineering, Khon Kaen University, Khon Kaen 40002 (Thailand)

    2016-08-15

    Electromagnetic interference (EMI) has been a significant issue for the current perpendicular-to-the-plane giant magnetoresistance (CPP-GMR) read heads because it can cause magnetic failure. Furthermore, the magnetic noise induced by the spin transfer torque (STT) effect has played an important role in the CPP read heads because it can affect the stability of the heads. Accordingly, this work proposed an investigation of the magnetic instabilities induced by EMI through the STT effect in a CPP-GMR read head via micromagnetic simulations. The magnetization fluctuation caused by EMI was examined, and then, magnetic noise was evaluated by using power spectral density analysis. It was found that the magnetization orientation can be fluctuated by EMI in close proximity to the head. The results also showed a multimode spectral density. The main contributions of the spectral density were found to originate at the edges of the stripe height sides due to the characteristics of the demagnetization field inside the free layer. Hence, the magnetic instabilities produced by EMI become a significant factor that essentially impacts the reliability of the CPP-GMR read heads. - Highlights: • The instability induced by electromagnetic interference in read head is examined. • The magnetization orientation can be fluctuated by electromagnetic interference. • The electromagnetic interference can induce additional noise spectra to the system. • The noise is mainly located at stripe height of the read head. • The noise induced by electromagnetic interference is a crucial factor for the head.

  13. 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...

  14. 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 ...

  15. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... with HEADS UP & CDC's Injury Center HEADS UP Resources File Formats Help: How do I view different ... 6348 Email CDC-INFO U.S. Department of Health & Human Services HHS/Open USA.gov Top

  16. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... Submit Button Connect with HEADS UP & CDC's Injury Center HEADS UP Resources File Formats Help: How do ... Page last updated: April 24, 2017 Content source: Centers for Disease Control and Prevention , National Center for ...

  17. Head and Neck Cancer—Patient Version

    Science.gov (United States)

    Head and neck cancers include cancers in the larynx (voice box), throat, lips, mouth, nose, and salivary glands. Start here to find information on head and neck cancer treatment in adults and children, causes and prevention, screening, research, and statistics.

  18. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... Training course: This page has moved Recommend on Facebook Tweet Share Compartir This training course has been ... with HEADS UP & CDC's Injury Center HEADS UP Resources ... HHS/Open USA.gov Top

  19. Head stabilization in whooping cranes

    Science.gov (United States)

    Kinloch, M.R.; Cronin, T.W.; Olsen, Glenn 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

  20. 29 CFR 1918.103 - Head protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Head protection. 1918.103 Section 1918.103 Labor... must ensure that head protection complies with any of the following consensus standards: (i) ANSI Z89.1... as head protection devices that are constructed in accordance with one of the above consensus...

  1. 29 CFR 1915.155 - Head protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Head protection. 1915.155 Section 1915.155 Labor... helmets. (1) Head protection must comply with any of the following consensus standards: (i) ANSI Z89.1... as head protection devices that are constructed in accordance with one of the above consensus...

  2. 29 CFR 1910.135 - Head protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 5 2010-07-01 2010-07-01 false Head protection. 1910.135 Section 1910.135 Labor... head protection. (1) Head protection must comply with any of the following consensus standards: (i... consensus standards will be deemed to be in compliance with the requirements of this section. [59 FR 16362...

  3. Small head size after atomic irradiation

    International Nuclear Information System (INIS)

    Miller, R.W.; Mulvihill, J.J.

    1975-01-01

    A study of children exposed to nuclear explosions in Hiroshima and Nagasaki showed small head size and mental retardation when exposure occurred less than 18 weeks of gestational age. Increased frequency of small head size occurred when maternal exposure was 10 to 19 rad. Tables and graphs are presented to show relationships between dose, gestational age, and frequency of small head size

  4. Health Coordination Manual. Head Start Health Services.

    Science.gov (United States)

    Administration for Children, Youth, and Families (DHHS), Washington, DC. Head Start Bureau.

    Part 1 of this manual on coordinating health care services for Head Start children provides an overview of what Head Start health staff should do to meet the medical, mental health, nutritional, and/or dental needs of Head Start children, staff, and family members. Offering examples, lists, action steps, and charts for clarification, part 2…

  5. 21 CFR 868.1930 - Stethoscope head.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Stethoscope head. 868.1930 Section 868.1930 Food... DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1930 Stethoscope head. (a) Identification. A stethoscope head is a weighted chest piece used during anesthesia to listen to a patient's heart, breath, and...

  6. Fuel rod pellet loading head

    International Nuclear Information System (INIS)

    Howell, T.E.

    1975-01-01

    An assembly for loading nuclear fuel pellets into a fuel rod comprising a loading head for feeding pellets into the open end of the rod is described. The pellets rest in a perforated substantially V-shaped seat through which air may be drawn for removal of chips and dust. The rod is held in place in an adjustable notched locator which permits alignment with the pellets

  7. Habitat Suitability Index Models: Yellow-headed blackbird

    Science.gov (United States)

    Schroeder, Richard L.

    1982-01-01

    Habitat preferences of the yellow-headed blackbird (Xanthocephalus xanthocephalus) are described in this publication. It is one of a series of Habitat Suitability Index (HSI) models and was developed through an analysis of available infomration on the species-habitat requirements of the species. Habitat use information is presented in a review of the literature, followed by the development of an HSI model, designed for use in impact assessment and habitat management activities.

  8. Psychometric Assessment of Stereoscopic Head-Mounted Displays

    Science.gov (United States)

    2016-06-29

    Journal Article 3. DATES COVERED (From – To) Jan 2015 - Dec 2015 4. TITLE AND SUBTITLE PSYCHOMETRIC ASSESSMENT OF STEREOSCOPIC HEAD- MOUNTED DISPLAYS...to render an immersive three-dimensional constructive environment. The purpose of this effort was to quantify the impact of aircrew vision on an...simulated tasks requiring precise depth discrimination. This work will provide an example validation method for future stereoscopic virtual immersive

  9. Bottom head failure program plan

    International Nuclear Information System (INIS)

    Meyer, R.O.

    1989-01-01

    Earlier this year the NRC staff presented a Revised Severe Accident Research Program Plan (SECY-89-123) to the Commission and initiated work on that plan. Two of the near-term issues in that plan involve failure of the bottom head of the reactor pressure vessel. These two issues are (1) depressurization and DCH and (2) BWR Mark I Containment Shell Meltthrough. ORNL has developed models for several competing failure mechanisms for BWRs. INEL has performed analytical and experimental work directly related to bottom head failure in connection with several programs. SNL has conducted a number of analyses and experimental activities to examine the failure of LWR vessels. In addition to the government-sponsored work mentioned above, EPRI and FAI performed studies on vessel failure for the Industry Degraded Core Rulemaking Program (IDCOR). EPRI examined the failure of a PWR vessel bottom head without penetrations, as found in some Combustion Engineering reactors. To give more attention to this subject as called for by the revised Severe Accident Research Plan, two things are being done. First, work previously done is being reviewed carefully to develop an overall picture and to determine the reliability of assumptions used in those studies. Second, new work is being planned for FY90 to try to complete a reasonable understanding of the failure process. The review and planning are being done in close cooperation with the ACRS. Results of this exercise will be presented in this paper

  10. 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.

  11. Booklet for sub-national stakeholders heading towards the COP 21. Agricultural and forestry focus. Key concepts on the impacts of climate change, climate policies and economic tools: insight from French territories

    International Nuclear Information System (INIS)

    Depoues, Vivian; Leseur, Alexia; Bordier, Cecile; Foucherot, Claudine; Lacan, Lea; Planton, Serge; Blanchard, Michele; Lemonsu, Aude; Martin, Eric; Masson, Valery; Soubeyroux, Jean-Michel; Ouzeau, Gaelle; Dandin, Philippe; Pigeon, Gregoire; Duvernoy, Jerome; Mondon, Sylvain; Bodiguel, Aude; Gouthiere, Laurence; Martin-Phipps, Cecile; Archambault, Sabrina; Joubert, Marion; Madariaga, Nicole; Coste, Marie-Alexandra; Viguie, Vincent; Avner, Paolo; Cassen, Christophe; Guivarch, Celine; Salagnac, Jean-Luc; Carrega, Marie; Menager, Yann

    2015-11-01

    This report, released in the year of the Paris Climate 2015 summit (COP21), reviews concepts vital for understanding and acting to address climate change at a regional level. Based on the experience of French territories it presents 37 fact-sheets aimed at local players, providing concise and informative access to the most up-to-date knowledge. It also offers feedback on the impacts of climate change, climate policies at a global, European and French level, and economic tools supporting climate change mitigation and adaptation

  12. GyroVR: Simulating Inertia in Virtual Reality using Head Worn Flywheels

    DEFF Research Database (Denmark)

    Gugenheimer, Jan; Wolf, Dennis; Eiríksson, Eyþór Rúnar

    2016-01-01

    We present GyroVR, head worn flywheels designed to render inertia in Virtual Reality (VR. Motions such as flying, diving or floating in outer space generate kinesthetic forces onto our body which impede movement and are currently not represented in VR. We simulate those kinesthetic forces...... by attaching flywheels to the users head, leveraging the gyroscopic effect of resistance when changing the spinning axis of rotation. GyroVR is an ungrounded, wireless and self contained device allowing the user to freely move inside the virtual environment. The generic shape allows to attach it to different...... positions on the users body. We evaluated the impact of GyroVR onto different mounting positions on the head (back and front) in terms of immersion, enjoyment and simulator sickness. Our results show, that attaching GyroVR onto the users head (front of the Head Mounted Display (HMD)) resulted in the highest...

  13. 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.

  14. 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

  15. Very Low Head Turbine Deployment in Canada

    International Nuclear Information System (INIS)

    Kemp, P; Williams, C; Sasseville, Remi; Anderson, N

    2014-01-01

    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

  16. 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

  17. Abusive head trauma and accidental head injury: a 20-year comparative study of referrals to a hospital child protection team

    Science.gov (United States)

    John, Simon; Vincent, Andrea L; Reed, Peter

    2015-01-01

    Aim To describe children referred for suspected abusive head trauma (AHT) to a hospital child protection team in Auckland, New Zealand. Methods Comparative review of demographics, histories, injuries, investigations and diagnostic outcomes for referrals under 15 years old from 1991 to 2010. Results Records were available for 345 children. Referrals increased markedly (88 in the first decade, 257 in the second), but the diagnostic ratio was stable: AHT 60%, accidental or natural 29% and uncertain cause 11%. The probability of AHT was similar regardless of socio-economic status or ethnicity. In children under 2 years old with accidental head injuries (75/255, 29%) or AHT (180/255, 71%), characteristics of particular interest for AHT included no history of trauma (88/98, 90%), no evidence of impact to the head (84/93, 90%), complex skull fractures with intracranial injury (22/28, 79%), subdural haemorrhage (160/179, 89%) and hypoxic ischaemic injury (38/39, 97%). In children over 2 years old, these characteristics did not differ significantly between children with accidental head injuries (21/47, 45%) and AHT (26/47, 55%). The mortality of AHT was higher in children over 2 years old (10/26, 38%) than under 2 years (19/180, 11%). Conclusions The striking increase in referrals for AHT probably represents increasing incidence. The decision to refer a hospitalised child with a head injury for assessment for possible AHT should not be influenced by socio-economic status or ethnicity. Children over 2 years old hospitalised for AHT are usually injured by mechanisms involving impact and should be considered at high risk of death. PMID:26130384

  18. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring teeth ... find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring teeth ...

  19. Chemotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Pfister, David G.

    1997-01-01

    Purpose/Objective: The role of chemotherapy in the management of squamous cell carcinoma of the upper aerodigestive tract is undergoing rapid evolution. Historically, the use of chemotherapy was limited to patients with incurable disease who had exhausted all surgical and radiation therapy options. The results of recent randomized trials, however, suggest an increasing role for chemotherapy as part of primary management in patients with unresectable disease; advanced larynx or hypopharynx cancer with the intent of larynx preservation, or advanced nasopharynx cancer. This refresher course will provide a comprehensive overview of the current indications for chemotherapy in the management of these malignancies, and will highlight areas of controversy and future directions of investigation. More specifically, the following areas will be emphasized. 1. The identification of drugs commonly used in the management of head and neck cancer, their customary dosing and side effects. 2. The impact of induction and/or adjuvant chemotherapy combined with surgery and radiation therapy as defined by randomized trials, including a discussion of the Head and Neck Contracts program and the Intergroup adjuvant trial. 3. The development of larynx/function preservation treatment programs, including a review of the Veterans Administration and EORTC larynx preservation studies. 4. The evolving role of chemotherapy as part of innovative combined modality programs, especially in patients with unresectable disease. The rationale and utility of sequential versus concomitant/alternating chemotherapy-radiation strategies, and relevant randomized clinical trials comparing the different strategies will be discussed. 5. The appropriate application of chemotherapy in the palliative setting, including a discussion of the relative merits of single-agent versus combination chemotherapy

  20. Chemotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Pfister, David G.

    1995-01-01

    Purpose/Objective: The role of chemotherapy in the management of squamous cell carcinoma of the upper aerodigestive tract is undergoing rapid evolution. Historically, the use of chemotherapy was limited to patients with incurable disease who had exhausted all surgical and radiation therapy options. The results of recent randomized trials, however, suggest an increasing role for chemotherapy as part of primary management in patients seeking to avoid potentially morbid surgical procedures or with unresectable disease. This refresher course will provide a comprehensive overview of the current indications for chemotherapy in the management of these malignancies, and will highlight areas of controversy and future directions of investigation. More specifically, the following areas will be emphasized. 1. The identification of drugs commonly used in the management of head and neck cancer, their customary dosing and side effects. 2. The impact of induction and/or adjuvant chemotherapy combined with surgery and radiation therapy as defined by randomized trials, including a discussion of the Head and Neck Contracts program and the Intergroup adjuvant trial. 3. The development of larynx/function preservation treatment programs, including a review of the Memorial Hospital experience with larynx preservation and the Veterans Administration larynx preservation study. 4. The evolving role of chemotherapy as part of innovative combined modality programs, especially in patients with unresectable disease. The rationale and utility of sequential versus concomitant/alternating chemotherapy-radiation strategies, and relevant randomized clinical trials comparing the different strategies will be discussed. 5. The appropriate application of chemotherapy in the palliative setting, including a discussion of the relative merits of single-agent versus combination chemotherapy

  1. Not a NICE CT protocol for the acutely head injured child

    International Nuclear Information System (INIS)

    Willis, A.P.; Latif, S.A.A.; Chandratre, S.; Stanhope, B.; Johnson, K.

    2008-01-01

    Aim: To assess the impact of the introduction of the Birmingham Children's Hospital (BCH) head injury computed tomography (CT) guidelines, when compared with the National Institute of Health and Clinical Excellence (NICE) guidelines, on the number of children with head injuries referred from the Emergency Department (ED) undergoing a CT examination of the head. Material and methods: All children attending BCH ED over a 6-month period with any severity of head injury were included in the study. ED case notes were reviewed and data were collected on a specifically designed proforma. Indications for a CT examination according to both NICE and BCH head injury guidelines and whether or not CT examinations were performed were recorded. Results: A total of 1428 children attended the BCH ED following a head injury in the 6-month period. The median age was 4 years (range 6 days to 15 years) and 65% were boys. Four percent of children were referred for a CT using BCH guidelines and were appropriately examined. If the NICE guidelines had been strictly adhered to a further 8% of children would have undergone a CT examination of the head. All of these children were discharged without complication. The remaining 88% had no indication for CT examination by either BCH or NICE and appropriately did not undergo CT. Conclusions: Adherence to the NICE head injury guidelines would have resulted in a three-fold increase in the total number of CT examinations of the head. The BCH head injury guidelines are both safe and appropriate in the setting of a large children's hospital experienced in the management of children with head injuries

  2. 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 curative...... of the dysphagia outcomes during and after treatment. Adherence to exercises was poor and dropouts due to especially fatigue were very frequent in both groups. Systematic swallowing exercises had no impact on swallowing outcomes within the first year after RT. Despite repeated supervised sessions, adherence...

  3. Mechanical properties and examination of cracking in TMI-2 pressure vessel lower head material

    International Nuclear Information System (INIS)

    Diercks, D.R.; Neimark, L.A.

    1993-09-01

    Mechanical tests have been conducted on material from 15 samples removed from the lower head of the Three Mile Island unit 2 nuclear reactor pressure vessel. Measured properties include tensile properties and hardness profiles at room temperature, tensile and creep properties at temperatures of 600 to 1200 degrees C, and Charpy V-notch impact properties at -20 to +300 degrees C. These data, which were used in the subsequent analyses of the margin-to-failure of the lower head during the accident, are presented here. In addition, the results of metallographic and scanning electron microscope examinations of cladding cracking in three of the lower head samples are discussed

  4. Head position modulates optokinetic nystagmus.

    Science.gov (United States)

    Pettorossi, V E; Ferraresi, A; Botti, F M; Panichi, R; Barmack, N H

    2011-08-01

    Orientation and movement relies on both visual and vestibular information mapped in separate coordinate systems. Here, we examine how coordinate systems interact to guide eye movements of rabbits. We exposed rabbits to continuous horizontal optokinetic stimulation (HOKS) at 5°/s to evoke horizontal eye movements, while they were statically or dynamically roll-tilted about the longitudinal axis. During monocular or binocular HOKS, when the rabbit was roll-tilted 30° onto the side of the eye stimulated in the posterior → anterior (P → A) direction, slow phase eye velocity (SPEV) increased by 3.5-5°/s. When the rabbit was roll-tilted 30° onto the side of the eye stimulated in the A → P direction, SPEV decreased to ~2.5°/s. We also tested the effect of roll-tilt after prolonged optokinetic stimulation had induced a negative optokinetic afternystagmus (OKAN II). In this condition, the SPEV occurred in the dark, "open loop." Modulation of SPEV of OKAN II depended on the direction of the nystagmus and was consistent with that observed during "closed loop" HOKS. Dynamic roll-tilt influenced SPEV evoked by HOKS in a similar way. The amplitude and the phase of SPEV depended on the frequency of vestibular oscillation and on HOKS velocity. We conclude that the change in the linear acceleration of the gravity vector with respect to the head during roll-tilt modulates the gain of SPEV depending on its direction. This modulation improves gaze stability at different image retinal slip velocities caused by head roll-tilt during centric or eccentric head movement.

  5. Essential radiology for head injury

    International Nuclear Information System (INIS)

    Mok, D.W.H.; Kreel, L.

    1988-01-01

    The book covers the guidelines established by the Royal College of Radiologists for the radiographic evaluation of head injuries. It presents a chapter reviewing the normal radiologic anatomy of the skull in six different projections. The advantages and limitations of each projection are addressed. The third chapter, contains 43 radiographs dedicated to the calcified pineal gland and other intracranial calcifications. The book reports on specific types of fractures: linear fractures of the vault, depressed fractures of the vault, fractures in children, fractures of the base of the skull, and fractures of the facial bones

  6. 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

  7. HEAD MOVEMENT DURING WALKING IN THE CAT

    Science.gov (United States)

    ZUBAIR, HUMZA N.; BELOOZEROVA, IRINA N.; SUN, HAI; MARLINSKI, VLADIMIR

    2016-01-01

    Knowledge of how the head moves during locomotion is essential for understanding how locomotion is controlled by sensory systems of the head. We have analyzed head movements of the cat walking along a straight flat pathway in the darkness and light. We found that cats' head left-right translations, and roll and yaw rotations oscillated once per stride, while fore-aft and vertical translations, and pitch rotations oscillated twice. The head reached its highest vertical positions during second half of each forelimb swing, following maxima of the shoulder/trunk by 20–90°. Nose-up rotation followed head upward translation by another 40–90° delay. The peak-to-peak amplitude of vertical translation was ~1.5 cm and amplitude of pitch rotation was ~3°. Amplitudes of lateral translation and roll rotation were ~1 cm and 1.5–3°, respectively. Overall, cats' heads were neutral in roll and 10–30° nose-down, maintaining horizontal semicircular canals and utriculi within 10° of the earth horizontal. The head longitudinal velocity was 0.5–1 m/s, maximal upward and downward linear velocities were ~0.05 and ~0.1 m/s, respectively, and maximal lateral velocity was ~0.05 m/s. Maximal velocities of head pitch rotation were 20–50 °/s. During walking in light, cats stood 0.3–0.5 cm taller and held their head 0.5–2 cm higher than in darkness. Forward acceleration was 25–100% higher and peak-to-peak amplitude of head pitch oscillations was ~20 °/s larger. We concluded that, during walking, the head of the cat is held actively. Reflexes appear to play only a partial role in determining head movement, and vision might further diminish their role. PMID:27339731

  8. 45 CFR 1308.21 - Parent participation and transition of children into Head Start and from Head Start to public...

    Science.gov (United States)

    2010-10-01

    ... into Head Start and from Head Start to public school. 1308.21 Section 1308.21 Public Welfare... AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD START... Standards § 1308.21 Parent participation and transition of children into Head Start and from Head Start to...

  9. Experimental Research on the Specific Energy Consumption of Rock Breakage Using Different Waterjet-Assisted Cutting Heads

    Directory of Open Access Journals (Sweden)

    Hongxiang Jiang

    2018-01-01

    Full Text Available To investigate the specific energy consumption (SE of rock breakage by cutting heads assisted by different types of waterjet and to identify optimal waterjet parameters and assistance types, rock cutting with and without waterjets was carried on a rock fragmentation test bed. SE is a comprehensive evaluation index and was developed according to the applied load on cutting head, and the SE under different cutting conditions was compared and analyzed. The results show that the SE of rock breakage without waterjet assistance increased with the increasing of rock compressive strength (RCS but that the limited drilling depth decreased. The effect of the waterjet pressure on the SE of rock breakage by the cutting head I was marked, and SE decreased by 30∼40% when the ratio between RCS and waterjet pressure was less than 1. However, the function of the waterjet assistance was poor; therefore, a ratio of 1 could be used to distinguish the rock breakage effect of cutting head I. For cutting head II, the rock damage from the waterjet impact was limited due to the large waterjet standoff distance; thus the rock breakage performance of cutting head II was also limited. The waterjet impacting at the tip of the conical pick using cutting head III could enter into the cracks caused by the mechanical pick and fracture the rock. Therefore, the rock breakage performance of cutting head III was better than that of cutting head II.

  10. A pre-Hispanic head.

    Directory of Open Access Journals (Sweden)

    Raffaella Bianucci

    Full Text Available 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.

  11. A pre-Hispanic head.

    Science.gov (United States)

    Bianucci, Raffaella; Jeziorska, Maria; Lallo, Rudy; Mattutino, Grazia; Massimelli, Massimo; Phillips, Genevieve; Appenzeller, Otto

    2008-04-30

    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.

  12. Anatomy of the infant head

    International Nuclear Information System (INIS)

    Bosma, J.F.

    1986-01-01

    This text is mainly an atlas of illustration representing the dissection of the head and upper neck of the infant. It was prepared by the author over a 20-year period. The commentary compares the anatomy of the near-term infant with that of a younger fetus, child, and adult. As the author indicates, the dearth of anatomic information about postnatal anatomic changes represents a considerable handicap to those imaging infants. In part 1 of the book, anatomy is related to physiologic performance involving the pharynx, larynx, and mouth. Sequential topics involve the regional anatomy of the head (excluding the brain), the skeleton of the cranium, the nose, orbit, mouth, larynx, pharynx, and ear. To facilitate use of this text as a reference, the illustrations and text on individual organs are considered separately (i.e., the nose, the orbit, the eye, the mouth, the larynx, the pharynx, and the ear). Each part concerned with a separate organ includes materials from the regional illustrations contained in part 2 and from the skeleton, which is treated in part 3. Also included in a summary of the embryologic and fetal development of the organ

  13. Intention tremor after head injury

    International Nuclear Information System (INIS)

    Iwadate, Yasuo; Saeki, Naokatsu; Namba, Hiroki; Odaki, Masaru; Oka, Nobuo.

    1989-01-01

    Eight cases of intention tremor as a late complication of head injury were investigated. The patients ranged in age from 3 to 24 years. All received severe head injuries and lapsed into coma immediately afterward (Glasgow Coma Scale scores ≤8). Six patients exhibited decerebration or decortication. Hemiparesis was present in six cases and oculomotor nerve palsy in four. In the chronic stage, all patients displayed some degree of impairment of higher cortical function and five had dysarthria and/or ataxia. Initial computed tomography (CT) scans within 3 hours after the injury were obtained in five cases, of which four showed a hemorrhagic lesion in the midbrain or its surroundings. Other CT findings were diffuse cerebral swelling (four cases), intraventricular hemorrhage (three), and multiple hemorrhagic lesions (two). In the chronic stage, generalized cortical atrophy or ventricular enlargement was noted in five cases. These clinical features and CT findings indicate diffuse brain damage as well as midbrain damage and may reflect shearing injury. (author)

  14. Computing camera heading: A study

    Science.gov (United States)

    Zhang, John Jiaxiang

    2000-08-01

    An accurate estimate of the motion of a camera is a crucial first step for the 3D reconstruction of sites, objects, and buildings from video. Solutions to the camera heading problem can be readily applied to many areas, such as robotic navigation, surgical operation, video special effects, multimedia, and lately even in internet commerce. From image sequences of a real world scene, the problem is to calculate the directions of the camera translations. The presence of rotations makes this problem very hard. This is because rotations and translations can have similar effects on the images, and are thus hard to tell apart. However, the visual angles between the projection rays of point pairs are unaffected by rotations, and their changes over time contain sufficient information to determine the direction of camera translation. We developed a new formulation of the visual angle disparity approach, first introduced by Tomasi, to the camera heading problem. Our new derivation makes theoretical analysis possible. Most notably, a theorem is obtained that locates all possible singularities of the residual function for the underlying optimization problem. This allows identifying all computation trouble spots beforehand, and to design reliable and accurate computational optimization methods. A bootstrap-jackknife resampling method simultaneously reduces complexity and tolerates outliers well. Experiments with image sequences show accurate results when compared with the true camera motion as measured with mechanical devices.

  15. Ulnar nerve entrapment complicating radial head excision

    Directory of Open Access Journals (Sweden)

    Kevin Parfait Bienvenu Bouhelo-Pam

    Full Text Available Introduction: Several mechanisms are involved in ischemia or mechanical compression of ulnar nerve at the elbow. Presentation of case: We hereby present the case of a road accident victim, who received a radial head excision for an isolated fracture of the radial head and complicated by onset of cubital tunnel syndrome. This outcome could be the consequence of an iatrogenic valgus of the elbow due to excision of the radial head. Hitherto the surgical treatment of choice it is gradually been abandoned due to development of radial head implant arthroplasty. However, this management option is still being performed in some rural centers with low resources. Discussion: The radial head plays an important role in the stability of the elbow and his iatrogenic deformity can be complicated by cubital tunnel syndrome. Conclusion: An ulnar nerve release was performed with favorable outcome. Keywords: Cubital tunnel syndrome, Peripheral nerve palsy, Radial head excision, Elbow valgus

  16. A customized head and neck support system

    International Nuclear Information System (INIS)

    Bentel, Gunilla C.; Marks, Lawrence B.; Sherouse, George W.; Spencer, David P.

    1995-01-01

    Purpose: To describe a customized head and neck immobilization system for patients receiving radiotherapy including a head support that conforms to the posterior contour of the head and neck. Methods: The system includes a customized headrest to support the posterior head and neck. This is fixed to a thermoplastic face mask that molds to the anterior head/face contours. The shape of these customized head and neck supports were compared to 'standard' supports. Results: This system is comfortable for the patients and appears to be effective in reproducing the setup of the treatment. Conclusions: The variability in the size and shape of the customized posterior supports exceeded that of 'standard' headrests. It is our clinical impression that the customized supports improve reproducibility and are now a standard part of our immobilization system. The quantitative analysis of the customized headrests and some commonly used 'standard' headrests suggests that the customized supports are better able to address variabilities in patient shape

  17. Validation of a noninvasive system for measuring head acceleration for use during boxing competition.

    Science.gov (United States)

    Beckwith, Jonathan G; Chu, Jeffrey J; Greenwald, Richard M

    2007-08-01

    Although the epidemiology and mechanics of concussion in sports have been investigated for many years, the biomechanical factors that contribute to mild traumatic brain injury remain unclear because of the difficulties in measuring impact events in the field. The purpose of this study was to validate an instrumented boxing headgear (IBH) that can be used to measure impact severity and location during play. The instrumented boxing headgear data were processed to determine linear and rotational acceleration at the head center of gravity, impact location, and impact severity metrics, such as the Head Injury Criterion (HIC) and Gadd Severity Index (GSI). The instrumented boxing headgear was fitted to a Hybrid III (HIII) head form and impacted with a weighted pendulum to characterize accuracy and repeatability. Fifty-six impacts over 3 speeds and 5 locations were used to simulate blows most commonly observed in boxing. A high correlation between the HIII and instrumented boxing headgear was established for peak linear and rotational acceleration (r2= 0.91), HIC (r2 = 0.88), and GSI (r2 = 0.89). Mean location error was 9.7 +/- 5.2 masculine. Based on this study, the IBH is a valid system for measuring head acceleration and impact location that can be integrated into training and competition.

  18. Tridimensional pose estimation of a person head

    International Nuclear Information System (INIS)

    Perez Berenguer, Elisa; Soria, Carlos; Nasisi, Oscar; Mut, Vicente

    2007-01-01

    In this work, we present a method for estimating 3-D motion parameters; this method provides an alternative way for 3D head pose estimation from image sequence in the current computer vision literature. This method is robust over extended sequences and large head motions and accurately extracts the orientation angles of head from a single view. Experimental results show that this tracking system works well for development a human-computer interface for people that possess severe motor incapacity

  19. Remediation of attention deficits in head injury.

    OpenAIRE

    Nag S; Rao S

    1999-01-01

    Head injury is associated with psychological sequelae which impair the patient′s psychosocial functioning. Information processing, attention and memory deficits are seen in head injuries of all severity. We attempted to improve deficits of focused, sustained and divided attention. The principle of overlapping sources of attention resource pools was utilised in devising the remediation programme. Tasks used simple inexpensive materials. Four head injured young adult males with post conc...

  20. 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.

  1. Posture of the head and pharyngeal swallowing

    International Nuclear Information System (INIS)

    Ekberg, O.

    1986-01-01

    Closure of the laryngeal vestibule during swallowing is important for protection of the airways. The present investigation included 53 patients with dysphagia examined cineradiographically with the head held in resting posture, flexion and extension. The ability to protect the airways by the downward movement of the epiglottis and by obliteration of the laryngeal vestibule was studied in different postures of the head. Of 35 patients with normal laryngeal obliteration with the head in resting position 10 showed a defective closure at swallowing in extension. In 18 patients with defective closure of the laryngeal vestibule in resting position 9 were improved on flexion and two on extension of the head. In one patient with defectie closure of the laryngeal vestibule in resting position swallowing in flexion showed an aggravated dysfunction. In our other patients the defective closure became more marked on extension. Four patients had less effective downward movement of the epiglottis with the head in extension. Of 10 patients with defective epiglottic movement with the head in resting position two were improved on tilting the head forwards. The results show that the position of the head influences the closure of the airways during swallowing. Patients with defective protection of the laryngeal vestibule should be instructed to swallow with the head tilted forwards. (orig.)

  2. Multi-head Watson-Crick automata

    OpenAIRE

    Chatterjee, Kingshuk; Ray, Kumar Sankar

    2015-01-01

    Inspired by multi-head finite automata and Watson-Crick automata in this paper, we introduce new structure namely multi-head Watson-Crick automata where we replace the single tape of multi-head finite automaton by a DNA double strand. The content of the second tape is determined using a complementarity relation similar to Watson-Crick complementarity relation. We establish the superiority of our model over multi-head finite automata and also show that both the deterministic and non-determinis...

  3. 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.

  4. Radial head button holing: a cause of irreducible anterior radial head dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su-Mi; Chai, Jee Won; You, Ja Yeon; Park, Jina [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Bae, Kee Jeong [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Orthopedic Surgery, Seoul (Korea, Republic of)

    2016-10-15

    ''Buttonholing'' of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign. Magnetic resonance imaging (MRI) clearly demonstrated anterior dislocation of the fractured radial head through the torn annular ligament. The anterior joint capsule and proximal portion of the annular ligament were interposed between the radial head and capitellum, preventing closed reduction of the radial head. Familiarity with this condition and imaging findings will aid clinicians to make a proper diagnosis and fast decision to perform an open reduction. (orig.)

  5. Head First WordPress

    CERN Document Server

    Siarto, Jeff

    2010-01-01

    Whether you're promoting your business or writing about your travel adventures, Head First WordPress will teach you not only how to make your blog look unique and attention-grabbing, but also how to dig into the more complex features of WordPress 3.0 to make your website work well, too. You'll learn how to move beyond the standard WordPress look and feel by customizing your blog with your own URL, templates, plugin functionality, and more. As you learn, you'll be working with real WordPress files: The book's website provides pre-fab WordPress themes to download and work with as you follow al

  6. CT of the neonatal head

    International Nuclear Information System (INIS)

    Mohan, S.; Rogan, E.A.; Batty, R.; Raghavan, A.; Whitby, E.H.; Hart, A.R.; Connolly, D.J.A.

    2013-01-01

    Computed tomography (CT) is used less often than other techniques on neonatal units. However, in the acute setting, CT can be invaluable in diagnosing or excluding potentially life-threatening conditions and guiding initial management in neonates. Common indications for scanning include trauma, suspected non-accidental injury, infection, or an acute hypoxic or metabolic event. The aim of this review is to provide an overview of the normal neonatal head at CT and compare this to the common pathological abnormalities. Several key features of each condition will be highlighted. It is important to note that some pathological conditions can have overlapping features at CT and, therefore, the clinical history and additional investigations are also of key importance in determining the diagnosis

  7. Low-head hydro power

    Science.gov (United States)

    Lemer, E. J.

    1980-11-01

    With a view toward increasing the U.S. electric output, the Army Corps of Engineers has estimated that 55 GW can be obtained immediately from new capacity at existing dams and 40 GW more over the long term. Given the long lead times needed to build new dams, most interest has centered on the existing dams. The Corps of Engineers has established that 21 GW can be obtained from hydroelectric and 34 GW from nonpower dams. Existing hydroelectric sites are being expanded by the utilities, but exploitation of the nonpower dams will require governmental encouragement, because the vast majority are low-head sites (dams less than 40 m high). In the present paper, the question of economics and national policy is examined. The advantages which would accrue from substituting axial turbines for the Kaplan turbine are noted.

  8. Natural head position: An overview.

    Science.gov (United States)

    Meiyappan, N; Tamizharasi, S; Senthilkumar, K P; Janardhanan, K

    2015-08-01

    Cephalometrics has given us a different perspective of interpreting various skeletal problems in the dentofacial complex. Natural head position (NHP) is a reproducible, physiologically determined aspect of function. To determine NHP, a horizontal or vertical reference line outside the crania was used, but preference was given generally to the horizontal. Various intra and extracranial cephalometric horizontal reference planes have been used to formulate diagnosis and plan individualized treatment for an integrated correction of the malocclusion cephalometrics is constantly undergoing refinements in its techniques and analyses to improve the clinical applications. Even though various methods for establishing NHP have been proposed, still it remains a challenge to the clinicians to implement the concept of NHP thoroughly in all the stages of treatment because of practical difficulties in the clinical scenario.

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

    International Nuclear Information System (INIS)

    Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitose

    1979-01-01

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

  10. The current status of oncolytic viral therapy for head and neck cancer

    Directory of Open Access Journals (Sweden)

    Matthew O. Old

    2016-06-01

    Full Text Available Objective: Cancer affects the head and neck region frequently and leads to significant morbidity and mortality. Oncolytic viral therapy has the potential to make a big impact in cancers that affect the head and neck. We intend to review the current state of oncolytic viruses in the treatment of cancers that affect the head and neck region. Method: Data sources are from National clinical trials database, literature, and current research. Results: There are many past and active trials for oncolytic viruses that show promise for treating cancers of the head and neck. The first oncolytic virus was approved by the FDA October 2015 (T-VEC, Amgen for the treatment of melanoma. Active translational research continues for this and many other oncolytic viruses. Conclusion: The evolving field of oncolytic viruses is impacting the treatment of head and neck cancer and further trials and agents are moving forward in the coming years. Keywords: Head and neck squamous cell carcinoma, Oncolytic viruses, Clinical trials, Novel therapeutics

  11. 49 CFR 214.113 - Head protection.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Head protection. 214.113 Section 214.113 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... conform to the national consensus standards for industrial head protection (American National Standards...

  12. Systematic biases in human heading estimation.

    Directory of Open Access Journals (Sweden)

    Luigi F Cuturi

    Full Text Available Heading estimation is vital to everyday navigation and locomotion. Despite extensive behavioral and physiological research on both visual and vestibular heading estimation over more than two decades, the accuracy of heading estimation has not yet been systematically evaluated. Therefore human visual and vestibular heading estimation was assessed in the horizontal plane using a motion platform and stereo visual display. Heading angle was overestimated during forward movements and underestimated during backward movements in response to both visual and vestibular stimuli, indicating an overall multimodal bias toward lateral directions. Lateral biases are consistent with the overrepresentation of lateral preferred directions observed in neural populations that carry visual and vestibular heading information, including MSTd and otolith afferent populations. Due to this overrepresentation, population vector decoding yields patterns of bias remarkably similar to those observed behaviorally. Lateral biases are inconsistent with standard bayesian accounts which predict that estimates should be biased toward the most common straight forward heading direction. Nevertheless, lateral biases may be functionally relevant. They effectively constitute a perceptual scale expansion around straight ahead which could allow for more precise estimation and provide a high gain feedback signal to facilitate maintenance of straight-forward heading during everyday navigation and locomotion.

  13. Clinical features of the exploding head syndrome.

    Science.gov (United States)

    Pearce, J M

    1989-07-01

    Fifty patients suffering from the "exploding head syndrome" are described. This hitherto unreported syndrome is characterised by a sense of an explosive noise in the head usually in the twilight stage of sleep. The associated symptoms are varied, but the benign nature of the condition is emphasised and neither extensive investigation nor treatment are indicated.

  14. Clinical features of the exploding head syndrome.

    OpenAIRE

    Pearce, J M

    1989-01-01

    Fifty patients suffering from the "exploding head syndrome" are described. This hitherto unreported syndrome is characterised by a sense of an explosive noise in the head usually in the twilight stage of sleep. The associated symptoms are varied, but the benign nature of the condition is emphasised and neither extensive investigation nor treatment are indicated.

  15. The Role of the Primary School Head.

    Science.gov (United States)

    Davies, Lester

    1987-01-01

    This study uses Henry Mintzberg's structural observation method to examine British primary school head teachers' work patterns and determine the nature of their role. Head teachers' days were characterized by brevity, variety, and fragmentation similar to those discussed in findings of other empirical managerial studies. Leadership roles stressed…

  16. Elastic plastic buckling of elliptical vessel heads

    International Nuclear Information System (INIS)

    Alix, M.; Roche, R.L.

    1981-08-01

    The risks of buckling of dished vessel head increase when the vessel is thin walled. This paper gives the last results on experimental tests of 3 elliptical heads and compares all the results with some empirical formula dealing with elastic and plastic buckling

  17. 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 use...

  18. Motion control of the Twente humanoid head

    NARCIS (Netherlands)

    Visser, L.C.; Carloni, Raffaella; Stramigioli, Stefano

    2009-01-01

    In this work, we present the design and the realization of the motion control algorithm implemented in the Twente hu- manoid head, a seven degrees of freedom (dof) robotic sys- tem. The aim of the project is to have a humanoid head that can serve as a research platform for human-machine interac-

  19. 76 FR 70009 - Head Start Program

    Science.gov (United States)

    2011-11-09

    ... importance of the early years of a child's growth and development. On December 12, 2007, the Improving Head... education, serving nearly one million of our nation's most vulnerable young children and their families. It... Administration for Children and Families 45 CFR Part 1307 Head Start Program; Final Rule #0;#0;Federal Register...

  20. Visual perception of axes of head rotation

    Science.gov (United States)

    Arnoldussen, D. M.; Goossens, J.; van den Berg, A. V.

    2013-01-01

    Registration of ego-motion is important to accurately navigate through space. Movements of the head and eye relative to space are registered through the vestibular system and optical flow, respectively. Here, we address three questions concerning the visual registration of self-rotation. (1) Eye-in-head movements provide a link between the motion signals received by sensors in the moving eye and sensors in the moving head. How are these signals combined into an ego-rotation percept? We combined optic flow of simulated forward and rotational motion of the eye with different levels of eye-in-head rotation for a stationary head. We dissociated simulated gaze rotation and head rotation by different levels of eye-in-head pursuit. We found that perceived rotation matches simulated head- not gaze-rotation. This rejects a model for perceived self-rotation that relies on the rotation of the gaze line. Rather, eye-in-head signals serve to transform the optic flow's rotation information, that specifies rotation of the scene relative to the eye, into a rotation relative to the head. This suggests that transformed visual self-rotation signals may combine with vestibular signals. (2) Do transformed visual self-rotation signals reflect the arrangement of the semi-circular canals (SCC)? Previously, we found sub-regions within MST and V6+ that respond to the speed of the simulated head rotation. Here, we re-analyzed those Blood oxygenated level-dependent (BOLD) signals for the presence of a spatial dissociation related to the axes of visually simulated head rotation, such as have been found in sub-cortical regions of various animals. Contrary, we found a rather uniform BOLD response to simulated rotation along the three SCC axes. (3) We investigated if subject's sensitivity to the direction of the head rotation axis shows SCC axes specifcity. We found that sensitivity to head rotation is rather uniformly distributed, suggesting that in human cortex, visuo-vestibular integration is