Specimens were obtained by using a single pass of the TC needle t

Specimens were obtained by using a single pass of the TC needle through the tissue. This resulted in 7 groups with 12 biopsy specimens obtained for each group. Overall, 84 biopsy specimens were obtained in the animal model and were sent for histology assessment. Vorinostat To test whether practical application of the cryoprobe introduced through an echoendoscope is feasible in humans by using classical echoendoscope positions such as in the stomach, pancreatic organ biopsy specimens were obtained in two recently deceased human cadavers (<72 hours postmortem), (1) through laparotomy puncture by using each

technique (CB, EUS-FNA, and TC) and (2) with standard EUS equipment by using an Olympus GF-UCT140-AL5 (Evis Exera II, Olympus, Hamburg, Germany) echoendoscope with an ALOKA processor (ProSound Alpha 10; Aloka Europe, Zug, Switzerland). The latter experiments were performed to assess maneuverability and handling of selleck products the EUS-guided CB. Specimens were obtained via transgastric puncture from the pancreatic body. Specimens were obtained by using a single pass of the cryoprobe needle through the tissue. This resulted in 5 groups with 12 biopsy specimens obtained for each group.

All biopsy specimens were assessed by a pathologist who was blinded to the biopsy method. Size of the specimen, presence of artifacts, and histopathologic assessability were evaluated by using a 7-point Likert scale (Fig. 2) developed for this study. Histopathologic assessability was considered the primary outcome parameter. We used a Likert scale with anchor points at 0, 2, 4, and 6; numbers 1, 3, and 5 represent interim values in between the anchor points.15 Measurement of the formalin-fixed, gross core was performed by using a ruler. In addition, the pathologist measured the paraffin-embedded core under his microscope ocular metric. Directly after puncture of the pancreas, a timer was started. A gauze was used to wipe fresh blood from the puncture site PIK3C2G every 3 seconds. Time until spontaneous cessation of bleeding was documented after each biopsy. Technical feasibility of CB was assessed for friction

between the probe and the channel, maneuverability, and macroscopic reliable specimen retrieval in the porcine and cadaver models. This was a subjective outcome evaluation by 3 investigators (D.vR., T.R., U.D.). Data were analyzed with descriptive statistics (median and interquartile ranges [IQR]). For bleeding times, biopsy size, artifacts, and histologic assessability, a 1-way analysis of variance test (Kruskal-Wallis) was used. The Dunn multiple comparison test was applied to compare pairs of group means. A P value < .05 was considered statistically significant. All P values are 2-sided and were not adjusted for the number of parameters evaluated. This study was the first trial evaluating the novel cryoprobe.

Due ionizing radiations oncogenic impact on children with RB1 mut

Due ionizing radiations oncogenic impact on children with RB1 mutations, CT imaging is used only when MRI is not available (82). In high-risk patients, imaging is coupled with lumbar puncture and bone marrow aspiration biopsy. Determinations of metastatic risk are typically based on clinical and histopathologic check details staging of the enucleated eye [83] and [84]. However, fewer eyes are being enucleated because of chemoreduction with focal therapy consolidation and the recent use of ophthalmic arterial chemotherapy for intraocular disease. Both these techniques likely result in downstaging, in which histopathologic markers for metastasis may disappear, leaving only

clinical staging [84], [85] and [86]. Therefore, before plaque therapy, the ABS-OOTF recommends (Level 2 Consensus) that children with risk of extraocular Rb undergo systemic staging. Communication between the radiation oncologist, ophthalmic oncologist, and medical physicist

is critical for any successful brachytherapy program (Level Gemcitabine clinical trial 2 Consensus). To facilitate this communication, a treatment form and fundus diagram should be available to all participating specialists. It should be made part of the radiation oncology medical record and should be available to the surgeon in the operating room. 1. The treatment form contains demographic identifying information about the patient, laterality of the involved eye, the largest basal dimension of the tumor, when treatment is scheduled, and contact information for the treatment by eye cancer specialists. Each tumor should be staged according to the latest AJCC or equivalent Union for International Cancer Control (UICC) staging system (currently the 7th edition) [87] and [88]. The medical physicist transfers this information to a computerized treatment planning system. Although described by the joint AAPM/ABS TG-129 report, this process also requires a determination of Fossariinae the radionuclide, prescription dose, and dose rate. For those centers using radioactive seeds, there must also be seed selection and orientation. The ABS-OOTF

recommends that all centers perform preimplant treatment planning with documentation of doses to critical structures (26). The ABS-OOTF also recommends that each plaque dosimetry plan undergo independent verification by a qualified medical physicist. The methods of preplanning, dose calculation, plaque design, plaque handling, and quality assurance are recently described in the TG-129 reports [13] and [26]. The ABS-OOTF found that 125I and 103Pd plaques are used by three or more centers in North America, 125I or 106Ru in Europe, solely 106Ru in Japan, and both 106Ru or 90Sr sources in Russia. Russian 90Sr plaques are currently used for uveal melanoma up to 2.5 mm in height and Rb up to 3 mm (10).

Clozapine (8-chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo [b,e]

Clozapine (8-chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo [b,e] [1,4] diazepine) (Sigma Aldrich, Bayouni Trading Co. Ltd., Al-Khobar, Saudi Arabia) was dissolved in 0.1 M HCl and pH-balanced check details in phosphate-buffered saline (PBS) (Sigma Aldrich, Bayouni Trading Co. Ltd., Al-Khobar, Saudi Arabia). This solution was administered intraperitoneally (i.p.) daily in 0.1-ml doses. All other chemicals used in this study were of analytical grade. The animals used

in this study were young male Wistar rats, 3-4 weeks of age and 120–150 g in body weight, from the animal facility of King Saud University, Riyadh, Saudi Arabia. Animals were housed in groups of 10 rats in standard clear polycarbonate cages, with food and water available ad libitum. Animals were kept on a 12-h light–dark schedule (6:00 am–6:00 pm), and all experimental testing was conducted during the light phase, between 9:00 am and 12:00 pm. All experiments were carried out in accordance with the National Institutes of Health guide for the care and use of laboratory animals (NIH Publications No. 8023, revised 1978). The Institutional Animal Use and Care Committee approved the experimental protocol.

All efforts were made to minimise animal suffering and to reduce the number of animals used. The animals were randomly divided into four groups. Clozapine was administered in doses of 10 (n =10), 15 (n =10) and 25 (n =13) mg/kg/day i.p. for 21 days in three groups. The fourth group (n =10), the control group, was treated with saline. The moderate to high doses of clozapine were based on previous reports [12]. The animal’s body weight (BW) was measured before selleck inhibitor and after the study period. At the end of the study period (21 days), rats were anesthetised with 2% halothane in O2 and subjected to echocardiographic study followed by hemodynamic measurements. At the end of hemodynamic measurements, blood samples were drawn by cardiac puncture. Hearts were excised, washed with ice-cold

saline, blotted with a piece of filter paper, and weighed immediately (HW), and the ratio to BW (HW/BW) was calculated. Hearts were then divided midventricularly into two halves, with one half immediately snap-frozen in liquid nitrogen for subsequent biochemical assays. Ventricles of the second half were used for histological and immunohistochemical Bupivacaine studies. Left ventricular (LV) function analysis was performed via echocardiography and hemodynamic measurement. Two-dimensional echocardiographic studies were performed under 0.5% halothane anaesthesia using an echocardiographic machine equipped with a 7.5-MHz transducer (SSD-5500; Aloka, Tokyo, Japan). M-mode tracings were recorded from the epicardial surface of the right ventricle; the short-axis view of the left ventricle was recorded to measure the LV dimension in diastole (LVDd) and LV dimension in systole (LVDs). LV fractional shortening (FS) and ejection fraction (EF) were calculated and expressed as percentages.

In the absence of any specific associated investigations, an expl

In the absence of any specific associated investigations, an explanation concerning the buy Belnacasan mechanisms involved remains debated. Given that we chose a low rotation speed for the ECC exercise, the participants in our study did not exert the same external mechanical power during the CON and ECC exercise sessions. We accepted this limitation to our study from the outset. Indeed

it has been shown that a bout of ECC exercise at moderate intensity, corresponding to 40% of the maximum single-leg concentric cycling power, but at a pedaling rate of 60rpm, led to both muscle pain and reduced exercise capacity.25 This can be explained at least in part by the greater difficulty in achieving ECC contraction, which is a more complex neuromotor task than CON contractions,

as it requires recruitment of larger areas of the cortex.31 Another limit was the position in ECC versus CON exercises. In CON exercise, subjects sat on a conventional ergometer, whereas in ECC, subjects were semiseated. Such a AZD2014 price difference, conditioned by the specific particularities of these 2 modes of exercises, could induce some different responses of the cardiovascular, respiratory, and muscle systems that could diminish the strength of our results. However, the internal mechanical power, determined by all the internal forces involved in the movement (inertia, friction, work done against gravity), is widely different in CON and ECC exercises.39 Our objective in this study was therefore limited to propose a simple, inexpensive technique (the force applied to the pedals) aiming to determine a well-tolerated, moderate-intensity ECC exercise to be used in clinical practice. Another limitation is that we did not evaluate anaerobic metabolism. Finally, the different findings must be further checked in deconditioned

subjects with chronic diseases. This procedure using the Borg Scale to evaluate the RPE during a CON exercise appears to be effective and safe to prescribe the intensity of an ECC exercise at a reduced speed, by determining the force the subject needs to exert on the pedals. This method can be used however to establish a well-tolerated level of ECC exercise, which could be used as a preconditioning level at the initial phase of an ECC training program. a. Custo med GmbH, Leibnizstr. 7, D-85521 Ottobrunn, Germany. We thank Philip Bastable for reviewing the English, and Philippe D’Athis, PhD for his help during the revision of the manuscript. “
“For a number of decades, ships-of-opportunity such as ferries have been used to collect hydrographic data in coastal and oceanic waters. In Norway the collection of salinity and temperature data on a ferry running along the coast started as early as the 1930s.

The findings of this study on Egypt DA-HAI rates form an integral

The findings of this study on Egypt DA-HAI rates form an integral part of the INICC and reflect the outcome and process surveillance data that were systematically collected. The study was carried out in 3 ICUs in three hospitals in two cities in Egypt from December 2008

to July 2010. Each hospital had an infection control team (ICT) with a physician, an infection control practitioner (ICP) with at least one year of experience in infection control (Table 1) and a microbiology laboratory to perform in vitro susceptibility testing of clinical isolates using standardized methods. Every hospital’s institutional review board agreed to the study protocol. Patient this website confidentiality was protected by codifying the recorded information, making it identifiable only to the ICT. The INICC surveillance program includes two components: outcome surveillance (DA-HAI rates and their adverse effects) and process surveillance (adherence to hand hygiene and other basic preventive infection control practices) [16]. Investigators were required to complete outcome and process surveillance forms at their hospitals, which were then sent to the INICC headquarters office in Buenos GDC-0449 solubility dmso Aires for their monthly analysis. The INICC surveillance program applies methods

and definitions for healthcare-associated infections (HAIs) developed by the U.S. Centers for Disease Control and Prevention (CDC) for the NNIS/NHSN program [6] and [17]; however, the INICC methods have been adapted to the setting of developing countries due to their different socioeconomic status and specific resource limitations [16]. Outcome surveillance includes the rates of CLAB, ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infection (CAUTI) per 1000 device-days, the microorganism profile, and the length of stay and

mortality in ICUs. The infection control and prevention strategies implemented in INICC member hospitals are based on inexpensive and basic evidence-based measures, including outcome surveillance, process surveillance, education and Dapagliflozin performance feedback on outcome surveillance and process surveillance [18], [19], [20] and [21]. Process surveillance was designed to assess compliance with easily measurable key infection control practices, such as surveillance of compliance rates for hand hygiene practices and specific measures for the prevention of CLAB, CAUTI and VAP [16]. Hand hygiene compliance by healthcare workers (HCWs), based on the frequency with which hand hygiene is performed when clearly indicated, is monitored by the ICP during randomly selected 1-h observation periods three times per week. Although HCWs are aware that hand hygiene practices are regularly monitored, they are not informed of the schedule for hand hygiene observations.

These hydrolases are normally confined at high concentrations in

These hydrolases are normally confined at high concentrations in cytoplasmic vesicles (granules) and only released upon cell activation. Detergents can easily free the proteases from the granules. It was shown that even the presence of one PMN per million RBCs is able to release enough proteolytic power to damage, if not fully inhibited, highly sensitive RBC proteins such as ankyrin

and protein 4.1.6 KU-60019 Another common situation that could give rise to artefactual results is the preparation of “ghosts” from RBCs by hypotonic haemolysis.17 If the RBCs are contaminated by PMNs and the buffers used are not effectively supplemented with anti-proteases, the RBC membrane proteins will almost certainly be damaged (Fig. 1B, C). The workaround to this problem is the filtration of the blood and the use of freshly prepared lysing buffers containing a working concentration of anti-proteases. Other factors that must be standardised to be able to compare the obtained data between different laboratories are the temperature, shear stress, medium content, especially traces of serum, and the condition of cells used in the experiments. Furthermore, recent studies emphasise the importance of co-factors and substrates of several receptors, which may contribute to the experimental outcome. Temperature-related artefacts include ion misbalance and the ensuing changes in cell volume and Ca2 +-dependent

processes. Temperature ABT-199 purchase sensitivity depends on the particular approach, but it can be severe, differing, e.g., between different types of ion transporters. The decrease in the activity of ion transporters with a decrease in temperature by 10° (Q10) is approximately

30-fold for the Reverse transcriptase Ca2 + pump,18 approximately 3-fold for the Na+/K+ pump19 and approximately 1.5–3-fold for most of the ion transporter systems.[20] and [21] Thus, temperature changes may have a pronounced effect on the intracellular Ca2 + levels and the Na+/K+ distribution. The temperature may not necessarily be fixed at 37 °C in particular experimental settings (e.g., controlling the temperature can be complicate for patch-clamp investigations). However, temperature as a factor has to be taken into account, and the potential side effects must be controlled. Serum and the multiple biologically active factors it contains, including albumin and factors bound to it, such as interleukins, prostaglandins, insulin and amino acids, can introduce artefacts. Depending on the experimental settings, investigations are conducted in serum-containing or serum-free media. Proteins introduced with serum have been shown to play an active role in regulating the activity of ion transporters in RBCs obtained from healthy and diseased subjects. Little is known about the serum components mediating the effects. It has been shown that lysophosphatidic acid (LPA) activates Ca2 + uptake by RBCs.

Fig  3B–D shows the same 3 mm slice selective hp 83Kr images as F

Fig. 3B–D shows the same 3 mm slice selective hp 83Kr images as Fig. 3A, but with a delay period

td between inhalation and start of the image acquisition ranging from 0.5 s to 1.5 s (td = 0 s in Fig. 3A). A new bolus of hp 83Kr was delivered for each of the images. As a clear trend observed directly in these PS 341 four images (Fig. 3A–D), the signal originating from the major airways was less affected by the delay time than the rest of the lung. The cause for the slower relaxation was presumably the smaller surface to volume (S/V) ratio in the airways as opposed to the alveolar space. Smaller airways were not resolved but contribute to the contrast observed in the MR images. Fig. 3E shows a T1 relaxation time map obtained from the td dependent signal decay of each volume element in Fig. 3A–D. The longitudinal relaxation time (averaged over 20 this website voxel) for the trachea is T1 = 5.3 ± 1.9 s and T1 = 3.0 ± 0.9 s for the main stem bronchus. The averaged relaxation times measured in lung parenchyma adjacent to the major airways and in the periphery of the lung are T1 = 1.1 ± 0.2 s and T1 = 0.9 ± 0.1 s respectively. The signal decays of selected voxel are shown in Fig. 4. The observed T1 data are in reasonable agreement with previous,

spatially unresolved bulk measurements of 83Kr T1 relaxation in excised rat lungs that also demonstrated that the addition of up to 40% of O2 did not significantly alter the T1 times [22]. SQUARE originates from surfaces but its effect is detected in the gas phase due to rapid exchange. It is however not known to what depth the alveolar surface, which is comprised Fossariinae of surfactant molecules and proteins, followed by a water layer, cell tissue, and the vascular system (filled with phosphate buffer solution in this work), is probed by the SQUARE effect. The relaxation of the krypton dissolved in extracellular water is too slow, i.e. T1 = 100 ms at 298 K [29], to be a major contributor to the observed T1 values in the alveolar region, given the small quantity of krypton dissolved in extracellular water. SQUARE may therefore originate from a deeper layer (i.e. cell tissue)

or may be caused by interactions of the krypton atoms with the outer surfactant layer. The answer to this question could have profound impact on potential usage of SQUARE for disease related contrast but its exploration is beyond the scope of this work. As Fig. 2 and Fig. 3 demonstrate, the extraction technique from low pressure (90–100 kPa) SEOP cells works well, generating reproducibly Papp = 2.0% with a line narrowed laser providing 23.3 W of power incident at the SEOP cell. This resulted in an approximately 10 fold increase in MR signal intensity as compared to the previously published results on hp 83Kr MRI in excised rat lungs [19]. An additional factor of 8.7 improvement in signal to noise ratio was achieved by using isotopically enriched to 99.925% 83Kr gas.

The phytoplankton groups differ in maximum growth rates, sinking

The phytoplankton groups differ in maximum growth rates, sinking rates, nutrient requirements, and optical properties. The 4 nutrients are nitrate, regenerated ammonium, silica to regulate diatom growth, and iron. Three detrital pools provide storage of organic material, sinking, and eventual remineralization. Carbon

Nutlin-3a order cycling involves dissolved organic carbon (DOC) and dissolved inorganic carbon (DIC; Fig. 2). DOC has sources from phytoplankton, herbivores, and carbon detritus, and a sink to DIC. DIC has sources from phytoplankton, herbivores, carbon detritus, and DOC, and is allowed to exchange with the atmosphere, which can be either a source or sink. The ecosystem sink for DIC is phytoplankton, through photosynthesis. This represents the biological pump portion PI3K inhibitors ic50 of the carbon dynamics. The solubility pump portion is represented by the interactions among temperature, alkalinity

(parameterized as a function of salinity), silica, and phosphate (parameterized as a function of nitrate). The alkalinity/salinity parameterization utilizes the spatial variability of salinity in the model adjusted to mean alkalinity TA=TA̲S/S̲where TA is total alkalinity and S is salinity. The underscore represents global mean values. TA is specified as 2310 μE kg−1 (Ocean Model Intercomparison Project (OCMIP; www.ipsl.jussieu.fr/OCMIP) and S as 34.8 PSU (global model mean). Since the model contains nitrate but not phosphate, we estimate phosphate by multiplying nitrate by 0.1. This is derived from the global mean ratio of nitrate to phosphate from NODC for their top three Florfenicol standard levels. The calculations for the solubility pump follow the standards set by the Ocean Model Intercomparison Project (reference above). We recognize that this approximation for alkalinity is not optimal, but the surface results compare favorably with data (see Gregg et al., 2013). The difference between the model and GLODAP global surface alkalinity is 2.7 μEq l−1

(=0.1%) with basin correlation of 0.95 (P < 0.05) ( Gregg et al., 2013). We consider this sufficient for the present purpose of intercomparing model results from forcing by different reanalysis products. We employ a locally-developed lookup table valid over modern ranges of DIC, salinity, temperature, and nutrients for computational efficiency, at little cost to accuracy. Air–sea CO2 exchange as a function of wind uses the Wanninkhof (1992) formulation, as is common in global and regional ocean carbon models (e.g., McKinley et al., 2006). A more complete description of NOBM can be found in Gregg et al. (2013). NOBM is spun-up for 200 years under climatological forcing from each reanalysis. Initial conditions for DIC are derived from the Global Data Analysis Project (GLODAP; Key et al., 2004). DOC initial conditions are set to 0 μM. Subsequent tests with non-zero DOC initial conditions showed negligible differences. Other initial conditions are described in Gregg and Casey (2007).

Scale size was determined by scanning electron microscopy To tes

Scale size was determined by scanning electron microscopy. To test the hypothesis that scales were a haven for Fusarium, leaves were inoculated with conidia. Detached leaves were disinfected with 1.5% hypochlorite and rinsed with distilled water. Leaves were inoculated at about 2 cm from the leaf base, within the non-chlorophylled potion, with 100 μl of the fungal suspension (105 conidia ml−1) of F. guttiforme (E-203; NRRL25624). Fungus was derived from single conidia from the INCAPER Plant Pathology Laboratory, according to Ventura (1994). Leaves inoculated with sterile

distilled water were used as control. A paradermic section of 1 cm2 was obtained from the abaxial face 24 h post-inoculation (hpi). These portions were cut and suspended in saline (0.9%), selleck screening library vortexed, diluted in saline and plated on potato dextrose agar (PDA

– Oxoid Unipath Ltda, Basingstoke, Hampshire, UK) to determine the number of colony forming units (CFU/cm2) of F. guttiforme. To confirm the identity of the colonies, slides were prepared from representative colonies, stained with lactophenol–cotton blue (0.1%) and observed under light microscopy. To observe surface germination of conidia, leaves were disinfected and rinsed as above. The leaf surface learn more was injured by use of a histological pin and immediately inoculated with conidia (105 conidia ml−1). After 24 hpi, leaf samples were free-hand cut in transverse sections and the sections were stained for 1–2 min., using lactophenol–cotton blue

(0.1%) for analyses of fungal hyphae in the scales. Statistical analysis was performed using completely randomized blocks with 5 repetitions. Each repetition was the means of 3 different leaves. Means were compared www.selleck.co.jp/products/Etopophos.html using Tukey’s tests with significance set at P < 0.05. Previous observation under field conditions showed absence of any fusariosis symptoms on cv. Vitoria, whilst the cv. Smooth Cayenne presented intermediate severity of the disease and cv. Perola extreme severity of fusariosis symptoms (Ventura and Zambolim, 2002). The anatomy of the pineapple leaf has already been described for ‘Smooth Cayenne’ by Krauss (1949). Our observations of the cultivars Vitoria and Perola found identical structures in each case. Scales were found on the surface of the unstratified epidermis of the hypostomatic leaf (Fig. 1A). Scales are peltate formed by a stalk inserted in the epidermis with a disk form head of shield-like (scutiform) structure (Fig. 1B–E). In frontal view the young scales present a group of central isodiametic cells, surrounded by a series of elongated cells. All these aggregated cells form a symmetrical shield (Fig. 1B). In mature scales, cells in the central region become less evident, the shield increases in size and becomes more asymmetric (405 μm of length ± 72), with a region formed of elongated cells (Fig. 1C and D).

These studies indicated an association between recurrent concussi

These studies indicated an association between recurrent concussion and both clinically diagnosed MCI45 Osimertinib and an increased risk of clinical depression44 in retired professional football players with an average age ± SD of 53.8±13.4 years and an average ± SD professional football playing career of 6.6±3.6 years. Besides having cross-sectional designs, a number of methodological weaknesses exist in these studies. The response rate was only 55%, and selection bias is a threat since it is unknown whether

respondents differed from nonrespondents. Other weaknesses include the lack of control for potential confounders (eg, chronic pain and substance abuse) and the risk of information bias (ie, self-reported memory problems might not indicate real or objective memory problems).

A significant limitation of these studies was the use of a self-reported history of concussion, since imperfect recall can generate differential recall bias.47 Kerr et al47 assessed the reliability of concussion history in this same cohort of retired professional football players and found that those who reported more concussions had worse physical and mental health at follow-up. This differential recall NVP-BKM120 molecular weight bias would result in an overestimation of the risk of MCI45 and depression44 resulting from concussions. In other words, those with MCI or depression, as well as their spouses, might have overreported their concussions, while those without these conditions might have underreported their concussions. Furthermore, Kerr et al demonstrated Fluorometholone Acetate that the reliability of concussion reporting was moderate (weighted Cohen κ=.48).47 This would result in a significant amount of misclassification of exposure status. Thus, the associations observed by Guskiewicz linking recurrent concussion with late-life MCI and depression may be misleading because of differential recall bias and other study weaknesses. Injury prevention and evidence-based

management should remain a high priority for amateur and professional athletes alike regardless of these possible negative associations, since most would agree that repeated head trauma is undesirable. However, ongoing publicity about “brain damage” after sport concussion might have a deleterious effect on recovery. Iverson and Gaetz48 state that it is important to avoid over-pathologizing neuropsychological test scores and postconcussion symptoms because this can inadvertently cause athletes to feel undue stress, anxiety, and depression. Athletes who worry and focus on their symptoms are at increased risk for protracted recovery patterns.48 We found no acceptable phase III studies that investigated prognosis after sport concussion. Of the 19 acceptable studies, approximately half were phase II, with the remainder being phase I; all provided exploratory evidence for potential associations between prognostic factors and recovery from sport concussion.