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Primary objective: To examine the utility of a coordinated, family/community-focused programme (PABICOP) vs. a standard approach for improving outcomes for children with ABI and their families.Research design: Pre-test-post-test design, with comparison group and follow-up.Methods and procedures: Ninety-six children (64 children receiving PABICOP services and 32 children receiving standard care) participated in the study. Measures were completed at baseline and 3 and 12 months later.Main outcomes and results: Parents/caregivers with more than 10 contacts with PABICOP scored significantly higher on an ABI knowledge quiz than either parents/caregivers with 10 contacts or less or the comparison group at post-test and follow-up. Parents/caregivers with 10 contacts or less with PABICOP reported significantly greater improvements in children's school and total competence on the CBCL than either parents/caregivers with more than 10 contacts or the comparison group at post-test and follow-up.Conclusions: PABICOP may be more useful for enhancing knowledge of ABI for parents/caregivers and for integrating children into the community over a 1-year period than a standard approach. The amount of service received appears to influence outcomes. [ABSTRACT FROM AUTHOR]

Background: Universities are vulnerable to infectious disease outbreaks, making them ideal environments to study transmission dynamics and evaluate mitigation and surveillance measures. Here, we analyze multimodal COVID-19-associated data collected during the 2020-2021 academic year at Colorado Mesa University and introduce a SARS-CoV-2 surveillance and response framework., Methods: We analyzed epidemiological and sociobehavioral data (demographics, contact tracing, and WiFi-based co-location data) alongside pathogen surveillance data (wastewater and diagnostic testing, and viral genomic sequencing of wastewater and clinical specimens) to characterize outbreak dynamics and inform policy. We applied relative risk, multiple linear regression, and social network assortativity to identify attributes or behaviors associated with contracting SARS-CoV-2. To characterize SARS-CoV-2 transmission, we used viral sequencing, phylogenomic tools, and functional assays., Findings: Athletes, particularly those on high-contact teams, had the highest risk of testing positive. On average, individuals who tested positive had more contacts and longer interaction durations than individuals who never tested positive. The distribution of contacts per individual was overdispersed, although not as overdispersed as the distribution of phylogenomic descendants. Corroboration via technical replicates was essential for identification of wastewater mutations., Conclusions: Based on our findings, we formulate a framework that combines tools into an integrated disease surveillance program that can be implemented in other congregate settings with limited resources., Funding: This work was supported by the National Science Foundation, the Hertz Foundation, the National Institutes of Health, the Centers for Disease Control and Prevention, the Massachusetts Consortium on Pathogen Readiness, the Howard Hughes Medical Institute, the Flu Lab, and the Audacious Project., Competing Interests: Declaration of interests P.C.S. is a co-founder of, shareholder in, and scientific advisor to Sherlock Biosciences, Inc.; she is also a Board member of and shareholder in Danaher Corporation. P.C.S. has filed IP related to genome sequencing and analysis., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Migraine is a common headache disorder, with cortical spreading depolarization (CSD) considered as the underlying electrophysiological event. CSD is a slowly propagating wave of neuronal and glial depolarization. Sleep disorders are well known risk factors for migraine chronification, and changes in wake-sleep pattern such as sleep deprivation are common migraine triggers. The underlying mechanisms are unknown. As a step towards developing an animal model to study this, we test whether sleep deprivation, a modifiable migraine trigger, enhances CSD susceptibility in rodent models., Methods: Acute sleep deprivation was achieved using the "gentle handling method", chosen to minimize stress and avoid confounding bias. Sleep deprivation was started with onset of light (diurnal lighting conditions), and assessment of CSD was performed at the end of a 6 h or 12 h sleep deprivation period. The effect of chronic sleep deprivation on CSD was assessed 6 weeks or 12 weeks after lesioning of the hypothalamic ventrolateral preoptic nucleus. All experiments were done in a blinded fashion with respect to sleep status. During 60 min of continuous topical KCl application, we assessed the total number of CSDs, the direct current shift amplitude and duration of the first CSD, the average and cumulative duration of all CSDs, propagation speed, and electrical CSD threshold., Results: Acute sleep deprivation of 6 h (n = 17) or 12 h (n = 11) duration significantly increased CSD frequency compared to controls (17 ± 4 and 18 ± 2, respectively, vs. 14 ± 2 CSDs/hour in controls; p = 0.003 for both), whereas other electrophysiological properties of CSD were unchanged. Acute total sleep deprivation over 12 h but not over 6 h reduced the electrical threshold of CSD compared to controls (p = 0.037 and p = 0.095, respectively). Chronic partial sleep deprivation in contrast did not affect CSD susceptibility in rats., Conclusions: Acute but not chronic sleep deprivation enhances CSD susceptibility in rodents, possibly underlying its negative impact as a migraine trigger and exacerbating factor. Our findings underscore the importance of CSD as a therapeutic target in migraine and suggest that headache management should identify and treat associated sleep disorders.

Agitation following TBI commonly occurs during the acute recovery phase. The ABS is a valid measure of agitation in adults following TBI. The objective of the study was to determine if ABS scores accurately measure acute agitation in pediatric patients recovering from TBI. The ABS was completed twice daily for 4 days and mean ABS scores were calculated. Physicians assessed patients' agitation daily using a VAS. In addition, interventions for agitation were recorded. The association between ABS and VAS scores was assessed using Spearman's correlation. The relationship between the number of medication classes taken for agitation (0, 1-2, or ≥3) and ABS scores was assessed using one-way analysis of variance. Finally, the association between the use of hand restraints and ABS scores was examined using an unpaired two-sample t -test. Twenty-six pediatric patients with acute TBI were included. ABS scores significantly associated with VAS scores. Patients that required interventions for agitation (hand restraints or ≥3 medication classes) had higher ABS scores than patients that did not receive any intervention. The study supports the use of ABS scoring to measure agitation in pediatric patients with TBI. However, additional studies are warranted to further support the validity of this scale. Abbreviations: TBI: Traumatic brain injury; ABS: Agitated Behaviour Scale; VAS: visual analog scale; PCCU: Pediatric Critical Care Unit.

Objective: Migraine, particularly with aura, is a risk factor for ischemic stroke. Recent data in migraine mutant mice suggest that cerebral hyperexcitability associated with migraine accelerates recruitment of ischemic penumbra into the core, resulting in faster infarct growth compared with wild type. We hypothesized that individuals with a history of migraine are more likely to exhibit increased recruitment of ischemic tissue into the infarct in acute stroke., Methods: In this retrospective case-control study, we identified participants with reliably documented migraine history, measured lesion volumes on diffusion-weighted and perfusion-weighted MRI obtained within 72 hours of symptom onset, calculated the proportion of ischemic tissue on perfusion-weighted imaging (PWI) hyperintense on diffusion-weighted imaging (DWI), and compared the proportion of patients with no-mismatch pattern defined as DWI lesion >83% of PWI lesion., Results: Migraineurs (n = 45) were younger, more often female, less likely to have vascular risk factors, and more often had cervical artery dissection, but otherwise did not differ from controls (n = 27). A significantly larger proportion of migraineurs had no-mismatch pattern, indicating that the entire perfusion defect was recruited into the infarct by the time of MRI (22% vs 4% of migraineurs and controls, respectively; p = 0.044). The difference was even more prominent in migraineurs with aura (36% vs 4%, p = 0.019). The association between migraine and no-mismatch pattern persisted after adjustment for time to MRI (p = 0.041)., Conclusions: This case-control study supports the hypothesis that a history of migraine, particularly with aura, is associated with a no-mismatch pattern during acute ischemic stroke, consistent with data obtained in migraine mutant mice., (© 2015 American Academy of Neurology.)

Background: Centralized and federated models for sharing data in research networks currently exist. To build multivariate data analysis for centralized networks, transfer of patient-level data to a central computation resource is necessary. The authors implemented distributed multivariate models for federated networks in which patient-level data is kept at each site and data exchange policies are managed in a study-centric manner., Objective: The objective was to implement infrastructure that supports the functionality of some existing research networks (e.g., cohort discovery, workflow management, and estimation of multivariate analytic models on centralized data) while adding additional important new features, such as algorithms for distributed iterative multivariate models, a graphical interface for multivariate model specification, synchronous and asynchronous response to network queries, investigator-initiated studies, and study-based control of staff, protocols, and data sharing policies., Materials and Methods: Based on the requirements gathered from statisticians, administrators, and investigators from multiple institutions, the authors developed infrastructure and tools to support multisite comparative effectiveness studies using web services for multivariate statistical estimation in the SCANNER federated network., Results: The authors implemented massively parallel (map-reduce) computation methods and a new policy management system to enable each study initiated by network participants to define the ways in which data may be processed, managed, queried, and shared. The authors illustrated the use of these systems among institutions with highly different policies and operating under different state laws., Discussion and Conclusion: Federated research networks need not limit distributed query functionality to count queries, cohort discovery, or independently estimated analytic models. Multivariate analyses can be efficiently and securely conducted without patient-level data transport, allowing institutions with strict local data storage requirements to participate in sophisticated analyses based on federated research networks., (© The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.)

This article reports findings of a study on self-injury, childhood abuse, and self capacities that supports a theory for understanding and assisting self-injuring individuals in crisis. In the study, 233 adults from partial hospital settings and an outpatient clinic answered questions concerning self-injury, abuse history, and three self capacities (the ability to tolerate strong affect, the ability to maintain a sense of self-worth, and the ability to maintain a sense of connection to others). More than 60% reported childhood abuse. More than half reported self-injury. Individuals with a history of self-injury showed greater impairment of self capacities than individuals who did not report self-injury. Individuals with a history of childhood abuse showed greater impairment than did individuals who did not report childhood abuse. Greatest impairment was associated with both self-injury and abuse. Implications of the results are explored and the theory for assisting self-injuring individuals in crisis is presented.

The transition experience of adolescent patients who transfer from pediatric to adult hemodialysis centres has not received attention in the pediatric nephrology literature. In order for health care professionals from both pediatric and adult hemodialysis centres to positively influence the quality of life during this transition, an understanding of the meanings adolescents attach to their transition experience must be explored. Phenomenology as a research paradigm was employed for this study. Phenomenology provides a method from which to study human experience as it is lived, including the meanings that individuals attach to the experience. This qualitative research study was designed to describe the meanings adolescents attached to their transition experience. Subsequent objectives of the study were: to identify implications for professional practice in both pediatric and adult hemodialysis centres; to positively influence the quality of life for adolescent hemodialysis patients during their transition; and to identify and define potential areas for further research related to the holistic needs of adolescent hemodialysis patients. A sample of three English-speaking adults between the ages of 18 and 22 years who were receiving hemodialysis treatments in an adult centre following transfer from a pediatric centre within one year were interviewed. The tape-recorded interviews were transcribed into verbatim text. In addition, field notes provided investigators with the supplemental information about the meaning and the context of the interview that the audiotape may have missed. The data were analyzed using a step-by-step procedure adapted from Colaizzi (1978). In the final step, the investigators integrated and synthesized the analysis into a descriptive meaning of the transition experience of adolescents who transferred from a pediatric to an adult hemodialysis centre. The findings of the study revealed a major theme of ownership that the adolescents described as being achieved in the adult hemodialysis centre through their increased knowledge of dialysis technology, through being held accountable for their dialysis care and through increased feelings of independence.