Normative Data Set of SWAY Balance Mobile Assessment in Pediatric Athletes.

OBJECTIVE: To examine and describe normative values for an objective, mobile measure of postural stability commonly used in concussion assessments, SWAY Balance (SWAY Medical, Tulsa, Oklahoma). DESIGN: Retrospective analysis of baseline balance assessments in a healthy pediatric population. SETTING: Baseline assessments completed by certified athletic trainers at an outpatient concussion center or sports medicine offices in Philadelphia, PA and surrounding suburban Pennsylvania and New Jersey or during an athletic trainer's baseline assessment of collegiate athletes at a National Collegiate Athletic Association (NCAA) Division-II University in Fort Lauderdale, FL. PARTICIPANTS: Test results of a sample of 466 athletes aged 5 to 18 years were included. INTERVENTIONS: The SWAY Balance test was administered using a mobile device on all participants as part of a standard preseason, baseline evaluation, following the standard evaluation protocol. MAIN OUTCOME MEASURES: Baseline SWAY Balance mobile assessment balance and reaction time scores, age and sex effects, were examined. RESULTS: Normative scores are described, with results stratified into 4 age groups (5-9, 10-12, 13-17, and 18 years old). Balance scores, overall and within each individual stance score, improved with the age of the participants. Sex effects on balance were only seen in single-leg stances, with females outperforming males. Reaction time was found to be faster in males and improved with age, peaking at 13 to 17 years old and slowing in 18-year-olds. CONCLUSIONS: Normative, age-specific SWAY Balance test results provided are of clinical use as references in the concussion assessments of pediatric athletes.

Comparison of microplastic isolation and extraction procedures from marine sediments.

Microplastics (MPs) are small (<5 mm) plastic particles which pose a threat to marine ecosystems. Identifying MPs is crucial for understanding their fate and effects. Many MP extraction methods exist, but procedural differences prevent meaningful comparisons across datasets. This method comparison examines the efficiency of five methods for extracting MPs (40-710 µm) from marine sediments. Known quantities of MPs were spiked into sediments. The MPs were extracted and enumerated to demonstrate percent recovery. Findings determined that sediment matrix, MP properties, and extraction method affect the percent recovery of MPs from sediments. Average recoveries of spiked microplastics were between 0 and 87.4% and varied greatly by sediment type, microplastic, and method of extraction. In general, larger particle and lower density MPs were more effectively recovered. Marine sediments low in organic matter and with larger grain size also had higher percent recoveries of MPs. These findings support the need for method optimization and unified procedures.

Effects of graphene oxide nanomaterial exposures on the marine bivalve, Crassostrea virginica.

Since its discovery in 2004, graphene has been used in a wide variety of fields including biomedicine, electronics, filtration materials, and surface coatings. The rapidly expanding consumer market for graphene family nanomaterials (GFNs), such as graphene oxide (GO), raises concern regarding their environmental toxicity. The aim of this study was to evaluate the effects of GO exposures in a marine filter-feeding bivalve (Crassostrea virginica) using sublethal biomarker approaches that can contribute to the development of an adverse outcome pathway (AOP). A 14-day study was conducted to identify tissue-specific molecular markers of GO toxicity using a static renewal design. Elevated lipid peroxidation and changes in glutathione-s-transferase (GST) activities were observed in gills and digestive gland tissues of the GO-exposed oysters. These cellular changes were noted for 2.5 and 5 mg/L GO exposures in seawater. Based on our results, reactive oxygen species (ROS)-induced oxidative damage is identified as a key event in the proposed AOP. Additionally, detoxification enzymes, such as GST, are thought to be involved in stress signaling leading to adverse effects on cellular health. This study is a part of our two-tier approach towards the identification of short- and long-term effects of GO exposures. This work, together with our previous 72 h exposure, represents the application of biomarker-based investigations in the process of AOP development for graphene family nanomaterials.

A 72-h exposure study with eastern oysters (Crassostrea virginica) and the nanomaterial graphene oxide.

Graphene is a 2-dimensional nanomaterial with unique mechanical, thermal, electrical, and optical properties. With increasing applications of graphene-family nanomaterials (GFNs) in electronics, biomedicine, and surface coatings, concern for their impacts on aquatic ecosystems is rising. Current information on the toxicity of GFNs, including graphene oxide, is scarce. Filter-feeding bivalves, such as eastern oysters, are good models for nanomaterial exposure studies. We present results from a 72-h static renewal oyster study using 1 and 10 mg/L graphene oxide, which, to our knowledge, is the first report on in vivo effects of graphene oxide exposures in marine bivalves. Water samples were analyzed for graphene oxide concentration and size assessments. Gill and digestive gland tissues were evaluated for lipid peroxidation and glutathione-S-transferase (GST) activity. In addition, gill sections were fixed for histopathological analyses. Elevated lipid peroxidation was noted in oysters exposed to 10 mg/L graphene oxide. No significant changes in GST activity were observed, but reduced total protein levels were found in digestive gland tissues of exposed oysters at both concentrations. Loss of mucous cells, hemocytic infiltration, and vacuolation were observed in gills of exposed oysters. The results indicate that short-term graphene oxide exposures can induce oxidative stress and epithelial inflammation and adversely affect overall oyster health. Further investigations regarding the fate and sublethal effects of graphene oxide are critical to understanding the risks associated with a rapidly growing graphene consumer market. Environ Toxicol Chem 2019;38:820-830. Published 2019 Wiley Periodicals Inc. on behalf of SETAC. This article is a US government work and, as such, is in the public domain in the United States of America.

A case matched study examining the reliability of using ImPACT to assess effects of multiple concussions.

BACKGROUND: Approximately 3.8 million sport and recreational concussions occur per year, creating a need for accurate diagnosis and management of concussions. Researchers and clinicians are exploring the potential dose-response cumulative effects of concussive injuries using computerized neuropsychological exams, however, results have been mixed and/or contradictory. This study starts with a large adolescent population and applies strict inclusion criteria to examine how previous mild traumatic brain injuries affect symptom reports and neurocognitive performance on the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) computerized tool. METHODS: After applying exclusion criteria and case matching, 204 male and 99 female participants remained. These participants were grouped according to sex and the number of previous self-reported concussions and examined for overall differences on symptoms reported and scores obtained on the ImPACT neurocognitive battery composites. In an effort to further reduce confounding factors due to the varying group sizes, participants were then case matched on age, sex, and body mass index and analyzed for differences on symptoms reported and scores obtained on the ImPACT neurocognitive battery composites. RESULTS: Case matched analysis demonstrated males with concussions experience significantly higher rates of dizziness (p = .027, η2 = .035), fogginess (p = .038, η2 = .032), memory problems (p = .003, η2 = .055), and concentration problems (p = .009, η2 = .046) than males with no reported previous concussions. No significant effects were found for females, although females reporting two concussions demonstrated a slight trend for experiencing higher numbers of symptoms than females reporting no previous concussions. CONCLUSIONS: The results suggest that male adolescent athletes reporting multiple concussions have lingering concussive symptoms well after the last concussive event; however, these symptoms were found to be conflicting and better explained by complainer versus complacent attitudes in the population examined. Our results conflict with a significant portion of the current literature that uses relatively lenient inclusion and exclusion criteria, providing evidence of the importance of strict inclusion and exclusion criteria and examination of confounding factors when assessing the effects of concussions.

Concussion history and knowledge base in competitive equestrian athletes.

BACKGROUND: Head injuries are responsible for the majority of serious equestrian sports injuries and deaths. Because of significant health risks to equestrians, education regarding the prevention of head and brain injuries is essential. HYPOTHESIS: A significant number of riders have experienced a concussion, and few have knowledge of concussion. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 2. METHODS: Ninety-four riders competing, riding, or attending equestrian events at the Palm Beach International Equestrian Center in Wellington, Florida, from January to April 2010 were surveyed. Measures of central tendency were utilized to evaluate response patterns. RESULTS: Almost half of equestrian riders (44%) experienced concussions during their careers. Those riders who suffered a brain injury were likely to return to riding without seeking medical clearance. Almost 40% of riders were never educated regarding concussions, while 15% received education from their trainers. CONCLUSION: Education of riders, parents, and horse trainers is needed to raise awareness of concussions and reduce the likelihood of subsequent injuries.