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Diabetes Mellitus , Salud Global , Medicina de Precisión , Humanos , Diabetes Mellitus/terapiaRESUMEN
Maintaining balance is a complex motor problem that requires coordinated contributions from multiple biological systems. Aging inevitably lessens the fidelity of biological systems, which can result in an increased risk of falling, and associated injuries. It is advantageous to land safely, but falls manifest in diverse ways, so different motor solutions are required to land safely. However, without considerable practice, it is difficult to recall the appropriate motor solution for a fall and then apply it effectively in the brief duration before hitting the ground. A complex systems perspective provides a lens through which to view the problem of safe-landing. It may be possible to use motor analogies to promote degeneracy within the perceptual-motor system so that, regardless of the direction in which an older person falls, their body self-organizes to land with less likelihood of injury.
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Being able to tread water effectively can improve the likelihood of survival following accidental immersion. People tread water in various ways, ranging from rudimentary 'doggy-paddle' to more elaborate techniques like the eggbeater, but little is known about the energetic and cognitive requirements of treading water. We therefore aimed to measure the demands of treading water techniques for people of different experience levels. Three cohorts, comprising 21 adult water treading experts (water polo players), 15 intermediate swimmers and 16 inexperienced swimmers, treaded water for 3 min each using four different techniques while cognitive and energetic economy measures were taken. For inexperienced swimmers, the flutter kick and breaststroke patterns produced the lowest self-reported physical and task load (rating of perceived exertion, NASA task load index), while cognitive (probe reaction time), cardiac (heart rate) and metabolic (oxygen consumption) load did not differ between techniques. In contrast, for expert water treaders, both breaststroke and eggbeater patterns produced lower cognitive, cardiac and metabolic loads. For intermediate swimmers, breaststroke resulted in the lowest cardiac and metabolic loads, as well as self-reported task load. Probe reaction time was highest while performing the eggbeater technique, indicating that this technique was challenging to coordinate and cognitively demanding. While the energetic demands of antiphase kicking patterns (such as eggbeater in experts or flutter kick in beginners) may be similarly low, the symmetric coordination of upright breaststroke may explain why this pattern's cognitive economy was favourable for all groups. As the eggbeater can be challenging to perform for many people, an upright breaststroke technique is an adequate alternative to adopt in survival situations.
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Natación , Deportes Acuáticos , Adulto , Humanos , Natación/fisiología , Consumo de Oxígeno , CogniciónRESUMEN
KEY MESSAGE: Greater embryo size in a large and carefully phenotyped mapping population was genetically associated with a greater number of longer seminal roots to increase grain yield in droughted field environments. Breeding modification of root architecture is challenging in field environments owing to genetic and phenotypic complexity, and poor repeatability with root sampling. Seeds from a large mapping population varying in embryo size were harvested from a common glasshouse and standardised to a common size before assessing in rolled germination paper at 12 and 20 °C for seedling growth. Differences in genotype means were large and heritabilities high (h2 = 0.55-0.93) indicating strong and repeatable genotypic differences for most root traits. Seminal roots 1 to 3 were produced on all seedlings, whereas growth of seminal roots 4, 5 and 6 was associated with differences in embryo size. Increases in seminal root number from 4 to 6 per plant were strongly, genetically correlated with increases in total seminal length (rg = 0.84, < 0.01). Multivariate analysis confirmed initiation and growth of seminal roots 1, 2 and 3, and of roots 4, 5 and 6 behaved as genetically independent (rPg = 0.15 ns) cohorts. Tails representing extremes in seedling root length and number were associated with significant differences in grain yield of up to 35% in droughted field environments but were not different in irrigated environments. Increases in grain yield were linked to greater lengths of seminal roots 4, 5 and 6 and were largely independent of plant height or development. This is the first report on the genetic relationship of seedling root architecture and embryo size, and potential in selection of seminal root size for accessing deep-soil moisture in droughted environments.
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Plantones , Triticum , Grano Comestible/genética , Genotipo , Fitomejoramiento , Raíces de Plantas/genética , Plantones/genética , Suelo , Triticum/genéticaRESUMEN
Mitochondrial DNA copy number (mtDNA-CN) measured from blood specimens is a minimally invasive marker of mitochondrial function that exhibits both inter-individual and intercellular variation. To identify genes involved in regulating mitochondrial function, we performed a genome-wide association study (GWAS) in 465,809 White individuals from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium and the UK Biobank (UKB). We identified 133 SNPs with statistically significant, independent effects associated with mtDNA-CN across 100 loci. A combination of fine-mapping, variant annotation, and co-localization analyses was used to prioritize genes within each of the 133 independent sites. Putative causal genes were enriched for known mitochondrial DNA depletion syndromes (p = 3.09 × 10-15) and the gene ontology (GO) terms for mtDNA metabolism (p = 1.43 × 10-8) and mtDNA replication (p = 1.2 × 10-7). A clustering approach leveraged pleiotropy between mtDNA-CN associated SNPs and 41 mtDNA-CN associated phenotypes to identify functional domains, revealing three distinct groups, including platelet activation, megakaryocyte proliferation, and mtDNA metabolism. Finally, using mitochondrial SNPs, we establish causal relationships between mitochondrial function and a variety of blood cell-related traits, kidney function, liver function and overall (p = 0.044) and non-cancer mortality (p = 6.56 × 10-4).
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Variaciones en el Número de Copia de ADN , ADN Mitocondrial , Megacariocitos/fisiología , Mitocondrias/genética , Activación Plaquetaria , Polimorfismo de Nucleótido Simple , Anciano , Proliferación Celular , Femenino , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Humanos , Masculino , Persona de Mediana Edad , Nucleótidos/metabolismo , FenotipoRESUMEN
Implicit motor learning paradigms aim to minimize verbal-analytical engagement in motor performance. Some paradigms do this by decreasing working memory activity during practice, which reduces explicit processes associated with the search for motor solutions (e.g., hypothesis testing). Here we designed a mentally demanding motor task to fatigue working memory prior to motor practice and then tested whether it reduced hypothesis testing. Fifty-nine participants were randomly assigned to complete the mentally demanding motor task (cognitive fatigue group) or to complete an undemanding motor task (nonfatigued control group). Feelings of fatigue, working memory functions, electroencephalography (EEG) Fz power, and vagal control were assessed pre- and posttask to quantify the effect of the mentally demanding motor task on cognitive fatigue. Thereafter, an adapted shuffleboard task was completed to determine the impact on hypothesis testing. Hypothesis testing was assessed by self-report, technique changes, and equipment-use solutions. Additionally, verbal-analytical engagement in motor performance was (indirectly) gauged with EEG T7-Fz connectivity and T7 power measures. Participants in the cognitive fatigue group reported more fatigue and displayed moderated working memory functions and Fz theta power. During practice of the shuffleboard task, participants also displayed more technique changes and higher verbal-analytical engagement in motor planning (EEG T7-Fz connectivity), compared with participants in the control group. The mentally demanding motor task suppressed working memory functions, but resulted in more, rather than less, hypothesis testing during shuffleboard practice. The implications are discussed in the context of implicit motor learning theory. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Memoria a Corto Plazo , Destreza Motora , Electroencefalografía , HumanosRESUMEN
The inodilator levosimendan, in clinical use for over two decades, has been the subject of extensive clinical and experimental evaluation in various clinical settings beyond its principal indication in the management of acutely decompensated chronic heart failure. Critical care and emergency medicine applications for levosimendan have included postoperative settings, septic shock, and cardiogenic shock. As the experience in these areas continues to expand, an international task force of experts from 15 countries (Austria, Belgium, China, Croatia, Finland, France, Germany, Greece, Hungary, Italy, the Netherlands, Spain, Sweden, Switzerland, and the USA) reviewed and appraised the latest additions to the database of levosimendan use in critical care, considering all the clinical studies, meta-analyses, and guidelines published from September 2019 to November 2021. Overall, the authors of this opinion paper give levosimendan a "should be considered" recommendation in critical care and emergency medicine settings, with different levels of evidence in postoperative settings, septic shock, weaning from mechanical ventilation, weaning from veno-arterial extracorporeal membrane oxygenation, cardiogenic shock, and Takotsubo syndrome, in all cases when an inodilator is needed to restore acute severely reduced left or right ventricular ejection fraction and overall haemodynamic balance, and also in the presence of renal dysfunction/failure.
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This research project aimed to develop and validate a rowing-specific reinvestment scale. In Study 1, a 24-item questionnaire was developed and the content validity was assessed using experts (N = 7) and pilot-tested in rowers (N = 24). Next, rowers (N = 282) completed the questionnaire with the remaining items, and exploratory factor analysis (EFA) was conducted. This further reduced the number of items and revealed two factors, rowing specific conscious motor processing (RS-CMP) and movement self-consciousness (RS-MSC). In Study 2, rowers (N = 270) completed the scale that was evaluated using confirmatory factor analysis (CFA). Moreover, the construct validity of the scale was investigated by asking them to complete measures of movement-specific reinvestment, perceived performance, self-consciousness, and state anxiety. Actual performance was also determined based on their race finishing position. Study 1 EFA resulted in a 2-factor model with six items assessing RS-CMP and six items assessing RS-MSC. Study 2 supported the factor structure of scale; CFA indicated an acceptable model fit with good internal consistency. Content validity was also supported, with evidence of concurrent, convergent, discriminant, and predictive validity. In conclusion, these studies provided good initial evidence for the validity and reliability of the RSRS.
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Ansiedad , Deportes Acuáticos , Análisis Factorial , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
In an immersion incident, a person may be required to tread water for extended periods of time in order to survive. Treading water, or maintaining a stable head position above the water surface, can be achieved in several different ways. Determining which treading water techniques are economic (energetically and cognitively) is an important first step in approaching evidence-based water safety instruction. The present study investigated the cognitive and metabolic demands associated with four main techniques for treading water in experienced water treaders. Skilled water treaders (n=21) performed four common treading techniques for 3min each: "running" in the water, "flutter kick" with hands sculling, "upright breaststroke," and "egg-beater." Self-reported rate of perceived exertion (RPE) and task load index (TLX) score, as well as objective measures of probe reaction time (PRT; i.e., response to auditory cues while treading), oxygen consumption and heart rate were assessed. The "egg-beater" technique and the "upright breaststroke" technique were linked to significantly lower cognitive and energetic demands compared to the other techniques (VO2: p<0.001 - "Running" M=29.02, SD=7.40/"Flutter kick" M=29.37, SD=8.56, "Breaststroke" M=23.47, SD=7.28, and "Eggbeater" M=23.18, SD=6.31). This study lays the groundwork for future research that may establish the ideal movement behavior in drowning situations and investigate movement instruction to less experienced treaders.
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Background: Decades of research, largely from associational studies, show that the relationships of movement proficiency with the cognitive and social aspects of development are particularly strong in early childhood. Children who move proficiently tend to have better cognitive skills and social behaviors. However, the mechanisms that underpin these relationships remain unclear and research that explores causation is necessary. This study will explore the antecedent role of movement proficiency in the cognitive and social domains of child development, by examining whether a targeted movement skills training program facilitates improvements in cognitive and social skills. Methods: A group-randomized controlled trial will be conducted, implementing a fundamental movement skills training program in Hong Kong kindergartens. Participants will consist of children aged 3-5 years (N = 158) who will be randomly allocated by class to either a training or active control condition. The training program (10 weeks × 2 bouts) will be informed by an error-reduced approach to skills learning, which will involve careful design and manipulation of equipment and training environment to minimize practice errors. The active control condition will consist of typical movement activities implemented in the kindergartens in the context of the local curriculum guide. Outcomes will be measured using standardized tests of gross motor skills proficiency, executive functioning, and social skills. Measurements will occur at baseline, mid-training, post-training, and follow-up. Latent variable longitudinal modeling will be used to analyze changes in the outcomes, with covariates that include sex, body composition, fine motor skills, and physical activity. Expected Results: The findings will subsequently be reported consistent with the Consolidated Standards of Reporting Trials (CONSORT) statement. Contributions to knowledge and understanding of child development are expected, through evidence of causal mechanisms surrounding the relationship of motor with cognitive and social development. The findings will also inform policy and practice related to early childhood development and education.
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Purpose A speech-specific reinvestment scale (SSRS) is a psychometric measure of the propensity to consciously control and monitor speech production. This study develops and validates an SSRS as well as examines its relationship with speech performance with the moderating effects of trait social anxieties (i.e., social interaction anxiety, public speaking anxiety, and social phobia). Method Scale development involves the following stages: (a) initial item generation based on relevant literature, (b) item evaluation through cognitive interviews with 24 healthy respondents, (c) scale reliability and validity tests using cross-sectional survey data from 498 healthy respondents, and (d) test-retest reliability assessment using longitudinal survey data from 185 healthy respondents. Respondents' speech performance is quantified using speech examination scores. Hierarchical moderated regression analyses are conducted to examine the moderating effects of trait social anxieties. Results The validated SSRS comprises 35 items, which can be categorized into four subdimensions, namely, speech movement self-consciousness, public consciousness of speech content, speech manner, and speech movement. Results show that respondents with low trait social anxieties indicate a generally positive relationship between public consciousness of speech movement and speech performance, whereas respondents with high trait social anxieties exhibit a nonsignificant relationship. Conclusions SSRS offers a reliable and valid method for assessing the predisposition for conscious speech control and monitoring, which plays a role in speech performance and is moderated by an individual's level of trait social anxiety. SSRS is a potential assessment tool for speech-language pathologists to evaluate the impacts of conscious speech control and monitoring on individuals with speech impairment.
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Ansiedad , Habla , Estudios Transversales , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
We examined the effect of verbalization of a phylogenetic motor skill, balance, in older and young adults with a low or a high propensity for conscious verbal engagement in their movements (reinvestment). Seventy-seven older adults and 53 young adults were categorized as high or low reinvestors, using the Movement Specific Reinvestment Scale, which assesses propensity for conscious processing of movements. Participants performed a pre- and post-test balance task that required quiet standing on a force-measuring plate. Prior to the post-test, participants described their pre-test balancing performance (verbalization) or listed animals (non-verbalization). Only young adults were affected by verbalization, with participants with a high propensity for reinvestment displaying increased medial-lateral entropy and participants with a low propensity for reinvestment displaying increased area of sway and medial-lateral sway variability following the intervention. The possible explanations for these results are discussed.
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Envejecimiento/fisiología , Procesos Mentales/fisiología , Movimiento/fisiología , Equilibrio Postural/fisiología , Anciano , Cognición , Entropía , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Conducta Verbal/fisiología , Adulto JovenRESUMEN
OBJECTIVES: The aim of this study was to examine the association between conscious monitoring and control of movements (i.e., movement-specific reinvestment) and visuomotor control during walking by older adults. METHOD: The Movement-Specific Reinvestment Scale (MSRS) was administered to 92 community-dwelling older adults, aged 65-81 years, who were required to walk along a 4.8-m walkway and step on the middle of a target as accurately as possible. Participants' movement kinematics and gaze behavior were measured during approach to the target and when stepping on it. RESULTS: High scores on the MSRS were associated with prolonged stance and double support times during approach to the stepping target, and less accurate foot placement when stepping on the target. No associations between MSRS and gaze behavior were observed. DISCUSSION: Older adults with a high propensity for movement-specific reinvestment seem to need more time to "plan" future stepping movements, yet show worse stepping accuracy than older adults with a low propensity for movement-specific reinvestment. Future research should examine whether older adults with a higher propensity for reinvestment are more likely to display movement errors that lead to falling.
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Atención , Movimiento , Caminata/fisiología , Anciano , Anciano de 80 o más Años , Atención/fisiología , Fenómenos Biomecánicos , Medidas del Movimiento Ocular , Femenino , Fijación Ocular , Humanos , Masculino , Movimiento/fisiología , Percepción Visual , Caminata/psicologíaRESUMEN
Background/Study Context: Adjustments of posture in response to balance challenges may lead to subsequent increases in conscious posture processing. If cognitive resources are stretched by conscious processing of postural responses fewer resources will be available to attend to environmental trip or fall hazards. The objective of the study was to explore brain activity related to conscious processing of posture as a function of movement specific reinvestment and fear of falling. Method: Forty-three older adults (M = 71.4, SD = 4.1) stood with a wide or narrow stance on a force-plate while neural coherence between verbal-analytical (T3) and motor planning (Fz) regions of the brain was assessed using electroencephalography. The propensity for movement specific reinvestment was assessed using the Chinese version Movement Specific Reinvestment Scale (MSRS-C) and fear of falling was assessed using the Chinese version Fall Efficacy Scale International (FES-I[CH]). Results: Scores from the MSRS-C were negatively correlated with changes in T3-Fz coherence that occurred when participants shifted from wide to narrow stance. Together, MSRS-C and FES-I(CH) uniquely predicted the percentage change in T3-Fz coherence between the two stance conditions. Conclusion: Presented with two postural tasks of different complexities, participants with a lower propensity for conscious control of their movements (movement specific reinvestment) exhibited larger changes in real-time brain activity (neural coherence) associated with conscious postural processing.
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Envejecimiento/fisiología , Encéfalo/fisiología , Postura/fisiología , Accidentes por Caídas , Anciano , Electroencefalografía , Miedo/fisiología , Femenino , Humanos , Masculino , Movimiento/fisiología , Equilibrio Postural/fisiologíaRESUMEN
Our understanding of how the gut microbiome interacts with its human host has been restrained by limited access to longitudinal datasets to examine stability and dynamics, and by having only a few isolates to test mechanistic hypotheses. Here, we present the Broad Institute-OpenBiome Microbiome Library (BIO-ML), a comprehensive collection of 7,758 gut bacterial isolates paired with 3,632 genome sequences and longitudinal multi-omics data. We show that microbial species maintain stable population sizes within and across humans and that commonly used 'omics' survey methods are more reliable when using averages over multiple days of sampling. Variation of gut metabolites within people over time is associated with amino acid levels, and differences across people are associated with differences in bile acids. Finally, we show that genomic diversification can be used to infer eco-evolutionary dynamics and in vivo selection pressures for strains within individuals. The BIO-ML is a unique resource designed to enable hypothesis-driven microbiome research.
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Bacterias/genética , Microbioma Gastrointestinal/genética , Filogenia , Selección Genética/genética , Bacterias/clasificación , Bacterias/aislamiento & purificación , Ácidos y Sales Biliares/genética , Ácidos y Sales Biliares/metabolismo , Bancos de Muestras Biológicas , Heces/microbiología , Variación Genética/genética , Genoma Bacteriano/genética , Humanos , Metaboloma/genéticaRESUMEN
Stomata regulate important physiological processes in plants and are often phenotyped by researchers in diverse fields of plant biology. Currently, there are no user-friendly, fully automated methods to perform the task of identifying and counting stomata, and stomata density is generally estimated by manually counting stomata. We introduce StomataCounter, an automated stomata counting system using a deep convolutional neural network to identify stomata in a variety of different microscopic images. We use a human-in-the-loop approach to train and refine a neural network on a taxonomically diverse collection of microscopic images. Our network achieves 98.1% identification accuracy on Ginkgo scanning electron microscropy micrographs, and 94.2% transfer accuracy when tested on untrained species. To facilitate adoption of the method, we provide the method in a publicly available website at http://www.stomata.science/.
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Procesamiento de Imagen Asistido por Computador , Redes Neurales de la Computación , Estomas de Plantas/anatomía & histología , Automatización , Bases de Datos como Asunto , Humanos , Modelos Lineales , FilogeniaRESUMEN
Urinary tract infections (UTIs) are common among college-aged women and often recur. Some antibiotics recommended to treat UTIs trigger dysbiosis of intestinal and vaginal microbiomes - where uropathogens originate, though few studies have investigated associations between these therapies with recurrent infections. We retrospectively analysed the electronic medical records of 6651 college-aged women diagnosed with a UTI at a US university student health centre between 2006 and 2014. Women were followed for 6 months for incidence of a recurrent infection. In a secondary analysis, associations in women whose experienced UTI recurrence within 2 weeks were also considered for potential infection relapse. Logistic regression was used to assess associations between infection recurrence or relapse and antibiotics prescribed, in addition to baseline patient characteristics including age, race/ethnicity, region of origin, year of encounter, presence of symptomology, pyelonephritis, vaginal coinfection and birth control consultation. There were 1051 instances of infection recurrence among the 6620 patients, indicating a prevalence of 16%. In the analysis of patient characteristics, Asian women were statistically more likely to experience infection recurrence whereas African American were less likely. No significant associations were identified between the antibiotic administered at the initial infection and the risk of infection recurrence after multivariable adjustment. Treatment with trimethoprim-sulphamethoxazole and being born outside of the USA were significantly associated with increased odds of infection relapse in the multivariate analysis. The results of the analyses suggest that treatment with trimethoprim-sulphamethoxazole may lead to an increased risk of UTI relapse, warranting further study.
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Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Infecciones Urinarias/tratamiento farmacológico , Adolescente , Adulto , Femenino , Humanos , Recurrencia , Estudios Retrospectivos , Estudiantes , Estados Unidos , Universidades , Adulto JovenRESUMEN
The ability to make fast, accurate decisions is an essential skill for all who play sport. However, measuring this ability has proved difficult for coaches and talent identification practitioners. Pattern recognition (a key factor in decision making) has commonly been measured using pattern recall tasks. This study aimed to understand whether accuracy when recalling rugby union patterns is a valid measure of on-field decision making performance. In Study 1, professional players recalled structured patterns of players from still images (N = 20) viewed for 5â s. On-field decision-making markers, including coaches' rankings of decision-making ability, playing position, number of years playing professionally and total number of years playing rugby union, were used as predictor variables of recall accuracy. Results showed that only total number of years playing rugby union was correlated with recall accuracy, suggesting that caution is necessary when adopting these tasks for talent identification purposes. The structured stimuli used in Study 1 were not representative of a true rugby union game, so Study 2 tested novice and expert players on a pattern recall task that included structured, semi-structured and unstructured rugby union patterns. Experts were significantly more accurate than novices when recalling structured and semi-structured patterns; however, there were no differences when recalling unstructured patterns. It was concluded that structured and semi-structured patterns should be used in future studies to test whether pattern recall tasks can be used for talent identification in rugby union.
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Aptitud , Rendimiento Atlético/psicología , Toma de Decisiones , Fútbol Americano/psicología , Recuerdo Mental , Adulto , Humanos , Masculino , Persona de Mediana EdadRESUMEN
INTRODUCTION: Explicit instruction (conscious knowledge/rules) is generally used for learning dental operative skills; however, recent work has demonstrated advantages of learning skills implicitly with minimal accrual of conscious knowledge and reduced attentional demands. Therefore, this study examined the effects of learning handpiece manipulation skills explicitly (errorful) and implicitly (errorless: limited error detection/correction) under conditions of increased attentional demands (ie multitasking and additional instructions). MATERIALS AND METHODS: Non-dental university students were randomly assigned to errorless (n = 11) or errorful (n = 8) groups. They used pencil lead instead of a bur, with errorless learners shading shapes from simple (small circle) to complex (cross), while errorful learners shaded the shapes in reverse. During testing, they completed simulated cavities in baseline, additional instructions and multitask conditions. Learning performance was calculated as per cent of the shape shaded successfully. Test performance was computed as error in cavity length/depth and was compared with dental students who had completed their operative technique course (n = 14). RESULTS: Errorless learners were more accurate than errorful learners especially when shading difficult shapes (P = 0.042). With additional instructions, errorless and errorful learners did not differ in cavity depth (P = 0.057) or length (P = 0.540). When multitasking, errorless learners prepared the cavity length (P = 0.048) but not depth (P = 0.920) more accurately than errorful learners. Overall, performance of errorless learners was comparable to dental students. CONCLUSIONS: These preliminary findings suggest handpiece skills can be acquired implicitly via errorless learning, and it is less attentionally demanding than errorful learning, as evident by maintenance of preparation performance when processing additional relevant instructions and multitasking.
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Competencia Clínica , Preparación de la Cavidad Dental , Educación en Odontología/métodos , Aprendizaje , Proyectos Piloto , Estudiantes de Odontología , HumanosRESUMEN
Objective: Hematopoietic stem cell transplantation (HSCT) is the only treatment known to slow or halt inflammatory demyelination among boys with the cerebral form of X-linked adrenoleukodystrophy (cALD), a devastating childhood condition affecting the central nervous system. HSCT can lead to a range of adverse outcomes including fatality. Previous studies have examined the potential predictors of post-HSCT survival and neurologic functioning. However, little is known about patients' daily-life adaptive functional outcomes (i.e., ability to communicate, maintain social relationships, and independently execute tasks of daily living). The purpose of this retrospective cohort study was to identify which patient characteristics and treatment-related variables predict long-term adaptive function among the survivors of HSCT for cALD. Methods: We obtained caregiver ratings of adaptive functioning of 65 transplant survivors at an average of 4.6 years (range: 1.0-24.1 years) post-HSCT. Using linear regression with penalized maximum likelihood estimation, we modeled the relative contribution of pre-transplant neurocognitive test performance, MRI severity, transplant regimen, and length of time since transplant on patient adaptive functioning outcomes. Results: Higher radiographic disease severity and poorer performance on baseline neurocognitive tests requiring fine motor skills and visual perception were associated with inferior adaptive functioning after HSCT. Use of radiation during the transplant preparative regimen also predicted poorer adaptive outcomes. Interpretation: In addition to radiological disease severity, baseline neurocognitive test performance is associated with post-transplant adaptive functional outcomes. Neurocognitive measures may play an important role in prognostic counseling and post-transplant treatment planning for patients considering HSCT for cALD.