Comprehensive Evaluation of Healthy Volunteers Using Multi-Modality Brain Injury Assessments: An Exploratory, Observational Study

Introduction: Even though mild traumatic brain injury is common and can result in persistent symptoms, traditional measurement tools can be insensitive in detecting functional deficits after injury. Some newer assessments do not have well-established norms, and little is known about how these measures perform over time or how cross-domain assessments correlate with one another. We conducted an exploratory study to measure the distribution, stability, and correlation of results from assessments used in mild traumatic brain injury in healthy, community-dwelling adults.Materials and Methods: In this prospective cohort study, healthy adult men and women without a history of brain injury underwent a comprehensive brain injury evaluation that included self-report questionnaires and neurological, electroencephalography, sleep, audiology/vestibular, autonomic, visual, neuroimaging, and laboratory testing. Most testing was performed at 3 intervals over 6 months.Results: The study enrolled 83 participants, and 75 were included in the primary analysis. Mean age was 38 years, 58 were male, and 53 were civilians. Participants did not endorse symptoms of post-concussive syndrome, PTSD, or depression. Abnormal neurological examination findings were rare, and 6 had generalized slowing on electroencephalography. Actigraphy and sleep diary showed good sleep maintenance efficiency, but 21 reported poor sleep quality. Heart rate variability was most stable over time in the sleep segment. Dynavision performance was normal, but 41 participants had abnormal ocular torsion. On eye tracking, circular, horizontal ramp, and reading tasks were more likely to be abnormal than other tasks. Most participants had normal hearing, videonystagmography, and rotational chair testing, but computerized dynamic posturography was abnormal in up to 21% of participants. Twenty-two participants had greater than expected white matter changes for age by MRI. Most abnormal findings were dispersed across the population, though a few participants had clusters of abnormalities.Conclusions: Despite our efforts to enroll normal, healthy volunteers, abnormalities on some measures were surprisingly common.Trial Registration: This study was registered at www.clinicaltrials.gov, trial identifier NCT01925963

Wireless transmission of biosignals for hyperbaric chamber applications

[EN] This paper presents a wireless system to send biosignals outside a hyperbaric chamber avoiding wires going through the chamber walls. Hyperbaric chambers are becoming more and more common due to new indications of hyperbaric oxygen treatments. Metallic walls physically isolate patients inside the chamber, where getting a patient's vital signs turns into a painstaking task. The paper proposes using a ZigBee-based network to wirelessly transmit the patient's biosignals to the outside of the chamber. In particular, a wearable battery supported device has been designed, implemented and tested. Although the implementation has been conducted to transmit the electrocardiography signal, the device can be easily adapted to consider other biosignals.The authors would like to thanks the University of Balearic Islands (UIB), the Miguel Hernandez University (UMH), MEDIBAROX unit of the Perpetuo Socorro Hospital and the "Catedra de Medicina Hiperbarica" (UMH) for their support allowing the use of its facilities for this work. The authors would also like to thank Borja Mas Boned for his help designing the LabVIEW application. This research has been carried out with funding and promotion of "Catedra de Medicina Hiperbarica" of the Miguel Hernandez University. http://nbio.umh.es/es/2010/12/01/catedra-de-medicina-hiperbarica-medibarox/.Perez-Vidal, C.; Gracia Calandin, LI.; Carmona, C.; Alorda, B.; Salinas, A. (2017). Wireless transmission of biosignals for hyperbaric chamber applications. PLoS ONE. 12(3):1-19. https://doi.org/10.1371/journal.pone.0172768S119123Sureda, A., Batle, J. M., Martorell, M., Capó, X., Tejada, S., Tur, J. A., & Pons, A. (2016). Antioxidant Response of Chronic Wounds to Hyperbaric Oxygen Therapy. PLOS ONE, 11(9), e0163371. doi:10.1371/journal.pone.0163371Branco, B. H. M., Fukuda, D. H., Andreato, L. V., Santos, J. F. da S., Esteves, J. V. D. C., & Franchini, E. (2016). The Effects of Hyperbaric Oxygen Therapy on Post-Training Recovery in Jiu-Jitsu Athletes. PLOS ONE, 11(3), e0150517. doi:10.1371/journal.pone.0150517Xu, Y., Ji, R., Wei, R., Yin, B., He, F., & Luo, B. (2016). The Efficacy of Hyperbaric Oxygen Therapy on Middle Cerebral Artery Occlusion in Animal Studies: A Meta-Analysis. PLOS ONE, 11(2), e0148324. doi:10.1371/journal.pone.0148324Lin, B.-S., Lin, B.-S., Chou, N.-K., Chong, F.-C., & Chen, S.-J. (2006). RTWPMS: A Real-Time Wireless Physiological Monitoring System. IEEE Transactions on Information Technology in Biomedicine, 10(4), 647-656. doi:10.1109/titb.2006.874194Hu, S., Wei, H., Chen, Y., & Tan, J. (2012). A Real-Time Cardiac Arrhythmia Classification System with Wearable Sensor Networks. Sensors, 12(9), 12844-12869. doi:10.3390/s120912844Burns, A., Greene, B. R., McGrath, M. J., O’Shea, T. J., Kuris, B., Ayer, S. M., … Cionca, V. (2010). SHIMMER™ – A Wireless Sensor Platform for Noninvasive Biomedical Research. IEEE Sensors Journal, 10(9), 1527-1534. doi:10.1109/jsen.2010.2045498Gil, Y., Wu, W., & Lee, J. (2012). A Synchronous Multi-Body Sensor Platform in a Wireless Body Sensor Network: Design and Implementation. Sensors, 12(8), 10381-10394. doi:10.3390/s120810381Chin-Teng Lin, Kuan-Cheng Chang, Chun-Ling Lin, Chia-Cheng Chiang, Shao-Wei Lu, Shih-Sheng Chang, … Li-Wei Ko. (2010). An Intelligent Telecardiology System Using a Wearable and Wireless ECG to Detect Atrial Fibrillation. IEEE Transactions on Information Technology in Biomedicine, 14(3), 726-733. doi:10.1109/titb.2010.2047401W. Y. Chung, Y. D. Lee, and S. J. Jung, 'A Wireless Sensor Network Compatible Wearable U-Healthcare Monitoring System Using Integrated Ecg, Accelerometer and Spo2', Conf Proc IEEE Eng Med Biol Soc, 2008 (2008), 1529–32.ZigBee Alliance; http://www.zigbee.org/Mahmood, A., Javaid, N., & Razzaq, S. (2015). A review of wireless communications for smart grid. Renewable and Sustainable Energy Reviews, 41, 248-260. doi:10.1016/j.rser.2014.08.036J.S. Lee, Y.W. Su, and C.C. Shen, "A comparative study of wireless protocols: Bluetooth, UWB, ZigBee, and Wi-Fi, 33rd Annual Conference of the IEEE Industrial Electronics Society (IECON), 2007, pp. 46–51.P.P. Parikh, M.G. Kanabar, and T.S. Sidhu, "Opportunities and challenges of wireless communication technologies for smart grid applications, IEEE PES General Meeting, 2010, pp. 1–7.Fadlullah, Z. M., Fouda, M. M., Kato, N., Takeuchi, A., Iwasaki, N., & Nozaki, Y. (2011). Toward intelligent machine-to-machine communications in smart grid. IEEE Communications Magazine, 49(4), 60-65. doi:10.1109/mcom.2011.5741147A.C. Olteanu, G.D. Oprina, N. Tapus, and S. Zeisberg, "Enabling mobile devices for home automation using ZigBee, 19th IEEE International Conference on Control Systems and Computer Science, 2013, pp. 189–195.Shang, Y. (2014). Vulnerability of networks: Fractional percolation on random graphs. Physical Review E, 89(1). doi:10.1103/physreve.89.012813R. Barea-Navarro. Biomedical Instrumentation. Chapter 3. University of Alcala

High Levels of Morbidity and Mortality Among Pediatric Hematopoietic Cell Transplant Recipients With Severe Sepsis: Insights From the Sepsis PRevalence, OUtcomes, and Therapies International Point Prevalence Study*

Objectives: Pediatric severe sepsis is a major cause of morbidity and mortality worldwide, and hematopoietic cell transplant patients represent a high-risk population. We assessed the epidemiology of severe sepsis in hematopoietic cell transplant patients, describing patient outcomes compared with children with no history of hematopoietic cell transplant. Design: Secondary analysis of the Sepsis PRevalence, OUtcomes, and Therapies point prevalence study, comparing demographics, sepsis etiology, illness severity, organ dysfunction, and sepsis-related treatments in patients with and without hematopoietic cell transplant. The primary outcome was hospital mortality. Multivariable logistic regression models were used to determine adjusted differences in mortality. Setting: International; 128 PICUs in 26 countries. Patients: Pediatric patients with severe sepsis prospectively identified over a 1-year period. Interventions: None. Measurements and Main Results: In patients with severe sepsis, 37/567 (6.5%) had a history of hematopoietic cell transplant. Compared with patients without hematopoietic cell transplant, hematopoietic cell transplant patients had significantly higher hospital mortality (68% vs 23%; p < 0.001). Hematopoietic cell transplant patients were more likely to have hospital acquired sepsis and had more preexisting renal and hepatic dysfunction than non–hematopoietic cell transplant patients with severe sepsis. History of hematopoietic cell transplant, renal replacement therapy, admission from inpatient floor, and number of organ dysfunctions at severe sepsis recognition were independently associated with hospital mortality in multivariable analysis; hematopoietic cell transplant conferred the highest odds of mortality (odds ratio, 4.00; 95% CI, 1.78–8.98). In secondary analysis of hematopoietic cell transplant patients compared with other immunocompromised patients with severe sepsis, history of hematopoietic cell transplant remained independently associated with hospital mortality (odds ratio, 3.03; 95% CI, 1.11–8.27). Conclusions: In an international study of pediatric severe sepsis, history of hematopoietic cell transplant is associated with a four-fold increased odds of hospital mortality after adjustment for potential measured confounders. Hematopoietic cell transplant patients more often originated from within the hospital compared to children with severe sepsis without hematopoietic cell transplant, possibly providing an earlier opportunity for sepsis recognition and intervention in this high-risk population

PhiSiGns: an online tool to identify signature genes in phages and design PCR primers for examining phage diversity

<p>Abstract</p> <p>Background</p> <p>Phages (viruses that infect bacteria) have gained significant attention because of their abundance, diversity and important ecological roles. However, the lack of a universal gene shared by all phages presents a challenge for phage identification and characterization, especially in environmental samples where it is difficult to culture phage-host systems. Homologous conserved genes (or "signature genes") present in groups of closely-related phages can be used to explore phage diversity and define evolutionary relationships amongst these phages. Bioinformatic approaches are needed to identify candidate signature genes and design PCR primers to amplify those genes from environmental samples; however, there is currently no existing computational tool that biologists can use for this purpose.</p> <p>Results</p> <p>Here we present PhiSiGns, a web-based and standalone application that performs a pairwise comparison of each gene present in user-selected phage genomes, identifies signature genes, generates alignments of these genes, and designs potential PCR primer pairs. PhiSiGns is available at (<url>http://www.phantome.org/phisigns/</url>; <url>http://phisigns.sourceforge.net/</url>) with a link to the source code. Here we describe the specifications of PhiSiGns and demonstrate its application with a case study.</p> <p>Conclusions</p> <p>PhiSiGns provides phage biologists with a user-friendly tool to identify signature genes and design PCR primers to amplify related genes from uncultured phages in environmental samples. This bioinformatics tool will facilitate the development of novel signature genes for use as molecular markers in studies of phage diversity, phylogeny, and evolution.</p

Human CD141+ (BDCA-3)+ dendritic cells (DCs) represent a unique myeloid DC subset that cross-presents necrotic cell antigens

The characterization of human dendritic cell (DC) subsets is essential for the design of new vaccines. We report the first detailed functional analysis of the human CD141+ DC subset. CD141+ DCs are found in human lymph nodes, bone marrow, tonsil, and blood, and the latter proved to be the best source of highly purified cells for functional analysis. They are characterized by high expression of toll-like receptor 3, production of IL-12p70 and IFN-β, and superior capacity to induce T helper 1 cell responses, when compared with the more commonly studied CD1c+ DC subset. Polyinosine-polycytidylic acid (poly I:C)–activated CD141+ DCs have a superior capacity to cross-present soluble protein antigen (Ag) to CD8+ cytotoxic T lymphocytes than poly I:C–activated CD1c+ DCs. Importantly, CD141+ DCs, but not CD1c+ DCs, were endowed with the capacity to cross-present viral Ag after their uptake of necrotic virus-infected cells. These findings establish the CD141+ DC subset as an important functionally distinct human DC subtype with characteristics similar to those of the mouse CD8α+ DC subset. The data demonstrate a role for CD141+ DCs in the induction of cytotoxic T lymphocyte responses and suggest that they may be the most relevant targets for vaccination against cancers, viruses, and other pathogens

Swift trust and commitment: the missing links for humanitarian supply chain coordination?

Coordination among actors in a humanitarian relief supply chain decides whether a relief operation can be or successful or not. In humanitarian supply chains, due to the urgency and importance of the situation combined with scarce resources, actors have to coordinate and trust each other in order to achieve joint goals. This paper investigated empirically the role of swift trust as mediating variable for achieving supply chain coordination. Based on commitment-trust theory we explore enablers of swift-trust and how swift trust translates into coordination through commitment. Based on a path analytic model we test data from the National Disaster Management Authority of India. Our study is the first testing commitment-trust theory (CTT) in the humanitarian context, highlighting the importance of swift trust and commitment for much thought after coordination. Furthermore, the study shows that information sharing and behavioral uncertainty reduction act as enablers for swift trust. The study findings offer practical guidance and suggest that swift trust is a missing link for the success of humanitarian supply chains

Untangling knowledge creation and knowledge integration in enterprise wikis

A central challenge organizations face is how to build, store, and maintain knowledge over time. Enterprise wikis are community-based knowledge systems situated in an organizational context. These systems have the potential to play an important role in managing knowledge within organizations, but the motivating factors that drive individuals to contribute their knowledge to these systems is not very well understood. We theorize that enterprise wiki initiatives require two separate and distinct types of knowledge-sharing behaviors to succeed: knowledge creation (KC) and knowledge integration (KI). We examine a Wiki initiative at a major German bank to untangle the motivating factors behind KC and KI. Our results suggest KC and KI are indeed two distinct behaviors, reconcile inconsistent findings from past studies on the role of motivational factors for knowledge sharing to establish shared electronic knowledge resources in organizations, and identify factors that can be leveraged to tilt behaviors in favor of KC or KI