Researchers at the University of Tennessee Chattanooga have developed a platform that measures an athlete’s risk of injury using the Internet of Things (IoT).
The new system could allow athletes at every level, from superstar to hopeful, to create a personal injury risk profile, and manage it from their own smartphones.
Professional athletes live with the knowledge that a serious injury could occur at any moment. Beyond the physical repercussions, these apparent twists of fate can damage successful careers, affect team members or clubs, and have a lasting impact economically and psychologically.
Part of the solution to the ever-present threat of injuries lies in no longer treating them as bad luck, claim researchers. Instead, athletes and their trainers or managers can use new technology to help predict when they might occur.
Their research is set out in Mitigating sports injury risks using Internet of Things and analytic approaches, a paper published in the journal Risk Analysis. It explains how screening procedures can help predict the likelihood of an injury using wireless devices and cloud analytics.
Sports injury management, even at a professional level, will always rely on some form of subjective assessment. That might come from the athlete in question, who’s determined to run or play in the next game, despite the pain. Or it might come from a doctor who has to interpret that information and make a split-second decision, while facing commercial or personal pressures.
However, the University of Tennessee Chattanooga researchers have done their best to remove this element from the screening process – or at least to provide as much objective data as possible to minimise the risk.
This greater objectivity is added by combining the athlete’s previous injury history with the results of a number of standardised screening tests. The result is a real-time dashboard providing details of each individual athlete’s status.
The research project was developed in real-world conditions with a team of American footballers.
A month before the players got together for preseason training, information on their previous injuries was collected using a Sport Fitness Index (SFI) survey. Each player then took a Unilateral Forefoot Squat (UFS) test, which assessed their ability to synchronise muscle responses in their legs while holding an upright position.
The researchers used accelerometers built into their smartphones to measure the results. The collected data was then integrated with the athletes’ self-reports of previous injuries and with longitudinal tracking of exposure to game conditions.
In their analysis of the data, the researchers found the ‘red zone’: athletes who played at least eight games were over three times more likely to suffer an injury than those who played fewer than eight games. Of those athletes who exhibited at least one risk factor, 42 percent then sustained an injury.
“Assigning all athletes to a single type of training program, without consideration of an individual’s unique risk profile, may fail to produce a substantial decrease in injury likelihood,” wrote Gary Wilkerson, lead author of the study.
“The results also provide a useful estimation of the odds of injury occurrence for each athlete during the subsequent season.”
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Moving forward, Wilkerson and his team predict that the prevalence of smartphones and other IoT devices will help to make these and similar screening tests more accessible to athletes at all levels.
Anybody participating in sport could then put all of their data together to identify their own personalised injury risk. A truly smart solution to a painful – and often costly – problem.
After Cupertino building official Albert Salvador visited Apple Park last year, he was concerned about employees running into the glass walls that were placed all around the campus as the cafeteria’s doors were indistinguishable from the glass walls, as we reported last month.
Researchers from the University of Bristol have just shared the promising results of a new treatment for spinal cord injuries that could help regenerate nerves and potentially improve patients’ quality of life.
The new therapy involves the transplantation of cells that have been modified to secrete a molecule that helps to remove scarring caused by spinal cord damage. This scarring can limit the regrowth of nerves, thus greatly hindering a patient’s potential for recovery.
Previous studies have shown that the enzyme chondroitinase ABC (ChABC) is effective at promoting nerve regrowth when used as a part of drug therapies for spinal injuries. Unfortunately, the enzyme does not have a long life once injected. That means patients must be subjected to repeated treatments for the enzyme to be effective.
Olfactory ensheathing cells have the ability to regenerate and repair themselves over the course of a person’s life in order to maintain the sense of smell. That ability makes these cells ideal for genetic modification when the goal is prolonging a molecule’s lifespan.
This new treatment from the University of Bristol team utilizes this ability of the olfactory cells to prolong the secretion of ChABC for the treatment of spinal cord injuries.
For their study, which has been published in PLOS ONE, the researchers injected mice with canine olfactory ensheathing cells that had been genetically modified to secrete ChABC. After transplantation, they observed the successful secretion of ChABC as well as the removal of some scarring. They also noted signs of successful nerve regeneration.
It is an important proof-of-concept for this revolutionary treatment method, but more testing is needed to determine effectiveness.
“While these initial results look promising, in order to determine the longer-term survival of our genetically modified cells and assess functional recovery, such as recovery of walking or recovery of continence, we need to carry out further studies to test these cell transplants in more chronic injury models,” Liang-Fong Wong, Senior Lecturer at Bristol Medical School and part of the study’s team, said in a news release.
If future tests in mice go as hoped, the treatment can then be adapted for other animals and, eventually, humans.
An increasing number of potential treatments to help restore lost functionality after a spinal cord injury are in the works, and while many of these solutions hold great promise, more testing is needed to prove their efficacy and safety.
Still, scientific innovation in fields such as neuroscience, medicine, and even robotics is giving victims of spinal cord injuries renewed hope of recovery.
Researchers out of the University of Louisville’s Kentucky Spinal Cord Injury Research Center (KSCIRC) have recently restored voluntary movement in a 28-year-old patient who suffered a spinal cord injury from a motorcycle accident. His treatment combined new technology with established science — electric stimulation through an implant on the spine and traditional rehabilitation techniques — to deliver potentially life-changing results.
Meanwhile, a promising therapy from Rush University Medical Center was able to restore motor function in four out of six paralyzed patients. That cell therapy builds on decades of stem cell research, a promising area of study for spinal injury treatments.
Studies like these can be a great source of hope for both those living with spinal injuries and their loved ones. While it may be quite a long time before these treatments are proven to live up to their lofty promise, the goal of ending the ability of a single devastating moment to put mobility in a stranglehold is a fierce motivator.
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Scientists in Sweden and the U.K. developed a surgical technique to reconnect the spinal cord with sensory neurons after traumatic spinal injuries. Now, by recreating the technique in rats, they have new insights into the cellular processes implicated in the technique. This new knowledge has the potential to assist the development of novel therapies for other spinal cord injuries — even those in which the spinal cord is severed.
The spine is the point of connection between the brain, sensory neurons (which transmit sensory information such as temperature, pain, and touch), and motor neurons (which control the muscles). At junction point between the spinal cord and both types of neurons, bundles of motor neurons form “motor roots” connecting with the cord, and sensory neurons create similar bundles called “sensory roots.” Traumatic injuries, including severed spinal cords, can tear both motor and sensory roots — when they do, the brain loses control of the connected neurons.
To date, it has been relatively simple for surgeons to implant new motor roots where they were torn, prompting them to reconnect, usually successfully. However, this kind of repair for sensory roots has been more problematic — that is, until this recently developed procedure, in which the original sensory nerve cells are cut and removed from the root and the remaining root itself is placed directly into the spinal cord in a deeper structure.
This area, called the dorsal horn, contains secondary sensory neurons that typically don’t connect directly to sensory roots. However, the technique achieved the return of some spinal reflexes in patients, proving that the implanted neuron did form a functional neural circuit with the spine after all.
New Hope For Spinal Injuries
In a more recent study published in Frontiers in Neurology, some of the same collaborators began working with rodents to try to understand how and why the new procedure worked. The team was able to study the technique and its mechanisms at the cellular level using a rat model of spinal injury.
After severing the spinal cords of the rats surgically, the researchers used the new technique to reattach the sensory roots. Between 12 to 16 weeks after surgery, the researchers tested the neurons with electricity to assess whether they formed a complete neural circuit. They also analyzed the rats’ neural tissue microscopically.
The electrical tests were positive, revealing a complete neural circuit and an integrated root. The microscopic analysis of the dorsal horn showed that small neural offshoots sprouted from the dendrites at the end of neurons inside the dorsal horn and spread into the implanted sensory root, resulting in a complete, functional neural circuit.
If the technique is working in the same way for humans as it did in the rats, the researchers are hopeful that encouraging new growth from spinal neurons might hold promise for repairing other kinds of nervous system and spinal cord injuries, including cases of severed spinal cords — without having to use any “secret glue.”
Nothing is as certain as death. Yet humans have come up with ways to push it further and further. The heart stops beating? Do CPR. The lungs fail? Use a mechanical ventilator. These techniques have saved the lives of millions. There is a point of no return, however: when the brain dies.
One company, Philadelphia-based Bioquark Inc., thinks it may be possible to push back on even that last step. Bioquark plans to launch a study to use stem cells and a slew of other therapies to bring a glimmer of life back to the dead brains of newly deceased patients.
The idea led to hundreds of chilling headlines and has met serious backlash from scientists and ethicists alike. While Bioquark’s proposed study may trigger ethical and practical concerns, experts do say advances in stem cell research and medical technologies mean someday brain injury could be reversible. Maybe (and that’s a big maybe) brain death won’t be the end of life.
“I agree stem cell technology in the neurosciences has tremendous potential, but we have to study it in a way that makes sense,” said Dr. Diana Greene-Chandos, assistant professor of neurosurgery and neurology at Ohio State University Wexner Medical Center. What doesn’t make sense, she says, is to apply stem cell research in complex human brains — very damaged ones — before animal studies have gotten far enough.
That’s why Bioquark’s proposed study, slated to take place in South America sometime this year, has caused such uproar in the science community. The team plans to administer therapies to 20 brain-dead subjects with the hope of stirring up electrical activity in the brain. The idea is to deliver stem cells to the brain and coax them to grow into new brain cells, or neurons, with the help of a nurturing peptide cocktail, electrical nerve stimulation, and laser therapy.
“We are employing this [combined] approach, using tools that by themselves have been employed extensively, but never in such an integrated process,” said Bioquark CEO Ira Pastor.
One critique is that such a study could give false hope to families who may have a poor understanding of the severity and irreversibility of brain death, and confuse it with coma or vegetative state. “There are a lot of gray areas in medicine. And we should all keep an open mind. But we need to make sure we are not misguiding our patients,” said Dr. Neha Dangayach, attending physician in the neurosurgical intensive care Unit at New York’s Mount Sinai Hospital.
Pastor’s response to the criticism? The public is catching up to the idea of brain death. He’s also clarified that full resurrection is not the company’s intended goal — at least not yet. “We are not claiming the ability to erase death. We are working on a very small window, a gray zone between reversible coma and death,” he said.
Ethics aside, critics say there are practical problems with the plan. There is insufficient evidence behind Bioquark’s approach, they argue, and the way the study is planned does not sound realistic.
When the brain dies, inflammation and swelling run amok, the connections between neurons disintegrate, arteries collapse, and blood flow shuts down. “Once someone is brain-dead, you can keep them on the ventilator but it’s very hard to keep the organs from shutting down and the heart beating for more than a few days,” said neurologist Richard Senelick. “Nature is going to run its course.”
So, many scientists say Bioquark’s study may be a quixotic quest — on par with cryogenic brain preservation and head transplants. They may sound good in theory but are so impractical that they have little chance of success. Nevertheless, experts agree the quest does raise serious questions that deserve answers. Just what would it take to save a brain? Perhaps resurrecting dead brains is not in the realm of possibility…but what is?
Brain Death and the Cell ‘Suicide Switch’
There is an immense reward in pursuing brain regeneration. If it pans out, it could potentially save the lives of those who are injured in an accident or, more commonly, suffer extreme brain damage following a cardiac arrest or stroke. Every year in the United States, about 350,000 people experience an out-of-hospital cardiac arrest, according to the American Heart Association. Only about 10 percent survive with good neurologic function. Another 130,000 people die of stroke annually.
To appreciate the challenge of saving the brain, first look at what it takes to kill it. It was long thought that death occurs when the heart stops. Now we know that death actually happens in the brain—and not in one single moment, but several steps. A patient lying in a coma in an intensive care unit may appear peaceful, but findings from biochemical studies paint a much different scene in his brain: fireworks at the cellular level.
When neurons encounter a traumatic event, like lack of blood flow after cardiac arrest, they go into a frenzy. Some cells die during the initial blackout. Others struggle to survive in the complex cascade of secondary injury mechanisms, triggered by the stress of being deprived of oxygen. Neurotransmitters spill out of neurons in high concentrations. Free radicals pile up, burning holes in brain cell membranes. The pierced cells respond to the attack by producing more inflammation, damaging other cells.
Eventually, the stress response triggers apoptosis, or the process of programmed cell death. In other words, the cell’s “suicide switch” gets turned on. The cells die one by one until the brain ceases to function.
That’s brain death: the complete and irreversible loss of function of the brain. Doctors determine brain death by checking whether the patient’s pupils react to light, whether he responds to pain, and if his body tries to breathe or has retained any other vital function of the brainstem, the part most resilient to injury.
“We have strict tests, because it’s a very serious question—the question of distinguishing life from death,” Dangayach said.
For brain damage at a much smaller scale, however, the situation could be manageable. Cutting-edge therapies are focused on this possibility.
More Neurons in a Pill?
Stem cells have brought an exciting potential opportunity to the grim area of treating brain injury. Currently, there’s no FDA-approved stem cell-based therapy for brain problems, and experts suggest staying away from any clinic that offers such therapies. But that doesn’t stop researchers from being excited about the possibilities. Unlike in other parts of the body, cells lost in the brain are gone forever. Could stem cells replace them?
“That’s a reasonable thing to ask,” neurologist Dr. Ariane Lewis of New York University said. Lewis is a strong critic of Bioquark’s approach, saying that the study “borders on quackery,” but she thinks stem cell research is promising for stroke recovery. “We have little evidence right now, and this is not a commonly employed therapy, but it’s a research question.”
Two regions in the adult brain contain stem cells that can give rise to new neurons, suggesting the brain has a built-in capacity to repair itself. Some of these cells can migrate long distances and reach the injury site.
In some injuries, the brain produces biological factors that stimulate stem cells. Researchers are working to identify those factors — with the aim of someday translating the findings into new drugs to boost a patient’s own stem cells.
“If we can identify factors that stimulate these cells we could directly repair [the brain],” said Dr. Steven Kernie, chief of pediatric critical care medicine at New York Presbyterian Hospital, who is working on this research.
Other teams have been working on turning different types of brain cells into neurons. A team at Penn State University developed a cocktail of molecules that can convert glial cells, a type of brain cell, into functioning neurons in mice. The cocktail of molecules could be packaged into drug pills, the researchers said, perhaps one day taken by patients to regenerate neurons.
Another option: transplant new neurons into the brain. In a 2016 study, scientists successfully transplanted young neurons into damaged brains of mice. A real-life injury in the human brain is a much messier situation than a clear-cut lesion made in the lab. But eventually, such advances may translate into techniques to repair stroke damage.
For diseases like Parkinson’s, in which a particular population of neurons is lost—as opposed to widespread indiscriminate damage — there have been several clinical trials with many more slated. Scientists in Australia are using brain cells of pigs as a substitute for lost neurons. Later this year, a Chinese clinical trial will implant young neurons derived from human embryonic stem cells into brains of Parkinson’s patients. And five more groups are planning similar trials over the next two years, Nature reported.
Approaches taken in Parkinson’s trials may be the most biologically plausible, Kernie said. If these trials are successful, they may pave the way for more widespread application of stem cells for treating brain diseases. “It’s not proven yet that it will work, but it’s something that’s on the horizon.”
“These Scientists Have a Plan To Cheat Death. Will It Work?” was originally published by NBC Universal Media, LLC on June 29, 2017 by Bahar Gholipour. Copyright 2017 NBC Universal Media, LLC. All rights reserved.