In vivo monitoring of neuronal loss in traumatic brain injury: a microdialysis study

Traumatic brain injury causes diffuse axonal injury and loss of cortical neurons. These features are well recognized histologically, but their in vivo monitoring remains challenging. In vivo cortical microdialysis samples the extracellular fluid adjacent to neurons and axons. Here, we describe a novel neuronal proteolytic pathway and demonstrate the exclusive neuro-axonal expression of Pavlov’s enterokinase. Enterokinase is membrane bound and cleaves the neurofilament heavy chain at positions 476 and 986. Using a 100 kDa microdialysis cut-off membrane the two proteolytic breakdown products, extracellular fluid neurofilament heavy chains NfH476−986 and NfH476−1026, can be quantified with a relative recovery of 20%. In a prospective clinical in vivo study, we included 10 patients with traumatic brain injury with a median Glasgow Coma Score of 9, providing 640 cortical extracellular fluid samples for longitudinal data analysis. Following high-velocity impact traumatic brain injury, microdialysate extracellular fluid neurofilament heavy chain levels were significantly higher (6.18 ± 2.94 ng/ml) and detectable for longer (>4 days) compared with traumatic brain injury secondary to falls (0.84 ± 1.77 ng/ml, <2 days). During the initial 16 h following traumatic brain injury, strong correlations were found between extracellular fluid neurofilament heavy chain levels and physiological parameters (systemic blood pressure, anaerobic cerebral metabolism, excessive brain tissue oxygenation, elevated brain temperature). Finally, extracellular fluid neurofilament heavy chain levels were of prognostic value, predicting mortality with an odds ratio of 7.68 (confidence interval 2.15–27.46, P = 0.001). In conclusion, this study describes the discovery of Pavlov’s enterokinase in the human brain, a novel neuronal proteolytic pathway that gives rise to specific protein biomarkers (NfH476−986 and NfH476−1026) applicable to in vivo monitoring of diffuse axonal injury and neuronal loss in traumatic brain injury

An analysis of the three-dimensional kinetics and kinematics of maximal effort punches among amateur boxers.

This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Performance Analysis in Sport on 27-9-18, available online: https://doi.org/10.1080/24748668.2018.1525651The purpose of this study was to quantify the 3D kinetics and kinematics of six punch types among amateur boxers. Fifteen males (age: 24.9 ± 4.2 years; stature: 1.78 ± 0.1 m; body mass: 75.3 ± 13.4 kg; boxing experience: 6.3 ± 2.8 years) performed maximal effort punches against a suspended punch bag during which upper body kinematics were assessed via a 3D motion capture system, and ground reaction forces (GRF) of the lead and rear legs via two force plates. For all variables except elbowjoint angular velocity, analysis revealed significant (P < 0.05) differences between straight, hook and uppercut punches. The lead hook exhibited the greatest peak fist velocity (11.95 ± 1.84 m/s), the jab the shortest delivery time (405 ± 0.15 ms), the rear uppercut the greatest shoulder-joint angular velocity (1069.8 ± 104.5°/s), and the lead uppercut the greatest elbow angular velocity (651.0 ± 357.5°/s). Peak resultant GRF differed significantly (P < 0.05) between rear and lead legs for the jab punch only. Whilst these findings provide novel descriptive data for coaches and boxers, future research should examine if physical and physiological capabilities relate to the key biomechanical qualities associated with maximal punching performance

Biomechanics of the head for Olympic boxer punches to the face

Objective: The biomechanics of the head for punches to the jaw and the risk of head injury from translational and rotational acceleration were studied. Results: Punch force averaged 3427 (standard deviation (SD) 811) N, hand velocity 9.14 (SD 2.06) m/s, and effective punch mass 2.9 (SD 2.0) kg. Punch force was higher for the heavier weight classes, due primarily to a higher effective mass of the punch. Jaw load was 876 (SD 288) N. The peak translational acceleration was 58 (SD 13) g, rotational acceleration was 6343 (SD 1789) rad/s(2), and neck shear was 994 (SD 318) N. Conclusions: Olympic boxers deliver straight punches with high impact velocity and energy transfer. The severity of the punch increases with weight class