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.

記載されたプロトコルは、損傷前/ベースライン試験および損傷後のフォローアップ評価を含み、3つのステーションを使用して完成する。この試験は、一度に、個別に、または各ステーションでの4人の被験者のグループで完了することができる。被験者は、下記の順序で各ステーションを進める。表1は、プロトコルのテスト投与スケジュールを示している。この研究のための倫理の承認はオランダBloorviewキッズリハビリテーション病院でオランダBloorview研究倫理委員会から得た。全ての参加者とその法的保護者が前に、プロトコルおよび関連データの収集を完了すると契約し、インフォームドコンセントを提供しています。 損傷前/ベースラインのテスト 1駅1：、プリ傷害人口統計情報の取得後の脳震盪症状報告及び休止状態心拍変動（HRV）データ<ol><li>テストのために到着した対象（複数）の前に、すべての機器が関数であることを確認適切かつテストの準備·評価室が不要に気晴らしがないことをる。 </li><li>親および件名の同意を確認した後、被験者の身長と体重を測定し、記録します。適切に各被験者に心拍数モニターストラップと時計を設定します。 </li><li>人口統計情報フォームを管理し、各被験者は5分間座っている間にポスト脳震盪の症状インベントリ（PCSI-C）の子バージョンを使用して、ポスト脳震盪の症状報告を収集します。 </li><li>各被験者は、クリーン消毒マットの上に地面に仰向け横たわったことがあります。 （[入]に設定したRR間隔機能付き）安静状態の心拍変動（HRV）のデータを記録するために心拍数のモニターの電源をオンにします。各被験者は、HRを記録しながら10分間話をすることなく、静かに仰向けに横たわったまま持っている。 </li><li> 10分後、状態HRVデータ収集を休んで仰向け嘘の終わりを示すために、時計の上のラップボタンをクリックします。ラップ府をクリックして、着座位置に戻るには、被写体を依頼状態着席HRVデータ収集休止の始まりを示すために、もう一度、時計上tton。 </li><li>各被験者は、話をせずに5分間座った位置に留まることがあります。 5分後、セッションおよび休止状態HRVデータ収集を終了する時計の記録機能を停止する。心拍数ストラップや時計を脱いで件名を確認して下さい。 </li></ol> 2駅2：認知パフォーマンスデータの取得<ol><li>各被験者は、マウスを使用して設定の個人的なノートPCで個別のブースに座ったことがあります。テスト環境は気晴らしから自由であることを確認してください。 </li><li>直後の脳震盪の評価と認知テスト（IMPACT）、迅速でコンピュータ化された神経心理学的評価ツール（完了するまでに約25分）を管理します。 </li></ol> 3駅3：スタティックバランス、握力や敏捷性/モータースキルデータの取得<ol><li>感覚Integratiの変更された臨床試験を用いて静的なバランス評価の管理ポータブルバランスシステム上の残高（M-CTSIB）の上。バランスシステムのforceplateの上に立っているが、対象は20秒間目を開けて立っ含ん4発注条件を完了する。 20秒間目を閉じて立っ; 20秒間のインデックス付きフォームパッドの上に開いた目で立っている。と目で立って20秒間インデックス付きフォームパッドは休業。 </li><li>ダイナモを使用し、測定し、右手と左手の両方のためのキロでレコードハンドグリップの強さ。まだ利き手で始まるそれぞれの手のための3つの連続した​​臨床試験を完了しながら、被験者ごとに利き手を記録します。撮影3試験のうち、それぞれの手の最大ハンドグリップも記録されます。各試行では被験者は3秒が中立上肢の位置を維持する（手のひらが体と手首ニュートラルに直面して、体の横に、直立ストレートアームを平行に立っている）のためのような硬質彼らができるようにグリップを絞るように言われている。 </li><li>廊下やジムでは、少なくとも広い2.5メートルと15メートルの長い敏捷/モーターの管理脳震盪モジュール - ABI-チャレンジアセスメント（ABI-CA）を用いてスキル評価。すべての1メートルのためのポイントをマーク一直線に地面にテープを置きます。次の順序で脳震盪モジュールで提供ガイドラインと採点基準以下のこれらの6のテストを管理します。 <ol><li>ジャンピング·ジャック（時限）： <ol><li>あなたの側面であなたの腕に立って腕と足を持つ &quot;X&quot;の位置にジャンプしてから、すぐに開始位置に戻るジャンプ。 15秒で行うことができますどのように多く数える。 </li></ol></li><li>パイロン/コーン障害物コースラン（時限）： <ol><li>早くすることができますが、あなたが安全に感じる速さで、バックエンド（10メートル）にパイロンの内外を実行します。パイロンに触れないでください。ストレートフィニッシュラインを通って実行します。 （3、5、7、10メートルに位置してパイロン） </li></ol></li><li>後方タンデム歩行（時限）： <ol><li>並ぶトラック上で、5メートルのためのタンデムパターンで後方に歩く。タンデムパターンは、そのopposに自分のかかとに触れている各手順のITEつま先。 </li></ol></li><li>変更されたシャトルラン（時限）： <ol><li> 、10メートルトラックに沿って実行してコース終了時にお手玉をピックアップして、出発点でバスケットにお手玉を配置するバックを実行します。彼らは足でスタートラインに彼らがバスケットに戻るたびに触れなければならない。すべてのお手玉が出発点で、バスケットになるまで、この3回繰り返します。 </li></ol></li><li>インとアウト（時限）： <ol><li> 40センチメートル離れている2本の平行線（パス内）の内側に両足で立つ。他のラインの外に移動し、反対の脚に続く対応するラインの外に片足を移動します。第一の足は、第2の足、続いて内側に戻される。サイクルは連続している必要がありますし、リズミカルなファッション（各ステップ間の等しい時間）で実施されるべきであり、前後に動いていない10倍を繰り返すことになる。 </li></ol></li><li>走り幅跳び立ちます。fとして両足で立ってから前方にジャンプすることができますし、3秒間の着陸を保持としてアル。最も遠い足裏の前面からの距離を測定し、記録します。 3件の試験は最も遠い距離を達成するために与えられている</li></ol></li></ol> 4。ポスト傷害/フォローアップテスト<ol><li>被写体がポスト脳震盪の症状を経験している間に、ポスト脳震盪データの取得<ol><li>被験者が負傷を被った同じ日に、研究スタッフは、電話または電子メールのいずれかを用いて被験者によって接触される。研究スタッフは負傷に関する臨床的および機能的な詳細を記録。 </li><li>直後に脳震盪（24〜48時間後に損傷）は、次の収集：安静時の心拍変動データを（リピートが1.3、1.5から1.10ステップ）;ポスト脳震盪の症状データ（繰り返しステップ1.4）;バランスデータ（反復ステップ3.1）。症状が試験中に悪化している場合、データ収集を停止し、残りの対象を可能にする。 </li><li>状態HRVデータ（反復は1.3、1.5から1.10ステップ）、ポスト脳震盪の症状データを休んで収集を継続する（ステップ1.4を繰り返します）、およびバランスデータ（反復ステップ3.1）週刊ポスト脳震盪の症状が解決されるまで。症状が試験中に悪化している場合、データ収集を停止し、残りの対象を可能にする。 </li><li>研究スタッフは、ポスト脳震盪の症状は（PCSI-Cを使用して）解決するかを決定するために、電話での被写体毎週でフォローアップ。 </li></ol></li></ol>件名はもはやポスト脳震盪の症状を経験している間に5ポスト脳震盪データを取得しない<ol><li>ポスト脳震盪の症状が解決した後に、1週間では、収集します。休止状態のHRVデータを（リピートが1.3、1.5から1.10ステップ）;ポスト脳震盪の症状データ（繰り返しステップ1.4）;認知能力データ（反復が2.1から2.2ステップ）;バランスデータ（反復ステップ3.1）;ハンドグリップデータ（反復ステップ3.2）;そして、敏捷性/運動能力データ（反復ステップ3.3）。症状が試験中に悪化している場合、データ収集を停止し、残りの対象を可能にする。 </li><li>解決した後の脳震盪の症状の後1ヶ月で、ステップ5.1を繰り返します。ポストの後3ヶ月の時点で-concussion症状は、繰り返しステップ5.1を解決した。ポスト脳震盪の症状の後に6ヵ月の時点では、手順5.1を解決した。 </li></ol>

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The authors have nothing to disclose.

このプロトコルは、脳震盪以下の青少年選手の回復を測定するマルチモーダルなアプローチを提示します。このプロトコルの重要な特徴は事前に傷害/ベースラインにパフォーマンスドメイン（認知、バランス、強さ、敏捷性、状態、心拍変動休止など ）、幅広いポスト脳震盪データの比較である。これらのデータは、脳震盪以下の個別のユース選手の中で回復を示すための手段とし?...

脳震盪は、1「外傷性生体力学的力によって誘発された脳に影響する複雑な病態生理学的プロセス」と定義することができ、短期および長期の身体的、認知的および/ ​​または行動的/情緒的症状2をもたらすことができる。機能的には、脳震盪と関連した症状は、日常的な活動の1の参加に大きな影響を与えると3を追求してすることができます。これは、米国内、1.6と380万脳震盪の間のスポーツ参加4の結果として、毎年発生すると推定されている。スポーツにかかわる子どもたちや若者に固有の、脳震盪は、最も一般的に報告された傷害5-7の一つです。日常の活動や子供や若者の間で脳震盪の有病率に与える影響脳震盪にもかかわらず、若者の脳はパフォーマンスドメインの多様渡って脳震盪どのように応答するかを報告する科学的データの不足が残っている。 ベースライントンesting、または回復に知らせる損傷後のテストスコアとの比較のためのベンチマークとして損傷前のテストスコアの使用は、青少年スポーツコミュニティ内人気の高まりの実践であり、「有用追加して有用であることが国際的に8が示唆されている脳震盪の管理の際の情報」（P.3）。最高のポスト脳震盪の症状（認知および行動/情緒体細胞）の多様性を表現するためには、ポスト脳震盪の回復の評価はアウトカム指標のさまざまなを含めることが重要です。また、電流脳震盪管理はポスト脳震盪の症状の主観的な報告書に大きく依存しています。この主観的な報告書の妥当性の因子9のさまざまな影響を与えることができ、過小報告症状10,11および回復のあまり正確で信頼性の指標の両方をもたらし得る。その結果、performan渡っポスト脳震盪の回復を測定するアプローチを探求する重要な必要性がある客観的かつ高感度の両方であるCEドメイン。 これは、認知、バランス、強度と敏捷性が脳震盪や脳損傷12-17以下の若者で損なわれることが実証されている。この試験プロトコル内に含ま対策が脳震盪後のこれらのドメイン間での回復への洞察を提供し、一般的に脳​​震盪管理に焦点を当てた臨床現場全体で使用されて検証された臨床テストツールの使用を組み込むために選択された。さらに、より多くの予備的な観点から、状態HRV休止するsympathovagalバランス18,19の正確な測定とみなすことができる。交感神経系は強壮剤抑制制御下にある間に健康的な集団において、sympathovagalバランスが、安静時に優勢である副交感神経系と定義される。これは、生理的ストレスに起因するポスト脳震盪は、2システム間の不均衡が存在するという仮説を立てたと状態の多動にシフトすることが載っている交感神経系と副交感神経系20の活動低下。 本研究のプロトコルの目的は、脳震盪後の回復のより、全体的な客観的かつ正確な理解を得るために青少年選手（年齢10〜18歳）の間で前後の脳震盪性能のマルチモーダルな評価を行うことである。本研究では、子供や青少年に特有の脳震盪管理とリハビリテーションプロトコルの開発と配信への洞察を提供することを目指します。

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			<td>Weight Watchers: Conair&#160;</td>
			<td>WW30WB</td>
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			<td>Measuring Tape</td>
			<td>Hi-Viz Lufkin</td>
			<td>HVC716CME</td>
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			<td>Heart Rate Monitor (Chest Strap and Watch)</td>
			<td>Polar</td>
			<td>RS800CX GPS</td>
			<td></td>
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			<td>Exercise/Yoga Mat</td>
			<td>Pur Athletics</td>
			<td>WTE10126</td>
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			<td>Sportline Stopwatch (Model 228)</td>
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			<td>Canadian Tire</td>
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a multi-modal approach to assessing recovery in youth athletes following concussion

脳震盪は、スポーツへの参加に関わる子どもや若者の間で最も一般的に報告された傷害の一つです。脳震盪の後、若者は、日常の活動や興味の追求（ 例えば、学校、スポーツ、仕事の1の参加に大きな影響を持つことができ短期および長期神経行動症状の範囲（認知および感情的な体細胞、/行動）を体験することができます家族/社会生活など ）。それにもかかわらず、若者のスポーツ集団内で脳震盪を探索で特異的に目的とした臨床的に駆動する研究の不足、および回復を測定することに、より具体的には、マルチモーダルなアプローチが残っている。この記事では、脳震盪以下の青少年のスポーツ選手の間で回復を測定することに新規でマルチモーダルなアプローチの概要を説明します。提示のアプローチは、損傷前/ベースラインテストとドメインの、多種多様な全体のパフォーマンスを評価するため、損傷後/フォローアップテスト（ポストconcus両方の使用を含むシオンの症状、認知、バランス、強さ、敏捷性/運動能力や休止状態心拍変動）。本研究の目的は、青少年選手（年齢10〜18歳）における脳震盪後の回復をより客観的かつ正確な理解を得ることである。本研究から得られた知見は、青少年スポーツのコミュニティに特定の管理やリハビリを脳震盪するための改良されたアプローチの開発と利用を通知するために助けることができる。

提示されたプロトコルは、現在進行中の調査である。 表1は、プロトコルのテスト投与スケジュールを示している。代表的な結果は、青年に脳震盪の影響を受けることが知られているパフォーマンスドメインの多様にわたってベースライン/損傷前及び後の脳震盪のデータを収集する可能性を実証するために提示される。プロトコルのすべての段階を完了したconcussed若さの一つの?...

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.

脳震盪に続いてユース選手での回復を評価するマルチモーダルアプローチ

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 ビュー.  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.

ビデオ: 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.

機能的磁気共鳴画像とヘッドの衝撃テレメトリーシステムを使用して青少年にスポーツ関連の脳震盪の影響の調査

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 ...

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.

胎児性アルコール暴露のゼブラフィッシュモデルの催奇形性変化を評価する

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.

磁気共鳴イメージング、体積CT画像と超音波を用いた乳がんの骨転移のヌードラットモデルにおける血管新生のマルチモーダルイメージング

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.

学生·アスリートで脳震盪の検討に神経科学のアプローチ

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.

完全なジャンププロトコルに従う主観的および客観的な回復特性の非侵襲的評価

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.

非経た栄養のためのオリーブオイルベースの3チャンバーバッグの安全性、有効性、および送達を評価する臨床試験

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.

次のユース選手の脳震盪の自律神経機能: 24 時間録音手法を使用して心拍数の変化の調査

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.

ひと歯肉移植血管新生を監視への新しいアプローチ

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.

マルチ モーダル ホーム睡眠の高齢者の監視

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.

学際的技術の開発と実装の青年と脳震盪と大人気経路を強化

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