The Effects of Early Physical Activity Compared to Early Physical Rest on Concussion Symptoms

Clinical Scenario: Currently, rest following concussion serves as the keystone of concussion treatment, but substantial evidence to support it is lacking. Recent literature suggests that early physical activity may be beneficial in reducing concussion symptoms which may influence clinical recovery time. Clinical Question: Does early physical activity decrease postconcussion symptoms compared to physical rest following concussion? Summary of Key Findings: A total of 5 articles were included that examined symptom duration changes at multiple time points. All 5 studies utilized follow-up time points compared to initial examination, but there was variance in the specific time points reported. Two studies employed control groups and compared strict or recommended rest to early activity or limited rest. Three studies were observational studies that directly compared baseline measurements to follow-up assessments. Clinical Bottom Line: Current evidence suggests that early physical activity in the acute phase following a concussion may decrease the time needed for symptom resolution compared to immediate rest. Strength of Recommendation: Using Centre for Evidence-Based Medicine 2011 level 3 evidence and higher, the results suggest that early physical activity during the acute phase of a concussion may decrease symptom duration; however, a lack of high-quality studies and inconsistent interventions are limitations to this recommendation.

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Self-Reported and Objectively Measured Physical Activity Among a Cohort of Postpartum Women: The PIN Postpartum Study

Journal of Physical Activity and Health ◽

10.1123/jpah.9.1.5 ◽

2012 ◽

Vol 9 (1) ◽

pp. 5-20 ◽

Cited By ~ 14

Author(s):

Kelly R. Evenson ◽

Amy H. Herring ◽

Fang Wen

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Post Partum ◽

Vigorous Physical Activity ◽

Moderate Activity ◽

Multiple Time ◽

Time Points ◽

Multiple Time Points ◽

Objectively Measured ◽

Objectively Measured Physical Activity

Background:Few studies measure physical activity objectively or at multiple time points during postpartum. We describe physical activity at 3- and 12-months postpartum among a cohort of women using both self-reported and objective measures.Methods:In total, 181 women completed the 3-month postpartum measures, and 204 women completed the 12-month postpartum measures. Participants wore an ActiGraph accelerometer for 1 week and completed in-home interviews that included questions on physical activity. A cohort of 80 women participated at both time points. Poisson regression models were used to determine whether physical activity differed over time for the cohort.Results:For the cohort, average counts/minute were 364 at 3-months post-partum and 394 at 12-months postpartum. At both time periods for the cohort, vigorous activity averaged 1 to 3 minutes/day, and moderate activity averaged 16 minutes/day. Sedentary time averaged 9.3 hours at 3-months postpartum and 8.8 hours at 12-months postpartum, out of a 19-hour day. Average counts/minute increased and sedentary behavior declined from 3- to 12-months postpartum.Conclusion:Interventions are needed to help women integrate more moderate to vigorous physical activity and to capitalize on the improvements in sedentary behavior that occur during postpartum.

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T88. THE IMPACT OF AGE OF ONSET AND ILLNESS DURATION ON WHITE MATTER AND COGNITION TRAJECTORIES IN SCHIZOPHRENIA: A 7-YEAR FOLLOW-UP STUDY ACROSS MULTIPLE TIME-POINTS

Schizophrenia Bulletin ◽

10.1093/schbul/sbz019.368 ◽

2019 ◽

Vol 45 (Supplement_2) ◽

pp. S237-S238

Author(s):

Marie B Jensen ◽

Bjørn H Ebdrup ◽

Christos Pantelis ◽

Mette Ø Nielsen ◽

Jayachandra Mitta Raghava ◽

...

Keyword(s):

White Matter ◽

Age Of Onset ◽

Multiple Time ◽

Time Points ◽

Illness Duration ◽

Follow Up Study ◽

Multiple Time Points ◽

The Impact

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Design and protocol of a comprehensive multicentre biobank for abdominal aortic aneurysms

BMJ Open ◽

10.1136/bmjopen-2018-028858 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028858 ◽

Cited By ~ 1

Author(s):

Hamid Jalalzadeh ◽

Reza Indrakusuma ◽

Jan D. Blankensteijn ◽

Willem Wisselink ◽

Kak K Yeung ◽

...

Keyword(s):

Abdominal Aortic Aneurysms ◽

Mixed Effects ◽

Aortic Aneurysms ◽

Mixed Effects Models ◽

Multiple Time ◽

Imaging Data ◽

Time Points ◽

Abdominal Aortic ◽

Multiple Time Points

IntroductionThe pathophysiology and natural course of abdominal aortic aneurysms (AAAs) are insufficiently understood. In order to improve our understanding, it is imperative to carry out longitudinal research that combines biomarkers with clinical and imaging data measured over multiple time points. Therefore, a multicentre biobank, databank and imagebank has been established in the Netherlands: the ‘Pearl Abdominal Aortic Aneurysm’ (AAA bank).Methods and analysisThe AAA bank is a prospective multicentre observational biobank, databank and imagebank of patients with an AAA. It is embedded within the framework of the Parelsnoer Institute, which facilitates uniform biobanking in all university medical centres (UMCs) in the Netherlands. The AAA bank has been initiated by the two UMCs of Amsterdam UMC and by Leiden University Medical Center. Participants will be followed during AAA follow-up. Clinical data are collected every patient contact. Three types of biomaterials are collected at baseline and during follow-up: blood (including DNA and RNA), urine and AAA tissue if open surgical repair is performed. Imaging data that are obtained as part of clinical care are stored in the imagebank. All data and biomaterials are processed and stored in a standardised manner. AAA growth will be based on multiple measurements and will be analysed with a repeated measures analysis. Potential associations between AAA growth and risk factors that are also measured on multiple time points can be assessed with multivariable mixed-effects models, while potential associations between AAA rupture and risk factors can be tested with a conditional dynamic prediction model with landmarking or with joint models in which linear mixed-effects models are combined with Cox regression.Ethics and disseminationThe AAA bank is approved by the Medical Ethics Board of the Amsterdam UMC (University of Amsterdam).Trial registration numberNCT03320408.

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Physical activity levels among ovarian cancer survivors: a prospective longitudinal cohort study

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-002107 ◽

2021 ◽

pp. ijgc-2020-002107

Author(s):

Tamara Jones ◽

Carolina Sandler ◽

Dimitrios Vagenas ◽

Monika Janda ◽

Andreas Obermair ◽

...

Keyword(s):

Physical Activity ◽

Ovarian Cancer ◽

Stage Iv ◽

Multiple Time ◽

Activity Levels ◽

Prospective Longitudinal Study ◽

Physical Activity Advice ◽

Physical Activity Levels ◽

Multiple Time Points ◽

Prospective Longitudinal

ObjectivePhysical activity following cancer diagnosis is associated with improved outcomes, including potential survival benefits, yet physical activity levels among common cancer types tend to decrease following diagnosis and remain low. Physical activity levels following diagnosis of less common cancers, such as ovarian cancer, are less known. The objectives of this study were to describe physical activity levels and to explore characteristics associated with physical activity levels in women with ovarian cancer from pre-diagnosis to 2 years post-diagnosis.MethodsAs part of a prospective longitudinal study, physical activity levels of women with ovarian cancer were assessed at multiple time points between pre-diagnosis and 2 years post-diagnosis. Physical activity levels and change in physical activity were described using metabolic equivalent task hours and minutes per week, and categorically (sedentary, insufficiently, or sufficiently active). Generalized Estimating Equations were used to explore whether participant characteristics were related to physical activity levels.ResultsA total of 110 women with ovarian cancer with a median age of 62 years (range 33–88) at diagnosis were included. 53–57% of the women were sufficiently active post-diagnosis, although average physical activity levels for the cohort were below recommended levels throughout the 2-year follow-up period (120–142.5min/week). A decrease or no change in post-diagnosis physical activity was reported by 44–60% of women compared with pre-diagnosis physical activity levels. Women diagnosed with stage IV disease, those earning a lower income, those receiving chemotherapy, and those currently smoking or working were more likely to report lower physical activity levels and had increased odds of being insufficiently active or sedentary.ConclusionsInterventions providing patients with appropriate physical activity advice and support for behavior change could potentially improve physical activity levels and health outcomes.

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Quantitative Checklist for Autism in Toddlers (Q-CHAT). A population screening study with follow-up: the case for multiple time-point screening for autism

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000700 ◽

2021 ◽

Vol 5 (1) ◽

pp. e000700

Author(s):

Carrie Allison ◽

Fiona E Matthews ◽

Liliana Ruta ◽

Greg Pasco ◽

Renee Soufer ◽

...

Keyword(s):

Phase 1 ◽

Autism Spectrum ◽

Population Screening ◽

Diagnostic Assessment ◽

Test Accuracy ◽

Multiple Time ◽

Phase 2 ◽

Time Points ◽

Screening Study

ObjectiveThis is a prospective population screening study for autism in toddlers aged 18–30 months old using the Quantitative Checklist for Autism in Toddlers (Q-CHAT), with follow-up at age 4.DesignObservational study.SettingLuton, Bedfordshire and Cambridgeshire in the UK.Participants13 070 toddlers registered on the Child Health Surveillance Database between March 2008 and April 2009, with follow-up at age 4; 3770 (29%) were screened for autism at 18–30 months using the Q-CHAT and the Childhood Autism Spectrum Test (CAST) at follow-up at age 4.InterventionsA stratified sample across the Q-CHAT score distribution was invited for diagnostic assessment (phase 1). The 4-year follow-up included the CAST and the Checklist for Referral (CFR). All with CAST ≥15, phase 1 diagnostic assessment or with developmental concerns on the CFR were invited for diagnostic assessment (phase 2). Standardised diagnostic assessment at both time-points was conducted to establish the test accuracy of the Q-CHAT.Main outcome measuresConsensus diagnostic outcome at phase 1 and phase 2.ResultsAt phase 1, 3770 Q-CHATs were returned (29% response) and 121 undertook diagnostic assessment, of whom 11 met the criteria for autism. All 11 screened positive on the Q-CHAT. The positive predictive value (PPV) at a cut-point of 39 was 17% (95% CI 8% to 31%). At phase 2, 2005 of 3472 CASTs and CFRs were returned (58% response). 159 underwent diagnostic assessment, including 82 assessed in phase 1. All children meeting the criteria for autism identified via the Q-CHAT at phase 1 also met the criteria at phase 2. The PPV was 28% (95% CI 15% to 46%) after phase 1 and phase 2.ConclusionsThe Q-CHAT can be used at 18–30 months to identify autism and enable accelerated referral for diagnostic assessment. The low PPV suggests that for every true positive there would, however, be ~4–5 false positives. At follow-up, new cases were identified, illustrating the need for continued surveillance and rescreening at multiple time-points using developmentally sensitive instruments. Not all children who later receive a diagnosis of autism are detectable during the toddler period.

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Use of TanDEM-X and SRTM-C Data for Detection of Deforestation Caused by Bark Beetle in Central European Mountains

Remote Sensing ◽

10.3390/rs13153042 ◽

2021 ◽

Vol 13 (15) ◽

pp. 3042

Author(s):

Kateřina Gdulová ◽

Jana Marešová ◽

Vojtěch Barták ◽

Marta Szostak ◽

Jaroslav Červenka ◽

...

Keyword(s):

Bark Beetle ◽

Synergistic Effects ◽

Canopy Height ◽

Surface Model ◽

Multiple Time ◽

Central European ◽

Time Points ◽

Bohemian Forest ◽

Multiple Time Points ◽

Surrounding Areas

The availability of global digital elevation models (DEMs) from multiple time points allows their combination for analysing vegetation changes. The combination of models (e.g., SRTM and TanDEM-X) can contain errors, which can, due to their synergistic effects, yield incorrect results. We used a high-resolution LiDAR-derived digital surface model (DSM) to evaluate the accuracy of canopy height estimates of the aforementioned global DEMs. In addition, we subtracted SRTM and TanDEM-X data at 90 and 30 m resolutions, respectively, to detect deforestation caused by bark beetle disturbance and evaluated the associations of their difference with terrain characteristics. The study areas covered three Central European mountain ranges and their surrounding areas: Bohemian Forest, Erzgebirge, and Giant Mountains. We found that vertical bias of SRTM and TanDEM-X, relative to the canopy height, is similar with negative values of up to −2.5 m and LE90s below 7.8 m in non-forest areas. In forests, the vertical bias of SRTM and TanDEM-X ranged from −0.5 to 4.1 m and LE90s from 7.2 to 11.0 m, respectively. The height differences between SRTM and TanDEM-X show moderate dependence on the slope and its orientation. LE90s for TDX-SRTM differences tended to be smaller for east-facing than for west-facing slopes, and varied, with aspect, by up to 1.5 m in non-forest areas and 3 m in forests, respectively. Finally, subtracting SRTM and NASA DEMs from TanDEM-X and Copernicus DEMs, respectively, successfully identified large areas of deforestation caused by hurricane Kyril in 2007 and a subsequent bark beetle disturbance in the Bohemian Forest. However, local errors in TanDEM-X, associated mainly with forest-covered west-facing slopes, resulted in erroneous identification of deforestation. Therefore, caution is needed when combining SRTM and TanDEM-X data in multitemporal studies in a mountain environment. Still, we can conclude that SRTM and TanDEM-X data represent suitable near global sources for the identification of deforestation in the period between the time points of their acquisition.

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Meta-analysis of effect sizes reported at multiple time points: A multivariate approach

Clinical Trials ◽

10.1177/1740774512453218 ◽

2012 ◽

Vol 9 (5) ◽

pp. 610-620 ◽

Cited By ~ 28

Author(s):

Thomas A Trikalinos ◽

Ingram Olkin

Keyword(s):

Random Effects ◽

Treatment Effects ◽

Multivariate Analyses ◽

Meta Analysis ◽

Effect Sizes ◽

Multiple Time ◽

Time Points ◽

Fixed And Random Effects ◽

Multiple Time Points ◽

Meta Analyses

Background Many comparative studies report results at multiple time points. Such data are correlated because they pertain to the same patients, but are typically meta-analyzed as separate quantitative syntheses at each time point, ignoring the correlations between time points. Purpose To develop a meta-analytic approach that estimates treatment effects at successive time points and takes account of the stochastic dependencies of those effects. Methods We present both fixed and random effects methods for multivariate meta-analysis of effect sizes reported at multiple time points. We provide formulas for calculating the covariance (and correlations) of the effect sizes at successive time points for four common metrics (log odds ratio, log risk ratio, risk difference, and arcsine difference) based on data reported in the primary studies. We work through an example of a meta-analysis of 17 randomized trials of radiotherapy and chemotherapy versus radiotherapy alone for the postoperative treatment of patients with malignant gliomas, where in each trial survival is assessed at 6, 12, 18, and 24 months post randomization. We also provide software code for the main analyses described in the article. Results We discuss the estimation of fixed and random effects models and explore five options for the structure of the covariance matrix of the random effects. In the example, we compare separate (univariate) meta-analyses at each of the four time points with joint analyses across all four time points using the proposed methods. Although results of univariate and multivariate analyses are generally similar in the example, there are small differences in the magnitude of the effect sizes and the corresponding standard errors. We also discuss conditional multivariate analyses where one compares treatment effects at later time points given observed data at earlier time points. Limitations Simulation and empirical studies are needed to clarify the gains of multivariate analyses compared with separate meta-analyses under a variety of conditions. Conclusions Data reported at multiple time points are multivariate in nature and are efficiently analyzed using multivariate methods. The latter are an attractive alternative or complement to performing separate meta-analyses.

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THE ROLE OF MEMORY PERSPECTIVE IN SOCIAL PHOBIA: IMMEDIATE AND DELAYED MEMORIES FOR ROLE-PLAYED SITUATIONS

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465802004034 ◽

2002 ◽

Vol 30 (4) ◽

pp. 415-425 ◽

Cited By ~ 34

Author(s):

Meredith E. Coles ◽

Cynthia L. Turk ◽

Richard G. Heimberg

Keyword(s):

Social Phobia ◽

Multiple Time ◽

Behavioral Models ◽

Social Situations ◽

Time Points ◽

Cognitive Behavioral Models ◽

Multiple Time Points ◽

Memory Perspective ◽

Field Perspective

Cognitive-behavioral models (Clark & Wells, 1995; Rapee & Heimberg, 1997) and recent research suggest that individuals with social phobia (SP) experience both images (Hackmann, Surawy, & Clark, 1998) and memories (Coles, Turk, Heimberg, & Fresco, 2001; Wells, Clark, & Ahmad, 1998) of anxiety-producing social situations from an observer perspective. The current study examines memory perspective for two role-played situations (speech and social interaction) at multiple time points (immediate and 3 weeks post) in 22 individuals with generalized SP and 30 non-anxious controls (NACs). At both time points, SPs recalled the role-plays from a more observer/less field perspective than did NACs. Further, over time, the memory perspective of SPs became even more observer/less field while the memory perspective of NAC remained relatively stable.

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The Silicon Peaches

Innovation in Real Places ◽

10.1093/oso/9780197508114.003.0003 ◽

2021 ◽

pp. 31-42

Author(s):

Dan Breznitz

Keyword(s):

Information And Communication Technologies ◽

Silicon Valley ◽

Communication Technologies ◽

Multiple Time ◽

Rapid Rise ◽

Time Points ◽

Start Up ◽

Information And Communication ◽

Multiple Time Points ◽

Start Ups

This chapter acknowledges that, for many regions, the idea of attracting cutting-edge tech start-ups is almost irresistible. Seemingly every community aspires to become the next Silicon Valley. But is that feasible? This chapter make these lessons concrete by elaborating on the rapid rise and, even faster and deeper, decline of America’s first Silicon Valley—Cleveland, Ohio. It then shows the near impossibility of trying to become the next Silicon Valley by analyzing the mysterious failure of Atlanta, Georgia—a city that diligently followed all the advice ever given to an aspiring new start-up hub, but somehow was always left only with the “potential.” We will see how at multiple time-points Atlanta’s companies were the leading innovators with the best products in the newest information and communication technologies (ICT), only to falter and be taken over by Silicon Valley companies without leaving any apparent impact on the region. It then brings in social-network research and the concept of embeddedness to explain why trying to recreate a Silicon Valley is a doomed (and expensive) enterprise.

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