Specialist Referral and Outcomes in Adolescent Athletes With Prior Concussion History

ObjectiveTo examine specialist referral patterns and clinical outcomes in adolescents with differing levels of prior concussion history.BackgroundLimited evidence exists on healthcare utilization and outcomes in concussed adolescent athletes with and without a history of prior concussion.Design/MethodsData were prospectively collected from participants aged 12–18 diagnosed with a sport-related concussion and documented prior concussion history between August 2015-March 2020. Participants were separated into 3 groups: 0, 1, and 2 + prior concussions. Demographics, medical history, specialist referrals, and clinical outcome variables obtained at 3-months post-concussion were analyzed.ResultsOne thousand one hundred ninety-seven participants were included: 114 (10.4%) had 2+, 213 (19.4%) had 1, and 770 (70.2%) had 0 prior concussions. There was no difference in sex or time to presentation. A small difference was found across age (15.3 ± 1.6 vs 14.9 ± 1.6 vs 14.5 ± 1.6 years, p < 0.001). Significant differences were also observed between groups in self-reported history of psychological disorders (14.9 vs 15 vs 8.4%, p = 0.01) and headaches/migraines (25.4 vs 20.2 vs 15.5%, p = 0.02). Significant differences between the groups were found in specialist referrals, with more referrals made in the 2 + group to physical therapy (39.6 vs 28.2 vs 23.4%, p = 0.001), neuropsychology (17.1 vs 5.3 vs 7.5%, p = 0.001), and neurology (8.9 vs 2.9 vs 2.2%, p = 0.001). Fewer participants in the 2 + group recovered in = 30 days (53.6 vs 65.6 vs 68.5%, p = 0.04) and reported lower rates of return to activity at 3-months post-concussion (67.9 vs 85.9 vs 87.6%, p < 0.001). No differences were seen in symptom severity, PHQ-8, or GAD-7 scores. All reported as 2 + vs 1 vs 0.ConclusionsConcussed adolescent athletes with a history of 2 or more prior concussions had a higher rate of specialist referrals, were less likely to have returned to prior level of play/activity 3 months following injury, and were less likely to have resolution of symptoms in 30 days or less.

Implementation of Straw Racks in Commercial Pig Housing—Impact on Straw Availability and Pig Behaviour

This study investigated if straw racks, which enable larger straw rations, induced a more straw-directed behaviour in pigs, as a mean to facilitate the provision of manipulable material and natural behaviour. It was conducted on a commercial farm (459 pigs, 42 pens, 30–120 kg) where half of the pens received 25 L of straw on the floor (CONTROL) and the other half of the pens received straw in a rack holding 44 L of straw (RACK). The pig behaviour in five randomly assigned pens per treatment were recorded for 24 h, during three periods of production. Pig activity levels, exploratory behaviour, pen utilization and available clean straw were scan sampled. During period 1, no pigs were observed interacting with the straw racks. During this period, CONTROL pigs conducted more straw-directed behaviour and less pen-directed behaviour compared to pigs in the pens with a rack during period 1. The lack of rack interactions may imply an underdeveloped spatial cognition in the pigs. Apart from period 1, there were no significant difference in behaviour between RACK and CONTROL pigs. The racks did not disturb the use of the pen. The absent treatment effect in periods 2 and 3 may reflect that there was a too small difference in straw ration between the treatments. In order to design and implement straw racks that promote straw interaction, future studies should focus on understanding pigs’ spatial cognition.

Methods for Detecting PER2:LUCIFERASE Bioluminescence Rhythms in Freely Moving Mice

Circadian rhythms are driven by daily oscillations of gene expression. An important tool for studying cellular and tissue circadian rhythms is the use of a gene reporter, such as bioluminescence from the reporter gene luciferase controlled by a rhythmically expressed gene of interest. Here we describe methods that allow measurement of circadian bioluminescence from a freely moving mouse housed in a standard cage. Using a LumiCycle In Vivo (Actimetrics), we determined conditions that allow detection of circadian rhythms of bioluminescence from the PER2 reporter, PER2::LUC, in freely behaving mice. The LumiCycle In Vivo applies a background subtraction that corrects for effects of room temperature on photomultiplier tube (PMT) output. We tested delivery of d-luciferin via a subcutaneous minipump and in the drinking water. We demonstrate spikes in bioluminescence associated with drinking bouts. Further, we demonstrate that a synthetic luciferase substrate, CycLuc1, can support circadian rhythms of bioluminescence, even when delivered at a lower concentration than d-luciferin, and can support longer-term studies. A small difference in phase of the PER2::LUC bioluminescence rhythms, with females phase leading males, can be detected with this technique. We share our analysis scripts and suggestions for further improvements in this method. This approach will be straightforward to apply to mice with tissue-specific reporters, allowing insights into responses of specific peripheral clocks to perturbations such as environmental or pharmacological manipulations.

Cooling Seasonal Performance Factor (CSPF) Application in Indonesia for Residential Air Conditioning (AC) Unit

As an archipelago country located around the equator line, Indonesia has a broad ambient temperature range of varying atmospheric conditions. This issue should be concerned with applying ISO 16358-1 to calculate Seasonal Energy Efficient Ratio (SEER) on cooling, or so-called the Cooling Seasonal Performance Factor (CSPF). The ISO 16358-1 recommend a set of bin temperature which can be used as the basis for calculating the CSPF. The research objectives are to compare the local ambient temperature of four cities in Indonesia (Jakarta, Bandung, Pontianak, and Palembang) with the ISO bin temperature. The normal distribution graph of temperature for every four cities in Indonesia shows a remarkable difference from the ISO bin temperature. Jakarta’s most occurring temperature range is 25 – 30 °C, Bandung is 21 – 23 °C, Pontianak is 24 – 26 °C, and Palembang is 24 – 26 °C, annually. Those numbers were compared to the ISO, which has the most occurring temperature range around 24 - 28 °C. The result on CSPF calculation of AC unit sample in the range of 4,000 – 17,000 Btu/hr (both non-inverter and inverter) using Indonesia local bin temperature compared with the ISO bin temperature has an average range of 5.10%. It was concluded that Indonesia’s local ambient temperature affects the CSPF value, especially on the AC inverter unit. On the other hand, the relatively small difference value of CSPF has an advantage in applying the ISO bin temperature for future Indonesia’s energy conservation policy. It could lead to harmonizing with other South-East Asian (ASEAN) countries specifically, and another country also applying the ISO 16358-1, in general.

Densification of Amorphous Calcium Phosphate: A Comparison of Cold Sintering Processes

The recent surge in interest in the densification of calcium phosphate powders needs consideration of all the influencing factors. Spark plasma sintering with the primary contribution from the spark plasma and cold compaction that densifies from the large compaction pressures were considered. X-ray diffraction and Fourier transform infra-red spectroscopy characterized the powder and tablet to confirm the retention of the amorphous phase. Density was measured using the Archimedes method and the microstructure was viewed by scanning electron microscopy. The densified tablets were indented by nanoindentation to determine the hardness and elastic modulus. Reports on the density showed that the smallest contribution to density arose from vacuum, a marginally higher densification from the spark plasma effect, but the largest densification arose from the use of significantly higher pressures. Nanoindentation showed a small difference in elastic modulus between tablets densified at 25 °C and 200 °C, but a larger difference in the hardness.

Tolerance Puzzles

This chapter provides a general schema for regimenting a broad family of puzzles of modal variation. These puzzles begin with a ‘Tolerance’ premise according to which an objects (or a certain kind of object) can differ in any small way along a certain parameter. This is supplemented with a ‘Non-contingency’ premise according to which the Tolerance premise is necessarily true if true at all, an ‘Iteration’ premise according to which anything possibly possible is possible, and a ‘Persistent Closeness’ premise according to which what counts as a ‘small difference’ is modally constant. These premises jointly imply the conclusion, ‘Hypertolerance’, that the object or objects in question can differ arbitrarily along the relevant parameter. We show how this schema is general enough to subsume puzzles involving time or objective chance, and discuss some difficulties that arise in trying to formulate compelling instantiations of the schema involving variation in originating matter.

Nonstationary holographic currents in a β-Ga2O3 crystal at wavelength λ = 457 nm

We report the excitation of nonstationary holographic currents in a monoclinic gallium oxide crystal. Although the crystal is almost transparent and insulating for a visible light, the dynamic space-charge gratings are recorded and holographic currents are observed for both the diffusion and drift modes. The anisotropy along the [100] and [010] directions is revealed, namely, there is a small difference in the transport parameters and a pronounced polarization dependence of the signal. The crystal’s photoconductivity, responsivity and diffusion length of electrons are estimated for the light wavelength λ = 457 nm.

An Eight-Channel Switching-Linear Hybrid Dynamic Regulator with Dual-Supply LDOs for Thermo-Optical Tuning

<div>A novel switching-linear hybrid dynamic regulator with dual-supply LDOs for thermo-optical tuning is presented in this brief. Compared with conventional designs, the proposed design leverages the intrinsic dual supplies to extend the operating range of the LDOs, and increases the thermo-optical tuning efficiency by reducing the dropout of the LDOs through dynamic voltage tracking. It can simultaneously regulate eight output channels and track 0.8 V_pp sinusoidal waveforms at different frequencies. Significant efficiency improvement of the proposed design is achieved for envelope signals with a small difference, which is common in thermo-optical tuning. Implemented in 130 nm CMOS process, the proposed design has a total chip area of 0.675 mm². The proposed design achieves a conversion efficiency of 88% at 1 V output driving a 200 ohms load. Its dynamic efficiency is about 80% when tracking 50 kHz sinusoidal signals.</div>

An Eight-Channel Switching-Linear Hybrid Dynamic Regulator with Dual-Supply LDOs for Thermo-Optical Tuning

<div>A novel switching-linear hybrid dynamic regulator with dual-supply LDOs for thermo-optical tuning is presented in this brief. Compared with conventional designs, the proposed design leverages the intrinsic dual supplies to extend the operating range of the LDOs, and increases the thermo-optical tuning efficiency by reducing the dropout of the LDOs through dynamic voltage tracking. It can simultaneously regulate eight output channels and track 0.8 V_pp sinusoidal waveforms at different frequencies. Significant efficiency improvement of the proposed design is achieved for envelope signals with a small difference, which is common in thermo-optical tuning. Implemented in 130 nm CMOS process, the proposed design has a total chip area of 0.675 mm². The proposed design achieves a conversion efficiency of 88% at 1 V output driving a 200 ohms load. Its dynamic efficiency is about 80% when tracking 50 kHz sinusoidal signals.</div>

Forward Problems Solving of Groundwater Flow using Stochastic Groundwater Vistas Method

In the forward problems, the hydraulic head value can be found by knowing the value of the groundwater parameter. Parameters of groundwater such as hydraulic conductivity, vary over space due to the variation of aquifer properties. Consequently, it is difficult or almost impossible to treat these kinds of variability by a deterministic approach because there is no exact value to be used as input for a parameter. The objective of this research was to obtain a mathematical model of groundwater flow made with the Groundwater Vistas Program that is in accordance with the physical model. Mathematical modeling of groundwater flow using the Groundwater Vistas Program with a stochastic approach and Monte Carlo simulation method where the input data (hydraulic conductivity, hydraulic head) is obtained from the physical model. Results showed that the sum of squares value from the scatter plot diagram of all realization points had a very small value (close to or even zero). The residual mean diagram showed the error value of all realizations had a very low value close to zero. The calculated head value (computed) compared with the results of the observation had a fairly small difference value (ranging from 0.0006−0.009 m). These results were considered quite good because in modeling it is impossible to get modeling results that are exactly the same as those being modeled. The results show that Groundwater Vistas can be used for modeling with very small errors and it can estimate values of hydraulic heads quite well.