We would like to thank the Canadian Institutes of Health Research (CIHR) who have provided funding for this research. Further, we would like to acknowledge Dr. Tim Taha and Dr. Scott Thomas from the University of Toronto for their assistance with the development of our protocol for the collection of resting state heart rate variability data.

所描述的协议包括受伤前/基准测试和伤后的后续评估，并采用三站完成。这个测试可以单独或四个科目，每个站的团体在同一时间完成。科目继续完成下面列出的顺序各站。表1示出了协议的测试给药时间表。从荷兰Bloorview研究伦理委员会获得在荷兰Bloorview儿童康复医院伦理委员会批准了这项研究。所有参加者和他们的法定监护人提供在完成签署的协议和相关的数据收集之前，知情同意书。 受伤前/基准测试 1站1：获取受伤前的人口统计资料显示，脑震荡后症状报告和静息状态心率变异性（HRV）数据<ol><li>此前科目的到达进行检测，确保所有设备功能荷兰国际集团正常，准备进行测试和评估的客房不受不必要的干扰。 </li><li>回顾家长和主题的同意后，测量并记录受试者的身高和体重。正确设置每个主题心脏监测仪带和手表。 </li><li>管理的人口信息表，并使用后震荡症状量表（PCSI-C），而每个主题就位5分钟的儿童版收集脑震荡后的症状报告。 </li><li>让每个主题仰卧躺在一个干净的消毒垫在地上。打开心脏速率监视器记录静息状态下心脏心率变异性（HRV）的数据（与RR间期功能设定为[开]）。让每个主题仍然躺在仰卧静静不说话10分钟，同时记录心率。 </li><li> 10分钟后，点击看一圈按钮，表示仰卧静息状态下心率变异性数据集合的末尾。让拍摄对象返回到一个固定的位置，请单击圈BU再次Xinjiang。棉花上的手表，表示静止状态坐着HRV数据收集开始。 </li><li>让每个主题停留在坐姿5分钟没有说话。 5分钟后，停止计时录制功能，以结束会话，静息状态下心率变异性的数据收集。让拍摄对象起飞的心脏速率和表带的手表。 </li></ol> 2站2：获得认知性能数据<ol><li>有各学科静坐在个人房间与个人笔记本电脑设置了鼠标。确保测试环境不受分心。 </li><li>管理直属脑震荡后评估和认知测试（IMPACT），快速和计算机化的神经心理评估工具（约25分钟即可完成）。 </li></ol> 3站3：获取静态平衡，握力​​和敏捷/运动技能数据<ol><li>管理使用感官集成公司的修改临床试验的静态平衡评估在便携式平衡系统平衡（M-CTSIB）的。而站在平衡系统forceplate，主体完成4有序的条件，包括站立睁眼，持续20秒;站立闭眼20秒;站在眼前的索引泡沫垫，持续20秒打开;就这样站着，闭着眼睛对索引的泡沫垫，持续20秒。 </li><li>用测力计，测量和千克为左右手记录手的握力。记录惯用手为每个主题，同时还完成了连续3个试验为每手开始的惯用手。出所采取的3项试验中，最大握每只手也将被记录。对于每一个实验的受试者被告知要挤握硬，因为他们可以在3秒保持中立上肢位置（直立，伸直手臂平行的尸体旁，掌心对着身体和手腕中性）。 </li><li>在走廊或健身房至少2.5米，宽15米长管理的敏捷性/马达技能考核使用ABI-挑战评估（ABI-CA） - 震荡模块。铺设胶带在地面上在一条直线上标记每1 m个点。按以下顺序给予这6个测试下的震荡模块中提供的准则和评分标准。 <ol><li>跳跃，千斤顶（定时）： <ol><li>用你的双臂站在身体两侧，并跳转到一个“X”立场的胳膊和腿，然后瞬间跳回起始位置。看看有多少人能在15秒内完成。 </li></ol></li><li>挂架/锥障碍训练场跑（定时）： <ol><li>运行进出挂架到底（10米）和背面一样快，你可以​​，但在你感到安全的速度。请勿触摸挂架。径直穿过终点线。 （位于3，5，7，10米主塔） </li></ol></li><li>向后步行串联（定时）： <ol><li>在赛道两旁，向后走在串联模式，持续5分钟。串联模式触摸自己的弱点，以自己的oppos伊特脚趾上的每个步骤。 </li></ol></li><li>修改折返跑（定时）： <ol><li>沿着10米的轨道上运行，拿起一个豆袋在课程结束后，并跑回把豆子放在一个篮子的起点。他们必须每次回到篮下的时间接触他们脚下的起跑线上。重复此操作三次，直到所有豆袋是在篮子在起点。 </li></ol></li><li>前前后后（定时）： <ol><li>站立，双脚的两条平行线（路径）是40厘米外内。移动一只脚相应的行之后对侧下肢的其他线路外运动之外。第一脚，然后返回到内侧，随后所述第二脚。周期必须是连续的，应在有节奏的方式（每个步骤之间的时间相等）来执行，并且将重复10倍不前进或后退。 </li></ol></li><li>站立，双脚为f向前跳转：立定跳远AR，你可以按住落地，持续3秒。测量和记录，从最远的后脚前部的距离。三项试验给出实现最遥远的距离</li></ol></li></ol> 4，伤后/后续测试<ol><li>获取脑震荡后的数据，同时受正经历脑震荡后的症状<ol><li>就在同一天一个主题受到伤害，研究人员通过使用受任何电话或电子邮件联系。研究人员记录了有关伤病的临床和功能细节。 </li><li>紧随其后的震荡（24-48小时后伤），收集：静息状态下心率变异性数据（重复步骤1.3，1.5-1.10）;脑震荡后的症状数据（重复步骤1.4）;平衡数据（重复步骤3.1）。如果症状在测试过程中加剧了，停止收集数据，并允许受休息。 </li><li>继续收集静止状态心率变异性数据（重复步骤1.3，1.5-1.10），脑震荡后的症状数据（重复步骤1.4），并平衡数据（重复步骤3.1）周，直到脑震荡后症状消失。如果症状在测试过程中加剧了，停止收集数据，并允许受休息。 </li><li>研究人员跟进与学科每周通过电话来确定何时脑震荡后症状缓解（使用PCSI-C）。 </li></ol></li></ol> 5，获得脑震荡后的数据，同时对象不再经历脑震荡后的症状<ol><li> 1周后，脑震荡后症状消失，收集：静息状态下心率变异性数据（重复步骤1.3，1.5-1.10）;脑震荡后的症状数据（重复步骤1.4）;认知表现数据（重复步骤2.1-2.2）;平衡数据（重复步骤3.1）;手柄的数据（重复步骤3.2）;和敏捷/运动技能数据（重复步骤3.3）。如果症状在测试过程中加剧了，停止收集数据，并允许受休息。 </li><li> 1个月后，脑震荡后症状消失，重复步骤5.1。在后3个月后-concussion症状消失，重复步骤5.1。在6个月后后震荡症状消失，重复步骤5.1。 </li></ol>

<ol>
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The authors have nothing to disclose.

该协议提出了一种多模态方式测量下震荡回升的青年运动员。该协议的一个关键特征是在广泛的性能域的脑震荡后的数据（认知，平衡，力量，敏捷，静息状态下心脏心率变异性等 ）到受伤前/基准的比较。这些数据作为一种手段，表明复苏之中以下震荡个别青年运动员。通过使用的认知，平衡，力量和敏捷性能常见和容易得到的临床测量，以及实验使用静息状态的HRV，该协议的目的是提?...

震荡可以被定义为1“影响引起的外伤性生物机械力的大脑复杂的病理生理过程”，并且可能导致短期和长期的躯体，认知和/或情绪/行为症状2。从功能上讲，脑震荡及相关症状可以在日常活动中对一个人的参与的显著影响，追求3。据估计，在美国，1.6至380万脑震荡，每年发生的体育参与4的结果。具体到参与体育的儿童和青少年，脑震荡是最常见的受伤5-7中的一个。尽管冲击震荡可能对日常活动和脑震荡是儿童和青少年的患病率，但仍然缺乏科学数据报告如何青年大脑反应在各种性能领域为脑震荡。 基准吨十分有趣的，或使用受伤前的测试成绩为基准，对伤后的测试成绩对比，告知恢复，是日益普及青少年体育界内的做法，并已建议国际8是“有益的补充有用脑震荡的管理过程中的信息“（第3页）。以最好地代表了脑震荡后症状（躯体，认知和情绪/行为）的各种性质，重要的是，脑震荡后恢复的评估包括各种结果的措施。此外，目前震荡的管理很大程度上依赖于脑震荡后的症状主观的报告。这种主观报告的有效性可通过多种因素9的影响，并可能导致两个报告不足的症状10,11和不准确的，可靠的恢复的指标。其结果是，有一个显著需要探索的方法来跨performan测量脑震荡后恢复CE域是客观和敏感。 它已被证明，认知，平衡，力量和敏捷可以在以下的青年脑震荡和脑损伤12-17被削弱。被选中列入本试验的方案中的措施提供以下震荡洞察在这些领域的恢复，并合并使用常常被认为是整个集中管理的脑震荡的临床环境中使用经过验证的临床测试工具。此外，从更为解释性透视，静息状态的HRV可以看作是交感平衡18,19的精确测量。在健康人群中，交感平衡被定义为在副交感神经系统占优势处于静止状态，而交感神经系统处于强直抑制控制。它是假设，脑震荡后，由于生理应力，这两个系统之间的不平衡会存在与静止状态可以转换到的动交感神经系统和副交感神经系统20的活动减退。 这项研究的协议的目的是为了获得恢复之后震荡更加全面，客观，准确地了解行为前后脑震荡的表现之间的青年运动员（年龄10-18岁）的多模态评估。本研究的目的是提供洞察开发和交付的特定于儿童和青年震荡的管理和康复方案。

<table border="0" cellpadding="0" cellspacing="0" width="584">
	<tbody>
		<tr>
			<td>Name of Reagent/ Equipment</td>
			<td>Company</td>
			<td>Catalog Number</td>
			<td>Comments/Description</td>
		</tr>
		<tr>
			<td>Scale</td>
			<td>Weight Watchers: Conair&#160;</td>
			<td>WW30WB</td>
			<td></td>
		</tr>
		<tr>
			<td>Measuring Tape</td>
			<td>Hi-Viz Lufkin</td>
			<td>HVC716CME</td>
			<td></td>
		</tr>
		<tr>
			<td>Heart Rate Monitor (Chest Strap and Watch)</td>
			<td>Polar</td>
			<td>RS800CX GPS</td>
			<td></td>
		</tr>
		<tr>
			<td>Exercise/Yoga Mat</td>
			<td>Pur Athletics</td>
			<td>WTE10126</td>
			<td></td>
		</tr>
		<tr>
			<td>Sportline Stopwatch (Model 228)</td>
			<td>EB Sport Group</td>
			<td>#2787</td>
			<td></td>
		</tr>
		<tr>
			<td>Laptop - MacBook Pro</td>
			<td>Apple</td>
			<td>A1278</td>
			<td></td>
		</tr>
		<tr>
			<td>Computerized Cognitive Assessment- Immediate Post-Concussion Assessment and Cognitive Task</td>
			<td>ImPACT Application&#39;s Inc.&#160;</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Hand Grip Dynamometer</td>
			<td>Sammons Preston- Smedley-Type</td>
			<td>5032P</td>
			<td></td>
		</tr>
		<tr>
			<td>BioSway</td>
			<td>Biodex Medical Supplies Inc.&#160;</td>
			<td>950-510</td>
			<td></td>
		</tr>
		<tr>
			<td>Painter&#39;s Mate Green Tape</td>
			<td>ShurTech Brands LLC</td>
			<td>#49462</td>
			<td></td>
		</tr>
		<tr>
			<td>Pylons/Cones (12&#34;)</td>
			<td>Canadian Tire</td>
			<td>84-295-4</td>
			<td></td>
		</tr>
		<tr>
			<td>Basket</td>
			<td>Canadian Tire</td>
			<td>42-9919-2</td>
			<td></td>
		</tr>
		<tr>
			<td>Bean Bags</td>
			<td>Eastpoint/Go Gater</td>
			<td>1-1-16392</td>
			<td></td>
		</tr>
	</tbody>
</table>

a multi-modal approach to assessing recovery in youth athletes following concussion

脑震荡是最常见的伤病当中涉及的体育参与儿童和青年中的一个。经过震荡，青年可以体验一系列短期和长期的神经行为症状（躯体，认知和情绪/行为），可以在日常活动和兴趣的追求（ 如学校，体育，工作，一个人的参与的显著影响，家庭/社会生活等 ）。尽管如此，仍然存在于临床驱动的研究贫乏的青年运动人口内探索震荡旨在具体，更具体地讲，多模式的方法来测量恢复。本文提供了一种新型的多模态方式测量复苏之中的青年运动员脑震荡如下概述。所提出的方法包括使用两个受伤前/基准测试和伤后/后续测试在各种不同的领域，以评估业绩（后concus锡永的症状，认知，平衡，力量，敏捷/运动技能和静息状态下心脏心率变异）。本研究的目的是为了获得恢复之后震荡青年运动员（年龄10-18岁）更客观，准确的认识。从这个研究结果可以帮助告知开发和利用改进的办法，以震荡的管理和康复具体到青少年体育界。

所提出的协议是一个正在进行的调查。 表1描述了协议的测试管理计划。代表性的成果，以示在各种已知由震荡青年受到影响性能域收集基线/受伤前和脑震荡后的数据的可行性。 à脑震荡的青春谁已经完成了协议的各个阶段提出证明到选定的观察指标复苏轨迹的一个案例。 图1提供了基线/受伤前的代表性数据脑震荡后认知能力，平衡和脑震荡后的症状。另外， 图2?...

Watch this Scientific Journal Video about A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion at JoVE.com

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion

This article provides an overview of a multi-modal approach to assessing recovery following concussion in youth athletes. The described protocol uses pre- and post-concussion assessment of performance across a wide variety of domains and can inform the development of improved concussion rehabilitation protocols specific to the youth sport community.

多模式的方法来评估恢​​复的青少年运动员脑震荡之后

Concussion is one of the most commonly reported injuries amongst children and youth involved in sport participation. Following a concussion, youth can ...

a-multi-modal-approach-to-assessing-recovery-youth-athletes-following

Research

JoVE Journal

Medicine

13.3K 次观看.  Holland Bloorview Kids Rehabilitation Hospital. This article provides an overview of a multi-modal approach to assessing recovery following concussion in youth athletes. The described protocol uses pre- and post-concussion assessment of performance across a wide variety of domains and can inform the development of improved concussion rehabilitation protocols specific to the youth sport community.

视频: A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion

An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth involved in organized sports such as competitive hockey are nearly six times more likely to suffer a severe concussion compared to children involved in other leisure physical activities2. While the most common cognitive sequelae of mTBI appear similar for children and adults, the recovery profile and breadth of consequences in children remains largely unknown2, as does the influence of pre-injury characteristics (e.g. gender) and injury details (e.g. magnitude and direction of impact) on long-term outcomes. Competitive sports, such as hockey, allow the rare opportunity to utilize a pre-post design to obtain pre-injury data before concussion occurs on youth characteristics and functioning and to relate this to outcome following injury. Our primary goals are to refine pediatric concussion diagnosis and management based on research evidence that is specific to children and youth. To do this we use new, multi-modal and integrative approaches that will:
 1.Evaluate the immediate effects of head trauma in youth 
2.Monitor the resolution of post-concussion symptoms (PCS) and cognitive performance during recovery 
3.Utilize new methods to verify brain injury and recovery
To achieve our goals, we have implemented the Head Impact Telemetry (HIT) System. (Simbex; Lebanon, NH, USA). This system equips commercially available Easton S9 hockey helmets (Easton-Bell Sports; Van Nuys, CA, USA) with single-axis accelerometers designed to measure real-time head accelerations during contact sport participation 3 - 5. By using telemetric technology, the magnitude of acceleration and location of all head impacts during sport participation can be objectively detected and recorded. We also use functional magnetic resonance imaging (fMRI) to localize and assess changes in neural activity specifically in the medial temporal and frontal lobes during the performance of cognitive tasks, since those are the cerebral regions most sensitive to concussive head injury 6. Finally, we are acquiring structural imaging data sensitive to damage in brain white matter.

This article provides an overview of a multi-modal approach to mild traumatic brain injury diagnosis and recovery in youth. This approach combines neuropsychological testing with functional magnetic resonance imaging and the Head Impact Telemetry System to monitor the relationship between head impacts and brain activity during cognitive testing.

在使用功能性磁共振成像和头部撞击遥测系统的青年与体育有关的震荡影响的调查

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth ...

科研

医学

Assessing Teratogenic Changes in a Zebrafish Model of Fetal Alcohol Exposure

Fetal alcohol syndrome (FAS) is a severe manifestation of embryonic exposure to ethanol. It presents with characteristic defects to the face and organs, including mental retardation due to disordered and damaged brain development. Fetal alcohol spectrum disorder (FASD) is a term used to cover a continuum of birth defects that occur due to maternal alcohol consumption, and occurs in approximately 4% of children born in the United States. With 50% of child-bearing age women reporting consumption of alcohol, and half of all pregnancies being unplanned, unintentional exposure is a continuing issue2. In order to best understand the damage produced by ethanol, plus produce a model with which to test potential interventions, we developed a model of developmental ethanol exposure using the zebrafish embryo. Zebrafish are ideal for this kind of teratogen study3-8. Each pair lays hundreds of eggs, which can then be collected without harming the adult fish. The zebrafish embryo is transparent and can be readily imaged with any number of stains. Analysis of these embryos after exposure to ethanol at different doses and times of duration and application shows that the gross developmental defects produced by ethanol are consistent with the human birth defect. Described here are the basic techniques used to study and manipulate the zebrafish FAS model.

In order to understand the molecular mechanisms of the ethanol-induced developmental damage, we have developed a zebrafish model of ethanol exposure and are exploring the physical, cellular, and genetic alterations that occur after ethanol exposure1. We then seek to find potential interventions and rapidly test them in this animal model.

在斑马鱼模型的胎儿酒精暴露评估致畸的变化

Fetal alcohol syndrome (FAS) is a severe manifestation of embryonic exposure to ethanol. It presents with characteristic defects to the face and organs, ...

Multi-modal Imaging of Angiogenesis in a Nude Rat Model of Breast Cancer Bone Metastasis Using Magnetic Resonance Imaging, Volumetric Computed Tomography and Ultrasound

Angiogenesis is an essential feature of cancer growth and metastasis formation. In bone metastasis, angiogenic factors are pivotal for tumor cell proliferation in the bone marrow cavity as well as for interaction of tumor and bone cells resulting in local bone destruction. Our aim was to develop a model of experimental bone metastasis that allows in vivo assessment of angiogenesis in skeletal lesions using non-invasive imaging techniques.
For this purpose, we injected 105 MDA-MB-231 human breast cancer cells into the superficial epigastric artery, which precludes the growth of metastases in body areas other than the respective hind leg1. Following 25-30 days after tumor cell inoculation, site-specific bone metastases develop, restricted to the distal femur, proximal tibia and proximal fibula1. Morphological and functional aspects of angiogenesis can be investigated longitudinally in bone metastases using magnetic resonance imaging (MRI), volumetric computed tomography (VCT) and ultrasound (US).
MRI displays morphologic information on the soft tissue part of bone metastases that is initially confined to the bone marrow cavity and subsequently exceeds cortical bone while progressing. Using dynamic contrast-enhanced MRI (DCE-MRI) functional data including regional blood volume, perfusion and vessel permeability can be obtained and quantified2-4. Bone destruction is captured in high resolution using morphological VCT imaging. Complementary to MRI findings, osteolytic lesions can be located adjacent to sites of intramedullary tumor growth. After contrast agent application, VCT angiography reveals the macrovessel architecture in bone metastases in high resolution, and DCE-VCT enables insight in the microcirculation of these lesions5,6. US is applicable to assess morphological and functional features from skeletal lesions due to local osteolysis of cortical bone. Using B-mode and Doppler techniques, structure and perfusion of the soft tissue metastases can be evaluated, respectively. DCE-US allows for real-time imaging of vascularization in bone metastases after injection of microbubbles7.
In conclusion, in a model of site-specific breast cancer bone metastases multi-modal imaging techniques including MRI, VCT and US offer complementary information on morphology and functional parameters of angiogenesis in these skeletal lesions.

In the pathogenesis of bone metastasis, angiogenesis is a crucial process and therefore represents a target for imaging and therapy. Here, we present a rat model of site-specific breast cancer bone metastasis and describe strategies to non-invasively image angiogenesis in vivo using magnetic resonance imaging, volumetric computed tomography and ultrasound.

利用磁共振成像，容积电脑断层扫描及超音波的裸鼠乳腺癌骨转移大鼠模型血管生成的多模态成像

Angiogenesis is an essential feature of cancer growth and metastasis formation. In bone metastasis, angiogenic factors are pivotal for tumor cell ...

A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 million concussions occur in sports and recreational activities annually. Concussion as defined by the 2013 Concussion Consensus Statement &#8220;may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an &#8216;impulsive&#8217; force transmitted to the head.&#8221; Concussions leave the individual with both short- and long-term effects. The short-term effects of sport related concussions may include changes in playing ability, confusion, memory disturbance, the loss of consciousness, slowing of reaction time, loss of coordination, headaches, dizziness, vomiting, changes in sleep patterns and mood changes. These symptoms typically resolve in a matter of days. However, while some individuals recover from a single concussion rather quickly, many experience lingering effects that can last for weeks or months. The factors related to concussion susceptibility and the subsequent recovery times are not well known or understood at this time. Several factors have been suggested and they include the individual&#8217;s concussion history, the severity of the initial injury, history of migraines, history of learning disabilities, history of psychiatric comorbidities, and possibly, genetic factors. Many studies have individually investigated certain factors both the short-term and long-term effects of concussions, recovery time course, susceptibility and recovery. What has not been clearly established is an effective multifaceted approach to concussion evaluation that would yield valuable information related to the etiology, functional changes, and recovery. The purpose of this manuscript is to show one such multifaceted approached which examines concussions using computerized neurocognitive testing, event related potentials, somatosensory perceptual responses, balance assessment, gait assessment and genetic testing.

There is great variability in an individual&#8217;s risk for concussion and their corresponding recovery. A multifaceted approach to concussion evaluation is warranted; including baseline testing of athletes before participation in sport and timely evaluation post injury. The goal of this protocol is to provide an appropriate multifaceted approach to examine concussions.

一个神经科学方法脑震荡的学生运动员的考试

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 ...

Non-invasive Assessments of Subjective and Objective Recovery Characteristics Following an Exhaustive Jump Protocol

Fast recovery after strenuous exercise is important in sports and is often studied via cryotherapy applications. Cryotherapy has a significant vasoconstrictive effect, which seems to be the leading factor in its effectiveness. The resulting enhanced recovery can be measured by using both objective and subjective parameters. Two commonly measured subjective characteristics of recovery are delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE). Two important objective recovery characteristics are countermovement jump (CMJ) performance and peak power output (PPO). Here, we provide a detailed protocol to induce muscular exhaustion of the frontal thighs with a self-paced, 3 x 30 countermovement jump protocol (30-s rest between each set). This randomized controlled trial protocol explains how to perform local cryotherapy cuff application (+ 8 &#176;C for 20 min) and thermoneutral cuff application (+ 32 &#176;C for 20 min) on both thighs as two possible post-exercise recovery modalities. Finally, we provide a non-invasive protocol to measure the effects of these two recovery modalities on subjective (i.e., DOMS of both frontal thighs and RPE) and objective recovery (i.e., CMJ and PPO) characteristics 24, 48, and 72 h post-application. The advantage of this method is that it provides a tool for researchers or coaches to induce muscular exhaustion, without using any expensive devices; to implement local cooling strategies; and to measure both subjective and objective recovery, without using invasive methods. Limitations of this protocol are that the 30 s rest period between sets is very short, and the cardiovascular demand is very high. Future studies may find the assessment of maximum voluntary contractions to be a more sensitive assessment of muscular exhaustion compared to CMJs.

This protocol describes the procedure for non-invasive recovery assessments during a 72 h recovery period. This protocol induces muscular exhaustion of the frontal thighs using countermovement jumps and uses either local cold-cuff or thermoneutral-cuff application as a recovery modality.

根据彻底的跳跃协议进行的主观和客观恢复特征的非侵入性评估

Fast recovery after strenuous exercise is important in sports and is often studied via cryotherapy applications. Cryotherapy has a significant ...

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based three-chamber bags (3CBs) and soybean-oil-based compounded bags (CoBs) in hospitalized adult patients. We designed a multicenter, randomized, prospective, open-label, noninferiority protocol to compare the efficacy, safety, and distribution of olive-oil-based 3CBs and soybean-oil-based CoB formulations in adult Chinese patients requiring PN during surgical intervention. Subjects were randomized to receive either one of the study treatments using an interactive voice or web-based recognition system in accordance with the randomization code. Randomization was further stratified based on the study site and surgical category. Both treatment groups received similar amounts of calories and protein. In addition, the two study treatments contained a similar composition of the amino-acid component. The only difference between the two PN formulations was the lipid constitution. The duration of administration of study treatments was a minimum of 5 days up to a maximum of 14 days after the surgical procedure. The primary efficacy endpoint was serum prealbumin levels on day 5 of the study. Noninferiority was proved if the anti-log of the lower bound of the 95% confidence interval (CI) of the treatment difference was at least 0.80. Other efficacy measures included treatment preparation time; duration to achieve tolerability of oral nutrition; associated infectious complications; length of hospitalization; and laboratory assessment of markers of nutrition, inflammation, metabolism, and oxidative stress. A total of 458 patients were enrolled in the study. The results showed that olive-oil-based 3CBs were non-inferior to soybean-based CoBs, besides being well tolerated. The infection rate was found to be significantly lower in the olive-oil-based 3CB group. Thus, this study may be used as a reference for future research on lipid emulsion and 3CBs.

Here, we present a protocol for a study comparing the efficacy, safety, and delivery of olive-oil-based 3CB and soybean-oil-based CoB formulations in adults requiring parenteral nutrition. The results revealed that olive-oil-based 3CBs is non-inferior and well tolerated compared to soybean formulations.

一项临床试验，评估基于橄榄油的三腔袋的亲子营养的安全性、有效性和交付

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based ...

Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology

Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To date, return-to-activity decision-making has been anchored in the monitoring of self-reported concussion symptoms and neurocognitive testing. However, multi-modal assessments that corroborate objective physiological measures with traditional subjective symptom reporting are needed and can be valuable. Heart rate variability (HRV) is a non-invasive physiological indicator of the autonomic nervous system, capturing the reciprocal interplay between the sympathetic and parasympathetic nervous systems. There is a dearth of literature exploring the effect of concussion on HRV in youth athletes, and developmental differences preclude the application of adult findings to a pediatric population. Further, the current state of HRV methodology has primarily included short-term (5-15 min) recordings, by using resting state or short-term physical exertion testing to elucidate changes following concussion. The novelty in utilizing a 24 h&#160;recording methodology is that it has the potential to capture natural variation in autonomic function, directly related to the activities a youth athlete performs on a regular basis. Within a prospective, longitudinal research setting, this novel approach to quantifying autonomic function can provide important information regarding the recovery trajectory, alongside traditional self-report symptom measures. Our objectives regarding a 24 h recording methodology were to (1) evaluate the physiological effects of a concussion in youth athletes, and (2) describe the trajectory of physiological change, while considering the resolution of self-reported post-concussion symptoms. To achieve these objectives, non-invasive sensor technology was implemented. The raw beat-to-beat time intervals captured can be transformed to derive time domain and frequency domain measures, which reflect an individual&#39;s ability to adapt and be flexible to their ever-changing environment. By using non-invasive heart rate technology, autonomic function can be quantified outside of a traditional controlled research setting.

We demonstrate a 24 h heart rate recording methodology to evaluate the influence of concussion across the recovery trajectory in youth athletes, within an ecologically valid context.

青年运动员脑震荡后的自主功能: 用24小时记录法探讨心率变异性

Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To ...

A Novel Approach to Monitoring Graft Neovascularization in the Human Gingiva

Laser speckle contrast imaging (LSCI) is a novel method for measuring superficial blood perfusion over large areas. Since it is non-invasive and avoids direct contact with the measured area, it is suitable for monitoring blood flow changes during wound healing in human patients. Vestibuloplasty is periodontal surgery to the oral vestibule, aiming to restore vestibular depth with simultaneous enlargement of the keratinized gingiva. In this special clinical case, a split thickness flap was elevated at the first upper premolar and a xenogenic collagen matrix was adapted to the resulting recipient bed. LSCI was used to monitor the re- and neovascularization of the graft and the surrounding mucosa for one year. A protocol is introduced for the correct adjustment of microcirculation measurement in the oral mucosa, highlighting difficulties and possible failures.
The clinical case study presented demonstrated that &#8212; following the appropriate protocol &#8212; LSCI is a suitable and reliable method for following up microcirculation in a healing wound in the human oral mucosa and gives useful information on graft integration.

This study introduces a protocol for measuring microcirculation in human oral mucosa by laser speckle contrast imaging. The monitoring of wound healing after vestibuloplasty combined with a xenogenic collagen graft is presented on a clinical case.

一种监测人牙龈移植新生血管的新方法

Laser speckle contrast imaging (LSCI) is a novel method for measuring superficial blood perfusion over large areas. Since it is non-invasive and avoids ...

Multi-Modal Home Sleep Monitoring in Older Adults

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and research participants. Home sleep testing has gained momentum in the field of sleep medicine due to its convenience and lower cost, as well as being more naturalistic. The accuracy and quality of home sleep testing, however, may be variable because studies are not monitored by sleep technologists. There has been some success in improving the accuracy of home sleep studies by having trained sleep technicians assist participants inside their homes with putting on the devices, but this can be intrusive and time-consuming for those involved. In this protocol, participants undergo at-home sleep monitoring with multiple devices: 1) a single-channel EEG device; 2) a home sleep test for sleep-disordered breathing and periodic limb movements; 3) actigraphy; and 4) sleep logs. A major challenge of this study is obtaining high-quality sleep monitoring data on the first attempt in order to minimize participant burden. This protocol describes the implementation of educational manuals with step-by-step instructions and photos. The goal is to improve the quality of home sleep testing.

Here, we present a protocol to improve the quality of data from home sleep testing by providing a method to enhance instructions through a structured participant visit. This protocol includes the implementation of a step-by-step educational manual with photos to ensure proper placement of equipment.

老年人多式家庭睡眠监测

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and ...

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion

The evidence-informed standardization of care along disease lines is recommended to improve outcomes and reduce healthcare costs. The aim of this project is to 1) describe the development and implementation of the Concussion Carepath, 2) demonstrate the process of integrating technology in the form of a mobile application to enable the carepath and guide clinical decision-making, and 3) present data on the utility of the C3 app in facilitating decision-making throughout the injury recovery process. A multi-disciplinary team of experts in concussion care was formed to develop an evidence-informed algorithm, outlining best practices for the clinical management of concussion along three phases of recovery &#8211; acute, subacute, and post-concussive. A custom mobile application, the Cleveland Clinic Concussion (C3) app was developed and validated to provide a platform for the systematic collection of objective, biomechanical outcomes and to provide guidance in clinical decision-making in the field and clinical environments. The Cleveland Clinic Concussion app included an electronic incident report, assessment modules to measure important aspects of cognitive and motor function, and a return to play module to systematically document the six phases of post-injury rehabilitation. The assessment modules served as qualifiers within the carepath algorithm, driving referral for specialty services as indicated. Overall, the carepath coupled with the C3 app functioned in unison to facilitate communication among the interdisciplinary team, prevent stagnant care, and drive patients to the right provider at the right time for efficient and effective clinical management.

A multidisciplinary carepath to standardize disparate concussion care was developed and implemented at the Cleveland Clinic. The Cleveland Clinic Concussion (C3) mobile application was used to enable the carepath through biomechanical outcomes characterizing cognitive and motor function. Patient outcomes improved while cost of care was reduced following implementation.

青少年及有脑震荡青少年多学科技术强化护理途径的开发与实施

The evidence-informed standardization of care along disease lines is recommended to improve outcomes and reduce healthcare costs. The aim of this project ...

多模式的方法来评估恢​​复的青少年运动员脑震荡之后

多模式的方法来评估恢复的青少年运动员脑震荡之后