Outcomes after Complicated and Uncomplicated Mild Traumatic Brain Injury at Three- and Six-Months Post-Injury: Results from the CENTER-TBI Study

The objective of this study was to provide a comprehensive examination of the relation of complicated and uncomplicated mild traumatic brain injury (mTBI) with multidimensional outcomes at three- and six-months after TBI. We analyzed data from the Collaborative European NeuroTrauma Effectiveness Research (CENTER-TBI) research project. Patients after mTBI (Glasgow Coma scale (GCS) score of 13–15) enrolled in the study were differentiated into two groups based on computed tomography (CT) findings: complicated mTBI (presence of any traumatic intracranial injury on first CT) and uncomplicated mTBI (absence of any traumatic intracranial injury on first CT). Multidimensional outcomes were assessed using seven instruments measuring generic and disease-specific health-related quality of life (HRQoL) (SF-36 and QOLIBRI), functional outcome (GOSE), and psycho-social domains including symptoms of post-traumatic stress disorder (PTSD) (PCL-5), depression (PHQ-9), and anxiety (GAD-7). Data were analyzed using a multivariate repeated measures approach (MANOVA-RM), which inspected mTBI groups at three- and six-months post injury. Patients after complicated mTBI had significantly lower GOSE scores, reported lower physical and mental component summary scores based on the SF-36 version 2, and showed significantly lower HRQoL measured by QOLIBRI compared to those after uncomplicated mTBI. There was no difference between mTBI groups when looking at psychological outcomes, however, a slight improvement in PTSD symptoms and depression was observed for the entire sample from three to six months. Patients after complicated mTBI reported lower generic and disease specific HRQoL and worse functional outcome compared to individuals after uncomplicated mTBI at three and six months. Both groups showed a tendency to improve from three to six months after TBI. The complicated mTBI group included more patients with an impaired long-term outcome than the uncomplicated group. Nevertheless, patients, clinicians, researchers, and decisions-makers in health care should take account of the short and long-term impact on outcome for patients after both uncomplicated and complicated mTBI

In Deadly Time: The Lasting On of Waste in Mayhew’s London

This paper examines the temporal dimension of waste in Henry Mayhew’s London Labour and the London Poor as an instance of how modernity has produced a largely hidden domain of the non-identical and indeterminate. Through a consideration of the phenomena of uselessness, decay and poverty I argue that the temporal dimension of waste is constituted as a corrosive or malign ‘Deadly Time.’ In placing such emphasis on time directed towards death, I aim to show that Mayhew’s undisciplined researches can be seen as a valuable source for understanding why modern thinking struggles to come to terms with waste

Study protocol P-MAPS: microbiome as predictor of severity in acute pancreatitis—a prospective multicentre translational study

Background!#!Acute pancreatitis (AP) is an inflammatory disorder that causes a considerable economic health burden. While the overall mortality is low, around 20% of patients have a complicated course of disease resulting in increased morbidity and mortality. There is an emerging body of evidence that the microbiome exerts a crucial impact on the pathophysiology and course of AP. For several decades multiple clinical and laboratory parameters have been evaluated, and complex scoring systems were developed to predict the clinical course of AP upon admission. However, the majority of scoring systems are determined after several days and achieve a sensitivity around 70% for early prediction of severe AP. Thus, continued efforts are required to investigate reliable biomarkers for the early prediction of severity in order to guide early clinical management of AP patients.!##!Methods!#!We designed a multi-center, prospective clinical-translational study to test whether the orointestinal microbiome may serve as novel early predictor of the course, severity and outcome of patients with AP. We will recruit 400 AP patients and obtain buccal and rectal swabs within 72 h of admission to the hospital. Following DNA extraction, microbiome analysis will be performed using 3rd generation sequencing Oxford Nanopore Technologies (ONT) for 16S rRNA and metagenomic sequencing. Alpha- and beta-diversity will be determined and correlated to the revised Atlanta classification and additional clinical outcome parameters such as the length of hospital stay, number and type of complications, number of interventions and 30-day mortality.!##!Discussion!#!If AP patients show a distinct orointestinal microbiome dependent on the severity and course of the disease, microbiome sequencing could rapidly be implemented in the early clinical management of AP patients in the future.!##!Trial registration!#!ClinicalTrials.gov Identifier: NCT04777812

Syntactical And Semantical Description Of Video Sequences

Archiving, processing, and intelligent retrieval of digital video sequences can be efficiently solved by a high-level representation of video sequences. We describe a complete system for encoding the context of video..

Entwicklung und Evaluation eines Konzeptes zur berufsübergreifenden Zusammenarbeit bei Patientinnen und Patienten mit palliativem Versorgungsbedarf (KOPAL) – Studienprotokoll

Marx G, Mallon T, Nauck F, et al. Entwicklung und Evaluation eines Konzeptes zur berufsübergreifenden Zusammenarbeit bei Patientinnen und Patienten mit palliativem Versorgungsbedarf (KOPAL) – Studienprotokoll. In: 13. Kongress der Deutschen Gesellschaft für Palliativmedizin. Zeitschrift für Palliativmedizin. Vol 21. Stuttgart: Georg Thieme Verlag; 2020