Brain pathology and symptoms linked to concussion history: beyond chronic traumatic encephalopathy.

Repeated head trauma acquired through sports injuries has been associated with the development of long-term disabling symptoms that negatively impact the quality of life. In this retrospective case series, 52 male former professional athletes involved in contact sports and with a history of multiple concussions were evaluated for chronic clinical symptoms and post-mortem neuropathological diagnoses. The clinical symptoms of 19 cases were examined in greater detail for symptom type, severity and duration. Information on neurological, psychiatric and physical symptoms, substance use profiles and concussion histories was obtained from the athletes' next of kin and assessed in relation to post-mortem neuropathological diagnoses. Cases were categorized into three different neuropathological groups: no major neuropathological findings, the presence of only chronic traumatic encephalopathy (CTE) and the diagnosis(es) of other neurodegenerative diseases. Age at death and the presence of DNA damage in the post-mortem brains were analysed for correlation with the clinical symptoms. In this case series, 14/52 (26.9%) cases (mean age 48.2 ± 11.4) had neuropathological evidence of low-stage/low-burden CTE. A total of 11/52 (21.2%) cases (mean age 38.7 ± 12.7) presented a similar profile and severity of behavioural symptoms to those with CTE, despite the lack of significant post-mortem neuropathological findings. A total of 27/52 (51.9%) cases (mean age 75.5 ± 8.7) presented with complex post-mortem neurodegenerative diagnoses, including Alzheimer's disease and other mixed pathologies, and clinical symptoms associated with language, memory and sensory dysfunction. The presence of DNA damage in the brain was found in all neuropathological groups, predominantly in the ependymal lining of ventricles, and phosphorylated histone H2AX staining was correlated with higher age at death (r = 0.59) and symptoms of language dysfunction (r = 0.56). Findings from our case series suggest that post-concussive symptoms are not driven by CTE. Our findings show that proteinopathies alone may not account for the complexity of the clinical manifestations and suggest the possibility of other drivers, such as DNA damage, as potentially useful markers of brain trauma. Broadening the search for biological markers that reflect the effects of brain injury, even when proteinopathy is not observed, and taking a symptom-driven approach are therefore advised.

Neuroimaging and Biosample Collection in the Toronto Adolescent and Youth Cohort Study: Rationale, Methods, and Early Data.

BACKGROUND: The Toronto Adolescent and Youth (TAY) Cohort Study will characterize the neurobiological trajectories of psychosis spectrum symptoms, functioning, and suicidality (i.e., suicidal thoughts and behaviors) in youth seeking mental health care. Here, we present the neuroimaging and biosample component of the protocol. We also present feasibility and quality control metrics for the baseline sample collected thus far. METHODS: The current study includes youths (ages 11-24 years) who were referred to child and youth mental health services within a large tertiary care center in Toronto, Ontario, Canada, with target recruitment of 1500 participants. Participants were offered the opportunity to provide any or all of the following: 1) 1-hour magnetic resonance imaging (MRI) scan (electroencephalography if ineligible for or declined MRI), 2) blood sample for genomic and proteomic data (or saliva if blood collection was declined or not feasible) and urine sample, and 3) heart rate recording to assess respiratory sinus arrhythmia. RESULTS: Of the first 417 participants who consented to participate between May 4, 2021, and February 2, 2023, 412 agreed to participate in the imaging and biosample protocol. Of these, 334 completed imaging, 341 provided a biosample, 338 completed respiratory sinus arrhythmia, and 316 completed all 3. Following quality control, data usability was high (MRI: T1-weighted 99%, diffusion-weighted imaging 99%, arterial spin labeling 90%, resting-state functional MRI 95%, task functional MRI 90%; electroencephalography: 83%; respiratory sinus arrhythmia: 99%). CONCLUSIONS: The high consent rates, good completion rates, and high data usability reported here demonstrate the feasibility of collecting and using brain imaging and biosamples in a large clinical cohort of youths seeking mental health care.

Learning strategy differentially impacts memory connections in children and adults.

Even once children can accurately remember their experiences, they nevertheless struggle to use those memories in flexible new ways-as in when drawing inferences. However, it remains an open question as to whether the developmental differences observed during both memory formation and inference itself represent a fundamental limitation on children's learning mechanisms, or rather their deployment of suboptimal strategy. Here, 7-9-year-old children (N = 154) and young adults (N = 130) first formed strong memories for initial (AB) associations and then engaged in one of three learning strategies as they viewed overlapping (BC) pairs. We found that being told to integrate-combine ABC during learning-both significantly improved children's ability to explicitly relate the indirectly associated A and C items during inference and protected the underlying pair memories from forgetting. However, this finding contrasted with implicit evidence for memory-to-memory connections: Adults and children both formed A-C links prior to any knowledge of an inference test-yet for children, such links were most apparent when they were told to simply encode BC, not integrate. Moreover, the accessibility of such implicit links differed between children and adults, with adults using them to make explicit inferences but children only doing so for well-established direct AB pairs. These results suggest that while a lack of integration strategy may explain a large share of the developmental differences in explicit inference, children and adults nevertheless differ in both the circumstances under which they connect interrelated memories and their ability to later leverage those links to inform flexible behaviours. RESEARCH HIGHLIGHTS: Children and adults view AB and BC pairs related through a shared item, B. This provides an opportunity for learners to connect A-C in memory. Being encouraged to integrate ABC during learning boosted performance on an explicit test of A-C connections (children and adults) and protected from forgetting (children). Children and adults differed in when implicit A-C connections were formed-occurring primarily when told to separately encode BC (children) versus integrate (adults), respectively. Adults used implicit A-C connections to facilitate explicit judgments, while children did not. Our results suggest developmental differences in the learning conditions promoting memory-to-memory connections.

Heard it through the grapevine: indirect networks and employee creativity.

Social networks can be important sources of information and insights that may spark employee creativity. The cross-fertilization of ideas depends not just on access to information and insights through one's direct network-the people one actually interacts with--but at least as much on access to the indirect network one's direct ties connect one to (i.e., people one does not interact with directly, but with whom one's direct ties interact). We propose that the reach efficiency of this indirect network--its nonredundancy in terms of interconnections--is positively related to individual creativity. To help specify the boundaries of this positive influence of the indirect network, we also explore how many steps removed the indirect network still adds to creativity. In addition, we propose that the efficiency (nonredundancy) of one's direct network is important here, because more efficient direct networks give one access to indirect networks with greater reach efficiency. Our hypotheses were supported in a multilevel analysis of multisource survey data from 223 sales representatives nested within 11 divisions of a Chinese pharmaceutical company. This analysis also showed that the creative benefits of reach efficiency were evident for 3 and 4 degrees of separation but were greatest for indirect ties that depend only on one's direct ties.

An integrative model of organizational safety behavior.

INTRODUCTION: This study develops an integrative model of safety management based on social cognitive theory and the total safety culture triadic framework. The purpose of the model is to reveal the causal linkages between a hazardous environment, safety climate, and individual safety behaviors. METHOD: Based on primary survey data from 209 front-line workers in one of the largest state-owned coal mining corporations in China, the model is tested using structural equation modeling techniques. RESULTS: An employee's perception of a hazardous environment is found to have a statistically significant impact on employee safety behaviors through a psychological process mediated by the perception of management commitment to safety and individual beliefs about safety. IMPACT ON INDUSTRY: The integrative model developed here leads to a comprehensive solution that takes into consideration the environmental, organizational and employees' psychological and behavioral aspects of safety management.