Physiology

Women and endurance running part one: how to train with your cycle – Canadian Running Magazine

Dr. Stacy Simsis a researcher, entrepreneur, recreational athlete and scientist whose area of expertise is exercise physiology and sports nutrition. Early in her career, she became frustrated by the fact that the vast majority of sports science treated women like small men most studies were conducted on men, and all the training, recovery and nutrition principles we learned from those studies were applied to women, despite the fact that female physiology is different from that of a man. We sat down with her to talk about these differences to determine how women runners can work with their bodies to become stronger, faster and healthier athletes.

RELATED: Why sports medicine research needs more women

Today, in Part One of this series, we will be diving into the female menstrual cycle and how it affects training. Part Two will cover nutrition strategies to boost performance throughout your cycle and how contraceptives affect training, and Part Three will look at puberty, perimenopause and menopause.

One of the most obvious differences between women and men, of course, is the female menstrual cycle. For years, a womans period was seen as being detrimental to her performance, but Sims says this is entirely false.

If you dont have a period, its detrimental [to your performance], she explains. Having a period means youre healthy, youre adapting and youre resilient to stress.

Sims explains that the reason having a period developed such a negative connotation in sports is because of the way sport developed. In the beginning, she says it acted as a male demonstration of aggression, with an emphasis on traditionally male qualities, like speed, strength, aggression and power. There has always been a taboo around the female menstrual cycle, so when you bring that into the sporting context, it came across as a weakness. Because of this, the idea that not having a period meant you were just as strong or trained just as hard as the men became endemic in sport.

This couldnt be farther from the truth. Having a period means youre getting enough nutrients to support your health and your training, your body is responding well to training adaptations and stress, your sleep patterns are good, your endocrine system is healthy and youre in an energy balance. No longer getting a regular period is the first red flag that something is amiss, and sets you up for health complications down the road, like loss of bone density, irregular sleep patterns and hormone dysfunction, among others.

Sims says that for so long, women have been told that when theyre on their periods, they should feel flat, tired, awful and that they should be hiding. Instead, she argues, we should be telling women the opposite that their periods are an opportunity to increase the intensity of their training sessions.

The more we get women to move during their periods, the better it is and the less symptomatology they have, she explains.

From a physiology standpoint, this also makes a lot of sense. The week that youre on your period (days one through seven of your cycle) is when your hormones are at their lowest point, and this makes your body more resilient to stress. This, then, is the time to do more high-intensity sessions, because you recover much better. The only caveat to this, says Sims, is women who experience heavy bleeding during the first couple of days of their period. In this case, you want to keep moving but shift the focus from high intensity to technical work like drills, or simply moving for movings sake. You can hit your training hard again once the heavy bleeding subsides.

The myths and perceptions around bleeding need to be extracted from the training conversation, says Sims.

Around ovulation, which is usually around day 14 of the cycle for most women, is another good time to schedule a hard training session. After that, as your levels of estrogen and progesterone begin to rise again, Sims suggests focusing more on steady-state runs. Finally, the five days before your period starts, which is when your body is most affected by hormones, should be treated more like a de-load or off-week. This is the time to back off the intensity and focus on other aspects of training like running drills, de-loading in the gym and working on technique. Every woman will be slightly different, so its important to track your cycle and take note of the days you feel better and the days you feel worse, and adjust your training plan accordingly. While there are many ways to do this, Sims is a big fan of the app, Wild AI.

If youre coaching a team of female athletes, Sims recommends coming up with a system that allows you to keep track of where each of your athletes are at, so that you can adjust their training accordingly (or, at the very least, adjust your expectations of individual athletes depending on the day).

This is where training is different than performance, says Sims. Train according to your menstrual cycle, but we know that the psychological aspect of performance supersedes the physiological.

If, for example, your race ends up falling on a day during your cycle that you typically dont feel your best, its easy to let that get to your head. Putting certain nutrition interventions in place and boosting yourself up mentally will help you overcome whatever physiological downfall you might be experiencing.

We have to separate out performance versus training, which hasnt been done well yet, explains Sims. When we talk about performance, theres never a negative point in the menstrual cycle. When we talk about training, there are ups and downs. We can get better training adaptations when our bodies are more resilient to stress, and then start to taper down to support that hard training. But for performance, just go, just hit it hard.

The key takeaway from this is that a womans period should not be seen as a detriment to performance, but rather as a tool to make her a better athlete. If women can learn to work with their physiology rather than against it, they will be healthier, happier and faster runners.

RELATED: Exercising and your period: changing the conversation

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Women and endurance running part one: how to train with your cycle - Canadian Running Magazine

Physiology

Is riding an electric bike good exercise, or just convenient transportation? – The Irish Times

Does riding an electric bike to work count as exercise, and not just a mode of transportation?

It can, if you ride right, according to a pragmatic new study comparing the physiological effects of e-bikes and standard road bicycles during a simulated commute. The study, which involved riders new to e-cycling, found that most could complete their commutes faster and with less effort on e-bikes than standard bicycles, while elevating their breathing and heart rates enough to get a meaningful workout.

But the benefits varied and depended, to some extent, on how peoples bikes were adjusted and how they adjusted to the bikes. The findings have particular relevance at the moment, as pandemic restrictions loosen and offices reopen, and many of us consider options other than packed trains to move ourselves from our homes to elsewhere.

Few people bike to work. Asked why, many tell researchers that bike commuting requires too much time, perspiration and accident risk. Simultaneously, though, people report a growing interest in improving their health and reducing their ecological impact by driving less.

In theory, both these hopes and concerns could be met or minimised with e-bikes. An alluring technological compromise between a standard, self-powered bicycle and a scooter, e-bikes look almost like regular bikes but are fitted with battery-powered electric motors that assist pedalling, slightly juicing each stroke.

With most e-bikes, this assistance is small, similar to riding with a placid tailwind, and ceases once you reach a maximum speed of about 30km/h or stop pedalling. The motor will not turn the pedals for you.

Essentially, e-bikes are designed to make riding less taxing, which means commuters should arrive at their destinations more swiftly and with less sweat. They can also provide a psychological boost, helping riders feel capable of tackling hills they might otherwise avoid. But whether they also complete a workout while e-riding has been less clear.

So, for the new study, which was published in March in the Translational Journal of the American College of Sports Medicine, researchers at Miami University in Oxford, Ohio decided to ask inexperienced cyclists to faux-commute. To do so, they recruited 30 local men and women, aged 19 to 61, and invited them to the physiology lab to check their fitness levels, along with their current attitudes about e-bikes and commuting.

Then, they equipped each volunteer with a standard road bike and an e-bike and asked them to commute on each bike at their preferred pace for approximately 5km. The cyclists pedalled around a flat loop course, once on the road bikes and twice with the e-bike. On one of these rides, their bike was set to a low level of pedal assistance, and on the other, the oomph was upped until the motor sent more than 200 watts of power to the pedals. Throughout, the commuters wore timers, heart rate monitors and facial masks to measure their oxygen consumption.

Afterward, to no ones surprise, the scientists found that the motorised bikes were zippy. On e-bikes, at either assistance level, riders covered the 5km several minutes faster than on the standard bike about 11 or 12 minutes on an e-bike, on average, compared to about 14 minutes on a regular bike. They also reported that riding the e-bike felt easier. Even so, their heart rates and respiration generally rose enough for those commutes to qualify as moderate exercise, based on standard physiological benchmarks, the scientists decided, and should, over time, contribute to health and fitness.

But the cyclists results were not all uniform or constructive. A few riders efforts, especially when they used the higher assistance setting on the e-bikes, were too physiologically mild to count as moderate exercise. Almost everyone also burned about 30 per cent fewer calories while e-biking than while road riding 344 to 422 calories on average on an e-bike versus 505 calories on a regular bike which may be a consideration if someone is hoping to use bike commuting to help lose weight.

And several riders told the researchers they worried about safety and control on the e-bikes, although most, after the two rides, reported greater confidence in their bike-handling skills, and found the e-commutes, compared to the road biking, more fun.

This study, though, was obviously small-scale and short-term, involving only three brief pseudo-commutes. Still, the findings suggest that riding an e-bike, like other forms of active transport, can be as good for the person doing it as for the environment, says Helaine Alessio, the chair of the department of kinesiology at Miami University, who led the new study with her colleague Kyle Timmerman and others.

But to increase your potential health benefits the most, she says, keep the pedal assistance level set as low as is comfortable for you. Also, for the sake of safety, practice riding a new e-bike or any standard bike on a lightly trafficked route until you feel poised and secure with bike handling.

Wear bright, visible clothing, too, and choose your commuting route wisely, Dr Alessio says. Look for bike paths and bike lanes whenever possible, even if you need to go a little bit out of your way. New York Times

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Is riding an electric bike good exercise, or just convenient transportation? - The Irish Times

Physiology

Quantifying stress & anxiety: Why corporate wellness programs will play a pivotal role in this paradigm shift – MedCity News

The past decade has seen us come on leaps and bounds as a society in our awareness and understanding of the scale and impact of mental health problems. In recent years, the focus has switched somewhat from reaction to prevention in parallel with the healthcare industry as a whole, in a bid to secure the sustainability of care services.

The economic impact of the mental health epidemic is a key driver behind governments and businesses move towards more preventive wellbeing initiatives. For instance, the World Health Organization (WHO) estimates that mental health problems in the workplace cost the global economy $1 trillion annually in lost productivity.

Stress and anxiety contribute heavily to this statistic. Stress is defined as the bodys reaction to feeling threatened or under pressure. Anxiety, which is often linked to stress, is defined as a feeling of unease, such as worry or fear, which can be mild or severe and is the main symptom of several mental disorders.

In the UK, for example, 57% of all working days lost to ill health were due to stress and anxiety in 2018. Its a similar story in the US, where its estimated that over half of all working days lost annually from absenteeism are stress-related, with the annual cost in 2013 alone equating to over $84 billion.

Stress and anxiety can also have a significant impact on an individuals physical health, affecting their work performance and productivity and causing further absenteeism. This form of poor mental health can impact physical health either directly through autonomic nervous system activity or indirectly as a result of unhealthy behaviors (e.g. poor diet, physical inactivity, alcohol abuse and smoking), increasing an individuals risk of developing cardiovascular problems.

It is therefore in an effort to break this chain, and in doing so save costs long-term, that employers are increasing their focus on establishing effective wellness programs, meaning any promotional activity or organizational policy that supports healthy behavior in the workplace and improves health outcomes. Corporate wellness programs nowadays include anything from healthy eating education, financial advice and access to weight loss and fitness programs, to more direct healthcare such as on-site medical screening, stress management, smoking cessation programs, and counseling services (in the form of employee assistance programs).

And this certainly can save costs long-term! Most famously, Johnson & Johnson leaders estimate that wellness programs have cumulatively saved the company $250 million on healthcare costs over the past decade; with a return of $2.71 for every dollar spent between 2002 and 2008. Its no surprise, then, that in 2020 the workplace wellness industry was estimated to be worth $48 billion globally.

Recent innovations in the space include the integration of wearable or smartphone technologies, used by employees to monitor and collect physical health data. These technologies provide employees with real-world physiological health insights to further incentivize participation in programs and increase and maintain their engagement. They simultaneously provide employers with an insight into the overall physical health of their workforce.

A golden opportunity to transform our relationship with mental health

However, with this most recent integration of digital health technologies comes a hitherto unrecognized opportunity to transform our understanding and treatment of mental health and wellbeing.

One of the primary barriers to delivering quality mental health care throughout history has been the difficulty in establishing accurate and objective methods to diagnose, assess and monitor treatment outcomes for psychological conditions. As was explained so eloquently by Washington University in November last year, if patients display symptoms of a heart attack, there are biological tests that can be run to look for diagnostic biomarkers that determine whether they are indeed suffering a heart attack or not. However, in the case of mental health disorders, the window by which we access the mind is still through psychological questioning, not biological parameters.

Mental health professionals screen, diagnose and monitor the symptoms and outcomes of patients through self-reported methods prone to excess subjectivity and therefore unreliability, such as diagnostic interviews and questionnaires. A patients self-reported symptoms are correlated with the ICD or DSM diagnostic manuals, yet challenges arise in the high heterogeneity of mental illnesses, low inter-rate reliability (i.e. poor agreement between clinicians diagnoses) and high comorbidity.

There is therefore a need to expand further than solely symptom-based to biology-based characterization of mental health conditions if we are to combat this unreliability and establish more evidence-based methods for diagnosis and monitoring, similar to our approach to physical illness.

So, how do we do this?

The National Institute for Mental Health for instance has already taken the first steps towards this with the RDoC (Research Domain Criteria). Advancements in MRI technology have also enabled research into understanding brain activity in certain depressive conditions.

But the most exciting development lies in the proliferation of wearable and smartphone health monitoring technologies. As the ability to collect vast amounts of physiological health data becomes more and more ubiquitous, the opportunity to utilize machine learning (ML) to extract new insights into the physiology of each individual grows larger.

With this comes the chance to uncover and establish personalized digital biomarkers for mental health conditions; described as indicators of mental state that can be derived through a patients use of a digital technology. These digital biomarkers can cover physiology (e.g. heart rate), cognition (e.g. eye movement on screens), behavioral (e.g. via GPS) and social (e.g. call frequency) factors. However, it is physiology that concerns us here.

Corporate wellness programs provide the perfect environment to explore the use of wearables and smartphone sensors in uncovering digital biomarkers which link physical health to mental wellbeing due to the huge potential benefits for all parties involved; employers and employees.

For example, by validating elements of cardiopulmonary functions as a digital biomarker for excess stress or anxiety disorders (a relationship for which some empirical evidence already exists), employers can not only identify stress and anxiety risks in the workplace and intervene earlier to protect employee mental wellbeing, but also establish an evidence-based approach for evaluating the effectiveness of workplace wellness initiatives. This is due to the fact that quantitative cardiopulmonary data would serve as a reliable measure of employee stress and/or mental wellbeing.

Employees, on the other hand, are empowered with insight into direct correlations between how they feel and their physical health. Therefore their increased engagement in wellness programs will improve their efficacy in preventing the deterioration of their mental health. For this reason, accessibility and ease-of-use must remain top of mind when choosing health monitoring technologies.

Finally, establishing digital biomarkers which correlate physiological parameters with mental health and wellbeing not only has the potential to provide more reliable tools for guiding diagnosis and evaluating patient outcomes but will also improve our understanding of the pathophysiology of mental disorders, in turn allowing for more effective preventive measures.

Photo: Creativeye99, Getty Images

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Quantifying stress & anxiety: Why corporate wellness programs will play a pivotal role in this paradigm shift - MedCity News

Physiology

Compound may prevent risk of form of arrhythmia from common medications – Washington University in St. Louis Newsroom

Dozens of commonly used drugs, including antibiotics, anti-nausea and anticancer medications, have a potential side effect of lengthening the electrical event that triggers contraction, creating an irregular heartbeat, or cardiac arrhythmia called acquired Long QT syndrome. While safe in their current dosages, some of these drugs may have a more therapeutic benefit at higher doses, but are limited by the risk of arrhythmia.

Through both computational and experimental validation, a multi-institutional team of researchers has identified a compound that prevents the lengthening of the hearts electrical event, or action potential, resulting in a major step toward safer use and expanded therapeutic efficacy of these medications when taken in combination.

The team found that the compound, named C28, not only prevents or reverses the negative physiological effects on the action potential, but also does not cause any change on the normal action potential when used alone at the same concentrations. The results, found through rational drug design, were published online in Proceedings of the National Academy of Sciences (PNAS) on May 14.

The research team was led by Jianmin Cui, professor of biomedical engineering in the McKelvey School of Engineering at Washington University in St. Louis; Ira Cohen, MD, PhD, Distinguished Professor of Physiology and Biophysics, professor of medicine and director of the Institute for Molecular Cardiology at the Renaissance School of Medicine at Stony Brook University; and Xiaoqin Zou, professor of physics, biochemistry and a member of the Dalton Cardiovascular Research Center and Institute for Data Science and Informatics at the University of Missouri.

The drugs in question, as well as several that have been pulled from the market, cause a prolongation of the QT interval of the heartbeat, known as acquired Long QT Syndrome, that predisposes patients to cardiac arrhythmia and sudden death. In rare cases, Long QT also can be caused by specific mutations in genes that code for ion channel proteins, which conduct the ionic currents to generate the action potential.

Although there are several types of ion channels in the heart, a change in one or more of them may lead to this arrhythmia, which contributes to about 200,000 to 300,000 sudden deaths a year, more deaths than from stroke, lung cancer or breast cancer.

The team selected a specific target, IKs, for this work because it is one of the two potassium channels that are activated during the action potential: IKr (rapid) and IKs (slow).

The rapid one plays a major role in the action potential, said Cohen, one of the worlds top electrophysiologists. If you block it, Long QT results, and you get a long action potential. IKs is very slow and contributes much less to the normal action potential duration.

It was this difference in roles that suggested that increasing IKs might not significantly affect normal electrical activity but could shorten a prolonged action potential.

Cui, an internationally renowned expert on ion channels, and the team wanted to determine if the prolongation of the QT interval could be prevented by compensating for the change in current and inducing the Long QT Syndrome by enhancing IKs. They identified a site on the voltage-sensing domain of the IKs potassium ion channel that could be accessed by small molecules.

Zou, an internationally recognized expert who specializes in developing new and efficient algorithms for predicting protein interactions, and the team used the atomic structure of the KCNQ1 unit of the IKs channel protein to computationally screen a library of a quarter of a million small compounds that targeted this voltage-sensing domain of the KCNQ1 protein unit. To do this, they developed software called MDock to test the interaction of small compounds with a specific protein in silico, or computationally.

By identifying the geometric and chemical traits of the small compounds, they can find the one that fits into the protein sort of a high-tech, 3D jigsaw puzzle. While it sounds simple, the process is quite complicated as it involves charge interactions, hydrogen bonding and other physicochemical interactions of both the protein and the small compound.

We know the problems, and the way to make great progress is to identify the weaknesses and challenges and fix them, Zou said. We know the functional and structural details of the protein, so we can use an algorithm to dock each molecule onto the protein at the atomic level.

One by one, Zou and her lab docked the potential compounds with the protein KCNQ1 and compared the binding energy of each one. They selected about 50 candidates with very negative, or tight, binding energies.

Cui and his lab then identified C28 using experiments out of the 50 candidates identified in silico by Zous lab. They validated the docking results by measuring the shift of voltage-dependent activation of the IKs channel at various concentrations of C28 to confirm that C28 indeed enhances the IKs channel function. They also studied a series of genetically modified IKs channels to reveal the binding of C28 to the site for the in silico screening.

Cohen and his lab tested the C28 compound in ventricular myocytes from a small mammal model that expresses the same IKs channel as humans. They found that C28 could prevent or reverse the drug-induced prolongation of the electrical signals across the cardiac cell membrane and minimally affected the normal action potentials at the same dosage. They also determined that there were no significant effects on atrial muscle cells, an important control for the drugs potential use.

We are very excited about this, Cohen said. In many of these medications, there is a concentration of the drug that is acceptable, and at higher doses, it becomes dangerous. If C28 can eliminate the danger of inducing Q-T prolongation, then these drugs can be used at higher concentrations, and in many cases, they can become more therapeutic.

While the compound needs additional verification and testing, the researchers say there is tremendous potential for this compound or others like it and could help to convert second-line drugs into first-line drugs and return others to the market. With assistance from the Washington University Office of Technology Management, they have patented the compound, and Cui has founded a startup company, VivoCor, to continue to work on the compound and others like it as potential drug candidates.

The work was accelerated by a Leadership and Entrepreneurial Acceleration Program (LEAP) Inventor Challenge grant Washington University in St. Louis in 2018 funded by the Office of Technology Management, the Institute of Clinical and Translational Sciences, the Center for Drug Discovery, the Center for Research Innovation in Biotechnology, and the Skandalaris Center for Interdisciplinary Innovation and Entrepreneurship.

This work was done by an effective drug design approach: identifying a critical site in the ion channel based on understanding of structure-function relation, using insilico dockingto identify compounds that interact with the critical site in the ion channel, validating functional modulation of the ion channel by the compound, and demonstrating therapeutic potential in cardiac myocytes, Zou said. Our three labs form a great team, and without any of them, this would not be possible.

The McKelvey School of Engineering at Washington University in St. Louis promotes independent inquiry and education with an emphasis on scientific excellence, innovation and collaboration without boundaries. McKelvey Engineering has top-ranked research and graduate programs across departments, particularly in biomedical engineering, environmental engineering and computing, and has one of the most selective undergraduate programs in the country. With 140 full-time faculty, 1,387 undergraduate students, 1,448 graduate students and 21,000 living alumni, we are working to solve some of societys greatest challenges; to prepare students to become leaders and innovate throughout their careers; and to be a catalyst of economic development for the St. Louis region and beyond.

Lin Y, Grinter S, Lu Z, Xu X, Wang H Z, Liang H, Hou P, Gao J, Clausen C, Shi J, Zhao W, Ma Z, Liu Y, White, K M, Zhao L, Kang P W, Zhang G, Cohen I, Zou X, Cui J. Modulating the voltage sensor of a cardiac potassium channel shows antiarrhythmic effects. Proceedings of the National Academy of Sciences (PNAS), date, DOI.

This research was supported by grants from the National Institutes of Health (R01 HL126774, R01 DK108989, R01 GM109980, R35GM136409; the American Heart Association (13GRNT16990076). The computations were performed on the high-performance computing infrastructure supported by NSF CNS-1429294 and the HPC resources supported by the University of Missouri Bioinformatics Consortium (UMBC).

Authors Jianmin Cui and Jingyi Shi are cofounders of a startup company, VivoCor LLC, which is targeting IKs for the treatment of cardiac arrhythmia.

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Compound may prevent risk of form of arrhythmia from common medications - Washington University in St. Louis Newsroom

Physiology

Why we find the sound of our voice cringeworthy – Scroll.in

As a surgeon who specialises in treating patients with voice problems, I routinely record my patients speaking. For me, these recordings are incredibly valuable. They allow me to track slight changes in their voices from visit to visit, and it helps confirm whether surgery or voice therapy led to improvements.

Yet I am surprised by how difficult these sessions can be for my patients. Many become visibly uncomfortable upon hearing their voice played back to them.

Do I really sound like that? they wonder, wincing.

(Yes, you do.)

Some become so unsettled they refuse outright to listen to the recording much less go over the subtle changes I want to highlight.

The discomfort we have over hearing our voices in audio recordings is probably due to a mix of physiology and psychology.

For one, the sound from an audio recording is transmitted differently to your brain than the sound generated when you speak.

When listening to a recording of your voice, the sound travels through the air and into your ears what is referred to as air conduction. The sound energy vibrates the ear drum and small ear bones. These bones then transmit the sound vibrations to the cochlea, which stimulates nerve axons that send the auditory signal to the brain.

However, when you speak, the sound from your voice reaches the inner ear in a different way. While some of the sound is transmitted through air conduction, much of the sound is internally conducted directly through your skull bones. When you hear your own voice when you speak, it is due to a blend of both external and internal conduction and internal bone conduction appears to boost the lower frequencies.

For this reason, people generally perceive their voice as deeper and richer when they speak. The recorded voice, in comparison, can sound thinner and higher-pitched, which many find cringeworthy.

There is a second reason hearing a recording of your voice can be so disconcerting. It really is a new voice one that exposes a difference between your self-perception and reality. Because your voice is unique and an important component of self-identity, this mismatch can be jarring. Suddenly you realise other people have been hearing something else all along.

Even though we may actually sound more like our recorded voice to others, I think the reason so many of us squirm upon hearing it is not that the recorded voice is necessarily worse than our perceived voice. Instead, we are simply more used to hearing ourselves sound a certain way.

A study published in 2005 had patients with voice problems rate their own voices when presented with recordings of them. They also had clinicians rate the voices. The researchers found that patients, across the board, tended to more negatively rate the quality of their recorded voice compared with the objective assessments of clinicians.

So if the voice in your head castigates the voice coming out of a recording device, it is probably your inner critic overreacting and you are judging yourself a bit too harshly.

Neel Bhatt is an Assistant Professor of Otolaryngology, UW Medicine at the University of Washington.

This article first appeared on The Conversation.

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Why we find the sound of our voice cringeworthy - Scroll.in

Physiology

Life on Earth may be carbon-based, but another element matters, too > News > USC Dornsife – USC Dornsife College of Letters, Arts and Sciences

Marine microbiologist Doug Capone details the current understanding of the role nitrogen-fixing marine microbes play in the nitrogen cycle in his latest book. [5 min read]

Middle school students learn in science class about the carbon cycle the flow of carbon among the atmosphere, living organisms, soil and the oceans. But another, less familiar cycle also plays a crucial role in the balance of nature: the nitrogen cycle.

Nitrogen constitutes about 78% of the Earths atmosphere, where it exists mainly in its most stable form, a gas called dinitrogen, or N2. A significant amount also resides in the oceans as dissolved gas.

Most animals and plants cant use N2; they first need it turned into a more reactive form, such as ammonia, through a process called nitrogen fixation. But only certain microorganisms can fix nitrogen, and many of those live in marine environments. They draw the N2from the water and, using a specialized enzyme, break the bond between the two nitrogen atoms and attach other atoms to each, making new molecules that other living organisms can use.

The process is crucial to life on Earth and directly affects humans.

The oceans are becoming an ever-increasing source of food for humanity, and nitrogen fixation is critical in maintaining many marine food webs, saidDoug Capone, professor ofbiological sciencesat the USC Dornsife College of Letters, Arts and Sciences. His research focuses on understanding how ocean microbes affect the movement of important elements, including carbon and nitrogen, through plants and animals and from land to sea to air and back.

Getting a fix on global fixation

Capone has studied diverse ecological systems throughout the world, including the tropical open ocean, coral reefs, mangroves, temperate estuaries, groundwater aquifers and Antarctic snows.

A thorough understanding of the factors involved in nitrogen fixation in the oceans could help future generations safely and sustainably farm the oceans, he said.

Capone, collaborating with Jonathan Zehr of the University of California, Santa Cruz, recently publishedMarine Nitrogen Fixation(Springer, 2021), which summarizes the extensive research and current understanding of marine nitrogen fixation. The book builds onan articlethe pair wrote and published last year at the request of the journalScience.

Capone, who holds the William and Julie Wrigley Chair in Environmental Studies, and Zehr, a Distinguished Professor at UC Santa Cruz, are widely respected authorities on marine nitrogen fixation.

Ive been working on aspects of marine N2fixation since my days as a Ph.D. student, Capone said. His dissertation focused on the importance of N2fixation in the tropical seagrassThalassia, also known as turtle grass.

In shallow tropical waters, turtle grass forms dense meadows that many sea-going species from microbes to mollusks to manatees call home. Nitrogen-fixing microbes, known scientifically as diazotrophs, live on the plants leaves and its roots, providing a critical source of nitrogen in the nutrient-depleted tropical waters, Capone said.

Combined expertise in a vital field of study

After landing his first faculty position at New Yorks Stony Brook University in the late 70s, Capone turned his attention to the open ocean, and in the decades since, he has led many research cruises to locations throughout the globe and conducted extensive research on the physiology, ecology and biogeochemical impact of open ocean diazotrophs.

Hes also spent a large share of his career mentoring young scientists and brought many others into this field.

Ive trained a gaggle of researches in this area undergrads, grad students and postdocs as well as having entrained researchers from diverse fields into the area of marine nitrogen fixation, he said.

Zehr is among those researchers, having joined Capones Stony Brook University Lab as a postdoctoral fellow in 1980.

His postdoc with me was not on N2fixation, but he subsequently joined me on many of the cruises I led to study this process in the tropical ocean, said Capone.

Zehr has gone on to establish one of the best model systems for studying functional genes in the environment, according to Capone. Major advances in uncovering the vast biodiversity of microbes in the environment have generally relied upon analyzing the ribosomal genes genes involved in creating ribosomes that are common to all life to establish relationships and diversity. Zehr has instead used the genes directly involved with nitrogen fixation to find and characterize previously unknown microbes capable of fixing N2in the ocean and to track the expression of these genes.

Well-known for his work among the tiniest marine plankton, Zehr discovered a biological partnership, or symbiosis, of two microorganisms found throughout much of the worlds upper ocean.

One partner, the host alga, is eukaryotic meaning it has a nucleus and is autotrophic, able to use light energy and fix carbon; that is, take up carbon dioxide to feed itself and produce new organic molecules.

The other partner is a small, unicellular cyanobacterium, or blue-green alga, that can also derive energy from light but is unable to fix carbon. However, it does fix N2.

The two exchange metabolites in their symbiosis, and the cyanobacterium is a major player in fixing N2in the oceans, says Capone, who also hints that his and Zehrs combined expertise is a kind of symbiosis in its own right, making them particularly well-suited to put togetherMarine Nitrogen Fixation.

In many ways, we complement each other Jon on the molecular biology, physiology and biogeography of nitrogen fixation, myself focusing on ecology and biogeochemistry, Capone says.

In the book, which is primarily intended for scientists, graduate students and upper division undergraduates, he and Zehr give a detailed overview of the current understanding of global marine nitrogen fixation. Topics include which marine microorganisms are fixing nitrogen, where they live and what environmental factors including human-caused changes such as ocean warming and acidification impact microbial activity. And they point out that much about the physiology and regulation of N2fixation remains to be uncovered.

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Life on Earth may be carbon-based, but another element matters, too > News > USC Dornsife - USC Dornsife College of Letters, Arts and Sciences

Physiology

Honoring the Class of 2021 – Daily Sentinel

REEDSVILLE Members of the Eastern High School Class of 2021 were recognized for their athletic and academic achievement during an awards ceremony on Thursday at Eastern High School.

Jenna Chadwell was announced as the Class of 2021 Valedictorian, with Layna Catlett announced as the Class of 2021 Salutatorian.

The remainder of the Top 10 of the Class of 2021 includes Jonna Epple, Olivia Barber, Skylar Honaker, Alysa Howard, Kelsey Roberts, Whitney Durst, Tessa Rockhold and Alisa Ord.

Class of 2021 graduates to receive an Honors Diploma include: Jake Barber, Olivia Barber, Layna Catlett, Jenna Chadwell, Whitney Durst, Jonna Epple, Ashton Guthrie, Skylar Honaker, Alysa Howard, McKenzie Long, Brianna Nutter, Alisa Ord, Kelsey Roberts, Kennadi Rockhold, Tessa Rockhold, and KayCee Schreckengost.

Jenna Chadwell was the WSAZ Best of the Class representative.

Class of 2021 National Honor Society members were Jake Barber, Matthew Blanchard, Natalie Browning, Layna Catlett, Whitney Durst, Jonna Epple, Ashton Guthrie, Skylar Honaker, Alysa Howard, Blake Newland, Brianna Nutter and Kelsey Roberts.

Hunter Corwin-Cline, a member of the Class of 2021 who passed away earlier this year, was recognized with the OHSAAs Courageous Student Award. Athletic Director Josh Fogle stated that the award recognized the strength, courage, and ability to overcome challenges which Hunter had shown during his life. The award was accepted by his mother Michelle Cline.

Athletic Awards

Steven Fitzgerald was recognized as the Ivan B. Walker Male Athlete of the Year. Sydney Sanders was recognized as the Ivan B. Walker Female Athlete of the Year.

Steven Fitzgerald and Ashton Guthrie received the OHSAA Archie Griffin Sportsmanship Award.

Matthew Blanchard and Jenna Chadwell received the OHSAA Scholar-Athlete Award.

Jake Barber and KayCee Schrekengost received the NFHS Award of Excellence.

US Army Reserve National Scholar-Athlete Awards were presented to Blake Newland and Whitney Durst.

Senior Athlete Awards were presented to Jake Barber, Olivia Barber, Matthew Blanchard, Layna Catlett, Jenna Chadwell, Whitney Durst, Jonna Epple, Steven Fitzgerald, Ashton Guthrie, Brad Hawk, Bruce Hawley, Alysa Howard, Derrisa Johnson, Owen Johnson, Jacey Martin, Blake Newland, William Oldaker, Alisa Ord, Conner Ridenour, Kelsey Roberts, Kennadi Rockhold, Tessa Rockhold, Sydney Sanders, KayCee Schrekengost, Faith Smeeks, Hunter Sisson and Preston Thorla.

Jim Barber was recognized with the Community Member Award.

Scholarships and additional awards

Eastern Athletic Boosters Scholarship Kelsey Roberts and Jake Barber, $1,000 each;

Emeri Connery Flying Eagle Scholarship Ashton Guthrie, $1,000;

Kevin Fick Scholarship Skylar Honaker, $1,000;

University of Rio Grande Jake Bapst Scholarship Whitney Durst, two years tuition approximately $10,000;

University of Rio Grande Robert S. Wood Scholarship Tessa Rockhold, $1,000;

4-H Cords Whitney Durst, Steven Fitzgerald, and McKenzie Long;

Jordan Hardwick Memorial Scholarship Tessa Rockhold;

Justin Hill Memorial Scholarship Jenna Chadwell and Tessa Rockhold, $500 each;

Eagles Scout Award Jake Barber;

Eastern Music Booster Scholarship Blake Newland and Matthew Blanchard;

Eastern Music Booster Awards Blake Newland, Matthew Blanchard, Derrisa Brewer-Johnson, Brogan Holter, Kelsey Reed, Katlyn Lawson, William Oldaker, Conner Ridenour, and Hunter Sisson.

ELEA Schoalrship Brad Hawk, Blake Newland and Nicole Bean (Athens High School), $500 each;

Board of Education Scholarships Valedictorian Scholarship, Jenna Chadwell, $550 (four years); Salutatorian Scholarship, Layna Catlett, $450 (four years); Green Scholarship, Jonna Epple, $425 (four years); White Scholarship, Skylar Honaker, $350 (two years);

William and Wilma Williams Scholarship Sydney Sanders and Whitney Durst, $750 each for four years;

Bill Call Scholarship Blake Newland, $2,100;

Lewis Parker Scholarship Alysa Howard, $1,000;

OVEC Kyger Creek Science Scholarship Jonna Epple, $450;

Eichinger Family Scholarship Layna Catlett and Alysa Howard, $2,500 each;

Hills Classic Cars Cruisin Saturday Night Car Show Scholarship Blake Newland, $1,000;

Washington State Community College Presidential Scholarship Skylar Honaker and Alisa Ord, $2,000 each per year;

Marshall University Opportunity Grant Alysa Howard, $2,000 per year;

Holzer Science Award Jonna Epple, $450;

Anatomy and Physiology Award Jonna Epple;

Calculus Kelsey Roberts;

Trigonometry Olivia Barber;

Transition to College Math Natalie Browning.

2021 Ohio Valley Publishing, all rights reserved.

Sydney Sanders receives the Ivan B. Walker Female Athlete of the Year award from Athletic Director Josh Fogle.

Steven Fitzgerald receives the Ivan B. Walker Male Athlete of the Year award from Athletic Director Josh Fogle.

Hunter Corwin-Cline, a member of the Class of 2021 who passed away earlier this year, was honored with the Courageous Student Award.

Skylar Honaker receives the Board of Education White Scholarship from board member Jessica Staley.

Michelle Cline, the mother of Hunter Corwin-Cline, accepts the Courageous Student Award from Athletic Director Josh Fogle in memory of her son Hunter.

Jake Barber was presented the Eagle Scout award and cords by Floyd Ridenour.

Jonna Epple receives the anatomy and physiology award and Holzer Science Award from Ginger Wills.

Members of the Eastern National Honor Society received their gold cords.

Whitney Durst, Steven Fitzgerald and McKenzie Long, 4-H members, received green cords to be worn at graduation from Carolyn Kesterson.

Tessa Rockhold receives the Jordan Hardwick Memorial Scholarship from Rebecca Birt.

Tessa Rockhold receives the University of Rio Grande Robert S. Wood Scholarship from Michelle Kennedy.

Kelsey Roberts receives the Eastern Athletic Booster Scholarship from Josh Fogle.

Eagles receive scholarships, awards

Sarah Hawley is the managing editor of The Daily Sentinel.

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Honoring the Class of 2021 - Daily Sentinel

Anatomy

Greys Anatomy Recap: Comings and Goings – Vulture

Photo: Richard Cartwright/ABC

Oh, Japril shippers, have you come back down from that high youve been riding since learning two weeks ago that our, lets call it improbable, dream of a reunion between Jackson and April as a romantic couple came true? Although nothing would be more of a balm to my weary soul than a hot Japril hookup after all this time, Im glad Greys Anatomy didnt push it too far and go there too fast theyre both single, in Boston together, and have never quite fit with another person the way they do each other, so, we know. And while Look Up Child offered us a nice emotional close to the character of Jackson Avery, Tradition is the real deal: Dr. Jackson Avery spends the episode saying good-bye to his friends and then finally peacing out from that glorious death trap that is Grey Sloan Memorial, at peace with his decision and eager to get started on the next thing.

Theres nothing too revelatory in Jacksons good-byes to the doctors most important to him, but they were all nice little homages to these relationships, and as an audience member from the beginning, all the clips from Greys-gone-by never fail to get me a little misty-eyed. He thanks Bailey and Webber for being examples of the kind of human, parent, and doctor he wanted to be when his own father failed so miserably. He thanks Jo for being a friend and for the hot sex. His good-bye with Meredith acknowledges both the bond they had over knowing what its like to have a last name with so much baggage and pressure and legacy, and the fact that they were the final two left from their residency year, and now itll be just Meredith. The Meredith/Jackson friendship was one that was always hinted at but never quite fully developed, but this scene complete with tears! was a nice little moment. It was all nice! Maybe weve just been worn down by the absolute dreariness of this season of Greys Anatomy, but it really was refreshing to find a whole bunch of story lines infused with hope and happiness. Who knew!

Speaking of, Meredith went home this week. Soon, that godforsaken beach will be a distant memory! Shes looking good, her tests are all great, and the doctors have no reason to keep her at the hospital any longer. Most of her exit story is about her wanting to avoid the surprise clap-out the hospital is planning for her and Bailey and Webber tiptoeing around telling Mer that DeLuca is dead. When they finally do, she looks upset for maybe five seconds and then informs them that DeLuca is okay because hes with his mother now, remembering their good-bye on the beach. And thats it! Dang, Mer! Thats cold. I mean, thankfully the episode sneaks in that moment between Jo and Carina Jo is officially in pink scrubs and a resident on Carinas service in which Jo, knowing that Carina is headed to Italy to help out at a hospital there and spread her brothers ashes, tells her how wonderful DeLuca was and that shes incredibly grateful to have known him. Its lovely! And also quite deserved since Andrew DeLuca did almost get beaten to death trying to help Jo, but like, come on, show, that shouldve been a conversation between Carina and Meredith, you know, the woman Andrew loved until the very end. DeLuca has been done so dirty!

After that anticlimactic reveal with Meredith, she gets Jackson to sneak her out of the hospital and drive her home without having to go through the fanfare of the clap-out. And then shes home and in a group hug with her kids and its all such a sigh of relief, isnt it?

There are other points of joy in this episode, including the patient story this week. A pregnant woman from the Suquamish tribe named Mary Ann comes in with her grandfather, who recently had COVID-19 and has now seeminglysuffered a stroke. Hes an elder in their tribe and a language carrier. As both Mary Ann and Intern Chee, who is Navajo, explain to Tom, COVID-19 has hit Native American populations hard and Mary Ann cannot lose her grandfather and their tribe cannot lose yetanother one of its leaders. Tom has itunder control. But, of course, Mary Ann goes into premature labor, which makes the stakes much higher!

Our new OB team, Carina and Jo, eventually help Mary Ann deliver little Rosie into the world. And her grandfather comes out of his stroke just fine thanks to Tom and a big assist from Intern Chee, who was raised by a family of healers and performs a smudging ceremony over Mr. Lawrence. Everyones okay, people! Today is not a day for sadness at Grey Sloan!

It is, however, a day for taking stock of how the pandemic has changed people. When Mr. Lawrence meets little Rosie over video chat, he tells her that one day shell get to tell the story of her birth, how she was born in a time of greatdevastation but that it led to a time of great resilience and change. And that she brought an abundance of joy with her when she arrived. Its a moving speech regardless, but it hits Tom especially hard. Throughout the episode, hes watched as Helm has burned out, learns that Jo had enough of surgery and so made a huge change in her career, and then after this speech, hes heard enough. He meets up with Jackson and explains to him that his experience with COVID has changed him. During histime in the hospital, he had six roommates who all died. He was the only white guy in the bunch and he was the onlyone thatsurvived and he needs to do something about that. He heard about Jacksons plans for the Fox Foundation and he wants in on the fight to change systemic racism in the health-care system. He doesnt care what the job is, what his title will be, or how much money is involved he simply wants to help, to be a true ally. Let me beworthy of being spared, he tells Jackson. Jackson hires him right there.

So we arent saying good-bye to just one doctor tonight Tom Koracick is headed to Boston, too. Dont completely despair, Tom fans: Greg Germann might be leaving Greys Anatomy as a series regular, but it seems hell be back for some guest-star stints in the future, so this isnt the lastweve seen of Tom Koracick. Still, Greys Anatomy is really shedding castmembers this season, huh?

Can we just talk about how Im already tearing up at the thought of Richard officiating Maggie and Winstons wedding? He was so sad coming to them apologizing for assuming hed be invited and worried he was stepping on toes, only to be so moved to hear that of course Maggies dad will be walking her down the aisle, but that they all couldnt think of a better person to marry them. My wish for them is a devastatingly romantic wedding.

Wait, so theres not even one final moment between Jackson and Maggie? After all weve been through watching those ding-dongs? Remember the killer fog???

Links so cute thinking hell ever get to move out of Merediths house and find some peace and quiet with Amelia and Scout. It turns out to be Owen who has to explain that the pull of that house and of the sister bond is so strong hes never fully getting out of there. Even Winston, who is new to these parts, can see Owens not making that up. Youre making it sound like a coven, Link says. Exactly, Link. Exactly.

The Helm stuff feels like a parallel to what this episode of Greys is doing as a whole its a bridge from the depressing mud weve been trudging through to something more hopeful, more like how things used to be. For Helm, we find her almostzombielike, so emotionally and physically spent from everything being a doctor duringthe pandemic has asked of her and she confides in Schmitt that all she can think about is walking away from medicine; she hates it now. But Schmitt sits by her side and seeing his best friend suffering so much, offers her a lifeline: She should move in with him (and Jo). No one should be alone through this. Her relief is palpable. For the first time in a long time, she feels lighter and hopeful.

Wow, okay, so Owen and Teddy are having lots of sex in the on-call room now? And smiling? What in the actual world?

Keep up with all the drama of your favorite shows!

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Greys Anatomy Recap: Comings and Goings - Vulture

Anatomy

UH Maui Anatomy and Physiology Instructor Honored for Excellence in Teaching – Maui Now

Trenton Niemi, anatomy and physiology instructor, UH Maui College

An anatomy and physiology instructor at the University of Hawaii Maui College STEM department was awarded the Regents Medal for Excellence in Teaching. The award recognizes faculty who exhibit an extraordinary level of subject mastery and scholarship, teaching effectiveness and creativity, and personal values beneficial to students.

Trenton Niemiwas born in Minnesota, but says he has always been called to the ocean.

University representatives say his commitment and dedication to his students has been recognized by his colleagues and students. Students laud his ability to make difficult concepts understandable, which is commendable considering the challenging nature of the material (i.e., anatomy, physiology).

Students also reported that he was an inspiring teacher. [He] explains in multiple ways so that we truly understand the information and he is the best instructor I have ever had, a student wrote.

Niemi moved toHawaiimore than 15 years ago and has taught withUHMaui College for 11 years, teachingPHYS141 and 142 lectures and labs as well as forKapiolaniCCs Emergency Medical Services Training program.

In addition to his passion for teaching, Niemis interests include bodyboarding, weight lifting and photography. Some of his photography can be seen on theUHMaui College channel.

He was among a list of 15 UH faculty members from across the state who were awarded the Regents Medal for Excellence in Teaching. Three additional instructors received the Regents Medal for Excellence in Research. In addition, six UH teachers have been recognized with the Frances Davis Award for Excellence in Undergraduate Teaching; and a Kauai Community College student and taro farmer has won the Masaki and Momoe Kunimoto Memorial Award for Outstanding Contributions to Vocational Education.

Our extraordinary, innovative, caring University of Hawaii faculty are second to none, said UH President David Lassner. Especially in these challenging times, their dedication and commitment elevates and inspires our students even as their scholarship and engagement helps address pressing global issues and improve lives across our islands.

The complete list of recipients of the Regents Medal for Excellence in Teaching, include:

The Regents Medal for Excellence in Research, which recognizes a faculty members scholarly contributions that expand the boundaries of knowledge and enrich the lives of all in the community, nation and the world, was awarded to:

The Frances Davis Award for Excellence in Undergraduate Teachingrecognizes dedication and demonstrated excellence as teachers of undergraduate students. It was established as a memorial to the late Frances Davis, who taught mathematics at Leeward Community College and UH Mnoa for 19 years. This years awardees are:

The Masaki and Momoe Kunimoto Memorial Award for Outstanding Contributions to Vocational Educationrewards outstanding achievement and significant contribution to vocational and technical education by a community college faculty member or student. The award was established by family members to honor the namesakes role in development of the food industry in Hawaii. This years winner is:

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UH Maui Anatomy and Physiology Instructor Honored for Excellence in Teaching - Maui Now

Anatomy

Anatomy of the hit that knocked out Maple Leafs captain John Tavares and the aftermath – Toronto Star

John Tavares is out of the playoffs indefinitely with a concussion.

The Maple Leafs captain took a pass from Jake Muzzin, a hit from Ben Chiarot and a knee to the head from Corey Perry in the first period of Thursday nights Game 1 against the Montreal Canadiens. He lay motionless on the ice after the game-changing perhaps life-altering play that lasted no more than a few seconds.

It looked like a very high-impact blow, so if you do the math the acceleration of his head and brain inside his head is at a pretty high velocity. Thats what causes concussion, said Dr. Charles Tator, Canadas leading expert on concussions. The good news is, it sounds like it was no more than a concussion. Thats good news, that they announced the tests were negative. Im assuming that means they did either a CAT scan or MRI to eliminate the possibility of cranial bleeding. Thats important.

Tavares has been released from hospital and is recovering at home. Tator did not treat Tavares, but the two are friends. Tavares once helped Tator with an instructional video for young hockey players on how to prevent concussions. Tavaress advice: Never hit from behind.

But thats not what happened here. This was every bit a hockey play.

Heres the anatomy of the hit.

9:39: With nine minutes and 39 seconds remaining in the first period, Muzzin gets control of the puck behind his net. No one is pressuring him, though Perry is on his way. Muzzin sees Tavares and an easy outlet pass to clear the zone and go on the attack. Chiarot stays close to Tavares, guessing correctly thats where the puck is going.

9:38: Muzzin launches a pass from the corner to Tavares at the blue line. Perry was on his way toward Muzzin, but circles to his right at the faceoff circle, following the trajectory of the pass. Hes picking up speed.

9:37: The puck is on Tavaress stick, but only for a split second. The idea is to tip it forward to a teammate. Nick Foligno and William Nylander are in the vicinity, but the puck never makes it. Chiarot times his hit to disrupt the pass. Its a clean, full-body, heavy hit, albeit at an awkward angle. Montreal players have been targeting Leafs stars all night, and this is no different.

9:36: Tavares falls to his right and tumbles toward the blue line. He bounces and rolls, but keeps his head from hitting the ice.

9:35: Tavares has rolled over so that his face is toward Perry, who is a mere stride away. Perry had been building to full speed, but seems aware enough that both Chiarot and Tavares are in his path that he slows down a bit, and raises his left leg just a little in an apparent attempt to go over Tavares. But the bended knee hits Tavares squarely in the face.

At the 9:31 mark, the whistle is blown. The referees often let play continue until the team of a downed player gets control of the puck. In this case Montreal had the puck, but the referees saw Tavares in distress. The training and medical staff from both teams came to his aid.

Paul Ayotte, the Leafs head trainer, is the first to arrive, holding the players head still as he tries to readjust Tavares from an awkward position. Almost immediately, he calls for a stretcher. Paramedics are quick to the scene. Torontos medical director Dr. Noah Forman and Montreals Dr. David Mulder are escorted to the ice by players.

The Canadiens mostly retreat to their bench. Most Leafs were around the scene but at a respectful distance. Jason Spezza, however, was right in there with the medical folks, talking to Tavares.

I was just trying to keep him calm, said Spezza. Scary moment. He wasnt really responding to much that was going on, so I was just trying to keep him calm. I talked to him when I got home and he said that he picked up my voice and recognized it, so I think thats why I just tried to keep talking him through it.

The villain in all of this is Perry, who has played that role his entire career. His reputation precedes him as a player who walks the line between clean and dirty hits. Fans on some teams would convict him on sight, but theres leeway on this play.

Even Foligno who fought Perry as payback on the ensuing faceoff to fulfil the NHLs unwritten code of justice didnt think the hit was intentional.

Only Perry knows what his true intent was in the moment, though it happened so quickly its hard to imagine intent could even be formed. Perry looked aghast at what had transpired. He and Tavares are, after all, friends off the ice.

When the stretcher carrying Tavares started to roll off the ice, Perry skated over to give Tavares a pat on the stomach, wishing him well.

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I felt sick to my stomach when I saw it and saw the way he was. Its a scary situation, said Perry. He got hit, I was coming out of the zone, I was trying to jump over him, and unfortunately I caught my knee on his head. I dont know what else to do there. I tried to jump. Its an unfortunate incident.

I know Johnny pretty well. Just hope hes OK.

Before the stretcher is off the ice, Tavares is able to raise his hand and give a thumbs up, a message to his teammates plus family and friends watching on TV that hes all right.

Tavares also called and texted teammates from St. Michaels Hospital, where he stayed overnight, to make sure they knew their captain was fine.

Johns a good friend (and) everybody was very concerned, said Spezza. Were happy to know that everythings looking on the ups, but definitely it was a moment where your mind races a little bit. You think about his family. But just seeing your buddy on the ice like that is scary moment.

The issue is the health of the brain. Protected by the cranium and, in a hockey players case, a helmet its still prone to violent jolts.

The best way to think of it is, the consistency of the brain is like Jell-O, said Tator. What happens is, its the jiggle of the brain that causes a concussion. With all the billions of nerve cells, and an even greater number of fibres that come off the nerve cells, those get jiggled.

And now they have to reset.

Unlike a broken bone, where healing can be monitored with X-rays, or a heart attack, where the severity can be measured by a blood test, there is no medical measurement for a concussions severity or the patients recovery, said Tator.

We only have the symptoms to go by, said Tator, how John feels if he has headaches, dizziness, nausea, sensitivity to light, sensitivity to sound. There are about 80 symptoms. We have to assess the symptoms to know whether hes recovering, and to what extent recovery is happening.

The good news is, recovery usually happens. Thats why we have to keep players out of action for a period of time to let the brain recover. If they go back too fast, and they get another blow before they fully recover, the damage is multiplied.

We like people to wait out at least a week, but some people could take even a year to recover. He shouldnt go back until hes completely recovered, which means all the symptoms would have gone before he should play. He can start skating, but he should not be in game play until all the symptoms have gone away.

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Anatomy of the hit that knocked out Maple Leafs captain John Tavares and the aftermath - Toronto Star