bluuebunny/crossref_metadata_2025 huggingface dataset:
Inflammatory-like status and acute stress response in horses after road transport
Authors: Arfuso Francesca , Rizzo Maria , Giannetto Claudia , Giudice Elisabetta , Piccione Giuseppe , Fazio Francesco , Cirincione Roberta , Cassata Giovanni , Cicero Luca
Published: June 2023

This study aimed to evaluate the change of white blood cell count, serum concentration of cortisol, C-reactive protein, albumin and globulin fractions in horse after road transport, and to assess the linkage among hypothalamic–pituitary–adrenal axis (HPA) and inflammatory reaction. From 10 horses blood samples were collected at rest, before road transport (218 km) (BT); after unloaded (AT), 30 and 60 min after unloaded (AT30 and AT60) in order to assess white blood cell count (WBC), serum cortisol, C-reactive protein (CRP), total proteins, albumin, α1-, α-2, β1-, β2- and γ-globulins. WBC, cortisol, CRP, α1-, α-2 and β2-globulins values increased after road transport than rest condition (p < 0.001). Albumin and A/G ratio showed lower values after road transport than rest (p < 0.001). Pearson’s test showed a negative correlation between cortisol and the values of WBC, CRP, α1-, α2-, β1-, β2- globulins, and a positive correlation between WBC and serum concentration of CRP, α1- and α2-, β1-, β2-globulins at AT and AT30. The results showed that road transport evokes an inflammatory like-status in horses. Moreover, the activation of HPA and the onset of acute phase reaction in response to road transport seem to be interconnected with effects on horse’s immune status.
Applying MCM-48 mesoporous material, equilibrium, isotherm, and mechanism for the effective adsorption of 4-nitroaniline from wastewater
Authors: Ali Nisreen S. , Harharah Hamed N. , Salih Issam K. , Cata Saady Noori M. , Zendehboudi Sohrab , Albayati Talib M.
Published: June 2023

In this work, the MCM-48 mesoporous material was prepared and characterized to apply it as an active adsorbent for the adsorption of 4-nitroaniline (4-Nitrobenzenamine) from wastewater. The MCM-48 characterizations were specified by implementing various techniques such as; scanning electron microscopy (SEM), Energy dispersive X-ray analysis (EDAX), X-ray diffraction (XRD), Brunauer–Emmett–Teller (BET) surface area, pore size distribution (PSD), and Fourier transform infrared (FTIR). The batch adsorption results showed that the MCM-48 was very active for the 4-nitroaniline adsorption from wastewater. The adsorption equilibrium results were analyzed by applying isotherms like Langmuir, Freundlich, and Temkin. The maximum experimental uptake according to type I Langmuir adsorption was found to be 90 mg g−1 approximately. The Langmuir model with determination coefficient R2 = 0.9965 is superior than the Freundlich model R2 = 0.99628 and Temkin model R2 = 0.9834. The kinetic adsorption was investigated according to pseudo 1st order, pseudo 2nd order, and Intraparticle diffusion model. The kinetic results demonstrated that the regression coefficients are so high R2 = 0.9949, that mean the pseudo 2nd order hypothesis for the adsorption mechanism process appears to be well-supported. The findings of adsorption isotherms and kinetics studies indicate the adsorption mechanism is a chemisorption and physical adsorption process.
Prioritization and functional validation of target genes from single-cell transcriptomics studies
Authors: Sokol Liliana , Cuypers Anne , Truong Anh-Co K. , Bouché Ann , Brepoels Katleen , Souffreau Joris , Rohlenova Katerina , Vinckier Stefan , Schoonjans Luc , Eelen Guy , Dewerchin Mieke , de Rooij Laura P.M.H. , Carmeliet Peter
Published: June 2023

Translation of academic results into clinical practice is a formidable unmet medical need. Single-cell RNA-sequencing (scRNA-seq) studies generate long descriptive ranks of markers with predicted biological function, but without functional validation, it remains challenging to know which markers truly exert the putative function. Given the lengthy/costly nature of validation studies, gene prioritization is required to select candidates. We address these issues by studying tip endothelial cell (EC) marker genes because of their importance for angiogenesis. Here, by tailoring Guidelines On Target Assessment for Innovative Therapeutics, we in silico prioritize previously unreported/poorly described, high-ranking tip EC markers. Notably, functional validation reveals that four of six candidates behave as tip EC genes. We even discover a tip EC function for a gene lacking in-depth functional annotation. Thus, validating prioritized genes from scRNA-seq studies offers opportunities for identifying targets to be considered for possible translation, but not all top-ranked scRNA-seq markers exert the predicted function.
Machine learning-aided band gap prediction of semiconductors with low concentration doping
Authors: Tang Yuqi , Chen Haiyuan , Wang Jianwei , Niu Xiaobin
Published: June 2023

The fitting process of the deep learning model based on few-shot algorithm within 300 epochs is shown (a), and the best predictive model demonstrates good performance in predicting band gap values of diluted doped semiconductors (b).
Special NaBH4hydrolysis achieving multiple-surface-modifications promotes the high-throughput water oxidation of CoN nanowire arrays
Authors: Liu Sirui , Shi Yuxin , Xu Lingling , Zhan Weican , Chen Meixi , Pan Xiaoyue , Yao Yuqing , Cai Jiajie , Zhang Mingyi , Ma Xinzhi
Published: June 2023

Ovcreation, robust BN species construction, and hydrophilic BOxmotif wrappings were simultaneously achieved on CoN nanowiresviaa facile room-temperature NaBH4spontaneous hydrolysis, which yields high-throughput water oxidation performance and structural stability.
Comparator‐noise‐based residue measurement and correction technique in 16 bit 1 MS/s SAR ADC
Authors: Zhang Panpan , Feng Wenjiang , Wang Peng , Zhao Peng , Song Yang
Published: June 2023

This letter presents an accuracy enhancement technique utilized in 16 bit fully differential successive‐approximation‐register analog‐to‐digital converters (SAR ADC). For noise performance improvement to obtain a higher ENOB, the residue measurement technique which statistically estimates the input residual error of comparator with Gaussian noise fitting is presented. The ADC digital output is compensated by the residue measurement results. It is verified in the 0.18‐μm 1P5M 5 V CMOS process. Finally, a 93.1 dB SNR and a 110.5 dB SFDR are measured operating at 1 MS/s with a 10‐kHz input tone and larger than 1‐dB SNR improvement is obtained in different chips.
Integration of lightweight cryptography and watermarking with compression for high speed and reliable communication of digital images in IoT
Authors: Nazari Hadi , Bidgoli Mahmoud Mahlouji , Ghasvari Hossein
Published: June 2023

The Internet of Things (IoT) has grown rapidly over the past few years. The main challenges for people who design and make these systems are to make them use less energy and use as small hardware as possible. Recording and sending compressed images in IoT systems must be secure. Secure image transmission requires encryption, watermarking, and compression. In choosing these algorithms, one should always consider energy efficiency and low hardware complexity. So, we propose a secure way to send data in IoT systems by combining encryption, watermarking, and compression. Depending on what is needed, we use a lightweight encryption algorithm, discrete wavelet transform (DWT) watermarking, and Discrete cosine transform + Lempel‐Ziv‐Welch (DCT+LZW) compression. In this method, the main contribution is to make a security pack that is small, strong, and easy to implement for secure image transmission on IoT systems. In the experiments, several images are used to judge how well the proposed integrated method works and how well it compares to other methods. When the proposed method was compared to other methods, the peak signal‐to‐noise ratio (PSNR) parameter improved by more than 20% in the Lena image and by more than 11% in the Baboon image.
Embedding antennas with tilted beam patterns into parabolic wave equation‐based models for tunnel propagation
Authors: Zhao Zhenyu , Qin Hao , Wang Junhong , Hou Weibin , Zhang Xingqi
Published: June 2023

Accurate radio wave prediction models are necessary for the innovation of mobile communication technology and the deployment of wireless sensor networks in railways. The parabolic wave equation (PWE) method is one commonly used method to predict the electromagnetic characteristic of long railway tunnels. However, the advent of novel antennas and technologies (e.g., beam steering, beamforming) has posed new challenges to PWE‐based models such as effective means of taking tilted beam patterns into account. This study addresses such a challenge by using tilted Gaussian beams to embed antennas with oriented patterns or tilted beam directions into PWE‐based models. The proposed approach does not reduce the simulation efficiency of PWE itself. The validity and practicability of the technique are demonstrated by comparing against ray‐tracing as well as experimental measurements in various tunnel environments.
Research on information lossless teleportation via the W states
Authors: Wang Ao , Wei Yu‐Zhen , Li Zong‐Yi , Jiang Min
Published: June 2023

In this article, a protocol for information lossless teleportation using W states is proposed. Firstly, the information lossless teleportation of an unknown state with a maximally entangled W‐state channel, which protects the original unknown state information even in case of teleportation failure is investigated. Next, we generalise our scheme to non‐maximally entangled W‐state channels. Finally, the principle of the proposed scheme is validated by performing experiments on the quantum circuit simulator Quirk. Our study shows that W states can be used to teleport any quantum state without information loss through single‐qubit measurements and local unitary operations.
The origin of the planetary nebula M 1–16
Authors: Gómez-Muñoz M. A. , Vázquez R. , Sabin L. , Olguín L. , Guillén P. F. , Zavala S. , Michel R.
Published: June 2023

We investigated the origin of the Planetary Nebula (PN) M 1–16 using narrow-band optical imaging, and high- and low-resolution optical spectra to perform a detailed morpho-kinematic and chemical studies. M 1–16 is revealed to be a multipolar PN that predominantly emits in [O III] in the inner part of the nebula and [N II] in the lobes. A novel spectral unsharp masking technique was applied to the position-velocity (PV) maps to reveal a set of multiple structures at the centre of M 1–16 spanning radial velocities from −40 km s−1 to 20 km s−1, with respect to the systemic velocity. The morpho-kinematic model indicates that the deprojected velocity of the lobe outflows are ≥100 km s−1, and particularly the larger lobes and knots have a deprojected velocity of ≃350 km s−1; the inner ellipsoidal component has a deprojected velocity of ≃29 km s−1. A kinematical age of ~8700 yr has been obtained from the model assuming a homologous velocity expansion law and a distance of 6.2 ± 1.9 kpc. The chemical analysis indicates that M 1–16 is a Type I PN with a central star of PN (CSPN) mass in the range of ≃0.618 – 0.713 M⊙ and an initial mass for the progenitor star between 2.0 and 3.0 M⊙ (depending on metallicity). An Teff ≃ 140 000 K and log(L/L⊙) = 2.3 was estimated using the 3MdB photoionisation models to reproduce the ionisation. stage of the PN. All of these results have led us to suggest that M 1–16 is an evolved PN, contrary to the scenario of proto-PN suggested in previous studies. We propose that the mechanism responsible for the morphology of M 1–16 is related to the binary (or multiple star) evolution scenario.
A priori and a posteriori error analysis for semilinear problems in liquid crystals
Authors: Maity Ruma Rani , Majumdar Apala , Nataraj Neela
Published: June 2023

In this paper, we develop a unified framework for the a priori and a posteriori error control of different lowest-order finite element methods for approximating the regular solutions of systems of partial differential equations under a set of hypotheses. The systems involve cubic nonlinearities in lower order terms, non-homogeneous Dirichlet boundary conditions, and the results are established under minimal regularity assumptions on the exact solution. The key contributions include (i) results for existence and local uniqueness of the discrete solutions using Newton–Kantorovich theorem, (ii) a priori error estimates in the energy norm, and (iii) a posteriori error estimates that steer the adaptive refinement process. The results are applied to conforming, Nitsche, discontinuous Galerkin, and weakly over penalized symmetric interior penalty schemes for variational models of ferronematics and nematic liquid crystals. The theoretical estimates are corroborated by substantive numerical results.
Contour-adaptive image restoration based on compressed sensing for ultrafast phenomena
Authors: Tsumori Masahiro , Nagai Shinichiro , Harakawa Ryosuke , Sasaki Toru , Iwahashi Masahiro
Published: June 2023

The compressed ultrafast photography (CUP) method is used to observe ultrafast light emission phenomena by restoring multiple images from a single observed image via a compressed sensing algorithm. However, because its regularization function is only suitable for ultrafast light emissions with lattice contours, the CUP method frequently produces artifacts in the restoration result. To solve this problem, we propose a restoration method that is suitable for ultrafast light emissions with any contour shapes. Specifically, we derive a regularization function that automatically estimates the contours of the ultrafast light emissions. Furthermore, we correct the movement of the ultrafast light emissions. By solving the inverse problem with the derived regularization function, accurate restoration results without artifacts can be obtained. Simulations using datasets that emulate fundamental phenomena show that the proposed method is superior to the conventional CUP method in terms of visual quality and the correlation with the original image.
Comparison of effectiveness and safety of sodium polystyrene sulfonate and sodium zirconium cyclosilicate for treatment of hyperkalemia in hospitalized patients
Authors: Sullivan Eileen , Ruegger Melanie , Dunne Ian , Sutaria Neil , Towers William F
Published: June 2023

Purpose

Potassium binders are frequently utilized for the treatment of hyperkalemia in hospitalized patients; however, there is limited data directly comparing individual agents. The purpose of this study was to compare the effectiveness and safety of sodium polystyrene sulfonate (SPS) and sodium zirconium cyclosilicate (SZC) for hyperkalemia treatment in hospitalized patients.

Methods

This retrospective cohort study evaluated adult patients who were admitted within a 7-hospital health system and received SPS or SZC for a serum potassium level greater than 5.0 mEq/L. Patients receiving dialysis prior to SPS/SZC administration, those receiving other potassium-lowering medications within 6 hours prior to blood sampling for a repeat potassium level, and those started on kidney replacement therapy prior to sampling for a repeat potassium level were excluded.

Results

Following evaluation of 3,903 patients, the mean reduction in serum potassium 4 to 24 hours after binder administration was 0.96 mEq/L with SPS and 0.78 mEq/L with SZC (P < 0.0001). The median dose of SPS was 30 g (interquartile range [IQR], 15-30 g) while the median (IQR) dose of SZC was 10 g (10-10 g). Resolution of hyperkalemia within 24 hours was achieved in a higher percentage of patients with use of SPS (74.9%) versus SZC (68.8%) (P < 0.001).

Conclusion

One of the largest comparisons of SPS and SZC conducted to date, this study demonstrated the effectiveness and safety of both agents. While a statistically greater reduction in serum potassium was observed with use of SPS, there was significant dosing variability among agents that limited the ability to directly compare specific doses. Further investigation is needed to determine the optimal dose of each agent for acute hyperkalemia management. This data will inform clinical decisions about the choice of potassium binder for acute hyperkalemia.
A-02 Preliminary Analyses of Brain Injury Perceptions in Adolescents and Associated Concussion Severity
Authors: Albrecht T , Beidler E , Schmitt A , French J , DiSanti J , Kontos A
Published: June 2023

Purpose

To determine the relationship between an adolescent athlete’s understanding of concussion and their initial injury severity.

Methods

Twenty-eight (75% male) concussed participants ages 11-17 (14.11+/-1.73) completed demographic items and the Brain Injury Perceptions Survey (BIP), an adaptation of the Illness Perceptions Questionnaire (IPQ), immediately following initial clinic evaluation. The sum of five items reflecting injury understanding were composited to form an illness coherence composite score. Clinical outcome measures included Vestibular/Ocular-Motor Screening (VOMS), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Post Concussive Symptom Scale (PCSS), and Concussion Clinical Profile Screening (CP Screen). Linear regressions were computed to determine if illness coherence explained variance in clinical outcomes.

Results

Illness coherence and clinical outcomes were inversely correlated and was predictive of initial response severity as measured by CP Screen Total (R2=.47, F(1,26)=22.62, p<.001), PCSS Total (R2=.33, F(1,25)=12.08, p=.002), and VOMS Symptom Total (R2=.39, F(1,25)=15.69, p<.001). Illness coherence was not predictive of performance in any cognitive domains. Gender and history of previous concussion did not result in total illness coherence composite score group differences.

Conclusions

Lesser understanding of injury in adolescent athletes is predictive of a more severe initial response to concussion. Clinicians need to facilitate their patients' understanding of concussion when treating adolescents in clinic. More research is needed to better explain the relationship between initial response severity and injury understanding. Future research can also focus on injury severity and general perceptions of injury.
A-04 Play After Concussion on Initial Symptom Burden and Length of Recovery
Authors: Allen D R , Guerin J , Bowman C , Gioia G A , Vaughan C G
Published: June 2023

Purpose

Removal from play after a concussion is a standard requirement across sports in order to reduce risk of re-injury. This study examines the effect of ongoing play on early symptom status and overall length of recovery.

Methods

191 adolescents aged 11-19 (mean age=15.3± 1.6, 57% male) presenting within 30 days of a concussion completed the Post-Concussion Symptom Inventory-2 (PCSI-2). Participants were recovered when their PCSI-2 Total Retrospective Adjusted Post-Injury Difference (RAPID) scores fell below the psychometrically established cut-off for minimal symptoms. ANOVAs compared initial symptom status and length of recovery (LOR) between those who continued play (CTP) and who were removed from play (RFP) after injury, by sex.

Results

No difference in initial symptom level was found between individuals who CTP versus those RFP (PCSI-2 RAPID mean 24.7 vs. 22.1, p=.41). A marginal difference was found in LOR between CTP versus RFP (31.7 vs. 27.2 days, p=.088). Marginally higher symptom levels were found for females vs. males (mean=26.4, 20.4, respectively, p=.055). Females took longer to recover than males (33.7 vs. 25.2 days, p=.001, η2=.05). There was no interaction between CTP by sex on symptom levels (p=.92) or on LOR (p=.10), after accounting for CTP and sex alone. However, females who CTP had longer LOR compared with females who were RFP (38.0 vs 29.3 days, p=.029).

Conclusions

Findings show marginal overall difference in symptom status but not LOR based on immediate removal from play. Females who CTP had longer recovery suggesting a possible sex-specific interaction effect of ongoing play after concussion.
A-05 Clinical Considerations for the Management of Post-Concussion Psychogenic Speech Impairments
Authors: Amalfe S A , Jennings S , McIndoe E , Durfee K , Dollar C , Womble M , Elbin R J
Published: June 2023

The purpose of this case study was to present clinical approaches for psychogenic speech impairments following concussion.

Methods

Retrospective chart review of a 17-year-old Black male (Patient 1) who sustained a sport-related concussion and a 46-year-old Hispanic female (Patient 2) who sustained a concussion following a motor vehicle accident and exhibited dysfluencies after injury. Both completed a clinical interview, symptom, neurocognitive, vestibular-ocular motor, and mood assessments at each clinical visit. Clinical impressions and management decisions were discussed with treating neuropsychologists.

Results

At intake, neither patient was attending school/work. Both endorsed significant state anxiety, mild depression, and processing speed impairment. Patient 1 reported dysfluency ~2 hours post-injury, characterized as rapid repetition of sounds followed by full words, which increased under stress. The clinical evaluation required extra time and included psychoeducation regarding atypical speech patterns and stress management. Patient 1 was encouraged to resume school, non-contact cheerleading, and counseling sessions. Speech dysfluencies resolved at 24 days post-injury without speech intervention. Patient 2 reported dysfluency at 32 days post-injury after witnessing an MVA which provoked isolated aphasia followed by a consistent psychogenic speech pattern. Dysfluency was triggered by light/noise sensitivity and some parts of the clinical evaluation were not tolerated following exposure. Vestibular therapy increased dysfluency and was replaced with speech therapy and numerous medication trials (SSRIs, beta-blockers, benzodiazepines) without success. The patient returned to work after 9 months and did not fully resolve speech abnormalities.

Conclusions

Speech abnormalities following concussion are variable and require the clinician to be flexible with the evaluation and treatment plan.
A-19 Sex Differences in Post-Concussion Symptom Reporting of Elementary School-Aged Children
Authors: Datoc A , Mathew A , Boucher S , Choi D , Ellis C , Abt J , Burkhart S
Published: June 2023

Purpose

Research on sex differences in the presentation of concussion has produced mixed findings and have primarily studied adolescents and adults. The purpose of this study was to explore sex differences in post-concussion symptom reporting and recovery time in elementary school-aged children.

Methods

Retrospective data were abstracted from the medical records of patients aged 5-10 who presented to a specialty concussion clinic between 2020-2023 (N=109, 67% male). Groups were divided based on sex (female=36, Mage=8.9; male=73, Mage=8.8). A MANCOVA was conducted to determine the relationship between sex and Post-Concussion Symptom Scale total scores at initial visit (PCSS-1), PCSS total scores at follow-up visit (PCSS-2), and recovery time. Covariates included were age and days since injury (DSI).

Results

Mean DSI at initial visit was 8.5±23.9 for females and 5.7±6.4 for males. There was a significant difference between males and females on the combined dependent variables (Wilks’ Λ=.87, F(3,103)=5.36, p=.002, partial η2=.14) after controlling for age and DSI. Females reported significantly more symptoms than males on PCSS-1 (Mfem=31.8±21.3, Mmale=22.4±19.3; p=.02) and PCSS-2 (Mfem=17.1±18.5, Mmale=6.0±10.2; p<.001). Recovery days were not significantly different between sexes (Mfem=38.7±43.6, Mmale=31.0±43.9; p=.06).

Conclusions

Commensurate with studies that have evaluated sex differences in concussion in older cohorts, females reported greater symptom burden than their male peers. While not significantly different, females took one week longer to recover than males, suggesting that higher symptom reporting during initial and subsequent concussion visits is not necessarily indicative of longer recovery time. To provide tailored care, future research should examine sex differences in specific symptoms reported post-concussion across age cohorts.
A-24 Behavioral Regulation is Associated With De creased Post-Concussion State Anxiety and Depression
Authors: Durfee K J , Jennings S , Womble M N , Amalfe S , Dollar C M , Schatz P , Kontos A P , Collins M W , Elbin R J
Published: June 2023

Purpose

To examine the effects of self-reported behavioral regulation on post-concussion anxiety and depression in individuals with sport-related concussion (SRC)

Methods

A retrospective chart review of patients (ages 15–25yrs) seeking care for a SRC within 1-7 days following injury were included in this study. Participants completed a self-report, 4-point Likert scale (0-Never, 3-Most of the Time) questionnaire that assessed the previous week’s frequency of Sleep, Physical Activity (PA), Diet, Hydration, and Stress Management behavioral regulation domains. Scores were divided into HIGH (Most of the Time) and LOW (Some of the Time – Never) regulation groups for each domain. A series of independent samples t-tests and analyses of covariance (ANCOVA) were used to compare these groups on state anxiety (STAI) and depression (PHQ-9) scores.

Results

One hundred thirty-two participants (M=16.42, SD=1.95 yrs, 45% female) completed the study measures at 3.85 days post injury (SD=1.40). Participants in the HIGH behavioral regulation groups for Sleep (F(1,129)=4.67, p=.03), PA (F(1,128)=8.88, p=.003), and Stress (t(130)=1.89, p=.03) demonstrated significantly lower state anxiety scores than the LOW groups. Depression scores were significantly lower for the HIGH behavioral regulation in Sleep (F(1,129)=8.70, p=.004), Diet (F(1,125)=10.22, p=.002), and PA (F(1,128)=5.09, p=.03) domains than the LOW groups.

Conclusions

Behavioral regulation affects post-concussion state anxiety and depression. This low cost, non-pharmacological strategy should be the first step for the management of SRC.
A-27 Using The Concussion Clinical Profiles Screening Tool And Pre-injury Risk Factors To Identify Concussion Profiles
Authors: Gomes D , Burley C , Rabon W , Preszler J , Collins M , Kontos A
Published: June 2023

Purpose

To determine the ability of the Concussion Clinical Profiles Screening Tool (CP Screen) and pre-injury risk factors to accurately predict concussion profiles.

Methods

Sample included 297 patients (59.3% male, mean age=16.6 years), 73.7% sport-related injuries, previously diagnosed with concussion. Patients completed the CP Screen and medical histories. Receiver operating characteristics (ROC curves) provided area under the curves, and sensitivity and specificity values.

Results

The post-traumatic migraine (PTM) composite resulted in an AUC of .63 (95% CI=.55-.68); sensitivity was 0.19 and specificity was .86 at a 4.5 symptom cutoff score. The anxiety/mood composite resulted in an AUC of 0.84 (95% CI=.78-.88); sensitivity was .56 and specificity was .88 at a 4.5 symptom and risk-factor cutoff score. The vestibular composite resulted in an AUC of 0.71 (95% CI=.66-.78); sensitivity was .37 and specificity was .87 at a 4.5 symptom and risk-factor cutoff score. The ocular composite resulted in an AUC of .55 (95% CI=.52-0.66); sensitivity was .30 and specificity was .79 at a 4.5 symptom and risk factor cutoff score. The cognitive composite resulted in an AUC of .52 (95% CI=.40-.57); sensitivity was .35 and specificity was .63 at a 4.2 symptom cutoff score.

Conclusions

The anxiety/mood and vestibular composites demonstrated strong predictive utility, while PTM, ocular, and cognitive fatigue composites did not. The combined CP Screen and health histories may be sufficient to predict concussion profiles within the domains of anxiety/mood and vestibular.
A-28 Systemic Failures Impacting Concussion Symptom Non Disclosure and “Toughing it out” Among Black Athletes
Authors: Goodwin G , Richards D , Williams J
Published: June 2023

Purpose

Despite socio-political and community efforts to shift the narrative among college and professional sports toward injury disclosure, “toughing it out” narratives continue to impact players and, more specifically, Black players. Symptom nondisclosure narratives disproportionately affect Black athletes' concussion symptom knowledge and willingness to disclose a concussion. The purpose of this study is a call for accountability, fellowship, and active caring of Black college and professional athlete’s in order to promote concussion symptom disclosure.

Data Selection

A literature review of peer-reviewed articles from 2018 to 2022 from PubMed and Google Scholar was conducted. Keywords include racial disparities, concussions, identity, and professional and college athletes. Informal analyses were used to identify and analyze themes across articles, including health disparities, concussions, and nondisclosures.

Data Synthesis

Black athletes are more likely to under-report concussion symptoms than their white counterparts. Power and privilege within the context of institutionalized racism inform disparities in concussion psychoeducation. Black athlete identity formation within white institutions further informs willingness to report symptoms. Consequently, concussion non-disclosure can put athletes at risk for repetitive head injury, persisting neurocognitive, and psychological deficits.

Conclusions

Recognizing the role of systemic racism in concussion symptom reporting is critical. Neuropsychologists are responsible for understanding intersectionality, institutional racism, and Black athlete identity. To this end, concussion symptom non-disclosure needs to be conceptualized as suppression of Black athletes' voices and wellbeing. A shift towards fellowship and active caring is needed to understand athlete identity among Black athletes and how these narratives influence symptom disclosure over time.
A-31 Normative Data For Cognitive, Physical, Affective, And Sleep-Arousal Symptom Subscales Of The SCAT-3 Symptom Evaluation
Authors: Ingram E O , Karr J E
Published: June 2023

Purpose

Develop baseline normative reference data for the Sport Concussion Assessment Tool-3 (SCAT-3) Symptom Evaluation and examine how sex and preexisting conditions relate to the symptom domains endorsed by collegiate athletes.

Methods

Participants (N=24,696 collegiate student-athletes; 62.6% Male, 61.5% White, 9.2% Hispanic or Latino) from the Concussion Assessment, Research, and Education Consortium completed the SCAT-3 at a preseason baseline. Using a four-factor model (i.e., cognitive, physical, affective, and sleep-arousal), normative percentiles were calculated for each symptom subscale and the total score, with stratifications by sex and number of preexisting conditions. Symptom score distributions were compared across stratifications using Mann-Whitney U tests.

Results

Generally, female athletes and those with more preexisting conditions endorsed significantly higher symptoms at baseline (e.g., 84th percentile affective score: males=1, females=3, p<.001, r=.14; females with 1 condition=4, 3+ conditions=8, p<.001, r=11; males with 1 condition=3, 3+ conditions=7, p<.01, r=.06). This pattern held for all but the physical (i.e., no difference between individuals with 1 and 3+ conditions) and sleep-arousal (i.e., no difference between males with 1 and 3+ conditions) subscales.

Conclusions

Female sex and preexisting conditions were associated with higher symptom burden on most subscales. A female athlete with a symptom score of 10 may appear to have elevated post-concussion symptoms; however, if she has 3 preexisting conditions, this experience is average (i.e., 50th percentile) compared to others with 3+ conditions at baseline. She may benefit from intervention, but symptoms may not be attributable to a concussion. Normative reference data may help indicate symptom severity when baseline data are unavailable.
A-33 Examining Acute Symptoms after Sport-Related Concussion in Collegiate Athletes with Pre-Injury Migraines
Authors: Jo J , Maxwell B A , Berkner P D , Iverson G L , Zuckerman S L , Terry D P
Published: June 2023

Purpose

To examine whether a personal history of migraines is associated with worse acute symptom burden following sport-related concussion (SRC) in collegiate athletes.

Methods

Data were collected through a prospective concussion surveillance system in 11 NCAA Division III college athletic programs between September 2014 and January 2023. Mann-Whitney U tests compared total Post Concussion Symptom Scale (PCSS) score and individual symptom scores (taken within 3 days of injury) between collegiate athletes with and without pre-injury migraines. Chi-squared tests were used to compare proportions of athletes endorsing individual symptoms (i.e., item score ≥1) between the two groups. Multivariable regression analyzed potential predictors of PCSS scores.

Results

Of 1,190 athletes with an SRC, 93 (7.8%) had a pre-injury history of migraines. No significant difference in total PCSS scores were found between athletes with and without pre-injury migraines (22.0±16.4 vs. 20.5±15.8; U=48719, p=.47). Athletes with pre-injury migraines reported greater “sensitivity to light” (1.59±1.59 vs. 1.23±1.41; p=.04) and “feeing more emotional” (0.91±1.27 vs. 0.70±1.30; p=.008). Athletes with migraine histories were more likely to endorse “feeing more emotional” (45.2% vs. 29.5%; p=.002). No differences were found across all other symptoms. In a multivariable model, history of migraine was not a significant predictor of acute PCSS scores, but those with a history of depression (β=0.12, p<.001) and longer days to symptom evaluation since injury (β=0.08, p=.005) had higher PCSS scores.

Conclusions

Collegiate athletes with a pre-existing history of migraines did not have higher acute symptom burden following SRC. Future studies should investigate whether migraine history is associated with recovery time.
A-35 Difficulty Speaking, Stuttering, and Missing Words Post-Concussion: Findings from Two Independent Studies
Authors: Kennedy C J , Garcia-Barrera M A
Published: June 2023

Purpose

The current investigation examined the potential consequences of concussion on speech-language abilities by analyzing quantitative and qualitative data from two independent studies.

Methods

Study 1: 185 rugby, soccer, football, rowing, and hockey athletes (M=17.42 years, SD=3.80; 44% female) completed the Rosenbaum Concussion Attitude and Knowledge Survey (RoCKAS). Study 2: 19 varsity soccer, rugby, volleyball, and basketball athletes (M=21.74 years, SD=2.13; 37% female) with history of at least one concussion completed individual one-hour semi-structured interviews, and thematic analysis was used to identify patterns across athletes’ experiences of concussion.

Results

Study 1: Quantitative analysis of athletes’ endorsements of distractor and legitimate post-concussive symptoms on the RoCKAS yielded a relatively low rate of endorsement across all distractor symptoms (1–29%, M=11%), with the exception of ‘difficulty speaking’, which was endorsed by majority (70%) of the sample. Study 2: Thematic analysis of interview content identified long-term difficulties with speech articulation (i.e., stuttering and word-finding) as a post-concussive symptom for 42% of the sample.

Conclusions

While speech abilities are largely thought to remain intact following concussion, quantitative and qualitative findings from these two independent studies suggest that speech difficulties may be an overlooked outcome of concussion. Several neuropsychological (e.g., attention, memory, executive function, or processing speed) and neuropathophysiological (e.g., diffuse axonal damage to cortico-subcortical pathways) processes may be underlying this relationship. Exploratory studies and longitudinal data are needed to elucidate the potential consequences of concussion on speech-language abilities.
A-41 The Use of Virtual Reality for the Diagnosis of Pediatric Sports-Related Concussion: A Feasibility Study
Authors: Mathew A , Datoc A , Boucher S , Choi D , Ellis C , Abt J , Worts P
Published: June 2023

Purpose

Virtual Reality (VR) based concussion software has shown potential in diagnosing sports-related concussion (SRC). The purpose of this study was to explore potential symptom provocation when using a VR based diagnostic concussion software among SRC patients.

Methods

Pediatric SRC patients aged 12-18 and within 72 hours from injury to initial visit were recruited. While wearing the VR device, patients were instructed to fixate gaze on various targets to track eye movements in a gamified manner. The Post-Concussive Symptom Scale (PCSS) and Virtual Reality Sickness Questionnaire (VRSQ) were administered on a scale of 0 (none) to 3 (severe).

Results

A total of 21 patients were eligible (Age=14.9±1.7; Female 57.1%; White 61.9%). Patients noted minimal to no symptoms in terms of discomfort (.48±.60), fatigue (.48±.68), headache (1.48±.60), eye strain (.90±.77), inattention (.38±.59), blurred vision (.29±.64), and dizziness (.71±.56) while completing the VR task.

Conclusions

Compared to other studies using VRSQ among healthy subjects, our sample of acutely injured children with SRC reported minimally provoked symptoms that were below empirically established limits. Specifically, both components of the VRSQ (ocular component MOcu=3.24, SD=1.89; disorientation component MDis=2.59, SD=2.27) ranked below the average limit compared to other studies using VRSQ (MOcu=6.7; MDis=5.8). Future research should gather validity and reliability data to establish the clinical environment in which to diagnose pediatric SRC.
A-48 Comparative Analysis of Adolescents With a Sport-Related Concussion Versus Non-Sport-Related Concussion During Initial Visit
Authors: Patel S , Trbovich A , Burley C , Mehmel B , Kegel N , Kontos A , Collins M
Published: June 2023

[Outstanding Trainee Award Winner]

Purpose

To investigate differences in pre-injury risk factors and clinical outcomes in adolescents with a Sport-Related Concussion (SRC) versus non-Sport-Related Concussion (non-SRC).

Methods

Participants (n=136, aged 10-18) presented to a specialty concussion clinic 2-30 (M=9.25) days post-injury. They completed a clinical interview with a trained clinician and were administered the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), Post-Concussion Symptom Scale (PCSS), Concussion Clinical Profile Screening (CP Screen), Vestibular/Ocular-Motor Screening (VOMS), Screen for Child Related Anxiety Disorders - Child Version (SCARED-C), and the Generalized Anxiety Disorder Assessment (GAD-7). Data analyses utilized independent sample t-tests, chi-square tests, and descriptive statistics to compare clinical outcomes of both groups during initial visit. Alpha was set to p<.05 for all analyses.

Results

Adolescents with non-SRC took longer to seek specialty concussion care, were majority female, and were older than the SRC group. Non-SRC participants also reported a higher rate of migraine, depression, and anxiety history (i.e., SCARED-C Panic Disorder, SCARED-C Generalized Anxiety Disorder, and SCARED-C Anxiety Disorder). Additionally, non-SRC participants reported more symptoms on the PCSS Total score, and on most VOMS items, including Smooth Pursuits, Horizontal and Vertical Saccades, Horizontal and Vertical Vestibular-Ocular Reflex, Visual Motion Sensitivity, as well as VOMS Total. Non-SRC group also reported higher post-injury anxiety scores (i.e., GAD-7). All findings were below the p-value of .05.

Conclusions

The study findings suggest that mechanism of injury and individual risk factors play a significant role in determining the clinical presentation of a concussion in an SRC and non-SRC adolescent population.
A-51 EYE-SYNC Saccade Outcomes and Health/Demographic Factors in CFL Athletes
Authors: Ree-Fedun Q , Wagner R , Mrazik M
Published: June 2023

Purpose

Examine the relationship between demographic and health factors, and oculomotor functioning during baseline testing in professional Canadian Football League (CFL) athletes.

Methods

428 male athletes participated in baseline concussion testing. Athletes ranged in age from 21 to 40 years (M=26.44, SD=2.87) and reported a history of 0, 1, or 2+ sport-related concussions (SRCs). All athlete participants completed the Head Check questions of demographics and medical history, and the EYE-SYNC saccade test to explore how the presence of a history of concussions, Attention-Deficit/Hyperactivity Disorder (ADHD), Learning Disability (LD), age, and post-exertion influenced baseline measures of oculomotor functioning using the EYE-SYNC saccade outcomes of accuracy and precision.

Results

Correlations revealed no significant relationships between combined vertical and horizontal saccade outcomes and the demographic/health variables (p>05). Independent t-tests indicated no significant differences in mean saccade performance between athletes with and without ADHD and/or LD (p>.05). A three-way multiple analysis of variance, run with age group and four saccade outcomes (LeftAccuracyXY, LeftPrecisionXY, RightAccuracyXY, RightPrecisionXY), showed no main effect of age group on the combined saccade outcomes F(8, 844)=.91, p=.50. Finally, a one-way repeated measures analysis of variance also revealed no significant differences from pre- to post-exertion assessments, F(4, 56)=.41, p=.80.

Conclusions

The oculomotor functioning of CFL athletes at baseline does not appear to be influenced by a history of concussion, ADHD, LD, age, or physical exertion. This information may help professionals with their clinical decision-making regarding SRC diagnosis.
A-52 Cognitive Functioning After Concussion is Associated with Academic Problems and School Stress
Authors: Richie R , Terheyden van S , Vaughan C , Gioia G
Published: June 2023

Purpose

Students experiencing concussion symptoms also report school difficulties and academic impacts. We examined the relationship of cognitive functioning with self-reported academic concerns and school stress, hypothesizing that students with lower working memory (WM) and processing speed (PS) scores would have higher reported academic concerns and greater school stress.

Methods

184 youth aged 8 to 18 diagnosed with a concussion (Mean age=14.4±2.2, 51% female, 67% white) completed the Concussion Learning Assessment and School Survey, 3rd Edition (CLASS-3), a validated self-reported rating scale of post-concussion academic problems and school stress. Pearson’s partial correlations, controlling for age and sex, assessed the relationship between the Academic Problems and School Stresses scales from the CLASS-3 with the WMI and PSI from the Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) and Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V).

Results

There were negative correlations between Processing Speed and Academic Problems (r(144)=-.33, p<.001) and School Stresses (r(160)=-.29, p=<.001). There was also a negative correlation between Working Memory and School Stresses (r(162)=-.24, p=.002) and Academic Problems (r(144)=-.15, p=.07).

Conclusions

Students with lower working memory and processing speed tend to report higher academic problems and school stresses. These results suggest that students with lower cognitive function experience higher school concerns, implying a need to establish appropriate school supports, particularly in students who experience cognitive dysfunction after a concussion.
A-55 Updated validation of the accuracy of reaction time assessment on computer-based tablet devices
Authors: Schatz P , Cuzzupe J , Leitner D L
Published: June 2023

Purpose

Computer-based assessment continues to evolve, migrating from paper- to computer- to tablet-based assessment/devices. Despite the increase in tablet ownership and use, there remains limited research validating their timing accuracy. The purpose of this study was to update previous (2015) research documenting timing delays on touchscreen devices.

Methods

Delays between stimulus presentation and (simulated) touch response were recorded using an custom-made timing device and a Javascript-based timer using an Acer Chromebook (Spin 211; Chrome OS 98.0), an 8th generation Apple iPad(iOS 15.4), a Kindle Fire HD 10 (Fire OS 7.3), and a Samsung Galaxy A7 (Android OS 11.0) at response intervals of 100, 250, 500, 1000 milliseconds (ms).

Results

The Chrome browser was consistently the fastest browser on the Acer and Samsung devices, and similar to Safari (Apple iPad) and Firefox (Samsung Galaxy). Using the Chrome browser, results showed significantly greater timing error on the Samsung tablet (88-105ms), than Kindle Fire (65-70ms), Apple iPad (49-54s) and Acer Chromebook (36-41ms), across all response intervals.

Conclusions

Due to inherent timing delays, touchscreen devices are not recommended for collection of simple RT. For choice RT measures on tablet devices, the Safari browser (Apple iOS devices) and Chrome Browser (Chromebooks or Kindle Fire) are recommended. However, use of the Samsung Galaxy tablets (any browser) and Kindle Fire (Silk browser) are not recommended.
A-60 Gender and Age Differences on the Sway Medical Mobile Balance Test
Authors: Stephenson K , Caccese J B , Cook N E , Berkner P , Iverson G L
Published: June 2023

Purpose

To determine if performance on the Sway Medical Mobile Application Balance Test differs by age and gender.

Methods

Pre-season baseline data from 33,784 individuals (51.3% girls/women) between ages 12 and 22 (mean=16.8 years, SD=2.5), tested in the summer of 2022, without a self-reported concussion in the past 6 months, and without self-reported ADHD were examined. Three Spearman correlations were used to assess the association between balance scores and age for the total sample, and for the boys/men and girls/women groups separately. Twelve Mann-Whitney U tests were used to compare genders on balance scores within each age group (12, 13, 14, through 22-years-old) and for the total sample. A Bonferroni correction was used to adjust for multiple comparisons, and the level of significance was set at p=0.004.

Results

There was a positive correlation between higher (i.e., better) balance scores and older age for the total sample (r=.25, p<.001), and within the boys/men (r=.30, p<.001) and girls/women groups separately (r=.21, p<.001). For every age, there was a significant difference between boys/men and girls/women on balance test scores, with girls/women obtaining higher (i.e., better) balance scores than boys/men. Effect sizes for these differences ranged from small to medium (Hedge’s g=.29-.65).

Conclusions

There are age and gender-related differences on baseline Sway Medical Mobile Balance Test scores. Girls/women performed better on the balance testing compared to boys/men at all ages. Additionally, the balance scores improved throughout adolescence and generally plateaued in early adulthood (18-22-years-old).