Individual Test Performance Research Articles

Tracking Changes in Physical Performance and Match Outputs in Elite Female Field Hockey Players Over an Olympic Cycle: A Follow-Up Study

This research aimed to analyse the physical performance and game-related statistics of 17 international female hockey players across an Olympic cycle, exploring whether these metrics changed synchronously. Data from 24 physical performance tests and 102 matches, monitored with 10 Hz GPS units, were evaluated. Minimal variability was observed in the 30 m sprint performance (Coefficient of Variation, CV = 2.3 ± 0.8%), while the greatest variability was found in pull-up tests (CV = 35.8 ± 12.1%). Significant temporal improvements were noted in the YoYo test (p < 0.001), and sprint times for 10m and 30m distances (p < 0.001 for both). Strength, muscular endurance, and neuromuscular metrics also enhanced significantly over time (p < 0.008). Reactive Strength Index (RSI), improved over time (p < 0.008), but none of the values differed significantly from the first test. On average, players covered 5469 ± 1159 m per match, with no significant change in high-speed running distance (637 ± 246 m) across the five years. However, the average running speed did increase (114 ± 13 m.min−1 ;p< 0.001). The findings elucidate the performance benchmarks for elite female hockey players and suggest that advancements in individual performance tests do not necessarily correlate with match statistics, underscoring the complexity of athletic progression and its implications for player management.

Relationships Between Functional Movement Quality and Sports Performance in Elite Figure Skating Athletes of China.

Zhitao, L, Junlong, D, Rui, Y, Leijiao, Y, Cheng, G, and Jun, Y. Relationships between functional movement quality and sports performance in elite figure skating athletes of China. J Strength Cond Res 38(11): e678-e685, 2024-This study aimed to determine the optimal functional movement screen (FMS) cut score for assessing the risk of sports injuries and to explore the correlations between functional movement quality and sports performance among elite figure skaters. A total of 22 elite figure pairs skaters in China underwent FMS, sports performance, and clinical examinations for sports injuries. The FMS cut score was determined using the receiver operating characteristic curve. Pearson's rank correlation analysis was used to quantify associations between the variables. (a) The optimal FMS cut score for assessing the risk of sports injuries was 13 (p = 0.008), with an area under curve of 0.838. The sensitivity and specificity were 0.889 and 0.692, respectively. (b) The trunk stability push-up (TSPU), an individual FMS test, predicted injuries in figure skaters (p = 0.015). (c) Moderate correlations were found between shoulder mobility and bench strength (r = -0.453, p = 0.034), counter movement jump (r = -0.582, p = 0.007), and 30-m sprint (r = 0.567, p = 0.009). A strong correlation was observed with squat jump (r = -0.774, p = 0.001). In addition, TSPU scores moderately correlated with 30-m sprint times (r = -0.511, p = 0.021) and 30-s average anaerobic power (r = 0.503, p = 0.024). These findings indicate that both the FMS total score ≤13 and the FMS individual score serve as indicators of injury risk in figure skaters. However, only the FMS individual score reflected the sports performance. This likely results from the similarity in kinetic chain systems and movement patterns involved in both the FMS individual test and sports performance, suggesting a promising assessment strategy for sports performance.

Is Broca's area critical for speech and language? Evidence from lesion-symptom mapping in chronic aphasia

IntroductionThe specific role that Broca's area plays in speech and language has been hotly debated in the literature. Some research has pointed to a specific role in particular aspects of speech production, while other findings have suggested additional roles in aspects of language comprehension. In the current study, we had the opportunity to take a broad approach by analyzing lesion and behavioral data from a large cohort of left hemisphere stroke patients. In this brief report, our objective was to identify which speech-language measures show a significant association with Broca's area, specifically pars opercularis and pars triangularis.MethodsLesion site and neuropsychological data from 173 chronic left hemisphere stroke patients were analyzed in the current study. Univariate lesion-symptom mapping (LSM) with rigorous correction was used to identify brain regions associated with individual test performance on a large battery of speech and language tasks. Multivariate LSM analyses were conducted in subsequent runs to confirm findings.ResultsThe LSM results identified many predictable left hemisphere gray and white matter regions significantly associated with the speech-language data, but Broca's area was not implicated in performance on any speech or language measure. Regions adjacent to Broca's area, however, in left central opercular, precentral, and insular cortices were associated with speech production and motor speech performance.DiscussionThe current study failed to identify a single speech or language measure in our comprehensive test battery that was dependent on Broca's area. This finding could not be attributed to a lack of power, as Broca's area had among the highest power values and substantial lesion coverage. Interrogation of data at the individual patient level revealed the likely source of this null finding: Patients with lesions involving Broca's area varied widely in their speech-language performance, with profiles ranging from non-aphasic to Broca's to global aphasia. Given previous studies in acute stroke patients and healthy participants implicating Broca's area in speech-language, the current findings suggest that Broca's area plays a more supplementary than critical role and can be compensated by surrounding brain regions in chronic stroke.

Validity and reliability of the VXSport (Omni) device on basketball movement parameters

The use of inertial devices in sport have become increasingly common. The aim of this study was to examine the within-day validity and reliability of a relatively new inertial measurement unit at measuring basketball movement parameters. Eighteen well-trained basketball players completed several individual performance tests including linear running and change of directions, acceleration, and decelerations, jumping and impacts to measure the validity and reliability of the microtechnology. The players also completed a specific test called the Basketball Exercise Simulation Test (BEST) to investigate whether the microtechnology could accurately detect more dynamic movements. Pearsons’s correlations were determined linking assessments of the practical measures taken from the inertial measurement unit to criterion measures. Testing revealed good validity between the microtechnology and criterion measures with the 20 m run test at various velocities (6 km.h-1, 12 km.h-1, 18 km.h-1, 24 km.h-1, maximal speed km.h-1 (mean bias <5%). However, total distance, body collisions, accelerations and decelerations showed lower validity (mean bias >10%). Total distance, number of sprints, number of sprints >15 km.h-1, number of decelerations >3m.s-2, number of accelerations and decelerations showed very large to nearly perfect reliability (ICC = 0.88 – 0.99). Whereas, relative distance (m.min-1), maximal speed (km.h-1), total number of accelerations (>3 m.s-2), total number of jumps, average heart rate showed high reliability (ICC 0.77 – 0.87). These results demonstrate the units were able to accurately detect most basketball movement patterns correctly with good repeatability.

Responsiveness of Subjective and Objective Measures of Pain and Function Following Operative Interventions for Musculoskeletal Conditions: A Narrative Review.

Musculoskeletal (MSK) disorders affect ~50% of US adults and 75% of those over the age of 65, representing a sizable economic and disability burden. Outcome measures, both objective and subjective, help clinicians and investigators determine whether interventions to treat MSK conditions are effective. This narrative review qualitatively compared the responsiveness of different types of outcome measures, a key measurement characteristic that assesses an outcome measure's ability to detect change in patient status. We evaluated elective orthopedic interventions as a model for assessing responsiveness because the great majority of patients improves following surgery. We searched for articles reporting responsiveness (quantified as effect size [ES]) of subjective and objective outcome measures after orthopedic surgery and included 16 articles reporting 17 interventions in this review. In 14 of 17 interventions, subjective function measures had an ES 10% greater than that of objective function measures. Two reported a difference in ES of <10%. The sole intervention that demonstrated higher ES of objective function used a composite measure. Sixteen interventions reported measures of subjective pain and/or mixed measures and subjective function. In nine interventions, subjective pain had a higher ES than subjective function by >10%, in three, subjective function had a higher ES than subjective pain by >10%, and in the remaining four, the difference between pain and function was <10%. These findings reinforce the clinical observation that subjective pain generally changes more than function following elective orthopedic surgery. They also suggest that subjective function measures are more responsive than objective function measures, and composite scores may be more responsive than individual performance tests.

Meta-Analysis on the Association between Echo Intensity, Muscle Strength, and Physical Function in Older Individuals.

The use of ultrasonographic echo intensity (EI) to evaluate skeletal muscle quality and its effects on strength, explosive power, and physical function (PF) in older individuals remains unclear. This meta-analysis evaluated the associations among EI, muscle strength (MS), and PF in older individuals. We conducted a systematic search of the PubMed, Embase, Web of Science, SPORT Discus, and CINAHL databases through October 2022 to identify primary studies examining the association between EI and MS/PF. Effect sizes were computed using a random-effects model and presented using forest plots. Pearson correlation coefficient (r) and I2 statistics were used to measure heterogeneity. This meta-analysis included 24 patients. EI demonstrated a negative association with maximal strength (r=-0.351; 95% confidence interval [CI], -0.411 to -0.288; p&lt;0.001) and explosive power (r=-0.342; 95% CI, -0.517 to -0.139; p=0.001) in older individuals. Handgrip strength also showed a significant negative correlation with EI (r=-0.361; 95% CI, -0.463 to -0.249; p&lt;0.001). However, we observed only a small and non-significant negative association between EI and gait speed (r=-0.003; 95% CI, -0.083 to -0.077; p=0.943), and a weak non-significant correlation with the chair stand test (r=0.072; 95% CI, -0.045 to 0.187; p=0.227). Increased EI was associated with lower strength and power but not with gait speed or chair test performance in older individuals. Further large-sample studies with long-term follow-up are needed to improve frailty prediction and risk assessment in this population.

Examination of the Wingate Anaerobic Power Test Performance in Athletes and Sedentary Individuals Within the Scope of Five-Second Segments

Bu çalışmanın ana amacı; sporcu ve sedanter bireylerde Wingate anaerobik güç testi (WAnT) performansının beş saniyelik segmentler ekseninde incelenmesidir. Çalışmanın ikincil amacı ise fiziksel özellikler ile WAnT performansı arasındaki ilişkiyi ortaya koymaktır. Çalışmaya iyi antrene durumdaki 13 erkek sporcu (Ort. yaş: 23,31 ± 2,06 yıl) ve 13 sağlıklı sedanter (Ort. yaş: 22,84 ± 1,99 yıl) gönüllü olarak katılmıştır. Öncelikle katılımcıların demografik ve antropometrik ölçüm aşaması tamamlanmıştır. Daha sonra katılımcılar, tek seanslık laboratuvar ölçümünde bir bisiklet ergometresi (Monark Wingate Ergometer model 834E) aracılığıyla 30 saniyelik WAnT (WAnT-30) protokolünü tamamlamıştır. Test yükü, vücut ağırlığının %7,5’i olarak belirlenmiştir. Test sonucunda ergometre yazılımından elde edilen WAnT-30 zirve güç (ZG) ve toplam altı segmentten oluşan beş saniyelik ortalama güç (OG) çıktıları kaydedilmiştir. Sporcular, WAnT-30 ZG ve tüm beş saniyelik segmentlere ait OG çıktılarında sedanterlere göre daha yüksek değerlere sahipti (p&amp;lt;0,001). Sporcularda WAnT-30 ZG değeri ile tüm beş saniyelik OG çıktıları arasında pozitif ilişki olduğu belirlenirken (p&amp;lt;0,05; r = 0,594- 0,970), sedanterlerde ise bu ilişki 3. segmentten sonra kaybolmuştur. Basit doğrusal regresyon sonuçlarına göre sporcularda boy uzunluğu ve vücut ağırlığı, WAnT-30 performansının en iyi belirteçleri olarak tespit edilmiştir (R2 = 0,362- 0,689 ve R2 = 0,457- 0,590 sırasıyla). Sonuç olarak, sporcuların WAnT-30’a ait tüm segmentlerde sedanter bireylere göre daha yüksek güç çıktısına sahip olduğu belirlenmiştir. Ayrıca sporcularda tam eforlu bir anaerobik performansın fiziksel özelliklerden etkilenebileceği görülmüştür. Sonraki çalışmalarda spesifik spor dallarından katılımcılarda farklı segment aralıkları kullanılarak anaerobik performansın gelişmiş bir değerlendirmesi yapılabilir.

5 Meta-Analysis of Cognitive Functioning Following Non-Severe COVID-19 Infection

Objective:To effectively diagnose and treat cognitive post-COVID-19 symptoms, it is important to understand objective cognitive difficulties across the range of acute COVID-19 severity. The aim of this meta-analysis is to describe objective neuropsychological test performance in individuals with non-severe (mild/moderate) COVID-19 cases in the post-acute stage of infection (&gt;28 days after initial infection).Participants and Methods:This meta-analysis was pre-registered with Prospero (CRD42021293124) and utilized the PRISMA reporting guidelines, with screening conducted by at least two independent reviewers for all aspects of the screening and data extraction process. Inclusion criteria were established before the article search and were as follows: (1) Studies using adult participants with a probable or formal and documented diagnosis of COVID-19 in the post-acute stage of infection; (2) Studies comparing cognitive functioning using objective neuropsychological tests in one or more COVID-19 groups and a comparison group, or one group designs using tests with normative data; (3) Asymptomatic, mild, or moderate cases of COVID-19. Twenty-seven articles (n=18,202) with three types of study designs and three articles with additional longitudinal data met our full criteria.Results:Individuals with non-severe initial COVID-19 infection demonstrated worse cognitive performance compared to healthy comparison participants (d=-0.412 [95% CI, -0.718, -0.176)], p=0.001). We used metaregression to examine the relationship between both average age of the sample and time since initial COVID-19 infection (as covariates in two independent models) and effect size in studies with comparison groups. There was no significant effect for age (b=-0.027 [95% CI (0.091, 0.038)], p=0.42). There was a significant effect for time since diagnosis, with a small improvement in cognitive performance for every day following initial acute COVID-19 infection (b=0.011 [95% CI (0.0039, 0.0174)], p=0.002). However, those with mild (non-hospitalized) initial COVID-19 infections performed better than did those who were hospitalized for initial COVID-19 infections (d=0.253 [95% CI (0.372, 0.134)], p&lt;0.001). For studies that used normative data comparisons, there was a small, non-significant effect compared to normative data (d=-0.165 [95% CI (-0.333, 0.003)], p=0.055).Conclusions:Individuals who have recovered from non-severe cases of COVID-19 may be at risk for cognitive decline or impairment and may benefit from cognitive health interventions.

The Efficacy of Cognitive Training on Neuropsychological Outcomes in Mild Cognitive Impairment: A Meta-Analysis.

Mild cognitive impairment (MCI) or mild neurocognitive disorder is an intermediate stage of cognitive impairment between normal cognitive aging and dementia. Given the absence of effective pharmacological treatments for MCI, increasing numbers of studies are attempting to understand how cognitive training (CT) could benefit MCI. This meta-analysis aims to update and assess the efficacy of CT on specific neuropsychological test performance (global cognitive functioning, short-term verbal memory, long-term verbal memory, generativity, working memory, and visuospatial abilities) in individuals diagnosed with MCI, as compared to MCI control groups. After searching electronic databases for randomized controlled trials, 31 studies were found including 2496 participants. Results showed that CT significantly improved global cognitive functioning, short-term and long-term verbal memory, generativity, working memory, and visuospatial abilities. However, no significant effects were observed for shifting, abstraction ability/concept formation, processing speed, and language. The mode of CT had a moderating effect on abstraction ability/concept formation. The findings provide specific insights into the cognitive functions influenced by CT and guide the development of tailored interventions for MCI. While CT holds promise, further research is needed to address certain cognitive deficits and assess long-term effects on dementia progression.

Pain in the Context of Virtual Neuropsychological Assessment of Older Adults.

Pain and cognitive impairment are prevalent and often co-occur in older adults. Because pain may negatively affect cognitive test performance, identification of pain in the context of neuropsychological evaluation is important. However, pain detection based on self-report presents challenges, and pain is often under-detected in this population. Alternative methods (e.g., video-based automatic coding of facial biomarkers of pain) may facilitate pain identification and thus enhance interpretation of neuropsychological evaluation results. The current study examined pain in the context of virtual neuropsychological assessment in 111 community-dwelling older adults, first seeking to validate the use of software developed to automatically code biomarkers of pain. Measures of pain, including self-report of acute and chronic pain and automatic coding of pain, were compared while participants completed neuropsychological testing. Self-reported pain was negatively associated with poorer performance on a measure of executive function (both acute and chronic pain) and a global cognitive screening measure (acute pain only). However, self-reported acute and chronic pain did not correlate significantly with most neuropsychological tests. Automatic coding of pain did not predict self-report of pain or performance on neuropsychological tests beyond the influence of demographic factors and psychological symptoms. Though results were largely not significant, correlations warrant further exploration of the influence of pain on neuropsychological test performance in this context to ensure that pain does not influence test performance in individuals with higher levels of pain and in other samples.

Bilingualism and intelligence in children exposed to poverty environments: A Raven's error pattern analysis using a generalized propensity score method

The main objective of this study is to compare the quantitative (correct answers) and qualitative (error types) performance of children belonging to different linguistic groups on a non-verbal reasoning test, Raven's Colored Progressive Matrices Test, after being matched based on level of exposure to poverty, certain individual characteristics and test performance. The sample is representative for Mexico at a population level and consists of children aged 5 to 12 (n = 4644), of which 671 are bilingual in Spanish and an indigenous language, 3970 are monolingual in Spanish and 78 are monolingual in an indigenous language. The results show significant quantitative differences with a lower overall performance in the Raven's test by bilingual children as compared to their monolingual (Spanish only) peers, but no qualitative differences when analyzing their error types. When considering each linguistic group individually, the relative frequency of three error types (Repetition, Wrong Principle, and Incomplete Correlate) is similar in children aged 5 to 8 and in those aged 9 to 12. However, considering the two age cohorts, the results reveal how the intragroup differences in each linguistic group, are only statistically significant in the case of Difference errors, in the group of monolingual children in Spanish.In addition to practical use that may be potentially derived from this empirical evidence, these results may also be encouraging from a methodological point of view. They demonstrate how the method used, in addition to permitting greater comparison between the experimental groups of a representative sample at a population level, does not present high sensitivity, either for the model used to estimate the Generalized Propensity Score method, or for the specific estimator used.

Improving dengue diagnosis and case confirmation in children by combining rapid diagnostic tests, clinical, and laboratory variables

BackgroundDengue is the most widely distributed arboviral disease in tropical and subtropical countries. Most suspected cases are diagnosed according to the clinical criteria, and early diagnosis is difficult. Moreover, in underdeveloped countries, several factors continue to challenge the diagnosis and surveillance of dengue cases. This study aimed to design a diagnostic algorithm using rapid diagnostic tests (RDTs), ELISA tests, and clinical and hematological variables to confirm dengue cases in febrile patients in Colombia.MethodsAltogether, 505 samples were collected. Serum samples were evaluated by RDTs (IgM and IgG antibodies and NS1 antigen), capture IgM and IgG ELISAs, and endpoint hemi-nested RT-PCR assay (qualitative). We statistically analyzed the performance of individual tests to determine the most useful ones to confirm dengue cases accurately.ResultsIndividual results for IgM, IgG, and NS1 RDTs yielded lower sensitivity and specificity values than the reference standard. High sensitivity and specificity were obtained after combining IgM and NS1 ELISA results (96.3% and 96.4%) and NS1 RDT plus IgM ELISA results (90.3% and 96.2%), respectively. Adjusted odds ratios (aORs) were calculated for clinical variables and laboratory tests to differentiate dengue from other febrile illnesses (OFI). This approach showed that myalgia, abdominal tenderness, and platelet count were identified with higher sensitivity to confirm dengue cases. IgM RDT and NS1 RDT differentiated dengue cases from OFI. A positive IgM RDT or a positive NS1 RDT combined with specific signs or symptoms confirmed 81.6% of dengue cases. A combination of clinical findings and a positive NS1 RDT or positive ELISA IgM confirmed 90.6% of the cases.ConclusionOur findings showed that clinical diagnoses in pediatric population alone cannot confirm true dengue cases and needs to be complemented by laboratory diagnostic tests. We also demonstrate the usefulness of combining clinical criteria with RDTs, suggesting that their implementation with the IgM ELISA test improves dengue case confirmation.

The effects of standardised versus individualised seat height on 1-minute sit-to-stand test performance in healthy individuals: a randomised crossover trial

PurposeWe aimed to (i) investigate differences in 1-minute sit-to-stand test (1MSTST) performance (i.e., the number of repetitions) between a standardised modality (i.e., starting from a conventional chair with 46 cm seat height) and an individualised modality (i.e., starting with a knee joint flexion angle of 90°), and to (ii) quantify the influence of tibia and femur length on 1MSTST performance.MethodsHealthy participants were recruited for this randomised crossover study, performing each 1MSTST modality twice in a randomised order. The primary outcome was the number of repetitions in the 1MSTST. Secondary endpoints were the acute responses in peripheral oxygen saturation, heart rate, and leg fatigue and dyspnoea. Additionally, we investigated correlations of performance with knee extensor strength in both modalities.ResultsThirty participants were recruited and completed the study. They achieved significantly less repetitions in the standardised 1MSTST compared to the individualised 1MSTST (B = − 12.1, 95% confidence interval [95% CI] = − 14.8/− 9.4, p < 0.001). We found a significant effect of femur length on 1MSTST performance (B = − 1.6, 95% CI = − 2.6/− 0.7, p = 0.01), tibia length showed significant interaction with the 1MSTST modality (B = 1.2, 95% CI = 0.2/2.2, p = 0.03).ConclusionAn individualisation of the 1MSTST starting position to 90° knee flexion angle leads to more repetitions compared to the traditional starting position. The higher repetition count is explained by controlling for differences in tibia length. We recommend individualisation of the 1MSTST, enabling more valid comparisons across populations and study samples.Trial registration numberhttp://www.ClinicalTrials.gov, NCT04772417.Trial registration dateFebruary 26, 2021.

Unmanned Surface Vehicle Using a Leader–Follower Swarm Control Algorithm

To overcome the limitations of a single unmanned surface vehicle (USV), this study investigated the swarm control algorithms of USVs. Among various swarm control methods, a leader–follower swarm control method was selected and studied. The performance of the swarm algorithm proposed in this study was verified through an actual sea area test. A USV was designed and manufactured by dividing the power and communication parts. The power system was equipped with a coulometer to monitor the battery state in real time to protect the system through a switch linked to the coulometer in the case of abnormalities in the battery and to prevent accidents. In addition, a communication system was established to process the sensor data and camera image data of the USV in real time. Consequently, the desired swarm formation was achieved through the separately constructed swarm control algorithm. Before the actual sea area test, individual performance tests of each sensor were conducted. Finally, the performance of the swarm algorithm was verified by conducting a sea area test. The performance of the controllers was confirmed to be good, and the swarm formation was confirmed to be successful.

Virtuous victims: Disability claimants who over- and under-report

Objective: The present study was the first to investigate the test performance and symptom reports of individuals who engage in both over-reporting (i.e., exaggerating or fabricating symptoms) and under-reporting (i.e., exaggerating positive qualities or denying shortcomings) in the context of a forensic evaluation. We focused on comparing individuals who over- and under-reported (OR + UR) with those who only over-reported (OR-only) on the MMPI-3. Method: Using a disability claimant sample referred for comprehensive psychological evaluations (n = 848), the present study first determined the rates of possible over-reporting (MMPI-3 F ≥ 75 T, Fp ≥ 70 T, Fs ≥ 100 T, or FBS or RBS ≥ 90 T) with (n = 42) and without (n = 332) under-reporting (L ≥ 65 T). Next, we examined group mean differences on MMPI-3 substantive scale scores and scores on several additional measures completed by the disability claimant sample during their evaluation. Results: The small group of individuals identified as both over-reporting and under-reporting (OR + UR) scored meaningfully higher than the OR-only group on several over- and under-reporting symptom validity tests, as well as on measures of emotional and cognitive/somatic complaints, but lower on externalizing measures. The OR + UR group also performed significantly worse than the OR-only group on several performance validity tests and measures of cognitive ability. Conclusions: The present study indicated that disability claimants who engage in simultaneous over- and under-reporting portray themselves as having greater levels of dysfunction but fewer externalizing tendencies relative to claimants who only over-report; however, these portrayals are likely less accurate reflections of their true functioning.

Do Patterns of Early Disease Severity Predict Grade 12 Academic Achievement in Youths With Childhood-Onset Chronic Rheumatic Diseases?

To test the association of early disease severity with grade 12 standards test performance in individuals with childhood-onset chronic rheumatic diseases (ChildCRDs), including juvenile arthritis and systemic autoimmune rheumatic diseases. We used linked provincial administrative data to identify patients with ChildCRDs born between 1979 and 1998 in Manitoba, Canada. Primary outcomes were Language and Arts Achievement Index (LAI) scores and Math Achievement Index (MAI) scores from grade 12 standards test results as well as enrollment data. The secondary outcome was enrollment in grade 12 by 17 years of age. Latent class trajectory analysis identified disease severity groups using physician visits following diagnosis. Multivariable linear regression tested the association of disease severity groups with LAI and MAI scores, and logistic regression tested the association of disease severity with age-appropriate enrollment, after adjusting for sociodemographic factors and psychiatric morbidities. The study cohort included 541 patients, 70.1% of whom were female. A 3-class trajectory model provided the best fit; it classified 9.7% of patients as having severe disease, 54.5% as having moderate disease, and 35.8% as having mild disease. After covariate adjustment, severe disease was associated with poorer LAI and MAI scores but not with age-appropriate enrollment. Among patients with ChildCRDs, those with severe disease performed more poorly on grade 12 standards tests, independent of sociodemographic and psychiatric risk factors. Clinicians should work with educators and policy makers to advocate for supports to improve educational outcomes of patients with ChildCRDs.

Critical Power, Work Capacity, and Recovery Characteristics of Team-Pursuit Cyclists.

Leading a 4-km team pursuit (TP) requires high-intensity efforts above critical power (CP) that deplete riders' finite work capacity (W'), whereas riders following in the aerodynamic draft may experience some recovery due to reduced power demands. This study aimed to determine how rider ability and CP and W' measures impact TP performance and the extent to which W' can reconstitute during recovery positions in a TP race. Three TP teams, each consisting of 4 males, completed individual performance tests to determine their CP and W'. Teams were classified based on their performance level as international (INT), national (NAT), or regional (REG). Each team performed a TP on an indoor velodrome (INT: 3:49.9; NAT: 3:56.7; and REG: 4:05.4; min:s). Ergometer-based TP simulations with an open-ended interval to exhaustion were performed to measure individual ability to reconstitute W' at 25 to 100W below CP. The INT team possessed higher CP (407 [4]W) than both NAT (381 [13]W) and REG (376 [15]W) (P < .05), whereas W' was similar between teams (INT: 27.2 [2.8]kJ; NAT: 29.3 [2.4]kJ; and REG: 28.8 [1.6]kJ; P > .05). The INT team expended 104% (5%) of their initial W' during the TP and possessed faster rates of recovery than NAT and REG at 25 and 50W below CP (P < .05). The CP and rate of W' reconstitution have a greater impact on TP performance than W' magnitude and can differentiate TP performance level.

Apparent digestibility and ingestive behavior of Nellore bulls with low and high residual feed intake.

The objective of this study was to determine the correlation between ingestive behavior, apparent digestibility, and residual feed intake (RFI) of finishing Nellore bulls fed a high concentrate diet. One hundred and twenty Nellore bulls, housed in individual pens, were evaluated in individual performance tests. The animals were fed a high concentrate diet (23:77 roughage/concentrate ratio). The animals were classified as low RFI, medium RFI, and high RFI. Data from ten animals from each group were used. Fecal production and nutrient digestibility were calculated using indigestible neutral detergent fiber as an internal marker. The feeding behavior was evaluated over 24h by direct observation every 5min. The most efficient animals (low RFI, 8.58kg DM/day) consumed 27.62% less feed than the least efficient animals (high RFI, 10.95kg DM/day). Animals with medium efficiency (mean RFI, 9.49kg DM/day) consumed 15.39% less than high RFI. Nutrient digestibility coefficients were similar except for ether extract (P < 0.03) which was 8% greater for the high-RFI animals. No effect was observed for ingestive behavior (P > 0.05). Animals spent, on average, 3h 28min feeding, 7h 32min ruminating, and 13h 40min in idle time. In the present study, ingestive behavior and dry matter digestibility were not responsible for between-animal variation in residual feed intake in Nellore bulls fed a high concentrate diet.

Increased rate of listening difficulties in autistic children

IntroductionAuditory challenges are both common and disruptive for autistic children and evidence suggests that listening difficulties may be linked to academic underachievement (Ashburner, Ziviani & Rodger, 2008). Such deficits may also contribute to issues with attention, behavior, and communication (Ashburner et al., 2008; Riccio, Cohen, Garrison & Smith, 2005). The present study aims to summarize the auditory challenges of autistic children with normal pure-tone hearing thresholds, and perceived listening difficulties, seen at auditory-ASD clinics in the US and Australia. MethodsData were compiled on a comprehensive, auditory-focused test battery in a large clinical sample of school-age autistic children with normal pure-tone hearing to date (N = 71, 6–14 years). Measures included a parent-reported auditory sensory processing questionnaire and tests of speech recognition in noise, binaural integration, attention, auditory memory and listening comprehension. Individual test performance was compared to normative data from children with no listening difficulties. ResultsOver 40% of patients exhibited significantly reduced speech recognition in noise and abnormal dichotic integration that were not attributed to deficits in attention. The majority of patients (86%) performed abnormally on at least one auditory measure, suggesting that functional auditory issues can exist in autistic patients despite normal pure-tone sensitivity. ConclusionIncluding functional listening measures during audiological evaluations may improve clinicians’ ability to detect and manage the auditory challenges impacting this population. Learner Outcomes: 1) Readers will be able to describe the auditory difficulties experienced by some autistic patients (ASD). 2) Readers will be able to describe clinical measures potentially useful for detecting listening difficulties in high-functioning autistic children.

Diagnostic Accuracy of Point of Care Cryptococcal Antigen Lateral Flow Assay in Fingerprick Whole Blood and Urine Samples for the Detection of Asymptomatic Cryptococcal Disease in Patients with Advanced HIV Disease.

ABSTRACTCryptococcal disease (CD) is a leading cause of mortality among individuals with advanced HIV disease (AHD). Screening with serum cryptococcal antigen (sCrAg) lateral flow assay (LFA) enables early detection of subclinical disease but requires venipuncture and laboratory processing. Clinic-based point of care (POC) CrAg screening tests using urine or fingerprick whole blood could facilitate early diagnosis of CD. We evaluated the diagnostic performance of POC clinic-based fingerprick whole blood and urine CrAg compared to the gold standard laboratory sCrAg LFA in screening for CD among asymptomatic individuals with CD4 counts of <200 cells/μL in Harare, Zimbabwe. sCrAg positive participants who consented to a lumbar puncture also had cerebrospinal fluid (CSF) CrAg testing and titers for CSF-positive specimens. A total of 1,333 individuals were screened, and over half (56.6%) were males. The median (interquartile range) CD4 count was 27.5 (11–46) cells/μL. We found a sensitivity of 63.8% (95% CI: 54.8–72.1) and specificity of 84.0% (95% CI: 81.7–86.0) for urine CrAg, and a sensitivity of 48.0% (95% CI: 39.1–57.1) and specificity of 99.5% (95% CI: 98.9–99.8) was found for fingerprick whole blood. The sensitivity of both POC CrAg tests increased in individuals with sCrAg titers of ≥1:160, CD4 count of <50 cells/μL and disseminated central nervous system (CNS) disease. Clinic-based POC urine and fingerprick whole blood CrAg testing performed better in screening for CD among AHD patients with CNS disease. More sensitive assays to identify AHD patients with asymptomatic CD are needed.IMPORTANCE Cryptococcal disease (CD) remains a leading cause of morbidity and mortality among individuals with advanced HIV disease (AHD). Identifying point of care (POC) approaches to screening for CD in asymptomatic individuals is important to guide therapeutic management. We evaluated the use of POC fingerprick whole blood and urine testing for cryptococcal disease in patients with AHD as compared with laboratory-based serum antigen testing. POC fingerprick whole blood and urine testing had low sensitivity and specificity in asymptomatic individuals with AHD. Most analysis has focused on evaluating test performance in symptomatic individuals. Here we show that POC testing with whole blood and urine samples should not be used to screen for asymptomatic CD in AHD.