Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
3.9
3.3
Journals
Brain Sciences
Special Issues
Health Disparities in Traumatic Brain Injury
share announcement

Health Disparities in Traumatic Brain Injury

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurorehabilitation".

Deadline for manuscript submissions: closed (20 May 2021) | Viewed by 20604

Special Issue Editor

Dr. John K. Yue

E-Mail Website
Guest Editor
Department of Neurosurgery, University of California, San Francisco, CA 94607, USA
Interests: traumatic brain injury; neurosurgery; neurotrauma; biomarkers; spinal cord injury; spine surgery; epidemiology; neuroimaging; outcomes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Traumatic brain injury (TBI) and concussion cause a significant healthcare burden worldwide. Rural and low-resource areas have a diminished capacity to care for TBI/concussion patients given their unique barriers to acute and ambulatory care. Conclusive findings and summative recommendations regarding the evolution of care, as well as gaps in care, in rural settings remain unavailable. This Special Issue welcomes the augmentation of evidence and the promotion of modalities to characterize and reduce the ongoing health disparities in TBI of varying severities, understand differential risk factors, outcomes, and barriers to care across urban, semi-rural, and rural settings, and improve resources, treatment, and outreach to rural and underserved communities. Clinical and translational research and review papers, especially those focused upon novel modalities for evaluating or improving health disparities, are welcome.

Dr. John K. Yue
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • concussion
  • epidemiology
  • health disparity
  • health economics
  • traumatic brain injury
  • rural
  • translational
  • underserved
  • urban

Published Papers (5 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review

9 pages, 513 KiB  
Article
Is the Regular Intake of Anticoagulative Agents an Independent Risk Factor for the Severity of Traumatic Brain Injuries in Geriatric Patients? A Retrospective Analysis of 10,559 Patients from the TraumaRegister DGU®
by Nicolas Eibinger, Sascha Halvachizadeh, Barbara Hallmann, Franz Josef Seibert, Paul Puchwein, Till Berk, Rolf Lefering, Kai Sprengel, Hans Christoph Pape, Kai Oliver Jensen and The TraumaRegister DGU
Brain Sci. 2020, 10(11), 842; https://doi.org/10.3390/brainsci10110842 - 12 Nov 2020
Cited by 5 | Viewed by 1920
Abstract
The purpose of this study was to assess anticoagulant medication as an independent factor influencing the occurrence of a severe traumatic brain injury in geriatric patients. Data were collected from the TraumaRegister DGU® between January 2015 and December 2018. We included patients [...] Read more.
The purpose of this study was to assess anticoagulant medication as an independent factor influencing the occurrence of a severe traumatic brain injury in geriatric patients. Data were collected from the TraumaRegister DGU® between January 2015 and December 2018. We included patients with an age of ≥65 years with a blunt TBI; an AISHead ≥2 but no other relevant injuries. Patients were divided into five subgroups: no anticoagulant medication, anti-platelet drugs, vitamin K antagonists, direct-oral-anticoagulants, and heparinoids. Separation between moderate TBI (AISHead 2–3) and severe TBI (AISHead ≥ 4) and multivariable regression analysis were performed. The average age of 10,559 included patients was 78.8 years with a mean ISS of 16.8 points and a mortality of 22.9%. The most common cause of injury was a low fall of <3 m with 72.8%. With increasing age, the number of patients without any anticoagulant therapy decreased from 65.9% to 29.9%. The intake of coagulation medication increased mortality significantly. Severe TBI was observed in 51% of patients without medication and ranged from 61 to 67% with anticoagulant drugs. After adjusting for confounding variables, the intake of VKA or DOACs was significantly associated with an increased risk of severe TBI. The use of anticoagulant medication is an independent factor and is associated with an increased severity of TBI depending on the type of medication used. Full article
(This article belongs to the Special Issue Health Disparities in Traumatic Brain Injury)
►▼ Show Figures

Figure 1

13 pages, 2656 KiB  
Article
A Novel Clinical Research Modality for Enrolling Diverse Participants Using a Diverse Team
by Phoebe Lay, Tapasvini Paralkar, Syed Hadi Ahmed, Minha Ghani, Sara Muneer, Ramsha Jinnah, Carolyn Chen, Jack Zeitz, Alejandra Nitsch and Nico Osier
Brain Sci. 2020, 10(7), 434; https://doi.org/10.3390/brainsci10070434 - 08 Jul 2020
Cited by 2 | Viewed by 3634
Abstract
The advancement of the pediatric traumatic brain injury (TBI) knowledge base requires biospecimens and data from large samples. This study seeks to describe a novel clinical research modality to establish best practices for enrolling a diverse pediatric TBI population and quantifying key information [...] Read more.
The advancement of the pediatric traumatic brain injury (TBI) knowledge base requires biospecimens and data from large samples. This study seeks to describe a novel clinical research modality to establish best practices for enrolling a diverse pediatric TBI population and quantifying key information on enrollment into biobanks. Screening form responses were standardized and cleaned through Google Sheets. Data were used to analyze total individuals at each enrollment stage. R was utilized for final analysis, including logistic model and proportion statistical tests, to determine further significance and relationships. Issues throughout data cleaning shed light on limitations of the consent modality. The results suggest that through a diverse research team, the recruited sample exceeds traditional measures of representation (e.g., sex, race, ethnicity). Sex demographics of the study are representative of the local population. Screening for candidates is critical to the success of the consent modality. The consent modality may be modified to increase the diversity of the study population and accept bilingual candidates. Researchers must implement best practices, including increasing inclusivity of bilingual populations, utilizing technology, and improving participant follow-up, to improve health disparities for understudied clinical populations. Full article
(This article belongs to the Special Issue Health Disparities in Traumatic Brain Injury)
►▼ Show Figures

Graphical abstract

15 pages, 938 KiB  
Article
Clinical Predictors of 3- and 6-Month Outcome for Mild Traumatic Brain Injury Patients with a Negative Head CT Scan in the Emergency Department: A TRACK-TBI Pilot Study
by Debbie Y. Madhok, John K. Yue, Xiaoying Sun, Catherine G. Suen, Nathan A. Coss, Sonia Jain, Geoffrey T. Manley and the TRACK-TBI Investigators
Brain Sci. 2020, 10(5), 269; https://doi.org/10.3390/brainsci10050269 - 01 May 2020
Cited by 14 | Viewed by 3541
Abstract
A considerable subset of mild traumatic brain injury (mTBI) patients fail to return to baseline functional status at or beyond 3 months postinjury. Identifying at-risk patients for poor outcome in the emergency department (ED) may improve surveillance strategies and referral to care. Subjects [...] Read more.
A considerable subset of mild traumatic brain injury (mTBI) patients fail to return to baseline functional status at or beyond 3 months postinjury. Identifying at-risk patients for poor outcome in the emergency department (ED) may improve surveillance strategies and referral to care. Subjects with mTBI (Glasgow Coma Scale 13–15) and negative ED initial head CT < 24 h of injury, completing 3- or 6-month functional outcome (Glasgow Outcome Scale-Extended; GOSE), were extracted from the prospective, multicenter Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot study. Outcomes were dichotomized to full recovery (GOSE = 8) vs. functional deficits (GOSE < 8). Univariate predictors with p < 0.10 were considered for multivariable regression. Adjusted odds ratios (AOR) were reported for outcome predictors. Significance was assessed at p < 0.05. Subjects who completed GOSE at 3- and 6-month were 211 (GOSE < 8: 60%) and 185 (GOSE < 8: 65%). Risk factors for 6-month GOSE < 8 included less education (AOR = 0.85 per-year increase, 95% CI: (0.74–0.98)), prior psychiatric history (AOR = 3.75 (1.73–8.12)), Asian/minority race (American Indian/Alaskan/Hawaiian/Pacific Islander) (AOR = 23.99 (2.93–196.84)), and Hispanic ethnicity (AOR = 3.48 (1.29–9.37)). Risk factors for 3-month GOSE < 8 were similar with the addition of injury by assault predicting poorer outcome (AOR = 3.53 (1.17–10.63)). In mTBI patients seen in urban trauma center EDs with negative CT, education, injury by assault, Asian/minority race, and prior psychiatric history emerged as risk factors for prolonged disability. Full article
(This article belongs to the Special Issue Health Disparities in Traumatic Brain Injury)
►▼ Show Figures

Figure 1

17 pages, 2150 KiB  
Article
Examining the Effects of Anabolic–Androgenic Steroids on Repetitive Mild Traumatic Brain Injury (RmTBI) Outcomes in Adolescent Rats
by Jason Tabor, David. K. Wright, Jennaya Christensen, Akram Zamani, Reid Collins, Sandy R. Shultz and Richelle Mychasiuk
Brain Sci. 2020, 10(5), 258; https://doi.org/10.3390/brainsci10050258 - 28 Apr 2020
Cited by 3 | Viewed by 4040
Abstract
Background: Repetitive mild traumatic brain injury (RmTBI) is increasingly common in adolescents. Anabolic–androgenic steroid (AAS) consumption among younger professional athletes is a significant risk factor for impaired neurodevelopment. Given the increased rates and overlapping symptomology of RmTBI and AAS use, we sought to [...] Read more.
Background: Repetitive mild traumatic brain injury (RmTBI) is increasingly common in adolescents. Anabolic–androgenic steroid (AAS) consumption among younger professional athletes is a significant risk factor for impaired neurodevelopment. Given the increased rates and overlapping symptomology of RmTBI and AAS use, we sought to investigate the behavioural and neuropathological outcomes associated with the AAS Metandienone (Met) and RmTBI on rats. Methods: Rats received either Met or placebo and were then administered RmTBIs or sham injuries, followed by a behavioural test battery. Post-mortem MRI was conducted to examine markers of brain integrity and qRT-PCR assessed mRNA expression of markers for neurodevelopment, neuroinflammation, stress responses, and repair processes. Results: Although AAS and RmTBI did not produce cumulative deficits, AAS use was associated with detrimental outcomes including changes to depression, aggression, and memory; prefrontal cortex (PFC) atrophy and amygdala (AMYG) enlargement; damaged white matter integrity in the corpus callosum; and altered mRNA expression in the PFC and AMYG. RmTBI affected general activity and contributed to PFC atrophy. Conclusions: Findings corroborate previous results indicating that RmTBI negatively impacts neurodevelopment but also demonstrates that AAS results in significant neuropathological insult to the developing brain. Full article
(This article belongs to the Special Issue Health Disparities in Traumatic Brain Injury)
►▼ Show Figures

Graphical abstract

Review

Jump to: Research

11 pages, 612 KiB  
Review
Pediatric Traumatic Brain Injury in the United States: Rural-Urban Disparities and Considerations
by John K. Yue, Pavan S. Upadhyayula, Lauro N. Avalos and Tene A. Cage
Brain Sci. 2020, 10(3), 135; https://doi.org/10.3390/brainsci10030135 - 28 Feb 2020
Cited by 19 | Viewed by 6480
Abstract
Introduction: Traumatic brain injury (TBI) remains a primary cause of pediatric morbidity. The improved characterization of healthcare disparities for pediatric TBI in United States (U.S.) rural communities is needed to advance care. Methods: The PubMed database was queried using keywords ((“brain/head trauma” OR [...] Read more.
Introduction: Traumatic brain injury (TBI) remains a primary cause of pediatric morbidity. The improved characterization of healthcare disparities for pediatric TBI in United States (U.S.) rural communities is needed to advance care. Methods: The PubMed database was queried using keywords ((“brain/head trauma” OR “brain/head injury”) AND “rural/underserved” AND “pediatric/child”). All qualifying articles focusing on rural pediatric TBI, including the subtopics epidemiology (N = 3), intervention/healthcare cost (N = 6), and prevention (N = 1), were reviewed. Results: Rural pediatric TBIs were more likely to have increased trauma and head injury severity, with higher-velocity mechanisms (e.g., motor vehicle collisions). Rural patients were at risk of delays in care due to protracted transport times, inclement weather, and mis-triage to non-trauma centers. They were also more likely than urban patients to be unnecessarily transferred to another hospital, incurring greater costs. In general, rural centers had decreased access to mental health and/or specialist care, while the average healthcare costs were greater. Prevention efforts, such as mandating bicycle helmet use through education by the police department, showed improved compliance in children aged 5–12 years. Conclusions: U.S. rural pediatric patients are at higher risk of dangerous injury mechanisms, trauma severity, and TBI severity compared to urban. The barriers to care include protracted transport times, transfer to less-resourced centers, increased healthcare costs, missing data, and decreased access to mental health and/or specialty care during hospitalization and follow-up. Preventative efforts can be successful and will require an improved multidisciplinary awareness and education. Full article
(This article belongs to the Special Issue Health Disparities in Traumatic Brain Injury)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-5
Back to TopTop