Assessment of Hamstring injury among rugby players, Diagnosis, and Return to play formula for a low-grade soft tissue
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The Outcomes of Neural Stem Cell Transplantation and Localized Drug Therapy on Patients
Suffering from Traumatic Brain Injury
John Doe
Panther ID: 1212121
Assignment #3
Florida International University
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Method
Traumatic Brain Injury (TBI) is a resonating issue here in the U.S. and it comes as no
surprise that it has increased in awareness as one of the nation’s most prevalent injury related
deaths within the last 15 years (American Speech-Language-Hearing Association [ASHA],
2009). It is an illness of great importance due to its association of injuries related to military
combat operations, both the Department of Defense (DoD) and Veteran Affairs (VA) are
recognized leaders in TBI care and are in constant joint health practices with research based
universities such as The University of Miami Miller School of Medicine and The University of
Michigan Health System [UMHS] (Dennis, 2013). My methods paper will incorporate a holistic
overview of the overall effectiveness of Neural Stem Cell (NSC) engraftment on TBI patients
based on publications reported within scholarly journals. The overall efficacy of treatment will
be compared to many control groups that serve as a basis to see if NSC outcomes lessen or
diminish possible injuries, as a disclaimer, findings within TBI based research do not support nor
condone that there is a cure to secondary injuries such as comas, neuronal cell death, loss of
motor or cognitive function, paralysis, or even death due to TBI. Simply put, this research paper
will look at collaborative efforts that a controlled laboratory setting has made in regards to
ameliorating TBI conditions in either acute or severe injuries and review the success of treatment
in the hopes that it can serve patients and their respective loved ones in finding more adequate
treatment platforms that can efficiently save lives in the long run.
Research Method & Design Appropriateness
According to Martyn Shuttleworth (2008), the top three most widely used research
methods are Experimental Research Methods, Opinion Based Research Methods, and
Observational Research Methods. There are a myriad of factors to take into account and evaluate
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when choosing the correct research method. Every experimental design must make compromises
and generalizations, so each individual researcher must minimize these, but, also do it while
being realistic (Shuttleworth, 2008).
Experimental Research Methods is a more straightforward experiment that involves the
standard practice of manipulating quantitative data and independent variables to generate
statistically analyzable data. The results generated can be quantified using a testable hypothesis,
with statistical information giving a clear and unambiguous picture (Shuttleworth, 2008).
Opinion Based Research Methods generally involve designing an experiment and collecting
numerical data that that can be represented via ordinal or interval types of measurements.
Questionnaires fall within this type of experimental method, since it is an effective way to
quantify data through a small sample survey and can provide a scale of opinion to emotion.
“Figures are arbitrary, but at least give a directional method of measuring intensity”
(Shuttleworth, 2008). Based on reports gathered by Shuttleworth (2008), Observational
Research Methods mostly involve researchers detaching themselves from the experiment and
simply witnessing the phenomenon they are most interested in. It’s characterized as a “quasi-
experimental” design and is primarily looked down upon in the scientific community. It oftenly
does not look to have a clearly defined research problem and questions may arise during the case
study, but, according to social scientists it does still provide insightful human knowledge when
applied to behavioral outcomes.
Quantitative research measurements encompass scientific data being strictly inputted into
statistical and other mathematical markers and definitions so as to finalize results via disproving
or proving a hypothesis. After statistical analysis of the data is done, a comprehensive answer
can be reached and the results can be legitimately discussed and published. Qualitative research
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is a fundamental tool that can be used by scientists and social scientists alike as a precursor to
quantitative research. It seeks to answer human behavior and tendencies that can then lead to a
testable hypothesis, since its techniques are extremely useful when a subject is too complex to be
answered by a simple yes or no hypothesis (Shuttleworth, 2008).
For the specifics of my research proposal, as discussed earlier, I will be analyzing
literature content on treatment viability of NSC in those who are afflicted with TBI. Most of the
data collected by lead investigators in the fields of Neuroscience, Emergency Medicine,
Neurosurgery and Neuro-trauma are obtained through quantifiable means. So for the sake of my
literature review, I will be surveying and scrutinizing quantifiable numerical data that
demonstrates a positive progression for affected TBI patients within the lab setting.
Population
Each year TBI contributes to a substantial number of deaths and cases that attribute to
permanent disability within the continental U.S. Within my study, because data is so crucial to
understanding the overall implications of this debilitating condition, attenuating impacts of TBI
can only be lessened with numbers that demonstrate the positive progression of feasible NSC
treatment in localized target areas of injured brain. Gaining information from a wide range of the
diverse population within the United States means heightening awareness of this very prevalent
public health dilemma. The Center for Disease Control and Prevention (CDCP, 2014), reports
that information regarding how TBI affects patients nationwide helps to inform TBI prevention
strategies, identify education strategies and research priorities, and helps to support the need for
services among those living with TBI. According to the CDCP (2014), more than 1.7 million
Americans sustain a TBI annually. More than 275,000 cases of TBI were hospitalized in
Emergency Departments, of those cases, 58,000 ended in death (CDCP, 2014).
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Another alarming population to take into consideration is gunshot victims that have
suffered a form of TBI known as Projectile Ballistics Brain Injury (PBBI). Florida in comparison
to other states has had the largest annual firearm-related fatality rate increase within the past
decade (Bramlett et. al, 2015). No current forms of therapy, other than invasive and life-
threatening surgery are available for PBBI based patients. This only further urges my point that
in order to begin to implementing a grand procedural design for national TBI treatment; its
innovative research at The University of Miami Miller School of Medicine at the local level that
must be able to explore additional treatment options due to the epidemic proportions of firearm
related PBBI in modern American society (Bramlett et al., 2015).
Sampling Frame
Based on the information collected, many sample sizes were collected since NSC
treatment has been tested under many circumstances, such as, hypothermic conditions, glucose
metabolism deprived brains, stroke induced brains, PBBI brain samples, and medically
synthesized brain tissue has been tested as well. Each individual test had its own treatment
methodology and comparable control group. The most recent extracted sample was obtained by
testing NSC engraftment measures on 18 Sprague-Dawley Laboratory mice. The control group
consisted of healthy brain tissue that was parrafinized (held in hydrocarbon wax sheet), and
PBBI tissue was held free-floating in wall plates via cryostat (machine meant to hold tissue at
relatively low temperatures). Both the control and independent variable group were looked under
100x objective lens microscope, both groups was seen to uncover which had developed more
neurodegeneration (neuronal cell death which is irreversible and is stained black) after a six
week period of being treated with NSC (Bullock, Dietrich &, Gajavelli, 2016).
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Data Collection
Data collection was not such an arduous task as most of the quantifiable data could be
extracted via public research articles. However, the analysis of NSC treatment effectiveness and
the necessary range that is needed to claim it as a success was very difficult, being that statistical
methods and Neuroscience are not my fields of practice. The integrity of the publicized works
were maintained by strictly pointing out and upholding the notion that advances in medical care
depend on rigorous, reliable and reproducible basic/clinical and translational research. The
scientific method used in NSC engraftment procedures and maintenance was predicated on being
able to test well-though-out study designs/hypothesis with meticulous data recording and
statistical data of the analysis.
The information I collected was also compared to The University of Michigan Health
System’s records on Neural Progenitor Cell (NPC) enhancement due to TBI related spinal cord
injury under similar conditions and approaches of that of UM Miller School of Medicine. Also, I
was part of the research conducted under Clinical Director Dr. Ross Bullock that measured the
potency of NSC treatment by comparing samples of PBBI brain that induced less
neurodegeneration along the pre-cortical track of the brain. Therefore, I understand the relevance
of the core scientific values of truthfulness, objectivity, unbiased and complete reporting of the
study results.
Data Analysis
Based on the quantitative measures that were needed in order to test the attainable goals
of my research methodology, I can with 95 percent confidence say that NSC engraftment
treatment does in fact diminish the secondary effects of immune-histo-globins (anti-
inflammatory response), neurodegeneration of white matter in traumatic brain and with
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medicated localized drug therapy help to proliferate neurogenesis of dead lateral tissue. Based on
my experimental analysis of neurodegeneration, I concluded that in normal brain
neurodegeneration occurs at a rate 10 percent less than neurogenesis. However, in unhealthy
tissue injected with NSC’s in 18 separate Dawley rats within a 6 week time frame,
neurodegeneration rose to an alarming 22 percent for the first three weeks, but, within the last
three weeks neurodegeneration was brought down to 8 percent and neurogenesis also rose by 11
percent on the bi-lateral portions of PBBI induced surfaces.
I based my values off of a standard mean and sample size intended to run a t-test. I
observed a p-value that was less than my alpha (comparative value) and was able to reject my
null hypothesis with a 95 percent confidence interval based on my sample proportion.
Additionally, according to Bramlett et al. (2015), vehicular pre-clinical studies of PBBI induced
mice show that under hypothermic conditions attenuation of inter-cranial pressure, neuro-
inflammation and inter-cranial hemorrhage were present within brain injury, but, its severity
grew at a lesser rate by a stall of 72 hours. Also, when injected with NSC into the caudal section
of the mouse brain, PBBI mice were able to “walk” onto a balance beam, albeit, they relied
heavily on the pathway of the balance beam rather than coordinated motor capacities (Bramlett et
al., 2015). Still this further demonstrates that the pre-clinical study shows an ambitious and
meaningful pathway to improved future patient health outcomes.
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References
American Speech-Language-Hearing Association. (2009). Current Perspectives on TBI.
Retrieved March 22,2016 from http://www.asha.org/aud/articles/CurrentTBI/
Bramlett, H., Bullock, R., Diaz, J., Gajavelli, S., Jackson, C., Spurlock, M., et al. (2015).
Penetrating Ballistic Brain Injury Reduces Focal & Global Brain Glucose Utilization: A
C-2DG autoradiography study in a rat model. Miami Project to Cure Paralysis,
Department of Nuerosurgery, University of Miami Miller School of Medicine. Published
on June 2015.
Bramlett, H., Bullock, R., Diaz, J., Gajavelli, S., Jackson, C., Spurlock, M., et al. (2015).
Penetrating Ballistic Brain Injury Systems and Methodology: A hippocampal
regenerative effect study in a rat model. Miami Project to Cure Paralysis, Department of
Neurosurgery, University of Miami Miller School of Medicine. Published on June 2015.
Bullock, R., Dietrich, WD., Gajavelli, S. (2016). Penetrating Ballistic Brain Injury Systems and
Methodology: Optimal maximal engraftment of human NSC’s via surgical intervention
or localized therapy injection. Miami Project to Cure Paralysis, Department of
Neurosurgery, University of Miami Miller School of Medicine. Published on February
2016.
Center for Disease Control and Prevention. (2014). Traumatic Brain Injury. Retrieved March
22, 2016, from http://www.cdc.gov/traumaticbraininjury/get_the_facts.html
Dennis, K. (2013). DoD/VA Common Definition. Audiology and speech pathology service.
Department of Veterans Affairs, Washington. D.C. Published on November 2013.
Shuttleworth, M. (2008). Different Research Methods. Retrieved Mar 22, 2016 from
Explorable.com: https://explorable.com/different-research-methods
http://www.asha.org/aud/articles/CurrentTBI/
http://www.cdc.gov/traumaticbraininjury/get_the_facts.html
https://explorable.com/users/martyn
https://explorable.com/different-research-methods
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