Mild Traumatic Brain Injury and Postconcussive Symptom Endorsement: A Parallel Comparison Between Two Nonclinical Cohorts.

INTRODUCTION: The prevalence of mild traumatic brain injury (mTBI) is commonly estimated based on indirect metrics such as emergency department visits and self-reporting tools. The study of postconcussive symptoms faces similar challenges because of their unspecific character and indistinct causality. In this article, we compare two nonclinical, epidemiological studies that addressed these two elements and were performed within a relatively narrow period in the state of Colorado. MATERIALS AND METHODS: De-identified datasets were obtained from a random digit-dialed survey study conducted by the Craig Hospital and a study surveying soldiers returning from deployment by Defense and Veteran Traumatic Brain Injury Center. Information pertinent to participants' demographics, a history of mTBI, and symptom endorsement was extracted and homogenized in order to establish a parallel comparison between the populations of the two studies. RESULTS: From the 1,558 (Warrior Strong, 679; Craig Hospital, 879) records selected for analysis, 43% reported a history of at least one mTBI. The prevalence was significantly higher among individuals from the Defense and Veteran Traumatic Brain Injury Center study independent of gender or race. Repetitive injuries were reported by 15% of the total combined cohort and were more prevalent among males. Symptom endorsement was significantly higher in individuals with a positive history of mTBI, but over 80% of those with a negative history of mTBI endorsed at least one of the symptoms interrogated. Significant differences were observed between the military and the civilian populations in terms of the types and frequencies of the symptoms endorsed. CONCLUSIONS: The prevalence of mTBI and associated symptoms identified in the two study populations is higher than that of previously reported. This suggests that not all individuals sustaining concussion seek medical care and highlights the limitations of using clinical reports to assess such estimates. The lack of appropriate mechanisms to determine symptom presence and causality remains a challenge. However, the differences observed in symptom reporting between cohorts raise questions about the nature of the symptoms, the impact on the quality of life for different individuals, and the effects on military health and force readiness.

Protection of Pea Aphids Associated with Coinfecting Bacterial Symbionts Persists During Superparasitism by a Braconid Wasp.

Bacterial endosymbionts that associate facultatively with insect herbivores can influence insect fitness and trophic interactions. The pea aphid, Acyrthosiphon pisum, can be protected from parasitism by the braconid wasp Aphidius ervi when harbouring particular symbiotic bacteria, with specific endosymbiont coinfections providing almost complete protection. However, studies often quantify aphid mummification with no control over parasitoid oviposition per aphid; thus, if mummy production fails or is low, the causes are often unclear. Here, we show that the high level of protection associated with the coinfecting endosymbionts Hamiltonella defensa and X-type is maintained even when pea aphids are superparasitised. This contrasts strongly with the protection provided by H. defensa alone, which has been shown by others to be overcome by superparasitism. By dissecting aphids exposed to two parasitoid attacks, we reveal that A. ervi deposits eggs equally freely in endosymbiont-infected and uninfected nymphs, and lack of mummification in endosymbiont-protected nymphs arises from failure of the wasp eggs to hatch or emerging larvae to develop.

Utility of the SLUMS as a cognitive screening tool among a nonveteran sample of older adults.

OBJECTIVES: To investigate the concurrent validity of the Saint Louis University Mental Status examination (SLUMS) by comparing the ability of the Mini-Mental State Examination (MMSE) and the SLUMS to predict performance on standard neuropsychological measures of memory and executive functioning. DESIGN: Cross-sectional. SETTING: University-based research clinic. PARTICIPANTS: Community-dwelling adults (N = 170) age 60 years and older (Mage = 73.08; SD = 8.18). MEASUREMENTS: The Trail Making Test (TMT), Rey Auditory Verbal Learning Test, Wisconsin Card Sorting Test (WCST), MMSE, and SLUMS. RESULTS: The distributional properties of the SLUMS and the MMSE were directly compared. The SLUMS showed statistically a smaller mean, lower rank scores, and less skewness than the MMSE. Comparisons of the correlations of the screening tests with the neuropsychological measures indicated that the SLUMS demonstrated stronger relationships with the TMT compared with the MMSE. Multiple regression analyses were conducted to determine the ability of the SLUMS and the MMSE to predict scores on common neuropsychological tests after controlling for demographic variables. Results demonstrated that the SLUMS significantly predicted performance across all measures over the MMSE and demographic variables, with the exception of the WCST's perseverative errors. However, the MMSE does not add to the prediction of neuropsychological functioning over the SLUMS. CONCLUSION: Although the SLUMS and the MMSE are strongly correlated, the SLUMS significantly adds to the prediction of neuropsychological measures beyond the MMSE scores. Our findings suggest that the SLUMS may be an appropriate measure to use as a screening tool among older adults and may have fewer ceiling effects than the MMSE.

Subjective organization, verbal learning, and forgetting across the life span: from 5 to 89.

UNLABELLED: BACKGROUND/STUDY CONTEXT: Previous tests of the relationship between subjective organization during encoding, aging, and recall have produced inconsistent findings. The present study investigates subjective organization and the acquisition and recall of verbal material across the life span (from 5 to 89 years of age) using two measures, the intertrial repetition paired frequency (PF) measure and the unidirectional subjective organization (SO) measure. METHODS: Participants (N = 2656) were administered a version of the Rey Auditory Verbal Learning Test, including a delayed recall trial. Analyses of variance (ANOVAs) were performed to examine the relationship between age and subjective organization and between age and recall. Mediation and growth curve analyses were performed to further examine the relationship between age, verbal acquisition, and subjective organization. RESULTS: Subjective organization was not predictive of verbal forgetting. Deficits in verbal acquisition and subjective organization were detected among children and elderly adults. Mediational analyses showed that age affected the number of words recalled as well as subjective organization, and that subjective organization affected the number of words recalled in children, young adults and elderly. Latent growth curve modeling suggests that increases in subjective organization over time are related to increases in recall over time for each age group. CONCLUSION: Subjective organization is predictive of recall, and both subjective organization and recall are lowest among children and elderly individuals. Age has direct effects on recall but this effect is partially mediated by subjective organization. Brain imaging studies showing increased prefrontal cortex activation during encoding of remembered words bolster our findings that age affects the relationship between verbal learning and organization of material during encoding.

Age effects on emotion recognition in facial displays: from 20 to 89 years of age.

UNLABELLED: BACKGROUND/STUDY CONTEXT: An emotion recognition task that morphs emotional facial expressions from an initial neutral expression to distinct increments of the full emotional expression was administered to 482 individuals, 20 to 89 years of age. METHODS: Participants assessed six basic emotions at 25%, 50%, 75%, and 100% of the full facial expression. RESULTS: Participants in the three oldest age groups (60s, 70s, and 80s) demonstrated decreased performance for the recognition of the fear, anger, and sad emotions. Increased age was associated with increased recognition rates for the disgust expression, whereas no age effect was detected for the happy and surprise expressions. Covariate analyses revealed age effects were reduced by processing speed, but were unaffected by decision-making ability. The effects of age on individual emotions and levels of presentation are discussed. CONCLUSION: These findings suggest that age has the greatest impact on the recognition of the sad emotion and the greatest age effect at the 50% level of presentation across the adult life span.

The recognition of facial expressions: an investigation of the influence of age and cognition.

The present study aimed to investigate changes in facial expression recognition across the lifespan, as well as to determine the influence of fluid intelligence, processing speed, and memory on this ability. Peak performance in the ability to identify facial affect was found to occur in middle-age, with the children and older adults performing the poorest. Specifically, older adults were impaired in their ability to identify fear, sadness, and happiness, but had preserved recognition of anger, disgust, and surprise. Analyses investigating the influence of cognition on emotion recognition demonstrated that cognitive abilities contribute to performance, especially for participants over age 45. However, the cognitive functions did not fully account for the older adults' impairments on expression recognition. Overall, the age-related deficits in facial expression recognition have implications for older adults' use of non-verbal communicative information.

Maternal tendencies in women are associated with estrogen levels and facial femininity.

Previous studies have shown that women with higher maternal tendencies are shorter and have lower testosterone levels than those with lower maternal tendencies. Here we report two studies that investigated the relationships between maternal tendencies and two further measures of physical masculinization/feminization; urinary estrogen metabolite (estrone-3-glucuronide: E1-3G) levels (Study 1) and rated facial femininity (Study 2). In Study 1, nulliparous women reported both their ideal number of children and ideal own age at first child and also provided urine samples. There was a significant positive correlation between measured late-follicular estrogen levels and reported ideal number of children. In Study 2, analyses of facial cues in two independent samples of women showed that the average facial characteristics of women who reported desiring many children were rated as more feminine than those desiring fewer children. Collectively, these results support the proposal that maternal tendencies are related to physical feminization and that this effect may, at least in part, reflect the influence of the hormone estrogen.

Cues to sex- and stress-hormones in the human male face: functions of glucocorticoids in the immunocompetence handicap hypothesis.

The stress-linked version of the immunocompetence handicap hypothesis has been proposed to account for inconsistencies in relationships between testosterone and immune response. The model has received some support from studies demonstrating roles of stress hormones in relationships between testosterone, immune function and secondary sexual ornamentation. Such work, however, has relied on artificial elevation of testosterone so may not reflect relationships in natural populations. We created human male facial stimuli on the basis of naturally co-occurring levels of salivary testosterone and the stress hormone cortisol. In Study 1 we tested female preferences for male faces with cues to combinations of the hormones across the menstrual cycle, and in Study 2 we tested perceptions of health and dominance in a novel set of facial stimuli. Females preferred cues to low cortisol, a preference that was strongest during the fertile phase of the menstrual cycle. The effects of cortisol on attractiveness and perceived health and dominance were contingent upon level of testosterone: the effects of the stress hormone were reduced when testosterone was high. We propose explanations for our results, including low cortisol as a cue to a heritable component of health, attractiveness as a predictor of low social-evaluative threat (and, therefore, low baseline cortisol) and testosterone as a proxy of male ability to cope efficiently with stressors.

Evidence for the stress-linked immunocompetence handicap hypothesis in human male faces.

The stress-linked immunocompetence handicap hypothesis (SL-ICHH) of sexual selection incorporates a role of the stress hormone corticosterone (C; cortisol in humans) in relationships between testosterone (T), immunity and secondary sexual trait expression. In support of this, C has been shown to mediate and moderate relationships between T and immune response and to be inversely related to attractiveness in some avian species. We predicted that female preferences for cues to T in human male faces would be contingent upon co-occurring cortisol levels. In study 1, we tested relationships between T and cortisol and attractiveness, masculinity and health ratings of raw male faces. We found cortisol to be inversely related to attractiveness. In study 2, we tested female preferences for male faces that were parametrically manipulated on the basis of cues to naturally co-occurring levels of T and cortisol across the menstrual cycle. Women preferred cues to low cortisol in general and in the fertile phase of the cycle, and there was an interaction between T and cortisol in general and in the non-fertile phase. Results were consistent with the SL-ICHH but not the original immunocompetence handicap model: females expressed preferences for cues to cortisol but not for cues to T, except in interaction with the stress hormone. Results inform the SL-ICHH by demonstrating female preferences for low cortisol and the nature of its interaction with T in humans, as well as indicating the traits that may be signalled by different combinations of the hormones including immune response, current health and resource acquisition characteristics.

The cutest little baby face: a hormonal link to sensitivity to cuteness in infant faces.

We used computer image manipulation to develop a test of perception of subtle gradations in cuteness between infant faces. We found that young women (19-26 years old) were more sensitive to differences in infant cuteness than were men (19-26 and 53-60 years old). Women aged 45 to 51 years performed at the level of the young women, whereas cuteness sensitivity in women aged 53 to 60 years was not different from that of men (19-26 and 53-60 years old). Because average age at menopause is 51 years in Britain, these findings suggest the possible involvement of reproductive hormones in cuteness sensitivity. Therefore, we compared cuteness discrimination in pre- and postmenopausal women matched for age and in women taking and not taking oral contraceptives (progestogen and estrogen). Premenopausal women and young women taking oral contraceptives (which raise hormone levels artificially) were more sensitive to variations of cuteness than their respective comparison groups. We suggest that cuteness sensitivity is modulated by female reproductive hormones.

Reproductive strategy, sexual development and attraction to facial characteristics.

Sexual reproduction strategies vary both between and within species in the level of investment in offspring. Life-history theories suggest that the rate of sexual maturation is critically linked to reproductive strategy, with high investment being associated with few offspring and delayed maturation. For humans, age of puberty and age of first sex are two developmental milestones that have been associated with reproductive strategies. Stress during early development can retard or accelerate sexual maturation and reproduction. Early age of menarche is associated with absence of younger siblings, absence of a father figure during early life and increased weight. Father absence during early life is also associated with early marriage, pregnancy and divorce. Choice of partner characteristics is critical to successful implementation of sexual strategies. It has been suggested that sexually dimorphic traits (including those evident in the face) signal high-quality immune function and reproductive status. Masculinity in males has also been associated with low investment in mate and offspring. Thus, women's reproductive strategy should be matched to the probability of male investment, hence to male masculinity. Our review leads us to predict associations between the rate of sexual maturation and adult preferences for facial characteristics (enhanced sexual dimorphism and attractiveness). We find for men, engaging in sex at an early age is related to an increased preference for feminized female faces. Similarly, for women, the earlier the age of first sex the greater the preference for masculinity in opposite-sex faces. When we controlled sexual dimorphism in male faces, the speed of sexual development in women was not associated with differences in preference for male facial attractiveness. These developmental influences on partner choice were not mediated by self-rated attractiveness or parental relationships. We conclude that individuals assort in preferences based on the rapidity of their sexual development. Fast developing individuals prefer opposite-sex partners with an increased level of sexually dimorphic facial characteristics.

Facial appearance is a cue to oestrogen levels in women.

Although many accounts of facial attractiveness propose that femininity in women's faces indicates high levels of oestrogen, there is little empirical evidence in support of this assumption. Here, we used assays for urinary metabolites of oestrogen (oestrone-3-glucuronide, E1G) and progesterone (pregnanediol-3-glucuronide, P3G) to investigate the relationship between circulating gonadal hormones and ratings of the femininity, attractiveness and apparent health of women's faces. Positive correlations were observed between late follicular oestrogen and ratings of femininity, attractiveness and health. Positive correlations of luteal progesterone and health and attractiveness ratings were marginally significant. Ratings of facial attributions did not relate to hormone levels for women wearing make-up when photographed. There was no effect of sex of rater on the relationships between oestrogen and ratings of facial appearance. These findings demonstrate that female facial appearance holds detectable cues to reproductive health that are considered attractive by other people.

Menstrual cycle, trait estrogen level, and masculinity preferences in the human voice.

Men with low testosterone (feminine men) invest in relationships and offspring more than men with high testosterone (masculine men). Women's attraction to testosterone dependent traits (e.g. masculine face shape) is enhanced during the late-follicular, fertile phase of the menstrual cycle. Attractive, feminine women have stronger preferences for masculine men as possible long-term partners than less attractive, masculine women. We manipulated 2 testosterone related vocal traits (voice pitch and apparent vocal-tract length) in voices to test if women prefer masculinized men's voices to feminized men's voices; masculinity preferences are enhanced at the fertile (late-follicular) menstrual cycle phase; the amount that masculinity preferences shift cyclically relates to average estrone-3-glucuronide concentration (the primary urinary metabolite of estrone, E3G). We found women displayed general masculinity preferences for men's voices; masculinity preferences were greater in the fertile (late-follicular) phase of the cycle than the non-fertile (early-follicular and luteal) phase; and this effect was most pronounced for women with low average E3G concentration. As feminine women (i.e. those with high average E3G levels) are most able to obtain investment even from masculine men, these women may not need to change their mating preference or strategy during the menstrual cycle as much as masculine women.

Commitment to relationships and preferences for femininity and apparent health in faces are strongest on days of the menstrual cycle when progesterone level is high.

Previous studies of changes in women's behavior during the menstrual cycle have offered insight into the motivations underpinning women's preferences for social cues associated with possible direct benefits (e.g., investment, low risk of infection) and indirect benefits (e.g., offspring viability). Here we sought to extend this work by testing for systematic variation in women's preferences for male and female faces and in their attitudes to their romantic relationship during the menstrual cycle. In Study 1, we found partnered women's reported commitment to their romantic relationship and preferences for femininity in male and female faces were strongest on days of the menstrual cycle when progesterone levels are increased (and fertility is low). Happiness in relationships did not change across the cycle. In Study 2, we found that the effect of cycle phase on women's preference for feminine faces was independent of increased attraction to apparent health in faces during the luteal phase. Collectively, these findings are further evidence that women's preferences for social cues associated with possible direct benefits and commitment to relationships are strongest during conditions characterized by raised progesterone level, while attraction to men displaying cues associated with possible indirect benefits is strongest when women are most fertile.

Menstrual cycle, pregnancy and oral contraceptive use alter attraction to apparent health in faces.

Previous studies demonstrating changes in women's face preferences have emphasized increased attraction to cues to possible indirect benefits (e.g. heritable immunity to infection) that coincides with periods of high fertility (e.g. the late follicular phase of the menstrual cycle). By contrast, here we show that when choosing between composite faces with raised or lowered apparent health, women's preferences for faces that are perceived as healthy are (i) stronger during the luteal phase of the menstrual cycle than during the late follicular, fertile phase, (ii) stronger in pregnant women than in non-pregnant women and (iii) stronger in women using oral contraceptives than in women with natural menstrual cycles. Change in preference for male faces was greater for short- than long-term relationships. These findings indicate raised progesterone level is associated with increased attraction to facial cues associated with possible direct benefits (e.g. low risk of infection) and suggest that women's face preferences are influenced by adaptations that compensate for weakened immune system responses during pregnancy and reduce the risk of infection disrupting foetal development.

Concordant preferences for opposite-sex signals? Human pheromones and facial characteristics.

We have investigated whether preferences for masculine and feminine characteristics are correlated across two modalities, olfaction and vision. In study 1, subjects rated the pleasantness of putative male (4,16-androstadien-3-one; 5alpha-androst-16-en-3-one) and female (1,3,5 (10),16-estratetraen-3-ol) pheromones, and chose the most attractive face shape from a masculine-feminine continuum for a long- and a short-term relationship. Study 2 replicated study 1 and further explored the effects of relationship context on pheromone ratings. For long-term relationships, women's preferences for masculine face shapes correlated with ratings of 4,16-androstadien-3-one and men's preferences for feminine face shapes correlated with ratings of 1,3,5(10),16-estratetraen-3-ol. These studies link sex-specific preferences for putative human sex pheromones and sexually dimorphic facial characteristics. Our findings suggest that putative sex pheromones and sexually dimorphic facial characteristics convey common information about the quality of potential mates.

Smelling human sex hormone-like compounds affects face gender judgment of men.

Although strong cross-sensory interactions between visual, tactile and auditory modalities have already been shown, we know little about how chemosensory information affects processing in other sensory modalities. We studied whether smelling gender-specific odorous sex hormone-like steroids: 5-alpha-androgenst-16-en-3-one (androgen) or oestra-1, 3, 5 (10), 16-tetraen-3-ol (estrogen) can bias face gender discrimination. We found that, as a result of inhalation of androgen, men perceive faces to be more masculine as compared to when they are exposed to estrogen. Our results provide evidence for specific cross-sensory effects of the gender-specific chemosensory cues on the categorization of visual face gender.

The Vivostat application system: a comparison with conventional fibrin sealant application systems.

The method of applying fibrin sealants may affect their physical properties and surgical performance. In this study, the characteristics of a novel fibrin-sealant application system (Vivostat were compared with conventional fibrin sealant spray systems. Delivery rates of Vivostat were highly reproducible in both high and low delivery modes (coefficient of variation [CV] < 1.0%) Airflow rates of Vivostat were 578 ml/min (6.6% (6.5% were lower and less variable than conventional systems, which ranged from 5000 to 10000 ml/min depending on the pressure. Spray forces of Vivostat were consequently lower than other systems and the deposited fibrin films formed were of more consistent thickness. Unlike other systems, blockages with Vivostat were rare on intermittent use. The Vivostat system offers the surgeon a controlled, precise and efficient means of fibrin sealant application with potential performance advantages over conventional spray application systems.

I am not an animal: mortality salience, disgust, and the denial of human creatureliness.

The present research investigated the need to distinguish humans from animals and tested the hypothesis derived from terror management theory that this need stems in part from existential mortality concerns. Specifically, the authors suggest that being an animal is threatening because it reminds people of their vulnerability to death; therefore, reminding people of their mortality was hypothesized to increase the need to distance from animals. In support, Study 1 revealed that reminders of death led to an increased emotional reaction of disgust to body products and animals. Study 2 showed that compared to a control condition, mortality salience led to greater preference for an essay describing people as distinct from animals; and within the mortality salient condition but not the control condition, the essay emphasizing differences from other animals was preferred to the essay emphasizing similarities. The implications of these results for understanding why humans are so invested in beautifying their bodies and denying creaturely aspects of themselves are discussed.

Neutrophils, unopposed neutrophil elastase, and alpha1-antiprotease defenses following human lung transplantation.

Neutrophils are sequestered in the newly transplanted lung after reperfusion or with infection, rejection, and chronic graft dysfunction. Because unopposed (free) neutrophil elastase (NE) released into bronchoalveolar secretions may injure the lung allograft and impair bacterial clearance, we assessed total neutrophil numbers, myeloperoxidase activity as an index of neutrophil influx and degranulation, alpha1-antiprotease (alpha1-AP) concentrations, and unopposed NE activity in bronchoalveolar secretions from lung transplant recipients. Unopposed NE activity was present in bronchoalveolar lavage fluid (BALF) from recipients transplanted for emphysema associated with alpha1-AP deficiency as well as recipients without such deficiency (171 of 2,137 BALF; 8%). Ten of 17 (59%) recipients with alpha1-AP deficiency who were followed for at least 1 yr after transplant with multiple surveillance and diagnostic bronchoscopies had at least one BALF containing unopposed NE, usually associated with the presence of > or = 10(5) colony forming units/ml BALF of aerobic bacteria. In contrast, 19 of 58 (33%) with emphysema not associated with alpha1-AP deficiency, 8 of 32 (25%) recipients with cystic fibrosis (CF), 6 of 16 (38%) with idiopathic pulmonary fibrosis (IPF), and 11 of 36 (31%) with other indications for transplant had unopposed NE in BALF. alpha1-AP levels were significantly elevated in the early posttransplant time period and could be augmented considerably in alpha1-AP-deficient recipients with episodes of infection or rejection. Our findings indicate that unopposed NE activity can be found in both alpha1-AP-deficient and alpha1-AP-sufficient recipients after transplantation, usually in association with endobronchial bacterial infection.