This article summarizes the selection of outcome measures by the interagency Traumatic Brain Injury (TBI) Outcomes Workgroup to address primary clinical research objectives, including documentation ...of the natural course of recovery from TBI, prediction of later outcome, measurement of treatment effects, and comparison of outcomes across studies. Consistent with other Common Data Elements Workgroups, the TBI Outcomes Workgroup adopted the standard 3-tier system in its selection of measures. In the first tier, core measures included valid, robust, and widely applicable outcome measures with proven utility in TBI from each identified domain, including global level of function, neuropsychological impairment, psychological status, TBI-related symptoms, executive functions, cognitive and physical activity limitations, social role participation, and perceived health-related quality of life. In the second tier, supplemental measures were recommended for consideration in TBI research focusing on specific topics or populations. In the third tier, emerging measures included important instruments currently under development, in the process of validation, or nearing the point of published findings that have significant potential to be superior to some older ("legacy") measures in the core and supplemental lists and may eventually replace them as evidence for their utility emerges.
Infants are endowed with a proclivity to acquire language, whether it is presented in the auditory or visual modality. Moreover, in the first months of life, listening to language supports ...fundamental cognitive capacities, including infants’ facility to form object categories (e.g., dogs and bottles). Recently, we have found that for English-acquiring infants as young as 4 months of age, this precocious interface between language and cognition is sufficiently broad to include not only their native spoken language (English), but also sign language (American Sign Language, ASL). In the current study, we take this work one step further, asking how “sign-naïve” infants—hearing infants with no prior exposure to sign language—deploy their attentional and social strategies in the context of episodes involving either spoken or sign language. We adopted a now-standard categorization task, presenting 4- to 6-month-old infants with a series of exemplars from a single category (e.g., dinosaurs). Each exemplar was introduced by a woman who appeared on the screen together with the object. What varied across conditions was whether this woman introduced the exemplar by speaking (English) or signing (ASL). We coded infants’ visual attentional strategies and their spontaneous vocalizations during this task. Infants’ division of attention and visual switches between the woman and exemplar varied as a function of language modality. In contrast, infants’ spontaneous vocalizations revealed similar patterns across languages. These results, which advance our understanding of how infants allocate attentional resources and engage with communicative partners across distinct modalities, have implications for specifying our theories of language acquisition.
Given widespread use of spike antibody in generating coronavirus disease vaccines, SARS-CoV-2 nucleocapsid antibodies are increasingly used to indicate previous infection in serologic surveys. ...However, longitudinal kinetics and seroreversion are poorly defined. We found substantial seroreversion of nucleocapsid total immunoglobulin, underscoring the need to account for seroreversion in seroepidemiologic studies.
To examine minor as well as major depression at 1 year posttraumatic brain injury (TBI), with particular attention to the contribution of depression severity to levels of societal participation.
...Observational prospective study with a 2-wave longitudinal component.
Inpatient rehabilitation centers, with 1-year follow up conducted primarily by telephone.
Persons with TBI (N=1570) enrolled in the TBI Model System database and followed up at 1-year postinjury.
Not applicable.
FIM, Patient Health Questionnaire-9, Participation Assessment with Recombined Tools-Objective, Glasgow Outcome Scale-Extended, and the Satisfaction With Life Scale.
Twenty-two percent of the sample reported minor depression, and 26% reported major depression at 1-year post-TBI. Both levels of depression were associated with sex (women), age (younger), preinjury mental health treatment and substance abuse, and cause of injury (intentional). There was a monotonic dose-response relationship between severity of depression and all 1-year outcomes studied, including level of cognitive and physical disability, global outcome, and satisfaction with life. With other predictors controlled, depression severity remained significantly associated with the level of societal participation at 1-year post-TBI.
Minor depression may be as common as major depression after TBI and should be taken seriously for its association to negative outcomes related to participation and quality of life. Findings suggest that, as in other populations, minor and major depression are not separate entities, but exist on a continuum. Further research should determine whether people with TBI traverse between the 2 diagnoses as in other patient groups.
Introduction Hand gestures and actions-with-objects (hereafter ‘actions’) are both forms of movement that can promote learning. However, the two have unique affordances, which means that they have ...the potential to promote learning in different ways. Here we compare how children learn, and importantly retain, information after performing gestures, actions, or a combination of the two during instruction about mathematical equivalence. We also ask whether individual differences in children’s understanding of mathematical equivalence (as assessed by spontaneous gesture before instruction) impacts the effects of gesture- and action-based instruction. Method Across two studies, racially and ethnically diverse third and fourth-grade students (N=142) were given instruction about how to solve mathematical equivalence problems (eg., 2+9+4=__+4) as part of a pretest-training-posttest design. In Study 1, instruction involved teaching students to produce either actions or gestures. In Study 2, instruction involved teaching students to produce either actions followed by gestures or gestures followed by actions. Across both studies, speech and gesture produced during pretest explanations were coded and analyzed to measure individual differences in pretest understanding. Children completed written posttests immediately after instruction, as well as the following day, and four weeks later, to assess learning, generalization and retention. Results In Study 1 we find that, regardless of individual differences in pre-test understanding of mathematical equivalence, children learn from both action and gesture, but gesture-based instruction promotes retention better than action-based instruction. In Study 2 we find an influence of individual differences: children who produced relatively few types of problem-solving strategies (as assessed by their pre-test gestures and speech) perform better when they receive action training before gesture training than when they receive gesture training first. In contrast, children who expressed many types of strategies, and thus had a more complex understanding of mathematical equivalence prior to instruction, performed equally with both orders. Discussion These results demonstrate that action training, followed by gesture, can be a useful stepping-stone in the initial stages of learning mathematical equivalence, and that gesture training can help learners retain what they learn.
To characterize employment stability and identify predictive factors of employment stability in working-age individuals after moderate-to-severe traumatic brain injury (TBI) that may be clinically ...addressed.
Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI.
Inpatient rehabilitation centers with telephone follow-up.
Individuals enrolled in the TBIMS-NDB since 2001, aged 18-59, with employment data at 2 or more follow-up interviews at years 1, 2, and 5 (N=5683).
Not applicable.
Employment stability, categorized using post-TBI employment data as no paid employment (53.25%), stably (27.20%), delayed (10.24%), or unstably (9.31%) employed.
Multinomial regression analyses identified predictive factors of employment stability, including younger age, white race, less severe injuries, preinjury employment, higher annual earnings, male sex, higher education, transportation independence postinjury, and no anxiety or depression at 1 year post-TBI.
Employment stability serves as an important measure of productivity post-TBI. Psychosocial, clinical, environmental, and demographic factors predict employment stability post-TBI. Notable predictors include transportation independence as well as the presence of anxiety and depression at year 1 post-TBI as potentially modifiable intervention targets.
Summary
Acquired haemophilia A (AHA) is a rare bleeding disorder caused by autoantibodies against human factor VIII (hFVIII). OBI‐1 is an investigational, B‐domain deleted, recombinant FVIII, porcine ...sequence, with low cross‐reactivity to anti‐hFVIII antibodies. Efficacy can be monitored with FVIII activity levels in addition to clinical assessments. This prospective, open label, phase 2/3 study was designed to evaluate the efficacy of OBI‐1 treatment for bleeding episodes in subjects with AHA. After an initial dose of 200 U kg−1, OBI‐1 was titrated to maintain target FVIII activity levels, in correlation with clinical assessments, throughout the treatment phase. All 28 subjects with AHA had a positive response to OBI‐1 treatment 24 h after initiation despite inhibition of FVIII activity levels immediately after infusion in 10 subjects with baseline anti‐porcine FVIII inhibitors. Control of the qualifying bleed was ultimately achieved in 24 of 28 subjects. No related serious adverse events, thrombotic events, allergic reactions or thrombocytopaenia occurred. The results of this study indicate that OBI‐1 is safe and effective in treating bleeding episodes in subjects with AHA. The ability to safely and effectively titrate dosing based on FVIII activity levels in this study demonstrates that OBI‐1 fulfils the unmet medical need to monitor the key coagulation parameter in AHA patients.
A great deal of attention has recently been paid to gesture and its effects on thinking and learning. It is well established that the hand movements that accompany speech are an integral part of ...communication, ubiquitous across cultures, and a unique feature of human behavior. In an attempt to understand this intriguing phenomenon, researchers have focused on pinpointing the
mechanisms
that underlie gesture production. One proposal––that gesture arises from simulated action (Hostetter & Alibali
Psychonomic Bulletin & Review
,
15
, 495–514,
2008
)––has opened up discussions about action, gesture, and the relation between the two. However, there is another side to understanding a phenomenon and that is to understand its
function
. A phenomenon’s function is its
purpose
rather than its
precipitating cause
––the
why
rather than the
how
. This paper sets forth a theoretical framework for exploring why gesture serves the functions that it does, and reviews where the current literature fits, and fails to fit, this proposal. Our framework proposes that whether or not gesture is simulated action in terms of its mechanism––it is clearly
not
reducible to action in terms of its function. Most notably, because gestures are abstracted representations and are not actions tied to particular events and objects, they can play a powerful role in thinking and learning beyond the particular, specifically, in supporting generalization and transfer of knowledge.
Examine considerations and perceived barriers to return to driving, and their association with psychosocial outcomes among adults with traumatic brain injury (TBI) who were not driving.
174 adults ...with moderate-to-severe TBI enrolled in the TBI Model System participated in this cross-sectional study. All participants were drivers prior to their TBI. Outcome measures included the Barriers to Driving Questionnaire, Disability Rating Scale, Patient Health Questionnaire-9, General Anxiety Disorder-7, and Satisfaction With Life Scale. Descriptive analyses examined considerations and barriers to driving, including differences associated with demographic characteristics. Moderation analyses investigated the extent to which disability moderated the relationship between barriers and psychosocial outcomes.
Social barriers were the most strongly endorsed domain, whereas physical barriers were endorsed least. The profile of endorsements differed for men and women, and for Black and White participants, on both theoretical considerations in returning to drive and experiences of barriers in doing so. Disability level moderated the relationship between barriers to driving and depression and life satisfaction, but not anxiety.
The experience of barriers to driving is differentially associated with psychosocial outcomes among nondriving adults with TBI. Adults with low disability appear to be at risk for distress, even compared to other nondrivers.
An Ancient Evolutionary Origin of the Rag1/2 Gene Locus Fugmann, Sebastian D.; Messier, Cynthia; Novack, Laura A. ...
Proceedings of the National Academy of Sciences - PNAS,
03/2006, Letnik:
103, Številka:
10
Journal Article
Recenzirano
Odprti dostop
The diversity of antigen receptors in the adaptive immune system of jawed vertebrates is generated by a unique process of somatic gene rearrangement known as V(D)J recombination. The Rag1 and Rag2 ...proteins are the key mediators of this process. They are encoded by a compact gene cluster that has exclusively been identified in animal species displaying V(D)J-mediated immunity, and no homologous gene pair has been identified in other organisms. This distinctly restricted phylogenetic distribution has led to the hypothesis that one or both of the Rag genes were coopted after horizontal gene transfer and assembled into a Rag1/2 gene cluster in a common jawed vertebrate ancestor. Here, we identify and characterize a closely linked pair of genes, SpRaglL and SpRag2L, from an invertebrate, the purple sea urchin (Strongylocentrotus purpuratus) with similarity in both sequence and genomic organization to the vertebrate Rag I and Rag2 genes. They are coexpressed during development and in adult tissues, and recombinant versions of the proteins form a stable complex with each other as well as with Rag1 and Rag2 proteins from several vertebrate species. We thus conclude that SpRaglL and SpRag2L represent homologs of vertebrate Ragi and Rag2. In combination with the apparent absence of V(D)J recombination in echinoderms, this finding strongly suggests that linked Rag1-and Rag2-like genes were already present and functioning in a different capacity in the common ancestor of living deuterostomes, and that their specific role in the adaptive immune system was acquired much later in an early jawed vertebrate.
PDF
