73 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
IzzyIllari/IzzyIllari.github.io: DATS6103 - Individual Project 2
No full textThe 2nd individual project for the DATS610 class at GWU for the Fall2020 semester with Professor Nima Zahadat. Author Izzy Illari.
Title: A scientific approach to brewing the perfect cup of joe
Why this data?
What makes a good cup of coffee is, by and large, a subjective question. How it's prepared, what flavors should be emphasized, how much sugar, etc, are all considered when the average person has a cup. The Coffee Quality Institute (CQI) was founded by the Specialty Coffee Association of America (SCAA) in 1996 to address quality of coffee and income issues at origin. The CQI trains "Q Graders", or individuals who have been certified by the CQI and who have received comprehensive training in the cupping of coffee samples for the purposes of scoring and identifying individual lots against the SCAA's physical and sensory criteria for specialty quality. The goal of this scoring system is to provide a way to discuss the quality of coffee throughout the chain from the producers to the buyers. In that sense then, there must be a way to find commonalities between high scoring coffees.
What are the characteristics of a high scoring coffee? Can we predict whether a coffee will score well or poorly? Is there an origin that is prefered? It is the goal of this project to determine if there is a way to determine good coffee from bad coffee, and what a model for determining that might look like.
About the data
This dataset contains reviews of 1312 arabica and 28 robusta coffee beans from the Coffee Quality Institute, and was provided by James LeDoux, a data scientist at BuzzFeed, over on his coffee database GitHub repo (https://github.com/jldbc/coffee-quality-database). The data in this repo were collected from the Coffee Quality Institute in January 2018
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
Essential skills for a global workplace: revisiting the DINAMITE model for post-pandemic higher education.
No full textThis paper investigates some of the recent terminology and concepts used to describe the type and nature of transferable skills that are developed and nurtured in students in Higher Education, with a particular focus on the DINAMITE model. This model was developed by the author in 2021, following research with employers in three different countries. This paper seeks to evaluate the relevance and suitability of this model in 2024, from the perspective of fellow pedagogical researchers at the author's home institution in Scotland. An online, semi-structured, focus group with eight academics was held in February 2024. A thematic analysis was applied to the data and compared to recent literature on transferable skill development in Higher Education. The findings suggest there is a lack of clarity and coherence concerning the different terms and concepts that are used to describe transferable skills within the context of Higher Education; however, there is strong awareness and understanding of the fundamental importance of these skills. The DINAMITE model has both strengths and weaknesses as a conceptual tool for understanding the transferable skills that are necessary for a global, digital workplace. Therefore, this paper proposes a revised version of the DINAMITE model based on the recommendations of the participants. Further research is needed to examine a wider range of academic, student and employer opinions on the terminology and concepts used to describe transferable skill development within Higher Education. A universally accepted model would enable key stakeholders to devise a more cohesive approach to transferable skill development in preparation for the workplace
Disabilities in Middle-Grade Literature
No full textThis Honors Senior Thesis explores textual themes regarding disability in literary works featuring protagonists with a disability. In particular, it analyzes the role of literature as a way to provide exposure to and connection with the life experiences of a protagonist with a disability. The author then uses that information to generate insight into how she should approach her own creative writing project—a young adult novel portraying the lived experience of a 13-year-old male protagonist with bipolar disorder. The author focuses her attention on three works: Izzy, Willy Nilly (Cynthia Voight, 1986), The Curious Incident of the Dog in the Nighttime (Mark Haddon, 2003), and El Deafo (Cece Bell, 2015). Each book depicts a protagonist with a specific, named disability (amputation, ASD, and deafness). She examines how these works express or reject media-perpetuated stereotypes about disability, such as “victim/helplessness” and “inspirational/heroic”. She then offers suggestions about how she will avoid such pitfalls in her own work
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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