bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 07 Three Brief, Public-Domain Performance-Validity Measures for Concussion Baseline Testing: Normative Performance and Sub-Optimal Cut Scores
Authors: Bankston A , Malkin R , LoGalbo A , Webbe F 
Published: July 2024

Abstract

Purpose
Purpose: We report normative data with non-athlete college students for three brief, public-domain performance validity tests (PVT) representing auditory-verbal memory (Rey Word Recognition Test; RWRT), auditory vigilance; (A-Test), and visual attention (Rey Dot Counting Test; DCT). Cut scores for suboptimal performance (SOP) were determined, and the importance of using multiple PVTs was established.

Method
Method: 150 non-athlete college students (45% female; representing four college year levels) were recruited via the college’s research participation application and assigned randomly to honest-effort, fake-bad, or instructed fake-bad groups. 50 student-athletes were selected randomly to compare athlete performance with non-athletes. Group differences for PVT measures, and receiver operating curve (ROC) cut scores for suboptimal performance are reported.

Results
Results: Only the RWRT measures met normality and homogeneity of variance assumptions. MANOVA with post-hoc Tukey tests showed no differences between groups for RWRT. For DCT and A-Test, non-parametric Kruskal-Wallis comparisons were conducted, each resulting in significant differences (all p &lt; 0.001) between honest-effort and SOP groups. No differences were found between the two SOP groups, nor athlete baseline vs honest effort groups, but athletes differed significantly from both SOP groups. ROC cut scores that suggested suboptimal effort were DCT combination score ≥ 15; RWRT combination score ≤ 12; and A-Test omission errors ≥1. Four participants from the honest-effort group and 49 from the fake-bad groups fell below criteria for two tests.

Conclusions
Conclusion: The DCT combination and A-Test omission scores were valid indicators of suboptimal performance. Combining multiple PVT “failures”maximized identification of suspect performers and minimized inclusion of honest-effort participants.
A - 08 Mental Health and Identity in Digital vs. Physical Sports (Individual vs. Team Dynamics)
Authors: Clise E , Logalbo A 
Published: July 2024

Abstract

Purpose
To investigate how digital (e-sports) vs traditional (physical) sports affect athletes’mental health outcomes and identity perceptions.

Method
39 e-sports athletes (37 male, 2 female, aged 17–23) and 188 physical athletes (94 male, 94 female, aged 17–23) were administered the Athletic Identity Measurement Scale-Plus (AIMS-Plus), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder 7th Edition (GAD-7) questionnaire during baseline concussion testing. The AIMS-Plus questionnaire contains a Role Identity Rating, where athletes rate the importance of family, friendships, athletics, academics, religion, and romance in their lives (0–100).

Results
No significant differences in PHQ-9 and GAD-7 totals were observed between e-sports and physical athletes [p &gt; 0.05]. E-sports athletes rated athletic and family identity lower than physical sports athletes (p = 0.015). Among physical sports athletes, higher athletic and family identity ratings were associated with lower PHQ-9 scores (p = 0.015), contrasting with nonsignificant findings in e-sports athletes. Among physical sports athletes, those participating in individual sports endorsed more symptoms on both GAD-7 and PHQ-9 than team sports athletes (p = 0.009; p = 0.045). Furthermore, individual sports athletes also rated family and athletic identity lower than team sports athletes (p &lt; 0.001; p = 0.041).

Conclusions
Sport modality (digital or physical) does not affect mental health scores, suggesting that other factors influence student-athlete emotional functioning. Stronger athletic and family-role identity may serve as protective factors against depression for physical athletes. Although e-sports athletes rated athletic and family-roles lower, they did not appear to be more likely to experience emotional distress. Findings have implications for tailoring treatment to different types of athletes.
A - 09 An Examination of Pre-Existing Individual Characteristics and Concussion Presentations among Collegiate Athletes
Authors: Collyer A , Murray K , Miller K , Capriglione A , D‚ÄôArgenzio N , Baath S , LoGalbo A 
Published: July 2024

Abstract

Purpose
To examine the relationship between pre-existing individual characteristics and concussion outcomes among collegiate athletes.

Method
Archival data were analyzed from 142 collegiate athletes, ages 17–24 (M = 19.84, SD = 1.50), diagnosed with concussion based on cognitive impairment and symptom endorsement (CS; n = 88) or symptom endorsement alone (S; n = 54).

Results
Statistical analyses revealed no significant group differences for nearly all pre-existing individual characteristics analyzed, including sex, depressive symptoms, history of ADHD, baseline ImPACT performance, and balance. However, among baseline SCAT-5 symptom clusters, a chi-squared test of independence revealed a statistically significant association between group and endorsement of one or more symptoms of the cognitive fatigue cluster, χ2(2) = 5.82, p = 0.016, Cramer’s V = 0.20. Specifically, CS athletes were more likely to endorse cognitive fatigue than S athletes. No group differences were observed among other baseline SCAT-5 symptom clusters. Meanwhile, a Mann–Whitney U test indicated that post-concussive PHQ-9 scores were significantly higher for CS athletes (Mdn = 3.50) than S athletes (Mdn = 2.00), U = 1727.50, z = −2.59, p = 0.010. Moreover, CS athletes were more likely to endorse more post-trauma symptomatology than S athletes, in addition to demonstrating cognitive impairments.

Conclusions
Compared to pre-existing individual characteristics, the severity of post-concussive symptoms appears to be a better indicator of concussion outcome in terms of whether athletes present with symptoms only versus symptoms and cognitive impairment. This suggests that these differences in outcome may be better explained by injury-related factors (e.g., severity of injury or impact).
A - 10 Post-Concussive Changes in Functional Status and Associations between Concussion Symptoms and Domain-Specific Impairment
Authors: Clise E , Nelson F , Poskus J , LoGalbo A 
Published: July 2024

Abstract

Purpose
To investigate post-concussive changes in functional status and the relationships between concussion symptoms and domain-specific impairment.

Method
25 collegiate athletes (11 males, 14 females, ages 17–23) were administered the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7th Edition (GAD-7), Vertigo Symptom Scale-Short Form (VSS-SF), and Sport Concussion Assessment Tool-5th Edition (SCAT-5) at baseline and post-injury evaluations. Athletes were diagnosed with concussion at post-injury. WHODAS 2.0 dimension-level scores in “cognition”, “mobility”, “self-care”, “getting along with others”, “life activities”, and “participation in society”were calculated via the second-order model approach. Disparity scores (d-scores) were calculating by subtracting baseline scores from post-injury scores.

Results
Dimension-level paired t-tests revealed significant increases in WHODAS 2.0 “cognition”(baseline: M = 2.36, SD = 0.70; post-injury: M = 2.96, SD = 1.65) and “participation in society”(baseline: M = 2.16, SD = 0.47; post-injury: M = 2.72, SD = 1.28) scores from baseline to post-injury [t(24) = 1.84, p = 0.039; t(24) = 2.59, p = 0.008], but not for other functional domains. SCAT-5 Symptom Severity d-scores were positively correlated with “getting along”d-scores (r = 0.42, p = 0.037). VSS-SF d-scores were positively correlated with “cognition”and “mobility”d-scores (r = 0.45, p = 0.025; r = 0.51, p = 0.009). GAD-7 and PHQ-9 d-scores were not significantly correlated with any functional domain d-scores.

Conclusions
Results suggest that concussed athletes report greater declines in cognitive functioning and participation in society, as compared to other WHODAS 2.0 functional dimensions. Additionally, increased post-concussive symptom severity and vertigo/imbalance difficulties appear to be associated with increased disability in certain functional dimensions. Dimension-specific compensatory strategies may be beneficial in improving the functional status of concussed athletes with similar symptom profiles.
A - 11 Autonomic Anxiety vs Generalized Anxiety: Predictive Recovery Time in Sport-Related Concussions among Collegiate Athletes
Authors: Nelson F , Clise E , LoGalbo A 
Published: July 2024

Abstract

Purpose
This study represents the second phase in testing a self-report anxiety questionnaire and self-report vestibular symptom questionnaire, including its subscales, as potential competing predictive factors of protracted concussion recovery times among collegiate athletes.

Method
The Vertigo Symptom Scale-Short Form (VSS-SF) and Generalized Anxiety Disorder-7 (GAD-7) were administered to 31 collegiate athletes (18 females, 13 males, ages 18–23) at baseline and post-injury. Participant data was grouped by number of days until symptom resolution post-concussion (1–10 days [N = 18], 11+ days [N = 13]). VSS-SF, VSS-SF-Autonomic-Anxiety (VSS-SF-A), VSS-SF-Vestibular-Balance (VSS-SF-V), and GAD-7 scores were calculated via scoring guidelines.

Results
Results from an independent-samples t-test demonstrated that post-injury VSS-SF-A scores were significantly higher among athletes with 11+ recovery days (M = 3.08, SD = 3.71) compared to those with 1–10 recovery days (M = 1.06, SD = 2.65); t(29) = 1.78, p = 0.043, Cohen’s d = 0.65. Similar t-tests for post-injury VSS-SF-V (11+ [M = 5.23, SD = 6.41], 1–10 [M = 3.17, SD = 3.67]) and GAD-7 (11+ [M = 4.08, SD = 4.84], 1–10 [M = 2.50, SD = 2.23]) scores were not significant; t(29) = 1.14, p = 0.132, t(29) = 1.22, p = 0.116. A linear regression revealed that post-injury VSS-SF-A scores significantly predicted recovery time and explained 14.1% of the variance (b = 0.88, R2 = 0.14, p = 0.037). Post-injury VSS-SF-V and GAD-7 scores were not significant predictors.

Conclusions
Results suggest that post-injury VSS-SF-A scores can aid in identifying athletes that may be at risk for longer recovery times. Additionally, post-concussive autonomic anxiety appears to have a greater influence on athletes’recovery time, as compared to generalized anxiety symptoms. Interventions directed towards reducing and/or coping with autonomic anxiety symptoms may be particularly important for supporting post-concussive recovery.
A - 12 Pre-Morbid Migraine Impact on Concussion Recovery Time
Authors: Kantharaj Ramya , Ray Darryl , Asuncion Mia , Burkhart Dr Scott 
Published: July 2024

Abstract

Purpose
This observational study evaluated how premorbid migraines impact post-concussion recovery time.

Method
Our retrospective-cohort study analyzed data gathered from 2021 to 2022. Data reviewed patients diagnosed with concussions from sports and non-sports injuries at the Children’s Health Andrews Institute in Plano, Texas at the outpatient sports medicine clinic. 1303 participants completed four assessments for their pretreatment testing. Of the total participants, 91 indicated diagnosed pre-morbid migraines. Measures including the Vestibular Ocular Motor Screening test (VOMS), King-Devick Test, C3 Trails A, B, and AB, and Post Concussion Symptom Scale (PCSS) were analyzed using an independent samples T test. The results along with demographic information and recovery time were recorded on paper then transferred onto an excel sheet.

Results
There was a significant difference in PCSS scores at initial visit for patients with pre-morbid migraines compared to those without pre-morbid migraines, t(1303) = 4.235, p = &lt;0.001. Levene’s test for equality of variances was violated for the following analysis and indicated no significance between premorbid migraines and those without pre-morbid in terms of recovery days, days since injury before seeking treatment, total visits, King Devick Test, Trails A/B/AB, or VOMS related headache scores.

Conclusions
The results of this study did not show any significance of premorbid migraines on concussion recovery time which contradicts prior findings. Individuals with premorbid migraines presented with higher PCSS symptoms during their initial clinical evaluation, but it did not impact recovery time. Future studies should evaluate how higher PCSS scores contribute to headache presentation during concussion recovery time.
A - 13 Social Determinants of Health and Health Equity in Return to Learn Following Sport-Related Concussion
Authors: Kissinger-Knox A , Stephenson K L , Santangelo J , Adubofour K , Iverson G L , Cook N E 
Published: July 2024

Abstract

Purpose
We conducted a narrative review and content analysis to (i) determine the extent to which research on return to learn (RTL) following sport-related concussion (SRC) has considered social determinants of health (SDoH) or health equity and (ii) provide recommendations to enhance the incorporation of SDoH and health equity into considerations of how best to support concussed students as they RTL following injury.

Data Selection
We coded 32 studies from a systematic review focused on clinical recovery following SRC, including RTL (Putukian et al., 2023). The review informed the latest Concussion in Sport Group consensus statement (Patricios et al., 2023). We examined studies to determine whether the SDoH domains and subcategories, derived from the US Department of Health and Human Services Healthy People 2020 and 2030 websites, were addressed. Pairs of raters coded articles independently and resolved disagreements through discussion.

Conclusions
SDoH remain largely unrepresented in studies on return to school following concussion. Future research is needed to better characterize how SDoH and health equity factors influence return to school following concussion to ensure that concussed and recovering students are supported.
A - 14 Examining Race-Associated Differences on Sway Medical System Balance and Cognitive Tests
Authors: Stephenson K , Maietta J E , Kissinger-Knox A M , Cook N E , Iverson G L 
Published: July 2024

Abstract

Purpose
To determine if there are race-associated differences in Sway Medical System balance and cognitive test scores among athletes undergoing baseline preseason testing.

Method
Athletes between 12 and 23 years old were administered the Sway Medical System balance and cognitive tests during pre-season baseline testing. Participants who did not report a past medical history of ADHD or concussion within the past 6 months were included (N = 32,918). Athletes who self-identified as “Black or African American”or “White”were compared on Balance, Reaction Time, Inspection Time, Impulse Control, and Memory module scores using Mann–Whitney U tests, and statistical tests were stratified by age and gender.

Results
The race-associated differences (effect sizes) between Black and White athletes ranged from extremely small (negligible) to small across all ages for both genders on Balance, Reaction Time, Inspection Time, and Impulse Control scores. For the Memory module, the effect sizes ranged from small to medium across all ages for both genders. White boys obtained higher Memory scores than Black boys (Hedge’s g = −0.18 to −0.43) and White men obtained higher Memory scores than Black men (g = −0.30 to −0.60). White girls obtained higher Memory scores than Black girls (g = −0.19 to −0.34).

Conclusions
The race-associated differences between Black and White student-athletes on Sway Medical System balance and cognitive test scores are generally negligible. The reasons for modest race-associated differences in Memory scores are unknown and future research to examine the potential role or influence of social risk factors and social psychological factors on test scores is recommended.
A - 15 Incorporating the Child Opportunity Index and Area Deprivation Index in Sport Concussion Research
Authors: Iverson G L , Santangelo J , Maietta J E , Cook N E 
Published: July 2024

Abstract

Purpose
Social determinants of health, including socioeconomic status (SES) and neighborhood characteristics, are underrepresented in concussion research. We examined two measures of neighborhood advantage and opportunity among patients accessing a multidisciplinary sports concussion clinic in Greater Boston.

Method
We collected the Child Opportunity Index (COI) and Area Deprivation Index (ADI) state decile scores and national percentile ranks for all new patients who presented to our clinic in 2023. The COI is an index of neighborhood conditions that may impact childhood development (e.g., education quality, SES, access to healthy food) with ratings from Very Low to Very High. The ADI characterizes an area’s socioeconomic conditions (e.g., income, housing quality, employment, education), with higher scores representing more disadvantage.

Results
There were 247 new patients who visited the clinic (Mage = 17.5, SDage = 5.2, 47.8% Girls/Women, 81.4% White, 4.0% Black, 6.5% Asian, 4.9% Hispanic). The majority lived in an area with a High or Very High state COI (74%) and High or Very High national COI (88%). The median ADI state decile was 2.00 (IQR = 1.00–4.00) and the median national percentile was 10.00 (IQR = 5.00–18.00) (representing the highest 10% of advantage). The state deciles for the two measures were correlated (Spearman rho = 0.64), but not redundant.

Conclusions
The COI and ADI are important, accessible measures of SES that can be included in future studies. Patients from low SES were greatly underrepresented in the clinic compared to the population of our metropolitan area. Patients were predominantly from higher SES, consistent with prior studies suggesting socioeconomic disparities accessing specialty concussion care.
A - 17 Pre-injury Predictors of Protracted Recovery from Pediatric Concussion: a Latent Class Analysis
Authors: June D , Iampietro M , Zelikovsky Z , Grady M , Master C 
Published: July 2024

Abstract

Purpose
This person-centered study examined pre-injury psychological and neurodevelopmental risk factors in youth experiencing persistent concussion symptoms (PCS). Latent class analysis (LCA) was used to empirically define groups of children and adolescents experiencing PCS, and compare their functional outcomes.

Method
126 pediatric patients (Mean age = 15.94 years; 65.1% female) experiencing PCS (Mean time since injury = 315 days) participated in a clinical neuropsychological consultation and evaluation within the Minds Matter Concussion Program at Children’s Hospital of Philadelphia. LCA models were run using pre-injury variables (mood and anxiety concerns, attention and learning challenges). Functional outcomes (neuropsychological performance, academic decline, symptom magnification) were then compared across the resulting classes.

Results
Statistical indicators [Akaike Information Criteria (804.59), adjusted Bayesian Information Criteria (801.01), Bootstrap Likelihood Ratio Test (p &lt; 0.001)] indicated that a two-class model provided the best fit. Class 1 (n = 58) was predominately females (78.3%) with comorbid pre-injury developmental (46.6% learning challenges, 54.6% attention concerns) and psychological concerns (75.6% anxiety, 48.9% mood concerns). Class 2 (n = 68) was half females (49.8%) with fewer comorbid pre-injury developmental (14.6% learning challenges, 22.5% attention concerns) and psychological concerns (39.3% anxiety, 0% mood concerns). The two classes did not significantly differ on functional outcomes. Standardized testing scores were within the average range across the sample.

Conclusions
Pre-injury risk factors contribute to persistent symptom experience and functional complaints in the absence of objective cognitive impairment. Given the incidence across groups, these findings highlight the importance of understanding psychological and neurodevelopmental factors, as well as sex-based differences when directing referrals and treatment of PCS within a multidisciplinary program.
A - 19 Reliability of Mobile Ecologic Momentary Assessment Platform ReCoUPS to Monitor Concussion Symptoms and Psychological HRQoL
Authors: Tracey A J , Bretzin A C , Rettmann A , Wiebe D J , Covassin T 
Published: July 2024

Abstract

Purpose
The purpose of this study was to determine the psychometric properties of a concussion symptom checklist and psychological health-related quality of life (PHRQoL) inventories administered by novel, mobile ecological momentary assessment (EMA) platform, Recovering Concussion Update on Progression of Symptoms (ReCoUPS) in healthy individuals.

Method
We enrolled 53 healthy individuals (female = 34; Μ age = 20.79 years, SD = 2.68) into our test–retest reliability study using the ReCoUPS platform on participants’smartphones. Thirty survey questions from the Sport Concussion Assessment Tool6 (SCAT-6) and the PROMIS Emotional Distress Shorts Forms Anxiety and Depression (PROMISAnx and PROMISDepress), were administered at random times, daily, for 7 days via ReCoUPS text messages. Eight days after enrollment, participants completed recalled PHRQoL (rPHRQoL) inventories (i.e., “within the past 7 days”). Cronbach’s alpha (Α) determined the internal consistency of momentary PHRQoL (mPHRQoL). Intraclass correlation coefficients (ICC), 2-way mixed effects model (95% confidence intervals,[CI]) measured agreement between rHRQoL and mPHRQoL. Spearman’s rho (rs) correlation coefficients determined linear relationships between mPHRQoL and SCAT-6 symptom clusters.

Results
There was strong internal consistency among all mPHRQoL items (PROMISAnx Α = 0.83; PROMISDepress Α = 0.95). rPHRQoL demonstrated excellent agreement with mPHRQoL (PROMISAnx ICC = 0.92, 95% CI: 0.57–0.99; PROMISDepress ICC = 0.79, 95% CI: −0.09-0.99). mPROMISAnx was significantly correlated with all clusters (affective rs = 0.81, p &lt; 0.001; cognitive-fatigue rs = 0.66, p &lt; 0.001; migraine rs = 0.34; p &lt; 0.001). mPROMISDepress was significantly correlated with affective (rs = 0.69, p &lt; 0.001) and cognitive-fatigue (rs = 0.58, p &lt; 0.001) clusters.

Conclusions
These findings ensure the robustness and generalizability of administering the SCAT-6 symptom checklist, PROMISAnx, and PROMISDepress via ReCoUPS for monitoring concussion symptoms and PHRQoL in healthy participants.