bluuebunny/crossref_metadata_2025 huggingface dataset:
A-23 Bouncing Back: The Resilience of Executive Functioning Post-Concussion
Authors: Dupriez-Mitchell B , VanderZwaag B , Kennedy C J , Doucette M , Garcia-Barrera M A
Published: June 2023

Purpose

This study aimed to examine the relationship between concussion history and executive function in a sample of Canadian university students.

Methods

247 participants completed an online survey and a web-based assessment battery consisting of nine computerized executive function tasks. Participants self-identified as ‘non-athletes’ (14.75%) or ‘athletes’ (85.25%) and reported having no history of concussion (n=183) or a history of one (n=37), two (n=15), or three or more (n=13) concussions. Bivariate correlations were used to examine the association between concussion history and executive function. The Kruskal-Wallis test was used to assess the effects of concussion history on objective (updating, shifting, and inhibition) and subjective (Total Executive Function Index, [EFI]) executive function.

Results

Concussion history was not significantly correlated with subjective executive functioning (i.e., EFI, r=-.054, p>.05), or computerized executive functioning, including shifting (r=-.014, p > .05), inhibition (r=-.000, p > .05), and updating (r=-.02, p>.05 ) performance. The Kruskal-Wallis test indicated that there was no significant effect of concussion history on EFI scores (χ2(45)=45.7, p=.36), nor shifting (χ2(202)=204.3, p=.44), inhibition (χ2(207)=207, p=.49), or updating (χ2(178)=180, p=.53) scores.

Conclusions

Our findings suggest that concussion history does not significantly impact executive functioning among university students with varying levels of athletic expertise. Protective factors (e.g., higher education and physical exercise engagement) may mitigate the detrimental effects of concussion on executive function.
A-25 Barriers to Protracted Sport Participation in Youth: What Should be the Focus?
Authors: Flowers J , Talamahe'a T , Eve H , Baldini D , Steinbaugh A , Hirst R
Published: June 2023

Purpose

Sports participation is recommended by the mental health field. However, the picture of sports in the U.S. has shifted from school-based to private clubs and continued participation may be difficult for lower income families. The present study examined the influence of socioeconomic status (SES) on total years playing sports, while exploring the influence of full scale IQ (FSIQ), as little research has assessed for intellectual ability as a barrier to youth participation.

Methods

The present study analyzed Wechsler Abbreviated Scale of Intelligence, 2nd Edition (WASI-II) FSIQ and SES, operationalized as maternal education level, data in a sample of youth athletes (n=69, 79.7% male), aged 8-18 years (mean=11.94). Participants competitively participated in soccer, basketball, baseball and/or American football. Multivariate linear regression investigated the influence of SES and FSIQ on total years playing sports.

Results

SES and FSIQ have a significant association with total years played (p<.001) and explain 23% of the variance, with a small combined effect size (r2 =.23). Individually, higher SES significantly predicted greater total years played (p=.005), while FSIQ did not (p=.15).

Conclusions

Higher SES predicted greater total years of sports participation among youth athletes, whereas FSIQ did not. This highlights a necessary focus for low-cost and accessible sporting programs. Due to the significant association with total years played, future research should examine the joint contributions of FSIQ and SES to sports participation.
A-26 Area Deprivation Index and Clinical Outcome Following Concussion in Adolescents
Authors: Gaudet C E , Cook N E , Kissinger-Knox A , Liu B , Stephenson K , Berkner P , Iverson G L
Published: June 2023

Purpose

The purpose of this study was to assess whether socioeconomic status is associated with clinical recovery time following concussion in adolescents.

Methods

Participants included adolescent student athletes (N=130; age M=16.6, SD=1.2; 60.8% boys, 39.2% girls) who attended one of nine selected high schools in Maine, USA. Schools were identified as either higher or lower SES based on the Area of Deprivation Index (ADI), and indicator of neighborhood disadvantage, associated with their address and the percent of students receiving free and reduced lunches. Athletic trainers entered injury and recovery dates into an online surveillance application between September 2014 and January 2020. Chi-square analyses and Kaplan-Meier survival analyses were used to compare the groups on two clinical outcomes: time to return to school and sports.

Results

Results of chi-square tests did not reveal between group differences in time to return to school at 21 or 28 days; however, groups differed in the percentage of adolescents who had returned to sports by 21 days (lower SES, 62.5%, higher SES 82.0%, χ2=4.96, p=.03, OR=2.73, 95% CI, 1.11-6.74) and 28 days (lower SES, 78.6%, higher SES 94.0%, χ2=5.18, p=.02, OR=4.27, 95% CI, 1.13-16.16) following concussion.

Conclusions

The adolescents attending lower SES schools took longer to reach medical clearance for return to sports. Further research is needed to better characterize factors underlying group differences in time to return to sports and examine a broader array of SES indicators. These results may reflect disparities in health care resources between schools serving higher versus lower SES areas.
A-30 The Association between Pre-injury Symptoms and Self-Efficacy in Youth with Concussion
Authors: Guerin J , Allen D , Bowman C , Vaughan C , Gioia G
Published: June 2023

Purpose

Youth’s self-efficacy for managing their recovery is associated with post-concussion symptom severity. The association between pre-injury symptoms and self-efficacy is not known.

Methods

Participants were 947 youth ages 9-18 (mean age=14.28, 52% female) with concussion (mean days since injury=19.11) and their caregivers. Participants and caregivers reported on pre-injury symptom domains (physical, cognitive, fatigue, and emotional) using the age-specific Post Concussion Symptom Inventory-2 (PCSI-2; 8-12 years, 13-18 years, caregiver versions). Self-efficacy for managing concussion recovery was measured using the Progressive Activities of Controlled Exertion-Self-Efficacy (PACE-SE) scale Total score. In these three groups, bivariate correlations examined associations among pre-injury symptoms and self-efficacy.

Results

PACE-SE Total score did not differ based on age or sex. In 9-12-year-olds (n=205), PCSI-2 self-ratings of pre-injury symptoms in the cognitive (r=-.15, p=.03) and emotional (r=-.27, p<.001) domains were negatively associated with the PACE-SE Total score. In 13-18-year-olds (n=742), PCSI-2 self-ratings of pre-injury symptoms in the physical (r=-.20), cognitive (r=-.23), fatigue (r=-.25), and emotional (r=-.34) domains were negatively associated with the PACE-SE Total score (all p<.001). PCSI-2 caregiver-ratings of pre-injury symptoms were not associated with PACE-SE Total score for either age group.

Conclusions

Pre-injury functioning appears to influence confidence in post-injury recovery. Management of concussion recovery should account for pre-injury functioning. Youth who report more difficulties at baseline may benefit from efforts to boost self-efficacy following injury. Future research might further investigate the relationship of the caregiver report of pre-injury functioning with self-efficacy.
A-32 Multidimensionality of the SCAT-3 Symptom Evaluation Before and After Sport-Related Concussion
Authors: Ingram E O , Karr J E
Published: June 2023

Purpose

To determine if a one- or four-factor model (i.e., cognitive, physical, affective, sleep-arousal) of post-concussion symptoms better fits the Sport Concussion Assessment Tool-3 (SCAT-3) Symptom Evaluation at baseline and post-injury time points.

Methods

Participants (N=24,696; 62.6% Male, 61.5% White, 9.2% Hispanic or Latino) were collegiate athletes from universities participating in the Concussion Assessment, Research, and Education Consortium. Student-athletes were given the SCAT-3 during a preseason baseline assessment, and four evaluations based on time since injury following concussion (i.e., 24-48 hours, asymptomatic, unrestricted return-to-play, and 6 months). A series of confirmatory factor analyses were used to test one- and four-factor models of the SCAT-3, using the Comparative Fit Index (CFI) to evaluate fit. A CFI ≥.95 indicated excellent fit and a difference in CFI≥.01 indicated superior fit during model comparison.

Results

The four-factor model showed superior fit at all time points compared to a one-factor model (One-factor: baseline=.89, 24-48 hours=.94, asymptomatic=.96, unrestricted return-to-play=.98, 6-months=.97; four-factor: baseline=.96, 24-48 hours=.97, asymptomatic=.98, unrestricted return-to-play=.99, 6-months=.99).

Conclusions

A multidimensional (i.e., four-factor) approach to the SCAT-3 Symptom Evaluation has a superior fit compared to a total score (i.e., one-factor) interpretation before and after injury. It is not yet clear how, or if, the four-factor model is beneficial in clinical settings for athletes with sport-related concussions. Symptom reporting is a large part of concussion assessment and return-to-play decisions, so future research should examine how concurrent relevant outcomes (i.e., neurocognitive performance, postural stability, long-term health, etc.) are related to symptom factor scores in comparison to total symptom scores.
A-34 Incidence of Sport-Related Concussion in Adaptive Sports: A Scoping Review
Authors: Kaplan D T , Broshek D K , Magill R T , Denton A H , Smetana R M
Published: June 2023

Purpose

Despite an increase in sport-related concussion (SRC) research for non-adaptive athletes, research on para athletes is sparse. The purpose of this scoping review was to examine the incidence of SRCs in para athletes to understand their risk for SRCs.

Methods

This review was registered with Open Science Framework and adhered to PRISMA-ScR guidelines. Searches of electronic databases (CINAHL, Google Scholar, MEDLINE, SPORTDiscus, and Web of Science) were conducted from database creation to February 1, 2023. Articles selected examined SRC incidence in para sports.

Results

Reviewers screened 202 title-abstracts and 32 articles qualified for full-text review, with 12 articles qualifying for data extraction for information on SRC incidence. Incidence rates varied across studies, ranging from no reported concussions to concussions accounting for 43% of injuries in a given sport. Sledge hockey and wheelchair basketball were the most frequently studied populations. Data suggested that para athletes are likely to sustain concussions at a similar rate to non-adaptive athletes. While data on sex differences were scarce, female athletes appeared to sustain more concussions than male athletes.

Conclusions

Based on limited published data, the incidence of SRCs in para athletes appears to be most prevalent in wheelchair basketball and sledge hockey and more common in female than male athletes. Given the limitations of published data, knowledge regarding incidence in other para sports is minimal. It will be important for future research to capture data across multiple para sports to determine concussion risk and inform the development and implementation of protocols for assessing and managing SRCs.
A-36 Performance of Children with Attention Deficit/Hyperactivity Disorder on the Sway Medical Mobile Balance and Cognitive Tests
Authors: Liu B C , Cook N E , Iverson G L
Published: June 2023

Purpose

There is a recognized need for more research relating to preseason balance and cognitive testing, as part of a sport-related concussion medical management program, for middle school children. We examined if preseason baseline performance on the Sway Medical Mobile Balance and Cognitive Tests differs by self-reported ADHD diagnosis in 12- and 13-year-old children.

Methods

Data from 2,501 children (49.1% girls) between 12- and 13-years-old (mean=13.64 years, standard deviation=0.48), tested in 2022, without a self-reported concussion in the past 6 months, were examined. Mann-Whitney U tests were used to compare balance and four cognitive test scores between children with and without self-reported ADHD, stratified by gender, and significance was set at p<.01.

Results

There were no significant differences on balance testing for boys or girls with ADHD compared to those without ADHD. Boys with ADHD performed slightly slower on the Impulse Control (p=.001, Hedge’s g=.14) and Inspection Time (p=.002, g=.22) tests than boys without ADHD. Girls with ADHD performed slightly slower on the Reaction Time test (p=.001, g=.33) than girls without ADHD. No differences were found on the Memory test for girls or boys.

Conclusions

Middle school aged boys and girls with ADHD did not perform worse on balance testing and some of the cognitive tests compared to children without ADHD. There were small magnitude differences on timed tests of Impulse Control and Inspection Time for boys and Reaction Time for girls, with youth who self-reported having ADHD performing slower than youth without ADHD.
A-37 Performance of Adolescents with Attention Deficit/Hyperactivity Disorder on Sway Medical Mobile Balance and Cognitive Tests
Authors: Liu B C , Cook N E , Iverson G L
Published: June 2023

Purpose

Prior research has revealed differences on some cognitive and balance tests between adolescents with and without attention deficit/hyperactivity disorder (ADHD). We examined if preseason baseline performance on the Sway Medical Mobile Balance and Cognitive Tests differs by self-reported ADHD diagnosis in in adolescents ages 14-18.

Methods

Test data from 26,460 adolescents (48.7% girls) between 14- and 18-years-old (mean=15.90 years, standard deviation=1.45), who underwent baseline testing in the summer of 2022 and denied having sustained a concussion in the past 6 months, were examined. Mann-Whitney U tests were used to compare balance and cognitive test scores between adolescents with and without a self-reported ADHD diagnosis within boys and girls, and significance was set at p<.01.

Results

For both boys and girls, adolescents with ADHD obtained worse scores (i.e., slower performance) on the Reaction Time, Impulse Control, and Inspection Time tests (p<.001) and lower scores (i.e., worse performance) on Memory tests (p<.001) and on balance testing (p<.001). Effect sizes for these differences ranged from tiny to small (Hedge’s g=.05-.24).

Conclusions

Adolescents aged 14-18 with a self-reported ADHD diagnosis performed slightly worse on the Sway Medical Mobile Balance and Cognitive Tests, with minimal to small effect sizes. For boys and girls, the largest differences (though small in magnitude) were noted on balance testing and the Memory and Inspection Time tests.
A-39 A Comparison of Concussion Reporting between the Olympic and Paralympic Games
Authors: Magill R , Broshek D , Kaplan D , Denton A , Smetana R
Published: June 2023

Purpose

Research has established that the Paralympic Games have a higher injury rate than the Olympic Games, but less is known about how concussion rates may differ between these two populations. Concussions in Paralympic athletes are more difficult to accurately diagnose due to the lack of robust concussion guidelines specific to para athletes. This literature review sought to compare reporting of concussion symptoms and incidence between the Paralympic and Olympic Games since 2010. Data Selection: Searches of Google Scholar, PubMed, and ResearchGate were performed to identify Paralympic and Olympic injury and surveillance study data. Hand-searching citation lists yielded additional results. Articles were included if they reported head injury and/or concussion data.

Results

Fourteen articles were included that provided injury surveillance study data from 2010 to 2022. Data on head injury and concussion incidence and diagnosis were extracted and reviewed. Between 2010 and 2018, higher concussion rates were reported in Olympic athletes, possibly due to the lack of concussion-specific injury questions for Paralympic athletes. When concussion-specific injury questions for Paralympic athletes were implemented in 2018, data suggests that Paralympic athletes sustained more concussions than Olympic athletes. Additionally, the review suggested potential under-reporting of concussions in Paralympic athletes, despite symptoms, suggesting incidence may be higher than reported.

Conclusions

Higher concussion rates in the Paralympic Games and possible under-reporting of concussions highlights the need for improved identification and evaluation of concussions in Paralympic athletes. Establishing robust guidelines for the identification, evaluation, and management of concussions for para athletes is critical to increase their safety.
A-42 Patient Perspectives and Attitudes Toward the Use of Virtual Reality in Pediatric Sports-Related Concussion
Authors: Mathew A , Datoc A , Boucher S , Choi D , Ellis C , Abt J , Worts P
Published: June 2023

Purpose

Virtual reality (VR) has garnered increased attention as a modality to evaluate sports-related concussion (SRC). The purpose of this study was to better understand patient perspectives and attitudes towards VR while in the acute phase of injury.

Methods

Pediatric SRC patients aged 12-18 and within 72 hours from injury to initial visit were recruited. After completion of a VR task, patients were asked to rate their attitudes and perceptions on a custom VR user experience survey, on a scale of 0 (strongly disagree) to 4 (strongly agree).

Results

A total of 21 patients were eligible (Age=14.9±1.7; Female 57.1%; White 61.9%). Patients reported that the VR task involved mental focus (3.14±.57), required eye movements in all directions (3.33±.97), and motivated them to “finish and win” (3.38±2.11). Patients were neutral in their evaluation of the strategic component of the VR task (2.48±.93). They denied any difficulties understanding task instructions (.67±.96).

Conclusions

Overall, VR may be a promising avenue of research to evaluate SRC in pediatric patients given the level of engagement, ease of administration, and rich data captured by the VR device. Future research should determine whether VR can be used to accurately diagnose SRC and gather user information about ways to amplify the game-like and strategic nature of the task.
A-43 Somatic and Cognitive Predictors of Concussion Recovery Length
Authors: Miller K , Costopoulos J , LoGalbo A
Published: June 2023

Purpose

This study explored the relationship between neurocognitive testing and symptom reporting before and after concussion and recovery duration. It was hypothesized that declines in cognition would predict length of recovery.

Methods

Neurocognitive data was collected from 257 college students at baseline and post-concussion using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT).

Results

Results revealed an increase in ImPACT Total Symptoms from baseline to post-injury predicted recovery time b=-.45, t(255)=4.25, p<.01, explaining a significant portion of variance in recovery time R2=.07, F(1,255)=18.35, p<.01. Meanwhile, changes in cognition were not significant predictors of recovery time. However, recovery time was longer among participants who declined in Verbal Memory (M=26.98, SD=37.80) compared to those with no decline (M=17.66, SD=24.38) t(249)=2.40, p< 01. Similar findings were observed among those who declined in Visual Motor Speed (M=27.22, SD=33.77) versus no decline (M=19.06, SD=34.58) t(232)=1.80, p<.05; decline in Reaction Time (M=28.55, SD= 39.67) versus no decline (M=16.71, SD=21.78) t(215)=2.91, p<.01; and those who had an increase in Total Symptoms (M=25.53, SD=35.16) versus no increase (M=10.12, SD=12.23) t(193)=5.07, p<.01.

Conclusions

ImPACT Total Symptom score appears to be the best predictor of length of recovery time after a concussion. However, declines in Verbal Memory, Visual Motor Speed, and Reaction time, and an increase in Total Symptom score, also appear to be related to a longer recovery time after a concussion.
A-46 MMA Athletes Demonstrate Different Brain Vital Sign Profiles Compared to Matched Controls at “Baseline”
Authors: Munce T A , Fickling S D , Poel D N , D’Arcy R C N
Published: June 2023

Purpose

We compared objective brain vital sign metrics derived from event-related potentials (ERPs) of mixed martial arts (MMA) athletes and matched control participants.

Methods

We recorded 101 successful EEG scans from 12 MMA athletes (24.8 ± 2.6 yr) and 18 matched control participants (26.5±3.5 yr). For this analysis, only “baseline” scans were considered (n=30). “Baseline” was at least 90 days from a previous fight and 90 days (MMA) or 1 year (control) following medical clearance from a previously diagnosed concussion. We derived objective, clinical metrics (brain vital signs) from ERPs for auditory sensation (N100), basic attention (P300), and cognitive processing (N400) evoked while participants listen to a 6-minute auditory stimulus sequence. EEG data were processed using standard methods. N100, P300, and N400 amplitudes and latencies were manually identified on evoked potential waveforms by a blinded reviewer. Differences between groups at the waveform level were evaluated with a mass-univariate analysis using non-parametric resampling. Brain vital signs were compared across groups with a Kruskal-Wallis H-test for independent samples, with FDR correction for multiple comparisons.

Results

Mass-univariate waveform analyses showed significant differences (P < 0.05) between MMA athletes and controls in both P300 and N400 ERPs. The Kruskal-Wallis test identified a significant difference in N400 amplitude (H=7.04, P=.008, Padj=.047) between MMA athletes and controls.

Conclusions

MMA athletes demonstrate significant differences in “baseline” brain vital signs compared to controls, indicating that exposure to repetitive head impacts in MMA may be associated with subconcussive changes in brain function.
A-47 Vestibular Symptoms and Recovery Time in Sport-Related Concussions among Collegiate Athletes
Authors: Nelson F , Clise E , LoGalbo A
Published: June 2023

Purpose

This study represents the initial phase in testing self-reported vestibular symptoms as potential predictive factors of protracted concussion recovery times among collegiate athletes.

Methods

Vestibular Symptoms Scale–Short Form (VSS-SF) was administered to 24 collegiate athletes (12 females, 12 males; ages=18-21) at baseline and post-injury. Participant data was grouped by number of days until symptom resolution post-concussion (1-10 days [N=13], 11-60 days [N=11]) and VSS-SF discrepancy scores (d-scores). To calculate d-scores, baseline scores were subtracted from post-injury scores for each athlete. Instances in which baseline scores were higher than post-injury were assigned a discrepancy score of 0. Concussion symptoms were documented using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and Sport Concussion Assessment Tool, 5th Edition (SCAT-5).

Results

Results from an independent samples t-test demonstrated that VSS-SF d-scores were significantly higher among athletes with 11+ post-concussive recovery days (M=9.64, SD=10.21) compared to those with 1-10 recovery days (M=2.92, SD=3.77), t(22)=2.21, p=.019). Additionally, a simple regression revealed that d-scores significantly predicted recovery time and explained 23.9% of the variance (b=.44, R2=.24, p=.015). Interaction and mediation results will be presented and discussed.

Conclusions

Results suggest that changes in VSS-SF pre- and post-concussion can differentiate athletes with relatively short versus longer recovery time and predict length of concussion recovery. Further research with a larger number of participants appears warranted.
A-49 Predictors of sleep quality among adolescents following concussion.
Authors: Perry C , Trbovich A M , Blaney N , Holland C L , Hirsh M , Reed A , Walzer K , Collins M W , Kontos A P
Published: June 2023

Purpose

To identify predictors of sleep quality following concussion in adolescents.

Methods

Ninety-four (47%-F) participants aged 11-17 (14.31±2.8) years within 7 days of injury were recruited from a specialty concussion clinic and emergency department. Participants completed demographics, mTBI and medical history, Adolescent Sleep-Wake Scale (ASWS), Concussion Clinical Profiles Screening (CP Screen), and Post-Concussion Symptom Scale (PCSS). Stepwise logistic regressions (LR) were used to identify predictors of ASWS scores. Results of the LR were used to create a probability test variable for receiver operating characteristic (ROC) curve analyses.

Results

Results of the LR for ASWS total sleep score were significant (p<.001) and accurately identified 83.1% of adolescents with sensitivity of 76.7% and specificity of 89.1%, with history of anxiety (Adj OR=9.52, 95%CI=1.71-52.63, p=.01) and CP Screen anxiety domain total score (Adj OR=1.92, 95% CI=1.41-2.61, p<.001) as significant predictors. ROC analysis of the combined probability test variable for total sleep score was significant with area under the curve (AUC)=.88 (95%CI=.80-.94, p<.001). Similar findings were supported for history of anxiety and CP Screen anxiety domain scores on individual sleep domain scores.

Conclusions

History of anxiety and higher CP Screen anxiety score were predictive of poor sleep among adolescents following concussion. Surprisingly, age, sex, mTBI and migraine history, as well as total higher symptoms burden were not associated with poor sleep following concussion. The findings suggest that clinicians should focus on interventions to reduce anxiety to enhance sleep among adolescents following concussion.
A-54 Increased Symptoms During a Post-Concussion Neuropsychological Evaluation are Associated with Intraindividual Cognitive Variability and Anxiety
Authors: Riegler K E , Thomas G A , Bradson M L , Arnett P A
Published: June 2023

Purpose

To examine the relationship between self-reported affect, cognitive functioning, and increased symptoms during a post-concussion neuropsychological evaluation.

Methods

46 collegiate athletes (M=34, F=12) completed a comprehensive neuropsychological evaluation within 14 days of concussion, including measures of depression (Beck Depression Inventory-Fast Screen (BDI-FS)) and anxiety (NEO Five Factor Inventory (NEO-FFI) Anxiety Subscale). Suggested cutoffs for significant depression (BDI-FS ≥4) and anxiety (NEO-FFI Anxiety Subscale ≥10) symptomatology were utilized. The 21-item Post-Concussion Scale (PCS) was administered at the beginning (Pre-PCS) and end (Post-PCS) of testing. A difference score was calculated by subtracting Post-PCS from Pre-PCS. Composites of mean neuropsychological performance and two intraindividual variability (IIV) indices (average standard deviation and maximum discrepancy score) were created separately for two domains: memory and attention/processing speed (APS).

Results

Cognitive functioning explained a significant amount of the variance in Pre-Post PCS difference scores, F(6,39)=5.13, p<.001, R2=.44. Both IIV indices for memory and APS (all p’s<.02) significantly predicted difference scores, with cognitive variability increasing as Pre-Post PCS difference scores increased, but traditional mean composites did not (p’s>.05). Athletes who reported significant anxiety symptomatology (M=-4.33, SD=4.41) were significantly more likely than those who did not (M=.21, SD=3.75) to experience an increase in PCS symptoms, t(37)=2.66, p=.01, 95% CI [1.09,8.00]. There were no significant Pre-Post PCS symptom changes between athletes reporting significant depression symptomatology (M=.43, SD=5.19) or not (M=-.15, SD=4.61).

Conclusions

Higher IIV in cognitive functioning and worse anxiety symptomatology, but not traditional mean differences in cognitive functioning or depression symptomatology, were associated with an increase in symptoms during a post-concussion evaluation.
A-56 Post-Concussion Depression Presents in Distinct and Unique Factors
Authors: Schatz P , D'Andrea A , Durfee K , Dollar C , Jennings S , Womble M , Elbin R J
Published: June 2023

Purpose

Post-concussion depression is a commonly endorsed symptom, and a key component of both the Emotional Cluster of the Post-Concussion Symptom Scale and also the Anxiety/Mood Clinical Profile. The purpose of this study was to explore the overlap between the PCSS and items on a widely used measure of depression, the PHQ9, in concussed athletes.

Methods

A sample of 365 athletes (mean age=15.10±2.25 years; 46% female) seeking care for a concussion at a specialty clinic within 30 days of injury (M= 7.79±7.1 days) were enrolled in the study. The PCSS and PHQ9 were administered to all participants. Two factor analyses were conducted, using: 1) all items from the PCSS and PHQ9, and 2) only the items from the PHQ9.

Results

The PCSS/PHQ9 FA identified only “Sadness” and “More Emotional” as sharing variance with PHQ9 items, including symptoms of “Feeling Down/Depressed/Hopeless”, “Feeling Bad About Self”, “Suicidal Thoughts” and “Little Interest/Pleasure in Doing Things”. PHQ9 items of “Trouble Concentrating”, “Moving/Speaking Slowly or Fidgety/Restless” and “Feeling Tired/Low Energy” loaded on a unique factor with no shared variance with PCSS items. Factor Analysis of only the PHQ9 items retained all but the “Poor Appetite or Overeating” item, yielding two distinct post-concussion depression factors: a Cognitive/Fatigue Factor and a Depressive/Rumination Factor.

Conclusions

Post-concussion depression presents as a unique two-factor construct, with some shared variance with PCSS items. Use of an additional measure of depression is recommended to identify post-concussion depressive symptoms beyond “sadness” and “more emotional” and help clinicians determine an appropriate treatment plan.
A-59 Sport-related concussion in para athletes: A scoping review of concussion assessment and management
Authors: Smetana R M , Kaplan D T , Magill R T , Denton A H , Broshek D K
Published: June 2023

Purpose

Current guidelines have lagged in addressing sport-related concussion (SRC) in athletes with disabilities, or para athletes. Concussion assessments may not accurately capture symptoms in para athletes or be appropriately accessible, resulting in challenges managing SRCs in these athletes. The objective of this scoping review was to summarize the current literature on SRC in para athletes, including assessment procedures and management of SRC.

Data Selection

This review was registered with Open Science Framework and adhered to PRISMA-ScR guidelines. Searches of electronic databases (CINAHL, Google Scholar, MEDLINE, SPORTDiscus, and Web of Science) were conducted from database inception to 02/01/2023. Articles selected examined SRC assessment and management in adaptive sports.

Data Synthesis

Reviewers screened 202 title-abstracts and 32 articles qualified for full-text review, with 9 articles qualifying for data extraction for information on SRC assessment and management. Most articles addressed baseline assessment (N=6), some addressed both assessment and management (N=2), and only one article addressed SRC management (N=1). Results identified discrepancies in the results of baseline data in para athletes. Differences in baseline composite scores and symptom reporting in para vs. non-adaptive athletes were also found. The literature acknowledged lack of validated assessment tools and SRC management guidelines for para athletes.

Conclusions

There is limited literature on the assessment and management of SRC in para athletes at both elite and non-elite levels, indicating a lag in research on para athletes as compared to non-adaptive athletes. Development or standardization of current baseline assessment procedures for SRC and subsequent management guidelines for para athletes is needed.
A-61 Exploring The Role Of Acculturation In The Development Of Post-Concussive Symptoms In Minority College Athletes
Authors: Tavares A
Published: June 2023

Purpose

This review explored the role acculturative stress may have in the development of post-concussive symptoms of minority college athletes.

Data Selection

The data was collected via scientific journals accessed library databases, google scholar, and PubMed. Criteria for the selection included: published since the year 2011, focus on college students, studies that were parsimonious and examined post-concussive symptoms, acculturation, and sports related concussions. Guidelines for abstracting data included comparing study abstract to text to confirm accuracy, and being aware of bias by selecting relevant research and interpreting results based on context and available evidence. Nine (N=9) studies were reviewed.

Results

The results showed that college athletes are at higher risk for developing PCS if they had experienced multiple concussions, pre-morbid mood disorders, and/or if they were experiencing co-morbid psychosocial stressors. Concerning acculturation among college students, the literature suggests that acculturative stress puts this population at an increased risk for the development of mood disorders like depression.

Conclusions

There may be a relationship between acculturation and the development of post-concussive symptoms in college students but more studies should be conducted that test the direct relationship.
A-63 Adolescent Males Demonstrate Greater Reduction in Dizziness Compared to Females after Vestibular Therapy Post-Concussion
Authors: Trbovich A M , Fazio-Sumrok V , Kegel N , Mucha A , Holland C , Siibo A M , Collins M W , Kontos A P
Published: June 2023

Purpose

To examine sex differences in treatment response to vestibular therapy following subacute concussion.

Methods

This secondary analysis of a double-blind RCT recruited adolescent concussion patients with vestibular dysfunction and randomized to either a vestibular intervention group (VESTIB) or a behavioral management group (CONTROL). Participants completed The Dizziness Handicap Inventory (DHI) at initial evaluation, 2, and 4 weeks (±5 days) postintervention. The intervention was administered by concussion specialized vestibular therapists. A 2x2x3 repeated-measures GLM was conducted to examine sex differences (male, female) on DHI score at 3 time points (initial evaluation, 2 and 4 weeks postintervention) for both groups (CONTROL, VESTIB).

Results

VESTIB (n=12, 6F/6M) and CONTROL (n=15, 10F/5M) participants were 15.39+/-1.57 years old, injured within 21 days of initial evaluation. Results of the repeated-measures GLM supported a main effect for decrease in DHI (F[2,22]=30.47, p<.001, Wilks'Λ=.27, partial η2=.74) across visits. There was a significant group x gender x time interaction for DHI (F[2,22]=4.45, p=.024, Wilks'Λ=0.71, partial η2=.29), in which the males in the VESTIB group had a more significant decrease in DHI, while similar change in DHI was observed across genders for the CONTROL group. A main effect for group on DHI score fell short of significance (p=.06).

Conclusions

Our preliminary study suggests adolescent males may experience a faster resolution of dizziness compared to females' post-concussion when receiving vestibular therapy, but behavioral management supported similar dizziness reduction rates between sexes. Future research should examine mechanisms for differences in treatment response, such as adherence to treatment or underlying physiological differences.
A-64 The Impact of a Sports-Related Concussion on Emotional Beliefs of Collegiate Athletes.
Authors: Uhren A , Breitmeyer A , Virden T
Published: June 2023

Purpose

The purpose of this review is to summarize the current literature on the effects of sports-related concussion on an athlete’s emotional beliefs. Emotional beliefs are an individual’s beliefs on whether emotions are controllable, as well as useful or unwanted. Understanding how a concussion affects an athlete’s emotional beliefs can assist in determining appropriate interventions for treatment. Data Selection: The informal literature search was conducted through EBSCOhost and PsychINFO databases from August 2022 through February 2023 for articles containing CONCUSSIONS plus one of the following: EMOTIONAL BELIEFS, COLLEGIATE ATHLETES, EMOTIONS. Inclusion criteria included data collected from a collegiate sample, article presented original research, articles published in 2000 or later, and articles contained relevant information regarding emotional beliefs in collegiate athletes. Due to the dearth in the literature regarding emotional beliefs, only five studies were reviewed.

Results

Currently within the literature, there is debate about the construct of emotional beliefs. The literature is mixed on how to define emotional beliefs as well as how to distinguish emotional beliefs from cognition. Within the literature there is agreement that emotional beliefs are additionally influenced by a myriad of factors. Although emotional changes are observed in concussed athletes, there has been little research on how concussions impact athlete's beliefs about their emotions. Baseline concussion testing often does not include any mood measures, thus limiting post-injury assessment to strictly cognitive domains.

Conclusions

Sustaining a concussion can lead to increased stress and exacerbate pre-existing psychological disturbances. Changes in emotional beliefs can affect an athlete’s mental well-being, which in turn can affect their athletic and academic performance. In sum, there is a need for further research on the effects of concussions on cognitive and emotional beliefs in the field of sports neuropsychology.
A-65 Early Academic Stress and Problems are Associated with Concussion Symptom Burden Across Recovery
Authors: Terheyden van S , Richie R , Vaughan C , Gioia G
Published: June 2023

Purpose

Concussion symptoms are associated with initial academic concerns in youth. We hypothesized that early academic stress and difficulty would be associated with greater symptom burden across recovery visits.

Methods

200 patients aged 8 to 18 (M age=14.4±2.2, 51% female, 67% white) with a concussion completed the Concussion Learning Assessment and School Survey, 3rd Edition (CLASS-3) at first visit, a validated self-reported rating scale of academic problems (AP; 14 items) and school stresses (SS; 6 items) along with the developmentally appropriate Post-Concussion Symptom Inventory-2 (PCSI-2), which generates Retrospectively-Adjusted Post-Injury Difference (RAPID) symptom scores by 8-12 and 13-18 age groups. Subgroups of participants completed the PCSI-2 only at visit 2 (n=128) and at visit 3 (n=29).

Results

There were significant positive partial correlations (p<.05), controlling for age and sex, between CLASS-3 scores and the PCSI-2 RAPID scores in the 8-12 age group for AP (V1 r=.60 and V2 r=.42) and SS (V1 r=.33 and V2 r=.34) and in the 13-18 group for AP (V1 r=.72, V2 r=.51, V3 r=.52) and SS (V1 r=.50, V2 r=.49). The effect was moderate, but not statistically significant due small sample sizes, at visit 3 in 8-12 group (AP V3 r=.50; SS r= .41) and in the 13-18 group for SS (r=.34).

Conclusions

Students with higher early academic problems and school stresses reported higher symptom burden over time. These results suggest that early academic supports to mitigate school problems and stress may subsequently lessen symptom burden across the course of recovery.
A-71 Olympic team rowers and team swimmers show altered functional brain activation during working memory and action inhibition
Authors: Yao Z-F , Sligte I G , Ridderinkhof K R
Published: June 2023

Purpose

High-level expertise in team-sports has been found to be associated with superior performance on executive functions (EFs) such as working memory (WM) and action inhibition, and with altered activation of brain areas related to these EFs. In most such studies, athletes were sampled from the domain of dynamic (i.e., open-skill) team-sports (e.g., soccer players). Whether static (i.e., closed-skill) team-sports athletes (e.g., rowers and synchronized swimmers) show superior EFs performance and differential EF-related functional brain activation as well remains unknown.

Methods

We recruited 14 elite closed-skill athletes, all national champions, and internationally competitive in various rowing disciplines, as well as 14 controls matched on gender, age, and education, and had them perform working memory and action inhibition (stop-signal) tasks during functional Magnetic Resonance Imaging (MRI) scanning.

Results

Group differences in performance in either task failed to obtain statistical significance, although athletes showed a numerical trend toward higher WM capacity than controls. Importantly, task-related BOLD responses suggested that Olympic closed-skill team athletes show stronger recruitment of brain areas that emphasize relatively stable task demands and weaker engagement of brain areas that emphasize rapidly changing demands imposed by extraneous stimulation.

Conclusions

Functional brain imaging data suggest that elite closed-skill athletes may employ different cognitive strategies.
The Health Impacts, Prevalence, and Acceptance Level of Cosmetics Interventions Among Females in Saudi Arabia
Authors: Alghamdi Hussam Y , Alrashed Abdulaziz M , Alzahrani Sultan M , Altalhi Ibtisam A , Althubaiti Reema S , Abd-Elrahman Tamer M
Published: June 2023

Background

With the rising global desire for beauty, cosmetic interventions have increased. Saudi Arabia ranked 29 among the top 30 fastest growing countries for cosmetic procedures.

Objectives

This study aims to investigate the prevalence, acceptance level, and health impacts of cosmetic interventions among females in Saudi Arabia.

Methods

This cross-sectional study was conducted from December 2022 to January 2023 among females living in Saudi Arabia. Participants’ acceptance of cosmetic interventions was assessed using an Arabic version of the validated Acceptance of Cosmetic Surgery Scale. The data were collected using a self-administered questionnaire.

Results

The study included 3007 females living in Saudi Arabia. About 58% of the participants were aged 18 to 25, and 72.9% were single. The prevalence of cosmetic interventions among the participants was 10%. A higher prevalence was observed among participants over 25 years, married, high economic status, employed, postgraduate, and participants recognizing the necessity of cosmetic interventions (P < .001). High acceptance levels toward cosmetic interventions were observed among older, married, employed, and postgraduate respondents and those with high economic status (P < .001). Meanwhile, knowing the adverse events of cosmetic interventions was associated with a low level of acceptance with a P-value of <.001.

Conclusions

The present study demonstrated a surprising prevalence of cosmetic interventions among females in Saudi Arabia. However, below-average acceptance of these interventions among the same population was reported. This could be a result of the surrounding culture that does not support or encourage undergoing cosmetic interventions. Further studies are recommended to assess the prevalence of those interventions using objective tools, such as medical records.

Level of Evidence: 4
Characterization of chitinolytic bacteria newly isolated from the termite Microcerotermes sp. and their biocontrol potential against plant pathogenic fungi
Authors: Chanworawit Kittipong , Wangsoonthorn Pachara , Deevong Pinsurang
Published: June 2023

Chitinolytic bacteria were isolated from guts and shells of the termite Microcerotermes sp. Among the nineteen morphologically different chitinolytic isolates, three isolates with highest extracellular chitinase production ratio (≥2.26) were selected. Based on molecular identification of 16S rRNA gene sequences and biochemical characterizations using API test kits and MALDI-TOF MS, these isolates were closely related to Bacillus thuringiensis (Mc_E02) and Paenibacillus species (Mc_E07 and Mc_G06). Isolate Mc_E02 exhibited the highest chitinase-specific activity (2.45 U/mg protein) at 96 h of cultivation, and the enzyme activity was optimized at pH 7.0 and 45 °C. The isolate showed highest and broad-spectrum inhibitory effect against three phytopathogenic fungi (Curvularia lunata, Colletotrichum capsici, and Fusarium oxysporum). Its 36-kDa chitinase exhibited the biomass reduction and mycelium inhibition against all fungi, with highest effects to Curvularia lunata. This research provides novel information about termite chitinolytic bacteria and their effective chitinase, with potential use as biocontrol tool.
Uni-GBSA: an open-source and web-based automatic workflow to perform MM/GB(PB)SA calculations for virtual screening
Authors: Yang Maohua , Bo Zonghua , Xu Tao , Xu Bo , Wang Dongdong , Zheng Hang
Published: June 2023

Binding free energy calculation of a ligand to a protein receptor is a fundamental objective in drug discovery. Molecular mechanics/Generalized-Born (Poisson–Boltzmann) surface area (MM/GB(PB)SA) is one of the most popular methods for binding free energy calculations. It is more accurate than most scoring functions and more computationally efficient than alchemical free energy methods. Several open-source tools for performing MM/GB(PB)SA calculations have been developed, but they have limitations and high entry barriers to users. Here, we introduce Uni-GBSA, a user-friendly automatic workflow to perform MM/GB(PB)SA calculations, which can perform topology preparation, structure optimization, binding free energy calculation and parameter scanning for MM/GB(PB)SA calculations. It also offers a batch mode that evaluates thousands of molecules against one protein target in parallel for efficient application in virtual screening. The default parameters are selected after systematic testing on the PDBBind-2011 refined dataset. In our case studies, Uni-GBSA produced a satisfactory correlation with the experimental binding affinities and outperformed AutoDock Vina in molecular enrichment. Uni-GBSA is available as an open-source package at https://github.com/dptech-corp/Uni-GBSA. It can also be accessed for virtual screening from the Hermite web platform at https://hermite.dp.tech. A free Uni-GBSA web server of a lab version is available at https://labs.dp.tech/projects/uni-gbsa/. This increases user-friendliness because the web server frees users from package installations and provides users with validated workflows for input data and parameter settings, cloud computing resources for efficient job completions, a user-friendly interface and professional support and maintenance.
HiCLift: a fast and efficient tool for converting chromatin interaction data between genome assemblies
Authors: Wang Xiaotao , Yue Feng
Published: June 2023

Motivation

With the continuous effort to improve the quality of human reference genome and the generation of more and more personal genomes, the conversion of genomic coordinates between genome assemblies is critical in many integrative and comparative studies. While tools have been developed for such task for linear genome signals such as ChIP-Seq, no tool exists to convert genome assemblies for chromatin interaction data, despite the importance of three-dimensional genome organization in gene regulation and disease.

Results

Here, we present HiCLift, a fast and efficient tool that can convert the genomic coordinates of chromatin contacts such as Hi-C and Micro-C from one assembly to another, including the latest T2T-CHM13 genome. Comparing with the strategy of directly remapping raw reads to a different genome, HiCLift runs on average 42 times faster (hours vs. days), while outputs nearly identical contact matrices. More importantly, as HiCLift does not need to remap the raw reads, it can directly convert human patient sample data, where the raw sequencing reads are sometimes hard to acquire or not available.

Availability and implementation

HiCLift is publicly available at https://github.com/XiaoTaoWang/HiCLift.