The role of concussion history and biological sex on baseline concussion clinical profile symptoms in adolescent rugby players.

BACKGROUND: Accurate concussion monitoring requires access to preinjury baseline data. This is particularly important in adolescent athletes who have a high risk of concussion and are prone to prolonged recovery. As Rugby Union is governed by similar laws for men and women, it is also an ideal population to rigorously examine the impact of biological sex on concussion symptoms. AIMS: To evaluate self-reported concussion symptoms at baseline in adolescent rugby union players, and examine if subtype-specific symptoms are affected by concussion history and biological sex. METHODS: Adolescent rugby union players aged 16-18 years were recruited during the 2022-2023 playing season. Participants completed a series of questionnaires covering post-concussion symptoms, concussion clinical profiles, anxiety, depression and fear avoidance behaviours. Independent variables of interest in analysis were biological sex and concussion history. RESULTS: 149 participants (75% male) were included. 42% (63/149) reported at least one previous concussion (average time since concussion: 18.7 months, range 1-72). Adolescents with a concussion history reported significantly higher scores than those with no history, across two clinical profiles (ocular and sleep), concussion symptom severity, and depression, all based on medium effect sizes (SMD 0.3-0.5). Females had significantly higher scores across cognitive/fatigue, ocular and sleep clinical profiles, concussion symptoms, anxiety and depression, each with large effect sizes (SMD > 0.5). CONCLUSIONS: Concussion history and sex are associated with higher baseline scores on specific concussion clinical profile, concussion symptom severity, and anxiety symptoms. These findings highlight the importance of considering baseline differences when interpreting post-injury clinical profile symptoms in adolescent rugby players. (Trial registration: ACTRN12622000931774).

The Role of Concussion History and Biological Sex on Pupillary Light Reflex Metrics in Adolescent Rugby Players: A Cross-Sectional Study.

Background: Concussion examination is based primarily on clinical evaluation and symptomatic reporting. Pupillary light reflex (PLR) metrics may provide an objective physiological marker to inform concussion diagnosis and recovery, but few studies have assessed PLR, and normative data are lacking, particularly for adolescents. Aim: To capture PLR data in adolescent rugby players and examine the effects of concussion history and biological sex. Design: Cross-sectional. Methods: Male and female adolescent rugby union players aged 16 to 18 years were recruited at the start of the 2022-2023 playing season. PLR was recorded using a handheld pupillometer which provided seven different metrics relating to pupil diameter, constriction/dilation latency, and velocity. Data were analysed using a series of 2 × 2 ANOVAs to examine the main effects of independent variables: biological sex, concussion history, and their interactions, using adjusted p-values (p < 0.05). Results: 149 participants (75% male) were included. A total of 42% reported at least one previous concussion. Most metrics were unaffected by the independent variables. There were however significant main effects for concussion history (F = 4.11 (1); p = 0.05) and sex (F = 5.42 (1); p = 0.02) in end pupil diameters, and a main effect for sex in initial pupil diameters (F = 4.45 (1); p = 0.04). Although no significant interaction effects were found, on average, females with a concussion history presented with greater pupillary diameters and velocity metrics, with many pairwise comparisons showing large effects (SMD > 0.8). Conclusions: Pupillary diameters in adolescent athletes were significantly affected by concussion history and sex. The most extreme PLR metrics were recorded in females with a history of concussion (higher pupillary diameters and velocities). This highlights the importance of establishing baseline PLR metrics prior to interpretation of the PLR post-concussion. Long-standing PLR abnormalities post-concussion may reflect ongoing autonomic nervous system dysfunction. This warrants further investigation in longitudinal studies.

Determining the Spectral Requirements for Cyanobacteria Detection for the CyanoSat Hyperspectral Imager with Machine Learning.

This study determines an optimal spectral configuration for the CyanoSat imager for the discrimination and retrieval of cyanobacterial pigments using a simulated dataset with machine learning (ML). A minimum viable spectral configuration with as few as three spectral bands enabled the determination of cyanobacterial pigments phycocyanin (PC) and chlorophyll-a (Chl-a) but may not be suitable for determining cyanobacteria composition. A spectral configuration with about nine ideally positioned spectral bands enabled estimation of the cyanobacteria-to-algae ratio (CAR) and pigment concentrations with almost the same accuracy as using all 300 spectral channels. A narrower spectral band full-width half-maximum (FWHM) did not provide improved performance compared to the nominal 12 nm configuration. In conclusion, continuous sampling of the visible spectrum is not a requirement for cyanobacterial detection, provided that a multi-spectral configuration with ideally positioned, narrow bands is used. The spectral configurations identified here could be used to guide the selection of bands for future ocean and water color radiometry sensors.

Demonstration of a Modular Prototype End-to-End Simulator for Aquatic Remote Sensing Applications.

This study introduces a prototype end-to-end Simulator software tool for simulating two-dimensional satellite multispectral imagery for a variety of satellite instrument models in aquatic environments. Using case studies, the impact of variable sensor configurations on the performance of value-added products for challenging applications, such as coral reefs and cyanobacterial algal blooms, is assessed. This demonstrates how decisions regarding satellite sensor design, driven by cost constraints, directly influence the quality of value-added remote sensing products. Furthermore, the Simulator is used to identify situations where retrieval algorithms require further parameterization before application to unsimulated satellite data, where error sources cannot always be identified or isolated. The application of the Simulator can verify whether a given instrument design meets the performance requirements of end-users before build and launch, critically allowing for the justification of the cost and specifications for planned and future sensors. It is hoped that the Simulator will enable engineers and scientists to understand important design trade-offs in phase 0/A studies easily, quickly, reliably, and accurately in future Earth observation satellites and systems.

Multisystem recovery after sport-related concussion in adolescent rugby players: a prospective study protocol.

INTRODUCTION: Sport-related concussion is one of the most common injuries in adolescent rugby players with evidence of prolonged recovery in some concussed athletes. Concussion is a complex pathophysiological process that can affect a variety of subsystems with multifactorial presentation. Most research on adolescents recovery after concussion focuses on neurocognitive functioning and symptom outcomes over the short term. There is a need to explore concussion recovery over time across multiple subsystems in adolescent rugby players. METHODS AND ANALYSIS: This prospective study will use sensorimotor and oculomotor outcomes in adolescent male and female rugby players aged 16-18 years. Players will be recruited from school or club rugby teams across the province of Ulster. Baseline assessment will be undertaken at the start of the playing season and will include questionnaires, Quantified Y Balance Test and Pupillary Light Reflex. Players who sustain a concussive event will be reassessed on all outcomes at 3 days, 7 days, 14 days, 23 days, 90 days, 180 days and 365 days postconcussion. For serial outcome data, we will examine response curves for each participant and make comparisons between known groups. We will use logistic regression to explore any association between demographic variables and recovery. The strength of the predictive model will be determined using R2, p values and ORs, with 95% CIs. ETHICS AND DISSEMINATION: Ethical approval has been granted for this study from Ulster University Research Ethics Committee (REC/14/0060). This study will be published in an open-access research journal on completion. TRIAL REGISTRATION NUMBER: ACTRN12622000931774p.

Simulated Inherent Optical Properties of Aquatic Particles using The Equivalent Algal Populations (EAP) model.

Paired measurements of phytoplankton absorption and backscatter, the inherent optical properties central to the interpretation of ocean colour remote sensing data, are notoriously rare. We present a dataset of Chlorophyll a (Chl a) -specific phytoplankton absorption, scatter and backscatter for 17 different phytoplankton groups, derived from first principles using measured in vivo pigment absorption and a well-validated semi-analytical coated sphere model which simulates the full suite of biophysically consistent phytoplankton optical properties. The optical properties of each simulated phytoplankton cell are integrated over an entire size distribution and are provided at high spectral resolution. The model code is additionally included to enable user access to the complete set of wavelength-dependent, angularly resolved volume scattering functions. This optically coherent dataset of hyperspectral optical properties for a set of globally significant phytoplankton groups has potential for use in algorithm development towards the optimal exploitation of the new age of hyperspectral satellite radiometry.

Corrigendum: Personalized digital intervention for depression based on social rhythm principles adds significantly to outpatient treatment.

[This corrects the article DOI: 10.3389/fdgth.2022.870522.].

GLORIA - A globally representative hyperspectral in situ dataset for optical sensing of water quality.

The development of algorithms for remote sensing of water quality (RSWQ) requires a large amount of in situ data to account for the bio-geo-optical diversity of inland and coastal waters. The GLObal Reflectance community dataset for Imaging and optical sensing of Aquatic environments (GLORIA) includes 7,572 curated hyperspectral remote sensing reflectance measurements at 1 nm intervals within the 350 to 900 nm wavelength range. In addition, at least one co-located water quality measurement of chlorophyll a, total suspended solids, absorption by dissolved substances, and Secchi depth, is provided. The data were contributed by researchers affiliated with 59 institutions worldwide and come from 450 different water bodies, making GLORIA the de-facto state of knowledge of in situ coastal and inland aquatic optical diversity. Each measurement is documented with comprehensive methodological details, allowing users to evaluate fitness-for-purpose, and providing a reference for practitioners planning similar measurements. We provide open and free access to this dataset with the goal of enabling scientific and technological advancement towards operational regional and global RSWQ monitoring.

Financial technologies (FinTech) for mental health: The potential of objective financial data to better understand the relationships between financial behavior and mental health.

Financial stability is a key challenge for individuals with mental illnesses. Symptomatic periods often manifest in poor financial decision-making including compulsive spending and risky behaviors. This article explores research opportunities and challenges in developing financial technologies (FinTech) to support individuals with mental health. Specifically, we focus on how objective financial data might lead to novel mental health assessment and intervention methods. We have used data from one individual with bipolar disorder (BD) (i.e., an N = 1 case study) to illustrate feasibility of collecting and analyzing objective financial data alongside mental health factors. While we have not found statistically significant trends nor our findings are generalizable beyond this case, our approach provides an insight into the potential of using objective financial data to identify early warning signs and thereby, enable preemptive care for individuals with serious mental illnesses. We have also identified challenges of accessing objective financial data. The paper outlines what data is currently available, what can be done with it, and what factors to consider when working with financial data. We have also explored future directions for developing interventions to support financial well-being and stability. Furthermore, we have described the technical, ethical, and equity challenges for financial data-driven assessments and intervention methods, as well as provided a broad research agenda to address these challenges.

Personalized digital intervention for depression based on social rhythm principles adds significantly to outpatient treatment.

We conducted a 16-week randomized controlled trial in psychiatric outpatients with a lifetime diagnosis of a mood and/or anxiety disorder to measure the impact of a first-of-its-kind precision digital intervention software solution based on social rhythm regulation principles. The full intent-to-treat (ITT) sample consisted of 133 individuals, aged 18-65. An exploratory sub-sample of interest was those individuals who presented with moderately severe to severe depression at study entry (baseline PHQ-8 score ≥15; N = 28). Cue is a novel digital intervention platform that capitalizes on the smartphone's ability to continuously monitor depression-relevant behavior patterns and use each patient's behavioral data to provide timely, personalized "micro-interventions," making this the first example of a precision digital intervention of which we are aware. Participants were randomly allocated to receive Cue plus care-as-usual or digital monitoring only plus care as usual. Within the full study and depressed-at-entry samples, we fit a mixed effects model to test for group differences in the slope of depressive symptoms over 16 weeks. To account for the non-linear trajectory with more flexibility, we also fit a mixed effects model considering week as a categorical variable and used the resulting estimates to test the group difference in PHQ change from baseline to 16 weeks. In the full sample, the group difference in the slope of PHQ-8 was negligible (Cohen's d = -0.10); however, the Cue group demonstrated significantly greater improvement from baseline to 16 weeks (p = 0.040). In the depressed-at-entry sample, we found evidence for benefit of Cue. The group difference in the slope of PHQ-8 (Cohen's d = -0.72) indicated a meaningfully more rapid rate of improvement in the intervention group than in the control group. The Cue group also demonstrated significantly greater improvement in PHQ-8 from baseline to 16 weeks (p = 0.009). We are encouraged by the size of the intervention effect in those who were acutely ill at baseline, and by the finding that across all participants, 80% of whom were receiving pharmacotherapy, we observed significant benefit of Cue at 16 weeks of treatment. These findings suggest that a social rhythm-focused digital intervention platform may represent a useful and accessible adjunct to antidepressant treatment (https://clinicaltrials.gov/ct2/show/NCT03152864?term=ellen+frank&draw=2&rank=3).

Can We Use the Oculus Quest VR Headset and Controllers to Reliably Assess Balance Stability?

Balance is the foundation upon which all other motor skills are built. Indeed, many neurological diseases and injuries often present clinically with deficits in balance control. With recent advances in virtual reality (VR) hardware bringing low-cost headsets into the mainstream market, the question remains as to whether this technology could be used in a clinical context to assess balance. We compared the head tracking performance of a low-cost VR headset (Oculus Quest) with a gold standard motion tracking system (Qualisys). We then compared the recorded head sway with the center of pressure (COP) measures collected from a force platform in different stances and different visual field manipulations. Firstly, our analysis showed that there was an excellent correspondence between the two different head movement signals (ICCs > 0.99) with minimal differences in terms of accuracy (<5 mm error). Secondly, we found that head sway mapped onto COP measures more strongly when the participant adopted a Tandem stance during balance assessment. Finally, using the power of virtual reality to manipulate the visual input to the brain, we showed how the Oculus Quest can reliably detect changes in postural control as a result of different types of visual field manipulations. Given the high levels of accuracy of the motion tracking of the Oculus Quest headset, along with the strong relationship with the COP and ability to manipulate the visual field, the Oculus Quest makes an exciting alternative to traditional lab-based balance assessments.

A COVID-19 outbreak in a long-term care facility in Massachusetts: Rapidity and extent of spread, resident symptoms, and mortality.

In the spring of 2020, COVID-19 spread rapidly through a long-term care facility in Massachusetts. 74 (of 134 total) residents tested positive, with 72 testing positive in the first three weeks of the outbreak. Fatigue, anorexia, myalgia, and confusion were the most common symptoms. 21 residents (28%) testing positive subsequently died.

Improved hyperspectral inversion of aquatic reflectance under non-uniform vertical mixing.

Estimating the concentration of water constituents by optical remote sensing assumes absorption and scattering processes to be uniform over the observation depth. Using hyperspectral reflectance, we present a method to direct the retrieval of the backscattering coefficient (bb(λ)) from reflectance (> 600 nm) towards wavebands where absorption by water dominates the reflectance curve. Two experiments demonstrate the impact of hyperspectral inversion in the selected band set. First, optical simulations show that the resulting distribution of bb(λ) is sensitive to particle mixing conditions, although a robust indicator of non-uniformity was not found for all scenarios of stratification. Second, in the absence of spectral backscattering profiles from in situ data sets, it is shown how substituting the median of bb(λ) into a near infra-red / red band ratio algorithm improved chlorophyll-a estimates (root mean square error 75.45 mg m-3 became 44.13 mg m-3). This approach also allows propagation of the uncertainty in bb estimates to water constituent concentrations.

Diagnostic Accuracy of Clinical Tests Assessing Ligamentous Injury of the Talocrural and Subtalar Joints: A Systematic Review With Meta-Analysis.

CONTEXT: Ankle sprains are the most common acute musculoskeletal injury. Clinical tests represent the first opportunity to assess the sprain's severity, but no systematic review has compared these tests to contemporary reference standards. OBJECTIVE: To determine the diagnostic accuracy of clinical tests assessing the talocrural and subtalar joint ligaments after ankle sprain. DATA SOURCES: CINAHL, EMBASE, MEDLINE, hand-searching, and PubMed-related article searches (inception to November 18, 2020). STUDY SELECTION: Eligible diagnostic studies compared clinical examination (palpation, joint laxity) against imaging or surgery. Studies at a high risk of bias or with high concerns regarding applicability on Quality Assessment of Diagnostic Accuracy Studies-2 were excluded from the meta-analysis. STUDY DESIGN: Systematic review and meta-analysis. LEVEL OF EVIDENCE: Level 3a. DATA EXTRACTION: True-positive, false-negative, false-positive, and true-negative findings were extracted to calculate sensitivity, specificity, and likelihood ratios. If ordinal data were reported, these were extracted to calculate Cohen's kappa. RESULTS: A total of 14 studies met the inclusion criteria (6302 observations; 9 clinical tests). No test had both sensitivity and specificity exceeding 90%. Palpation of the anterior talofibular ligament is highly sensitive (sensitivity 95%-100%; specificity 0%-32%; min-max; n = 6) but less so for the calcaneofibular ligament (sensitivity 49%-100%; specificity 26%-79%; min-max; n = 6). Pooled data from 6 studies (885 observations) found a low sensitivity (54%; 95% CI 35%-71%) but high specificity (87%; 95% CI 63%-96%) for the anterior drawer test. CONCLUSION: The anterior talofibular ligament is best assessed using a cluster of palpation (rule out), and anterior drawer testing (rule in). The talar tilt test can rule in injury to the calcaneofibular ligament, but a sensitive clinical test for the ligament is lacking. It is unclear if ligamentous injury grading can be done beyond the binary (injured vs uninjured), and clinical tests of the subtalar joint ligaments are not well researched. The generalizability of our findings is limited by insufficient reporting on blinding and poor study quality. REGISTRATION: Prospero ID: CRD42020187848. DATA AVAILABILITY: Data are available in a public, open access repository on publication, including our RevMan file and the CSV file used for meta-analysis: http://doi.org/10.5281/zenodo.4917138.

How Do Hip Exercises Improve Pain in Individuals With Patellofemoral Pain? Secondary Mediation Analysis of Strength and Psychological Factors as Mechanisms.

OBJECTIVE: To determine whether the effect of hip exercise on patellofemoral pain is mediated through changes in hip muscle strength or psychological factors. DESIGN: Secondary mediation analysis of a randomized clinical trial, in which 218 participants with patellofemoral pain were randomly assigned to receive foot orthoses or hip exercises. METHODS: Pain (Knee injury and Osteoarthritis Outcome Score pain subscale) and number of pain-free squats at 12 weeks were the outcomes for this mediation analysis, as they are pathognomonic of patellofemoral pain. Hip strength dynamometry (abduction, adduction, and external rotation) and psychological characteristics (pain catastrophizing, kinesiophobia, and anxiety) measured at 6 weeks were considered as potential mediators. We used mediation analysis to decompose the total effect of treatment on the outcome into (1) the "indirect effect" (ie, the portion acting through the mediator) and (2) the "direct effect." RESULTS: The effect of hip exercise on pain and squats was not mediated by any of the strength or psychological mediators analyzed. All indirect effects were small and showed wide 95% confidence intervals (CIs) that contained zero (eg, for pain-free squats: abduction strength, -0.13; 95% CI: -0.49, 0.23; Tampa Scale of Kinesiophobia, -0.17; 95% CI: -0.64, 0.30). CONCLUSION: Hip strength improved after hip exercise, yet strength did not mediate improvements in pain and pain-free squats, and alternative psychological mediators were not implicated. J Orthop Sports Phys Ther 2021;51(12):602-610. doi:10.2519/jospt.2021.10674.

Use of monitoring technology and injury incidence among recreational runners: a cross-sectional study.

BACKGROUND: Monitoring technology is increasingly accessible to recreational runners. Our aim was to examine patterns of technology use in recreational runners, and its potential association with injury. METHODS: We conducted a cross-sectional questionnaire study in a sample of adult runners. Recruitment took place at three different 5 km parkrun event across Northern Ireland. Demographics, technology use, running behaviour and running-related injury (RRI) history were examined. Regression analyses were performed to determine relationships between variables. RESULTS: Responses were obtained from 192 of 483 eligible finishers (39.8% response rate). Average age was 45.9 years (SD 10.3), with males (47.1 years SD 9.7) slightly older than females (44.8 years SD 10.8). On average, participants ran 3.0 days per week (SD 1.3), with an average weekly distance of 22.6 km (SD 19.7). Males typically ran further (MD 6.2 km/week; 95% CI 0.4 to 12.0) than females. Monitoring technology was used by 87.4% (153/175); with GPS watches the most common device (87.6% (134/153)). Runners using monitoring technology ran further (MD 14.4 km/week; 95% CI 10.3 to 18.5) and more frequently (MD 1.3 days/week; 95% CI 0.7 to 1.9) than those who did not use monitoring technology. There was no significant difference in average age between runners who used monitoring technology and those who did not (MD 4.0 years; 95% CI -0.7 to 8.7). RRI was reported by 40.6% (71/175) of participants in the previous 12 months. In a univariate analysis, none of the selected predictors (age, number of days run per week, distance run per week, or usage of technology to modify training pattern) (p > 0.1) were associated with RRI. CONCLUSIONS: This study found a high prevalence of monitoring technology usage among recreational runners. While the incidence of RRI remains high, it is not associated with the usage of monitoring technology. Further prospective research should examine if monitoring technology can reduce RRI incidence among recreational runners in future.

Concussion History and Balance Performance in Adolescent Rugby Union Players.

BACKGROUND: Sports-related concussion is a worldwide problem. There is a concern that an initial concussion can cause prolonged subclinical disturbances to sensorimotor function that increase the risk of subsequent injury. The primary aim of this study was to examine whether a history of sports-related concussion has effects on static and dynamic balance performance in adolescent rugby players. HYPOTHESIS: Dynamic balance would be worse in players with a history of concussion compared with those with no history of concussion. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Male adolescent rugby players aged 14 to 18 years from 5 schools were recruited before the start of the 2018-2019 playing season. Participants completed questionnaires and physical tests, including dynamic Y balance and single-leg static balance (eyes closed) tests, while performing single and dual tasks. Dynamic balance was assessed using inertial sensor instrumentation. Dependent variables were normalized reach distance and the sample entropy (SEn) of the 3 axes (x, y, and z). RESULTS: Of the 195 participants, 100 reported a history of concussion. Those with a history of concussion demonstrated higher SEn in all directions, with highest values during anterior (standardized mean difference [SMD], 0.4; 95% CI, 0.0-0.7; P = .027) and posteromedial (SMD, 0.5; 95% CI, 0.2-0.9; P = .004) reach directions compared with those with no history. There was no difference between groups (concussion history vs control) in traditional Y balance reach distances in the anterior or posteromedial directions or single-leg static balance during both single- (P = .47) and dual-task (P = .67) conditions. CONCLUSION: Adolescent rugby union athletes with a history of concussion had poorer dynamic balance during performance tasks compared with healthy controls. Static single-leg balance tests, either single or dual task, may not be sensitive enough to detect sensorimotor deficits in those with a history of concussion.

Xylem network connectivity and embolism spread in grapevine(Vitis vinifera L.).

Xylem networks are vulnerable to the formation and spread of gas embolisms that reduce water transport. Embolisms spread through interconduit pits, but the three-dimensional (3D) complexity and scale of xylem networks means that the functional implications of intervessel connections are not well understood. Here, xylem networks of grapevine (Vitis vinifera L.) were reconstructed from 3D high-resolution X-ray micro-computed tomography (microCT) images. Xylem network performance was then modeled to simulate loss of hydraulic conductivity under increasingly negative xylem sap pressure simulating drought stress conditions. We also considered the sensitivity of xylem network performance to changes in key network parameters. We found that the mean pit area per intervessel connection was constant across 10 networks from three, 1.5-m stem segments, but short (0.5 cm) segments fail to capture complete network connectivity. Simulations showed that network organization imparted additional resistance to embolism spread beyond the air-seeding threshold of pit membranes. Xylem network vulnerability to embolism spread was most sensitive to variation in the number and location of vessels that were initially embolized and pit membrane vulnerability. Our results show that xylem network organization can increase stem resistance to embolism spread by 40% (0.66 MPa) and challenge the notion that a single embolism can spread rapidly throughout an entire xylem network.