King-Devick concussion test performs poorly as a screening tool in elite rugby union players: a prospective cohort study of two screening tests versus a clinical reference standard

BACKGROUND: The King-Devick (KD) test is an objective clinical test of eye movements that has been used to screen for concussion. We characterised the accuracy of the KD test and the World Rugby Head Injury Assessment (HIA-1) screening tools as methods of off-field evaluation for concussion after a suspicious head impact event. METHODS: A prospective cohort study was performed in elite English rugby union competitions between September 2016 and May 2017. The study population comprised consecutive players identified with a head impact event with the potential to result in concussion. The KD test was administered off-field, alongside the World Rugby HIA-1 screening tool, and the results were compared with the preseason baseline. Accuracy was measured against a reference standard of confirmed concussion, based on the clinical judgement of the team doctor after serial assessments. RESULTS: 145 head injury events requiring off-field medical room screening assessments were included in the primary analysis. The KD test demonstrated a sensitivity of 60% (95% CI 49.0 to 70) and a specificity of 39% (95% CI 26 to 54) in identifying players subsequently diagnosed with concussion. Area under the receiver operating characteristic curve for prolonged KD test times was 0.51 (95% CI 0.41 to 0.61). The World Rugby HIA-1 off-field screening tool sensitivity did not differ significantly from the KD test (sensitivity 75%, 95% CI 66 to 83, P=0.08), but specificity was significantly higher (91%, 95% CI 82 to 97, P<0.001). Although combining the KD test and the World Rugby HIA-1 multimodal screening assessment achieved a significantly higher sensitivity of 93% (95% CI 86% to 97%), there was a significantly lower specificity of 33% (95% CI 21% to 48%), compared with the HIA-1 test alone. CONCLUSIONS: The KD test demonstrated limited accuracy as a stand-alone remove-from-play sideline screening test for concussion. As expected with the addition of any parallel test, combination of the KD test with the HIA-1 off-field screening tool provided improved sensitivity in identifying concussion, but at the expense of markedly lower specificity. These results suggest that it is unlikely that the KD test will be incorporated into multimodal off-field screening assessments for concussion at the present time

A video analysis of head injuries satisfying the criteria for a head injury assessment in professional Rugby Union: a prospective cohort study

Objectives Concussion is the most common match injury in professional Rugby Union, accounting for 25% of match injuries. The primary prevention of head injuries requires that the injury mechanism be known so that interventions can be targeted to specifically overall incidence by focusing on characteristics with the greatest propensity to cause a head injury. Methods 611 head injury assessment (HIA) events in professional Rugby Union over a 3-year period were analysed, with specific reference to match events, position, time and nature of head contact. Results 464 (76%) of HIA events occur during tackles, with the tackler experiencing a significantly greater propensity for an HIA than the ball carrier (1.40 HIAs/1000 tackles for the tackler vs 0.54 HIAs/1000 tackles for the ball carrier, incidence rate ratio (IRR) 2.59). Propensity was significantly greater for backline players than forwards (IRR 1.54, 95%CI 1.28 to 1.84), but did not increase over the course of the match. Head to head contact accounted for the most tackler HIAs, with the greatest propensity. Conclusions By virtue of its high propensity and frequency, the tackle should be the focus for interventions that may include law change and technique education. A specific investigation of the characteristics of the tackle is warranted to refine the approach to preventative strategies

Quantifying the contribution of sediment compaction to late Holocene salt-marsh sea-level reconstructions, North Carolina, USA

Salt-marsh sediments provide accurate and precise reconstructions of late Holocene relative sea-level changes. However, compaction of salt-marsh stratigraphies can cause post-depositional lowering (PDL) of the samples used to reconstruct sea level, creating an estimation of former sea level that is too low and a rate of rise that is too great. We estimated the contribution of compaction to late Holocene sea-level trends reconstructed at Tump Point, North Carolina, USA. We used a geotechnical model that was empirically calibrated by performing tests on surface sediments from modern depositional environments analogous to those encountered in the sediment core. The model generated depth-specific estimates of PDL, allowing samples to be returned to their depositional altitudes. After removing an estimate of land-level change, error-in-variables changepoint analysis of the decompacted and original sea-level reconstructions identified three trends. Compaction did not generate artificial sea-level trends and cannot be invoked as a causal mechanism for the features in the Tump Point record. The maximum relative contribution of compaction to reconstructed sea-level change was 12%. The decompacted sea-level record shows 1.71 mm yr−1 of rise since AD 1845

Proposed method to calculate asset values for road structures

The Public Finance Management Act (PFMA), requires national and provincial government departments to “prepare financial statements for each financial year in accordance with generally recognised accounting practice”. The Municipal Finance Management Act (MFMA) includes similar requirements for municipalities. The “generally recognised accounting practice” for national and provincial government departments is the Modified Cash Standard, being the reporting framework prescribed by the National Treasury, Office of the Accountant General (OAG). Municipalities have to comply with the Standards of Generally Recognised Accounting Practice 17 (GRAP 17). Both these accounting standards require that an immovable asset, which qualifies for recording as a capital asset such as road structures (bridges, major culverts, etc.), must be measured at its cost. Where the cost of an immovable asset cannot be determined accurately, the immovable asset should be measured at fair value. In the case of specialised buildings and other man-made structures, an entity need to estimate fair value using a depreciated replacement cost approach. Replacement cost is the value of an asset that replicates the existing asset most efficiently, while providing the same level of service. This paper describes a proposed method to calculate the depreciated replacement cost for road structures, such as bridges and major culverts. The replacement cost of a structure is the cost to replace the structure with a similar structure at current rates. It is based on a unit rate for the replacement cost. The depreciated replacement cost is the optimised replacement cost after deducting an allowance for wear or consumption to reflect the remaining or economic service life of the structure. This is achieved by multiplying the replacement cost of the structure with an average condition index. The average condition index is calculated using the degree and extent ratings from the DER-ratings for the structural elements of the structure. The DER-ratings are the degree, extent and relevancy ratings of defects on the structure, using the defects based rating system described in the draft TMH19 Manual for the Visual Assessment of Road StructuresPapers Presented at the 2018 37th Southern African Transport Conference 9-12 July 2018 Pretoria, South Africa. Theme "Towards a desired transport future: safe, sufficient and affordable"

Excavations at the Lower Palaeolithic Site at Elveden, Suffolk

The Lower Palaeolithic site at Elveden, Suffolk, was the subject of new excavations from 1995–1999. Excavations around the edge and in the centre of the former clay-pit revealed sediments infilling a lake basin that had formed in Lowestoft till, overlying Chalk, the till being attributed to the Anglian glaciation (MIS 12). The lake sediments contain pollen that can be assigned to pollen zones HoI and HoIIa of the early Hoxnian (MIS 11). Overlying grey clays contain ostracods, molluscs, vertebrates, and carbonate concretions. Together they are indicative of a fluvial environment in a temperate climate. AAR ratios (amino acid racemisation) on the molluscs also suggest correlation with MIS 11. Further indications of a fluvial context are indicated by thin spreads of lag gravel along opposite sides of the clay-pit, marking the edges of a channel. The gravel forms the raw material for the human industries which consist of handaxes, flake tools, flakes, and cores. Further artefacts are found in the overlying black clay, which is interpreted as a palaeosol that formed with the silting-up of the channel. The basin was further infilled with colluvial ‘brickearths’, which also contain artefacts that are probably derived from the underlying gravel. Further evidence of soil formation was identified in the ‘brickearth’. Coversands with periglacial involutions overlie the ‘brickearth’ at the top of the sequence. These probably formed in the last cold stage, the Devensian

Towards a toolkit for the assessment and monitoring of musculoskeletal ageing

The complexities and heterogeneity of the ageing process have slowed the development of consensus on appropriate biomarkers of healthy ageing. The MRC-Arthritis Research UK Centre for Integrated research into Musculoskeletal Ageing (CIMA) is a collaboration between researchers and clinicians at the Universities of Liverpool, Sheffield and Newcastle. One of CIMA's objectives is to 'Identify and share optimal techniques and approaches to monitor age-related changes in all musculoskeletal tissues, and to provide an integrated assessment of musculoskeletal function', i.e. to develop a toolkit for assessing musculoskeletal ageing. This toolkit is envisaged as an instrument that can be used to characterise and quantify musculoskeletal function during 'normal' ageing, lend itself to use in large-scale, internationally important cohorts, and provide a set of biomarker outcome measures for epidemiological and intervention studies designed to enhance healthy musculoskeletal ageing. Such potential biomarkers include: biochemical measurements in biofluids or tissue samples, in vivo measurements of body composition, imaging of structural and physical properties, and functional tests. The CIMA Toolkit Working Group assessed candidate biomarkers of musculoskeletal ageing under these four headings, detailed their biological bases, strengths and limitations, and made practical recommendations for their use. In addition, the CIMA Toolkit Working Group identified gaps in the evidence base and suggested priorities for further research on biomarkers of musculoskeletal ageing

Heavy mineral analysis by ICP-AES a tool to aid sediment provenancing

Correlation and provenancing of sediments/sedimentary rocks can be achieved by several techniques; a common approach is through the identification and quantification of heavy minerals using a petrological microscope. This can be time consuming, the analysis of heavy minerals by inductively coupled plasma atomic emission spectroscopy offers a faster alternative, by determining key elements associated with specific heavy minerals. Here we outline a method for determining heavy mineral species though ICP-AES using high temperature fusion with a lithium metaborate flux to ensure complete dissolution of resistate minerals. The method was tested in a provenance study of desert sands from the United Arab Emirates. The results are compared with those derived from traditional optical microscopy. These show good agreement for minerals with specific geochemical signatures, whilst the overall geochemistry of the heavy mineral concentrate was diagnostic of potential sediment sources. This geochemical approach is capable of processing large numbers of samples rapidly and is advocated as a screening technique. A combination of geochemical and mineralogical data produced by these techniques provides a powerful diagnostic tool for studies of heavy mineral signatures in sediments frequently used in mineral reconnaissance, paleogeographic reconstruction and reservoir characterisation in the petroleum industry

Organic Pollutants, Heavy Metals and Toxicity in Oil Spill impacted Salt Marsh Sediment Cores, Staten Island, New York City, USA

Sediment cores from Staten Island's salt marsh contain multiple historical oil spill events that impact ecological health. Microtox solid phase bioassay indicated moderate to high toxicity. Multiple spikes of TPH (6524 to 9586 mg/kg) and Σ16 PAH (15.5 to 18.9 mg/kg) were co-incident with known oil spills. A high TPH background of 400–700 mg/kg was attributed to diffuse sources. Depth-profiled metals Cu (1243 mg/kg), Zn (1814 mg/kg), Pb (1140 mg/kg), Ni (109 mg/kg), Hg (7 mg/kg), Cd 15 (mg/kg) exceeded sediment quality guidelines confirming adverse biological effects. Changes in Pb206/207 suggested three metal contaminant sources and diatom assemblages responded to two contamination events. Organic and metal contamination in Saw Mill Creek Marsh may harm sensitive biota, we recommend caution in the management of the 20–50 cm sediment interval because disturbance could lead to remobilisation of pre-existing legacy contamination into the waterway

Relative sea-level change in Newfoundland, Canada during the past ∼3000 years

Several processes contributing to coastal relative sea-level (RSL) change in the North Atlantic Ocean are observed and/or predicted to have distinctive spatial expressions that vary by latitude. To expand the latitudinal range of RSL records spanning the past ∼3000 years and the likelihood of recognizing the characteristic fingerprints of these processes, we reconstructed RSL at two sites (Big River and Placentia) in Newfoundland from salt-marsh sediment. Bayesian transfer functions established the height of former sea level from preserved assemblages of foraminifera and testate amoebae. Age-depth models constrained by radiocarbon dates and chronohorizons estimated the timing of sediment deposition. During the past ∼3000 years, RSL rose by ∼3.0 m at Big River and by ∼1.5 m at Placentia. A locally calibrated geotechnical model showed that post-depositional lowering through sediment compaction was minimal. To isolate and quantify contributions to RSL from global, regional linear, regional non-linear, and local-scale processes, we decomposed the new reconstructions (and those in an expanded, global database) using a spatio-temporal statistical model. The global component confirms that 20th century sea-level rise occurred at the fastest, century-scale rate in over 3000 years (P > 0.999). Distinguishing the contributions from local and regional non-linear processes is made challenging by a sparse network of reconstructions. However, only a small contribution from local-scale processes is necessary to reconcile RSL reconstructions and modeled RSL trends. We identified three latitudinally-organized groups of sites that share coherent regional non-linear trends and indicate that dynamic redistribution of ocean mass by currents and/or winds was likely an important driver of sea-level change in the North Atlantic Ocean during the past ∼3000 years

Numerical comparison of two approaches for the study of phase transitions in small systems

We compare two recently proposed methods for the characterization of phase transitions in small systems. The validity and usefulness of these approaches are studied for the case of the q=4 and q=5 Potts model, i.e. systems where a thermodynamic limit and exact results exist. Guided by this analysis we discuss then the helix-coil transition in polyalanine, an example of structural transitions in biological molecules.Comment: 16 pages and 7 figure