Search results for: brain Injury
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1870

Search results for: brain Injury

1510 Bayesian Networks Scoping the Climate Change Impact on Winter Wheat Freezing Injury Disasters in Hebei Province, China

Authors: Xiping Wang,Shuran Yao, Liqin Dai

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Many studies report the winter is getting warmer and the minimum air temperature is obviously rising as the important climate warming evidences. The exacerbated air temperature fluctuation tending to bring more severe weather variation is another important consequence of recent climate change which induced more disasters to crop growth in quite a certain regions. Hebei Province is an important winter wheat growing province in North of China that recently endures more winter freezing injury influencing the local winter wheat crop management. A winter wheat freezing injury assessment Bayesian Network framework was established for the objectives of estimating, assessing and predicting winter wheat freezing disasters in Hebei Province. In this framework, the freezing disasters was classified as three severity degrees (SI) among all the three types of freezing, i.e., freezing caused by severe cold in anytime in the winter, long extremely cold duration in the winter and freeze-after-thaw in early season after winter. The factors influencing winter wheat freezing SI include time of freezing occurrence, growth status of seedlings, soil moisture, winter wheat variety, the longitude of target region and, the most variable climate factors. The climate factors included in this framework are daily mean and range of air temperature, extreme minimum temperature and number of days during a severe cold weather process, the number of days with the temperature lower than the critical temperature values, accumulated negative temperature in a potential freezing event. The Bayesian Network model was evaluated using actual weather data and crop records at selected sites in Hebei Province using real data. With the multi-stage influences from the various factors, the forecast and assessment of the event-based target variables, freezing injury occurrence and its damage to winter wheat production, were shown better scoped by Bayesian Network model.

Keywords: bayesian networks, climatic change, freezing Injury, winter wheat

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1509 Kinetics and Toxicological Effects of Kickxia elatine Extract-Based Silver Nanoparticles on Rat Brain Acetylcholinesterase

Authors: Noor Ul Huda, Mushtaq Ahmed, Nadia Mushtaq, Naila Sher, Rahmat Ali Khan

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Purpose: The green synthesis of AgNPs has been favored over chemical synthesis due to their distinctive properties such as high dispersion, surface-to-volume ratio, low toxicity, and easy preparation. In the present work, the biosynthesis of AgNPs (KE-AgNPs) was carried out in one step by using the traditionally used plant Kickxia elatine (KE) extract and then investigated its enzyme inhibiting activity against rat’s brain acetylcholinesterase (AChE) in vitro. Methods: KE-AgNPs were synthesized from 1mM AgNO₃ using KE extract and characterized by UV–spectroscopy, SEM, EDX, XRD, and FTIR analysis. Rat’s brain acetylcholinesterase (AChE) inhibition activity was evaluated by the standard protocol. Results: UV–spectrum at 416 nm confirmed the formation of KE-AgNPs. X-ray diffraction (XRD) pattern presented 2θ values corresponding to the crystalline nature of KE-AgNPs with an average size of 42.47nm. The scanning electron microscope (SEM) analysis confirmed the presence of spherical-shaped and huge density KE-AgNPs with a size of 50nm. Fourier transform infrared spectroscopy (FT-IR) suggested that the functional groups present in KE extract and on the surface of KE-AgNPs are responsible for the stability of biosynthesized NPs. Energy dispersive X-ray (EDX) displayed an intense sharp peak at 3.2 keV, presenting that Ag was the chief element with 61.67%. Both KE extract and KE-AgNPs showed good and potent anti-AChE activity, with higher inhibition potential at a concentration of 175 µg/ml. Statistical analysis showed that both KEE and AgNPs exhibited non-competitive type inhibition against AChE, i.e., Vmax decreased (34.17-68.64% and 22.29- 62.10%) in the concentration-dependent mode for KEE and KE-AgNPs respectively and while Km values remained constant. Conclusions: KEE and KE-AgNPs can be considered an inhibitor of rats’ brain AChE, and the synthesis of KE-AgNPs-based drugs can be used as a cheaper and alternative option against diseases such as Alzheimer’s disease.

Keywords: Kickxia elatine, AgNPs, brain homogenate, acetylcholinesterase, kinetics

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1508 Urine Neutrophil Gelatinase-Associated Lipocalin as an Early Marker of Acute Kidney Injury in Hematopoietic Stem Cell Transplantation Patients

Authors: Sara Ataei, Maryam Taghizadeh-Ghehi, Amir Sarayani, Asieh Ashouri, Amirhossein Moslehi, Molouk Hadjibabaie, Kheirollah Gholami

Abstract:

Background: Acute kidney injury (AKI) is common in hematopoietic stem cell transplantation (HSCT) patients with an incidence of 21–73%. Prevention and early diagnosis reduces the frequency and severity of this complication. Predictive biomarkers are of major importance to timely diagnosis. Neutrophil gelatinase associated lipocalin (NGAL) is a widely investigated novel biomarker for early diagnosis of AKI. However, no study assessed NGAL for AKI diagnosis in HSCT patients. Methods: We performed further analyses on gathered data from our recent trial to evaluate the performance of urine NGAL (uNGAL) as an indicator of AKI in 72 allogeneic HSCT patients. AKI diagnosis and severity were assessed using Risk–Injury–Failure–Loss–End-stage renal disease and AKI Network criteria. We assessed uNGAL on days -6, -3, +3, +9 and +15. Results: Time-dependent Cox regression analysis revealed a statistically significant relationship between uNGAL and AKI occurrence. (HR=1.04 (1.008-1.07), P=0.01). There was a relation between uNGAL day +9 to baseline ratio and incidence of AKI (unadjusted HR=.1.047(1.012-1.083), P<0.01). The area under the receiver-operating characteristic curve for day +9 to baseline ratio was 0.86 (0.74-0.99, P<0.01) and a cut-off value of 2.62 was 85% sensitive and 83% specific in predicting AKI. Conclusions: Our results indicated that increase in uNGAL augmented the risk of AKI and the changes of day +9 uNGAL concentrations from baseline could be of value for predicting AKI in HSCT patients. Additionally uNGAL changes preceded serum creatinine rises by nearly 2 days.

Keywords: acute kidney injury, hemtopoietic stem cell transplantation, neutrophil gelatinase-associated lipocalin, Receiver-operating characteristic curve

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1507 Quantification of Global Cerebrovascular Reactivity in the Principal Feeding Arteries of the Human Brain

Authors: Ravinder Kaur

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Introduction Global cerebrovascular reactivity (CVR) mapping is a promising clinical assessment for stress-testing the brain using physiological challenges, such as CO₂, to elicit changes in perfusion. It enables real-time assessment of cerebrovascular integrity and health. Conventional imaging approaches solely use steady-state parameters, like cerebral blood flow (CBF), to evaluate the integrity of the resting parenchyma and can erroneously show a healthy brain at rest, despite the underlying pathogenesis in the presence of cerebrovascular disease. Conversely, coupling CO₂ inhalation with phase-contrast MRI neuroimaging interrogates the capacity of the vasculature to respond to changes under stress. It shows promise in providing prognostic value as a novel health marker to measure neurovascular function in disease and to detect early brain vasculature dysfunction. Objective This exploratory study was established to:(a) quantify the CBF response to CO₂ in hypocapnia and hypercapnia,(b) evaluate disparities in CVR between internal carotid (ICA) and vertebral artery (VA), and (c) assess sex-specific variation in CVR. Methodology Phase-contrast MRI was employed to measure the cerebrovascular reactivity to CO₂ (±10 mmHg). The respiratory interventions were presented using the prospectively end-tidal targeting RespirActTM Gen3 system. Post-processing and statistical analysis were conducted. Results In 9 young, healthy subjects, the CBF increased from hypocapnia to hypercapnia in all vessels (4.21±0.76 to 7.20±1.83 mL/sec in ICA, 1.36±0.55 to 2.33±1.31 mL/sec in VA, p < 0.05). The CVR was quantitatively higher in ICA than VA (slope of linear regression: 0.23 vs. 0.07 mL/sec/mmHg, p < 0.05). No statistically significant effect was observed in CVR between male and female (0.25 vs 0.20 mL/sec/mmHg in ICA, 0.09 vs 0.11 mL/sec/mmHg in VA, p > 0.05). Conclusions The principal finding in this investigation validated the modulation of CBF by CO₂. Moreover, it has indicated that regional heterogeneity in hemodynamic response exists in the brain. This study provides scope to standardize the quantification of CVR prior to its clinical translation.

Keywords: cerebrovascular disease, neuroimaging, phase contrast MRI, cerebrovascular reactivity, carbon dioxide

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1506 Localization of Frontal and Temporal Speech Areas in Brain Tumor Patients by Their Structural Connections with Probabilistic Tractography

Authors: B.Shukir, H.Woo, P.Barzo, D.Kis

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Preoperative brain mapping in tumors involving the speech areas has an important role to reduce surgical risks. Functional magnetic resonance imaging (fMRI) is the gold standard method to localize cortical speech areas preoperatively, but its availability in clinical routine is difficult. Diffusion MRI based probabilistic tractography is available in head MRI. It’s used to segment cortical subregions by their structural connectivity. In our study, we used probabilistic tractography to localize the frontal and temporal cortical speech areas. 15 patients with left frontal tumor were enrolled to our study. Speech fMRI and diffusion MRI acquired preoperatively. The standard automated anatomical labelling atlas 3 (AAL3) cortical atlas used to define 76 left frontal and 118 left temporal potential speech areas. 4 types of tractography were run according to the structural connection of these regions to the left arcuate fascicle (FA) to localize those cortical areas which have speech functions: 1, frontal through FA; 2, frontal with FA; 3, temporal to FA; 4, temporal with FA connections were determined. Thresholds of 1%, 5%, 10% and 15% applied. At each level, the number of affected frontal and temporal regions by fMRI and tractography were defined, the sensitivity and specificity were calculated. At the level of 1% threshold showed the best results. Sensitivity was 61,631,4% and 67,1523,12%, specificity was 87,210,4% and 75,611,37% for frontal and temporal regions, respectively. From our study, we conclude that probabilistic tractography is a reliable preoperative technique to localize cortical speech areas. However, its results are not feasible that the neurosurgeon rely on during the operation.

Keywords: brain mapping, brain tumor, fMRI, probabilistic tractography

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1505 Gestalt in Music and Brain: A Non-Linear Chaos Based Study with Detrended/Adaptive Fractal Analysis

Authors: Shankha Sanyal, Archi Banerjee, Sayan Biswas, Sourya Sengupta, Sayan Nag, Ranjan Sengupta, Dipak Ghosh

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The term ‘gestalt’ has been widely used in the field of psychology which defined the perception of human mind to group any object not in part but as a 'unified' whole. Music, in general, is polyphonic - i.e. a combination of a number of pure tones (frequencies) mixed together in a manner that sounds harmonious. The study of human brain response due to different frequency groups of the acoustic signal can give us an excellent insight regarding the neural and functional architecture of brain functions. Hence, the study of music cognition using neuro-biosensors is becoming a rapidly emerging field of research. In this work, we have tried to analyze the effect of different frequency bands of music on the various frequency rhythms of human brain obtained from EEG data. Four widely popular Rabindrasangeet clips were subjected to Wavelet Transform method for extracting five resonant frequency bands from the original music signal. These frequency bands were initially analyzed with Detrended/Adaptive Fractal analysis (DFA/AFA) methods. A listening test was conducted on a pool of 100 respondents to assess the frequency band in which the music becomes non-recognizable. Next, these resonant frequency bands were presented to 20 subjects as auditory stimulus and EEG signals recorded simultaneously in 19 different locations of the brain. The recorded EEG signals were noise cleaned and subjected again to DFA/AFA technique on the alpha, theta and gamma frequency range. Thus, we obtained the scaling exponents from the two methods in alpha, theta and gamma EEG rhythms corresponding to different frequency bands of music. From the analysis of music signal, it is seen that loss of recognition is proportional to the loss of long range correlation in the signal. From the EEG signal analysis, we obtain frequency specific arousal based response in different lobes of brain as well as in specific EEG bands corresponding to musical stimuli. In this way, we look to identify a specific frequency band beyond which the music becomes non-recognizable and below which in spite of the absence of other bands the music is perceivable to the audience. This revelation can be of immense importance when it comes to the field of cognitive music therapy and researchers of creativity.

Keywords: AFA, DFA, EEG, gestalt in music, Hurst exponent

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1504 Enabling Oral Communication and Accelerating Recovery: The Creation of a Novel Low-Cost Electroencephalography-Based Brain-Computer Interface for the Differently Abled

Authors: Rishabh Ambavanekar

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Expressive Aphasia (EA) is an oral disability, common among stroke victims, in which the Broca’s area of the brain is damaged, interfering with verbal communication abilities. EA currently has no technological solutions and its only current viable solutions are inefficient or only available to the affluent. This prompts the need for an affordable, innovative solution to facilitate recovery and assist in speech generation. This project proposes a novel concept: using a wearable low-cost electroencephalography (EEG) device-based brain-computer interface (BCI) to translate a user’s inner dialogue into words. A low-cost EEG device was developed and found to be 10 to 100 times less expensive than any current EEG device on the market. As part of the BCI, a machine learning (ML) model was developed and trained using the EEG data. Two stages of testing were conducted to analyze the effectiveness of the device: a proof-of-concept and a final solution test. The proof-of-concept test demonstrated an average accuracy of above 90% and the final solution test demonstrated an average accuracy of above 75%. These two successful tests were used as a basis to demonstrate the viability of BCI research in developing lower-cost verbal communication devices. Additionally, the device proved to not only enable users to verbally communicate but has the potential to also assist in accelerated recovery from the disorder.

Keywords: neurotechnology, brain-computer interface, neuroscience, human-machine interface, BCI, HMI, aphasia, verbal disability, stroke, low-cost, machine learning, ML, image recognition, EEG, signal analysis

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1503 Methylphenidate and Placebo Effect on Brain Activity and Basketball Free Throw: A Randomized Controlled Trial

Authors: Mohammad Khazaei, Reza Rostami, Hasan Gharayagh Zandi, Rouhollah Basatnia, Mahbubeh Ghayour Najafabadi

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Objective: Methylphenidate has been demonstrated to enhance attention and cognitive processes, and placebo treatments have also been found to improve attention and cognitive processes. Additionally, methylphenidate may have positive effects on motion perception and sports performance. Nevertheless, additional research is needed to fully comprehend the neural mechanisms underlying the effects of methylphenidate and placebo on cognitive and motor functions. Methods: In this randomized controlled trial, 18 young semi-professional basketball players aged 18-23 years were randomly and equally assigned to either a Ritalin or Placebo group. The participants performed 20 consecutive free throws; their scores were recorded on a 0-3 scale. The participants’ brain activity was recorded using electroencephalography (EEG) for 5 minutes seated with their eyes closed. The Ritalin group received a 10 mg dose of methylphenidate, while the Placebo group received a 10mg dose of placebo. The EEG was obtained 90 minutes after the drug was administere Results: There was no significant difference in the absolute power of brain waves between the pre-test and post-tests in the Placebo group. However, in the Ritalin group, a significant difference in the absolute power of brain waves was observed in the Theta band (5-6 Hz) and Beta band (21-30 Hz) between pre- and post-tests in Fp2, F8, and Fp1. In these areas, the absolute power of Beta waves was higher during the post-test than during the pre-test. The Placebo group showed a more significant difference in free throw scores than the Ritalin group. Conclusions: In conclusion, these results suggest that Ritalin effect on brain activity in areas associated with attention and cognitive processes, as well as improve basketball free throws. However, there was no significant placebo effect on brain activity performance, but it significantly affected the improvement of free throws. Further research is needed to fully understand the effects of methylphenidate and placebo on cognitive and motor functions.

Keywords: methylphenidate, placebo effect, electroencephalography, basketball free throw

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1502 Expression of Inflammatory and Cell Death Genes and DNA Damage Induced by Endotoxic Shock in Laying Hens

Authors: Mariam G. Eshak, Ahmed Abbas, M. I. El-Sabry, M. M. Mashaly

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This investigation was conducted to determine the physiological response and evaluate the expression of inflammatory and cell death genes and DNA damage induced by endotoxic shock in laying hens. Endotoxic shock was induced by a single intravenous injection of 107 Escherichia coli (E. coli,) colony/hen. In the present study, 240 forty-week-old laying hens (H&N) were randomly assigned into 2 groups with 3 replicates of 40 birds each. Hens were reared in battery cages with wire floors in an open-sided housing system under natural conditions. Housing and general management practices were similar for all groups. At 42-wk of age, 45 hens from the first group (15 replicate) were infected with E. coli, while the same number of hens from the second group was injected with saline and served as a control. Heat shock protein-70 (HSP-70) expression, plasma corticosterone concentration, body temperature, and the gene expression of bax, caspase-3 activity, P38, Interlukin-1β (Il-1β), and tumor necrosis factor alpha (TNF-α) genes and DNA damage in the brain and liver were measured. Hens treated with E. coli showed significant (P≤0.05) increase of body temperature by 1.2 ᴼC and plasma corticosterone by 3 folds compared to the controls. Further, hens injected with E.Coli showed markedly over-expression of HSP-70 and increase DNA damage in brain and liver. These results were synchronized with activating cell death program since our data showed significant (P≤0.05) high expression of bax and caspase-3 activity genes in the brain and liver. These results were related to remarkable over-inflammation gene expression of P38, IL-1β, and TNF-α in brain and liver. In conclusion, our results indicate that endotoxic shock induces inflammatory physiological response and triggers cell death program by promoting P38, IL-1β, and TNF-α gene expression in the brain and liver.

Keywords: chicken, DNA damage, Escherichia coli, gene expression, inflammation

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1501 Addressing Sexual Health in Males with Spinal Cord Injury in Rural South India: Using the Knowledge to Action Framework to Evaluate an Education Manual on Improving Knowledge, Attitudes and Practices

Authors: Cassandra Maffei, Effie Pomaki, Salomé Deslauriers-Brouillard, Levana Dahan, Caroline Storr, Ramasubramanian Ponnusamy, Philippe S. Archambault

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Sexual health education following spinal cord injury (SCI) remains poorly integrated into the rehabilitation process, especially in low-income countries where the topics of disability and sexuality are stigmatized. This research aimed to evaluate a sexual health manual that was created and distributed amongst males with SCI who had received rehabilitation services at Amar Seva Sangam (ASSA), a rehabilitation center located in rural South India. A service evaluation was completed to collect data from a convenience sample of 37 males with spinal cord injuries. Data were analyzed using descriptive statistics and content analysis. The service evaluation showed that the manual was well received by the sample and had positive impacts on secondary outcome measures, including relationship dynamics and quality of life. It can thus be used as an effective adjunct tool to support the improvement of sexual health knowledge, attitudes, and practices of individuals with SCI.

Keywords: spinal cord injury, sexual health, rehabilitation, India, education, service evaluation

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1500 The Concept of Neurostatistics as a Neuroscience

Authors: Igwenagu Chinelo Mercy

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This study is on the concept of Neurostatistics in relation to neuroscience. Neuroscience also known as neurobiology is the scientific study of the nervous system. In the study of neuroscience, it has been noted that brain function and its relations to the process of acquiring knowledge and behaviour can be better explained by the use of various interrelated methods. The scope of neuroscience has broadened over time to include different approaches used to study the nervous system at different scales. On the other hand, Neurostatistics based on this study is viewed as a statistical concept that uses similar techniques of neuron mechanisms to solve some problems especially in the field of life science. This study is imperative in this era of Artificial intelligence/Machine leaning in the sense that clear understanding of the technique and its proper application could assist in solving some medical disorder that are mainly associated with the nervous system. This will also help in layman’s understanding of the technique of the nervous system in order to overcome some of the health challenges associated with it. For this concept to be well understood, an illustrative example using a brain associated disorder was used for demonstration. Structural equation modelling was adopted in the analysis. The results clearly show the link between the techniques of statistical model and nervous system. Hence, based on this study, the appropriateness of Neurostatistics application in relation to neuroscience could be based on the understanding of the behavioural pattern of both concepts.

Keywords: brain, neurons, neuroscience, neurostatistics, structural equation modeling

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1499 Uncommon Case of Falx Subdural Hematoma

Authors: Thu Nguyen, Jane Daugherty-Luck

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Falx subdural hematoma is a life-threatening condition associated with high mortality. We present a patient case who had fallen with no head injury or loss of conspicuousness. She had tenderness along cervical and thoracic lumbar spine. CT head revealed falx subdural hematoma. The patient was managed medically. The pathophysiology of falx subdural hematoma is linked to laceration of bridging veins provoked by frontal or occipital impact. Posttraumatic subdural hematoma is commonly caused by inertia instead of facture or cerebral contusion resulting from direct impact. The theory is consistent with the lack of fracture in most cases in the literature. Our patient had neither contusion nor fracture.

Keywords: falx subdural hematoma, traumatic head injury, CT head scan, bridging veins, inertia

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1498 Magnitude of Infection and Associated factor in Open Tibial Fractures Treated Operatively at Addis Ababa Burn Emergency and Trauma Center April, 2023

Authors: Tuji Mohammed Sani

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Back ground: An open tibial fracture is an injury where the fractured bone directly communicates with the outside environment. Due to the specific anatomical features of the tibia (limited soft tissue coverage), more than quarter of its fractures are classified as open, representing the most common open long-bone injuries. Open tibial fractures frequently cause significant bone comminution, periosteal stripping, soft tissue loss, contamination and are prone to bacterial entry with biofilm formation, which increases the risk of deep bone infection. Objective: The main objective of the study was to determine Prevalence of infection and its associated factors in surgically treated open tibial fracture in Addis Ababa Burn Emergency and Trauma (AaBET) center. Method: A facility based retrospective cross-sectional study was conducted among patient treated for open tibial fracture at AaBET center from September 2018 to September 2021. The data was collected from patient’s chart using structured data collection form, and Data was entered and analyzed using SPSS version 26. Bivariable and multiple binary logistic regression were fitted. Multicollinearity was checked among candidate variables using variance inflation factor and tolerance, which were less than 5 and greater than 0.2, respectively. Model adequacy were tested using Hosmer-Lemeshow goodness of fitness test (P=0.711). AOR at 95% CI was reported, and P-value < 0.05 was considered statistically significant. Result: This study found that 33.9% of the study participants had an infection. Initial IV antibiotic time (AOR=2.924, 95% CI:1.160- 7.370) and time of wound closure from injury (AOR=3.524, 95% CI: 1.798-6.908), injury to admission time (AOR=2.895, 95% CI: 1.402 – 5.977). and definitive fixation method (AOR=0.244, 95% CI: 0.113 – 0.4508) were the factors found to have a statistically significant association with the occurrence of infection. Conclusion: The rate of infection in open tibial fractures indicates that there is a need to improve the management of open tibial fracture treated at AaBET center. Time from injury to admission, time from injury to first debridement, wound closure time, and initial Intra Venous antibiotic time from the injury are an important factor that can be readily amended to improve the infection rate. Whether wound closed before seven days or not were more important factor associated with occurrences of infection.

Keywords: infection, open tibia, fracture, magnitude

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1497 Injury Patterns and Outcomes in Alcohol Intoxicated Trauma Patients Admitted at Level I Apex Trauma Centre of a Developing Nation

Authors: G. Kaushik, A. Gupta, S. Lalwani, K. D. Soni, S. Kumar, S. Sagar

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Objective: Alcohol is a leading risk factor associated with the disability and death due to RTI. Present study aims to demonstrate the demographic profile, injury pattern, physiological parameters of victims of trauma following alcohol consumption arriving in the emergency department (ED) and mortality in alcohol intoxicated trauma patients admitted to Apex Trauma Center in Delhi. Design and Methods: Present study was performed in randomly selected 182 alcohol breath analyzer tested RTI patients from the emergency department of Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences, New Delhi for over a period of 3 months started from September 2013 to November 2013. Results: A total 182 RTI patients with blunt injury were selected between 30-40 years of age and equally distributed to male and female group. Of these, 93 (51%) were alcohol negative and 89 (49%) were alcohol positive. In 89 alcohol positive patients, 47 (53%) had Artificial Airway as compared to 17 (18%), (p < 0.001) in the other group. The Glasgow Coma Scale (GCS) score was lower (p < 0.001) and higher Injury Severity Score (ISS) was observed in alcohol positive group as compared to other group (p < 0.03). Increased number of patients (58%) were admitted to Intensive Care Unit (ICU), in alcohol positive group (p < 0.001) and they were in ICU for longer time compare to other group (p < 0.001). The alcohol positive patients were on ventilator support for longer duration as compared to non-alcoholic group (p < 0.001). Mortality rate was higher in alcohol intoxicated patients as compared to non-alcoholic RTI patients, however, the difference was not statistically significant. Conclusion: This study revealed that GCS, mean ISS, ICU stay, ventilation time etc. might have considerable impact on mortality in alcohol intoxicated patients as compared to non-alcoholic group.

Keywords: road traffic injuries, alcohol, trauma, emergency department

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1496 Verification and Proposal of Information Processing Model Using EEG-Based Brain Activity Monitoring

Authors: Toshitaka Higashino, Naoki Wakamiya

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Human beings perform a task by perceiving information from outside, recognizing them, and responding them. There have been various attempts to analyze and understand internal processes behind the reaction to a given stimulus by conducting psychological experiments and analysis from multiple perspectives. Among these, we focused on Model Human Processor (MHP). However, it was built based on psychological experiments and thus the relation with brain activity was unclear so far. To verify the validity of the MHP and propose our model from a viewpoint of neuroscience, EEG (Electroencephalography) measurements are performed during experiments in this study. More specifically, first, experiments were conducted where Latin alphabet characters were used as visual stimuli. In addition to response time, ERPs (event-related potentials) such as N100 and P300 were measured by using EEG. By comparing cycle time predicted by the MHP and latency of ERPs, it was found that N100, related to perception of stimuli, appeared at the end of the perceptual processor. Furthermore, by conducting an additional experiment, it was revealed that P300, related to decision making, appeared during the response decision process, not at the end. Second, by experiments using Japanese Hiragana characters, i.e. Japan's own phonetic symbols, those findings were confirmed. Finally, Japanese Kanji characters were used as more complicated visual stimuli. A Kanji character usually has several readings and several meanings. Despite the difference, a reading-related task and a meaning-related task exhibited similar results, meaning that they involved similar information processing processes of the brain. Based on those results, our model was proposed which reflects response time and ERP latency. It consists of three processors: the perception processor from an input of a stimulus to appearance of N100, the cognitive processor from N100 to P300, and the decision-action processor from P300 to response. Using our model, an application system which reflects brain activity can be established.

Keywords: brain activity, EEG, information processing model, model human processor

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1495 Possible Protective Role of Angiotensin II Antagonist on Bacterial Endotoxin Induced Acute Lung Injury: Morphological Study on Adult Male Albino Rat

Authors: Mohamed Bakry Mohamed Ali, Mohamed Ehab El-Din Mustafa, Joseph Naiem Sabet Aziz, Sarah Mahmoud Ali Kaooh

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Background: Acute lung injury (ALI) is one of the major challenges in intensive care medicine. The most common extrapulmonary cause of ALI is sepsis, accounting more than 30% of the cases in humans. Lipopolysaccharide (LPS) has gained wide acceptance as a clinically relevant model of ALI. Lipopolysaccharide is a glycoprotein forming the major constituent of bacterial endotoxin. Losartan is angiotensin II type 1 (AT1) receptor antagonists. It is widely used for management of hypertension. It was recently suggested that losartan protects against septic ALI. It would thereby prevent LPS-induced ALI. Aim of the work and design of the experiment: This work investigated the injurious effect of lipopolysaccharide (LPS) and ALI on adult male albino rat at 24 hours and 14 days of LPS administration and the possible protective role of losartan pretreatment. LPS has deteriorated animal survival and behavior. It increased lung weight and induced lung histological damage. These changes could be much reduced by the losartan pretreatment. Conclusion: Administration of losartan before LPS could largely reduce these LPS/ ALI induced short and long term alterations. It could be recommended that patients susceptible to developing ALI, as in ICU, should receive a protective dose of angitensin II type 1 (AT1) receptor blocker as losartan.

Keywords: acute lung injury (ALI), lipopolysaccharide (LPS), losartan

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1494 Teaching Children about Their Brains: Evaluating the Role of Neuroscience Undergraduates in Primary School Education

Authors: Clea Southall

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Many children leave primary school having formed preconceptions about their relationship with science. Thus, primary school represents a critical window for stimulating scientific interest in younger children. Engagement relies on the provision of hands-on activities coupled with an ability to capture a child’s innate curiosity. This requires children to perceive science topics as interesting and relevant to their everyday life. Teachers and pupils alike have suggested the school curriculum be tailored to help stimulate scientific interest. Young children are naturally inquisitive about the human body; the brain is one topic which frequently engages pupils, although it is not currently included in the UK primary curriculum. Teaching children about the brain could have wider societal impacts such as increasing knowledge of neurological disorders. However, many primary school teachers do not receive formal neuroscience training and may feel apprehensive about delivering lessons on the nervous system. This is exacerbated by a lack of educational neuroscience resources. One solution is for undergraduates to form partnerships with schools - delivering engaging lessons and supplementing teacher knowledge. The aim of this project was to evaluate the success of a short lesson on the brain delivered by an undergraduate neuroscientist to primary school pupils. Prior to entering schools, semi-structured online interviews were conducted with teachers to gain pedagogical advice and relevant websites were searched for neuroscience resources. Subsequently, a single lesson plan was created comprising of four hands-on activities. The activities were devised in a top-down manner, beginning with learning about the brain as an entity, before focusing on individual neurons. Students were asked to label a ‘brain map’ to assess prior knowledge of brain structure and function. They viewed animal brains and created ‘pipe-cleaner neurons’ which were later used to depict electrical transmission. The same session was delivered by an undergraduate student to 570 key stage 2 (KS2) pupils across five schools in Leeds, UK. Post-session surveys, designed for teachers and pupils respectively, were used to evaluate the session. Children in all year groups had relatively poor knowledge of brain structure and function at the beginning of the session. When asked to label four brain regions with their respective functions, older pupils labeled a mean of 1.5 (± 1.0) brain regions compared to 0.8 (± 0.96) for younger pupils (p=0.002). However, by the end of the session, 95% of pupils felt their knowledge of the brain had increased. Hands-on activities were rated most popular by pupils and were considered the most successful aspect of the session by teachers. Although only half the teachers were aware of neuroscience educational resources, nearly all (95%) felt they would have more confidence in teaching a similar session in the future. All teachers felt the session was engaging and that the content could be linked to the current curriculum. Thus, a short fifty-minute session can successfully enhance pupils’ knowledge of a new topic: the brain. Partnerships with an undergraduate student can provide an alternative method for supplementing teacher knowledge, increasing their confidence in delivering future lessons on the nervous system.

Keywords: education, neuroscience, primary school, undergraduate

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1493 Neural Synchronization - The Brain’s Transfer of Sensory Data

Authors: David Edgar

Abstract:

To understand how the brain’s subconscious and conscious functions, we must conquer the physics of Unity, which leads to duality’s algorithm. Where the subconscious (bottom-up) and conscious (top-down) processes function together to produce and consume intelligence, we use terms like ‘time is relative,’ but we really do understand the meaning. In the brain, there are different processes and, therefore, different observers. These different processes experience time at different rates. A sensory system such as the eyes cycles measurement around 33 milliseconds, the conscious process of the frontal lobe cycles at 300 milliseconds, and the subconscious process of the thalamus cycle at 5 milliseconds. Three different observers experience time differently. To bridge observers, the thalamus, which is the fastest of the processes, maintains a synchronous state and entangles the different components of the brain’s physical process. The entanglements form a synchronous cohesion between the brain components allowing them to share the same state and execute in the same measurement cycle. The thalamus uses the shared state to control the firing sequence of the brain’s linear subconscious process. Sharing state also allows the brain to cheat on the amount of sensory data that must be exchanged between components. Only unpredictable motion is transferred through the synchronous state because predictable motion already exists in the shared framework. The brain’s synchronous subconscious process is entirely based on energy conservation, where prediction regulates energy usage. So, the eyes every 33 milliseconds dump their sensory data into the thalamus every day. The thalamus is going to perform a motion measurement to identify the unpredictable motion in the sensory data. Here is the trick. The thalamus conducts its measurement based on the original observation time of the sensory system (33 ms), not its own process time (5 ms). This creates a data payload of synchronous motion that preserves the original sensory observation. Basically, a frozen moment in time (Flat 4D). The single moment in time can then be processed through the single state maintained by the synchronous process. Other processes, such as consciousness (300 ms), can interface with the synchronous state to generate awareness of that moment. Now, synchronous data traveling through a separate faster synchronous process creates a theoretical time tunnel where observation time is tunneled through the synchronous process and is reproduced on the other side in the original time-relativity. The synchronous process eliminates time dilation by simply removing itself from the equation so that its own process time does not alter the experience. To the original observer, the measurement appears to be instantaneous, but in the thalamus, a linear subconscious process generating sensory perception and thought production is being executed. It is all just occurring in the time available because other observation times are slower than thalamic measurement time. For life to exist in the physical universe requires a linear measurement process, it just hides by operating at a faster time relativity. What’s interesting is time dilation is not the problem; it’s the solution. Einstein said there was no universal time.

Keywords: neural synchronization, natural intelligence, 99.95% IoT data transmission savings, artificial subconscious intelligence (ASI)

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1492 Neuropsychology of Social Awareness: A Research Study Applied to University Students in Greece

Authors: Argyris Karapetsas, Maria Bampou, Andriani Mitropoulou

Abstract:

The aim of the present work is to study the role of brain function in social awareness processing. Mind controls all the psychosomatic functions. Mind’s functioning enables individual not only to recognize one's own self and propositional attitudes, but also to assign such attitudes to other individuals, and to consider such observed mental states in the elucidation of behavior. Participants and Methods: Twenty (n=20) undergraduate students (mean age 18 years old) were involved in this study. Students participated in a clinical assessment, being conducted in Laboratory of Neuropsychology, at University of Thessaly, in Volos, Greece. Assessment included both electrophysiological (i.e.Event Related Potentials (ERPs) esp.P300 waveform) and neuropsychological tests (Raven's Progressive Matrices (RPM) and Sally-Anne test). Results: Initial assessment’s results confirmed statistically significant differences between the males and females, as well as in score performance to the tests applied. Strong correlations emerged between prefrontal lobe functioning, RPM, Sally-Anne test and P300 latencies. Also, significant dysfunction of mind has been found, regarding its three dimensions (straight, circular and helical). At the end of the assessment, students received consultation and appropriate guidelines in order to improve their intrapersonal and interpersonal skills. Conclusions: Mind and social awareness phenomena play a vital role in human development and may act as determinants of the quality of one’s own life. Meanwhile, brain function is highly correlated with social awareness and it seems that different set of brain structures are involved in social behavior.

Keywords: brain activity, emotions, ERP's, social awareness

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1491 Dosimetric Analysis of Intensity Modulated Radiotherapy versus 3D Conformal Radiotherapy in Adult Primary Brain Tumors: Regional Cancer Centre, India

Authors: Ravi Kiran Pothamsetty, Radha Rani Ghosh, Baby Paul Thaliath

Abstract:

Radiation therapy has undergone many advancements and evloved from 2D to 3D. Recently, with rapid pace of drug discoveries, cutting edge technology, and clinical trials has made innovative advancements in computer technology and treatment planning and upgraded to intensity modulated radiotherapy (IMRT) which delivers in homogenous dose to tumor and normal tissues. The present study was a hospital-based experience comparing two different conformal radiotherapy techniques for brain tumors. This analytical study design has been conducted at Regional Cancer Centre, India from January 2014 to January 2015. Ten patients have been selected after inclusion and exclusion criteria. All the patients were treated on Artiste Siemens Linac Accelerator. The tolerance level for maximum dose was 6.0 Gyfor lenses and 54.0 Gy for brain stem, optic chiasm and optical nerves as per RTOG criteria. Mean and standard deviation values of PTV98%, PTV 95% and PTV 2% in IMRT were 93.16±2.9, 95.01±3.4 and 103.1±1.1 respectively; for 3DCRT were 91.4±4.7, 94.17±2.6 and 102.7±0.39 respectively. PTV max dose (%) in IMRT and 3D-CRT were 104.7±0.96 and 103.9±1.0 respectively. Maximum dose to the tumor can be delivered with IMRT with acceptable toxicity limits. Variables such as expertise, location of tumor, patient condition, and TPS influence the outcome of the treatment.

Keywords: brain tumors, intensity modulated radiotherapy (IMRT), three dimensional conformal radiotherapy (3D-CRT), radiation therapy oncology group (RTOG)

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1490 Autopsy-Based Study of Abdominal Traffic Trauma Death after Emergency Room Arrival

Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

Abstract:

We experience the autopsy cases that the deceased was alive in emergency room on arrival. Bleeding is the leading cause of preventable death after injury. This retrospective study aimed to characterize opportunities for performance improvement identified in patients who died from traffic trauma and were considered by the quality improvement of education system. The Japan Advanced Trauma Evaluation and Care (JATEC) education program was introduced in 2002. We focused the abdominal traffic trauma injury. An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 41 post-mortems of road traffic accident between April 1999 and March 2014 subjected to medico-legal autopsy at the department of Forensic Medicine, Shiga University of Medical Science. 16 patients (39.0%) were abdominal trauma injury. The mean period of survival after meet with accident was 13.5 hours, compared abdominal trauma death was 27.4 hours longer. In road traffic accidents, the most injured abdominal organs were liver followed by mesentery. We thought delayed treatment was associated with immediate diagnostic imaging, and so expected to expand trauma management examination.

Keywords: abdominal traffic trauma, preventable death, autopsy, emergency medicine

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1489 Anti-Ulcer Activity of Hydro Alcoholic Extract of Ficus bengalensis Linn Bark in Experimental Rats

Authors: Jagdish Baheti, Sampat Navale

Abstract:

The present study was performed to evaluate the anti-ulcerogenic activity of hydro-alcoholic extract of Ficus bengalensis Linn. against ethanol-induced gastric mucosal injury in rats and pylorus ligation gastric secretion in rats. Five groups of adult wistar rats were orally pre-treated respectively with carboxy methyl cellulose (CMC) solution (ulcer control group), Omeprazole 20 mg/kg (reference group), and 100, 200 and 300 mg/kg F. bengalensis Linn. bark extract in CMC solution (experimental groups), one hour before oral administration of absolute ethanol to generate gastric mucosal injury. Rats were sacrificed and the ulcer index, gastric volume, gastric pH, free acidity, total acidity of the gastric content was determined. Grossly, the ulcer control group exhibited severe mucosal injury, whereas pre-treatment with F. bengalensis Linn. bark extract exhibited significant protection of gastric mucosal injury in both model. Histological studies revealed that ulcer control group exhibited severe damage of gastric mucosa, along with edema and leucocytes infiltration of submucosal layer compared to rats pre-treated with F. bengalensis Linn. bark extract which showed gastric mucosal protection, reduction or absence of edema and leucocytes infiltration of submucosal layer. Acute toxicity study did not manifest any toxicological signs in rats. The present finding suggests that F. bengalensis Linn. bark extract promotes ulcer protection as ascertained grossly and histologically compared to the ulcer control group.

Keywords: Ficus bengalensis Linn., gastric ulcer, hydroalcoholic, pylorus ligation

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1488 The Effect Study of Meditation Music in the Elderly

Authors: Metee Pigultong

Abstract:

The research aims at 1) composition of meditation music, 2) study of the meditation time reliability. The population is the older adults who meditated practitioners in the Thepnimitra Temple, Don Mueang District, Bangkok. The sample group was the older persons who meditated practitioners from the age of 60 with five volunteers. The research methodology was time-series to conduct the research progression. The research instruments included: 1) meditation music, 2) brain wave recording form. The research results found that 1) the music combines the binaural beats suitable for the meditation of the older persons, consisting of the following features: a) The tempo rate of the meditation music is no more than 60 beats per minute. b) The musical instruments for the meditation music arrangement include only 4-5 pieces. c) The meditation music arrangement needs to consider the nature of the right instrument. d) Digital music instruments are suitable for composition. e) The pure-tone sound combined in music must generate a brain frequency at the level of 10 Hz. 2) After the researcher conducted a 3-weeks brain training procedure, the researcher performed three tests for the reliability level using Cronbach's Alpha method. The result showed that the meditation reliability had the level = .475 as a moderate concentration.

Keywords: binaural beats, music therapy, meditation, older person, the Buddhist meditated practitioners

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1487 IoT Based Approach to Healthcare System for a Quadriplegic Patient Using EEG

Authors: R. Gautam, P. Sastha Kanagasabai, G. N. Rathna

Abstract:

The proposed healthcare system enables quadriplegic patients, people with severe motor disabilities to send commands to electronic devices and monitor their vitals. The growth of Brain-Computer-Interface (BCI) has led to rapid development in 'assistive systems' for the disabled called 'assistive domotics'. Brain-Computer-Interface is capable of reading the brainwaves of an individual and analyse it to obtain some meaningful data. This processed data can be used to assist people having speech disorders and sometimes people with limited locomotion to communicate. In this Project, Emotiv EPOC Headset is used to obtain the electroencephalogram (EEG). The obtained data is processed to communicate pre-defined commands over the internet to the desired mobile phone user. Other Vital Information like the heartbeat, blood pressure, ECG and body temperature are monitored and uploaded to the server. Data analytics enables physicians to scan databases for a specific illness. The Data is processed in Intel Edison, system on chip (SoC). Patient metrics are displayed via Intel IoT Analytics cloud service.

Keywords: brain computer interface, Intel Edison, Emotiv EPOC, IoT analytics, electroencephalogram

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1486 Management of Tibial Bone Defects Following Grade Three Injury in Adults

Authors: Rajendra Kumar Kanojia

Abstract:

Background; Massive bone gaps are common following road side accidents and injury to the tibia, specially open grade three fractures. It has been seen that the diaphyseal fractures in the tibia are prone to non-union, there are certain reasons known very well, like less soft tissues around the lower third tibia, less vascularity, less options of fixation of the fractures after trauma and prolonged surgical time, operation theatre time and special surgical means. Aim of study; To know the suitability of the ilizarov ring fixators in staged treatment of the fracture of the both bones leg, including tibia, we wish to see the role of ilizarov in management of open grade three fractures which have been operated and debrided, for getting the length use of ilizaorv ring in a tertiary canter is the aim of the study.

Keywords: open fracture, staged management, ilizarov, bone grafting, lengthening

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1485 Whole Body Cooling Hypothermia Treatment Modelling Using a Finite Element Thermoregulation Model

Authors: Ana Beatriz C. G. Silva, Luiz Carlos Wrobel, Fernando Luiz B. Ribeiro

Abstract:

This paper presents a thermoregulation model using the finite element method to perform numerical analyses of brain cooling procedures as a contribution to the investigation on the use of therapeutic hypothermia after ischemia in adults. The use of computational methods can aid clinicians to observe body temperature using different cooling methods without the need of invasive techniques, and can thus be a valuable tool to assist clinical trials simulating different cooling options that can be used for treatment. In this work, we developed a FEM package applied to the solution of the continuum bioheat Pennes equation. Blood temperature changes were considered using a blood pool approach and a lumped analysis for intravascular catheter method of blood cooling. Some analyses are performed using a three-dimensional mesh based on a complex geometry obtained from computed tomography medical images, considering a cooling blanket and a intravascular catheter. A comparison is made between the results obtained and the effects of each case in brain temperature reduction in a required time, maintenance of body temperature at moderate hypothermia levels and gradual rewarming.

Keywords: brain cooling, finite element method, hypothermia treatment, thermoregulation

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1484 A Five–Year Review Study of Epidemiology of Ocular and Adnexal Injuries Requiring Surgical Intervention in a Middle Eastern Area: Al Ain, UAE

Authors: Tahra AlMahmoud, Sameeha Mohamed Al Hadhrami, Mohamed Elhanan, Hanan Naser Alshamsi, Fikri Abu-Zidan

Abstract:

Background: To the best of the author(s)’ knowledge there are no epidemiological studies for traumatic eye injuries in UAE, neither data on groups at risk or mechanisms for ocular trauma. Purpose: To report the epidemiology of eye injuries that required hospital admission and surgery at a referral center at the eastern part of Abu Dhabi. Method: Retrospective charts review of all patients who had suffered an eye injury that required surgical intervention between 2012 and 2017 at Al Ain Hospital. Demographic data, place of occurrence, the cause of injury, visual acuity (VA) before and after treatment, number of admission days and follow up were extracted. Data were tabulated and presented as number (%), mean (SD), or median (range) as appropriate. Wilcoxon signed rank test was used for VA outcome. Results: One hundred forty-one patients were identified, 96 eyes with open-globe and 48 other types of injuries. The mean age of the patients was 26±15.5 years, and 89% were male. Majority of injuries occurred at the workplace (50.4%) followed by home (31.2%). Trauma with a sharp object (24.1%), blunt object (16.3%), nail (11.3%), and hammer on metal (7.8%) were the most common etiologies of injury. Corneas injuries (48.2%) was the most frequent cause for visual acuity limitation followed by lens/cataract (23.4%). Among the traumatized eyes, 30 eyes (21.3%) retained intraocular foreign body, Mean admission days was 3.16± 2.81days (1-16) and a number of follow up visit was 3.17± 4.11times (0-26). Conclusion: Ocular trauma requiring surgical intervention is an area of concern in particular for occupations involving work with metals. This work may give insight into the value and necessity of implementing preventive measures.

Keywords: epidemiology, Middle Eastern area, occupational injury, ocular traumas

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1483 Patient-Reported Adverse Reactions to Adolescent Non-Suicidal Self-Injury Disclosures and Implications for Clinical Practice

Authors: Renee Fabian, Jordan Davidson

Abstract:

Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

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1482 The Effect of β-Cryptoxanthin on Testicular Ischemia-Reperfusion Injury in a Rat Model: Evidence from Testicular Histology

Authors: Kianoush Mohammadnejad, Rahim Mohammadi, Ali Soleimanzadeh, Ali Shalizar Jalai, Farshid Sareafzadeh Rezaei

Abstract:

Testicular torsion and detorsion are significant clinical issues for infertile men. Torsion of the spermatic cord is an emergency condition resulting from the rotation of the testis and epididymis around the axis of the spermatic cord. A rat testis model was used to assess the effects of β-cryptoxanthin on ischemia-reperfusion injury. Twenty healthy male Wistar rats were included and randomized into four investigational groups (n = 5): Group SHAM: In this group, midline incision of the scrotum was performed, and the testicles were taken out for 2 hours with a 720-degree rotation. Group ISCHEMIA: In this group, a midline incision of the scrotum was performed, and the testicles were taken out and underwent ischemia for 2 hours with a 720-degree rotation. Group IS/REP/Oil: In this group, a midline scrotum cut was performed the testicles were taken out, and ischemia was created for 2 hours with a 720-degree rotation and at the end of ischemia 100 µL of corn oil (β-cryptoxanthin solvent) was injected intraperitoneally. Group IS/REP/CRPTXNTN 2.5: The same as group IS/REP/Oil as well as intraperitoneal administration of 100 µL of β-cryptoxanthin (2.5 µg/kg) at the end of ischemia. In all groups, the testes were returned back to the scrotum and, after 60 days, were dissected out and removed for histopathological analyses. β-cryptoxanthin at the dose of 2.5 µg/kg significantly improved histologic indices compared to other treatment groups (p<0.05). β-cryptoxanthin could be helpful in minimizing ischemia-reperfusion injury in testicular tissue exposed to ischemia.

Keywords: beta-cryptoxanthin, testis, Ischemia-reperfusion, Intraperitoneal

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1481 The Diurnal and Seasonal Relationships of Pedestrian Injuries Secondary to Motor Vehicles in Young People

Authors: Amina Akhtar, Rory O'Connor

Abstract:

Introduction: There remains significant morbidity and mortality in young pedestrians hit by motor vehicles, even in the era of pedestrian crossings and speed limits. The aim of this study was to compare incidence and injury severity of motor vehicle-related pedestrian trauma according to time of day and season in a young population, based on the supposition that injuries would be more prevalent during dusk and dawn and during autumn and winter. Methods: Data was retrieved for patients between 10-25 years old from the National Trauma Audit and Research Network (TARN) database who had been involved as pedestrians in motor vehicle accidents between 2015-2020. The incidence of injuries, their severity (using the Injury Severity Score [ISS]), hospital transfer time, and mortality were analysed according to the hours of daylight, darkness, and season. Results: The study identified a seasonal pattern, showing that autumn was the predominant season and led to 34.9% of injuries, with a further 25.4% in winter in comparison to spring and summer, with 21.4% and 18.3% of injuries, respectively. However, visibility alone was not a sufficient factor as 49.5% of injuries occurred during the time of darkness, while 50.5% occurred during daylight. Importantly, the greatest injury rate (number of injuries/hour) occurred between 1500-1630, correlating to school pick-up times. A further significant relationship between injury severity score (ISS) and daylight was demonstrated (p-value= 0.0124), with moderate injuries (ISS 9-14) occurring most commonly during the day (72.7%) and more severe injuries (ISS>15) occurred during the night (55.8%). Conclusion: We have identified a relationship between time of day and the frequency and severity of pedestrian trauma in young people. In addition, particular time groupings correspond to the greatest injury rate, suggesting that reduced visibility coupled with school pick-up times may play a significant role. This could be addressed through a targeted public health approach to implementing change. We recommend targeted public health measures to improve road safety that focus on these times and that increase the visibility of children combined with education for drivers.

Keywords: major trauma, paediatric trauma, road traffic accidents, diurnal pattern

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