Grant to support University of Dayton-led community brain health initiative

The University of Dayton will receive a three-year, $450,000 grant from The Dayton Foundation to fund education, research and community outreach to help improve prevention, treatment and rehabilitation for traumatic brain injurie

Overview of convolutional neural networks architectures for brain tumor segmentation

Due to the paramount importance of the medical field in the lives of people, researchers and experts exploited advancements in computer techniques to solve many diagnostic and analytical medical problems. Brain tumor diagnosis is one of the most important computational problems that has been studied and focused on. The brain tumor is determined by segmentation of brain images using many techniques based on magnetic resonance imaging (MRI). Brain tumor segmentation methods have been developed since a long time and are still evolving, but the current trend is to use deep convolutional neural networks (CNNs) due to its many breakthroughs and unprecedented results that have been achieved in various applications and their capacity to learn a hierarchy of progressively complicated characteristics from input without requiring manual feature extraction. Considering these unprecedented results, we present this paper as a brief review for main CNNs architecture types used in brain tumor segmentation. Specifically, we focus on researcher works that used the well-known brain tumor segmentation (BraTS) dataset

The dialogic construction of patient involvement in patient-centred neurorehabilitation

This paper explores how the practice of patient involvement in neurorehabilitation is constructed in tension-riddled professional narratives. I adopt dialogic communication theory to focus on how involvement is constructed across different roles and voices. My analysis is based on an action research project that uses a dialogical communication perspective and participatory methods to explore patient-centred care through the eyes of healthcare professionals. I argue that patient involvement is constructed as a demanding process that requires memory, presence, communicative abilities and temporal understanding of personal needs. These requirements are not explicit in the situated institutionalized practices. As well, I show how the available involvement strategies are laced with taken for granted characteristics, which fall short in the situation that arises when patients do not have the ability to participate or play the role of an active patient. The findings in this paper contribute to the growing literature on patient-centred healthcare by empirically investigating how the discursive configuration of patient, health professional and institutional practices intertwine in producing certain inherent expectations, habits and taken for granted perspectives in care delivery. I also suggest that the findings can usefully be incorporated into patient-centred care design and organizational strategies in order to take into account both the patient, relatives and healthcare professionals as vital for creating a patient-centred practice, organization and professional environment

Clinical and cognitive correlates tractography analysis in patients with white matter hyperintensity of vascular origin

PurposeWhite matter hyperintensity lesions (WMHL) in the brain are a consequence of cerebral small vessel disease and microstructural damage. Patients with WMHL have diverse clinical features, and hypertension, advanced age, obesity, and cognitive decline are often observed. However, whether these clinical features are linked to interrupted structural connectivity in the brain requires further investigation. This study therefore explores the white matter pathways associated with WMHL, with the objective of identifying neural correlates for clinical features in patients with WMHL.MethodsDiffusion magnetic resonance imaging (MRI) and several clinical features (MoCA scores, hypertension scores, body mass index (BMI), duration of hypertension, total white matter lesion loads, and education.) highly related to WMHL were obtained in 16 patients with WMHL and 20 health controls. We used diffusion MRI connectometry to explore the relationship between clinical features and specific white matter tracts using DSI software.ResultsThe results showed that the anterior splenium of the corpus callosum, the inferior longitudinal fasciculus, the anterior corpus callosum and the middle cerebellar peduncle were significantly correlated with hypertension scores (false discovery rate (FDR) = 0.044). The anterior splenium of the corpus callosum, the left thalamoparietal tract, the inferior longitudinal fasciculus, and the left cerebellar were significantly correlated with MoCA scores (FDR = 0.016). The anterior splenium of corpus callosum, inferior fronto-occipital fasciculus, cingulum fasciculus, and fornix/fimbria were significantly correlated with body mass index (FDR = 0.001).ConclusionOur findings show that hypertension score, MoCA score, and BMI are important clinical features in patients with WMHL, hypertension degree and higher BMI are associated with whiter matter local disconnection in patients with WMHL, and may contribute to understanding the cognitive impairments observed in patients with WMHL

Health risks of practicing martial arts

Kontaktnim sportovima se u zadnjih dvadeset godina počelo baviti sve više ljudi, raznih dobnih skupina, radi raznih razloga, kao što su rekreacija, zdravlje ili natjecanje. Zbog sve veće popularnosti kontaktnih sportova, što zbog televizijskih prijenosa velikih mečeva, što zbog sve prisutnijih akcijskih filmova, učestalije bavljenje ovim sportovima dovodi do sve češćih ozljeda tipičnih za te aktivnosti. Postoji potreba za detaljnijim opisom i analizom učestalosti, lokalizacija, liječenja i mogućnosti prevencije tih tipičnih povreda u ovim vrstama sporta. Sportska ozljeda kao pojam označava sve ozljede koje su se dogodile za vrijeme tjelesne aktivnosti (natjecanja, treninzi, rekreacija). Raznovrsnost borilačkih sportova, kao i ozljeda u svakom pojedinom sportu je velika. Ovaj rad analizira tri tipična kontaktna sporta, boks, karate i judo, koji se treniraju diljem svijeta. Povrede u ova tri sporta predstavljaju veliku većinu svih ozljeda koje se mogu dogoditi u ostalim kontaktnim sportovima.Contact sports in the last twenty years began to engage more people, different age groups, to various reasons, such as recreation, health or competition. Due to the increasing popularity of contact sports, because of television broadcasts of major matches, which due to ubiquitous action movies, frequently engage in these sports leads to increasingly frequent injuries typical for these activities. There is a need for a detailed description and analysis of the frequency, localization, treatment and possible prevention of these injuries typical in these types of sports. Sports injury as a term means all injuries that occurred during physical activity (competition, training, recreation). Variety of martial arts, as well as injuries in each sport is great. This paper analyzes three typical contact sports, boxing, karate and judo, which are trained around the world. Injuries in these three sports represent the vast majority of injuries that occur in other contact sports

Health risks of practicing martial arts

Kontaktnim sportovima se u zadnjih dvadeset godina počelo baviti sve više ljudi, raznih dobnih skupina, radi raznih razloga, kao što su rekreacija, zdravlje ili natjecanje. Zbog sve veće popularnosti kontaktnih sportova, što zbog televizijskih prijenosa velikih mečeva, što zbog sve prisutnijih akcijskih filmova, učestalije bavljenje ovim sportovima dovodi do sve češćih ozljeda tipičnih za te aktivnosti. Postoji potreba za detaljnijim opisom i analizom učestalosti, lokalizacija, liječenja i mogućnosti prevencije tih tipičnih povreda u ovim vrstama sporta. Sportska ozljeda kao pojam označava sve ozljede koje su se dogodile za vrijeme tjelesne aktivnosti (natjecanja, treninzi, rekreacija). Raznovrsnost borilačkih sportova, kao i ozljeda u svakom pojedinom sportu je velika. Ovaj rad analizira tri tipična kontaktna sporta, boks, karate i judo, koji se treniraju diljem svijeta. Povrede u ova tri sporta predstavljaju veliku većinu svih ozljeda koje se mogu dogoditi u ostalim kontaktnim sportovima.Contact sports in the last twenty years began to engage more people, different age groups, to various reasons, such as recreation, health or competition. Due to the increasing popularity of contact sports, because of television broadcasts of major matches, which due to ubiquitous action movies, frequently engage in these sports leads to increasingly frequent injuries typical for these activities. There is a need for a detailed description and analysis of the frequency, localization, treatment and possible prevention of these injuries typical in these types of sports. Sports injury as a term means all injuries that occurred during physical activity (competition, training, recreation). Variety of martial arts, as well as injuries in each sport is great. This paper analyzes three typical contact sports, boxing, karate and judo, which are trained around the world. Injuries in these three sports represent the vast majority of injuries that occur in other contact sports

Vocational Rehabilitation of Clients with Brain Injury: An Investigation of Racial Disparity within The Rehabilitation Services Administration (RSA) 911 Database

Finding and maintaining employment is an ongoing problem for persons with disabilities, especially those with brain injuries. State vocational rehabilitation agencies are the primary authority responsible for providing employment-related services for individuals with disabilities throughout the United States. Little effort has been committed to identifying disparities in health and rehabilitation services provided to Americans with disabilities, particularly those with brain injuries. The purpose of this investigation was to utilize Aday and Andersen\u27s Framework for the Study of Access to examine racial disparity within the Rehabilitation Services Administration 911 Database, and thus the vocational rehabilitation system, among clients with brain injury. Upon review of the descriptive findings, Whites and Asian or Pacific Islanders were more likely to be accepted for rehabilitation than Blacks and American Indians or Alaskan Natives. Acceptance rates for males and females were similar. Clients, who received their primary source of support from “other” sources at the time of application, were least likely to be accepted for vocational rehabilitation. Hispanics appeared to have lower acceptance rates than non-Hispanics. Persons with greater than a high school education were more likely to be accepted for rehabilitation than persons with less education who had completed schooling through the regular education system. Exhaustive CHAID findings suggest that racial disparity in rehabilitation acceptance rates is not a clear cut issue. Each of the racial groups was more likely to be accepted for rehabilitation under different circumstances. Consequently, a definitive broadcast statement about racial disparity within the Federal Rehabilitation System cannot be made. With regard to reason for closure, although the Chi-square analyses for the current investigation were significant, the degree of association was extremely modest. There did not appear to be a practical difference between White and non-White clients with regard to reason for closure. Future research, and practice and policy implications are discussed

Acute lung injury in paediatric intensive care: course and outcome

Introduction: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) carry a high morbidity and mortality (10-90%). ALI is characterised by non-cardiogenic pulmonary oedema and refractory hypoxaemia of multifactorial aetiology [1]. There is limited data about outcome particularly in children. Methods This retrospective cohort study of 85 randomly selected patients with respiratory failure recruited from a prospectively collected database represents 7.1% of 1187 admissions. They include those treated with High Frequency Oscillation Ventilation (HFOV). The patients were admitted between 1 November 1998 and 31 October 2000. Results: Of the 85, 49 developed acute lung injury and 47 had ARDS. There were 26 males and 23 females with a median age and weight of 7.7 months (range 1 day-12.8 years) and 8 kg (range 0.8-40 kg). There were 7 deaths giving a crude mortality of 14.3%, all of which fulfilled the Consensus I [1] criteria for ARDS. Pulmonary occlusion pressures were not routinely measured. The A-a gradient and PaO2/FiO2 ratio (median + [95% CI]) were 37.46 [31.82-43.1] kPa and 19.12 [15.26-22.98] kPa respectively. The non-survivors had a significantly lower PaO2/FiO2 ratio (13 [6.07-19.93] kPa) compared to survivors (23.85 [19.57-28.13] kPa) (P = 0.03) and had a higher A-a gradient (51.05 [35.68-66.42] kPa) compared to survivors (36.07 [30.2-41.94]) kPa though not significant (P = 0.06). Twenty-nine patients (59.2%) were oscillated (Sensormedics 3100A) including all 7 non-survivors. There was no difference in ventilation requirements for CMV prior to oscillation. Seventeen of the 49 (34.7%) were treated with Nitric Oxide including 5 out of 7 non-survivors (71.4%). The median (95% CI) number of failed organs was 3 (1.96-4.04) for non-survivors compared to 1 (0.62-1.62) for survivors (P = 0.03). There were 27 patients with isolated respiratory failure all of whom survived. Six (85.7%) of the non-survivors also required cardiovascular support.Conclusion: A crude mortality of 14.3% compares favourably to published data. The A-a gradient and PaO2/FiO2 ratio may be of help in morbidity scoring in paediatric ARDS. Use of Nitric Oxide and HFOV is associated with increased mortality, which probably relates to the severity of disease. Multiple organ failure particularly respiratory and cardiac disease is associated with increased mortality. ARDS with isolated respiratory failure carries a good prognosis in children

ACUTE STRESS AND TRAUMA AT WORK: PREVENTION AND RISK MANAGEMENT IN THE BANKING SECTOR

Background Relevance of the topic and the necessity for scientific investigation Robberies at the bank branches are potentially traumatic events. Many bank employees experiencing a robbery in their workplace suffer important negative consequences as numerous clinical symptoms of post-traumatic stress, worse physical health, impaired productivity and intention to leave their job, both immediately and up to six months after bank robbery. Despite decreasing in frequency, there is an ongoing risk in the bank branches: such events are difficult to predict, and primary intervention strategies may not completely eliminate the risk. Motives for choosing a particular topic Although bank robberies are potentially traumatic event, little is known about the psychological sequelae of those involved. Post-traumatic stress disorder (PTSD) literature has largely focused on victims of specific traumas, such as sexual violence, natural disaster, and military combat. PTSD in the occupational context is still under-investigated, and research mainly concerns specific occupational groups as emergency service personnel, police officers, firefighters, and health care workers. Studies concerning the psychological consequences of bank robberies are limited, mostly based on convenience samples, and vary in outcomes measures and design substantially, thus making comparisons difficult. \u2003 Research problem and why it is worthwhile studying Since only a minority of subjects experiencing such event in the workplace develop long-term clinically important symptoms and functional impairment, understanding the antecedents of occupational PTSD is a key goal of research. A better understanding of risk factors associated to post-traumatic stress reactions may improve early treatment and preventive intervention, thus reducing PTSD onset and worsening of symptoms. Research objectives The study has three main objectives. The first aim is to evaluate the impact of bank robbery on employees psychological well-being, thus investigating post-traumatic stress reactions. The second one is to better understand risk factors associated to the onset of post-traumatic symptomatology. Consequently, the third aim is to inform the development of new interventions and risk management strategies. Research methodology Nine hundred twenty-four employees of a primary Italian bank group, victims of 238 different robberies, voluntarily joined an employer-sponsored post-robbery support program: - a structured and collective support interview (i.e. psychological debriefing) was conducted with robbery victims within 7-15 days after the event (T1) at the bank branch. A self-reported questionnaire collected socio-demographic information, number of bank robberies occurred during participants\u2019 working life, detailed description of the last robbery with closed and open-ended questions, assessment of post-traumatic stress reaction (Impact of Event Scale); - a follow-up psychological assessment (through structured individual interviews) was conducted 45 days after the first session (T2). Interview investigated victims\u2019 general health conditions and self-reported trajectory of post-traumatic symptoms after robbery, victims\u2019 evaluation of the intervention, assessment of post-traumatic stress reaction (Impact of Event Scale). To accomplish with our objectives, the following statistical analysis were adopted: - Absolute and relative frequencies or means and standard deviations, \u3c72 and one-way ANOVA for categorical or continuous variables respectively. - Logistic and linear multilevel regression to estimate the impact of predictive values on post-traumatic symptoms: random intercept mixed-effect regression models to account for subjects\u2019 clustering within robberies. Three hierarchical models were adopted (Model 1: pre-trauma risk factors; Model 2: peri-trauma risk factors; Model 3: subjective perception and reaction to robberies). - Residual pseudo-likelihood test (H0: \u3c3 2 = 0) to assess the significance of unmeasured robbery- related factors; latent variable threshold model approach for the calculation of the variance partition coefficient. Results The final sample consisted in 595 subjects, victims of 238 different robberies. Correlates of early post-robbery reactions were age, being female, being cashier, geographical region, perception of robbers as out of control; after including feelings of fear, terror and hopelessness during the robbery, all the other variables lost statistical significance. IES scores decreased during the follow-up ( 06T1-T2=15.76; p34, a cut-off suggestive of Post-traumatic stress disorder (PTSD). In the multivariable model, age, being female, being cashier, presence of arms, being injured, were associated with PTSD diagnosis. After including early subjective reaction, IES score at T1 was the strongest predictor. Unmeasured robbery-related factors explained a significant portion (24%) of IES variance at T1 after excluding small groups (number of colleagues <5). Limitations Possible selection bias due to the voluntary participation into the intervention program cannot be excluded. Information on non-occupational traumatic events occurred in subjects\u2019 life time and pre-existent psychiatric disorders, as well as perceived support after the event, could not be collected. Assessment of post-traumatic stress symptoms relied on self-report measure without a thorough clinical examination; thus, Impact of Event Scale did not include all criteria for Post-traumatic stress disorder stated by recent DSM-V. Originality of the study The study gives an original contribution to the existing literature of psychological sequelae following bank robbery: to date, this is the longitudinal study with the largest sample assessing prevalence and predictors of post-traumatic stress symptoms; logistic and linear multilevel regression provided a valuable understanding of risk factors; furthermore, no studies had previous investigated the role of group factor in the aftermath of post-traumatic reaction following bank robbery or acute stress at work. Conclusion/Practical implication Our findings showed that bank robbery is a potential traumatizing event associated with both immediate and long-term posttraumatic stress symptoms. Results suggested the weight of subjective variables, such as personal perception of robbery severity and early emotional reaction, in identifying persons at higher risk to develop PTSD. Our findings may help management and prevention of acute stress and trauma in the banking sector, contributing to post-traumatic stress literature. Finally, group factors, an often overlooked dimension in post-traumatic stress literature, might affect the risk of PTSD, thus encouraging further research