Video analysis and verification of direct head impacts recorded by wearable sensors in junior rugby league players

Background: Rugby league is a high-intensity collision sport that carries a risk of concussion. Youth athletes are considered to be more vulnerable and take longer to recover from concussion than adult athletes. Purpose: To review head impact events in elite-level junior representative rugby league and to verify and describe characteristics of X-patchTM-recorded impacts via video analysis. Study Design: Observational case series. Methods: The X-patchTM was used on twenty-one adolescent players (thirteen forwards and eight backs) during a 2017 junior representative rugby league competition. Game-day footage, recorded by a trained videographer from a single camera, was synchronised with X-patchTM-recorded timestamped events. Impacts were double verified by video review. Impact rates, playing characteristics, and gameplay situations were described. Results: The X-patchTM-recorded 624 impacts ≥ 20g between game start and finish, of which 564 (90.4%) were verified on video. Upon video review, 413 (73.2%) of all verified impacts ≥ 20g where determined to be direct head impacts. Direct head impacts ≥ 20g occurred at a rate of 5.2 impacts per game hour; 7.6 for forwards and 3.0 for backs (range = 0–18.2). A defender’s arm directly impacting the head of the ball carrier was the most common event, accounting for 21.3% (n = 120) of all impacts, and 46.7% of all “hit-up” impacts. There were no medically diagnosed concussions during the competition. Conclusion: The majority (90.4%) of head impacts ≥ 20g recorded by the X-patchTM sensor were verified by video. Double verification of direct head impacts in addition to cross-verification of sensor-recorded impacts using a secondary source such as synchronised video review can be used to ensure accuracy and validation of data

Verifying head impacts recorded by a wearable sensor using video footage in rugby league: A preliminary study

Background: Rugby league is a full-contact collision sport with an inherent risk of concussion. Wearable instrumented technology was used to observe and characterize the level of exposure to head impacts during game play. Purpose: To verify the impacts recorded by the x-patch™ with video analysis. Study design: Observational case series. Methods: The x-patch™ was used on eight men’s semi-professional rugby league players during the 2016 Newcastle Rugby League competition (five forwards and three backs). Game day footage was recorded by a trained videographer using a single camera located at the highest midfield location to verify the impact recorded by the x-patch™. Videographic and accelerometer data were time synchronized. Results: The x-patch™ sensors recorded a total of 779 impacts ≥ 20 g during the games, of which 732 (94.0%) were verified on video. In addition, 817 impacts were identified on video that did not record an impact on the sensors. The number of video-verified impacts ≥ 20 g, per playing hour, was 7.8 for forwards and 4.8 for backs (range = 3.9–19.0). Impacts resulting in a diagnosed concussion had much greater peak linear acceleration (M = 76.1 g, SD = 17.0) than impacts that did not result in a concussion (M = 34.2g, SD = 18.0; Cohen’s d = 2.4). Conclusions: The vast majority (94%) of impacts ≥ 20 g captured by the x-patch™ sensor were video verified in semi-professional rugby league games. The use of a secondary source of information to verify impact events recorded by wearable sensors is beneficial in clarifying game events and exposure levels

Coupling Between Doppler Radar Signatures and Tornado Damage Tracks

On April 27, 2011, the southeastern United States was raked with several episodes of severe weather. Numerous tornadoes caused extensive damage, and tragically, the deaths of over 300 people. In Alabama alone, there were 61 confirmed tornados, 4 of them produced EF5 damage, and several were on the ground an hour or more with continuous damage tracks exceeding 80km. The use of Doppler radars covering the region provided reflectivity and velocity signatures that allowed forecasters to monitors the severe storms from beginning to end issuing hundreds of severe weather warnings throughout the day. Meteorologists from the the NWS performed extensive surveys to assess the intensity, duration, and ground track of tornadoes reported during the event. Survey activities included site visits to the affected locations, analysis of radar and satellite data, aerial surveys, and interviews with eyewitnesses. Satellite data from NASA's MODIS and ASTER instruments played a helpful role in determining the location of tornado damage paths and in the assessment. High resolution multispectral and temporal composites helped forecasters corroborate their damage assessments, determine starting and ending points for tornado touchdowns, and helped to provide forecasters with a better big-picture view of the damage region. The imagery also helped to separate damage from the April 27th tornados from severe weather that occurred earlier that month. In a post analysis of the outbreak, tornado damage path signatures observed in the NASA satellite data have been correlated to "debris ball" signatures in the NWS Doppler radars and a special ARMOR dual-polarization radar operated by the University of Alabama Huntsville during the event. The Doppler radar data indicates a circular enhanced reflectivity signal and rotational couplet in the radial velocity likely associated with the tornado that is spatially correlated with the damage tracks in the observed satellite data. An algorithm to detect and isolate the "debris ball" from precipitation signatures in the dual polarization radar data has been developed and verified using the NASA damage track data

Depressed mood predicts pulmonary rehabilitation completion among women, but not men

SummaryBackgroundAs many as 30% of patients who start pulmonary rehabilitation (PR) fail to complete it, and depressed mood has been associated with PR non-completion. Depression is more common in women than men with COPD and historically women with COPD have been under studied. However, no studies to date have investigated gender-specific predictors of PR completion.MethodsThe study included 111 patients with COPD who enrolled in a community based outpatient PR program in Providence, RI. Patients who attended 20 or more sessions were designated “completers”. Depression was measured using the CES-D. Logistic regression models were evaluated to test depressed mood as a predictor of PR completion. Analyses controlled for demographic and health variables found to differ between completers and non-completers.ResultsPatients were 95% white and 49.5% women, and 74% had a GOLD stage ≥3. Sixty-eight percent of patients were PR completers. A logistic regression model, showed that lower depressed mood independently predicted PR completion across all patients (adjusted OR = 0.92, p = .002). In gender-stratified analyses, lower depressed mood was an independent predictor of PR completion for women (adjusted OR = .91, p = .024) but not men (adjusted OR = .97, p = .45). Greater 6-min walk test distance was also an independent predictor of PR completion among women.ConclusionDepressed mood is an important predictor of completion of community based PR among women. Screening and brief treatment of depression should be considered in practice

Hdac6 regulates Tip60-p400 function in stem cells

In embryonic stem cells (ESCs), the Tip60 histone acetyltransferase activates genes required for proliferation and silences genes that promote differentiation. Here we show that the class II histone deacetylase Hdac6 co-purifies with Tip60-p400 complex from ESCs. Hdac6 is necessary for regulation of most Tip60-p400 target genes, particularly those repressed by the complex. Unlike differentiated cells, where Hdac6 is mainly cytoplasmic, Hdac6 is largely nuclear in ESCs, neural stem cells (NSCs), and some cancer cell lines, and interacts with Tip60-p400 in each. Hdac6 localizes to promoters bound by Tip60-p400 in ESCs, binding downstream of transcription start sites. Surprisingly, Hdac6 does not appear to deacetylate histones, but rather is required for Tip60-p400 binding to many of its target genes. Finally, we find that, like canonical subunits of Tip60-p400, Hdac6 is necessary for robust ESC differentiation. These data suggest that Hdac6 plays a major role in the modulation of Tip60-p400 function in stem cells. DOI: http://dx.doi.org/10.7554/eLife.01557.001

Role of IL-6 in Exercise Training- and Cold-Induced UCP1 Expression in Subcutaneous White Adipose Tissue

Expression of brown adipose tissue (BAT) associated proteins like uncoupling protein 1 (UCP1) in inguinal WAT (iWAT) has been suggested to alter iWAT metabolism. The aim of this study was to investigate the role of interleukin-6 (IL-6) in exercise training and cold exposure-induced iWAT UCP1 expression. The effect of daily intraperitoneal injections of IL-6 (3 ng/g) in C57BL/6 mice for 7 days on iWAT UCP1 expression was examined. In addition, the expression of UCP1 in iWAT was determined in response to 3 days of cold exposure (4°C) and 5 weeks of exercise training in wild type (WT) and whole body IL-6 knockout (KO) mice. Repeated injections of IL-6 in C57BL/6 mice increased UCP1 mRNA but not UCP1 protein content in iWAT. Cold exposure increased iWAT UCP1 mRNA content similarly in IL-6 KO and WT mice, while exercise training increased iWAT UCP1 mRNA in WT mice but not in IL-6 KO mice. Additionally, a cold exposure-induced increase in iWAT UCP1 protein content was blunted in IL-6 KO mice, while UCP1 protein content in iWAT was lower in both untrained and exercise trained IL-6 KO mice than in WT mice. In conclusion, repeated daily increases in plasma IL-6 can increase iWAT UCP1 mRNA content and IL-6 is required for an exercise training-induced increase in iWAT UCP1 mRNA content. In addition IL-6 is required for a full induction of UCP1 protein expression in response to cold exposure and influences the UCP1 protein content iWAT of both untrained and exercise trained animals

Sex Differences in Substance Use and Misuse: A Toxicology Investigators\u27 Consortium (ToxIC) Registry Analysis

Background: Variations between male and female populations are previously reported in classes of harmfully used/misused drugs, severity of substance use disorder and risk of relapse. The aim of this study was to provide a review of bedside medical toxicologist managed, sex-specific poisonings in adults that present with harmful drug use/misuse. Methods: ToxIC Registry cases \u3e /=19 and \u3c /=65 years old, with harmful drug use or misuse during the timeframe June 2010-December 2016, were studied. Demographics, primary agents of toxic exposure, administration route and complications were analyzed. Descriptive methods were used in the analysis. Results: The database included 51,440 cases. Of these, 3426 cases were analyzed in which the primary reason for the encounter was harmful substance use/misuse. Females were found to harmfully use/misuse pharmaceutical drugs (N=806, 65.6%) more than nonpharmaceutical drugs (N=423, 34.4%). Males more frequently used nonpharmaceutical drugs (N=1189, 54.1%) than pharmaceutical drugs (1008, 45.9%). Analgesics were used by females (N= 215, 18.2%) and males (N=137, 6.6%). Sedative hypnotics were used by females (N=165, 14%) and males (N=160, 7.8%). Psychoactive agents were used by males (N=325, 15.8%) and females (N=67, 5.7%). Sympathomimetics were used by males (N=381, 18.5%) and females (N=151, 12.8%). The majority of both male and female participants, 1712 (57.9%), utilized an oral route of administration. However, 312 (16.5%) of males utilized inhalation vs 73 (6.8%) of females inhaled their substance. Conclusion: There were sex-specific differences among patients evaluated for harmful substance use/misuse by toxicologists. Considering these differences in regards to management and preventive approaches may be indicated

Dual-Polarimetric Radar-Based Tornado Debris Paths Associated with EF-4 and EF-5 Tornadoes over Northern Alabama During the Historic Outbreak of 27 April 2011

An historic tornado and severe weather outbreak devastated much of the southeastern United States between 25 and 28 April 2011. On 27 April 2011, northern Alabama was particularly hard hit by a large number of tornadoes, including several that reached EF-4 and EF-5 on the Enhanced Fujita damage scale. In northern Alabama alone, there were approximately 100 fatalities and hundreds of more people who were injured or lost their homes during the havoc caused by these violent tornadic storms. Two long-track and violent (EF-4 and EF-5) tornadoes occurred within range of the University of Alabama in Huntsville (UAHuntsville) Advanced Radar for Meteorological and Operational Research (ARMOR, C-band dual-polarimetric). A unique capability of dual-polarimetric radar is the near-real time identification of lofted debris associated with ongoing tornadoes on the ground. The focus of this paper is to analyze the dual-polarimetric radar-inferred tornado debris signatures and identify the associated debris paths of the long-track EF-4 and EF-5 tornadoes near ARMOR. The relative locations of the debris and damage paths for each tornado will be ascertained by careful comparison of the ARMOR analysis with NASA MODIS (Moderate Resolution Imaging Spectroradiometer) and ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer) satellite imagery of the tornado damage scenes and the National Weather Service tornado damage surveys. With the ongoing upgrade of the WSR-88D (Weather Surveillance Radar - 1988 Doppler) operational network to dual-polarimetry and a similar process having already taken place or ongoing for many private sector radars, dual-polarimetric radar signatures of tornado debris promise the potential to assist in the situational awareness of government and private sector forecasters and emergency managers during tornadic events. As such, a companion abstract (Schultz et al.) also submitted to this conference explores "The use of dual-polarimetric tornadic debris signatures in an operational setting.

Neurocognitive function in HIV infected patients on antiretroviral therapy

OBJECTIVE To describe factors associated with neurocognitive (NC) function in HIV-positive patients on stable combination antiretroviral therapy. DESIGN We undertook a cross-sectional analysis assessing NC data obtained at baseline in patients entering the Protease-Inhibitor-Monotherapy-Versus-Ongoing-Triple therapy (PIVOT) trial. MAIN OUTCOME MEASURE NC testing comprised of 5 domains. Raw results were z-transformed using standard and demographically adjusted normative datasets (ND). Global z-scores (NPZ-5) were derived from averaging the 5 domains and percentage of subjects with test scores >1 standard deviation (SD) below population means in at least two domains (abnormal Frascati score) calculated. Patient characteristics associated with NC results were assessed using multivariable linear regression. RESULTS Of the 587 patients in PIVOT, 557 had full NC results and were included. 77% were male, 68% Caucasian and 28% of Black ethnicity. Mean (SD) baseline and nadir CD4+ lymphocyte counts were 553(217) and 177(117) cells/µL, respectively, and HIV RNA was <50 copies/mL in all. Median (IQR) NPZ-5 score was -0.5 (-1.2/-0) overall, and -0.3 (-0.7/0.1) and -1.4 (-2/-0.8) in subjects of Caucasian and Black ethnicity, respectively. Abnormal Frascati scores using the standard-ND were observed in 51%, 38%, and 81%, respectively, of subjects overall, Caucasian and Black ethnicity (p<0.001), but in 62% and 69% of Caucasian and Black subjects using demographically adjusted-ND (p = 0.20). In the multivariate analysis, only Black ethnicity was associated with poorer NPZ-5 scores (P<0.001). CONCLUSIONS In this large group of HIV-infected subjects with viral load suppression, ethnicity but not HIV-disease factors is closely associated with NC results. The prevalence of abnormal results is highly dependent on control datasets utilised. TRIAL REGISTRY ClinicalTrials.gov, NCT01230580