Padded Helmet Shell Covers in American Football: A Comprehensive Laboratory Evaluation with Preliminary On-Field Findings

Protective headgear effects measured in the laboratory may not always translate to the field. In this study, we evaluated the impact attenuation capabilities of a commercially available padded helmet shell cover in the laboratory and field. In the laboratory, we evaluated the efficacy of the padded helmet shell cover in attenuating impact magnitude across six impact locations and three impact velocities when equipped to three different helmet models. In a preliminary on-field investigation, we used instrumented mouthguards to monitor head impact magnitude in collegiate linebackers during practice sessions while not wearing the padded helmet shell covers (i.e., bare helmets) for one season and whilst wearing the padded helmet shell covers for another season. The addition of the padded helmet shell cover was effective in attenuating the magnitude of angular head accelerations and two brain injury risk metrics (DAMAGE, HARM) across most laboratory impact conditions, but did not significantly attenuate linear head accelerations for all helmets. Overall, HARM values were reduced in laboratory impact tests by an average of 25% at 3.5 m/s (range: 9.7 - 39.6%), 18% at 5.5 m/s (range: -5.5 - 40.5%), and 10% at 7.4 m/s (range: -6.0 - 31.0%). However, on the field, no significant differences in any measure of head impact magnitude were observed between the bare helmet impacts and padded helmet impacts. Further laboratory tests were conducted to evaluate the ability of the padded helmet shell cover to maintain its performance after exposure to repeated, successive impacts and across a range of temperatures. This research provides a detailed assessment of padded helmet shell covers and supports the continuation of in vivo helmet research to validate laboratory testing results.Comment: 49 references, 8 figure

Sharing and community curation of mass spectrometry data with Global Natural Products Social Molecular Networking

The potential of the diverse chemistries present in natural products (NP) for biotechnology and medicine remains untapped because NP databases are not searchable with raw data and the NP community has no way to share data other than in published papers. Although mass spectrometry techniques are well-suited to high-throughput characterization of natural products, there is a pressing need for an infrastructure to enable sharing and curation of data. We present Global Natural Products Social molecular networking (GNPS, http://gnps.ucsd.edu), an open-access knowledge base for community wide organization and sharing of raw, processed or identified tandem mass (MS/MS) spectrometry data. In GNPS crowdsourced curation of freely available community-wide reference MS libraries will underpin improved annotations. Data-driven social-networking should facilitate identification of spectra and foster collaborations. We also introduce the concept of ‘living data’ through continuous reanalysis of deposited data

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Gamma Knife radiosurgery as salvage therapy for gangliogliomas after initial microsurgical resection.

Gangliogliomas (GG) are considered WHO grade I rare tumors. While they commonly manifest as temporal lobe epilepsy, they can be located anywhere in the brain. Primary treatment is complete microsurgical resection. Remnant or recurrent GG can benefit from radiation therapy. Here, we present a series of GG who received Gamma Knife radiosurgery (GKR) after initial microsurgery. Between October 2009 and February 2020, four patients benefitted from such approach. The median age at surgery was 16 years (mean 17, 11-25) and at the time of GKR was 22.5 years (mean 23, 19-28). Initial clinical symptom was epilepsy in 3 cases and incidental in one. Biopsy was firstly performed in one case. One patient had stereotactic electroencephalography. The respective anatomical locations were right parieto-occipital, sylvian, left paraventricular and left inferior parietal. Gamma Knife radiosurgery was performed after a median time of 3.5 years after initial gross total microsurgical resection (GTR). The median follow-up after GKR was 54 months (mean 58.5, 6-120). The median marginal dose was 18 Gy (mean 17.5, 16-18). The median target volume was 0.5 mL (mean 0.904, 0.228-2.3). The median prescription isodose volume was 0.6 mL (mean 0.9, 0.3-2.4). At last follow-up, GG majorly decreased in 3 patients, remained stable in one. Gamma Knife radiosurgery is safe and effective for remnant GG after GTR. Primary treatment remains microsurgical resection, especially in cases with symptomatic mass effect or with epilepsy. Single fraction GKR can be a valuable option for remnant or recurrent tumors after initial resection

Assessing the effect of manual physical activity on proximal hand phalanges using Hellenistic and modern skeletal samples from Greece

International audienc

Variability of primary and bacterial production in a coral reef lagoon (New Caledonia)

International audienceWe assessed the temporal variability of nutrients, phytoplankton and bacterioplankton at two sites of different trophic status in New Caledonia's South-West lagoon, a tropical coastal ecosystem. During stable meteorological conditions, Chl.a, bacterial production and nutrient concentrations experience weak but consistent daily variation. Short-term (1–2 week interval) fluctuations of planktonic variables are in the same range as annual variations at both sites. A part of these short term variations is linked to local meteorological events (wind in the main channel, precipitation at the coastal station). Although annual variations are weak compared to short term variations, phytoplankton and bacterioplankton production show consistent temporal patterns, with maxima in December–January and April–May and minima in August. Annual bacterial production represents 21% and 34% of particulate primary production at the oligotrophic and mesotrophic sites, respectively. Mineral nutrient availability indicates that nitrogen is probably the primary limiting factor of phytoplankton throughout the year

Does the use of connected devices contribute to the empowerment of patients with cystic fibrosis for the management of their pulmonary exacerbations? A grounded theory from the MucoExocet study

peer reviewe

Composante RAdioLogique de l'Exposome, multi-expositions, risques de cancers et d'autres pathologies chroniques dans la cohorte Constances : le projet CORALE

National audienceContexte L’ensemble de la population est multi-exposé tout au long de sa vie aux rayonnements ionisants (RIs) à des niveaux variables, via de multiples sources naturelles et artificielles, dans le cadre de l’environnement résidentiel, de différentes activités (ex: trajets aériens) ou pour raisons médicales (procédures diagnostiques ou thérapeutiques). Si le caractère cancérogène des RIs est solidement documenté pour des doses supérieures à 100 milliGrays, la quantification des effets de multi-expositions aux RIs et à d’autres facteurs de risque de cancer est peu documentée, excepté l’interaction entre tabac et radon sur le risque de cancer du poumon. Méthode CORALE permettra la reconstitution la plus exhaustive possible des doses de RIs d’origines environnementales (radon, rayonnements telluriques et cosmiques, alimentation, installations nucléaires et autres sources artificielles), médicales (procédures diagnostiques et thérapeutiques) et professionnelles reçues par les participants de la cohorte Constances depuis leur naissance. Ces reconstitutions seront effectuées par l'IRSN, en collaboration avec l'UMS INSERM/UVSQ gérant Constances, grâce à des croisements de données multiples : historiques résidentiels des participants depuis leur naissance, questionnaires, Système National des Données de Santé renseignant les expositions médicales, bases de données gérees par l’IRSN. CORALE estimera ensuite les risques de cancers et d’autres pathologies chroniques potentiellement associés aux doses cumulées reçues en tenant compte des multi-expositions documentées à d'autres facteurs de risque de ces pathologies.Résultats Le protocole de CORALE a été rédigé. Les résultats d’un pilote suggèrent que cette étude pourra être menée chez environ 100 000 participants. Un premier financement européen obtenu via le projet RadoNorm permettra de démarrer CORALE en 2021. Conclusion Constances dispose d’atouts majeurs pour progresser vers la caractérisation de l’exposome et de ses liens avec les pathologies chroniques. CORALE s’inscrit dans un programme de recherche à long terme sur les effets des multi-expositions aux RIs mais aussi à d’autres expositions environnementales. ObjectivesThe first objective of the CORALE project is to carry out the broadest possible reconstruction of doses of IR from environmental sources (radon, terrestrial and cosmic radiation, food, nuclear installations and other artificial sources), medical (diagnostic and therapeutic procedures) and occupational (nuclear workers but also other industries using radioactive sources, health professionals… ) received by participants in the Constances cohort since birth, following the logic of the exposome concept (for its radiological component). The second objective will be to estimate the risks of cancers and other chronic diseases potentially associated with the cumulative doses received (from several sources of IR and over time) taking into account the potential influence of the context of multi-exposures to other risk factors.MethodsIn order to reconstruct the annual doses due to radioactivity of natural and artificial origin received by each member of the Constances cohort since their birth, a large number of sources of radioactivity must be considered. Reconstructions related to environmental, medical and occupational exposures will be performed by different units of the IRSN in collaboration with the Constances cohort team. To do this, a questionnaire will be sent to cohort members who have already provided their residential histories. The statistical analyses (e.g., Cox models with time-dependent covariates) will be carried out at the IRSN epidemiology laboratory and will benefit from the expertise of radiobiologists, supporting the exploration of specific hypotheses and interpretations. The use of innovative regression methods on exposure profiles will be explored in collaboration with the University of Paris.PerspectivesCORALE is part of a broader long-term research programme, which will include the effects of other multi-exposures (e.g., IR and other environmental exposures) and the study of risk and exposure biomarkers through the Constances biobank, further complementing the application of the exposome concept through the study of within-body regulations following exposures. This program will help improve the characterization of the exposome and its relation with chronic diseases in the Constances cohort