65 research outputs found
The impact of age and severity on dementia after traumatic brain injury: a comparison study
No full textBackground: Growing evidence associates traumatic brain injury (TBI) with increased risk of dementia, but few studies have evaluated associations in patients younger than 55 yr using non-TBI orthopedic trauma (NTOT) patients as controls to investigate the influence of age and TBI severity, and to identify predictors of dementia after trauma. Objective: To investigate the relationship between TBI and dementia in an institutional group. Methods: Retrospective cohort study (2000-2018) of TBI patients aged 45 to 100 yr vs NTOT controls. Primary outcome was dementia after TBI (followed ≤10 yr). Cox proportional hazards models were used to assess risk of dementia; logistic regression models assessed predictors of dementia. Results: Among 24 846 patients, TBI patients developed dementia (7.5% vs 4.6%) at a younger age (78.6 vs 82.7 yr) and demonstrated higher 10-yr mortality than controls (27% vs 14%; P < .001). Mild TBI patients had higher incidence of dementia (9%) than moderate/severe TBI (5.4%), with lower 10-yr mortality (20% vs 31%; P < .001). Risk of dementia was significant in all mild TBI age groups, even 45 to 54 yr (hazard ratio 4.1, 95% CI 2.7-7.8). A total of 10-yr cumulative incidence was higher in mild TBI (14.4%) than moderate/severe TBI (11.3%) and controls (6.8%) (P < .001). Predictors of dementia include TBI, sex, age, hypertension, hyperlipidemia, stroke, depression, anxiety, and Injury Severity Score. Conclusion: Mild and moderate/severe TBI patients experienced higher incidence of dementia, even in the youngest group (45-54 yr old), than NTOT controls. All TBI patients, especially middle-aged adults with minor injury who are more likely to be overlooked, should be monitored for dementia
2024-25 Casey ASPA 135 ANTOS data collection using SAEF AIoT Prototype 1.5 platforms
No full textProgress Code: completedStatement: Data collected by a new prototype smart sensing solution, sensor calibrations may not be accurate.<b>Purpose</b><br/>Measure summer environmental conditions at a proposed future East-ANTOS advanced site and a nearby long-term vegetation monitoring site. Data to be used to understand and model differences between the two locations.Casey 24/25 deployment of two SAEF Artificial Intelligence of Things (AIoT) Prototype 1.5 platforms for data collection in ASPA 135 at Antarctic Nearshore and Terrestrial Observing System (ANTOS) monitoring sites. Field logistic support by AAS 4644 (ANTOS) using smart sensing platforms developed under AAS 4628 (SAEF; SR200100005).<br/><br/>Two AIOT v1.5 units deployed in ASPA 135: <br/>Box 1: ASPA 135 – selected ANTOS tower site (camera facing moss site)<br/>Location: 110.538867809103, -66.2828989690345<br/>External thermocouples measured soil surface (few mm under surface)<br/><br/>Box 2: Long-term vegetation monitoring site (camera facing east)<br/>Location: 110.538288974015, -66.2818963416407<br/>External thermocouples measured inside branched structure of Usnea lichens (above soil surface) <br/><br/>Each unit included an array of sensors and an onboard camera. <br/>Data logged: 06/12/2024 – 03/02/2025. <br/>Sampling rate: hourly<br/><br/>Measurements (unit): <br/>1. Time sample recorded (AEST; YYYY-MM-DD_hh-mm-ss)<br/>2, Temperature inside AIoT enclosure; DHT31 sensor (deg C)<br/>3, Relative humidity inside AIoT enclosure; DHT31 sensor (%)<br/>4, Amount of current used by AIoT sensor interface shield; INA260 (mA)<br/>5, Voltage at sensor interface shield; INA260 (mV)<br/>6, Wattage at main board (sensor interface shield); INA260 (mW)<br/>7, Voltage from battery bank; INA260 (mV)<br/>8. Thermocouple 0 temperature (soil/vegetation); MCP9600 (deg C)<br/>9. Thermocouple 1 temperature (soil/vegetation); MCP9600 (deg C)<br/>10. Thermocouple 2 temperature (soil/vegetation); MCP9600 (deg C)<br/>11. Thermocouple 3 temperature (soil/vegetation); MCP9600 (deg C)<br/>12. Photosynthetic Photon Flux Density; Apogee SQ-500 sensor (µmol/m2/s)<br/>13. Temperature from weather station; HMP60 (deg C)<br/>14. Relative humidity from weather station; HMP60 (%)<br/><br/>Project team:<br/>- Dr Johan Barthelemy – SAEF CI, project lead, supported software development of platform<br/>- Dr Krystal Randall – SAEF Postdoc, field deployed system<br/>- Cameron Angus – Hardware engineer, supported development and assembly of platform<br/>- Dr Jane Wasley – ANTOS CI, supported field deployment of syste
A rare presentation of hypertrophic olivary degeneration secondary to primary central nervous system lymphoma
No full textCase report: A 71-year-old man presented with a 2-week history of nausea, vomiting, unsteady gait, and diplopia
Occult cervical spinal dural arteriovenous fistula masquerading as acute spinal cord ischemia
No full textAcute presentation of upper and lower extremity motor weakness is commonly attributed to intracerebral ischemic infarct upon initial examination. For those that exhibit acute onset of bilateral weakness, it is important to expand the differential diagnosis to include spinal cord ischemic involvement. One cause of ischemic lesions is spinal dural arteriovenous (AV) fistulas which are generally found in the thoraco-lumbar region. They present with progressive paraplegia or quadriplegia due to changes in the spinal venous pressure and eventual myelopathy. We present a 60 year old gentleman with bilateral upper extremity weakness and right lower extremity weakness preceded by upper back and neck pain. Initial studies included both Magnetic resonance imagine (MRI) of the brain and also the cervical spine that demonstrated abnormal signal intensity within the anterior cervical cord from C3-C7 levels concerning for spinal cord infarct. In our case there were no flow voids to suggest dilated perimedullary vessels that usually prompt further diagnostic evaluation through a spinal angiogram. However, given the clinical suspicion, a spinal angiogram was obtained that demonstrated a cervical dural AV fistula supplied by a dural branch vessel originating from the left vertebral artery. We will highlight the importance of recognizing the clinical presentation of spinal dural AV fistulas; the usual findings on imaging, the value of considering further diagnostic tests if clinical suspicion is high, and provide an overview of the spinal dural AV treatment
Severe leukoaraiosis portends a poor outcome after traumatic brain injury
No full textFirst author Nils Henninger is a doctoral student in the Millennium PhD Program (MPP) in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.BACKGROUND AND PURPOSE: It is now well accepted that traumatic white matter injury constitutes a critical determinant of post-traumatic functional impairment. However, the contribution of preexisting white matter rarefaction on outcome following traumatic brain injury (TBI) is unknown. Hence, we sought to determine whether the burden of preexisting leukoaraiosis of presumed ischemic origin is independently associated with outcome after TBI. METHODS: We retrospectively analyzed consecutive, prospectively enrolled patients of > /=50 years (n = 136) who were admitted to a single neurological/trauma intensive care unit. Supratentorial white matter hypoattenuation on head CT was graded on a 5-point scale (range 0-4) reflecting increasing severity of leukoaraiosis. Outcome was ascertained according to the modified Rankin Scale (mRS) and Glasgow outcome scale (GOS) at 3 and 12 months, respectively. RESULTS: After adjustment for other factors, leukoaraiosis severity was significantly associated with a poor outcome at 3 and 12 months defined as mRS 3-6 and GOS 1-3, respectively. The independent association between leukoaraiosis and poor outcome remained when the analysis was restricted to patients who survived up to 3 months, had moderate-to-severe TBI [enrollment Glasgow Coma Scale (GCS) < /=12; p = 0.001], or had mild TBI (GCS 13-15; p = 0.002), respectively. CONCLUSION: We provide first evidence that preexisting cerebral small vessel disease independently predicts a poor functional outcome after closed head TBI. This association is independent of other established outcome predictors such as age, comorbid state as well as intensive care unit complications and interventions. This knowledge may help improve prognostic accuracy, clinical management, and resource utilization
"Literature tests and the Elementary Education Assessment System (SAEF) of the Fortaleza´s Secretary of Education: qualitative and quantitative errors investigation in the Portuguese language descriptors in the fifth grade of Fortaleza´s Elementary School"
No full textA presente pesquisa tem como objetivo investigar as incidências de erros cometidos por alunos do 5º ano do Ensino Fundamental nas avaliações diagnósticas do Sistema de Avaliação do Ensino Fundamental (SAEF) de Língua Portuguesa, com foco nos descritores D1, D2, D3 e D4. O SAEF, desenvolvido pela Secretaria Municipal de Educação (SME) desde 2009, visa monitorar a aprendizagem dos estudantes de diferentes séries, inicialmente do 1º e 2º ano e, posteriormente, abrangendo do 1º ao 9º ano. Este sistema utiliza instrumentos de avaliação como o Protocolo do Programa de Alfabetização na Idade Certa (PAIC) e a Provinha Brasil, com foco em competências de leitura e escrita. A coleta de dados ao longo dos anos consolidou um sistema robusto de acompanhamento educacional, permitindo uma análise das dificuldades de aprendizagem dos alunos. A literatura, como componente essencial do currículo escolar, está intimamente ligada à capacidade de interpretação e produção textual, fatores que influenciam diretamente no sucesso acadêmico. Com a implementação das Avaliações Diagnósticas de Rede (ADR), que ocorrem mensal e periodicamente, é possível identificar não apenas os erros cometidos, mas também as tendências manifestas nas respostas dos alunos. A segmentação das avaliações possibilita a observação das variações de desempenho ao longo do tempo, contribuindo para um diagnóstico mais preciso das dificuldades enfrentadas pelos estudantes em relação a cada descritor da língua portuguesa. A pesquisa adotará metodologia qualitativa, examinando os dados das provas aplicadas, organizadas segundo os descritores considerados mais importantes para o desenvolvimento da capacidade leitora dos alunos, analisando, assim, os principais motivos que levam os avaliados ao equívoco. A abordagem teórica e documental abordará a importância da literatura, utilizando-se as obras de Antonio Candido para maior suporte da literatura técnica a fim de justificar as competências apresentadas nos referidos descritores e a literatura como direito humano e fundamental. O referencial bibliográfico contará também com a abordagem teórica da crítica literária, utilizando-se como parametro a teoria da recepção, com o intuito de examinar o potencial de leitura dos estudantes, notadamente, estabelecendo a relação entre a literatura e os conceitos pessoais do autor, contextualizando o espaço cultural onde estariam inseridos e como estes tem reflexos na interpretação literária. A análise qualitativa levará em consideração fatores como a formação dos professores, a abordagem pedagógica utilizada e o contexto cultural dos alunos. A formação docente, por exemplo, pode afetar a maneira como os estilos literários são abordados em sala de aula, influenciando a compreensão dos alunos. Além de identificar os erros cometidos por descritor, a pesquisa buscará, de igual forma, oferecer sugestões para a melhoria das práticas pedagógicas nas escolas. Espera-se que os resultados obtidos possam ser utilizados pela SME para que o Poder Público se responsabilize quanto à disponibilização de programas de formação continuada para educadores e a restruturação curricular. Por fim, essa pesquisa volta-se para a valorização da literatura como meio de desenvolver competências essenciais para a formação integral dos estudantes, tendo em vista que a identificação e a compreensão dos estilos literários nas avaliações serão fundamentais para estabelecer correlações que informem práticas pedagógicas mais adequadas e contextualizadas, favorecendo o aprendizado significativo da literaturaThis research aims to investigate the incidence of errors made by 5th grade elementary school students in diagnostic assessments of the Fundamental Education Assessment System (SAEF) of Portuguese Language, focusing on descriptors D1, D2, D3 and D4. The SAEF, developed by the Municipal Department of Education (SME) since 2009, aims to monitor students learning in different grades, initially from the 1st and 2nd grade and, later, covering the 1st to 9th grade. This system uses assessment instruments such as the Protocol of the Literacy Program at the Right Age (PAIC) and the “Provinha Brasil”, focusing on reading and writing skills. Data collection over the years has consolidated a robust educational monitoring system, allowing an analysis of students' learning difficulties. Literature, as an essential component of the school curriculum, is closely linked to the ability to interpret and produce texts, factors that directly influence academic success. With the implementation of Diagnostic Network Assessments (ADR), which occur monthly and periodically, it is possible to identify not only the errors committed, but also the trends evident in the students' responses. The segmentation of the assessments makes it possible to observe the variations in performance over time, contributing to a more accurate diagnosis of the difficulties faced by students in relation to each descriptor of the Portuguese language. The research will adopt a qualitative methodology, examining the data from the tests applied, organized according to the descriptors considered most important for the development of the students' reading ability skills, thus analyzing the main reasons that lead the evaluated to make mistakes. The theoretical and documentary approach will address the importance of literature, using the works of Antonio Candido for greater support of the technical literature in order to justify the skills presented in the aforementioned descriptors and literature as a human and fundamental right. The bibliographical reference will also include the theoretical approach of literary criticism, using reception theory as a parameter, in order of examining the reading potential of students, notably by establishing the relationship between literature and the personal concepts of the author, contextualizing the cultural space in which they would be inserted and how these have an impact on literary interpretation. The qualitative analysis will take into account factors such as teacher training, the pedagogical approach used and the cultural context of the students. Teacher training, for example, can affect the way literary styles are addressed in the classroom, influencing students' understanding. In addition to identifying errors made by descriptor, the research will also seek to offer suggestions for improving pedagogical practices in schools. It is expected that the results obtained can be used by the SME so that the Public Authorities take responsibility for providing continuing education programs for educators and restructuring the school curriculum. Finally, this research focuses on the appreciation of literature as a means of developing essential skills for the comprehensive education of students, given that the identification and understanding of literary styles in assessments will be fundamental to establishing correlations that inform more appropriate and contextualized pedagogical practices, favoring the significant learning of literatur
BRAIN TOPiC Study: Assessing Variability in Traumatic Brain Injury (TBI) Outcome Prognostication – Do Self-Fulfilling Prophecies Exist in TBI, Too?
No full textOBJECTIVE: In this study, we surveyed clinicians caring for patients with moderate-severe traumatic brain injury (msTBI) to assess (1) possible variability in outcome prognostication in TBI, varying by clinicians level of training and medical specialty, (2) possible biases and self-fulfilling prophecies, and (3) whether specific ICU medical complications may influence clinicians in their outcome prognostication. BACKGROUND: Patients with msTBI commonly die from withdrawal of support, likely as a consequence of an unfavorable outcome prognosis provided to the family by the treating physician. It is unknown whether prognostication may lead to self-fulfilling prophecies, and whether the presence of intensive care unit (ICU) complications may accentuate possible provider bias. DESIGN/METHODS: We conducted an anonymous electronic survey of clinicians, including faculty members (Neurology, Neurosurgery, Trauma, Anesthesia/Critical Care), neurology house staff, ICU affiliate practitioners and neuroICU nurses at a single Level I trauma center. The survey included three TBI case vignettes and their respective ICU courses. Questions were designed to assess the utilization of known TBI prognostic models, relative importance of ICU complications for outcome prognostication and aggressiveness of care recommended by the survey participant. RESULTS: The survey response rate was 72% (106 surveys returned). In all 3 cases, the majority of participants did not recommend withdrawal of care, but did predict unfavorable 6-month outcomes. 51% of participants consider medical ICU complications as very important in TBI prognostication. Age, ICU course and head CT findings are the prognostic variables considered most important to outcomes. CONCLUSIONS: We have discovered great variability in outcome predictions made by clinicians with different levels of experience in treating msTBI. Self-fulfilling prophecies may exist in msTBI outcomes. Outcome estimates should focus not only on admission variables, but also on ICU complications in order to guide clinicians in providing prognostication
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