Background Early detection of dementia is critical for intervention and care planning but remains difficult. Computerized cognitive testing provides an accessible and promising solution to address these current challenges. Objective The aim of this study was to evaluate a computerized cognitive testing battery (BrainCheck) for its diagnostic accuracy and ability to distinguish the severity of cognitive impairment. Methods A total of 99 participants diagnosed with dementia, mild cognitive impairment (MCI), or normal cognition (NC) completed the BrainCheck battery. Statistical analyses compared participant performances on BrainCheck based on their diagnostic group. Results BrainCheck battery performance showed significant differences between the NC, MCI, and dementia groups, achieving 88% or higher sensitivity and specificity (ie, true positive and true negative rates) for separating dementia from NC, and 77% or higher sensitivity and specificity in separating the MCI group from the NC and dementia groups. Three-group classification found true positive rates of 80% or higher for the NC and dementia groups and true positive rates of 64% or higher for the MCI group. Conclusions BrainCheck was able to distinguish between diagnoses of dementia, MCI, and NC, providing a potentially reliable tool for early detection of cognitive impairment.

Understanding factors affecting the susceptibility of organisms to thermal stress is of enormous interest in light of our rapidly changing climate. When adaptation is limited, thermal acclimation and deacclimation abilities of organisms are critical for population persistence through a period of thermal stress. Holobionts (hosts plus associated symbionts) are key components of various ecosystems, such as coral reefs, yet the contributions of their two partners to holobiont thermal plasticity are poorly understood. Here, we tested thermal plasticity of the freshwater cnidarian Hydra viridissima (green hydra) using individual behavior and population responses. We found that algal presence initially reduced hydra thermal tolerance. Hydra with algae (symbiotic hydra) had comparable acclimation rates, deacclimation rates, and thermal tolerance after acclimation to those without algae (aposymbiotic hydra) but they had higher acclimation capacity. Acclimation of the host (hydra) and/or symbiont (algae) to elevated temperatures increased holobiont thermal tolerance and these effects persisted for multiple asexual generations. In addition, acclimated algae presence enhanced hydra fitness under prolonged sublethal thermal stress, especially when food was limited. Our study indicates while less intense but sublethal stress may favor symbiotic organisms by allowing them to acclimate, sudden large, potentially lethal fluctuations in climate stress likely favor aposymbiotic organisms. It also suggests that thermally stressed colonies of holobionts could disperse acclimated hosts and/or symbionts to other colonies, thereby reducing their vulnerability to climate change.

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Despite its high frequency of occurrence, mild traumatic brain injury (mTBI), or concussion, is difficult to recognize and diagnose, particularly in pediatric populations. Conventional methods to diagnose mTBI primarily rely on clinical questionnaires and sometimes include imaging such as computed tomography (CT) or pencil and paper neuropsychological testing. However, these methods are time consuming, require administration/interpretation from health professionals, and lack adequate test sensitivity and specificity. We explore the use of BrainCheck, a computerized neurocognitive test that is available on iPad, iPhone or computer desktop, for mTBI assessment. The BrainCheck battery consists of 6 gamified traditional neurocognitive tests that assess areas of cognition vulnerable to mTBI such as attention, processing speed, executing functioning, and coordination. We administered BrainCheck to 25 participants diagnosed with mTBI at the emergency department (ED) of Children's hospital within 96 hours of admittance to the ED, and 153 normal controls at a local high school. Statistical analysis included Chi-Square tests, Analysis of Variance (ANOVA), independent sample t-tests, and Hochberg tests to examine differences between mTBI, diagnoses by current gold standard clinical exam, and control groups on each assessment in the battery. Significant metrics from these assessments were used to build a logistic regression model that distinguishes mTBI from non-mTBI participants. Receiver operator score (ROC) analysis of our logistic regression model found a sensitivity of 84% and specificity of 80%. BrainCheck has potential in distinguishing mTBI from non-mTBI participants, by providing a shorter, gamified test battery to assess cognitive function after brain injury, while also providing a method for tracking recovery with the opportunity to do so remotely from a patient's home.