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This study used a virtual, simulated 3 vs. 3 rugby task to investigate whether gaps opening in particular running channels promote different actions by the ball carrier player and whether an effect of rugby expertise is verified. We manipulated emergent gaps in three different locations: Gap 1 in the participant's own running channel, Gap 2 in the first receiver's running channel, and Gap 3 in the second receiver's running channel. Recreational, intermediate, professional, and nonrugby players performed the task. They could (i) run with the ball, (ii) make a short pass, or (iii) make a long pass. All actions were digitally recorded. Results revealed that the emergence of gaps in the defensive line with respect to the participant's own position significantly influenced action selection. Namely, "run" was most often the action performed in Gap 1, "short pass" in Gap 2, and "long pass" in Gap 3 trials. Furthermore, a strong positive relationship between expertise and task achievement was found. [ABSTRACT FROM AUTHOR]

Background Context: Clinical outcomes are directly related to patient selection and treatment indications for improved quality of life. With emphasis on quality and value, it is essential that treatment recommendations are optimized., Purpose: The purpose of the North American Spine Society (NASS) Appropriate Use Criteria (AUC) is to determine the appropriate (ie, reasonable) multidisciplinary treatment recommendations for patients with metastatic neoplastic vertebral fractures across a spectrum of more common clinical scenarios., Study Design: A Modified Delphi process., Patient Sample: Systematic Review OUTCOME MEASURES: Final rating for cervical fusion recommendation as either "Appropriate," "Uncertain," or "Rarely Appropriate" based on the median final rating among the raters., Methods: The methodology was based on the AUC development process established by the Research AND Development (RAND) Corporation. The topic of neoplastic vertebral fracture was selected by NASS for its Clinical Practice Guideline development (CPG). In conjunction, the AUC work group determined key modifiers and adopted the standard definitions developed by CPG, with minimal modifications. A literature search and evidence analysis performed by the CPG were reviewed by the AUC work group. A separate multidisciplinary rating group was assembled. Based on the literature, provider experience, and group discussion, each scenario was scored on a 9-point scale on 2 separate occasions, once without discussion and then a second time following discussion based on the initial responses. The median rating for each scenario was then used to determine if indications were rarely appropriate (1-3), uncertain / maybe appropriate (4-6), or appropriate (7-9). Consensus was not mandatory., Results: Medical management was essentially always appropriate. Radiation therapy was appropriate 50% of the time and uncertain otherwise, and directly related to radiosensitivity of the tumor. Ablation was never rated appropriate with agreement, and about 50% of the time was rated as uncertain. For cement augmentation, the scenarios without stenosis or neurological changes, stable fractures with less than 80% height loss and intact posterior wall, and higher VAS pain scores accounted for 88% probability of an appropriate rating. Otherwise, cement augmentation was uncertain 68% of the time. Surgery was rated as appropriate with agreement in 35%, and uncertain or appropriate with disagreement in 59% of scenarios. The most important variables determining final rating for surgery (in order) were stability, spinal stenosis, and prognosis., Conclusions: Multidisciplinary appropriate treatment criteria were generated based on the RAND methodology. Recommendations were made for medical treatment, ablation, radiation, cement augmentation, and surgery based on 432 practical clinical scenarios. This document provides comprehensive evidence-based recommendations for evaluation and treatment of metastatic neoplastic vertebral fractures. The document in its entirety will be found on the NASS website (https://www.spine.org/Research-Clinical-Care/Quality-Improvement/Appropriate-Use-Criteria)., Competing Interests: Declaration of competing interest One or more of the authors declare financial or professional relationships on ICMJE-TSJ disclosure forms., (Copyright © 2025 Elsevier Inc. All rights reserved.)

Introduction: The use of tourniquets in combat medicine continues to be a key focus as they have consistently been shown to combat one of the leading causes of preventable death on the battlefield, massive hemorrhage to extremities. The present study analyzed tourniquet application among combat medics (68W) and combat lifesavers (CLSs) in a training environment to determine whether trainees' performance is consistent among one another and whether performance can be associated with participant demographics such as experience or role., Materials and Methods: Study participants treated male and female patient simulators within a tactical field care phase, both of which experienced an amputated leg and required the application of a Combat Application Tourniquet (CAT). To assess tourniquet application variability and performance, a series of application subtasks and potential errors were measured via video coding of the scenarios by a team of 5 coders. Time to tourniquet application and tourniquet application duration were also coded to assess correlations between application duration and variability or performance., Results: Results from analyzing tourniquet application subtasks and errors through a series of one-way ANOVA tests showed that application of the CAT first, hasty CAT application, and high tourniquet application were not predictive of participant role, time within the role, and self-reported tourniquet skill, confidence, or experience. Such demographic variables were also not predictive of successful tourniquet application as defined by the number of windlass rod rotations. Results from binomial logistic regressions showed that participant role and self-reported tourniquet skill and experience were predictors of tourniquet application duration., Conclusion: The findings suggest that high variability in CAT application methodology and performance exists among CLS and combat medics, which is largely not predictable by various demographics such as role, experience within the designated role, and self-reported confidence, skill, or experience. The observed disconnect between training or experience and CAT application performance suggests substantial variability in the consistency of training for both CLS and 68W soldiers. These inconsistencies may stem from variability in instructor knowledge, teaching styles, or training materials or may be developed through informal methods such as experiences in the field or recommendations from colleagues and experts. These findings highlight a potential need to reassess CAT application training, particularly in regard to consistency and validation. Finally, it should be noted that the study's findings may be limited or fail to capture some study effects because of the sample size and wide range of reported experience among participants., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Objective: This study explored the impact of in-vehicle messages relative to roadside messages to alert drivers to events within a simulated work zone, in order to determine if these messages can improve driving performance within the work zone., Background: Safety risks in work zones are usually mitigated by design standards and clear signage to communicate work zone information to drivers. Due to distraction and other driving task demands, these signs are not always noticed by motorists, nor are they always followed when they are noticed., Method: The driving simulation tested drivers in two different types of work zones, shoulder work, and lane closure. Participants drove through these work zones three times, each with different messaging interfaces to communicate hazardous events to the driver. The interfaces included a roadside, portable changeable message sign, a smartphone presenting only auditory messages, and a smartphone presenting audio-visual messages., Results: There was significantly better driving performance on key metrics including lane deviation for the in-vehicle message conditions relative to the roadside signs. Furthermore, drivers directed visual attention toward the roadway for the in-vehicle message conditions relative to the roadside sign condition., Conclusion: The results indicate that in-vehicle messaging could provide benefits to primary task performance in driving if the message content is appropriately designed., Application: The findings provide support for a design framework to support in-vehicle communication to drivers approaching work zones and other environments to safely alert them to hazards.

The J-turn intersection is a novel roadway design which decreases the points of conflict at an intersection, by restricting straight crossing and left-turning movements from the minor road across the highway. The novelty of the intersection design may lead to driver errors and dissatisfaction. This study provides an examination of how naïve or first-time drivers may initially navigate J-turns during their first and early exposures to the novel intersection design. Thirty-six participants with limited previous experience and knowledge of J-turns participated in a simulation study to examine their acceptance of J-turns and left turning navigational performance at three simulated J-turn intersections in counterbalanced order, each featuring one of three signage levels. Results revealed participants committed slightly more frequent minor errors (e.g., inefficient lane selection) and significantly more major errors (e.g., missed U-turn) during the first J-turn exposure and these errors tended to decline during subsequent exposures, while moderate severity errors (e.g., risky lane change) slightly increased. Participants' J-turn acceptance significantly declined following simulated driving exposure. The decline in J-turn acceptance was found to be greater among participants who experienced major severity errors; however, more frequent minor errors were associated with increased acceptance. Signage level had little effect on errors, but participants preferred improved signage or on-road markings to guide crossing movements. This work suggests that advanced educational programs and community initiatives should be utilized to prepare drivers for how to navigate J-turns rather than only rely on J-turn exposure to improve driver performance and acceptance., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: The brevity of training for soldiers and combat medics to learn how to provide treatment on the battlefield may restrict optimal performance for treating chest and airway injuries, particularly when treating female soldiers. The present study tested treatment performance on patient simulators by battlefield medic trainees to determine whether there is a need for more extensive training on chest and airway procedures on female soldiers., Materials and Methods: Battlefield medic trainees treated male and female patient simulators in counterbalanced order. The assessment considered the effects of patient gender and order on procedures performed, particularly critical chest and airway interventions such as needle chest decompression (NCD), and considered the appropriate order of treatment tasks. Four coders rated video footage of three simulated procedures, i.e., tourniquet, chest seal (front and back application), and NCD, using a binary coding system to determine completeness and order correctness according to the Massive hemorrhage, Airway, Respiration, Circulation, and Head injury/Hypothermia (MARCH) mnemonic., Results: Results from analysis of variance showed that when presented with a female patient first, trainees performed significantly fewer total procedures on both the female and male simulators. More experienced trainees completed significantly more procedures compared to trainees with minimal experience. Results from the binary logistic regression showed that trainees with more experience and trainees presented with the male patient simulator first performed significantly more procedures in the correct order. Finally, an examination of the NCD procedure found that trainees presented with the female patient simulator first had more errors and that trainees with less experience were less likely to perform the procedure adequately., Conclusions: The findings suggest that treating a female patient first may lead to undertreatment of both patients. Furthermore, the observed differences in treating sensitive areas of the body (e.g., near female breasts) suggest providing greater opportunities for trainees to practice often missed or incorrectly performed procedures. Treating a female patient remains a novel experience for many trainees, such that trainees are less likely to fully treat a female patient and are less likely to treat female soldiers for the most life-threatening injuries. In fact, the initial presentation of the female patient simulator appeared to affect experienced trainees, suggesting that removing the experience of novelty and stress requires more extensive exposure and alternative training. The study's small sample size with a wide range of trainee experience may limit the findings, which may fail to capture some study effects. Finally, the study did not request trainees' experience treating female soldiers, so future studies should examine the extent to which experience is predictive of performance. There is a need for more interactive approaches in patient simulations to provide opportunities for practice, especially those that require the treatment of sensitive areas., (© The Association of Military Surgeons of the United States 2022. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

When interacting with the environment, sensory information is essential to guide movements. Picking up the appropriate sensory information (both visual and auditory) about the progression of an event is required to reach the right place at the right time. In this study, we aimed to see if general tau theory could explain the audiovisual guidance of movement in interceptive action (an interception task). The specific contributions of auditory and visual sensory information were tested by timing synchronous and asynchronous audiovisual interplays in successful interceptive trials. The performance was computed by using the tau-coupling model for information-movement guidance. Our findings revealed that while the auditory contribution to movement guidance did change across conditions, the visual contribution remained constant. In addition, when comparing the auditory and visual contributions, the results revealed a significant decrease in the auditory compared to the visual contribution in just one of the asynchronous conditions where the visual target was presented after the sound. This may be because more attention was drawn to the visual information, resulting in a decrease in the auditory guidance of movement. To summarize, our findings reveal how tau-coupling can be used to disentangle the relative contributions of the visual and auditory sensory modalities in movement planning., Competing Interests: Declaration of competing interest All authors declare no conflict of interest., (Copyright © 2023. Published by Elsevier B.V.)

Objective: The objective of this review was to spotlight specific methods for people working from home to apply restorative environment research to improve productivity and mental health during shelter-in-place., Background: The COVID-19 pandemic has led to sheltering-in-place and telework. While necessary, these strategies may lead to negative consequences such as social isolation and worse performance. However, nature environments have been shown to have a variety of positive effects in several different settings, including improved attention, positive affect, and increased job satisfaction, and these may be translated to the home workspace setting., Method: This provides a narrative review of the environmental psychology literature, describing articles involving nature in a task performance or stress context and how it has been applied. It then moves on to discuss how these findings could possibly be applied in the context of workers during the COVID-19 pandemic., Results: Although beneficial results are mixed, the review found a variety of relatively simple and cost-effective methods that could assist workers during the COVID-19 pandemic, including taking a break in nature and implementing nature in the workspace., Application: The application of restorative environment research could be an efficient way of mitigating the negative psychological effects due to at-home sheltering and telework in order to combat COVID-19.

Electric scooters (or e-scooters) are among the most popular micromobility options that have experienced an enormous expansion in urban transportation systems across the world in recent years. Along with the increased usage of e-scooters, the increasing number of e-scooter-related injuries has also become an emerging global public health concern. However, little is known regarding the risk factors for e-scooter-related crashes and injury crashes. This study consisted of a two-phase survey questionnaire administered to a cohort of e-scooter riders ( n = 210), which obtained exposure information on riders' demographics, riding behaviors (including infrastructure selection), helmet use, and other crash-related factors. The risk ratios of riders' self-reported involvement in an e-scooter-related crash (i.e., any crash versus no crash) and injury crash (i.e., injury crash versus non-injury crash) were estimated across exposure subcategories using the Negative Binomial regression approach. Males and frequent users of e-scooters were associated with an increased risk of e-scooter-related crashes of any type. For the e-scooter-related injury crashes, more frequently riding on bike lanes (i.e., greater than 25% of the time), either protected or unprotected, was identified as a protective factor. E-scooter-related injury crashes were more likely to occur among females, who reported riding on sidewalks and non-paved surfaces more frequently. The study may help inform public policy regarding e-scooter legislation and prioritize efforts to establish suitable road infrastructure for improved e-scooter riding safety.

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.

Study Design: This was a narrative review., Objective: The objective of this study was to identify commonly utilized venous thromboembolism (VTE) prophylactic measures, spine surgeon perspective, and provide pharmacologic recommendations from the literature., Summary of Background Data: Considered a preventable cause of morbidity and mortality, VTE remains an important iatrogenic diagnosis of concern. Reported rates of VTE following spine surgery vary widely (0.3%-31.0%)., Materials and Methods: A MEDLINE query identified literature reporting on VTE prevention and outcomes in the setting of spine surgery. Findings extracted from the included articles were summarized in a narrative review format to identify salient aspects of the current literature., Results: Sixty articles were summarized. Many anticoagulation medications that are described in the literature target factors involved in the coagulation cascade common pathway including aspirin and other antiplatelet medications, heparins, and warfarin. Newer direct inhibitors of thrombin and factor Xa are now being utilized for VTE prevention, although with limited use specifically in spine surgery., Conclusions: Perioperative management of antiplatelet and anticoagulation medications in spine surgery requires evidence-based protocols that can account for patient comorbidities and surgery-specific features. Future studies should prospectively focus on establishing stronger recommendations based on pathology, surgical indications, patient comorbidities, region of the spine, and broad surgical intervention to enable effective prophylaxis for VTE., Level of Evidence: Level II., Competing Interests: S.A.Q.: has been a consultant for Paradigm Spine, Globus Medical Inc., and Stryker K2M; receives royalties from Globus Medical Inc., Stryker K2M; has ownership interest in Avaz Surgical, Vital 5 (past relationship); has served on the scientific advisory board/other office for the Association of Bone and Joint Surgeons, Cervical Spine Research, Contemporary Spine Surgery, Healthgrades, International Society for the Advancement of Spine Surgery, LifeLink.com Inc., Minimally Invasive Spine Surgery Group, Minimally Invasive Spine Study Group, North American Spine Society, Simplify Medical Inc., Society of Minimally Invasive Spine Surgery, Spinal Simplicity LLC; has served on the editorial board of the Annals of Translational Medicine, Global Spine Journal, Journal of American Academy of Orthopaedic Surgeons, Spine, The Spine Journal; has received honoraria from AMOpportunities, RTI Surgical Inc.; and has received speakers fees from Globus Medical Inc. The remaining authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Perceptual information about unfolding events is important for guiding decisions about when and how to move in real-world action situations. As an exemplary case, road-crossing is a perceptual-motor task where age has been shown to be a strong predictor of risk due to errors in action-based decisions. The present study investigated age differences between three age groups (Children: 10-12 years old; Adults: 19-39 years old; Older Adults: 65 + year olds) in the use of perceptual information for selection, timing, and control of action when crossing a two-way street in an immersive, interactive virtual reality environment. Adults and children selected gaps to cross that were consistent with the use of a time-based information variable (tau), whereas older adults tuned less into the time-based variable (tau) to guide road-crossing decisions. For action initiation and control, children and adults also showed a strong ability to precisely time their entry with respect to the lead vehicle maximising the available time to cross and coordinating walking movements with the tail vehicle to ensure they were not on a collision course. In contrast, older adults delayed action initiation and showed difficulty coordinating self-movement with the approaching vehicle. This study and its results tie together age-based differences in the three components of action decision-making (selection, timing and control) within a unified framework based on perceptual information. The implications of these age-related differences in action decisions and crossing behaviours are discussed in the context of road safety., (© 2021. Crown.)

Background: Postbariatric hypoglycemia (PBH) is a rare but growing complication of bariatric surgery. Many aspects have yet to be established, including the blood glucose threshold which represents clinically important hypoglycemia in affected patients., Objective: To confirm the glucose threshold below which neuroglycopenic (NG) symptoms arise in patients with PBH during provoked and real-world hypoglycemia as an indicator of clinically important hypoglycemia., Setting: Stanford University School of Medicine., Methods: Forty patients with PBH were enrolled. Thirty-two patients underwent hypoglycemia provocation in the clinical research unit (CRU) during which symptoms and blood glucose concentrations were assessed. A sensitivity analysis and stepwise linear regression were conducted evaluating relationships between symptoms and glucose levels. To validate CRU findings in the real-world setting, 8 sex-, age-, body mass index (BMI)-, and disease severity-matched patients underwent 20 days of at-home continuous glucose monitoring (CGM), self-monitoring of blood glucose (SMBG), and symptom assessment by electronic diary (eDiary)., Results: In response to hypoglycemia provocation 19%, 59%, and 22% of patients developed a postprandial glucose nadir <70-54 mg/dL , <54-40 mg/dL, and <40 mg/dL, respectively. Number of NG symptoms was highest when glucose was in the <54-40 mg/dL range, although 23% of those with NG symptoms in this range, and 37% with NG symptoms below this range lacked autonomic symptoms, indicating substantial hypoglycemia unawareness. Sensitivity of symptoms to detect hypoglycemia was poor other than for drowsiness, while specificity was high for all NG symptoms. Confusion, sweating, drowsiness, and incoordination were significant independent predictors of hypoglycemia. Events captured during real-world monitoring mirrored CRU data, showing a spike in NG symptoms in the <54-40 mg/dL range. CGM captured up to 10-fold more events than were patient-perceived and captured by SMBG/eDiary., Conclusion: Due to the peak in NG symptoms at glucose <54-40 mg/dL during provoked and real-world hypoglycemia, the low sensitivity/high specificity of NG symptoms to detect hypoglycemia, and high prevalence of hypoglycemia unawareness at glucose values <54 mg/dL, we propose that blood glucose <54 mg/dL should be taken to signify clinically important hypoglycemia in patients with established PBH., (Copyright © 2021. Published by Elsevier Inc.)

The International Space Station (ISS) has around 3-5 crew members on-board at all times, and they normally stay on the ISS for about 5-7months in duration. Since March 2020, 170 long-duration space missions have occurred on the ISS. Thus, long-duration space missions are an integral part of space exploration and will only continue to expand in duration as missions to the Moon and Mars are on the horizon. However, long-duration space missions present several challenges to human crew members. Most of these challenges have been associated with physiological adaptation to microgravity, including motion sickness, muscle atrophy, and cardiovascular deconditioning. While not as well-studied, another major factor to consider when planning long-duration space missions is the psychological impact of the environment on the astronauts. Astronauts living in space will be unable to access natural landscapes and other environments found to have restorative effects on psychological stress and overall well-being. On top of being unable to access these restorative natural environments, astronauts will also be exposed to the stressful, unfamiliar environment of space. The purpose of this mini-review is to first summarize the literature related to stressors associated with space. Next, an overview of the large breadth of literature on the biophilia hypothesis and restorative environments will be provided, as these may serve as relatively simple and cost-effective solutions to mitigate the stress faced during long-duration space missions. Lastly, considerations related to the design of such environments in a space capsule as well as future directions will be presented., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Neilson, Craig, Altman, Travis, Vance and Klein.)

Objective: The aim of this study is to replicate Berto's (2005) heavily cited work on attention restoration., Background: Nature interventions have gained increased interest for improving performance of attentionally demanding tasks. Berto (2005) indicated that viewing digital nature images could improve performance on a subsequent response inhibition task, the sustained attention to response task (SART). However, experimental design and statistical concerns about her experiments as well as failure to support her findings across multiple unpublished studies in our laboratory provided rationale for this replication study., Method: Twenty participants were each assigned to one of three digital image conditions: nature, urban, and control. Participants performed the SART before and after digital image exposure., Results: SART performance metrics (total correct target responses, mean response time, and transformed d ') were analyzed using 2 (SART) × 3 (image interventions) mixed design ANOVAs. The results failed to replicate Berto (2005)., Conclusion: Possible reasons for not replicating Berto (2005) are discussed, including (1) sample differences, (2) different testing environments and procedures, (3) insufficient attentional depletion, and (4) individual differences., Applications: Research needs to determine the effectiveness of such interventions, the specific attention tasks that might benefit, and the individual difference variables relevant for attention restoration.

Context: Postbariatric hypoglycemia (PBH), characterized by enteroinsular axis overstimulation and hyperinsulinemic hypoglycemia, is a complication of bariatric surgery for which there is no approved therapy., Objective: To evaluate efficacy and safety of avexitide [exendin (9-39)], a glucagon-like peptide-1 antagonist, for treatment of PBH., Methods: A multicenter, Phase 2, randomized, placebo-controlled crossover study (PREVENT). Eighteen female patients with PBH were given placebo for 14 days followed by avexitide 30 mg twice daily and 60 mg once daily, each for 14 days in random order. The main outcome measures were glucose nadir and insulin peak during mixed-meal tolerance testing (MMTT) and hypoglycemic events captured by self-monitoring of blood glucose (SMBG), electronic diary, and blinded continuous glucose monitoring (CGM)., Results: Compared with placebo, avexitide 30 mg twice daily and 60 mg once daily raised the glucose nadir by 21% (P = .001) and 26% (P = .0002) and lowered the insulin peak by 23% (P = .029) and 21% (P = .042), corresponding to 50% and 75% fewer participants requiring rescue during MMTT, respectively. Significant reductions in rates of Levels 1 to 3 hypoglycemia were observed, defined, respectively, as SMBG <70 mg/dL, SMBG <54 mg/dL, and a severe event characterized by altered mental and/or physical function requiring assistance. CGM demonstrated reductions in hypoglycemia without induction of clinically relevant hyperglycemia. Avexitide was well tolerated, with no increase in adverse events., Conclusion: Avexitide administered for 28 days was well tolerated and resulted in robust and consistent improvements across multiple clinical and metabolic parameters, reinforcing the targeted therapeutic approach and demonstrating durability of effect. Avexitide may represent a first promising treatment for patients with severe PBH., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society.)

Free kicks are an important goal scoring opportunity in football. It is an unwritten rule that the goalkeeper places a wall of defending players with the aim of making scoring harder for the attacking team. However, the defensive wall can occlude the movements of the kicker, as well as the initial part of the ball trajectory. Research on one-handed catching suggests that a ball coming into view later will likely delay movement initiation and possibly affect performance. Here, we used virtual reality to investigate the effect of the visual occlusion of the initial ball trajectory by the wall on the performance of naïve participants and skilled goalkeepers. We showed that movements were initiated significantly later when the wall was present, but not by the same amount as the duration of occlusion (~200ms, versus a movement delay of ~70-90ms); movements were thus initiated sooner after the ball came into view, based on less accumulated information. For both naïve participants and skilled goalkeepers this delayed initiation significantly affected performance (i.e., 3.6cm and 1.5cm larger spatial hand error, respectively, not differing significantly between the groups). These performance reductions were significantly larger for shorter flight times, reaching increased spatial errors of 4.5cm and 2.8cm for both groups, respectively. Further analyses showed that the wall-induced performance reduction did not differ significantly between free kicks with and without sideward curve. The wall influenced early movement biases, but only for free kicks with curve in the same direction as the required movement; these biases were away from the final ball position, thus hampering performance. Our results cannot suggest an all-out removal of the wall-this study only considered one potential downside-but should motivate goalkeepers to continuously evaluate whether placing a wall is their best option. This seems most pertinent when facing expert free kick takers for whom the wall does not act as a block (i.e., whose kicks consistently scale the wall)., Competing Interests: The authors have declared that no competing interests exist. Although Professor Craig is now the CEO of INCISIV Ltd., a commercial entity (founded in May 2018), INCISIV Ltd. has had nothing to do with the design of our study, has not funded it nor is it set to gain financially from the results. None of our results can be commercialized by this company. The affiliation with INCISIV Ltd. does not alter our adherence to PLOS ONE policies on sharing data and materials.

Alerts presented through the auditory modality improve drivers' crash avoidance performance in driving simulations, but drivers' ability to accurately localise the source of the auditory alerts is understudied. Because the results of driving simulation studies may hinge on assumptions that sound locations are accurately perceived by drivers, this study used a sound localisation task in a full-chassis driving simulator. Twenty-nine participants engaged in a sound localisation task while seated in the driving simulator. Performance was assessed by sound localisation accuracy, relative directional error, and participant confidence across seven sound sources surrounding the simulator. Performance was best when sounds were presented in left and right cardinal regions, and poorest when presented from the front and rear. Participants were less confident in their localisation judgments when sounds were presented from the rear. Practitioner summary: Drivers' ability to accurately localise auditory alerts is understudied. Participants performed an auditory localisation task with external sounds while seated in a full-chassis driving simulator. Participants were better detecting sounds from the sides instead of the front and rear. This has implications for external auditory alarms during driving. Abbreviations: ANOVA: analysis of variance; dB: decibel; f: frequency; Hz: hertz; LHD: left hand drive; ms: milliseconds; RTI: realtime technologies; s: seconds; SPL: sound pressure level.

Recent road-crossing literature has found that older adults show performance differences between estimation and perception-action tasks suggesting an age-related difficulty in accurately calibrating the information picked up from the surrounding environment to their action capabilities (Lobjois and Cavallo, 2009). The present study investigated whether participants could accurately perceive gap affordances via information that specifies the time-to-arrival of the approaching cars. To ensure the opportunities for action were the same across different age groups, independent of the actor's action capabilities, the action of crossing the road was standardised. A total of 45 participants (15 children, aged 10-12, 15 adults aged 19-39, 15 older adults aged 65+) were asked to judge, by pressing a button in a head-mounted display, whether the gap between oncoming cars afforded crossing. When the participant pressed the button, they moved across the road at a fixed speed. Adherence to a time-based variable (namely tau) explained 85% and 84% of the variance in both the children and adults' choices, respectively. Older adults tuned less into the time-based variable (tau) with it only accounting for 59% of the variance in road-crossing decisions. These findings suggest that, the ability to use tau information which specifies whether a gap affords crossing or not, deteriorates with age., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

Background: Hypoglycemia is an increasingly recognized complication of bariatric surgery. Mechanisms contributing to glucose lowering remain incompletely understood. We aimed to identify differentially abundant plasma proteins in patients with post-bariatric hypoglycemia (PBH) after Roux-en-Y gastric bypass (RYGB), compared to asymptomatic post-RYGB., Methods: Proteomic analysis of blood samples collected after overnight fast and mixed meal challenge in individuals with PBH, asymptomatic RYGB, severe obesity, or overweight recruited from outpatient hypoglycemia or bariatric clinics., Results: The top-ranking differentially abundant protein at 120 min after mixed meal was fibroblast growth factor 19 (FGF-19), an intestinally derived hormone regulated by bile acid-FXR signaling; levels were 2.4-fold higher in PBH vs. asymptomatic post-RYGB (mean + SEM, 1094 ± 141 vs. 428 ± 45, P < 0.001, FDR < 0.01). FGF-19 ELISA confirmed 3.5-fold higher concentrations in PBH versus asymptomatic (360 ± 70 vs. 103 ± 18, P = 0.025). To explore potential links between increased FGF-19 and GLP-1, residual samples from other human studies in which GLP-1 was modulated were assayed. FGF-19 levels did not change in response to infusion of GLP-1 and PYY in overweight/obese individuals. Infusion of the GLP-1 receptor antagonist exendin 9-39 in recently operated asymptomatic post-RYGB did not alter FGF-19 levels after mixed meal. By contrast, GLP-1 receptor antagonist infusion yielded a significant increase in FGF-19 levels after oral glucose in individuals with PBH. While plasma bile acids did not differ between PBH and asymptomatic post-RYGB, these data suggest unique interrelationships between GLP-1 and FGF-19 in PBH., Conclusions: Taken together, these data support FGF-19 as a potential contributor to insulin-independent pathways driving postprandial hypoglycemia in PBH.

Introduction: Lateral lumbar interbody fusion (LLIF) is a safe treatment for degenerative spine conditions. However, risk of complications such as vascular injuries remains. We report a unique case of an intercostal artery (ICA) hemorrhage with hemothorax following LLIF., Case Presentation: One hour after a right-sided LLIF L3-4 with posterior decompression L2-4 and L3-5 instrumentation, the patient became hypotensive, anemic and required vasopressor support. Evaluation revealed a right-sided hemothorax, which was caused by a bleeding intercostal artery, laterally at the 10th intercostal space. A lateral thoracotomy was performed to stop the bleeding. After vessel ligation and placement of two chest tubes, the patients' hemodynamics improved. The patient remained intubated overnight and was extubated on the first postoperative day., Discussion: Vascular injury is a rare complication of LLIF procedures. Most vascular injuries are segmental vessel lacerations, which resolve postoperatively. This is the first case description of ICA bleeding associated with LLIF surgery. Spontaneous ICA bleeding exists, but surgeons should be aware of careful handling in patients with vascular risk factors, especially with regard to patient positioning required in certain spinal surgical approaches. Timely vascular injury identification is critical for hemostasis and clinical management., Competing Interests: Conflict of interestCMC reports grants from Mallinckrodt Pharmaceuticals, and personal fees from Heron Therapeutics, with both relationships outside of the submitted work. APH reports personal fees from Altus Spine, other from Pfizer, Inc, grants from NuVasive, outside the submitted work. The remaining authors declare that they have no conflict of interests., (© The Author(s), under exclusive licence to International Spinal Cord Society 2019.)

Background/objectives: African-American women have the greatest prevalence of obesity in the United States, and higher rates of type 2 diabetes than Caucasian women, yet paradoxically lower plasma triglycerides (TG), visceral fat and intrahepatic fat, and higher high-density lipoprotein (HDL)-cholesterol. Visceral fat has not been evaluated against insulin resistance in African-American women, and TG/HDL-cholesterol has been criticized as a poor biomarker for insulin resistance in mixed-sex African-American populations. Adipocyte hypertrophy, reflecting adipocyte dysfunction, predicts insulin resistance in Caucasians, but has not been studied in African-Americans. Our goal was to assess whether traditional correlates of insulin resistance, measures of adiposity and adipocyte characteristics similarly predict peripheral insulin resistance in African-American and Caucasian women., Subjects/methods: Thirty-four healthy African-American (n = 17) and Caucasian (n = 17) women, matched for age (mean = 53.0 yrs) and body mass index (BMI) (mean = 30 kg/m 2 ), underwent a steady-state plasma glucose test to measure insulin sensitivity; computed tomography (fat distribution); and a periumbilical scalpel biopsy (adipocyte characterization). By-race analyzes utilized analysis of covariance; linear regressions evaluated relationships between metabolic/adipose variables. All analyses adjusted for BMI and menopausal status., Results: Insulin sensitivity did not differ between groups (p = 0.65). Neither BMI, nor %body fat or thigh fat predicted insulin resistance in African-American women. Fasting TG (p = 0.046), HDL-cholesterol (p = 0.0006) and TG/HDL-cholesterol ratio (p = 0.009) strongly predicted insulin resistance in African-American women. Despite being lower in African-American women, hepatic fat and visceral adipose tissue (VAT) correlated with insulin resistance in both groups, as did fasting glucose, VAT/SAT (subcutaneous adipose tissue) ratio, and %SAT (inverse)., Conclusions: Total adiposity measures and adipocyte hypertrophy did not predict insulin resistance in African-American women, but did in Caucasian women. Plasma TG and HDL-cholesterol were significant predictors of insulin resistance in African-American women. Our findings demonstrate the need to identify race and sex-specific biomarkers for metabolic risk profiling.

Objective: To measure contributing attentional processes, particularly that of executive attention, to two iterations of the abbreviated vigilance task., Background: Joel Warm was at the forefront of vigilance research for decades, and resource theory is currently the dominant explanation for the vigilance decrement. The underlying mechanisms contributing to both overall performance and the decrement are only partly understood., Method: Seventy-eight participants answered questionnaires about their attentional skills and stress state, performed the Attention Network Test and two blocks of the 12-min abbreviated vigilance task, with a brief break between the two vigils during which they viewed images intended to affect performance. Changes in oxygenated hemoglobin were measured with functional near-infrared imaging., Results: Expected patterns were observed for both iterations of the abbreviated vigilance task, with performance declining after the first 2 min. Manipulations intended to evaluate whether executive processes contributed to vigilance performance failed to observe an effect. Other factors, particularly orienting and alerting attentional networks, task engagement, and subclinical ADHD symptomology were associated with performance. Significant factors for the first and second vigilance blocks were different., Conclusion: We suggest that (a) cognitive control is not a predominant factor, at least for the abbreviated vigilance task, and (b) attentional mechanisms and stress states affecting performance on the abbreviated vigilance task change over time., Application: Potential applications of this research include the use of breaks for sustained attention tasks involving high sensory load, and implications for the use of the abbreviated vigilance task as a proxy for general vigilance processes.

In Parkinson's disease (PD) self-directed movement, such as walking, is often found to be impaired while goal directed movement, such as catching a ball, stays relatively unaltered. This dichotomy is most clearly observed when sensory cueing techniques are used to deliver patterns of sound and/or light which in turn act as an external guide that improves gait performance. In this study we developed visual cues that could be presented in an immersive, interactive virtual reality (VR) environment. By controlling how the visual cues (black footprints) were presented, we created different forms of spatial and temporal information. By presenting the black footprints at a pre-specified distance apart we could recreate different step lengths (spatial cues) and by controlling when the black footprints changed color to red, we could convey information about the timing of the foot placement (temporal cues). A group of healthy controls (HC; N = 10) and a group of idiopathic PD patients (PD, N = 12) were asked to walk using visual cues that were tailored to their own gait performance [two spatial conditions (115% [N] and 130% [L] of an individual's baseline step length) and three different temporal conditions (spatial only condition [NT], 100 and 125% baseline step cadence)]. Both groups were found to be able to match their gait performance (step length and step cadence) to the information presented in all the visual cue conditions apart from the 125% step cadence conditions. In all conditions the PD group showed reduced levels of gait variability ( p < 0.05) while the HC group did not decrease. For step velocity there was a significant increase in the temporal conditions, the spatial conditions and of the interaction between the two for both groups of participants ( p < 0.05). The coefficient of variation of step length, cadence, and velocity were all significantly reduced for the PD group compared to the HC group. In conclusion, our results show how virtual footsteps presented in an immersive, interactive VR environment can significantly improve gait performance in participants with Parkinson's disease.

Studying freezing of gait (FOG) in the lab has proven problematic. This has primarily been due to the difficulty in designing experimental setups that maintain high levels of ecological validity whilst also permitting sufficient levels of experimental control. To help overcome these challenges, we have developed a virtual reality (VR) environment with virtual doorways, a situation known to illicit FOG in real life. To examine the validity of this VR environment, an experiment was conducted, and the results were compared to a previous "real-world" experiment. A group of healthy controls ( N  = 10) and a group of idiopathic Parkinson disease (PD) patients without any FOG episodes ( N  = 6) and with a history of freezing (PD-f, N  = 4) walked under three different virtual conditions (no door, narrow doorway (100% of shoulder width) and standard doorway (125% of shoulder width)). The results were similar to those obtained in the real-world setting. Virtual doorways reduced step length and velocity while increasing general gait variability. The PD-f group always walked slower, with a smaller step length, and showed the largest increases in gait variability. The narrow doorway induced FOG in 66% of the trials, while the standard doorway caused FOG in 29% of the trials. Our results closely mirrored those obtained with real doors. In short, this methodology provides a safe, personalized yet adequately controlled means to examine FOG in Parkinson's patients, along with possible interventions.

This study investigates how active exploration helps users of sensory substitution devices (SSDs) to detect action-relevant information. A vibrotactile SSD was developed that generates stimulation that is contingent on the users' movements. Target direction was specified by the location of the vibratory stimulation, and target distance by the size and intensity of the pattern of stimulation. A series of experiments was performed with blindfolded participants. In Experiments 1a to 1c, participants used the SSD to align their central body axis with prespecified targets. These experiments differed in the number of actuators that were used and whether online perception-action coupling was present. In Experiment 2, participants approached targets with forward locomotion along a straight line. Experiment 3 combined the previous experiments and studied the concomitant walking and steering toward targets. Oscillatory movements, which facilitated information pickup, were observed in all experiments. The exploratory oscillations were shown to depend on the online perception-action coupling and were related to cases of hyperacuity, for which absolute errors were found to be smaller than the areas of sensitivity of the actuators. It is concluded that, to improve the utility of SSDs, future research with SSDs should pay more attention to the role of active information detection. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Study Design: Prospective analysis of resource utilization (RU) after lumbar surgery., Objective: To determine contributions of patient psychosocial variables to RU, specifically length of stay (LOS) and discharge destination., Summary of Background Data: Associations between demographic/clinical variables and RU are well-established; less is known about associations between psychosocial variables, such as social support and depressive/anxiety symptoms, and RU., Methods: Preoperatively 532 patients provided standard ratings of depressive and anxiety symptoms and amount of social support. Clinical variables included calculation of a composite score reflecting invasiveness of surgery. Two outcomes were considered: LOS ≤ 3 or > 3 days; and discharged home without external services or discharged with external services. Independent variables in multivariable logistic models were demographic/clinical and psychosocial variables., Results: Mean age was 56 years, 55% were men, 87% had degenerative conditions, 40% had a positive depression screen, 62% had anxiety greater than population norms, and 77% reported as much social support as wanted. Variables that remained associated with a LOS > 3 days (53%) in multivariable analysis were: older age (OR 1.8, confidence interval, CI, 1.2-2.8); female sex (OR 1.9, CI 1.2-2.9), less social support (OR 1.4, CI 1.1-1.7); obesity (OR 1.8, CI 1.1-2.8), worse functional status (OR 1.0, CI 1.0-1.0), and more invasive surgery (OR 3.0, CI 2.4-3.7). Variables that remained associated with discharged with external services (17%) in multivariable analysis were: older age (OR 3.3, CI 1.9-5.9); less social support (OR 1.3, CI 1.0-1.7); positive depression screen (OR 1.9, CI 1.1-3.4); more anxiety (OR 2.4, CI 1.3-4.2); major comorbidity (OR 1.7, CI 1.0-2.8); and more invasive surgery (OR 1.9, CI 1.5-2.5)., Conclusion: This study confirms the importance of demographic/clinical variables as predictors of greater RU after lumbar surgery and provides preliminary evidence for the importance of concurrent psychosocial variables, particularly less social support, and worse psychological well-being., Level of Evidence: 2.

Aim: To evaluate the efficacy, pharmacokinetic (PK) profile and tolerability of subcutaneous (s.c.). exendin 9-39 (Ex-9) injection in patients with post-bariatric hypoglycaemia (PBH)., Methods: Nine women who had recurrent symptomatic hypoglycaemia after undergoing Roux-en-Y gastric bypass were enrolled in this 2-part, single-blind, single-ascending-dose study. In Part 1, a single participant underwent equimolar low-dose intravenous (i.v.) vs s.c. Ex-9 administration; in Part 2, 8 participants were administered single ascending doses of s.c. Ex-9 during an oral glucose tolerance test (OGTT). Glycaemic, hormonal, PK and symptomatic responses were compared with those obtained during the baseline OGTT., Results: Although an exposure-response relationship was observed, all doses effectively prevented hyperinsulinaemic hypoglycaemia and improved associated symptoms. On average, the postprandial glucose nadir was increased by 66%, peak insulin was reduced by 57%, and neuroglycopenic symptoms were reduced by 80%. All doses were well tolerated with no treatment-emergent adverse events observed., Conclusions: Injection s.c. of Ex-9 appears to represent a safe, effective and targeted therapeutic approach for treatment of PBH. Further investigation involving multiple doses with chronic dosing is warranted., (© 2017 John Wiley & Sons Ltd.)

Background: The majority of older adults do not reach the physical activity guidelines. One possible explanation for this may be that older adults overestimate their physical activity levels, because they are unable to identify exercise intensity., Methods: Forty-four older adults were recruited and randomly assigned into two walking groups lasting 6 weeks. The intervention group was asked to walk a minimum of 150 min per week at moderate intensity using walking cadence indicated with a pedometer. The control group did not get any feedback on walking intensity., Results: The ability to identify moderate intensity while walking did not significantly improve in neither groups (p = 0.530). However, participants in the intervention group increased significantly the time spent at moderate intensity, in 10 min bouts (p < 0.01)., Discussion: A pedometer providing walking cadence to reach moderate intensity is a good tool for increasing time walked at the recommended intensity, but not because participants know more what is considered moderate intensity.

Study Design: Retrospective case-control study., Purpose: The purpose of this study was to examine the effect of antidepressants on blood loss and transfusion requirements in spinal surgery patients., Overview of Literature: Several studies have shown an increase in perioperative bleeding in orthopedic surgery patients on antidepressant drug therapy, yet no study has examined the impact of these agents on spinal surgery patients., Methods: Charts of patients who underwent single-level spinal fusion (posterior lumbar interbody fusion with posterior instrumentation) performed by five fellowship-trained surgeons at a tertiary spine center between 2008 and 2013, were retrospectively reviewed. Exclusion criteria included select medical comorbidities, select drug therapy, and Amercian Society of Anesthesiologists Physical Status Classification score of greater than 2. Serotonergic antidepressants were examined in multivariate analysis to assess their predictive value on estimated blood loss and risk of transfusion., Results: A total of 235 patients, of which 52% were female, were included. Allogeneic blood was transfused in 7% of patients. The average estimated blood loss was 682±463 mL. Selective serotonin reuptake inhibitors were taken by 10% of all patients. Multivariable regression analysis showed that intake of selective serotonin reuptake inhibitors was a significant predictor for blood loss (average increase of 34%, p =0.015) and for the need of allogeneic blood transfusion (odds ratio, 4.550; p =0.029)., Conclusions: There was a statistically significant association between selective serotonin reuptake inhibitors and both increased blood loss and risk of allogeneic red blood cell transfusion. Surgeons and perioperative providers should take these findings into account when assessing patients' preoperative risk for blood loss and transfusion., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Aims/hypothesis: Post-bariatric hypoglycaemia (PBH) is a rare, but severe, metabolic disorder arising months to years after bariatric surgery. It is characterised by symptomatic postprandial hypoglycaemia, with inappropriately elevated insulin concentrations. The relative contribution of exaggerated incretin hormone signalling to dysregulated insulin secretion and symptomatic hypoglycaemia is a subject of ongoing inquiry. This study was designed to test the hypothesis that PBH and associated symptoms are primarily mediated by glucagon-like peptide-1 (GLP-1)., Methods: We conducted a double-blinded crossover study wherein eight participants with confirmed PBH were assigned in random order to intravenous infusion of the GLP-1 receptor (GLP-1r) antagonist. Exendin (9-39) (Ex-9), or placebo during an OGTT on two separate days at the Stanford University Clinical and Translational Research Unit. Metabolic, symptomatic and pharmacokinetic variables were evaluated. Results were compared with a cohort of BMI- and glucose-matched non-surgical controls (NSCs)., Results: Infusion of Ex-9 decreased the time to peak glucose and rate of glucose decline during OGTT, and raised the postprandial nadir by over 70%, normalising it relative to NSCs and preventing hypoglycaemia in all PBH participants. Insulin AUC and secretion rate decreased by 57% and 71% respectively, and peak postprandial insulin was normalised relative to NSCs. Autonomic and neuroglycopenic symptoms were significantly reduced during Ex-9 infusion., Conclusions/interpretation: GLP-1r blockade prevented hypoglycaemia in 100% of individuals, normalised beta cell function and reversed neuroglycopenic symptoms, supporting the conclusion that GLP-1 plays a primary role in mediating hyperinsulinaemic hypoglycaemia in PBH. Competitive antagonism at the GLP-1r merits consideration as a therapeutic strategy., Trial Registration: ClinicalTrials.gov NCT02550145.

Aim: The physiologic mechanisms underlying the relationship between obesity and insulin resistance are not fully understood. Impaired adipocyte differentiation and localized inflammation characterize adipose tissue from obese, insulin-resistant humans. The directionality of this relationship is not known, however. The aim of the current study was to investigate whether adipose tissue inflammation is causally-related to impaired adipocyte differentiation., Methods: Abdominal subcutaneous(SAT) and visceral(VAT) adipose tissue was obtained from 20 human participants undergoing bariatric surgery. Preadipocytes were isolated, and cultured in the presence or absence of CD14+ macrophages obtained from the same adipose tissue sample. Adipocyte differentiation was quantified after 14 days via immunofluorescence, Oil-Red O, and adipogenic gene expression. Cytokine secretion by mature adipocytes cultured with or without CD14+macrophages was quantified., Results: Adipocyte differentiation was significantly lower in VAT than SAT by all measures (p<0.001). With macrophage removal, SAT preadipocyte differentiation increased significantly as measured by immunofluorescence and gene expression, whereas VAT preadipocyte differentiation was unchanged. Adipocyte-secreted proinflammatory cytokines were higher and adiponectin lower in media from VAT vs SAT: macrophage removal reduced inflammatory cytokine and increased adiponectin secretion from both SAT and VAT adipocytes. Differentiation of preadipocytes from SAT but not VAT correlated inversely with systemic insulin resistance., Conclusions: The current results reveal that proinflammatory immune cells in human SAT are causally-related to impaired preadipocyte differentiation, which in turn is associated with systemic insulin resistance. In VAT, preadipocyte differentiation is poor even in the absence of tissue macrophages, pointing to inherent differences in fat storage potential between the two depots., Competing Interests: The authors have declared that no competing interests exist.

Objective: To determine the optimal dose of vitamin D supplementation to achieve biochemical vitamin D sufficiency in extremely low gestational age newborns in a masked randomized controlled trial., Study Design: 100 infants 23 0/7-27 6/7 weeks gestation were randomized to vitamin D intakes of placebo (n = 36), 200 IU (n = 34), and 800 IU/d (n = 30) (approximating 200, 400, or 1000 IU/d, respectively, when vitamin D routinely included in parenteral or enteral nutrition is included). The primary outcomes were serum 25-hydroxy vitamin D concentrations on postnatal day 28 and the number of days alive and off respiratory support in the first 28 days., Results: At birth, 67% of infants had 25-hydroxy vitamin D <20 ng/mL suggesting biochemical vitamin D deficiency. Vitamin D concentrations on day 28 were (median [25th-75th percentiles], ng/mL): placebo: 22 (13-47), 200 IU: 39 (26-57), 800 IU: 84.5 (52-99); P < .001. There were no differences in days alive and off respiratory support (median [25th-75th percentiles], days): placebo: 1 (0-11), 200 IU: 0 (0-8), and 800 IU: 0.5 (0-22); P = .63, or other respiratory outcomes among groups., Conclusions: At birth, most extremely preterm infants have biochemical vitamin D deficiency. This biochemical deficiency is reduced on day 28 by supplementation with 200 IU/d and prevented by 800 IU/d. Larger trials are required to determine if resolution of biochemical vitamin D deficiency improves clinical outcomes., Trial Registration: ClinicalTrials.gov: NCT01600430., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Place learning is thought to be an adaptive and flexible facet of navigation. Due to the flexibility of this learning, it is thought to be more complex than the simpler strategies such as learning a particular route or navigating through the use of cues. Place learning is crucial in a familiar environment as it allows an individual to successfully navigate to the same endpoint, regardless of where in the environment the journey begins. Much of the research to date focusing on different strategies employed for navigation has used human subjects or other mammals such as rodents. In this series of experiments, the spatial memory of four different species of fish (goldfish, killifish, zebrafish and Siamese fighting fish) was analysed using a plus maze set-up. Results suggest that three of the species showed a significant preference for the adoption of a place strategy during this task, whereas zebrafish showed no significant preference. Furthermore, zebrafish took significantly longer to learn the task than the other species. Finally, results suggest that zebrafish took the least amount of time (seconds) to complete trials both during training and probe.

There is lack of consistent evidence as to how well PD patients are able to accurately time their movements across space with an external acoustic signal. For years, research based on the finger-tapping paradigm, the most popular paradigm for exploring the brain's ability to time movement, has provided strong evidence that patients are not able to accurately reproduce an isochronous interval [i.e., Ref. (1)]. This was undermined by Spencer and Ivry (2) who suggested a specific deficit in temporal control linked to emergent, rhythmical movement not event-based actions, which primarily involve the cerebellum. In this study, we investigated motor timing of seven idiopathic PD participants in event-based sensorimotor synchronization task. Participants were asked to move their finger horizontally between two predefined target zones to synchronize with the occurrence of two sound events at two time intervals (1.5 and 2.5 s). The width of the targets and the distance between them were manipulated to investigate impact of accuracy demands and movement amplitude on timing performance. The results showed that participants with PD demonstrated specific difficulties when trying to accurately synchronize their movements to a beat. The extent to which their ability to synchronize movement was compromised was found to be related to the severity of PD, but independent of the spatial constraints of the task.

To intercept a moving object, one needs to be in the right place at the right time. In order to do this, it is necessary to pick up and use perceptual information that specifies the time to arrival of an object at an interception point. In the present study, we examined the ability to intercept a laterally moving virtual sound object by controlling the displacement of a sliding handle and tested whether and how the interaural time difference (ITD) could be the main source of perceptual information for successfully intercepting the virtual object. The results revealed that in order to accomplish the task, one might need to vary the duration of the movement, control the hand velocity and time to reach the peak velocity (speed coupling), while the adjustment of movement initiation did not facilitate performance. Furthermore, the overall performance was more successful when subjects employed a time-to-contact (tau) coupling strategy. This result shows that prospective information is available in sound for guiding goal-directed actions.

While the origins of consonance and dissonance in terms of acoustics, psychoacoustics and physiology have been debated for centuries, their plausible effects on movement synchronization have largely been ignored. The present study aimed to address this by investigating whether, and if so how, consonant/dissonant pitch intervals affect the spatiotemporal properties of regular reciprocal aiming movements. We compared movements synchronized either to consonant or to dissonant sounds and showed that they were differentially influenced by the degree of consonance of the sound presented. Interestingly, the difference was present after the sound stimulus was removed. In this case, the performance measured after consonant sound exposure was found to be more stable and accurate, with a higher percentage of information/movement coupling (tau coupling) and a higher degree of movement circularity when compared to performance measured after the exposure to dissonant sounds. We infer that the neural resonance representing consonant tones leads to finer perception/action coupling which in turn may help explain the prevailing preference for these types of tones.

Indirect evidence suggests that impaired triglyceride storage in the subcutaneous fat depot contributes to the development of insulin resistance via lipotoxicity. We directly tested this hypothesis by measuring, in vivo, TG synthesis, de novo lipogenesis (DNL), adipocyte proliferation, and insulin suppression of lipolysis in subcutaneous adipose tissue of BMI-matched individuals classified as insulin resistant (IR) or insulin sensitive (IS). Nondiabetic, moderately obese subjects with BMI 25-35 kg/m(2), classified as IR or IS by the modified insulin suppression test, consumed deuterated water ((2)H2O) for 4 weeks. Deuterium incorporation into glycerol, palmitate, and DNA indicated TG synthesis, DNL, and adipocyte proliferation, respectively. Net TG synthesis and DNL in adipose cells were significantly lower in IR as compared with IS subjects, whereas adipocyte proliferation did not differ significantly. Plasma FFAs measured during an insulin suppression test were 2.5-fold higher in IR subjects, indicating resistance to insulin suppression of lipolysis. Adipose TG synthesis correlated directly with DNL but not with proliferation. These results provide direct in vivo evidence for impaired TG storage in subcutaneous adipose tissue of IR as compared with IS. Relative inability to store TG in the subcutaneous depot may represent a mechanism contributing to the development of insulin resistance in the setting of obesity., (Copyright © 2015 by the American Society for Biochemistry and Molecular Biology, Inc.)