Search results for: clinical translation

Authors: Yutong Xu, Wanting Zhang, Jia Wang, Zihan Guo, Weiguang Ma

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Background: The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience. Aims: To evaluate the resilience level of Chinese nursing interns and identify the factors affecting resilience early in their careers. Methods: The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment scale for Nurse, and the Career Adapt-Abilities Scale. Structural equation modeling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped Confidence Intervals. Results: The nursing interns showed a moderately high level of resilience[M(SD)=70.15(19.90)]. Gender, scholastic attainment, had a scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns’ resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.58, 0.12, respectively, p＜0.01). career adaptability also positively affected career adaptability (β = 0.26, p < 0.01), and played a fully mediating role in the relationship between clinical learning environment and resilience. Conclusion: Career adaptability can enhance the influence of clinical learning environment on resilience. The promotion of career adaptability and the clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for those female nursing interns with low academic performance. Implications for Nursing Educators Nursing educators should pay attention to the cultivation of nursing students' resilience; for example, by helping them integrate to the clinical learning environment and improving their career adaptability. Reporting Method: The STROBE criteria were used to report the results of the observations critically. Patient or Public Contribution No patient or public contribution.

Keywords: resilience, clinical learning environment, career adaptability, nursing interns

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Authors: Yong Cang

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RJV001 is a subcutaneous injection containing mutated recombinant Collagenase H (ColH), leading to disruption of collagen matrix in adipose tissue and programmed cell death of adipocytes. Here we reported our clinical investigation of the safety, tolerance and pharmacodynamics of localized RJV001 injection into healthy human abdominal fat tissues (NCT04821648, Arizona Research Center). Investigate the safety, tolerance and clinical pharmacodynamics of subcutaneous RJV001 in humans. In the dose-escalating study, 18 subjects completed the study, 100% female, 78% white, with a mean age of 42[±9.9]. All three tested dose (0.05, 0.075 and 0.15 mg/injection), up to 30 injections, were safe and well-tolerated. Bruising and tenderness to palpation, mild to moderate, were the most frequent local skin reactions but nearly all resolved within 30 days. Additionally, physician-monitored ultrasound measurement showed that a reduction in abdominal fat tissue thickness was consistently observed in Cohort C (0.075, 0.15 mg/injection, 30injections), with a mean reduction of 7.37 [± 2.020] mm. Based on this clinical study, RJV001 has been advanced to phase II clinical studies. In the dose-escalating study, subcutaneously administered RJV001 was safe and well-tolerated in healthy adults up to 0.15 mg/injection, 30 injections. Fat reduction and adipocytolysis were observed by ultrasound measurements and histological analysis for exploratory purposes.

Keywords: fat reduction, mutant collagenase, clinical trial, subcutaneous injection

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students. 

Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant

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Authors: Kulwinder Singh Mann

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The innovative features of information system, known as Radiology Information System (RIS), for electronic medical records has shown a good impact in the hospital. The objective is to help and make their work easier; such as for a physician to access the patient’s data and for a patient to check their bill transparently. The interoperability of RIS with the other intra-hospital information systems it interacts with, dealing with the compatibility and open architecture issues, are accomplished by two novel mechanisms. The first one is the particular message handling system that is applied for the exchange of information, according to the Health Level Seven (HL7) protocol’s specifications and serves the transfer of medical and administrative data among the RIS applications and data store unit. The second one implements the translation of information between the formats that HL7 and Digital Imaging and Communication in Medicine (DICOM) protocols specify, providing the communication between RIS and Picture and Archive Communication System (PACS) which is used for the increasing incorporation of modern medical imaging equipment.

Keywords: RIS, PACS, HIS, HL7, DICOM, messaging service, interoperability, digital images

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Authors: Shabnam Naderi

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Traditional understandings of ethics considered translators, translations, technologies and other agents as separate and prioritized human agents. In fact, ethics was equated with morality. This disengaged understanding of ethics is superseded by an ethics of relation/entanglement in the posthuman philosophy. According to this ethics of entanglement, human and nonhuman agents are in constant ‘intra-action’. The human is not separate from nature, from technology and from other nonhuman entities, and an ethics of translation in this regard cannot be separated from technology and ecology and get defined merely within the realm of human-human encounter. As such, a posthuman ethics offers opportunities for change and responds to the changing nature of reality, it is negotiable and reveals itself as a moment-by-moment practice (i.e. as temporally emergent and beyond determinacy and permanence). Far from the linguistic or cultural, or individual concerns, posthuman translational ethics discusses how the former rigid norms and laws are challenged in a process ontology which puts emphasis on activity and activation and considers ethics as surfacing in activity, not as a predefined set of rules and values. In this sense, traditional ethical principles like faithfulness, accuracy and representation are superseded by principles of privacy, sustainability, multiplicity and decentralization. The present conceptual study, drawing on Ferrando’s philosophical posthumanism (as a post-humanism, as a post-dualism and as a post-anthropocentrism), Deleuze-Guattarian philosophy of immanence and Barad’s physics-philosophy strives to destabilize traditional understandings of translation ethics and bring an ethics that has loose ends and revolves around multiplicity and decentralization into the picture.

Keywords: ethics of entanglement, post-anthropocentrism, post-dualism, post-humanism, translation

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Authors: Xiao-Yin Liu, Liang-Xue Zhou

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Traumatic brain injury (TBI), as a kind of nerve trauma caused by an external force, affects people all over the world and is a global public health problem. Although there are various clinical treatments for brain injury, including surgery, drug therapy, and rehabilitation therapy, the therapeutic effect is very limited. To improve the therapeutic effect of TBI, scaffolds combined with exosomes are a promising but challenging method for TBI repair. In this study, we examined whether a novel 3D-printed collagen/chitosan scaffold/exosomes derived from neural stem cells (NSCs) pretreated with insulin growth factor-1 (IGF-I) scaffolds (3D-CC-INExos) could be used to improve TBI repair and functional recovery after TBI. Our results showed that composite scaffolds of collagen-, chitosan- and exosomes derived from NSCs pretreated with IGF-I (INExos) could continuously release the exosomes for two weeks. In the rat TBI model, 3D-CC-INExos scaffold transplantation significantly improved motor and cognitive function after TBI, as assessed by the Morris water maze test and modified neurological severity scores. In addition, immunofluorescence staining and transmission electron microscopy showed that the recovery of damaged nerve tissue in the injured area was significantly improved by 3D-CC-INExos implantation. In conclusion, our data suggest that 3D-CC-INExos might provide a potential strategy for the treatment of TBI and lay a solid foundation for clinical translation.

Keywords: traumatic brain injury, exosomes, insulin growth factor-1, neural stem cells, collagen, chitosan, 3D printing, neural regeneration, angiogenesis, functional recovery

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Authors: Rossella Resi

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This paper describes a project carried out in an Italian school with English learning pupils combining three didactic tools which are attested to be relevant for the success of young learner’s language curriculum: the use of technology, the intralingual and interlingual mediation (according to CEFR) and the cultural dimension. Aim of this project was to test a technological hands-on translation activity like subtitling in a formal teaching context and to exploit its potential as motivational tool for developing listening and writing, translation and cross-cultural skills among language learners. The activities proposed involved the use of professional subtitling software called Aegisub and culture-specific films. The workshop was optional so motivation was entirely based on the pleasure of engaging in the use of a realistic subtitling program and on the challenge of meeting the constraints that a real life/work situation might involve. Twelve pupils in the age between 16 and 18 have attended the afternoon workshop. The workshop was organized in three parts: (i) An introduction where the learners were opened up to the concept and constraints of subtitling and provided with few basic rules on spotting and segmentation. During this session learners had also the time to familiarize with the main software features. (ii) The second part involved three subtitling activities in plenum or in groups. In the first activity the learners experienced the technical dimensions of subtitling. They were provided with a short video segment together with its transcription to be segmented and time-spotted. The second activity involved also oral comprehension. Learners had to understand and transcribe a video segment before subtitling it. The third activity embedded a translation activity of a provided transcription including segmentation and spotting of subtitles. (iii) The workshop ended with a small final project. At this point learners were able to master a short subtitling assignment (transcription, translation, segmenting and spotting) on their own with a similar video interview. The results of these assignments were above expectations since the learners were highly motivated by the authentic and original nature of the assignment. The subtitled videos were evaluated and watched in the regular classroom together with other students who did not take part to the workshop.

Keywords: ICT, L2, language learning, language mediation, subtitling

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Authors: Hossein Ghaedamini, Salman Farahbakhsh, Alireza Amirbeigi, Zahra Saghafi, Salman Daneshi, Alireza Ghaedamini

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Background: Assessing the challenges of clinical education of medical students is one of the most important and sensitive parts of medical education. The aim of this study was to investigate the views and experiences of Kerman medical students on the factors that facilitate and inhibit the quality of clinical education. Materials and Methods: This research was qualitative and used a phenomenological approach. The study population included medical interns of Kerman University of Medical Sciences in 1400. The method of data collection was in-depth interviews with participants. Data were encoded and analyzed by Claizey stepwise model. Results: First, about 540 primary codes were extracted in the form of two main themes (facilitators and inhibitors) and 10 sub-themes including providing motivational models and creating interest in interns, high scientific level of professors and the appropriate quality of their teaching, the use of technology in the clinical education process, delegating authority and freedom of action and more responsibilities to interns, inappropriate treatment of some officials, professors, assistants and department staff with their interns, inadequate educational programming, lack of necessary cooperation and providing inappropriate treatment by clinical training experts for interns, inadequate evaluation method in clinical training for interns, poor quality mornings, the unefficiency of grand rounds, the inappropriate way of evaluating clinical training for interns, the lack of suitable facilities and conditions with the position of a medical intern, and the hardwork of some departments were categorized. Conclusion: Clinical education is always mixed with special principles and subtleties, and special attention to facilitators and inhibitors in this process has an important role in improving its quality.

Keywords: clinical education, medical students, qualitative study, education

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Authors: Lu-Chiu Huang, Pei-Pei Chen, Li-Chin Yu, Chiao-Wen Kuo, Tsui-Tao Liu, Rung-Chuang Feng

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Purpose: People put increasing emphasis on demands of medical quality and protecting their interests. Patients' or family's dissatisfaction with medical care may easily lead to medical dispute. Physician-family communication plays an essential role in medical care. A sound communication cannot only strengthen patients' belief in the medical team but make patient have definite insight into treatment course of the disease. A family meeting provides an effective platform for communication between clinical staff, patients and family. Decisions and consensuses formed in family meetings can promote patients' or family's satisfaction with medical care. Clinical staff's attitudes toward family meeting may determine behavioral intentions to hold family meeting. This study aims to explore clinical staff's difficulties in holding family meeting and evaluate how their attitudes and behavior influence the effect of family meetings. Methods: This was a cross-sectional study. It was conducted at a regional teaching hospital in Taipei city. The research team developed its own structural questionnaires, whose expert validity was checked by the nursing experts. Participants filled in the questionnaires online. Data were collected by convenience sampling. A total of 568 participants were invited. They included doctors, nurses, social workers, and so on. Results: 1) The average score of ‘clinical staff’s attitudes to family meetings’ was 5.15 (SD=0.898). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It indicated that clinical staff had positive attitudes toward family meetings, 2) The average score of ‘clinical staff’s behavior to family meetings’ was 5.61 (SD=0.937). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It meant clinical staff tended to have positive behavior at the family meeting, and 3) The average score of ‘Difficulty in conducting family meetings’ was 5.15 (SD=0.897). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. The higher the score was, the less difficulty the clinical staff felt. It demonstrated clinical staff felt less difficulty in conducting family meetings. Clinical staff's identification with family meetings brought favored effects. Persistent and active promotion for family meetings can bring patients and family more benefits. Implications for practice: Understanding clinical staff's difficulty in participating family meeting and exploring their attitudes or behavior toward physician-family communication are helpful to develop modes of interaction. Consequently, quality and satisfaction of physician-family communication can be increased.

Keywords: clinical staff, communication, family meeting, physician-family

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Authors: Phawida Wattanasoonthorn

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Ventilator-associated pneumonia is a serious infection found to be among the top three infections in the hospital. To investigate the effects of clinical practice guideline on knowledge and preventive practices of nursing personnel, and incidences of ventilator-associated pneumonia. A pre-post quasi-experimental study on 17 professional nurses, and 123 ventilator-associated pneumonia patients admitted to the surgical intensive care unit, and the accident and surgical ward of Songkhla Hospital from October 2013 to January 2014. The study found that after using the clinical practice guideline, the subjects’ median score increased from 16.00 to 19.00. The increase in practicing correctly was from 66.01 percent to 79.03 percent with the statistical significance level of .05, and the incidences of ventilator-associated pneumonia decreased by 5.00 percent. The results of this study revealed that the use of the clinical practice guideline helped increase knowledge and practice skill of nursing personnel, and decrease incidences of ventilator-associated pneumonia. Thus, nursing personnel should be encouraged, reminded and promoted to continue using the practice guideline through various means including training, providing knowledge, giving feedback, and putting up posters to remind them of practicing correctly and sustainably.

Keywords: Clinical Practice Guideline, knowledge, Preventive Ventilator, Pneumonia

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Authors: Modestus Queen

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As we know, diplomatic languages carry the political ideology and cultural stance of the country. Knowing that China's diplomatic discourse is complicated and is heavily flavored with Chinese characteristics, one of the core goals of President Xi's administration is to properly tell the story of China. This cannot be done without proper translation or interpretation of major Chinese diplomatic concepts. Therefore, this research seeks to interpret the relevance of "Yi" as used in "Zhèngquè Yì Lì Guān". The author argues that it is not enough to translate a document but that it must be properly interpreted to portray it as political, economic, cultural and diplomatic relevant to the target audience, in this case, African people. The first finding in the current study indicates that literal translation is a bad strategy, especially in Chinese diplomatic discourses. The second finding indicates that "Yi" can be used as a framework to analyze Sino-Africa relations from economic, social and political perspectives, and the third finding indicates that "Yi" is the guiding principle of China's foreign policy towards Africa.

Keywords: Yi, justice, China-Africa, interpretation, diplomatic discourse, discourse reconstruction

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Authors: Getachew Belay Kassahun

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Background: Locally established clinical laboratory reference intervals (RIs) are required to interpret laboratory test results for screening, diagnosis, and prognosis. The objective of this study was to establish a reference interval of clinical chemistry parameters among apparently healthy adolescents aged between 12 and 17 years in Mekelle, Tigrai, in the northern part of Ethiopia. Methods: Community-based cross-sectional study was employed from December 2018 to March 2019 in Mekelle City among 172 males and 172 females based on a Multi-stage sampling technique. Blood samples were tested for Fasting blood sugar (FBS), alanine amino transferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), Creatinine, urea, total protein, albumin (ALB), direct and indirect bilirubin (BIL.D and BIL.T) using 25 Bio system clinical chemistry analyzer. Results were analyzed using SPSS version 23 software and based on the Clinical Laboratory Standard Institute (CLSI)/ International Federation of Clinical Chemistry (IFCC) C 28-A3 Guideline which defines the reference interval as the 95% central range of 2.5th and 97.5th percentiles. Mann Whitney U test, descriptive statistics and box and whisker were statistical tools used for analysis. Results: This study observed statistically significant differences between males and females in ALP, ALT, AST, Urea and Creatinine Reference intervals. The established reference intervals for males and females, respectively, were: ALP (U/L) 79.48-492.12 versus 63.56-253.34, ALT (U/L) 4.54-23.69 versus 5.1-20.03, AST 15.7- 39.1 versus 13.3- 28.5, Urea (mg/dL) 9.33-24.99 versus 7.43-23.11, and Creatinine (mg/dL) 0.393-0.957 versus 0.301-0.846. The combined RIs for Total Protein (g/dL) were 6.08-7.85, ALB (g/dL) 4.42-5.46, FBS(mg/dL) 65-110, BIL.D (mg/dL) 0.033-0.532, and BIL.T (mg/dL) 0.106-0.812. Conclusions: The result showed a marked difference between sex and company-derived values for selected clinical chemistry parameters. Thus, the use of age and sex-specific locally established reference intervals for clinical chemistry parameters is recommended.

Keywords: reference interval, adolescent, clinical chemistry, Ethiopia

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Authors: Daphne Alroy-Thiberge

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Trauma-impacted individuals present unique treatment challenges that include high reactivity, hyper-and hypo-arousal, poor adherence to therapy, as well as powerful transference and counter-transference experiences in therapy. This work provides an overview of the clinical tenets most often encountered in trauma-impacted individuals. Further, it provides readily applicable clinical techniques to optimize therapeutic rapport and facilitate accelerated positive mental health outcomes. Finally, integrated neuroscience and clinical evidence-based data are discussed to shed new light on crisis states in trauma-impacted individuals. This knowledge is utilized to provide effective and concrete interventions towards rapid and successful de-escalation of the impacted individual. A highly interactive, adult-learning-principles-based modality is utilized to provide an organic learning experience for participants. The information and techniques learned aim to increase clinical effectiveness, reduce staff injuries and burnout, and significantly enhance positive mental health outcomes and self-determination for the trauma-impacted individuals treated.

Keywords: clinical competencies, crisis interventions, psychotherapy techniques, trauma informed care

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Authors: Alexey Yu. Martynov, Sulejman Bayramov

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Introduction: The myocardial bridging is the most common anomaly of the coronary arteries (CA). Depending on the examination method, the frequency of detected myocardial bridges (MB) varies in a rather wide range. The typical clinical manifestations of MB are angina pectoris, arrhythmias, sudden cardiac death. Objective: To study the incidence of MB in patients hospitalized with coronary artery disease (CAD). To assess clinical manifestations of MB in patients admitted with CAD. Materials and methods: A retrospective analysis of 19159 case histories of patients admitted at clinical city hospital in Moscow from 01.01.2018 to 31.12 2019 with CAD was performed. 9384 patients’ coronary angiographies (CAG) were examined for MB. The localization of MB, the degree of coronary contraction by MB, the number of MB, isolated MB and combined with CAD were assessed. The clinical manifestations of MB were determined. Results: MB was detected in 52 patients all with one myocardial bridge. 20 patients with MB have intact CA, and 32 patients have MB combined with CAD. Among 20 patients with intact CA: I degree of MB contraction (up to 50%) was detected in 9 patients. Clinical manifestations in five cases were angina pectoris, in 3 myocardial infarction (MI) - 1 patients with ST segment elevation MI (STEMI), 2 without ST segment elevation MI (NSTEMI), 1 post-infarction cardiosclerosis (PICS). Stable angina II FC in 3, III FC in 1, vasospastic angina (VSA) in 1 patient. II degree of MB contraction (up to 50-70%) was determined in 9 patients: in seven cases angina pectoris was detected, 1 NSTEMI, 1 PICS. Stable angina II FC in 3, III FC in 1, VSA in 3 patients. III degree of MB contraction (> 70%) detected in 2 patients. II FC stable angina in one case, PICS in another. Among 32 patients having MB combined with CAD I degree of MB contraction was observed in 20 patients. Clinical manifestations in 12 cases were angina pectoris in 8 II FC and in 4 III FC, 7 MI 6 with STEMI and 1 NSTEMI, 1 PICS. II degree of MB contraction was detected in 7 patients, 4 of them had angina pectoris, 3 MI 2 with STEMI and 1 NSTEMI. Stable angina II FC in 3, VSA in 1 patients. III degree of MB contraction was diagnosed in five patients. In two cases, II FC and III FC stable angina were observed, 2 MI with STEMI and NSTEMI, 1 PICS. Conclusions: MB incidence is one in 368 patients with CAD. The most common involvement (68%) is MB combined with CA atherosclerotic lesions. MB with intact CA are detected in one-third (32%) of patients. The first-degree MB contraction is most frequent condition. MI is more often detected in intact CA with first degree MB than in the second degree. The degree of MB contraction was not correlated with the severity of the clinical manifestations.

Keywords: clinical manifestations, coronary angiography, coronary artery disease, myocardial bridging, myocardial infarction, stable angina

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Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan

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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.

Keywords: audit, clinical, radiotherapy, improving functionality

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Authors: Jinfeng Zhang, Chun-Sing Lee

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Pure nanodrugs (PNDs) – nanoparticles consisting entirely of drug molecules, have been considered as promising candidates for the next-generation nanodrugs. However, the traditional preparation method via reprecipitation faces critical challenges including low production rates, relatively large particle sizes and batch-to-batch variations. Here, for the first time, we successfully developed a novel, versatile and controllable strategy for preparing PNDs via an anodized aluminium oxide (AAO) template-assisted method. With this approach, we prepared PNDs of an anti-cancer drug (VM-26) with precisely controlled sizes reaching the sub-20 nm range. This template-assisted approach has much higher feasibility for mass production comparing to the conventional reprecipitation method and is beneficial for future clinical translation. The present method is further demonstrated to be easily applicable for a wide range of hydrophobic biomolecules without the need of custom molecular modifications and can be extended for preparing all-in-one nanostructures with different functional agents.

Keywords: drug delivery, pure nanodrugs, size control, template

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Authors: Sanam Preet Singh

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Music in comparison to any other art form is more reactive and alive. It has the capacity to directly interact with the listener's mind and generate an emotional response. All the major research conducted in the area majorly relied on the listener’s perspective to draw an understanding of music and its effects. There is a very small number of studies which focused on the source from which music originates, the music composers. This study aims to understand the process of how music composers understand and perceive emotions and how they translate them into music, in simpler terms how music composers encode their compositions to express determining emotions. One-to-one in-depth semi structured interviews were conducted, with 8 individuals both male and female, who were professional to intermediate-level music composers and Thematic analysis was conducted to derive the themes. The analysis showed that there is no single process on which music composers rely, rather there are combinations of multiple micro processes, which constitute the understanding and translation of emotions into music. In terms of perception of emotions, the role of processes such as Rumination, mood influence and escapism was discovered in the analysis. Unique themes about the understanding of their top down and bottom up perceptions were also discovered. Further analysis also revealed the role of imagination and emotional trigger explaining how music composers make sense of emotions. The translation process of emotions revealed the role of articulation and instrumentalization, in encoding or translating emotions to a composition. Further, applications of the trial and error method, nature influences and flow in the translation process are also discussed. In the end themes such as parallels between musical patterns and emotions, comfort zones and relatability also emerged during the analysis.

Keywords: comfort zones, escapism, flow, rumination

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Authors: Yuqiao Zhou

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The Sapir-Whorf hypothesis (SWH) emphasizes the effect produced by language on people’s minds. According to linguistic relativity, language has evolved over the course of human life on earth, and, in turn, the acquisition of language shapes learners’ thoughts. Despite much attention drawn by SWH, few scholars have attempted to analyse people’s thoughts via their literary works. And yet, the linguistic choices that create a narrative can enable us to examine its writer’s thoughts. Still, less work has been done on the impact of language on the minds of bilingual people. Internationalization has resulted in an increasing number of bilingual and multilingual individuals. In China, where more than one hundred languages are used for communication, most people are bilingual in Mandarin Chinese (the official language of China) and their own dialect. Taking as its corpus the ethnic minority myth of Ge Sa-er Wang by Alai and its English translation by Goldblatt and Lin, this paper aims to analyse the effects of culture on bilingual people’s minds. It will first analyse Alai’s thoughts on using the original version of Ge Sa-er Wang; next, it will examine the thoughts of the two translators by looking at translation choices made in the English version; finally, it will compare the cultural influences evident in the thoughts of Alai, and Goldblatt and Lin. Whereas Alai can speak two Sino-Tibetan languages – Mandarin Chinese and Tibetan – Goldblatt and Lin can speak two languages from different families – Mandarin Chinese (a Sino-Tibetan language) and English (an Indo-European language). The results reveal two systems of thought existing in the translators’ minds; Alai’s text, on the other hand, does not reveal a significant influence from North China, where Mandarin Chinese originated. The findings reveal the inconsistency of a second language’s influence on people’s minds. Notably, they suggest that the more different the two languages are, the greater the influence produced by the second language culture on people’s thoughts. It is hoped that this research will expand the scope of SWH as well as shed light on future translation studies on ethnic minority literature.

Keywords: Sapir-Whorf hypothesis, cultural translation, cultural-specific items, Ge Sa-er Wang, ethnic minority literature, Tibet

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Authors: A. Satty, H. Mwambi

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Much clinical trials data-based research are characterized by the unavoidable problem of dropout as a result of missing or erroneous values. This paper aims to review some of the various techniques to address the dropout problems in longitudinal clinical trials. The fundamental concepts of the patterns and mechanisms of dropout are discussed. This study presents five general techniques for handling dropout: (1) Deletion methods; (2) Imputation-based methods; (3) Data augmentation methods; (4) Likelihood-based methods; and (5) MNAR-based methods. Under each technique, several methods that are commonly used to deal with dropout are presented, including a review of the existing literature in which we examine the effectiveness of these methods in the analysis of incomplete data. Two application examples are presented to study the potential strengths or weaknesses of some of the methods under certain dropout mechanisms as well as to assess the sensitivity of the modelling assumptions.

Keywords: incomplete longitudinal clinical trials, missing at random (MAR), imputation, weighting methods, sensitivity analysis

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Authors: Sujata Chaturvedi, Ishita Pant, Deepak Kumar Jha, Vinod Kumar Singh Gautam, Chandra Bhushan Tripathi

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Objective: To describe clinical, histopathological and immunohistochemical profile of glioblastoma in patients and to correlate these findings with patient survival. Material and methods: 30 cases of histopathologically diagnosed glioblastomas were included in this study. These cases were analysed in detail for certain clinical and histopathological parameters. Immunohistochemical staining for p53, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), mouse double minute 2 homolog (MDM2) and Ki67 was done and scores were calculated. Results of these findings were correlated with patient survival. Results: A retrospective analysis of the histopathology records and clinical case files was done in 30 cases of glioblastoma (WHO grade IV). The mean age of presentation was 50.6 years with a male predilection. The most common involved site was the frontal lobe. Amongst the clinical parameters, age of the patient and extent of surgical resection showed a significant correlation with the patient survival. Histopathological parameters showed no significant correlation with the patient survival, while amongst the immunohistochemical parameters expression of MDM2 showed a significant correlation with the patient survival. Conclusion: In this study incorporating clinical, histopathological and basic panel of immunohistochemistry, age of the patient, extent of the surgical resection and expression of MDM2 showed significant correlation with the patient survival.

Keywords: glioblastoma, p53, EGFR, VEGF, MDM2, Ki67

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Authors: Edward C. Smith

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Historical narration in literature and film is an act that necessarily develops and deforms history, whether consciously or unconsciously. Such “translation” suffers or thrives depending on its historical context and on the ability of the artist/artists to make choices that enhance or diminish social and political reality. This “translation” and its challenges is examined from within the historical and political context of the 1930 Berlin film premiere of “All Quiet on the Western Front,” a film based on Erich Maria Remarque’s 1928 best-selling novel. Both the film and the novel appeared during a period in which the “aestheticization” of reality predominated. This was an era in early 20th-century European society in which life was conceived of as innately artistic and structured like an art form. The emergence of this modern consciousness, one in which memory and history surrendered their former authority, enabled conservative propaganda of the period to denounce all art that did not adhere conceptually to its political tenets, with “All Quiet” becoming yet another of its “victims.”

Keywords: documentary and propaganda film, film and TV audiences, international literature in film studies, popular culture and film

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Authors: Wafaa M. El- Kotb, Soheir Mohamed Weheida, Manal E. Fareed

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The aim of this study was to determine the effect of implementing a teaching module about diet and exercises on clinical outcomes of patients with gout. Subjects: A purposive sample of 60 adult gouty patients was selected and randomly and alternatively divided into two equal groups 30 patients in each. Setting: The study was conducted in orthopedic out patient's clinic of Menoufia University. Tools of the study: Three tools were utilized for data collection: Knowledge assessment structured interview questionnaire, Clinical manifestation assessment tools and Nutritional assessment sheet. Results: All patients of both groups (100 %) had poor total knowledge score pre teaching, while 90 % of the study group had good total knowledge score post teaching by three months compared to 3.3 % of the control group. Moreover the recovery outcomes were significantly improved among study group compared to control group post teaching. Conclusion: Teaching study group about diet and exercises significantly improved their clinical outcomes. Recommendation: Patient's education about diet and exercises should be ongoing process for patients with gout.

Keywords: clinical outcomes, diet, exercises, teaching module

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Authors: Y. Bablu Singh, B. S. Purkayashtha, Chungkham Yashawanta Singh

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Morphological analysis forms the basic foundation in NLP applications including syntax parsing Machine Translation (MT), Information Retrieval (IR) and automatic indexing in all languages. It is the field of the linguistics; it can provide valuable information for computer based linguistics task such as lemmatization and studies of internal structure of the words. Computational Morphology is the application of morphological rules in the field of computational linguistics, and it is the emerging area in AI, which studies the structure of words, which are formed by combining smaller units of linguistics information, called morphemes: the building blocks of words. Morphological analysis provides about semantic and syntactic role in a sentence. It analyzes the Manipuri word forms and produces several grammatical information associated with the words. The Morphological Analyzer for Manipuri has been tested on 3500 Manipuri words in Shakti Standard format (SSF) using Meitei Mayek as source; thereby an accuracy of 80% has been obtained on a manual check.

Keywords: morphological analysis, machine translation, computational morphology, information retrieval, SSF

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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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Authors: Wen-jing Shan

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The Chinese annotated edition of “Experience and education: The 60th anniversary edition,” originally written in English by John Dewey (1859-1952), was published in 2015 by this author. A report of the process and results of the translation and annotation of the book is the purpose of this paper. It is worth mentioning that the original 1938 edition was considered as the best concise statement on education by John Dewey, one the most important educational theorists of the twentieth century. One of the features of this The 60th anniversary edition is that the original publisher, Kappa Delta Pi International Honor Society, invited four contemporary Deweyan scholars who had been awarded the Society’s Laureate Scholar to write a review of the book published by Dewey, who was the first to receive this honor. The four scholars are Maxine Greene(1917-2014), Philip W. Jackson(1928-2015), Linda Darling-Hammond(1951-), and O. L. Davis, Jr.(1928-). The original 1938 edition, the best concise statement on education by the most important educational theorist of the twentieth century, was translated into Chinese for five times after its publication in the U.S.A, three in the 1940s, one in the 1990s, and one in 2010s. Nonetheless, the five translations have few or no annotations and have some flaws of mis-interpretations and lack of information. The author retranslated and annotated the book to make the interpretations more faithful, expressive, and elegant, and providing the readers with more understanding and more correct information. This author started the project of translation and annotation sponsored by Taiwan Ministry of Science and Technology in August 2011 and finished and published by July 2015. The work, the author, did was divided into three stages. First, in the preparatory stage of the project, the summary of each chapter, the rationale of the book, the textual commentary, the development of the original and Chinese editions, and reviews and criticisms, as well as Dewey’s biography and bibliography were initially investigated. Secondly, on the basis of the above preliminary work, the translation with annotation of Experience and Education, an epitome of Dewey’s biography and bibliography, a chronology, and a critical introduction for the Experience and Education were written. In the critical introduction, Dewey’s philosophy of experience and educational ideas will be examined along the timeline of human thought. And the vast literature about Dewey and his work will be instrumental to reveal the historical significance of Experience and Education on the modern age and make the critical introduction more knowledgeable. Third, the final stage took another two years to review and revise the draft of the work and send it for publication. There are two parts in the book. The first part is a scholarly introduction including Dewey’s chronicle (in short form), Dewey’s mind, people and life, the importance of “Experience and education”, the necessity of re-translation and re-annotation of “Experience and education” into Chinese. The second part is the re-translation and re-annotation version, including Dewey’s “Experience and education” and four papers written by contemporary scholars.

Keywords: John Dewey, experience and education: the 60th anniversary edition, translation, annotation

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Authors: Eun Jeong Yu, Inn Soo Kang, Tae Ki Yoon, Mi Kyoung Koong

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Advanced female age is associated with higher cycle cancelation rates, lower clinical pregnancy rate, increased miscarriage and aneuploidy rates in IVF (In Vitro Fertilization) cycles. This retrospective cohort study was conducted at a Cha Fertility Center, Seoul Station. All fresh non-donor IVF cycles performed in women aged 40 years and above from January 2016 to December 2016 were reviewed. Donor/recipient treatment, PGD/PGS (Preimplantation Genetic Diagnosis/ Preimplantation Genetic Screening) were excluded from analysis. Of the 1,166 cycles from 753 women who completed ovulation induction, 1,047 were appropriate for the evaluation according to inclusion and exclusion criterion. IVF cycles were categorized according to age and grouped into the following 1-year age groups: 40, 41, 42, 43, 44, 45 and > 46. The mean age of patients was 42.4 ± 1.8 years. The median AMH (Anti-Mullerian Hormone) level was 1.2 ± 1.5 ng/mL. The mean number of retrieved oocytes was 4.9 ± 4.3. The clinical pregnancy rate and live birth rate in women > 40 years significantly decreased with each year of advancing age (p < 0.001). The clinical pregnancy rate decreased from 21% at the age of 40 years to 0% at ages above 45 years. Live birth rate decreased from 12.3% to 0%, respectively. There were no clinical pregnancy outcomes among 95 patients aged above 45 years of age. The overall miscarriage rate was 40.7% (range, 36.7%-70%). The transfer of at least one good quality embryo was associated with about 4-9% increased chance of a clinical pregnancy rate. Therefore, IVF in old age women less than 46 had a reasonable chance for successful pregnancy outcomes especially when good quality embryo is transferred.

Keywords: advanced maternal age, in vitro fertilization, pregnancy rate, live birth rate

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Authors: Marina Fomina

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The paper focuses on the category of semantic subject within the framework of a functional approach to linguistics. The semantic subject is related to similar notions such as the grammatical subject and the bearer of predicative feature. It is the multifaceted nature of the category of subject that 1) triggers a number of issues that, syntax-wise, remain to be dealt with (cf. semantic vs. syntactic functions / sentence parts vs. parts of speech issues, etc.); 2) results in a variety of approaches to the category of subject, such as formal grammatical, semantic/syntactic (functional), communicative approaches, etc. Many linguists consider the prototypical approach to the category of subject to be the most instrumental as it reveals the integrity of denotative and linguistic components of the conceptual category. This approach relates to subject as a source of non-passive predicative feature, an element of subject-predicate-object situation that can take on a variety of semantic roles, cf.: 1) an agent (He carefully surveyed the valley stretching before him), 2) an experiencer (I feel very bitter about this), 3) a recipient (I received this book as a gift), 4) a causee (The plane broke into three pieces), 5) a patient (This stove cleans easily), etc. It is believed that the variety of roles stems from the radial (prototypical) structure of the category with some members more central than others. Translation-wise, the most “treacherous” subject types are the peripheral ones. The paper 1) features a peripheral status of spatial impersonal sentence models such as U menia v ukhe zvenit (lit. I-Gen. in ear buzzes) within the category of semantic subject, 2) makes a structural and semantic analysis of the models, 3) focuses on their Russian-English translation patterns, 4) reveals non-prototypical features of subjects in the English equivalents.

Keywords: bearer of predicative feature, grammatical subject, impersonal sentence model, semantic subject

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Authors: R. Tariq, R. Lee

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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

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Authors: Angeliki Gkiouzeli, Christine Rotonda, Elise Eby, Claire Touchet, Marie-Jo Brennstuhl, Cyril Tarquinio

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Resilience is a psychological concept of possible relevance to the development and maintenance of chronic pain (CP). It refers to the ability of individuals to maintain reasonably healthy levels of physical and psychological functioning when exposed to an isolated and potentially highly disruptive event. Extensive research in recent years has supported the importance of this concept in the CP literature. Increased levels of resilience were associated with lower levels of perceived pain intensity and better mental health outcomes in adults with persistent pain. The ongoing project seeks to include the concept of pain-specific resilience in the French literature in order to provide more appropriate measures for assessing and understanding the complexities of CP in the near future. To the best of our knowledge, there is currently no validated version of the pain-specific resilience measure, the Pain Resilience scale (PRS), for French-speaking populations. Therefore, the present work aims to address this gap, firstly by performing a linguistic and cultural translation of the scale into French and secondly by studying the internal validity and reliability of the PRS for French CP populations. The forward-translation-back translation methodology was used to achieve as perfect a cultural and linguistic translation as possible according to the recommendations of the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) group, and an online survey is currently conducted among a representative sample of the French population suffering from CP. To date, the survey has involved one hundred respondents, with a total target of around three hundred participants at its completion. We further seek to study the metric properties of the French version of the PRS, ''L’Echelle de Résilience à la Douleur spécifique pour les Douleurs Chroniques'' (ERD-DC), in French patients suffering from CP, assessing the level of pain resilience in the context of CP. Finally, we will explore the relationship between the level of pain resilience in the context of CP and other variables of interest commonly assessed in pain research and treatment (i.e., general resilience, self-efficacy, pain catastrophising, and quality of life). This study will provide an overview of the methodology used to address our research objectives. We will also present for the first time the main findings and further discuss the validity of the scale in the field of CP research and pain management. We hope that this tool will provide a better understanding of how CP-specific resilience processes can influence the development and maintenance of this disease. This could ultimately result in better treatment strategies specifically tailored to individual needs, thus leading to reduced healthcare costs and improved patient well-being.

Keywords: chronic pain, pain measure, pain resilience, questionnaire adaptation

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Authors: Moon Jung Kim, Guil Rhim

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The clinical sensitivity of the “VEUPLEXTM TBI assay”, a clinical trial medical device, in mild traumatic brain injury was 28.6% (95% CI, 19.7%-37.5%), and the clinical specificity was 94.0% (95% CI, 89.3%). -98.7%). In addition, when the results analyzed by marker were put together, the sensitivity was higher when interpreting the two tests together than the two tests, UCHL1 and GFAP alone. Additionally, when sensitivity and specificity were analyzed based on CT results for the mild traumatic brain injury patient group, the clinical sensitivity for 2 CT-positive cases was 50.0% (95% CI: 1.3%-98.7%), and 19 CT-negative cases. The clinical specificity for cases was 68.4% (95% CI: 43.5% - 87.4%). Since the low clinical sensitivity for the two CT-positive cases was not statistically significant due to the small number of samples analyzed, it was judged necessary to secure and analyze more samples in the future. Regarding the clinical specificity analysis results for 19 CT-negative cases, there were a large number of patients who were actually clinically diagnosed with mild traumatic brain injury but actually received a CT-negative result, and about 31.6% of them showed abnormal results on VEUPLEXTM TBI assay. Although traumatic brain injury could not be detected in 31.6% of the CT scans, the possibility of actually suffering a mild brain injury could not be ruled out, so it was judged that this could be confirmed through follow-up observation of the patient. In addition, among patients with mild traumatic brain injury, CT examinations were not performed in many cases because the symptoms were very mild, but among these patients, about 25% or more showed abnormal results in the VEUPLEXTM TBI assay. In fact, no damage is observed with the naked eye immediately after traumatic brain injury, and traumatic brain injury is not observed even on CT. But in some cases, brain hemorrhage may occur (delayed cerebral hemorrhage) after a certain period of time, so the patients who did show abnormal results on VEUPLEXTM TBI assay should be followed up for the delayed cerebral hemorrhage. In conclusion, it was judged that it was difficult to judge mild traumatic brain injury with the VEUPLEXTM TBI assay only through clinical findings without CT results, that is, based on the GCS value. Even in the case of CT, it does not detect all mild traumatic brain injury, so it is difficult to necessarily judge that there is no traumatic brain injury, even if there is no evidence of traumatic brain injury in CT. And in the long term, more patients should be included to evaluate the usefulness of the VEUPLEXTM TBI assay in the detection of microscopic traumatic brain injuries without using CT.

Keywords: brain injury, traumatic brain injury, GFAP, UCHL1

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