Fitness-to-drive after mild traumatic brain injury: Mapping the time trajectory of recovery in the acute stages post injury

Introduction

Little is known about the trajectory of recovery in fitness-to-drive after mild traumatic brain injury (mTBI). This means that health-care professionals have limited evidence on which to base recommendations to this cohort about driving.

Objective

To determine fitness-to-drive status of patients with a mTBI at 24 h and two weeks post injury, and to summarise issues reported by this cohort about return to driving.

Method

Quasi-experimental case-control design. Two groups of participants were recruited: patients with a mTBI (n = 60) and a control group with orthopaedic injuries (n = 60). Both groups were assessed at 24 h post injury on assessments of fitness-to-drive. Follow-up occurred at two weeks post injury to establish driver status.

Main Measures

Mini mental state examination, occupational therapy-drive home maze test (OT–DHMT), Road Law Road Craft Test, University of Queensland-Hazard Perception Test, and demographic/interview form collected at 24 h and at two weeks.

Results

At the 24 h assessment, only the OT–DHMT showed a difference in scores between the two groups, with mTBI participants being significantly slower to complete the test (p = 0.01). At the two week follow-up, only 26 of the 60 mTBI participants had returned to driving. Injury severity combined with scores from the 24 h assessment predicted 31% of the variance in time taken to return to driving. Delayed return to driving was reported due to: “not feeling 100% right” (n = 14, 23%), headaches and pain (n = 12, 20%), and dizziness (n = 5, 8%).

Conclusion

This research supports existing guidelines which suggest that patients with a mTBI should not to drive for 24 h; however, further research is required to map factors which facilitate timely return to driving.     

The effect of auditory distraction on the useful field of view in hearing impaired individuals and its implications for driving

This study assessed whether the increased demand of listening in hearing impaired individuals exacerbates the detrimental impact of auditory distraction on a visual task (useful field of view test), relative to normally hearing listeners. Auditory distraction negatively affects this visual task, which is linked with various driving performance outcomes. Hearing impaired and normally hearing participants performed useful field of view testing with and without a simultaneous listening task. They also undertook a cognitive test battery. For all participants, performing the visual and auditory tasks together reduced performance on each respective test. For a number of subtests, hearing impaired participants showed poorer visual task performance, though not to a statistically significant extent. Hearing impaired participants were significantly poorer at a reading span task than normally hearing participants and tended to score lower on the most visually complex subtest of the visual task in the absence of auditory task engagement. Useful field of view performance is negatively affected by auditory distraction, and hearing loss may present further problems, given the reductions in visual and cognitive task performance suggested in this study. Suggestions are made for future work to extend this study, given the practical importance of the findings.     

Radial basis functions: Developments and applications to planetary scale flows

Radial basis functions (RBFs) can be seen as a major generalization of pseudospectral (PS) methods, abandoning the orthogonality of the basis functions and in return obtaining much improved simplicity and geometric flexibility. Spectral accuracy becomes now easily available also when using completely unstructured node layouts, permitting local node refinements in critical areas. The first major PDE applications for which RBFs have been shown to compete successfully against the best currently available numerical approaches can be found in the geosciences. Examples that are discussed here include translating vortex roll-ups (cyclogenesis), nonlinear flows on the sphere modeled by the shallow water equations, and 3D convection in the earth’s mantle.     

Mind the gap: AEDP interventions translating attachment theory into clinical practice.

There has been a gap between the prolific attachment theory and research literature and a relative paucity of guidance about how to apply attachment theory to clinical practice. AEDP (Accelerated Experiential-Dynamic Psychotherapy) explicitly fills this theory/practice gap. This article will explore three aspects of clinical practice that foster secure attachment bonds, and will also address what kind of therapist an attachment therapist is. It will outline the importance of nonverbal communication; it will start to catalogue what I call experiential language: specific words and interventions that are evocative of experience and emotion. Finally it will assert that self-disclosure is an essential attachment-creating intervention, and it will explain the importance of metaprocessing and Metatherapeutic processing to titrate therapeutic interactions moment-to-moment in session and to promote metacognitional thinking as well. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Polymeric prodrugs containing neridronate and ferrocene: Synthesis,characterization, and antimalarial activity

Polyamidoamine prodrugs containing ferrocene derivatives and neridronate were successfully synthesized and characterized by NMR, FTIR, SEM, and EDX analyses. Appearance of characteristic peaks in ¹H and ³¹P NMR or EDX spectra were used to confirm the presence of neridronate or ferrocene in the conjugates and co-conjugates. In vitro evaluation of the new materials revealed improved antimalarial activity, especially for conjugate 5 and corresponding co-conjugate 8, when compared with chloroquine and quinine. Hemolysis studies revealed that synthesized prodrugs had no effect on the integrity of the host red blood cell membrane; a direct effect on the intra-erythrocytic parasite was, however, noted.     

Nanoformulation of Brain‐Derived Neurotrophic Factor with Target Receptor‐Triggered‐Release in the Central Nervous System

Brain‐derived neurotrophic factor (BDNF) is identified as a potent neuroprotective and neuroregenerative agent for many neurological diseases. Regrettably, its delivery to the brain is hampered by poor serum stability and rapid brain clearance. Here, a novel nanoformulation is reported composed of a biocompatible polymer, poly(ethylene glycol)‐b‐poly(l ‐glutamic acid) (PEG‐PLE), that hosts the BDNF molecule in a nanoscale complex, termed here Nano‐BDNF. Upon simple mixture, Nano‐BDNF spontaneously forms uniform spherical particles with a core–shell structure. Molecular dynamics simulations suggest that binding between BDNF and PEG‐PLE is mediated through electrostatic coupling as well as transient hydrogen bonding. The formation of Nano‐BDNF complex stabilizes BDNF and protects it from nonspecific binding with common proteins in the body fluid, while allowing it to associate with its receptors. Following intranasal administration, the nanoformulation improves BDNF delivery throughout the brain and displays a more preferable regional distribution pattern than the native protein. Furthermore, intranasally delivered Nano‐BDNF results in superior neuroprotective effects in the mouse brain with lipopolysaccharides‐induced inflammation, indicating promise for further evaluation of this agent for the therapy of neurologic diseases.     

Modeling the Extraction Rate Coefficient for the Extraction of Yttrium by DEHPA Using Organic-Phase Recycle

ABSTRACT

Extraction of yttrium (Y) from sulfuric acid was studied using di(2-ethylhexyl) phosphate (DEHPA). A portion of the organic phase was recycled back into the mixer after extraction for the mixer to operate at a moderate organic-to-aqueous volumetric phase ratio while processing at a low organic-to-aqueous flow rate ratio. The effective performance of the mixer was evaluated when operating at different organic-phase flow fractions. To model the extraction rate coefficient, a 2-factor designed experiment was performed by conducting both equilibrium and mixer-settler tests. The organic-phase flow fraction was varied over four discrete levels while the extractant concentration was varied over three discrete levels. Increasing the organic-phase flow fraction yielded a continual increase in the extraction rate coefficient. In contrast, increasing the extractant concentration yielded an initial increase followed by a subsequent decrease in the extraction rate coefficient. The decline in the extraction rate coefficient was attributed to a decrease in the yttrium-extractant complex’s diffusion coefficient. High metal loading caused an elevated organic-phase viscosity and thus the low diffusion coefficient. An extraction rate coefficient model is proposed to describe the effects of extractant concentration, viscosity and organic-phase flow fraction. Mass transfer resistance was largely in the organic phase.     

An Advanced TALSPEAK Concept Using 2-Ethylhexylphosphonic Acid Mono-2-Ethylhexyl Ester as the Extractant

A method for separating the trivalent actinides and lanthanides is being developed using 2-ethylhexylphosphonic acid mono-2-ethylhexyl ester (HEH[EHP]) as the extractant. The method is based on the preferential binding of the actinides in the aqueous phase by N-(2-hydroxyethyl)ethylenediamine-N,N’,N’-triacetic acid (HEDTA), which serves to keep the actinides in the aqueous phase while the lanthanides are extracted into an organic phase containing HEH[EHP]. The process is very robust, showing little dependence upon the pH or the HEH[EHP], HEDTA, and citrate concentrations over the ranges that might be expected in a nuclear fuel recycling plant. Single-stage runs with a 2-cm centrifugal contactor indicate that modifications to the process chemistry may be needed to increase the extraction rate for Sm, Eu, and Gd. The hydraulic properties of the system are favorable to application in centrifugal contactors.