bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loss of Consciousness is Associated with Increased Neurocognitive Intra-Individual Variability Following Sports-Related Concussion
Authors: Merritt V C , Greenberg L S , Meyer J E , Arnett P A 
Published: July 2019

Abstract

Purpose
Traditional markers of concussion severity, including loss of consciousness (LOC), retrograde amnesia (RA), and post-traumatic amnesia (PTA), have been inconsistently associated with neurocognitive performance following sports-related concussion. The purpose of this study was to evaluate whether LOC, RA, and PTA influence a particular aspect of post-concussion cognitive functioning—across-test intra-individual variability (IIV).

Methods
Concussed athletes (N=119; 77.3% male) were evaluated, on average, 8.55 days post-concussion (SD=11.27; Mdn=4 days) via clinical interview and neuropsychological assessment. Primary outcomes of interest included two measures of IIV-an average standard deviation (ASD) score and a maximum discrepancy (MD) score-computed from 18 norm-referenced variables.

Results
A one-way ANCOVA adjusting for time since injury revealed a significant effect of LOC on the ASD (F(1, 116)=6.78, p=.010, ηp2=.055) and MD (F(1, 116)=5.65, p=.019, ηp2=.046) scores, such that athletes with LOC displayed significantly greater IIV than athletes without LOC. In contrast, measures of IIV did not significantly differ between athletes who did and did not experience RA or PTA (all p>.05).

Conclusion
LOC, but not RA or PTA, was associated with greater variability, or inconsistencies, in cognitive performance following concussion. This suggests that LOC may be a relevant consideration when evaluating post-concussion cognitive dysfunction. IIV has recently been established as a sensitive measure of cognitive functioning in a variety of clinical samples and has been associated with underlying neurobiological integrity. Taken together, our results implicate LOC as a possible contributing factor of less efficient cognitive functioning following concussion and may help detect athletes at risk for poor clinical outcomes.
An Examination of Concussion Recovery Time in Athletes Ages 13–18
Authors: Burkhart S , Ellis C , Baggett J , Smurawa T , Polousky J 
Published: July 2019

Abstract

Purpose
The purpose of this study was to examine recovery time from concussion utilizing date of injury and date of return to play. It was hypothesized females would have longer recovery times by age and dual gender sports (baseball/softball, basketball, soccer, swimming/diving, and track/field).

Methods
This study used data from the Rank One Health Injury Surveillance Database (ROH ISD) between 2012–18, in student-athletes ages 13 to 18. This study examined concussion reporting by Athletic Trainers (ATCs) at both middle schools and high schools. Independent sample t-tests were performed by gender, age (13–15, 16–18), and sport with p < 0.05 being statistically significant.

Results
A total of 3,967 concussions with an average age of 15.34 (SD = 1.43), with a defined date of injury and date of return to play were recorded by ATCs. There was a significant effect in recovery time for gender, F(1, 3965) = 3.36, p<0.001 with females taking longer to recover than males. There was a statistically significant effect in recovery time for age, F(1, 3965) = 3.97, p<0.001 with athletes ages 13–15 taking longer to recovery than athletes ages 16–18. Females also experienced longer recovery when comparing sports, with significant differences observed in baseball/softball, soccer, swimming/diving, and track/field.

Conclusion
This study marks the largest examination of recovery time in student athletes ages 13–18. The findings from this study provide further evidence for longer observed recovery time in females compared to males.
Trends in United States High School Soccer Concussion Reporting from 2012–2017
Authors: Burkhart S , Ellis C , Baggett J , Smurawa T , Polousky J 
Published: July 2019

Abstract

Purpose
The purpose of this study was to provide updated high school soccer concussion incidence rates by gender and event type. It was hypothesized more soccer injuries occur in females, during games, and that females would have higher injury rates and risk.

Methods
This study used data from the Rank One Health Injury Surveillance Database (ROH ISD) between 2012–17, from 1,999 high schools in student-athletes ages 14 to 18. This study examined high school soccer concussion incidence rate reporting by Athletic Trainers (ATCs). Injury rates per 1,000 Athletic Exposures, injury rate ratios (IRRs), and risk ratios (RR) were calculated by event type. All 95% confidence intervals (CIs) not containing 1.0 were considered statistically significant.

Results
A total of 6,669 concussions with an average age of 15.62 (SD=1.26) were reported by ATCs in high school soccer from 2012-17. More concussions occurred in games (4,527; 67.9%) than practices (2,142; 32.1%). During games, males (3.49/1,000 AEs) had lower rates than females (7.78/1,000 AEs). During practice, males (0.52/1,000 AEs) had lower rates than females (0/97/1,000 AEs). Injury risk ratio was higher in games than practices for males (RR=6.71; 95% CI=6.67, 6.75) and females (RR=8.11; 95% CI=8.08, 8.14).

Conclusion
This study marks the largest epidemiological high school soccer concussion incidence investigation to date. The findings from this study provide updated high school soccer concussion incidence rates and provide further evidence of differences in injury rates when comparing practices and games.
Etiology and Clinical Presentation of Concussion: An Age- and Sex-matched Case Series
Authors: Porter S S , Spy K G , Worts P R 
Published: July 2019

Abstract

Purpose
Differential patterns of clinical presentation in concussion have been explored previously based on etiology (e.g., sport vs. non-sport) and may be affected by biomechanical, pathophysiological, and psychological factors. The purpose of the study was to compare neurocognitive performance and symptom presentation across different etiologies in concussed patients.

Methods
36 concussion patients, 12 slip-and-fall (SNF) were age- and sex-matched with motor vehicle accident (MVA) and sport-related concussions (SRC) (20.3±1.5 years; 4 males; 8 females per group). They were evaluated ≤ 2 weeks (7.2±3.7 days) after their injury. Patients completed medical history, an Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), and Post-Concussion Symptom Scale (PCSS) at initial visit. Descriptive statistics, a series of Kruskal-Wallis H Tests, χ² tests and one-way ANOVAs were performed using SPSS 24.

Results
The three groups exhibited no differences in verbal memory (p=0.11), visual memory (p=0.10), visual motor speed (p=0.19), or reaction time (p=0.19) composites. There were no differences in symptom severity (p=0.69) or symptom count (p=0.99) or the cognitive-migraine-fatigue (p=0.69), somatic (p=0.26), affective (p=0.92), or sleep (p=0.73) symptom clusters. Comorbidities (i.e., learning disorder, previous concussion, migraine, seizure, psychological condition, or motion sickness) were not significantly different across groups.

Conclusion
No significant differences were found on ImPACT or PCSS across etiologies. When controlling for comorbidities and demographic variables, these groups appear similar at the initial evaluation. Future research will focus on practice patterns and clinical outcomes.
Addressing the ``Replication Crisis'' in Sports Neuropsychology: Validation of the Two-Factor Theory of ImPACT
Authors: Schatz P , Bogar K , Elbin R J 
Published: July 2019

Abstract

Purpose
The "replication crisis" in psychology and across the broader field of social sciences raises criticism due to a lack of data to show that esoteric research findings can be replicated. The present study replicated and validated the two-factor “memory” and “speed” structure of ImPACT (Schatz & Maerlender, 2013).

Methods
High school aged athletes (N=18,918, Mean age=15.4, SD=1.2) who completed pre-season baseline ImPACT testing were randomly assigned to one of 5 independent samples of approximately 3,780 athletes. Exploratory factor analyses (FA) for a two-factor solution were conducted with ImPACT composite scores within each of the five groups. Post-Concussion Symptom Scale (PCSS) scores were included, with the expectation they would load on a third, unique factor.

Results
All five samples met assumptions for FA (KMO Measure of Sampling Adequacy above .600), and all five analyses yielded the same “memory” and “speed” two-factor structure. Visual Motor Speed and Reaction Time loaded on the first "Speed" factor and Verbal and Visual Memory loaded on a second "Memory" factor. The PCSS scores loaded on a third, unique “symptom” factor.

Conclusion
Replication of the two-factor structure for ImPACT in a five large high school sample further validates the model. Given that both visual and verbal memory involve encoding of information presented visually, use of a “memory” factor may improve interpretation of ImPACT scores. Similarly, similarities between constructs measuring speed of responding (Reaction Time) and speed of processing (Visual Motor Processing Speed) may be best explained using a “speed” factor.
Comparison of Clinical Outcomes Following Patients' First and Second Concussions
Authors: Jennings S , French J , Holland C , Collins M , Kontos A P 
Published: July 2019

Abstract

Purpose
The objective of this study was to examine differences in self-reported symptoms, neurocognitive performance, and vestibular-ocular insufficiencies between patients’ first and second concussions. A secondary purpose was to explore the role of risk factors on recovery.

Methods
We conducted a retrospective medical chart review of 73 (32-M/41-F) patients aged 15.69 (SD=1.67) years from a concussion specialty clinic with two separate concussions (84.9% of 1st and 79.5% of 2nd sport-related) that occurred between August 2010 and April 2018. Clinical outcomes included the PCSS, ImPACT, and the Vestibular/Ocular Motor Screening (VOMS). A series of paired samples t-tests were used to compare clinical outcomes along with chi-square analyses for risk factor associations.

Results
Verbal memory scores were higher following the second (M=80.67, SD=15.3) (M=76.32, SD=15.65) (t[73]=–2.18, p=.03) concussion. Visual motor processing speed was faster following the second concussion (M=35.04, SD= 7.90) (M=31.35, SD=7.63) (t[73]=–5.72, p<.001). There were no other significant differences observed. Recovery time was similar for the first (61.07, SD=58.41.5) and second (67.91 SD=70.10) respectively, t(70)=–.91, p=.37. There was no relationship between any risk factors, and recovery time for either injury with the exception a significant association between gender and recovery time (>21 days) with the 1st injury for females (χ2, N=73)=10.58, p=.001.

Conclusion
Findings suggest that a second concussion does not result in more pronounced symptoms, worse neurocognitive performance, or increased deficits on vestibular/ocular performance and/or longer recovery time. The only significant risk factor to a recovery over 21 days included gender.
Sleep Symptoms Among Patients with Different Concussion Clinical Profiles
Authors: Sufrinko A , Brustman K , Combs J , Collins M W , Kontos A P 
Published: July 2019

Abstract

Purpose
To evaluate if the classification of patients into one or more concussion clinical profiles could predict which patients would have sleep problems postinjury.

Methods
Based on distribution of total sleep symptoms among a sample of 416 concussion patients (M=15.27±2.13 years old, 48.8% male) evaluated within 30 days of injury, the top one-third were designated as the high sleep symptom group (n=151) and lowest one-third as low sleep symptoms group (n=172). The middle third of participants were excluded. A logistic regression (LR) analysis was performed with sleep symptom group (low or high) as the DV and the clinical profiles as predictor variables.

Results
Results of the LR revealed that the model significantly predicted sleep group (omnibus X2(5)=24.23, p<.001) but accounted for only between 7.2% and 9.7% of the variance in sleep symptoms. Overall 61.6% of predictions were accurate, with 67.4% of the patients with no sleep problems successfully classified and 55% in the high sleep symptoms group accurately classified. Only the mood (p=.003) and vestibular (p=.01) clinical profiles reliably predicted sleep group membership.

Conclusion
Understanding the presence or absence of each clinical profile post-concussion was useful in predicting which patients had a high degree of sleep symptoms post injury. Specifically, having a mood and/or vestibular clinical profile was associated with membership in the high sleep symptoms group. Clinicians should consider behavioral management strategies to improve sleep, especially among patients with those clinical profiles associated with sleep problems.
Resiliency and Post-Concussion Symptoms in Adolescents with Sport-Related Concussions
Authors: Bunt S C , Wanf H H , Straub J J , Meredith-Duliba T , Didehbani N , Sabo T , Bell K , Batjer H , Cullum C M 
Published: July 2019

Abstract

Purpose
Resiliency is a factor affecting an individual’s ability to “bounce back” from stressful events, including injury. A Sport-Related Concussion (SRC) may constitute a stressful event for athletes, yet the association of resiliency with symptoms following SRC is not well known. Thus, we sought to determine if a brief measure of resiliency was related to initial symptoms following SRC in adolescent athletes.

Methods
Subjects (n=458, 199 female, 259 male) aged 12–25 with SRC were evaluated within 30 days of injury (M= 8.35 days, SD=6.98) at a North Texas Concussion Registry (ConTex) clinic. Subjects completed the Sport Concussion Assessment Tool-5 symptom evaluation and the Brief Resiliency Scale (BRS). Subjects were grouped into low (n=56,) average (n= 280), and high (n=122) resiliency groups according to the BRS. ANOVA was conducted to compare initial concussion symptoms across resiliency groups.

Results
Subjects with low resiliency reported a greater number of symptoms (M=12.96, SD=6.79) than those with high resiliency (M=9.47, SD=6.52; p<.005) and a higher level of symptoms (M=34.73, SD=25.90 vs M=25.11 SD=24.72; p<.02). Subjects with low resiliency also reported higher levels of emotional symptoms (Irritability, Sadness, Nervousness, and Feeling More Emotional) than those with average and high resiliency.

Conclusion
Our findings suggest that low resiliency may be associated with greater symptoms following SRC. For emotional symptoms, resiliency level (low, average, high) showed a linear relationship with symptom level. However, the potential relationship between resiliency and recovery or persistence of symptoms over time remains a question.
The Utility of the King-Devick Test in Evaluating Professional Ice Hockey Players with Suspected Concussion
Authors: Echemendia R J , Bruce J M , Thelen J , Comper P , Hutchison M , Meeuwisse W 
Published: July 2019

Abstract

Purpose
The King-Devick (KD) is a measure of rapid number naming used in the evaluation of sports-related concussion (SRC). Recent data from the Canadian Football League and Rugby Union suggest that the KD should not be used as a stand-alone measure of SRC. The purpose of this study was to examine the diagnostic utility of the KD in professional ice hockey players.

Methods
NHL players who were suspected of having a concussion were evaluated with the KD and either the SCAT3 or the SCAT5. Players who were evaluated and not diagnosed with concussion served as Active controls. A small group of non-Active control players was also tested twice and was included in the present study for comparison.

Results
1605 players were evaluated with the KD at baseline. Of these, 53 were diagnosed with concussion, 76 were Active controls, and 11 were non-Active controls. Concussed players revealed a decline in performance from baseline to acute evaluation, t(52)=3.05, p<.01, d=.42 while Active controls significantly improved, t(75)=2.05, p<.05, d=.24. No significant change between baseline and acute testing was observed for non-Active controls. Using a cut score of any decline in performance from baseline to suspected injury evaluation yielded Sensitivity=64%, Specificity=61%, Positive Predictive Value=53% and Negative Predictive Value=71%.

Conclusion
Our data are consistent with previous studies suggesting that while the KD is useful in differentiating concussed and not concussed athletes acutely, the relatively low predictive values indicate that a decline in KD performance should not be used as a standalone measure to diagnose concussion.
Traditional Chinese medicine Dingkun Pill facilitates uterine receptivity for implantation in mice†
Authors: Huang Lin , Wang Lemeng , Bao Haili , Xu Yingchun , Meng Meiqing , Qiao Manting , Wang Haibin , Kong Shuangbo 
Published: July 2019

AbstractDingkun Pill (DK) is one of the representative traditional Chinese medicines, which has been used in the treatment of gynecological diseases for hundreds of years. Accumulative observations and evidence have shown the beneficial effects of DK, including enhancing the function of hypothalamic-pituitary-ovarian axis. However, the underlying mechanisms remain elusive. In this study, the effects of DK on uterine receptivity and implantation were explored by a series of studies with different mouse models. The results showed that DK can advance the time of implantation by influencing the expression of estrogen target genes to facilitate embryo implantation. DK was efficient to activate embryo implantation at the presence of suboptimal estrogen in delayed implantation mouse model. Our further study revealed that the improvement of DK on receptivity establishment is attributed to the differential regulation of DK on implantation-associated genes. This study provides previously unappreciated molecular mechanism of DK in embryo implantation and benefits the potential clinical application of DK in human reproduction improvement.
Is there a need for accepting paraphyletic taxa? A case study in the Sardinian endemic Cymbalaria muelleri (Plantaginaceae)
Authors: Carnicero Pau , Schönswetter Peter , Garcia-Jacas Núria , Galbany-Casals Mercè 
Published: July 2019

AbstractEvolution does not always result in dichotomous phylogenetic trees. For instance, in anacladogenetic speciation, where a new species originates by budding, the ancestral taxon is often initially paraphyletic. Here we study Cymbalaria muelleri (Plantaginaceae), a chasmophytic species endemic to Sardinia, a major island in the Mediterranean Basin. Its distribution range is divided into two well-delimited geographical groups with some morphological differences. Using a combination of morphology, molecular data (amplified fragment length polymorphism fingerprinting) and relative genome size, we found that the two geographical groups should be considered two separate taxa, which split through anacladogenesis. Accordingly, we formally describe the new paraphyletic subspecies C. muelleri subsp. villosa as the ancestor, from which C. muelleri subsp. muelleri originated by budding. Morphological analyses support the differentiation of the two subspecies, and there are strong diagnostic characters to differentiate them. In addition to morphology and genetics, slightly divergent habitat preferences and the disjunct distribution of the two subspecies also support the recognition of two taxa. Genome size data obtained for the two subspecies are consistent with the previously established hexaploidy of C. muelleri.
Burst suppression uncovers rapid widespread alterations in network excitability caused by an acute seizure focus
Authors: Liou Jyun-You , Baird-Daniel Eliza , Zhao Mingrui , Daniel Andy , Schevon Catherine A , Ma Hongtao , Schwartz Theodore H 
Published: July 2019

Abstract
Burst suppression is an electroencephalogram pattern of globally symmetric alternating high amplitude activity and isoelectricity that can be induced by general anaesthetics. There is scattered evidence that burst suppression may become spatially non-uniform in the setting of underlying pathology. Here, we induced burst suppression with isoflurane in rodents and then created a neocortical acute seizure focus with injection of 4-aminopyridine (4-AP) in somatosensory cortex. Burst suppression events were recorded before and after creation of the focus using bihemispheric wide-field calcium imaging and multielectrode arrays. We find that the seizure focus elicits a rapid alteration in triggering, initiation, and propagation of burst suppression events. Compared with the non-seizing brain, bursts are triggered from the thalamus, initiate in regions uniquely outside the epileptic focus, elicit marked increases of multiunit activity and propagate towards the seizure focus. These findings support the rapid, widespread impact of focal epilepsy on the extended brain network.
Hitting Times for Random Walks on Sierpiński Graphs and Hierarchical Graphs
Authors: Qi Yi , Dong Yuze , Zhang Zhongzhi , Zhang Zhang 
Published: July 2019

AbstractThe Sierpiński graphs and hierarchical graphs are two much studied self-similar networks, both of which are iteratively constructed and have the same number of vertices and edges at any iteration, but display entirely different topological properties. Both graphs have a large variety of applications: Sierpiński graphs have a close connection with WK-recursive networks that are employed extensively in the design and implementation of local area networks and parallel processing architectures, while hierarchical graphs can be used to model complex networks. In this paper, we study hitting times for several absorbing random walks in Sierpiński graphs and hierarchical graphs. For all considered random walks, we determine exact solutions to hitting times for both graphs. The obtained explicit expressions indicate that the hitting times in both graphs behave quite differently. We show that the structural difference of the graphs is responsible for the disparate behaviors of their hitting times.
Health care use and remaining needs for support among women with breast cancer in the first 15 months after diagnosis: the role of the GP
Authors: Lo-Fo-Wong Deborah N , de Haes Hanneke C , Aaronson Neil K , van Abbema Doris L , Admiraal Jolien M , den Boer Mathilda D , van Hezewijk Marjan , Immink Marcelle , Kaptein Ad A , Menke-Pluijmers Marian B , Russell Nicola S , Schriek Manon , Sijtsema Sieta , van Tienhoven Geertjan , Sprangers Mirjam A 
Published: July 2019

Abstract

Background
The number of women with breast cancer in general practice is rising. To address their needs and wishes for a referral, GPs might benefit from more insight into women’s health care practices and need for additional support.

Objective
To examine the prevalence of health care use and remaining needs among women with breast cancer in the first 15 months after diagnosis.

Methods
In this multicentre, prospective, observational study women with breast cancer completed a questionnaire at 6 and 15 months post-diagnosis. Medical data were retrieved through chart reviews. The prevalence of types of health care used and remaining needs related to medical, psychosocial, paramedical and supplementary service care (such as home care), was examined with descriptive analyses.

Results
Seven hundred forty-six women completed both questionnaires. At both assessments patients reported that they had most frequent contact with medical and paramedical providers, independent of types of treatment received. Three to fifteen percent of the patients expressed a need for more support. Prominent needs included a wish for more frequent contact with a physiotherapist, a clinical geneticist and a psychologist. Patients also wanted more help for chores around the house, particularly in the early post-treatment phase.

Conclusion
A small but relevant percentage of women with breast cancer report having unmet needs. GPs may need to be particularly watchful of their need for more support from specific providers. Future research into the necessity of structural needs assessment among cancer patients in general practice is warranted.