Neural cell injury pathology due to high-rate mechanical loading

Successful detection and prevention of brain injuries relies on the quantitative identification of cellular injury thresholds associated with the underlying pathology. Here, by combining a recently developed inertial microcavitation rheology technique with a 3D in vitro neural tissue model, we quantify and resolve the structural pathology and critical injury strain thresholds of neural cells occurring at high loading rates such as encountered in blast exposures or cavitation-based medical procedures. We find that neuronal dendritic spines characterized by MAP2 displayed the lowest physical failure strain at 7.3%, whereas microtubules and filamentous actin were able to tolerate appreciably higher strains (14%) prior to injury. Interestingly, while these critical injury thresholds were similar to previous literature values reported for moderate and lower strain rates (<100 1/s), the pathology of primary injury reported here was distinctly different by being purely physical in nature as compared to biochemical activation during apoptosis or necrosis.

The Injury Mechanism of Traumatic Amputation

Traumatic amputation has been one of the most defining injuries associated with explosive devices. An understanding of the mechanism of injury is essential in order to reduce its incidence and devastating consequences to the individual and their support network. In this study, traumatic amputation is reproduced using high-velocity environmental debris in an animal cadaveric model. The study findings are combined with previous work to describe fully the mechanism of injury as follows. The shock wave impacts with the casualty, followed by energised projectiles (environmental debris or fragmentation) carried by the blast. These cause skin and soft tissue injury, followed by skeletal trauma which compounds to produce segmental and multifragmental fractures. A critical injury point is reached, whereby the underlying integrity of both skeletal and soft tissues of the limb has been compromised. The blast wind that follows these energised projectiles completes the amputation at the level of the disruption, and traumatic amputation occurs. These findings produce a shift in the understanding of traumatic amputation due to blast from a mechanism predominately thought mediated by primary and tertiary blast, to now include secondary blast mechanisms, and inform change for mitigative strategies.

Association of a history of falls or syncope with intracranial bleeding in patients with atrial fibrillation

Background In patients with atrial fibrillation (AF), anticoagulation effectively reduces the risk of ischemic stroke. However, up to 50% of patients are not receiving this treatment. A history of falls or syncope and an associated risk of intracranial hemorrhage are commonly reported reasons for undertreatment, though these have not been well studied. Purpose To investigate the association of a history of falls or syncope with the risk of intracranial hemorrhage in patients with AF. Methods Patients with a history of AF from the RE-LY, AVERROES and ACTIVE A and W trials were combined into a large cohort. “Critical injury” was defined as any injury that resulted in death, was deemed to be life-threatening or resulted in permanent disability. A “serious injury” was defined as an injury that required hospitalization. “Other injuries” were defined as those that did not meet criteria for critical or serious injury. We used logistic regression and propensity-matched Cox models to assess the association between falls or syncope and adverse outcomes. Results Among 37,973 patients, 11.9% (n=4503) had a history of falls, 17.5% (n=6655) had a history of syncope and 25.1% (n=9518) had a history of either falls or syncope. The mean age of the cohort was 71±9.3 years and 58% were male. The median CHADS2 score was 2. A history of falls or syncope was not associated with the risk of incident intracranial hemorrhage (HR 1.11, 95% CI 0.88–1.4). In propensity-matched multivariable models, a history of falls or syncope was associated with an increased risk of death (HR 1.14, 95% CI 1.07–1.22), stroke (HR 1.17, 95% CI 1.05–1.3), myocardial infarction (HR 1.28, 95% CI 1.09–1.52) and major bleeding (HR 1.27, 95% CI 1.16–1.4). Moreover, a history of falls or syncope was associated with increased risk of critical injury (OR 1.97, 95% CI 1.52–2.54), serious injury (OR 2.06, 95% CI 1.75–2.43) and “other injury” (OR 1.58, 95% CI 1.46–1.72). Conclusions A history of falls or syncope is common in patients with atrial fibrillation; however, neither history was associated with increased risk of intracranial hemorrhage. These patients were at an increased risk of death, stroke, myocardial infarction and major bleeding, suggesting that they should receive anticoagulation for stroke prevention. Funding Acknowledgement Type of funding source: None

Dynamic Behaviour of High Performance of Sand Surfaces Used in the Sports Industry

The sand surface is considered a critical injury and performance contributing factor in different sports, from beach volleyball to greyhound racing. However, there is still a significant gap in understanding the dynamic behaviour of sport sand surfaces, particularly their vibration behaviour under impact loads. The purpose of this research was to introduce different measurement techniques to the study of sports sand surface dynamic behaviour. This study utilised an experimental drop test, accelerometry, in-situ moisture content and firmness data, to investigate the possible correlation between the sand surface and injuries. The analysis is underpinned by data gathered from greyhound racing and discussed where relevant.

Women’s Gendered Experiences of Traumatic Brain Injury

Despite recognizing that women have worse outcomes after traumatic brain injury (TBI), little is known about how gender influences their experiences of this critical injury. Past research has been dominated by androcentrism and quantitative approaches, leaving the lived experience of women with TBI insufficiently examined. To gain insight into their experiences, this qualitative study interviewed 19 Canadian women with mild and moderate-to-severe TBIs. Applying a thematic analysis, we discerned three themes: Gender prevails considers choosing to do gender over complying with physician advice; Consequences of TBI impeding performativity explores how women frame themselves as terrible people for being unable to do gender post-TBI; and Perceptions of receiving care looks at gendered caregiving expectations. These results broadly align with research on how doing gender influences recovery and health outcomes. We discuss the implications of our findings for knowledge translation, future research on women’s TBI recovery, and clinical practice.

Development and Analysis of Semi-Automatic Safety Inflation Bag

Various safety gears and techniques are available in cars but save for the helmet, not much of safety gears have been introduced for the bike riders. Bike riders indulge in fatal accidents during their rides and race riders in spite of wearing the best safety gears get injured severely with spinal cord and chest being most vulnerable during the impact. Daily riders or race riders, accidents are inevitable. It’s entirely upon us to equip ourselves with an additional safety gear for our own safety purposes. The project, safety inflation bag, provides the best solution to prevent injuries to spinal cord and chest. Here, a pneumatic actuator is used to inflate the air channels sewn inside the bag which provides protection for chest and spinal cord. This technique is implemented in a bag, as bag is most commonly used during bike rides. Be it for office goers or for riders on long trips, bag is necessary and fixating the safety gear inside the bag serves the rider than just for carrying items. It could save the life. It could prevent him from enduring critical injury to spinal cord or chest. During the time of impact, the pneumatic cylinder goes off, releasing the compressed air through the air channels pressed against chest and spinal cord thus inflating them at the right time to provide a solid balloon protection. This project could serve as the first step to a major safety innovation for bike riders.