bluuebunny/crossref_metadata_2025_split huggingface dataset:
A-18 Utility of the Child SCAT-5: Performance Differences Across Assessments in Pediatric Concussion
Authors: Fazio-Sumrok V , Blaney N , Kissinger-Knox A , Eagle S , Kegel N , Trbovich A , Kontos A P 
Published: June 2020

Abstract

Objective
In 2017, the Sport Concussion Assessment Tool-5 Child (Child SCAT-5) was introduced as a tool for clinicians to assess cognitive function and symptoms in children following a concussion (Davis, 2017; Echmendia, 2017); however, there are limited data supporting its use. The purpose of this study was to assess performance on the Child SCAT-5 among concussed pediatric patients (i.e., 5–9 years) across two clinic visits.

Method
Participants included 95 children (42.15% female) aged 5–9 years (7.42 +/− 1.12) who were diagnosed with a concussion within 30 days of injury (8.75 +/− 5.65 days). Patients underwent clinical interview and Child SCAT-5. Paired t-tests were used to compare measures on symptomatology, neurocognitive function, and balance performance between their first two clinical encounters (18.07 +/− 16.05 days).

Results
Analyses revealed significant improvements for immediate memory (p &lt; 0.001) and delayed recall (p = 0.035), as well as improvements in symptom count (p &lt; 0.001), symptom severity (p &lt; 0.001), and back-to-normal rating (p = 0.004). Headaches (85.6%), feeling tired a lot (65.9%), getting tired easily (59.3%), difficulty concentrating (57.1%), and being distracted (54.9%) were the most commonly reported symptoms at patients’ initial clinic visit.

Conclusions
The findings from this study indicate that the Child SCAT-5 is useful for identifying common symptoms in pediatric patients tracking symptom improvement across clinic visits. The measure was also useful in identifying improvements in neurocognitive functioning in this population, particularly memory performance. Further research should focus on how the Child SCAT-5 and other pediatric-specific measures can assess and track improvement in clinical outcomes for this at-risk population.
A-23 Mental Health Outcomes of Elite Athletes Following Sport Related Concussion
Authors: Hoyle C , Mrazik M , Naidu D 
Published: June 2020

Abstract

Objective
Investigation of anxiety and depression symptoms at baseline and following sport related concussion in a population of professional and collegiate football players.

Method
A quasi-experimental prospective longitudinal design was implemented. Participants included 198 Canadian Football League and University of Alberta varsity football players at baseline. Additionally, this study tracked 13 concussed athletes, 12 orthopaedic control athletes, and 15 healthy control athletes over approximately a 2 month period. Statistical analysis included an ANOVA and repeated measures ANOVA to identify differences in mental health at baseline as well as after injury at 3 time points (24-48 hours post injury, asymptomatic, and 1 month post return to play).

Results
At baseline, players who had a history of 1 or more concussions reported a greater number of anxiety and depression symptoms in comparison to players who did not have a history of concussion (F(2, 197) = 66.75, (p =.000)). At the group level, there were no differences in anxiety and depression symptoms between players who sustained a concussion, orthoepic injury, or no injury across the four time points measured (depression (F(3, 58) = 1.05, (p =.404); anxiety (F(3, 58) = 1.65, (p =.151)). However, individuals who sustained a concussion displayed significant changes in symptoms of anxiety (F(3, 12) = 9.004, (p =.000)) and depression (F(3, 12) = 11.396, (p =.000)) over time. Specifically, concussed players reported an increase in anxiety related symptoms between baseline report and 24-48 hours post injury (p = .042), a decrease between 24-48 hours and 1 month post return to play (p = .002) and a decrease between asymptomatic and 1 month post return to play (p = .036) time points. Additionally, players who sustained a concussion reported a significant increase in depressive symptoms between 24-48 hours post injury and 1 month post return to play (p = .029) and a decrease between asymptomatic and 1 month post return to play (p = .014) time points. This change over time was not found in the orthopaedic injury (depression (F(3, 11) = 2.467, (p =.14); anxiety (F(3, 11) = 2.242, (p =.15)) or healthy control groups (depression; (F(3, 14) = 2.177, (p =.17); anxiety; F(3, 14) = 1.435, (p =.30)).

Conclusions
Results from this study suggest that a history of concussion impacts baseline self-report of anxiety and depression symptoms. Furthermore, players who sustained a concussion experienced subtle increases in anxiety and depressive symptoms in the short term and not in the long term. Players with who sustained an orthopaedic injury and healthy players did not show these changes in anxiety and depression symptom report. It appears that in this small sample concussion produced unique outcomes related to mental health functioning in the short term.
A-30 Symptom Count Versus Symptom Severity: Which is a Better Predictor of Time to Recovery?
Authors: Pardini J , Pardini D , Sterling J , Docherty M , Mattis J 
Published: June 2020

Abstract

Objective
Evaluation of self-reported symptoms is a key component of concussion management. This study examined whether symptom count, a more parsimonious method to gather symptom information, would predict recovery better than symptom severity.

Method
Participants were 1267 (39.3% female) adolescents ages 10–18 (M = 14.7, SD = 1.8) who were evaluated and diagnosed with a concussion by a physician within 10 days of injury. At their initial visit, participants completed the ImPACT computerized test and the included post-concussion symptom scale. The primary outcome was number of weeks (M = 3.2, SD = 1.8) until participants were cleared to return to play by the treating physician based on a standardized protocol.

Results
Symptom count and symptom severity were highly correlated (r = .89, p &lt; .001). When examined in separate linear regression models, both symptom count (β = .28, p &lt; .001) and symptom severity (β = .25, p &lt; .001) predicted weeks until return to play after controlling for age, gender, prior history of concussion, and neurocognitive test performance. However, when symptom count and severity were both included in the same regression model, symptom count continued to predict weeks to recovery (β = .31, p &lt; .001) and the effect of symptom severity was reduced to non-significance (β = −.03, p = .64).

Conclusions
Symptom count at initial clinic visit predicted recovery time, eliminating the predictive power of symptom severity when both were entered in the same regression model. Thus, symptom count may be a more robust and more parsimonious assessment than traditional severity ratings, which may save clinic time and allow for additional multimodal assessments.
A-32 Acute Concussive Symptom Profiles in Adolescents and Young Adults with History of Depression and Anxiety
Authors: Presley C , Meredith-Duliba T , Tarkenton T , Stokes M , Miller S , Bell K , Batjer H , Cullum C M 
Published: June 2020

Abstract

Objective
The aims of this study are (1) to examine the clinical symptom profiles of individuals with depression and/or anxiety history following a concussion and (2) to compare profile differences across groups.

Method
Participants aged 12-25 (n=129, mean=15.6) with premorbid diagnoses of depression (n=24), anxiety (n=50), or depression+anxiety (n=55) were evaluated within 21 days after sustaining a concussion as part of the North Texas Concussion Registry (ConTex) using the Post-Concussion Symptom Scale (PCSS). Following the model described by Kontos and Collins (2014), symptom clusters were derived from the PCSS to create six domains (cognitive/fatigue, vestibular, ocular, posttraumatic migraine, anxiety/mood, cervical). ANOVAs with Tukey’s post-hoc tests were conducted to compare domain symptom severity and total symptom severity across groups.

Results
There were no demographic differences between groups. A single symptom profile was prominent across each group, with the primary, secondary, and tertiary symptomatic domains being posttraumatic migraine, ocular, and cognitive/fatigue, respectively. Across each domain the depression+anxiety group was most symptomatic, followed in order by the depression and anxiety groups. The depression+anxiety group reported significantly higher anxiety/mood (M=2.0 vs. M=1.3) and cognitive/fatigue (M=2.9 vs M=2.1) symptom severity compared to the anxiety group. Group differences on total symptom severity approached significance (F=2.83, p=.06).

Conclusions
The observed symptom profiles suggest that the acute-concussive response is similar in adolescents and young adults with history of depression and/or anxiety. Multiple premorbid conditions, such as depression and anxiety, appear to magnify overall symptom severity. Further research is warranted to understand the relationship between symptom burden and premorbid mental health factors.
A-33 VOMS Scores Relationship to C3 Logix Trail Scores in Females
Authors: Price A M , Caze T , Knell G , Burkhart S 
Published: June 2020

Abstract

Objective
Burkhart and colleagues (2020) showed that positive screening on the Vestibular Ocular Motor Screening (VOMS) and slower C3 Logix Trails (C3LT) were predictive of protracted recovery in female adolescents. The purpose of this study was to see if there was a relationship between positive screening on the VOMS and slower C3LT times in a similar population.

Method
220 females aged 10–18 were administered the VOMS and C3LT between 2017–2019. We hypothesized that positive screening on the VOMS (i.e. symptom provocation of +2, convergence of &gt; 6 mm) would be related to slower speeds on C3LT A and B. Odds ratios were calculated to estimate the likelihood of screening positive on the VOMS based on C3LT times.

Results
Slower times on C3LT A and B, one to two standard deviations (SD) above the mean, was not related to a positive screening on the VOMS. However, performing a faster C3LT A time, one SD below the mean, was 68% less likely to screen positively on the VOMS (OR = 0.32, 95%CI = 0.16–0.62, p = 0.001) compared to those not 1 SD below the mean.

Conclusions
Though C3LT has a visual scanning component, positive screening on the VOMS was not related to slower processing speeds on the C3LT in females age 10–18.
A-46 Deconstructing Competitiveness: The Effect of Age on Athlete’s Desire to Succeed, Win, and Achieve Goals
Authors: Webber A M , Wong R E , Du Plessis S , Garcia-Barrera M A 
Published: June 2020

Abstract

Objective
Our previous research indicated that athletes scoring high in competitiveness were less likely to report sports-related concussion symptoms and withdraw from the game. The present study examined whether athletes’ desire to succeed (competitiveness motive), win (win orientation), and achieve personal goals (goal orientation) were related to the age of players.

Method
Participants included 161 athletes, ages 14–32 (M = 17.6 years; 33.2% female), recruited from a mid-sized Canadian city participating in low (rowing), moderate (soccer) and high (hockey, rugby, football) contact sports. Confirmatory factor analysis was first used to evaluate the structure of the Sports Orientation Questionnaire. Then, using SEM, athletes’ competitiveness, goal orientation, and win orientation were predicted by age.

Results
High internal consistency was obtained within each factor (.84–.93). The model demonstrated suboptimal fit for this sample (CFI = .84; χ2f/df ratio = 2.02; RMSEA = .087; 90% CI: .077–.097). All factors were significantly related to age, indicating that athletes’ desire to succeed (competitiveness motive; β = .18, p = .009), achieve personal goals (goal orientation; β = .26, p = .007), and win (win orientation; β = .30, p = .000) increases with age.

Conclusion
The small positive association between age and competitiveness, win, and goal orientation indicates that older athletes are more competitive than younger athletes. Given that competitiveness predicts athletes’ intention to report a concussion, clinicians and coaches should pay particular attention to senior athletes who demonstrate high levels of general competitiveness and who are driven by the desire to win and achieve personal goals. Therefore, interventions targeting the barriers to reporting concussions should evaluate subco.
RP-HPLC Method for the Determination and Quantification of Artesunate
Authors: Saeed Muhammad Asad , Ansari Muhammad Tayyab , Ch Bashir Ahmad , Zaman Muhammad 
Published: June 2020

Abstract
A simple, rapid and cost-effective reverse phase high-performance liquid chromatographic (RP-HPLC) method was developed for the quantification of artesunate. C18 Promosil (ODS, 150 × 4.6 mm, 5 μm) column was used as stationary phase to separate the drug. Mobile phase comprised of ethanol: water (65:35) having pH 4.5 was run isocratically at a flow rate of 1 mL/min at 27°C. The method was validated according to ICH guidelines for linearity, precision, accuracy, robustness, specificity, limit of detection (LOD) and limit of quantification (LOQ). The method was found accurate, precise and robust with an average retention time of 4.509 min and 0.5357 %RSD. Good linearity was observed in the concentration range of 2–10 mg/ml with regression coefficient R2 value of 0.9995 and slope value of 369,928. Conclusively, as per ICH norms, the developed method was successfully validated and used for the quantification of artesunate in fast dissolving tablets (FDTs).
Incidence, Etiology, and Severity of Acute Gastroenteritis Among Prospectively Enrolled Patients in 4 Veterans Affairs Hospitals and Outpatient Centers, 2016–2018
Authors: Cardemil Cristina V , Balachandran Neha , Kambhampati Anita , Grytdal Scott , Dahl Rebecca M , Rodriguez-Barradas Maria C , Vargas Blanca , Beenhouwer David O , Evangelista Karen V , Marconi Vincent C , Meagley Kathryn L , Brown Sheldon T , Perea Adrienne , Lucero-Obusan Cynthia , Holodniy Mark , Browne Hannah , Gautam Rashi , Bowen Michael D , Vinjé Jan , Parashar Umesh D , Hall Aron J 
Published: June 2020

Abstract

Background
Acute gastroenteritis (AGE) burden, etiology, and severity in adults is not well characterized. We implemented a multisite AGE surveillance platform in 4 Veterans Affairs Medical Centers (Atlanta, Georgia; Bronx, New York; Houston, Texas; and Los Angeles, California), collectively serving &gt;320 000 patients annually.

Methods
From 1 July 2016 to 30 June 2018, we actively identified inpatient AGE case patients and non-AGE inpatient controls through prospective screening of admitted patients and passively identified outpatients with AGE through stool samples submitted for clinical diagnostics. We abstracted medical charts and tested stool samples for 22 pathogens by means of multiplex gastrointestinal polymerase chain reaction panel followed by genotyping of norovirus- and rotavirus-positive samples. We determined pathogen-specific prevalence, incidence, and modified Vesikari severity scores.

Results
We enrolled 724 inpatients with AGE, 394 non-AGE inpatient controls, and 506 outpatients with AGE. Clostridioides difficile and norovirus were most frequently detected among inpatients (for AGE case patients vs controls: C. difficile, 18.8% vs 8.4%; norovirus, 5.1% vs 1.5%; P &lt; .01 for both) and outpatients (norovirus, 10.7%; C. difficile, 10.5%). The incidence per 100 000 population was highest among outpatients (AGE, 2715; C. difficile, 285; norovirus, 291) and inpatients ≥65 years old (AGE, 459; C. difficile, 91; norovirus, 26). Clinical severity scores were highest for inpatient norovirus, rotavirus, and Shigella/enteroinvasive Escherichia coli cases. Overall, 12% of inpatients with AGE had intensive care unit stays, and 2% died; 3 deaths were associated with C. difficile and 1 with norovirus. C. difficile and norovirus were detected year-round with a fall/winter predominance.

Conclusions
C. difficile and norovirus were leading AGE pathogens in outpatient and hospitalized US veterans, resulting in severe disease. Clinicians should remain vigilant for bacterial and viral causes of AGE year-round.
Persistent and Emerging Pneumococcal Carriage Serotypes in a Rural Gambian Community After 10 Years of Pneumococcal Conjugate Vaccine Pressure
Authors: Usuf Effua , Bottomley Christian , Gladstone Rebecca , Bojang Ebrima , Jawneh Kaddijatou , Cox Isatou , Jallow Edrissa , Bojang Abdoulie , Greenwood Brian , Adegbola Richard A , Bentley Stephen D , Hill Philip C , Roca Anna 
Published: June 2020

Abstract

Background
The continuing impact of pneumococcal conjugate vaccines (PCVs) in regions with high pneumococcal transmission is threatened by the persistence of vaccine serotypes (VTs) and the emergence of nonvaccine serotypes (NVTs).

Methods
In 2016, we conducted a cross-sectional carriage survey (CSS5) in a community where PCV7 was first introduced in 2006 during a cluster-randomized trial conducted before nationwide introduction of PCV7 (2009) and PCV13 (2011). We estimated prevalence of PCV13 VT and NVT by age and compared these with earlier surveys before (CSS0), during (CSS1-3), and after the trial but before PCV13 (CSS4). Genomic analysis was conducted for the nontypeable pneumococci.

Results
Prevalence of PCV13 VT carriage decreased during the 10 years between CSS0 and CSS5 across all age groups (67.6% to 13.5%, P &lt; .001; 59.8% to 14.4%, P &lt; .001; 43.1% to 17.9%, P &lt; .001; and 24.0% to 5.1%, P &lt; .001, in &lt;2, 2–4, 5–14, and ≥15 years, respectively). However, there was no difference between CSS4 and CSS5 in children ≥2 years and adults (children &lt;2 years, no data). The prevalence of PCV13 NVT increased between CSS0 and CSS5 for children &lt;2 years but decreased in older children and adults. In CSS5, serotypes 3, 6A, and 19F were the most common VT and nontypeable isolates were the most common NVT. Among nontypeable isolates, 73.0% lost the ability to express a capsule. Of these, 70.8% were from a VT background.

Conclusions
The decrease in PCV13 VT that has occurred since the introduction of PCV13 appears to have plateaued. Significant carriage of these serotypes remains in all age groups.
An Analysis of Antibacterial Drug Development Trends in the United States, 1980–2019
Authors: Dheman Nidhi , Mahoney Nicole , Cox Edward M , Farley John J , Amini Thushi , Lanthier Michael L 
Published: June 2020

Abstract
We present a longitudinal analysis of investigational new drug applications (INDs) for new, systemic antibacterial drugs under active development between 1980 and 2019, evaluating the characteristics of these investigational drugs and the outcomes of these drug development programs. The number of INDs in active development declined by two-thirds, from 39 active INDs at its peak in 1987 to a low 13 in 2001, with decreased development of new cephalosporin, quinolone, and macrolide drugs and reduced participation from large pharmaceutical firms. Antibacterial drug development activity rebounded substantially from 2002 to 2009, primarily led by involvement of small pharmaceutical companies. As of 31 December 2019, the number of active INDs has declined to an 11-year low, and the number of antibacterial INDs initiated with the US Food and Drug Administration during 2010–2019 was lower than any of the previous 3 decades. Antibacterial drug development programs initiated in the 1980s and 1990s had high success rates, with &gt;40% of INDs obtaining marketing approval, in a median time of about 6 years from IND receipt to approval. For drug development programs initiated between 2000 and 2009, we found that IND-to-approval rates reduced to 23%, with median development times for approved antibacterial drugs increasing to 8.2 years. The majority of INDs in development as of 31 December 2019 come from already established drug classes, most in early stages of development, and few are sponsored by large pharmaceutical companies.
Identification, Management, and Outcomes of Combination Antiretroviral Treatment Failure in Adolescents With Perinatal Human Immunodeficiency Virus Infection in Asia
Authors: Bartlett Adam W , Sudjaritruk Tavitiya , Mohamed Thahira J , Anugulruengkit Suvaporn , Kumarasamy Nagalingeswaran , Phongsamart Wanatpreeya , Ly Penh Sun , Truong Khanh Huu , Van Nguyen Lam , Do Viet Chau , Ounchanum Pradthana , Puthanakit Thanyawee , Chokephaibulkit Kulkanya , Lumbiganon Pagakrong , Kurniati Nia , Nik Yusoff Nik Khairulddin , Wati Dewi Kumara , Sohn Annette H , Kariminia Azar 
Published: June 2020

Abstract

Background
Combination antiretroviral therapy (cART) failure is a major threat to human immunodeficiency virus (HIV) programs, with implications for individual- and population-level outcomes. Adolescents with perinatally acquired HIV infection (PHIVA) should be a focus for treatment failure given their poorer outcomes compared to children and adults.

Methods
Data (2014–2018) from a regional cohort of Asian PHIVA who received at least 6 months of continuous cART were analyzed. Treatment failure was defined according to World Health Organization criteria. Descriptive analyses were used to report treatment failure and subsequent management and evaluate postfailure CD4 count and viral load trends. Kaplan-Meier survival analyses were used to compare the cumulative incidence of death and loss to follow-up (LTFU) by treatment failure status.

Results
A total 3196 PHIVA were included in the analysis with a median follow-up period of 3.0 years, of whom 230 (7.2%) had experienced 292 treatment failure events (161 virologic, 128 immunologic, 11 clinical) at a rate of 3.78 per 100 person-years. Of the 292 treatment failure events, 31 (10.6%) had a subsequent cART switch within 6 months, which resulted in better immunologic and virologic outcomes compared to those who did not switch cART. The 5-year cumulative incidence of death and LTFU following treatment failure was 18.5% compared to 10.1% without treatment failure.

Conclusions
Improved implementation of virologic monitoring is required to realize the benefits of virologic determination of cART failure. There is a need to address issues related to accessibility to subsequent cART regimens, poor adherence limiting scope to switch regimens, and the role of antiretroviral resistance testing.