Integration mapping of cardiac fibroblast single-cell transcriptomes elucidates cellular principles of fibrosis in diverse pathologies.

Single-cell technology has allowed researchers to probe tissue complexity and dynamics at unprecedented depth in health and disease. However, the generation of high-dimensionality single-cell atlases and virtual three-dimensional tissues requires integrated reference maps that harmonize disparate experimental designs, analytical pipelines, and taxonomies. Here, we present a comprehensive single-cell transcriptome integration map of cardiac fibrosis, which underpins pathophysiology in most cardiovascular diseases. Our findings reveal similarity between cardiac fibroblast (CF) identities and dynamics in ischemic versus pressure overload models of cardiomyopathy. We also describe timelines for commitment of activated CFs to proliferation and myofibrogenesis, profibrotic and antifibrotic polarization of myofibroblasts and matrifibrocytes, and CF conservation across mouse and human healthy and diseased hearts. These insights have the potential to inform knowledge-based therapies.

Predicting resilience of migratory birds to environmental change.

The pace and scale of environmental change represent major challenges to many organisms. Animals that move long distances, such as migratory birds, are especially vulnerable to change since they need chains of intact habitat along their migratory routes. Estimating the resilience of such species to environmental changes assists in targeting conservation efforts. We developed a migration modeling framework to predict past (1960s), present (2010s), and future (2060s) optimal migration strategies across five shorebird species (Scolopacidae) within the East Asian-Australasian Flyway, which has seen major habitat deterioration and loss over the last century, and compared these predictions to empirical tracks from the present. Our model captured the migration strategies of the five species and identified the changes in migrations needed to respond to habitat deterioration and climate change. Notably, the larger species, with single or few major stopover sites, need to establish new migration routes and strategies, while smaller species can buffer habitat loss by redistributing their stopover areas to novel or less-used sites. Comparing model predictions with empirical tracks also indicates that larger species with the stronger need for adaptations continue to migrate closer to the optimal routes of the past, before habitat deterioration accelerated. Our study not only quantifies the vulnerability of species in the face of global change but also explicitly reveals the extent of adaptations required to sustain their migrations. This modeling framework provides a tool for conservation planning that can accommodate the future needs of migratory species.

Influence of modified starches on mental performance and physical activity following an exhaustive bout of exercise.

Slow-releasing carbohydrates may delay the effects of fatigue after exhaustive exercise. The purpose of this study was to observe the influence that hydrothermally modified starches (HMS) and traditional maltodextrin (MAL) supplements had on physical endurance and mental performance following exhaustive exercise. Male participants completed a VO2 max and 2 days of cycling sessions using a Velotron ergometer. Cycling sessions were performed at 70% of the VO2 max workload for 150 min. Supplements were consumed 30 min before cycling and during exercise at the 120-min mark (1 g CHO/kg body weight). Brain activity was measured using a Neuroscan 64-channel electroencephalogram cap. Go-no-go and N-back tasks were performed before and after cycling bouts. Blood glucose, lactate, ketones, and urine-specific gravity were measured before, during, and after cycling. VO2 and rate of perceived exertion were recorded in 15-min intervals. Ketones increased significantly more for HMS than MAL from pre- to postcycling measurements (p < 0.05). Reaction times for go-no-go and N-back were faster for HMS postexercise. Event-related potential differences were present in both mental tasks following exhaustive exercise. HMS supplementation decreased the impact of cognitive and physical fatigue postexercise.

Roles of the Red List of Ecosystems in the Kunming-Montreal Global Biodiversity Framework.

The Kunming-Montreal Global Biodiversity Framework (GBF) of the UN Convention on Biological Diversity set the agenda for global aspirations and action to reverse biodiversity loss. The GBF includes an explicit goal for maintaining and restoring biodiversity, encompassing ecosystems, species and genetic diversity (goal A), targets for ecosystem protection and restoration and headline indicators to track progress and guide action1. One of the headline indicators is the Red List of Ecosystems2, the global standard for ecosystem risk assessment. The Red List of Ecosystems provides a systematic framework for collating, analysing and synthesizing data on ecosystems, including their distribution, integrity and risk of collapse3. Here, we examine how it can contribute to implementing the GBF, as well as monitoring progress. We find that the Red List of Ecosystems provides common theory and practical data, while fostering collaboration, cross-sector cooperation and knowledge sharing, with important roles in 16 of the 23 targets. In particular, ecosystem maps, descriptions and risk categories are key to spatial planning for halting loss, restoration and protection (targets 1, 2 and 3). The Red List of Ecosystems is therefore well-placed to aid Parties to the GBF as they assess, plan and act to achieve the targets and goals. We outline future work to further strengthen this potential and improve biodiversity outcomes, including expanding spatial coverage of Red List of Ecosystems assessments and partnerships between practitioners, policy-makers and scientists.

Minimal Detectable Change for the ImPACT Subtests at Baseline.

OBJECTIVE: To establish the minimal detectable change (MDC) of the subtests that comprise the composite scores from remotely administered Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baselines. METHOD: Remote ImPACT baseline data from 172 (male = 45, female = 127) National Collegiate Athletic Association Division I student-athletes from the 2020 and 2021 athletic preseasons were used to calculate the MDC at the 95%, 90%, and 80% confidence intervals (CIs) for all subtest scores used to generate the four core composite scores and the impulse control composite. RESULTS: The MDCs for the verbal memory subtests at the 95% CI were 10.31 for word memory percent correct, 4.68 for symbol match total correct hidden, and 18.25 for three letters percentage correct. Visual memory subtest MDCs were 19.03 for design memory total percent correct and 4.90 for XO total correct memory. Visual motor speed subtest MDCs were 18.89 for XO total correct interference and 5.40 for three letters average counted correctly. Reaction time (RT) MDCs were 0.12 for XO average correct, 0.95 for symbol match average correct RT, and 0.28 for color match average correct. Impulse control MDCs were 5.97 for XO total incorrect and 1.15 for color match total commissions. One-way repeated measures MANOVA, repeated measures ANOVAs, and Wilcoxon signed-ranks test all suggested no significant difference between any subtests across two remote ImPACT baselines. CONCLUSIONS: The ImPACT subtest scores did not significantly change between athletic seasons. Our study suggests the subtests be evaluated in conjunction with the composite scores to provide additional metrics for clinical interpretation.

Gaze Control and Tactical Decision-Making Under Stress in Active-Duty Police Officers During a Live Use-of-Force Response.

Police officers during dynamic and stressful encounters are required to make rapid decisions that rely on effective decision-making, experience, and intuition. Tactical decision-making is influenced by the officer's capability to recognize critical visual information and estimation of threat. The purpose of the current study is to investigate how visual search patterns using cluster analysis and factors that differentiate expertise (e.g., years of service, tactical training, related experiences) influence tactical decision-making in active-duty police officers (44 active-duty police officers) during high stress, high threat, realistic use of force scenario following a car accident and to examine the relationships between visual search patterns and physiological response (heart rate). A cluster analysis of visual search variables (fixation duration, fixation location difference score, and number of fixations) produced an Efficient Scan and an Inefficient Scan group. Specifically, the Efficient Scan group demonstrated longer total fixation duration and differences in area of interests (AOI) fixation duration compared to the Inefficient Scan group. Despite both groups exhibiting a rise in physiological stress response (HR) throughout the high-stress scenario, the Efficient Scan group had a history of tactical training, improved return fire performance, had higher sleep time total, and demonstrated increased processing efficiency and effective attentional control, due to having a background of increased tactical training.

Virtual Reality Application for Vestibular/Ocular Motor Screening: Current Clinical Protocol Versus a Novel Prototype.

BACKGROUND: Virtual reality (VR) has been explored to improve baseline and postinjury assessments in sport-related concussion (SRC). Some experience symptoms related to VR, unrelated to concussion. This may deter use of vestibular/ocular motor screening (VOMS) using VR. Baseline VR VOMS symptomatology differentiates baseline from overall symptomatology. HYPOTHESIS: There will be no difference between current clinical manual VOMS (MAN), a clinical prototype (PRO), and VR for symptom provocation change score (SPCS) and near point of convergence (NPC) average score in a healthy population and sex differences among the 3 modes of administration. STUDY DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 688 National Collegiate Athletic Association Division I student-athletes completed VOMS using 3 methods (MAN, N = 111; female athletes, N = 47; male athletes, N = 64; average age, 21 years; PRO, N = 365; female athletes, N = 154; male athletes, N = 211; average age, 21 years; VR, N = 212; female athletes, N = 78; male athletes, N = 134; average age = 20 years) over a 3-year period (2019-2021) during annual baseline testing. Exclusion criteria were as follows: self-reported motion sickness in the past 6 months, existing or previous neurological insult, attention deficit hyperactivity disorder, learning disabilities, or noncorrected vision impairment. Administration of MAN followed the current clinical protocols, PRO used a novel prototype, and VR used an HTC Vive Pro Eye head mounted display. Symptom provocation was compared using Mann-Whitney U tests across each VOMS subtest with total SPCS and NPC average by each method. RESULTS: MAN had significantly (P < 0.01) more baseline SPCS (MAN = 0.466 ± 1.165, PRO = 0.163 ± 0.644, VR = 0.161 ± 0.933) and significantly (P < 0.01) and more SPCS (MAN = 0.396 ± 1.081, PRO = 0.128 ± 0.427, VR = 0.48 ± 0.845) when compared with PRO and VR. NPC average measurements for VR (average, 2.99 ± 0.684 cm) were significantly greater than MAN (average, 2.91 ± 3.35 cm; P < 0.01; Cohen's d = 0.03) and PRO (average, 2.21 ± 1.81 cm; P < 0.01; Cohen's d = 0.57). For sex differences, female athletes reported greater SPCS with PRO (female athletes, 0.29 ± 0.87; male athletes, 0.06 ± 0.29; P < 0.01) but not in VR or MAN. CONCLUSION: Using a VR system to administer the VOMS may not elicit additional symptoms, resulting in fewer false positives and is somewhat stable between sexes. CLINICAL RELEVANCE: VOMS may allow for standardization among administrators and reduce possible false positives.

Assessing between-officer variability in responses to a live-acted deadly force encounter as a window to the effectiveness of training and experience.

We aimed to infer the effectiveness of officers' training and experience by assessing consistency of behavioural responses between them. If officers facing the same scenario respond in similar ways, this implies their use of shared cognition, through acquired in-common tactical knowledge. Officers (n = 42) responded to a live-acted scenario in which an assailant ultimately discharged his weapon. Triangulated camera positions assessed their movement patterns, final positions, and weapon responses relative to when the assailant fired his weapon. We also assessed the officers' visual search and gathered information regarding their experience and rest. Our second aim was to examine sources of variability in the officers' responses. We found extensive variability in all aspects of the response. Experience did not impact spatial or temporal behavioural responses. However, longer hours awake and lower reported rest negatively impacted officers' responses. We conclude that officers had insufficient training and experience to demonstrate in-common knowledge.Practitioner summary: Police officers showed high spatial and temporal variability in response to the same scenario. This implies inadequate tactical training, and is supported by our finding that training and experience did not impact performance. Instead, the officers' variability was constrained by their visual search, and the hours awake before being tested.

Is gaze cuing more like endogenous or exogenous orienting?

People shift their attention in the direction of another person's gaze. This phenomenon, called gaze cuing, shares properties with purely endogenous (i.e., "deliberate") and purely exogenous (i.e., "reflexive") control of spatial attention. For example, as with purely endogenous orienting, gaze cues appear at visual fixation; yet, as with purely exogenous orienting, gaze cues elicit shifts of attention rapidly after their appearance. Prior experiments have shown that when controlled endogenously versus exogenously, the effects of attention upon the processing of targets are dramatically different. Briand and Klein (1987; see also Briand, 1998) showed that endogenous orienting is additive with opportunities for illusory conjunctions, whereas exogenous orienting is interactive. Klein (1994) showed that endogenous orienting is interactive with nonspatial expectancies, whereas exogenous orienting is additive. In the present project, we applied this double-dissociation strategy to attention controlled by gaze cues. In Experiment 1, gaze cuing effects (in accuracy) were additive with opportunities for illusory conjunctions (akin to endogenous control), whereas in Experiment 2, gaze cuing was additive with the nonspatial expectancy effect (akin to exogenous orienting). Therefore, in the nature of its effects upon performance, gaze cuing functions like a hybrid of endogenous and exogenous orienting. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Slippage of the attentional beam when searching in space and in time.

"Slippage" of attention in time and space has been studied separately, using visual search (e.g., Snyder, 1972) and rapid serial visual presentation (RSVP) (e.g., McLean, Broadbent, & Broadbent, 1982). The primary purpose of the current study was to see if we could replicate these findings of slippage and if we did, to use individual differences to explore relationships between slippage in the temporal and spatial domains. The participants identified and localized targets in visual search and in RSVP sequences. In Experiment 1, we used visual search and RSVP tasks closely replicating the methods of Snyder and McLean et al. In Experiment 2, we closely equated the two tasks as far as possible while maintaining the crucial space/time difference. Consistent with the previous studies, and reflecting binding errors (or slippage) in both space and time, erroneously reported identities were predominantly from items adjacent to the targets. Correlations between measures of the slippage in space (visual search) and time (RSVP) were near zero, suggesting that different attentional 'beams' bind features in space and time, a possibility that is consistent with other behavioural as well as neuropsychological evidence.

Preliminary Examination of Guardian Cap Head Impact Kinematics Using Instrumented Mouthguards.

CONTEXT: Guardian Caps (GCs) are currently the most popular external helmet-add on designed to reduce the head impact magnitude experienced by American football players. GCs have been endorsed by influential professional organizations, however few studies evaluating the efficacy of GCs are publicly available. OBJECTIVE: The objective of this study is to present preliminary on-field head kinematics data for NCAA Division I American football players using instrumented mouthguards through closely matched pre-season workouts both with and without GCs. DESIGN: Case Series. SETTING: The study took place during the 2022 American football pre-season. PATIENTS OR OTHER PARTICIPANTS: 25 Male NCAA Division I student-athletes participating in American football completed some portion of the 6 workouts included in this study. Of the 25 total participants, 7 completed all 6 workouts using their instrumented mouthguards. MAIN OUTCOME MEASURE(S): The peak linear acceleration (PLA), peak angular acceleration (PAA) and total impacts were collected using instrumented mouthguards (iMG) during 3 pre-season workouts using traditional helmets (TRAD), and 3 with Guardian Caps used in additional to a traditional helmet (GC). The TRAD and GC values for PLA, PAA and total impacts were analyzed using ANOVAs. RESULTS: There was no significant difference between the collapsed mean values for the entire sample between TRAD and GC for PLA (TRAD=16.3±2.0, GC=17.2±3.3Gs; p=0.20), PAA (TRAD=992.1±209.2, GC=1029.4±261.1rad/s2; p=0.51 and the total amount of impacts (TRAD=9.3±4.7, GC=9.7±5.7; p=0.72). Similarly, no difference was observed between TRAD and GC for PLA (TRAD=16.1±1.2, GC=17.2±2.79Gs; p=0.32), PAA (TRAD=951.2±95.4, GC=1038.0±166.8rad/s2; p=0.29 and total impacts (TRAD=9.6±4.2, GC=9.7±5.04s; p=0.32) between sessions for the7 repeated players. CONCLUSIONS: These data suggest no difference in head kinematics data (PLA, PAA and total impacts) when GCs are worn. This study suggests GCs may not be effective in reducing the magnitude of head impacts experienced by NCAA Division I American football players.

Widespread retreat of coastal habitat is likely at warming levels above 1.5 °C.

Several coastal ecosystems-most notably mangroves and tidal marshes-exhibit biogenic feedbacks that are facilitating adjustment to relative sea-level rise (RSLR), including the sequestration of carbon and the trapping of mineral sediment1. The stability of reef-top habitats under RSLR is similarly linked to reef-derived sediment accumulation and the vertical accretion of protective coral reefs2. The persistence of these ecosystems under high rates of RSLR is contested3. Here we show that the probability of vertical adjustment to RSLR inferred from palaeo-stratigraphic observations aligns with contemporary in situ survey measurements. A deficit between tidal marsh and mangrove adjustment and RSLR is likely at 4 mm yr-1 and highly likely at 7 mm yr-1 of RSLR. As rates of RSLR exceed 7 mm yr-1, the probability that reef islands destabilize through increased shoreline erosion and wave over-topping increases. Increased global warming from 1.5 °C to 2.0 °C would double the area of mapped tidal marsh exposed to 4 mm yr-1 of RSLR by between 2080 and 2100. With 3 °C of warming, nearly all the world's mangrove forests and coral reef islands and almost 40% of mapped tidal marshes are estimated to be exposed to RSLR of at least 7 mm yr-1. Meeting the Paris agreement targets would minimize disruption to coastal ecosystems.

Using Solution History to Control Hydrogel Properties of a Perylene Bisimide.

pH dependence on water soluble aggregates is well-known in the field of low molecular weight gelators (LMWGs), with different aggregates sometimes having very different properties depending on their final pH. This aggregation determines their applications and performance. Here, we investigate the pH dependence of perylene bisimide gels; initially solutions are formed at a high pH and gels form as the pH is decreased. We find it is not only the final pH but also the starting pH that can impact the resulting gel. We use small angle neutron scattering (SANS), rheology, 1 H NMR spectroscopy and absorption spectroscopy to examine the effect of starting pH on gelation kinetics and final gel properties. Adjusting the solution from pH 9 (where there are few or no aggregates) to pH 6 results in the formation of different worm-like micelles than the ones directly formed at pH 6, leading to again gels with different mechanical properties. This work highlights the importance of controlling the pH of solutions before gelation, but also opens up more possible morphologies and therefore more properties from the same molecule.

Preliminary Examination of Guardian Cap Head Impact Data Using Instrumented Mouthguards.

Purpose The objective of this study is to present preliminary on-field head kinematics data for NCAA Division I American football players through closely matched pre-season workouts both with and without Guardian Caps (GCs). Methods 42 NCAA Division I American football players wore instrumented mouthguards (iMMs) for 6 closely matched workouts, 3 in traditional helmets (PRE) and 3 with GCs (POST) affixed to the exterior of their helmets. This includes 7 players who had consistent data through all workouts. Results There was no significant difference between the collapsed mean values for the entire sample between PRE and POST for peak linear acceleration (PLA) (PRE=16.3, POST=17.2Gs; p=0.20), Peak Angular Acceleration (PAA) (PRE=992.1, POST=1029.4rad/s2; p=0.51 and the total amount of impacts (PRE=9.3, POST=9.7; p=0.72). Similarly, no difference was observed between PRE and POST for PLA (PRE=16.1, POST=17.2Gs; p=0.32), PAA (PRE=951.2, POST=1038.0rad/s2; p=0.29 and total impacts (PRE=9.6, POST=9.7; p=0.32) between sessions for the 7 repeated players. Conclusion These data suggest no difference in head kinematics data (PLA, PAA and total impacts) when GCs are worn. This study suggests GCs are not effective in reducing the magnitude of head impacts experienced by NCAA Division I American football players.

Concussed Neural Signature is Substantially Different than Fatigue Neural Signature in Non-concussed Controls.

Traumatic brain injuries can result in short-lived and long-lasting neurological impairment. Identifying the correct recovery timeframe is challenging, as balance-based metrics may be negatively impacted if testing is performed soon after exercise. Thirty-two healthy controls and seventeen concussed individuals performed a series of balance challenges, including virtual reality optical flow perturbation. The control group completed a backpacking protocol to induce moderate fatigue. Concussed participants had lower spectral power in the motor cortex and central sulcus when compared to fatigued controls. Moreover, concussed participants experienced a decrease in overall theta band spectral power while fatigued controls showed an increase in theta band spectral power. This neural signature may be useful to distinguish between concussed and non-concussed fatigued participants in future assessments.

Theta tACS impairs episodic memory more than tDCS.

Episodic memory deficits are a common consequence of aging and are associated with a number of neurodegenerative disorders (e.g., Alzheimer's disease). Given the importance of episodic memory, a great deal of research has investigated how we can improve memory performance. Transcranial electrical stimulation (TES) represents a promising tool for memory enhancement but the optimal stimulation parameters that reliably boost memory are yet to be determined. In our double-blind, randomised, sham-controlled study, 42 healthy adults (36 females; 23.3 ± 7.7 years of age) received anodal transcranial direct current stimulation (tDCS), theta transcranial alternating current stimulation (tACS) and sham stimulation during a list-learning task, over three separate sessions. Stimulation was applied over the left temporal lobe, as encoding and recall of information is typically associated with mesial temporal lobe structures (e.g., the hippocampus and entorhinal cortex). We measured word recall within each stimulation session, as well as the average number of intrusion and repetition errors. In terms of word recall, participants recalled fewer words during tDCS and tACS, compared to sham stimulation, and significantly fewer words recalled during tACS compared with tDCS. Significantly more memory errors were also made during tACS compared with sham stimulation. Overall, our findings suggest that TES has a deleterious effect on memory processes when applied to the left temporal lobe.

Exploring the risks and benefits of flexibility in biodiversity offset location in a case study of migratory shorebirds.

Biodiversity offsets aim to counterbalance the residual impacts of development on species and ecosystems. Guidance documents explicitly recommend that biodiversity offset actions be located close to the location of impact because of higher potential for similar ecological conditions, but allowing greater spatial flexibility has been proposed. We examined the circumstances under which offsets distant from the impact location could be more likely to achieve no net loss or provide better ecological outcomes than offsets close to the impact area. We applied a graphical model for migratory shorebirds in the East Asian-Australasian Flyway as a case study to explore the problems that arise when incorporating spatial flexibility into offset planning. Spatially flexible offsets may alleviate impacts more effectively than local offsets; however, the risks involved can be substantial. For our case study, there were inadequate data to make robust conclusions about the effectiveness and equivalence of distant habitat-based offsets for migratory shorebirds. Decisions around offset placement should be driven by the potential to achieve equivalent ecological outcomes; however, when considering more distant offsets, there is a need to evaluate the likely increased risks alongside the potential benefits. Although spatially flexible offsets have the potential to provide more cost-effective biodiversity outcomes and more cobenefits, our case study showed the difficulty of demonstrating these benefits in practice and the potential risks that need to be considered to ensure effective offset placement.

Estudio de los riesgos y beneficios de la flexibilidad en la ubicación de compensación de la biodiversidad en el estudio de caso de aves costeras migratorias Resumen Las compensaciones de la biodiversidad buscan contrabalancear el impacto residual que tiene el desarrollo sobre las especies y los ecosistemas. Los documentos guía recomiendan explícitamente que las acciones de estas compensaciones estén ubicadas cerca del lugar del impacto debido al potencial elevado de que haya condiciones ecológicas similares, aunque ya hay propuestas de una mayor flexibilidad espacial. Analizamos las circunstancias bajo las cuales las compensaciones alejadas del lugar de impacto tendrían mayor probabilidad de lograr pérdidas netas nulas o de proporcionar mejores resultados ecológicos que las compensaciones cercanas al área de impacto. Aplicamos un modelo gráfico para las aves costeras migratorias en el corredor aéreo asiático-australasiático del este como estudio de caso para estudiar los problemas que surgen cuando se incorpora la flexibilidad espacial a la planeación de las compensaciones. Las compensaciones espacialmente flexibles pueden mitigar los impactos más efectivamente que las compensaciones locales; sin embargo, los riesgos que esto involucra pueden ser considerables. En nuestro estudio de caso hubo datos insuficientes para concluir contundentemente sobre la efectividad y equivalencia de las compensaciones basadas en los hábitats distantes para las aves costeras migratorias. Las decisiones en torno a la ubicación de las compensaciones deberían estar impulsadas por el potencial para obtener resultados ecológicos equivalentes; sin embargo, al considerar compensaciones más alejadas, existe la necesidad de evaluar el incremento probable de riesgos junto a los beneficios potenciales. Aunque las compensaciones espacialmente flexibles tienen el potencial para proporcionar resultados más rentables y más beneficios colaterales, nuestro estudio de caso mostró la dificultad para demostrar estos beneficios en la práctica y los riesgos potenciales que necesitan considerarse para asegurar una ubicación efectiva de las compensaciones.

Older adults with a history of falling exhibit altered cortical oscillatory mechanisms during continuous postural maintenance.

Background and Aim: The significant risk of falling in older adults 65 years or older presents a substantial problem for these individuals, their caretakers, and the health-care system at large. As the proportion of older adults in the United States is only expected to grow over the next few decades, a better understanding of physiological and cortical changes that make an older adult more susceptible to a fall is crucial. Prior studies have displayed differences in postural dynamics and stability in older adults with a fall history (FH) and those who are non-fallers (NF), suggesting surplus alterations that occur in some older adults (i.e., FH group) in addition to the natural aging process. Methods: The present study measured postural dynamics while the FH, NF, and young adult (YA) groups performed continuous postural maintenance. In addition, electroencephalography activity was recorded while participants performed upright postural stance to examine any group differences in cortical areas involved in postural control. Results: As expected, older participants (FH and NF) exhibited worse postural stability, as evidenced by increased excursion, compared to the YA group. Further, while NF and YA show increased alpha activity in occipital areas during the most demanding postural task (eyes closed), the FH group did not show any differences in occipital alpha power between postural tasks. Conclusions: As alpha activity reflects suppression of bottom-up processing and thus diversion of cognitive resources toward postural centers during more demanding postural maintenance, deficits in this regulatory function in the FH group are a possible impaired cortical mechanism putting these individuals at greater fall risk. Relevance for Patients: Impaired inhibitory function in older adults may impact postural control and increase their risk of falling. Interventions that aim at addressing cortical processing deficits may improve postural stability and facilitate independent living in this population.

Minimal detectable change for the ImPACT test administered remotely.

CONTEXT: The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is one of the most widely used computerized neurocognitive assessment batteries in athletics, serving as both a baseline and post-injury assessment. It has become increasingly popular to administer the ImPACT baseline test in an un-supervised remote environment, however, it is unknown if the lack of supervision affects the test-retest reliability. OBJECTIVE: To establish the minimal detectable change (MDC) of composite scores from the ImPACT test when administered to National Collegiate Athletic Association (NCAA) Division I student-athletes in an un-supervised remote environment before two consecutive athletic seasons. DESIGN: Cross-Sectional. SETTING: Participants were provided with a unique link and detailed written instructions on how to complete the ImPACT test at home. PATIENTS OR OTHER PARTICIPANTS: NCAA Division I student-athletes. MAIN OUTCOME MEASURE(S): Remote ImPACT baseline test results from the 2020-2021 and 2021-2022 athletic seasons were analyzed. The MDC was calculated at the 95%, 90%, and 80% confidence intervals for each of the ImPACT composite scores, as well as the average and standard deviation. RESULTS: The MDC at the 95% confidence interval was found to be 18.6 for the verbal memory composite score, 24.44 for visual memory, 8.76 for visual motor, 0.14 for reaction time, and 6.13 for impulse control. One-way repeated measures MANOVA, repeated measures ANOVA, and Wilcoxon signed-ranks test all suggest no significant difference between the composite scores and impulse control between time points. CONCLUSIONS: The ImPACT test composite scores and impulse control did not significantly change between the two remote testing time points when administered approximately a year between testing. Our study suggests the MDC serve as a clinician's guide for evaluating changes in ImPACT baseline scores and in making clinical judgments on sports-related concussion when the test is administered at home.