Diffuse Associations Between Drosophila suzukii and Filamentous Fungal Microbes May Alter Caneberry Disease Dynamics.

Interactions between microorganisms and frugivorous insects can modulate fruit rot disease epidemiology. Insect feeding and/or oviposition wounds may create opportunities for fungal infection. Passive and active dispersal of fungal inoculums by adult insects also increases disease incidence. In fall-bearing raspberries and blackberries, such vectoring interactions could increase crop damage from the invasive pestiferous vinegar fly Drosophila suzukii (spotted-wing drosophila). Periods of peak D. suzukii activity are known to overlap with several species of primary fruit rot pathogen, particularly Botrytis cinerea and Cladosporium cladosporioides, and previous work indicates that larvae co-occur with and feed on various filamentous fungi at low rates. To further our understanding of the epidemiological consequences that may emerge from these associations, we surveyed the filamentous fungal community associated with adult D. suzukii, isolating and molecularly identifying fungi externally and internally (indicating feeding) from field-collected adults over 3 years. We isolated and identified 37 unique genera of fungi in total, including known raspberry pathogens. Most fungi were detected infrequently, and flies acquired and carried fungi externally at higher richness, frequency, and density relative to internally. In a worst-case scenario laboratory vectoring assay, D. suzukii adults were able to transfer B. cinerea and C. cladosporioides to sterile media at 0, 24, 48, and 72 h after exposure to sporulating cultures in Petri dishes. These results collectively suggest an adventitious vectoring association between D. suzukii and fruit rot fungi that has the potential to alter caneberry disease dynamics.

Pilot Collection and Evaluation of Head Kinematics in Stock Car Racing.

The goal of this work was to collect on-track driver head kinematics using instrumented mouthpieces and characterize environmental exposure to accelerations and vibrations. Six NASCAR drivers were instrumented with custom-fit mouthpieces to collect head kinematic data. Devices were deployed at four tracks during practice and testing environments and configured to collect approximately 11 min of linear acceleration and rotational velocity data at 200 Hz. This continuous data collection, combined with film review, allowed extraction of complete laps of data. In addition to typical data processing methods, a moving-point average was calculated and subtracted from the overall signal for both linear acceleration and rotational velocity to determine the environmental component of head motion. The current analysis focuses on 42 full laps of data collected at four data collection events. The number of laps per track ranged from 2 to 23. Linear acceleration magnitudes for all 42 laps ranged from 2.46 to 7.48 g and rotational velocity ranged from 1.25 to 3.35 rad/s. After subtracting the moving average, linear acceleration ranged from 0.92 to 5.45 g and rotational velocity ranged from 0.57 to 2.05 rad/s. This study has established the feasibility of using an instrumented mouthpiece to measure head kinematics in NASCAR and presented a technique for isolating head motion due to cornering acceleration from those due to short-term perturbations experienced by the driver.

Head Impact Exposure in Female Collegiate Soccer by Activity Type.

Soccer, one of the most popular sports in the world, has one of the highest rates of sports-related concussions. Additionally, soccer players are frequently exposed to nonconcussive impacts from intentionally heading the ball, a fundamental component of the sport. There have been many studies on head impact exposure in soccer, but few focus on soccer practices or practice activities. This study aimed to characterize the frequency and magnitude of head impacts in National Collegiate Athletic Association Division I female soccer practice activities using a custom-fit instrumented mouthpiece. Sixteen players were instrumented over the course of 54 practice sessions. Video analysis was performed to verify all mouthpiece-recorded events and classify practice activities. Category groupings of practice activities include technical training, team interaction, set pieces, position-specific, and other. Differences in head impact rates and peak resultant kinematics were observed across activity types and category groupings. Technical training had the highest impact rate compared to other category groupings. Impacts occurring during set piece activities had the highest mean kinematic values. Understanding drill exposure can help inform coaches on training plans aimed to reduce head impact exposure for their athletes.

Characterization of Head Acceleration Exposure During Youth Football Practice Drills.

Many head acceleration events (HAEs) observed in youth football emanate from a practice environment. This study aimed to evaluate HAEs in youth football practice drills using a mouthpiece-based sensor, differentiating between inertial and direct HAEs. Head acceleration data were collected from athletes participating on 2 youth football teams (ages 11-13 y) using an instrumented mouthpiece-based sensor during all practice sessions in a single season. Video was recorded and analyzed to verify and assign HAEs to specific practice drill characteristics, including drill intensity, drill classification, and drill type. HAEs were quantified in terms of HAEs per athlete per minute and peak linear and rotational acceleration and rotational velocity. Mixed-effects models were used to evaluate the differences in kinematics, and generalized linear models were used to assess differences in HAE frequency between drill categories. A total of 3237 HAEs were verified and evaluated from 29 football athletes enrolled in this study. Head kinematics varied significantly between drill categorizations. HAEs collected at higher intensities resulted in significantly greater kinematics than lower-intensity drills. The results of this study add to the growing body of evidence informing evidence-based strategies to reduce head impact exposure and concussion risk in youth football practices.

Characterization of head impact exposure in boys' youth ice hockey.

Ice hockey has one of the highest concussion rates among youth sports. Sensor technology has been implemented in contact and collision sports to inform the frequency and severity of head impacts experienced on-ice. However, existing studies have utilized helmet-mounted sensors with limited accuracy. The objective of this study was to characterize head kinematics of contact events in a sample of youth boys' hockey players using a validated instrumented mouthpiece with improved accuracy. Head kinematics from 892 video-verified events were recorded from 18 athletes across 127 sessions. Median peak resultant linear acceleration, rotational velocity, and rotational acceleration of video-verified events were 7.4 g, 7.7 rad/s, and 576 rad/s2, respectively. Contact events occurred at a higher rate in games (2.48 per game) than practices (1.30 per practice). Scenarios involving head contact had higher peak kinematics than those without head contact. This study improves our understanding of head kinematics in boys' youth hockey.

Head Impact Kinematics and Brain Deformation in Paired Opposing Youth Football Players.

Head impact exposure is often quantified using peak resultant kinematics. While kinematics describes the inertial response of the brain to impact, they do not fully capture the dynamic brain response. Strain, a measure of the tissue-level response of the brain, may be a better predictor of injury. In this study, kinematic and strain metrics were compared to contact characteristics in youth football. Players on 2 opposing teams were instrumented with head impact sensors to record impact kinematics. Video was collected to identify contact scenarios involving opposing instrumented players (ie, paired contact scenarios) and code contact characteristics (eg, player role, impact location). A previously validated, high-resolution brain finite element model, the atlas-based brain model, was used to simulate head impacts and calculate strain metrics. Fifty-two paired contact scenarios (n = 105 impacts) were evaluated. Lighter players tended to have greater biomechanical metrics compared to heavier players. Impacts to the top of the helmet were associated with lower strain metrics. Overall, strain was better correlated with rotational kinematics, suggesting these metrics may be better predictors of the tissue-level brain response than linear kinematics. Understanding the effect of contact characteristics on brain strain will inform future efforts to improve sport safety.

Head Kinematics in Youth Ice Hockey by Player Speed and Impact Direction.

Hockey is a fast-paced sport known for body checking, or intentional collisions used to separate opponents from the puck. Exposure to these impacts is concerning, as evidence suggests head impact exposure (HIE), even if noninjurious, can cause long-term brain changes. Currently, there is limited understanding of the effect of impact direction and collision speed on HIE. Video analysis was used to determine speed and direction for 162 collisions from 13 youth athletes. These data were paired with head kinematic data collected with an instrumented mouthpiece. Relationships between peak resultant head kinematics and speeds were evaluated with linear regression. Mean athlete speeds and relative velocity between athletes ranged from 2.05 to 2.76 m/s. Mean peak resultant linear acceleration, rotational velocity, and rotational acceleration were 13.1 g, 10.5 rad/s, and 1112 rad/s2, respectively. Significant relationships between speeds and head kinematics emerged when stratified by contact characteristics. HIE also varied by direction of collision; most collisions occurred in the forward-oblique (ie, offset from center) direction; frontal collisions had the greatest magnitude peak kinematics. These findings indicate that HIE in youth hockey is influenced by speed and direction of impact. This study may inform future strategies to reduce the severity of HIE in hockey.

Characterization of Head Impact Exposure in Women's Collegiate Soccer.

Soccer players are regularly exposed to head impacts by intentionally heading the ball. Evidence suggests repetitive subconcussive head impacts may affect the brain, and females may be more vulnerable to brain injury than males. This study aimed to characterize head impact exposure among National Collegiate Athletic Association women's soccer players using a previously validated mouthpiece-based sensor. Sixteen players were instrumented during 72 practices and 24 games. Head impact rate and rate of risk-weighted cumulative exposure were compared across session type and player position. Head kinematics were compared across session type, impact type, player position, impact location, and ball delivery method. Players experienced a mean (95% confidence interval) head impact rate of 0.468 (0.289 to 0.647) head impacts per hour, and exposure rates varied by session type and player position. Headers accounted for 89% of head impacts and were associated with higher linear accelerations and rotational accelerations than nonheader impacts. Headers in which the ball was delivered by a long kick had greater peak kinematics (all P < .001) than headers in which the ball was delivered by any other method. Results provide increased understanding of head impact frequency and magnitude in women's collegiate soccer and may help inform efforts to prevent brain injury.

Modulating glutamine metabolism to control viral immuno-inflammatory lesions.

Infection of the cornea with HSV results in an immune-inflammatory reaction orchestrated by proinflammatory T cells that is a major cause of human vision impairment. The severity of lesions can be reduced if the representation of inflammatory T cells is changed to increase the presence of T cells with regulatory function. This report shows that inhibiting glutamine metabolism using 6-Diazo-5-oxo-l-norleucine (DON) administered via intraperitoneal (IP) starting 6 days after ocular infection and continued until day 15 significantly reduced the severity of herpetic stromal keratitis lesions. The therapy resulted in reduced neutrophils, macrophages as well proinflammatory CD4 Th1 and Th17 T cells in the cornea, but had no effect on levels of regulatory T cells. A similar change in the representation of inflammatory and regulatory T cells occurred in the trigeminal ganglion (TG) the site where HSV infection establishes latency. Glutamine metabolism was shown to be required for the in-vitro optimal induction of both Th1 and Th17 T cells but not for the induction of Treg that were increased when glutamine metabolism was inhibited. Inhibiting glutamine metabolism also changed the ability of latently infected TG cells from animals previously infected with HSV to reactivate and produce infectious virus.

Characterization of On-Field Head Impact Exposure in Youth Soccer.

The objective of this research was to characterize head impacts with a validated mouthpiece sensor in competitive youth female soccer players during a single season with a validated mouthpiece sensor. Participants included 14 youth female soccer athletes across 2 club-level teams at different age levels (team 1, ages 12-13 y; team 2, ages 14-15 y). Head impact and time-synchronized video data were collected for 66 practices and games. Video data were reviewed to characterize the type and frequency of contact experienced by each athlete. A total of 2216 contact scenarios were observed; heading the ball (n = 681, 30.7%) was most common. Other observed contact scenarios included collisions, dives, falls, and unintentional ball contact. Team 1 experienced a higher rate of headers per player per hour of play than team 2, while team 2 experienced a higher rate of collisions and dives. A total of 935 video-verified contact scenarios were concurrent with recorded head kinematics. While headers resulted in a maximum linear acceleration of 56.1g, the less frequent head-to-head collisions (n = 6) resulted in a maximum of 113.5g. The results of this study improve the understanding of head impact exposure in youth female soccer players and inform head impact exposure reduction in youth soccer.

Characterizing head impact exposure in youth female soccer with a custom-instrumented mouthpiece.

While many research efforts have focused on head impact exposure in professional soccer, there have been few studies characterizing exposure at the youth level. The aim of this study is to evaluate a new instrumentation approach and collect some of the first head impact exposure data for youth female soccer players. Athletes were instrumented with custom-fit mouthpieces that measure head impacts. Detailed video analysis was conducted to identify characteristics describing impact source (e.g., kick, header, throw). A total of 763 verified head impacts were collected over 23 practices and 8 games from 7 athletes. The median peak linear accelerations, rotational velocities, and rotational accelerations of all impacts were 9.4 g, 4.1 rad/s, and 689 rad/s2, respectively. Pairwise comparisons resulted in statistically significant differences in kinematics by impact source. Headers following a kicked ball had the highest accelerations and velocity when compared to headers from thrown or another header.

Validation of a Custom Instrumented Retainer Form Factor for Measuring Linear and Angular Head Impact Kinematics.

Head impact exposure in popular contact sports is not well understood, especially in the youth population, despite recent advances in impact-sensing technology which has allowed widespread collection of real-time head impact data. Previous studies indicate that a custom-instrumented mouthpiece is a superior method for collecting accurate head acceleration data. The objective of this study was to evaluate the efficacy of mounting a sensor device inside an acrylic retainer form factor to measure six-degrees-of-freedom (6DOF) head kinematic response. This study compares 6DOF mouthpiece kinematics at the head center of gravity (CG) to kinematics measured by an anthropomorphic test device (ATD). This study found that when instrumentation is mounted in the rigid retainer form factor, there is good coupling with the upper dentition and highly accurate kinematic results compared to the ATD. Peak head kinematics were correlated with r2 > 0.98 for both rotational velocity and linear acceleration and r2 = 0.93 for rotational acceleration. These results indicate that a rigid retainer-based form factor is an accurate and promising method of collecting head impact data. This device can be used to study head impacts in helmeted contact sports such as football, hockey, and lacrosse as well as nonhelmeted sports such as soccer and basketball. Understanding the magnitude and frequency of impacts sustained in various sports using an accurate head impact sensor, such as the one presented in this study, will improve our understanding of head impact exposure and sports-related concussion.

Molecular speciated isotope dilution mass spectrometric methods for accurate, reproducible and direct quantification of reduced, oxidized and total glutathione in biological samples.

Novel protocols were developed to accurately quantify reduced (GSH), oxidized (GSSG) and total (tGSH) glutathione in biological samples using molecular speciated isotope dilution mass spectrometry (SIDMS). For GSH and GSSG measurement, the sample was spiked with isotopically enriched analogues of the analytes ((310)GSH and (616)GSSG), along with N-ethylmaleimide (NEM), and treated with acetonitrile to solubilize the endogenous analytes via protein precipitation and equilibrate them with the spikes. The supernatant was analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and the analytes were quantified with simultaneous tracking and correction for auto-oxidation of GSH to GSSG. For tGSH assay, a (310)GSH-spiked sample was treated with dithiothreitol (DTT) to convert disulfide-bonded glutathione to GSH. After removing the protein, the supernatant was analyzed by LC-MS/MS and the analyte was quantified by single-spiking isotope dilution mass spectrometry (IDMS). The mathematical relationships in IDMS and SIDMS quantifications are based on isotopic ratios and do not involve calibration curves. The protocols were validated using spike recovery tests and by analyzing synthetic standard solutions. Red blood cell (RBC) and saliva samples obtained from healthy subjects, and whole blood samples collected and shipped from a remote location were analyzed. The concentrations of tGSH in the RBC and whole blood samples were 2 orders of magnitude higher than those found in saliva. The fractions of GSSG were 0.2-2.2% (RBC and blood) and 15-47% (saliva) of the free glutathione (GSH + 2xGSSG) in the corresponding samples. Up to 3% GSH was auto-oxidized to GSSG during sample workup; the highest oxidations (>1%) were in the saliva samples.

Pediatric chaplains iterative process to address religious & spiritual struggle: a qualitative study.

The growing body of literature on religious and spiritual (R/S) struggles consistently highlights its association with various health outcomes in Pediatrics. Chaplains or spiritual care providers, as members of interdisciplinary teams, frequently offer spiritual care to patients and families grappling with R/S struggles. However, there is a paucity of literature demonstrating how chaplains address R/S struggle in their practice. This study aimed to construct a theory describing the process by which pediatric chaplains conceptualize and address it. Employing a constructivist Grounded Theory study design, we sought to comprehend the approaches pediatric chaplains utilize in addressing R/S struggles. Following a semi-structured interview guide, we interviewed twelve Board Certified or Board Certification-eligible chaplains. Findings reveal that chaplains use an iterative three-phase process to address R/S struggles. Thirteen categories emerged, which were further organized into four major themes: Assessing, Processing, Intervening, and Navigating Limitations. A model depicting this iterative process was constructed.

Evaluation of Deep Brain Stimulation (DBS) Lead Biomechanical Interaction with Brain Tissue.

The current study aims to examine the effect of material properties on implanted leads used for deep brain stimulation (DBS) using finite element (FE) analysis to investigate brain deformation around an implanted DBS lead in response to daily head accelerations. FE analysis was used to characterize the relative motion of the DBS lead in a suite of fifteen cases sampled from a previously derived kinematic envelope representative of everyday activities describing translational and rotational pulse shape, magnitude, and duration. Load curves were applied to the atlas-based brain model (ABM) with a scaled Haversine acceleration pulse in four directions of rotation: + X, - Y, + Y, and + Z. In addition to the fifteen sampled cases, six experimental cases taken from a previous literature review were also simulated for comparison. The current investigation found that there was very little difference in brain response for the DBS leads with two different material properties. In general, the brain and DBS lead experienced the greatest deformation during rotation about the Z axis for similar load cases. In conclusion, this study showed that there was no significant difference in implanted DBS lead deformation based on lead material properties.

Driver head kinematics in grassroots dirt track racing crashes: A pilot analysis.

Motorsport athletes experience head acceleration loading during crashes; however, there is limited literature quantifying the frequency and magnitude of these loads, particularly at the grassroots level of the sport. Understanding head motion experienced during crash events in motorsport is necessary to inform interventions to improve driver safety. This study aimed to quantify and characterize driver head and vehicle kinematics during crashes in open-wheel grassroots dirt track racing. Seven drivers (ages 16-22, n = 2 female) competing in a national midget car series were enrolled in this study over two racing seasons and were instrumented with custom mouthpiece sensors. Drivers' vehicles were outfitted with an incident data recorder (IDR) to measure vehicle acceleration. Forty-one crash events were verified and segmented into 139 individual contact scenarios via film review. Peak resultant linear acceleration (PLA) of the vehicle and PLA, peak rotational acceleration (PRA), and peak rotational velocity (PRV) of the head were quantified and compared across the part of the vehicle contacted (i.e., tires or chassis), the vehicle location contacted (e.g., front, left, bottom), the external object contacted (i.e., another vehicle, wall, or the track), and the principal direction of force (PDOF). The median (95th percentile) PLA, PRA, and PRV of the head and PLA of the vehicle were 12.3 (37.3) g, 626 (1799) rad/s2, 8.92 (18.6) rad/s, and 23.2 (88.1) g, respectively. Contacts with a non-horizontal PDOF (n = 98, 71%) and contact with the track (n = 96, 70%) were common in the data set. Contact to the left side of the vehicle, with the track, and with a non-horizontal PDOF tended to have the greatest head kinematics compared to other factors in each sub-analysis. Results from this pilot study can inform larger studies of head acceleration exposure during crashes in the grassroots motorsports environment and may ultimately support evidence-based driver safety interventions.

Controlling the Burden of COVID-19 by Manipulating Host Metabolism.

The coronavirus disease 2019 (COVID-19) pandemic caused by the coronavirus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to cause global health problems, but its impact would be minimized if the many effective vaccines that have been developed were available and in widespread use by all societies. This ideal situation is not occurring so other means of controlling COVID-19 are needed. In this short review, we make the case that manipulating host metabolic pathways could be a therapeutic approach worth exploring. The rationale for such an approach comes from the fact that viruses cause metabolic changes in cells they infect, effective host defense mechanisms against viruses requires the activity of one or more metabolic pathways, and that hosts with metabolic defects such as diabetes are more susceptible to severe consequences after COVID-19. We describe the types of approaches that could be used to redirect various aspects of host metabolism and the success that some of these maneuvers have had at controlling other virus infections. Manipulating metabolic activities to control the outcome of COVID-19 has to date received minimal attention. Manipulating host metabolism will never replace vaccines to control COVID-19 but could be used as an adjunct therapy to the extent of ongoing infection.

Cumulative strain-based metrics for predicting subconcussive head impact exposure-related imaging changes in a cohort of American youth football players.

OBJECTIVE: Youth football athletes are exposed to repetitive subconcussive head impacts during normal participation in the sport, and there is increasing concern about the long-term effects of these impacts. The objective of the current study was to determine if strain-based cumulative exposure measures are superior to kinematic-based exposure measures for predicting imaging changes in the brain. METHODS: This prospective, longitudinal cohort study was conducted from 2012 to 2017 and assessed youth, male football athletes. Kinematic data were collected at all practices and games from enrolled athletes participating in local youth football organizations in Winston-Salem, North Carolina, and were used to calculate multiple risk-weighted cumulative exposure (RWE) kinematic metrics and 36 strain-based exposure metrics. Pre- and postseason imaging was performed at Wake Forest School of Medicine, and diffusion tensor imaging (DTI) measures, including fractional anisotropy (FA), and its components (CL, CP, and CS), and mean diffusivity (MD), were investigated. Included participants were youth football players ranging in age from 9 to 13 years. Exclusion criteria included any history of previous neurological illness, psychiatric illness, brain tumor, concussion within the past 6 months, and/or contraindication to MRI. RESULTS: A total of 95 male athletes (mean age 11.9 years [SD 1.0 years]) participated between 2012 and 2017, with some participating for multiple seasons, resulting in 116 unique athlete-seasons. Regression analysis revealed statistically significant linear relationships between the FA, linear coefficient (CL), and spherical coefficient (CS) and all strain exposure measures, and well as the planar coefficient (CP) and 8 strain measures. For the kinematic exposure measures, there were statistically significant relationships between FA and RWE linear (RWEL) and RWE combined probability (RWECP) as well as CS and RWEL. According to area under the receiver operating characteristic (ROC) curve (AUC) analysis, the best-performing metrics were all strain measures, and included metrics based on tensile, compressive, and shear strain. CONCLUSIONS: Using ROC curves and AUC analysis, all exposure metrics were ranked in order of performance, and the results demonstrated that all the strain-based metrics performed better than any of the kinematic metrics, indicating that strain-based metrics are better discriminators of imaging changes than kinematic-based measures. Studies relating the biomechanics of head impacts with brain imaging and cognitive function may allow equipment designers, care providers, and organizations to prevent, identify, and treat injuries in order to make football a safer activity.

Characterizing Exposure to Head Acceleration Events in Youth Football Using an Instrumented Mouthpiece.

Understanding characteristics of head acceleration events (HAEs) in youth football is vital in developing strategies to improve athlete safety. This study aimed to characterize HAEs in youth football using an instrumented mouthpiece. Youth football athletes (ages 11-13) participating on two teams were enrolled in this study for one season. Each athlete was instrumented with a mouthpiece-based sensor throughout the season. HAEs were verified on film to ensure that mouthpiece-based sensors triggered during contact. The number of HAEs, peak resultant linear and rotational accelerations, and peak resultant rotational velocity were quantified. Mixed effects models were used to evaluate differences in mean kinematic metrics among all HAEs for session type, athlete position, and contact surface. A total of 5,292 HAEs were collected and evaluated from 30 athletes. The median (95th percentile) peak resultant linear acceleration, rotational acceleration, and rotational velocity was 9.5 g (27.0 g), 666.4 rad s-2 (1863.3 rad s-2), and 8.5 rad s-1 (17.4 rad s-1), respectively. Athletes experienced six (22) HAEs per athlete per session (i.e., practice, game). Competition had a significantly higher mean number of HAEs per athlete per session and mean peak rotational acceleration. Peak resultant rotational kinematics varied significantly among athlete positions. Direct head impacts had higher mean kinematics compared to indirect HAEs, from body collisions. The results of this study demonstrate that session type, athlete position, and contact surface (i.e., direct, indirect) may influence HAE exposure in youth football.

Pilot characterization of head kinematics in grassroots dirt track racing.

OBJECTIVE: The objective of this study was to utilize an instrumented mouthpiece sensor to characterize head kinematics experienced by grassroots dirt track race car drivers. METHODS: Four dirt track race car drivers (ages 16-19) were instrumented with custom mouthpiece sensors capable of accurately measuring head motion during racing. Sensors were deployed before races and recorded tri-axial linear acceleration and rotational velocity for approximately 10 min at 200 Hz. Film review was performed to identify data associated with racing laps. For each lap, moving average kinematics were computed and subtracted from the head motion signals to obtain 'adjusted' head motion accounting for lower frequency variance due to periodic motion around the track. From adjusted data, linear and angular head perturbations (i.e., deviations from moving average) were extracted using a custom algorithm. RESULTS: Data was collected during 400 driver-races. A total of 2438 laps were segmented from mouthpiece recordings. The median (95th percentile) peak linear acceleration, rotational velocity, and rotational acceleration of all laps were 5.33 (8.28) g, 2.89 (4.60) rad/s, and 179 (310) rad/s2, respectively. Angular perturbations occurred most frequently about the anterior-posterior axis (median lap frequency = 6.39 Hz); whereas linear perturbations occurred most frequently in the inferior-superior direction (7.96 Hz). Nine crash events were recorded by the mouthpiece sensors. The median (95th percentile) peak head kinematics of these events were 13.4 (36.6) g, 9.67 (21.9) rad/s, and 630 (1330) rad/s2. CONCLUSIONS: Mouthpiece sensors can be used to measure head kinematics during active racing. Laps, head perturbations, and crashes may be useful units of observation to describe typical head kinematic exposure experienced by drivers while racing. Subsequent research is needed to understand the associations between repetitive racing exposure and neurological function. Higher magnitude events (i.e., crashes) are not uncommon and may result in concussion or more severe injury. Results represent novel characterizations of head kinematic exposure experienced in a dirt track racing environment. This information may inform evidence-based strategies (e.g., vehicle/seat design) to improve driver safety.