Background: There is a lack of well-validated clinical decision tools to assist clinicians with risk stratification of bleeding trauma patients. Objective: This thesis derives and validates a clinical prediction score in order to identify patients requiring major interventions for traumatic hemorrhage. Methods: We created a model based on the pre-specification of predictors. We conducted a systematic review of prediction models and a survey of traumatologists to identify candidate predictors. We conducted a derivation study of 748 trauma patients from 2014 to 2017. Results: The final model included systolic BP, clinical exam, lactate, FAST and CT. The c-statistic was 0.953 (naïve) and 0.952 following optimism-correction with bootstrap validation. Discussion: This thesis utilizes pre-specification to minimize reliance on small datasets and potential for over-optimism. Pre-specification is based on the best available knowledge within the literature and clinical expert community. Conclusion: A simple score is proposed for risk stratification of bleeding trauma patients.

Thesis (Ph. D.)--University of Hong Kong, 2002. / Includes bibliographical references (leaves 211-219).

Thesis (M.S.)--University of Wisconsin--Madison, 1967. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (M.D.)--University of Pennsylvania, 1801. / Microform version available in the Readex Early American Imprints series.

Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (leaves 199-214).

Thesis (Doctoral)--Ludwig-Maxilians-Universität zu München, 1935.

Thesis (Doctoral)--Ludwig-Maxilians-Universität zu München, 1935.

Legibus almae hujus Academiae, quae, omnes eos lauream Appollinarem ambientes, aliquid progressus sui in scientia medica testimonium, in publicam proferre sanciunt, obtemperanti, de Apoplexia Sanguinea in Paginis sequentibus pauca, mihi in animo est disserere; morbus, quo, sive symptomatum saevitiam, accessus rapiditatem, stragesve luctuosas, quas inter homines quotidie edit, nullus medici attentionem peritiamque majore jure sibi vindicat.

Lau Yun-wong. / "April 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 117-126). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web.

There are two types of stroke: ischemic and hemorrhagic. Intracerebral hemorrhage (ICH) accounts for about 15% of all strokes and is often severe. Currently no treatments are available to reduce injury, but rehabilitation may improve recovery. Most studies focus on ischemia, putting little emphasis on understanding recovery after hemorrhage. In chapter 2, we evaluated exercise prior to and/or following ICH. Similar protocols improve recovery after ischemic stroke, and we hypothesized that the treatment would also reduce deficits after hemorrhagic injury. However, exercise was not beneficial for ICH and increased intensity of treatment worsened functional outcome. In chapter 3 we assessed amphetamine and/or rehabilitation after ICH, an intervention also shown to improve recovery after ischemia. The rehabilitation consisted of environmental enrichment (EE) with modest amounts of training on beam and skilled reaching. Rehabilitation but not amphetamine partially improved recovery. Skilled reaching was not improved by rehabilitation so we decided to combine EE with more reach training. In chapter 4, we found that two weeks of rehabilitation (EE and skilled reaching), started one week after ICH significantly reduced lesion volume, and improved recovery on walking and skilled reaching tests. We were particularly interested in the mechanisms contributing to the reduction in lesion volume after ICH, and attempted to identify these. In chapter 5, we used the same rehabilitation intervention as in chapter 4 to determine if treatment alters dendritic complexity, spine density, or cell proliferation. Unfortunately, the reduction in lesion volume from chapter 4 was not replicated. But we were able to identify several plastic changes. Dendritic complexity was increased in neurons of the forelimb motor cortex ipsilateral to injury. Dendritic complexity of neurons in the peri-hematoma region and corresponding area in the uninjured hemisphere were also increased. In contrast, rehabilitation did not alter spine density or cell proliferation. In summary, we found that treatments that work for ischemic stroke do not necessarily work for hemorrhagic injury. Some methods of rehabilitation are able to reduce functional deficits and in some cases lesion volume after ICH. These rehabilitation effects are likely due to enhanced plasticity and not cell genesis.