Funded Injury Control Research Centers (ICRCs)

Project Title: Improving the Diagnosis and Prognosis of Inflicted Head Trauma in Infants
Grant Number: 5-R49-CE323155
Project Period: 09/01/03-08/31/08
Description: A case-control study is proposed to evaluate the utility of novel biochemical markers in the serum of infants at risk for inflicted traumatic brain injury (iTBI). Preliminary data in children show that serum levels of neuron specific enolase (NSE), S100B (an astrocyte marker), and myelin basic protein (MBP), are sensitive indicators of both non-inflicted TBI (nTBI) and iTBI - even in the setting of mild injury. The specific aim is to determine the predictive values of serum levels of NSE for detecting brain injury in children at increased risk of iTBI, and determine whether the use of a panel of three biochemical markers further improves diagnostic accuracy. Serum NSE, S100B and/or MBP levels will be measured in 500 children <1-year of age at increased risk for iTBI. The levels will be compared to those in controls without TBI. History, physical examination, marker levels and an assessment of outcome over a 3-year period, will be used to categorize infants into three groups: iTBI, no iTBI, and indeterminate. The sensitivity, specificity, and negative and positive predictive values will be calculated based on infants in the iTBI and nTBI categories.

Project Title: The Impact of Neuroendocrine Hormones on Pathophysiology & Outcomes After TBI
Grant Number: 5-R49-CE323155
Project Period: 09/01/03-08/31/08
Description: The primary goals are to: 1) characterize peri-injury gonadal hormone production after TBI; 2) to evaluate the relationship between peri-injury gonadal hormone production and cerebrospinal fluid markers of TBI pathophysiology; and 3) evaluate the relationship between peri-injury hormone production, chronic alterations in hormonal status, and long-term outcome. The long-term goal is to understand how gonadal hormones affect mechanisms of injury, recovery, and efficacy with therapeutic interventions after TBI.

Project Title: Managing Return-to-Play Decision Following Mild Traumatic Brain Injury
Grant Number: 5-R49-CE323155
Project Period: 09/01/03-08/31/08
Description: The aim is to estimate the incidence of mild traumatic brain injury (mTBI) and to develop guidelines for managing return-to-play decisions following mTBI during sport. The study will recruit males ages 14 years and over who play high school or community level (non-elite) Australian football. The players (n=2245) will be recruited over a 3-year period and followed for one football season with the outcome of interest being mTBI as defined by the American Congress of Rehabilitation. Demographic information and recent past history of head injury, information on potential risk factors and a baseline neuropsychological test (ImPACT©), will be collected. Post-injury cognitive functioning will also be assessed using ImPACT©. Based on the findings from the cohort study and following an extensive review of existing state, national and international guidelines and policies, new guidelines for returning players to the game following mTBI will be developed.

Project Title: The Impact of Pregnancy-Associated Crashes on Birth Outcomes and Infant Survival
Grant Number: 5-R49-CE323155
Project Period: 09/01/03-08/31/07
Description: The study will utilize modem data linkage methods to identify ~14,000 female drivers in Pennsylvania who were pregnant at the time of a police-reported motor-vehicle crash, for the years 2001-2004. Pregnancy status will be determined by examining the crash date in relation to the gestational age of fetal deaths or infant births. Crash factors, including crash severity and crash geometries, will be derived from the police report. Information regarding the types and severity of maternal injury will be identified from linked police, EMS and hospital data. Infant birth and fetal death certificates will provide information on adverse reproductive outcomes and those will be correlated with crash and injury factors as predictors. Associations will be examined between crash severity and environmental factors, maternal injury factors, and the risk of adverse birth outcomes while controlling for known confounders such as mothers age, parity, smoking, and alcohol use. The project will also conduct a pilot study looking at the feasibility of a follow-up study among the exposed offspring at 4-5 years of age to lay the groundwork for future studies assessing longer-term functional impairments and disabilities.

Project Title: Infant Head Injury Risk in Falls Using Experimental and Computational Models
Grant Number: 5-R49-CE323155
Project Period: 09/01/03-08/31/06
Description: Background: In children 1 year and younger, with the exception of motor vehicle crashes, serious head injury is more likely to be a result of abuse than unintentional injury.
Specific Aim: Develop and experimentally validate computer simulation models to investigate head injury risk associated with common pediatric falls in 1-year old children.
Methods: To meet the specific aim, computer simulation modeling techniques will be utilized along with falls experiments using an anthropomorphic dummy (ATD) to validate simulation models. To validate computer simulation models, a 1-year old CRABI instrumented ATD will be used to experimentally recreate fall scenarios. Both free falls and side lying falls from horizontal surfaces (i.e., falls from beds, change tables, etc) from varying heights will be studied. Both the experimental and simulation methods will be used to study the influence of various environment parameters on pediatric head injury risk in common falls. Summary of Outcome: The goal is to obtain a more objective understanding of head injury risk associated with common pediatric falls in 1-year-olds.