Epidemiology of traumatic brain injury in Europe

Background: Traumatic brain injury (TBI) is a critical public health and socio-economic problem throughout the world, making epidemiological monitoring of incidence, prevalence and outcome of TBI necessary. We aimed to describe the epidemiology of traumatic brain injury in Europe and to evaluate the methodology of incidence studies. Method: We performed a systematic review and meta-analyses of articles describing the epidemiology of TBI in European countries. A search was conducted in the PubMed electronic database using the terms: epidemiology, incidence, brain injur*, head injur* and Europe. Only articles published in English and reporting on data collected in Europe between 1990 and 2014 were included. Results: In total, 28 epidemiological studies on TBI from 16 European countries were identified in the literature. A great variation was found in case definitions and case ascertainment between studies. Falls and road traffic accidents (RTA) were the two most frequent causes of TBI, with falls being reported more frequently than RTA. In most of the studies a peak TBI incidence was seen in the oldest age groups. In the meta-analysis, an overall incidence rate of 262 per 100,000 for admitted TBI was derived. Conclusions: Interpretation of published epidemiologic studies is confounded by differences in inclusion criteria and case ascertainment. Nevertheless, changes in epidemiological patterns are found: falls are now the most common cause of TBI, most notably in elderly patients. Improvement of the quality of standardised data collection for TBI is mandatory for reliable monitoring of epidemiological trends and to inform appropriate targeting of prevention campaigns

Phosphonium-based polythiophene conjugated polyelectrolytes with different surfactant counterions: thermal properties, self-assembly and photovoltaic performances

© 2020 Society of Industrial Chemistry Phosphonium-based polythiophene conjugated polyelectrolytes (CPEs) with three different counterions (dodecylsulfate, octylsulfate and perfluorooctane sulfonate) are synthesized to determine how the nature of the counterion affects the thermal properties, the self-assembly in thin films and the performance as the cathode interfacial layer in polymer solar cells (PSCs). The counterion has a significant effect on the thermal properties of the CPEs, affecting both their glass transition and crystalline behaviour. Grazing-incidence wide-angle X-ray scattering studies also indicate that changing the nature of the counterion influences the microstructural organization in thin films (face-on versus edge-on orientation). The affinity of the CPEs with the underlying photoactive layer in PSCs is highly correlated with the counterion species. Finally, in addition to an increase of the power conversion efficiency of ca 15% when using these CPEs as cathode interfacial layers in PSCs, a higher device stability is noted, compared to a reference device with a calcium interlayer. © 2020 Society of Industrial Chemistry

Design and Process Development for Smart Phone Medication Dosing Support System and Educational Platform in HIV/Aids-TB Programs in Zambia

The widespread adoption of cell phones and other mobile platforms represents an opportunity to extend the benefits of personalized, point-of-care, healthcare applications to providers and patients in the developing world. However, the challenges facing the effective deployment of mobile health care applications are complex, and thus require a scalable, flexible, and configurable approach. A service-oriented-architecture-based conceptual framework is proposed to address the challenges of developing and deploying mobile health care applications. A particular emphasis of the framework is a service-agent-modeling-based composite process-personalization support that is needed to support the diverse and adaptable needs of the users

Self-assembled conjugated polyelectrolyte-surfactant complexes as efficient cathode interlayer materials for bulk heterojunction organic solar cells

Conjugated polyelectrolyte–surfactant cathodic interface layers lead to improved power conversion efficiencies in organic solar cells.</p

All-conjugated cationic copolythiophene "rod-rod" block copolyelectrolytes: Synthesis, optical properties and solvent-dependent assembly

The optical and thermal properties and solvent-dependent assembly of all-conjugated cationic copolythiophene block copolyelectrolytes are investigated.</p

Prehospital Trauma Care among 68 European Neurotrauma Centers: Results of the CENTER-TBI Provider Profiling Questionnaires

The first hour following traumatic brain injury (TBI) is considered crucial to prevent death and disability. It is, however, not established yet how the prehospital care should be organized to optimize recovery during the first hour. The objective of the current study was to examine variation in prehospital trauma care across Europe aiming to inform comparative effectiveness analyses on care for neurotrauma patients. A survey on prehospital trauma care was sent to 68 neurotrauma centers from 20 European countries participating in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study. The survey was developed using literature review and expert opinion and was pilot tested in 16 centers. All participants completed the questionnaire. Advanced life support was used in half of the centers (n = 35; 52%), whereas the other centers used mainly basic life support (n = 26; 38%). A mobile medical team (MMT) could be dispatched 24/7 in most centers (n = 66; 97%). Helicopters were used in approximately half of the centers to transport the MMT to the scene (n = 39; 57%) and the patient to the hospital (n = 31, 46%). Half of the centers used a stay-and-play approach at the scene (n = 37; 55%), while the others used a scoop-and-run approach or another policy. We found wide variation in prehospital trauma care across Europe. This may reflect differences in socio-economic situations, geographic differences, and a general lack of strong evidence for some aspects of prehospital care. The current variation provides the opportunity to study the effectiveness of prehospital interventions and systems of care in comparative effectiveness research

Prehospital Trauma Care among 68 European Neurotrauma Centers: Results of the CENTER-TBI Provider Pr

The first hour following traumatic brain injury (TBI) is considered crucial to prevent death and disability. It is, however, not established yet how the prehospital care should be organized to optimize recovery during the first hour. The objective of the current study was to examine variation in prehospital trauma care across Europe aiming to inform comparative effectiveness analyses on care for neurotrauma patients. A survey on prehospital trauma care was sent to 68 neurotrauma centers from 20 European countries participating in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study. The survey was developed using literature review and expert opinion and was pilot tested in 16 centers. All participants completed the questionnaire. Advanced life support was used in half of the centers (n = 35; 52%), whereas the other centers used mainly basic life support (n = 26; 38%). A mobile medical team (MMT) could be dispatched 24/7 in most centers (n = 66; 97%). Helicopters were used in approximately half of the centers to transport the MMT to the scene (n = 39; 57%) and the patient to the hospital (n = 31, 46%). Half of the centers used a stay-and-play approach at the scene (n = 37; 55%), while the others used a scoop-and-run approach or another policy. We found wide variation in prehospital trauma care across Europe. This may reflect differences in socio-economic situations, geographic differences, and a general lack of strong evidence for some aspects of prehospital care. The current variation provides the opportunity to study the effectiveness of prehospital interventions and systems of care in comparative effectiveness research

GJ 1252b: A Hot Terrestrial Super-Earth With No Atmosphere

The increasing numbers of rocky, terrestrial exoplanets known to orbit nearby stars (especially M dwarfs) has drawn increased attention to the possibility of studying these planets' surface properties, and atmospheric compositions & escape histories. Here we report the detection of the secondary eclipse of the terrestrial exoplanet GJ1252b using the Spitzer Space Telescope's IRAC2 4.5 micron channel. We measure an eclipse depth of 149(+25/-32) ppm, corresponding to a day-side brightness temperature of 1410(+91/-125) K and consistent with the prediction for no atmosphere. Comparing our measurement to atmospheric models indicates that GJ1252b has a surface pressure of <10 bar, substantially less than Venus. Assuming energy-limited escape, even a 100 bar atmosphere would be lost in <1 Myr, far shorter than estimated age of 3.9+/-0.4 Gyr. The expected mass loss could be overcome by mantle outgassing, but only if the mantle's carbon content were >7% by mass - over two orders of magnitude greater than that found in Earth. We therefore conclude that GJ1252b has no significant atmosphere. Model spectra with granitoid or feldspathic surface composition, but with no atmosphere, are disfavored at >2 sigma. The eclipse occurs just +1.4(+2.8/-1.0) min after orbital phase 0.5, indicating e cos omega=+0.0025(+0.0049/-0.0018), consistent with a circular orbit. Tidal heating is therefore likely to be negligible to GJ1252b's global energy budget. Finally, we also analyze additional, unpublished TESS transit photometry of GJ1252b which improves the precision of the transit ephemeris by a factor of ten, provides a more precise planetary radius of 1.180+/-0.078 R_E, and rules out any transit timing variations with amplitudes <1 min.Comment: ApJL in press. 16 pages, 12 figures, 10 eclipses, 1 bandpass. Models will be available at journal websit

Probiotic Sonicates Selectively Induce Mucosal Immune Cells Apoptosis through Ceramide Generation via Neutral Sphingomyelinase

This is an open-access article distributed under the terms of the Creative Commons Attribution License.-- et al.[Background]: Probiotics appear to be beneficial in inflammatory bowel disease, but their mechanism of action is incompletely understood. We investigated whether probiotic-derived sphingomyelinase mediates this beneficial effect. [Methodology/Principal Findings]: Neutral sphingomyelinase (NSMase) activity was measured in sonicates of the probiotic L. brevis (LB) and S. thermophilus (ST) and the non-probiotic E. coli (EC) and E. faecalis (EF). Lamina propria mononuclear cells (LPMC) were obtained from patients with Crohn's disease (CD) and Ulcerative Colitis (UC), and peripheral blood mononuclear cells (PBMC) from healthy volunteers, analysing LPMC and PBMC apoptosis susceptibility, reactive oxygen species (ROS) generation and JNK activation. In some experiments, sonicates were preincubated with GSH or GW4869, a specific NSMase inhibitor. NSMase activity of LB and ST was 10-fold that of EC and EF sonicates. LB and ST sonicates induced significantly more apoptosis of CD and UC than control LPMC, whereas EC and EF sonicates failed to induce apoptosis. Pre-stimulation with anti-CD3/CD28 induced a significant and time-dependent increase in LB-induced apoptosis of LPMC and PBMC. Exposure to LB sonicates resulted in JNK activation and ROS production by LPMC. NSMase activity of LB sonicates was completely abrogated by GW4869, causing a dose-dependent reduction of LB-induced apoptosis. LB and ST selectively induced immune cell apoptosis, an effect dependent on the degree of cell activation and mediated by bacterial NSMase. [Conclusions]: These results suggest that induction of immune cell apoptosis is a mechanism of action of some probiotics, and that NSMase-mediated ceramide generation contributes to the therapeutic effects of probiotics.The funding sources included grants from Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Ministerio de Ciencia e Innovación (SAF2005-00280 and SAF2008-03676 to MS, FIS2009-00056 to AM, SAF2009-11417 to JCF), Fundación Ramón Areces (to MS), the National Institutes of Health (DK30399 and DK50984 to CF) and the Research Center for Liver and Pancreatic Diseases funded by the United States National Institute for Alcohol Abuse and Alcoholism (P50 AA 11999 to JCF).Peer reviewe