bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Verbal Fluency Performance, Fight Exposure, and Subcortical Region Brain Volumes in Professional Fighters
Authors: Bennett L , Bernick C , Banks S 
Published: July 2019

Abstract

Purpose
Verbal fluency performance has been shown to be sensitive to preclinical cognitive changes in neurodegenerative diseases and may detect early, trauma-related cognitive and volumetric changes amongst professional fighters. Baseline verbal fluency performance and volumes of relevant subcortical brain structures were expected to decline as number of professional fights (NoPF) increased, while controlling for education.

Methods
Baseline letter and semantic fluency performance, NoPF, and structural brain imaging from 548 active and retired fighters who participated in the Professional Fighters Brain Health Study were considered. ANCOVAs were conducted to assess differences in verbal fluency performance by NOPF, while controlling for years of education. Number of professional fights were stratified into low (0-20 fights), medium (21-40 fights), and high (41 or more fights).

Results
Semantic fluency performance differed across the three levels of NoPF (F(2, 542)=4.56; p<.02). In addition, significant positive correlations between semantic fluency performance and volumes in the following regions were observed: left thalamus, left putamen, left pallidum, bilateral caudates, bilateral amygdalae, bilateral hippocampi, and bilateral accumbens (all p’s<.05). In contrast, letter fluency performance was not significantly associated with NoPF or volumes of relevant subcortical brain structures (all p’s>.05).

Conclusion
Semantic fluency may be low-cost, easy-to-administer harbinger of emerging cognitive dysfunction and lower volumes in related subcortical brain regions. Additional assessment of clinical utility is necessary.
Sources of Acquired Concussion Information Reported by Parents of Youth Athletes
Authors: Bretzin A C , Beidler E , Anderson M , Schmitt A , Covassin T 
Published: July 2019

Abstract

Purpose
Examining the relationships between demographics (sex, geographic location) and sources of acquired concussion information, and where parents would take their child for concussion evaluation.

Methods
A cross-sectional survey collecting demographics and concussion knowledge of parents (male: n=136/359, 38%; female: n=22/359, 62%) of youth athletes (i.e., football, ice hockey, lacrosse, soccer) in Michigan (n=131/359, 36.5%) and Pennsylvania (n=228/359, 62%). Separate Chi-square tests for independence examined the relationship between demographics (sex, geographic location) and sources of acquired concussion information, and where parents would take their child for concussion evaluation.

Results
Overall, parents recognized common concussion signs and symptoms and had general knowledge of concussion. There was a significant association between sex and acquiring information from sports medicine physicians (male: 31.6%, female: 18.9%; χ2 (1, n=358)=6.83, p=.009), and sports news outlets (male: 32.4%, female: 18.9%; χ2 (1, n=358)=7.62, p=.006). There was a significant association between geographic location and acquiring information from a coach (Michigan: 72.5%, Pennsylvania: 40.4%; χ2 (1, n=359)=32.22, p<.001), recreational league officials/league mandated paperwork (Michigan: 50.4%, Pennsylvania: 26.3%; χ2 (1, n=359)=20.11, p<.001), and youth sport state concussion laws (Michigan: 38.2%, Pennsylvania: 10.5%; χ2 (1, n=359)=37.18, p<.001). There was a significant association between geographic location and where parents would take their child for concussion evaluation (χ2 (3, n=338)=19.76, p<.001).

Conclusion
Sex and geographic location may influence where parents of youth athletes acquire concussion information and where they may seek medical attention.
Evaluating the Prevalence of Low Factor Scores on the ImPACT™ Quick Test in Adolescents and Adults using Multivariate Base Rates
Authors: Wallace J , Covassin T , Schatz P , Iverson G 
Published: July 2019

Abstract

Purpose
The ImPACT™ Quick Test (QT) is a brief iPad-based battery of neurocognitive tests that has been standardized on a sample of children, adolescents, and adults (ages 12-70). We sought to provide information regarding the prevalence of low ImPACT™ QT scores in the normative sample to improve clinical interpretation and reduce the risk of over-interpreting, or misinterpreting, a single low score.

Methods
Participants included 616 individuals ranging in age from 12 to 70, who were assessed individually. The ImPACT QT includes five subtests, contributing to three factor scores: Motor Speed, Memory, and Attention Tracker. The prevalence of low factor scores, stratified by age and gender, were calculated using multivariate base rates.

Results
In the total sample, obtaining 1 score below the 25th percentile was common (base rate, BR=31.8%), but obtaining 2 or more scores in this range was uncommon (BR=13.3%). Similarly, obtaining 1 score below the 16th percentile was common (BR=22.3%), but obtaining two or more scores in this range was very uncommon (BR=5.4%). There were small differences in base rate between genders and the number of low scores were fairly similar across the age groups.

Conclusion
Results from this study parallel previous work illustrating that a substantial percentage of healthy individuals will obtain one or more low test score when administered a battery of multiple cognitive test measures. Given that some healthy, non-concussed individuals will obtain a single score below expected cut-offs, clinicians should caution against overinterpreting a single low test score.
Age of First Exposure to Contact Sports and Neurocognitive Performance in U.S. Service Academy Athletes
Authors: Caccese J B , Iverson G L , Cameron K L , Houston M N , McGinty G T , Jackson J C , O’Donnell P , Pasquina P , Broglio S P , McCrea M A , McAllister T W 
Published: July 2019

Abstract

Purpose
To examine the association between estimated age of first exposure (eAFE) to contact sports and neurocognitive performance and symptom ratings in collegiate U.S. Military Service Academy athletes. We hypothesized that contact-sports participation before the age of 12 would not be associated with worse neuropsychological test performance or greater symptom reporting.

Methods
Male cadets (N=891) who participated in contact sports [i.e., in lacrosse (n=211), wrestling (n=170), ice hockey (n=81), soccer (n=119), rugby (n=10)], or non-contact sports (n=298), completed the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test before the season. Generalized linear modeling was used to predict each cognitive domain score and the symptom severity score. Predictor variables were entered in the following order: group (contact vs. non-contact), eAFE (eAFE<12 vs. eAFE≥12), group-by-eAFE, and covariates for learning accommodation status, concussion history, and age.

Results
The group-by-eAFE interaction was not significant for any of the ImPACT composite scores (Verbal Memory, Wald Χ2=.073, p=.788; Visual Memory, Wald Χ2=2.71, p=.100; Visual Motor Speed, Wald Χ2=.078, p=.780; Reaction Time, Wald Χ2=.003, p=.955; Symptom Severity, Wald Χ2=2.87, p=.090). Learning accommodation history was associated with lower scores on Visual Motor Speed (Χ2=6.19, p=.013, B=-2.97). Older age was associated with faster reaction time (Χ2=4.40, p=.036, B=-.006) and lesser symptom severity (Χ2=5.55, p=.019, B=-.068). No other parameters were significant.

Conclusion
We observed no association between eAFE, contact-sport participation, cognitive functioning, or subjectively-experienced symptoms in this cohort. Earlier eAFE to RHI is not related to worse neurocognitive performance or greater subjectively-experienced symptoms in collegiate student-athletes enrolled in military academies.
Altitude and Concussions in the NFL: Is There Really a “Mile-High” Effect?
Authors: Bogar K , Schatz P 
Published: July 2019

Abstract

Purpose
The literature on altitude and concussions in football shows some evidence of protective effects of living and training and playing at high altitudes. We explored the likelihood of sustaining concussions within the AFC West division, specifically comparing games hosted at high altitude in Denver versus games hosted by at low altitudes in Los Angeles, Oakland, and Kansas City.

Methods
Information was recorded for all regular season AFC West division games (N= 42) occurring in the 2012–2018 seasons. Altitude for each stadium was calculated using DaftLogic’s Google Sandbox. Concussion incidence for the 2012–2018 seasons was collected from PBS Frontline’s Concussion-Watch and weekly injury reports (NFL.com). Chi-square analyses compared likelihood of: concussions occurring in High Altitude versus Low Altitude, a Broncos player sustaining a concussion in High Altitude versus Low Altitude, and a non-Broncos AFC West player sustain a concussion in High Altitude versus Low Altitude.

Results
Chi-square analyses revealed no greater likelihood of players sustaining concussions in High Altitude versus Low Altitude (p=.35), or of Broncos (p=1.00) or non-Broncos (p=.47) AFC West players sustaining concussions in High Altitude versus Low Altitude.

Conclusion
Altitude is not a significant factor for increased likelihood of concussions, and popular theories such as “the mile-high effect” are not supported by the data. We found no evidence for the proposed protective factor of living and training at high altitude for Broncos team members, as they showed an equal likelihood of sustaining a concussion at high and low altitude.
Concussion Assessment and Return to Sport for a High School, Legally Blind, Female Swimmer
Authors: Custer A , Tatman J , Lee J 
Published: July 2019

Abstract

Purpose
Limited research exists on treatment of sport concussion in visually impaired individuals. Adaptation to athlete’s needs is vital for individualized sport specific return to play (RTP).

Methods
Fifteen year-old, visually impaired, female, swimmer presented to an interdisciplinary Sport Concussion Program for protracted recovery with complaints of disequilibrium, headaches, cognitive fatigue, and exacerbation of premorbid resting nystagmus after being kicked in the head during practice. Patient is legally blind due to Peter’s Anomaly and right retinal detachment, with history of migraine, carsickness, and glaucoma. Patient completed two visits with clinical sports neuropsychologist and three vestibular therapy (VT) appointments, assessed via Post-Concussion Symptom Scale (PCSS), Montreal Cognitive Assessment (MoCA-BLIND), Modified Balance Error Scoring System (mBESS), Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence scale (ABC), Buffalo Concussion Treadmill Test (BCTT), and Children's Memory Scales (CMS). Differential Diagnosis: Concussion, Post-Concussion Syndrome, Post-Traumatic Headache, Vestibular Dysfunction.

Results
Initial consult revealed PCSS of 35 and normal MoCA-BLIND (18/22). Patient’s mBESS improved from 7 to 3 errors with VT, DHI mildly elevated (36%), ABC moderately elevated (43%). VT consisted of: neuromuscular re-education, balance training, positional changes, cognitive activity, sport specific RTP progressions (dry land modifications, transitions into water, communication to team athletic trainer). BCTT passed on third VT visit. Patient cleared for RTP with PCSS at 7 and (CMS) Stories, Word Lists, Numbers, and Sequences subtests within expectations (average to high average ranges).

Conclusion
This case study illustrates an interdisciplinary approach to concussion treatment with modification of established tools and proposal of sport specific RTP guidelines for visually impaired athletes.
Self-Reported History of Seizure, Baseline Neurocognitive Performance, and Symptoms Reported in High School Athletes
Authors: Datoc A , Lashley L 
Published: July 2019

Abstract

Purpose
To examine whether a self-reported history of seizure is associated with differences in baseline neurocognitive performance and total reported symptoms.

Methods
Data was derived from a de-identified Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) database of high school athletes in Florida. After inclusion and exclusion criteria were applied, athletes were separated into groups dependent on self-reported history of seizure. 260 athletes (Mage=15.49, SD=1.26; 57.1% male) reported a history of seizure, and 260 athletes were randomly selected from those with no such history (Mage=15.64, SD=1.22; 61.1% male).

Results
ANOVA (alpha=.05) revealed significant differences between groups on the visual memory composite (F[1,559]=4.915, p=.027) and total symptom score (F[1,559]=28.596, p<.001) at baseline. Athletes with a self-reported history of seizure performed significantly worse than athletes without on visual memory and reported significantly higher total symptom scores. No significant between-group differences were found on the other composites of ImPACT.

Conclusion
The association between seizure history and decreased neurocognitive performance has been documented in the neuropsychological literature, and may be explained by differences at a microstructural level such as differences in white matter integrity (Yassine et al., 2018). While these microstructural differences have implications on cognitive functioning and symptomatology, the present study surprisingly found comparable scores between athletes with a history of seizure and those without. Previous researchers published similar findings; however, differences were observed on the visual-motor speed composite of ImPACT (Zalneraitis et al., 2017). The inconsistencies and small effect sizes in the present literature highlight the need for investigators to determine the clinical significance of these results in concussion evaluations.
Effects of Headache on CNS Vital Signs Performance in a Concussed Community Sample
Authors: Moreno C C , Houck Z , Svingos A , Greif S , Hromas G , Jaffee M , Heaton S , Deming C , Bauer R M 
Published: July 2019

Abstract

Purpose
Headache (HA) is the most common symptom following concussion. We examined the effect of HA on CNS Vital Signs (CNSVS) performance.

Methods
Data were analyzed from 63 patients (25 males, Mdn age [IQR]=23.0 [21.0], Mdn days since injury [IQR]=66.0 [112.0]) presenting to an interdisciplinary concussion clinic. HA disorders were diagnosed post-injury by a board-certified neurologist and obtained from medical records. Nearly half (51%) of the sample had a HA diagnosis. We analyzed the performance on CNSVS multiple test domains: Composite Memory, Psychomotor Speed, Complex Attention, and Cognitive Flexibility. Chi-square test of independence assessed differences in demographic and medical history factors among those with and without HA diagnosis. Multivariate analyses of covariance assessed the influence of HA on CNSVS multiple test domains. Factors significantly different between groups were added as covariates.

Results
There were significant interactions of loss of consciousness (LOC; Χ2(1, 63)= 6.22, p=.013), history of attention-deficit/hyperactivity disorder (ADHD; Χ2(1, 63)= 5.13, p=.023), and daytime sleepiness (Χ2(1, 63)= 6.14, p=.013) among those with and without HA diagnosis. The presence of these medical conditions composed 19%, 28%, and 40%, respectively, of HA diagnoses. There was no statistically significant omnibus effect of HA diagnosis on the four CNSVS domain scores without covariates (F[4, 58]= 0.46, p=.76, ηp2=.03) or when controlling for LOC, history of ADHD, and daytime sleepiness (F[4, 55]=0.44, p=.78, ηp2=.03).

Conclusion
Findings suggest that HA diagnosis is unrelated to performance on CNSVS in individuals after concussion.
Coping Style in Recovery of Injured College Athletes Differs for Concussion Versus Orthopedic Injury
Authors: Croes-Orf E , Roccaforte A , Webbe F 
Published: July 2019

Abstract

Purpose
To examine the coping style and depressive symptomology among student-athlete injury type (concussive vs. orthopedic) to better understand recovery factors.

Methods
Eighty-two (54.9% male) student-athletes, aged 18–25, completed the Coping with Health Injuries and Problems (CHIP) and PHQ-9 questionnaires during preparticipation medical evaluation. Baseline data scores were gathered in both student-athlete groups.

Results
A significant interaction was found between coping style and group, χ2(6)=14.06, p<.05), Cramer’s V=.29. Adjusted residuals indicated that within the concussion group, the percentage of participants who used instrumental coping (4.2%) was significantly lower than the percentage of participants who used palliative coping (41.7%), distraction coping (33.3%), and emotional preoccupation (20.8%). Conversely, participants in the orthopedic injury group were significantly more likely to utilize instrumental coping (43.3%) than the other types of coping. There was no significant relationship found between coping styles and the total PHQ-9 score. However, a significant negative relationship was found between instrumental coping and the item that measures a depressive symptom of suicidal ideation (r(82)=-.27, p=.01). Thus, reported suicidal ideation was correlated with decreased instrumental coping and vice-versa.

Conclusion
Type of injury had a significant relationship with the athlete’s coping style. Concussed athletes preferred palliative coping and the orthopedic injury group preferred instrumental coping. Importantly, these results can help psychologists formulate a better treatment plan tailored to the preferred coping strategy of the athlete and analyze how it affects recovery.
Development and Clinical Relevance of a Summary Score for the SCAT-5
Authors: DaCosta A , Roccaforte A , Webbe F 
Published: July 2019

Abstract

Purpose
Early versions of the Sports Concussion Assessment Tool utilized a summary score, but it was removed in the third edition due to lack of empirical support (Guskiewicz et al., 2013). Echemendia et al. (2017) note that the SCAT-5’s changes, such as an expansion from a 5-word to 10-word list, improved utility over previous additions. Therefore, empirical support for a summary score on the SCAT-5 should be reassessed.

Methods
Collegiate athletes (N=532, 64% male) completed the SCAT-5 and ImPACT during their baseline evaluation. Various SCAT-5 summary score formulas were created to determine a concurrently valid summary score that remained comprehensive of all three SCAT-5 domains (cognitive, symptom, vestibular). The summary score was calculated by: [Immediate Memory Total + Delayed Recall + Orientation + Concentration + (30 – BESS Total Errors) - Total Symptom Score].

Results
Pearson correlations determined that the summary score was significantly correlated with ImPACT Verbal Memory (r=.27, p<.001), Visual Memory (r=.24, p<.001), Visual-Motor Speed (r=.30, p<.001), Reaction Time (r=-.25, p<.001) and Total Symptoms (r=-.18, p<.001).

Conclusion
Our results support the validity of a SCAT-5 summary score. Clinically, the summary score is intended to measure changes in global functioning across baseline, post-trauma and follow-up concussion evaluation. Additionally, it should serve as a measure of global progression during the acute post-trauma window of sideline to post-trauma evaluation. Future research should examine the SCAT-5 summary score with outcome measures such as recovery time.
Defensive posture in a terrestrial salamander deflects predatory strikes irrespective of body size
Authors: Myette Alexander L , Hossie Thomas J , Murray Dennis L 
Published: July 2019

Abstract
A wide variety of prey use defensive postures as a means of protection from predators. Many salamanders engage in broadly similar defensive postures, which may function as a warning signal and reduce the probability of attack, or may deflect predator attacks away from vital body parts. The extent to which these strategies (i.e., aposematism and deflection) act exclusively or synergistically, however, remains unknown. We deployed clay salamanders in the field, manipulating size (small, large) and posture (resting, defensive), and documented attack rates across three predator types. Competing risks analysis revealed that attack rates were affected by model size, deployment period, and leaf litter depth at the site of deployment, whereas model posture had no significant effect. Model size and posture did not interact, indicating that defensive posture was ineffective in deterring attack irrespective of prey size. Model prey in the defensive posture received significantly more attacks on the tail irrespective of size, and the defensive posture was more effective at deflecting avian attacks compared to mammal predation. We conclude that defensive posture increases tail conspicuousness without increasing predation risk, and primarily functions to deflect attacks away from vital body parts. The efficacy of defection may be further increased by tail undulation, however our use of static models means that we cannot exclude aposematic or deimatic functions for such movements. Our results provide important support for the deflection hypothesis in explaining antipredator behavior, and thereby set the stage for additional research targeting the functionality of attack deflection in natural predator–prey encounters.
Growth arrest-specific protein-6/AXL signaling induces preeclampsia in rats†
Authors: Hirschi Kelsey M , Tsai Kary Y F , Davis Taylor , Clark J Christian , Knowlton M Nekel , Bikman Benjamin T , Reynolds Paul R , Arroyo Juan A 
Published: July 2019

AbstractPreeclampsia (PE) is a complicated obstetric complication characterized by increased blood pressure, decreased trophoblast invasion, and inflammation. The growth arrest-specific 6 (Gas6) protein is known to induce dynamic cellular responses and is elevated in PE. Gas6 binds to the AXL tyrosine kinase receptor and AXL-mediated signaling is implicated in proliferation and migration observed in several tissues. Our laboratory utilized Gas6 to induce preeclamptic-like conditions in pregnant rats. Our objective was to determine the role of Gas6/AXL signaling as a possible model of PE. Briefly, pregnant rats were divided into three groups that received daily intraperitoneal injections (from gestational day 7.5 to 17.5) of phosphate buffered saline (PBS), Gas6, or Gas6 + R428 (an AXL inhibitor administered from gestational day 13.5 to 17.5). Animals dispensed Gas6 experienced elevated blood pressure, increased proteinuria, augmented caspase-3-mediated placental apoptosis, and diminished trophoblast invasion. Gas6 also enhanced expression of several PE-related genes and a number of inflammatory mediators. Gas6 further enhanced placental oxidative stress and impaired mitochondrial respiration. Each of these PE-related characteristics was ameliorated in dams and/or their placentae when AXL inhibition by R428 occurred in tandem with Gas6 treatment. We conclude that Gas6 signaling is capable of inducing PE and that inhibition of AXL prevents disease progression in pregnant rats. These results provide insight into pathways associated with PE that could be useful in the clarification of potential therapeutic approaches.
Column-orthogonal strong orthogonal arrays of strength two plus and three minus
Authors: Zhou Yongdao , Tang Boxin 
Published: July 2019

Summary
Strong orthogonal arrays have better space-filling properties than ordinary orthogonal arrays for computer experiments. We consider column-orthogonal strong orthogonal arrays of strength two plus and three minus, and present methods of constructing such designs. Several situations are examined, including those of four or higher levels and mixed levels. The methods are based on both regular and nonregular designs. The resulting designs inherit the good property of strong orthogonal arrays of strength two plus or three and have the additional property of column orthogonality. This type of design is a better choice for computer experiments.