Comparison of Head Impact Exposure Across Common Activities in Youth Soccer

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S24.1-S24
Author(s):  
Stewart Pritchard ◽  
Tanner Filben ◽  
Sebastian Haja ◽  
Logan Miller ◽  
Mark Espeland ◽  
...  
Keyword(s):  
Linear Models ◽  
The United States ◽  
Head Impact ◽  
Technical Training ◽  
Neurocognitive Deficits ◽  
Game Play ◽  
Team Interaction ◽  
Activity Types ◽  
Training Activities ◽  
Training Team

ObjectiveThe objective of this study was to compare head impact exposure across common training activities in soccer.BackgroundSoccer is a popular youth sport in the United States, but repetitive head impacts during training may result in neurocognitive deficits. Current research has identified factors associated with increased head impact exposure in soccer, but research has yet to contextualize head impact exposure across soccer activities. Modifying practice structure may be an avenue for reducing head impact exposure and concussion risk in soccer.Design/MethodsEight U15 soccer players participated in this study for 2 soccer seasons. Players wore a custom instrumented mouthpiece sensor during all practices and games. On-field activities were recorded with a time-synchronized camera. Research personnel recorded the duration of all practice (e.g., technical training, team interaction) and game activities performed by each player, and film review was performed to identify all head contact events during each session. Head impact exposure was quantified in terms of peak kinematics and impacts per player per hour. The amount of time an athlete was exposed to an activity was also evaluated. Mixed effects models were used to compare peak kinematics and generalized linear models were used to compare impact rates across activity types.ResultsActivity types were associated with peak kinematics and impact rate. Technical training activities were associated with higher impact rates and lower mean kinematics compared to other activity types. Team interaction activities and game play were associated with the highest rotational kinematics, but the lowest impact rates. A similar number of player-to-player contact events occurred within technical training, team interaction, and game play activities.ConclusionsInterventions designed to reduce head impact frequency in soccer may benefit from targeting technical training activities; whereas, interventions designed to reduce head impact magnitude may benefit from targeting team interaction and game activities.

scholarly journals Football concussion case series using biomechanical and video analysis

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S2.2-S2
Author(s):  
Mirellie Kelley ◽  
Jillian Urban ◽  
Derek Jones ◽  
Alexander Powers ◽  
Christopher T. Whitlow ◽  
...  
Keyword(s):  
Video Analysis ◽  
Case Series ◽  
Linear Acceleration ◽  
The United States ◽  
Head Impact ◽  
Rotational Acceleration ◽  
Impact Location ◽  
Injury Mechanisms ◽  
The Mean ◽  
Impact Data

Approximately 1.1–1.9 million sport-related concussions among athletes ≤18 years of age occur annually in the United States, but there is limited understanding of the biomechanics and injury mechanisms associated with concussions among lower level football athletes. Therefore, the objective of this study was to combine biomechanical head impact data with video analysis to characterize youth and HS football concussion injury mechanisms. Head impact data were collected from athletes participating on 22 youth and 6 HS football teams between 2012 and 2017. Video was recorded, and head impact data were collected during all practices and games by instrumenting players with the Head Impact Telemetry (HIT) System. For each clinically diagnosed concussion, a video abstraction form was completed, which included questions concerning the context in which the injury occurred. Linear acceleration, rotational acceleration, and impact location were used to characterize the concussive event and each injured athlete's head impact exposure on the day of the concussion. A total of 9 (5 HS and 4 youth) concussions with biomechanics and video of the event were included in this study. The mean [range] linear and rotational acceleration of the concussive impacts were 62.9 [29.3–118.4] g and 3,056.7 [1,046.8–6,954.6] rad/s2, respectively. Concussive impacts were the highest magnitude impacts for 6 players and in the top quartile of impacts for 3 players on the day of injury. Concussions occurred in both practices (N = 4) and games (N = 5). The most common injury contact surface was helmet-to-helmet (N = 5), followed by helmet-to-ground (N = 3) and helmet-to-body (N = 1). All injuries occurred during player-to-player contact scenarios, including tackling (N = 4), blocking (N = 4), and collision with other players (N = 1). The biomechanics and injury mechanisms of concussions varied among athletes in our study; however, concussive impacts were among the highest severity for each player and all concussions occurred as a result of player-to-player contact.

scholarly journals A global scientific literature of research on water quality indices: trends, biases and future directions

2014 ◽  
Vol 26 (3) ◽  
pp. 245-253 ◽  
Author(s):  
Maria Tereza Ribeiro Alves ◽  
Fabrício Barreto Teresa ◽  
João Carlos Nabout
Keyword(s):  
Water Quality ◽  
Linear Models ◽  
Scientific Literature ◽  
Information Criterion ◽  
The United States ◽  
Water Index ◽  
Resource Managers ◽  
Quality Of Water ◽  
Number Of Publications

AIM: Water quality has been the subject of many recent studies, moreover, the physical, chemical and biological parameters of water are used to investigate water quality and can be combined into a single index, the Water Quality Index (WQI), for use by water resource managers and the general public. The aim of this study was to use scientometrics to evaluate how water quality has been addressed in the international scientific literature. METHOD: For the quantitative analysis of the publications on WQI, we used the search database SCOPUS (http://www.scopus.com). The search was performed using the words "QUALIT* WATER* INDEX*" in papers published in all databases (through 2011). RESULTS: We found 554 articles that dealt with the use of WQI the number of publications has increased significantly over the last 20 years. India had the most studies, with 177 articles, followed by China, Brazil and the United States. These four countries together published 57% of studies on WQI. We generated 15 linear models to explain the number of publication by study sit (country). According to the Akaike Information Criterion (AIC), the best model to explain the number of publications by country was the model that combined Sanitation and Public Supply. CONCLUSION: Finally, this paper presents the state of scientific literature on WQI and demonstrates the growing interest of the scientific community in this issue, which is certainly due to the importance of the quantity and quality of water for human supply, economics, health and the conservation of water resources.

scholarly journals Game-Related Impacts in High School Boys’ Lacrosse

2019 ◽  
Vol 7 (4) ◽  
pp. 232596711983558 ◽  
Author(s):  
Shane V. Caswell ◽  
Patricia Kelshaw ◽  
Andrew E. Lincoln ◽  
Lisa Hepburn ◽  
Reginald Dunn ◽  
...  
Keyword(s):  
High School ◽  
Rotational Velocity ◽  
Linear Acceleration ◽  
The United States ◽  
Head Impact ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Head Impacts ◽  
Direct Head ◽  
The Impact

Background: The rate of concussions in boys’ lacrosse is reported to be the third highest among high school sports in the United States, but no studies have described game-related impacts among boys’ lacrosse players. Purpose: To characterize verified game-related impacts, both overall and those directly to the head, in boys’ varsity high school lacrosse. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 77 male participants (mean age, 16.6 ± 1.2 years; mean height, 1.77 ± 0.05 m; mean weight, 73.4 ± 12.2 kg) were instrumented with sensors and were videotaped during 39 games. All verified game-related impacts ≥20 g were summarized in terms of frequency, peak linear acceleration (PLA), and peak rotational velocity (PRV). Descriptive statistics and impact rates per player-game (PG) with corresponding 95% CIs were calculated. Results: Overall, 1100 verified game-related impacts were recorded (PLA: median, 33.5 g [interquartile range (IQR), 25.7-51.2]; PRV: median, 1135.5 deg/s [IQR, 790.0-1613.8]) during 795 PGs. The rate for all verified game-related impacts was 1.38 impacts per PG (95% CI, 1.30-1.47). Of these, 680 (61.8%) impacts (PLA: median, 35.9 g [IQR, 26.7-55.5]; PRV: 1170.5 deg/s [IQR, 803.2-1672.8]) were directly to the head (impact rate, 0.86 impacts/PG [95% CI, 0.79-0.92]). Overall, midfielders (n = 514; 46.7%) sustained the most impacts, followed by attackers (n = 332; 30.2%), defenders (n = 233; 21.2%), and goalies (n = 21; 1.9%). The most common mechanisms for overall impacts and direct head impacts were contact with player (overall: n = 706 [64.2%]; head: n = 397 [58.4%]) and stick (overall: n = 303 [27.5%]; head: n = 239 [35.1%]), followed by ground (overall: n = 73 [6.6%]; head: n = 26 [3.8%]) and ball (overall: n = 15 [1.4%]; head: n = 15 [2.2%]). Direct head impacts were associated with a helmet-to-helmet collision 31.2% of the time, and they were frequently (53.7%) sustained by the players delivering the impact. Nearly half (48.8%) of players delivering contact used their helmets to initiate contact that resulted in a helmet-to-helmet impact. Players receiving a head impact from player contact were most often unprepared (75.9%) for the collision. Conclusion: The helmet is commonly used to initiate contact in boys’ high school lacrosse, often targeting defenseless opponents. Interventions to reduce head impacts should address rules and coaching messages to discourage intentional use of the helmet and encourage protection of defenseless opponents.

HIV/AIDS in Later Life

2018 ◽  
Author(s):  
Philip Sayegh ◽  
David J. Moore ◽  
Pariya Fazeli Wheeler
Keyword(s):  
Successful Aging ◽  
Neuropsychiatric Symptoms ◽  
Later Life ◽  
Well Being ◽  
The United States ◽  
Neurocognitive Deficits ◽  
Everyday Functioning ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

Since the first cluster of people with HIV was identified in 1981, significant biomedical advances, most notably the development of antiretroviral therapy (ART), have led to considerably increased life expectancy as well as a reduction in the morbidity and mortality associated with HIV/AIDS. As a result, HIV/AIDS is no longer considered a terminal illness, but rather a chronic illness, and many persons living with HIV/AIDS are beginning to enter or have already reached later life. In fact, Americans ages 50 years and older comprise approximately half of all individuals with HIV/AIDS and represent the most rapidly growing subpopulation of persons living with HIV/AIDS in the United States. Despite significant advances in HIV/AIDS treatment and prognosis, older adults living with HIV (OALH) face a number of unique challenges and circumstances that can lead to exacerbated symptoms and poorer outcomes, despite demonstrating generally better ART adherence than their younger counterparts. These detrimental outcomes are due to both chronological aging and cohort effects as well as social and behavioral factors and long-term ART use. For instance, neurocognitive deficits and neuropsychiatric symptoms, including depression, anxiety, apathy, and fatigue, are often observed among OALH, which can result in feelings of loneliness, social isolation, and reduced social support. Taken together, these factors can lead to elevated levels of problems with everyday functioning (e.g., activities of daily living) among OALH. In addition, sociocultural factors such as race/ethnicity, ageism, sexism, homophobia, transphobia, geographic region, socioeconomic status and financial well-being, systemic barriers and disparities, and cultural values and beliefs play an influential role in determining outcomes. Notwithstanding the challenges associated with living with HIV/AIDS in later life, many persons living with HIV/AIDS are aging successfully. HIV/AIDS survivor and community mobilization efforts, as well as integrated care models, have resulted in some significant improvements in overall HIV/AIDS patient care. In addition, interventions aimed at improving successful aging outcomes among OALH are being developed in an attempt to effectively reduce the psychological and physical morbidity associated with HIV disease.

Asymmetric Exchange Rate Effects on Cross-Border Freight Flows between the United States and Canada

2020 ◽  
Vol 2674 (4) ◽  
pp. 348-361
Author(s):  
Junwook Chi
Keyword(s):  
Exchange Rate ◽  
Linear Models ◽  
Bilateral Trade ◽  
Nonlinear Models ◽  
Exchange Rate Volatility ◽  
The United States ◽  
Trade Flows ◽  
Asymmetric Effects ◽  
Cross Border ◽  
Long Run

This paper investigates possible asymmetric influences of the exchange rate on cross-border freight flows between the U.S.A. and Canada. Linear and nonlinear autoregressive distributed lag models are used to test for the existence of long-run asymmetric effects of 1) currency appreciation and depreciation and 2) exchange rate volatility changes on trade flows by truck, rail, air, vessel, and pipeline. This paper provides evidence that both currency value and exchange rate volatility affect the U.S.–Canada freight flows in an asymmetric manner. The long-run results of the nonlinear models show that exchange rate is found to be significantly associated with the bilateral trade flows between the U.S.A. and Canada. Exchange rate volatility tends to be significantly associated with trade flows in the nonlinear models, while its effects are insignificant in most cases in the linear models. These findings suggest that the conventional linear specification may mislead the asymmetric effects of exchange rate uncertainty on cross-border freight flows. It is also found that exchange rate sensitivities of U.S.–Canada trade flows by transport mode can differ significantly from those of aggregate trade flows. The information derived from disaggregate trade data can be useful for traders and shippers to develop a long-term strategic plan for infrastructure investment and service expansion.

scholarly journals A New Look at Cohort Trend and Underlying Mechanisms in Cognitive Functioning

2020 ◽  
Author(s):  
Hui Zheng
Keyword(s):  
Cognitive Functioning ◽  
Baby Boomers ◽  
Linear Models ◽  
The United States ◽  
Household Wealth ◽  
Summary Score ◽  
Birth Cohorts ◽  
Explanatory Variables ◽  
Greatest Generation ◽  
Underlying Mechanisms

Abstract Objectives The prevalence of dementia in the United States seems to have declined over the last few decades. We investigate trends and their underlying mechanisms in cognitive functioning (CF) across 7 decades of birth cohorts from the Greatest Generation to Baby Boomers. Methods Data come from 30,191 participants of the 1996–2014 Health and Retirement Study. CF is measured as a summary score on a 35-point cognitive battery of items. We use generalized linear models to examine the trends in CF and explanatory variables across birth cohorts. Then, Karlson–Holm–Breen decomposition method is used to evaluate the contribution of each explanatory variable to the trend of CF. Results CF has been improving from the Greatest Generation to Late Children of Depression and War Babies, but then significantly declines since the Early-Baby Boomers and continues into Mid-Baby Boomers. This pattern is observed universally across genders, race/ethnicities, education groups, occupations, income, and wealth quartiles. The worsening CF among Baby Boomers does not originate from childhood conditions, adult education, or occupation. It can be attributed to lower household wealth, lower likelihood of marriage, higher levels of loneliness, depression and psychiatric problems, and more cardiovascular risk factors (e.g., obesity, physical inactivity, hypertension, stroke, diabetes, and heart disease). Discussion The worsening CF among Baby Boomers may potentially reverse past favorable trends in dementia as they reach older ages and cognitive impairment becomes more common if no effective interventions and policy responses are in place.

HSR19-088: Severe Obesity Does Not Worsen Transplantation Outcome in Multiple Myeloma

2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-088
Author(s):  
Zhubin J. Gahvari ◽  
Michael Lasarev ◽  
Jens C. Eickhoff ◽  
Aric C. Hall ◽  
Peiman Hematti ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Linear Models ◽  
Severe Obesity ◽  
Health Hazard ◽  
The United States ◽  
Hospital Length Of Stay ◽  
Nccn Guidelines ◽  
Post Transplant ◽  
Risk Of Death ◽  
Increased Risk

Background: Obesity, and in particular severe obesity, is increasingly prevalent in the United States. Epidemiological studies have shown an association in multiple myeloma (MM) between obesity and mortality (Teras et al, Br J Haematol 2014). Autologous peripheral blood stem cell transplantation (autoPBSCT) remains a crucial aspect of treating MM, and the NCCN Guidelines recommend all eligible patients be evaluated for transplant. There is limited data analyzing the relationship between severe obesity and transplant outcomes in MM patients in the era of modern therapy, routine post-transplant maintenance, and genetic-based risk stratification. Methods: We retrospectively reviewed consecutive patients undergoing autoPBSCT for MM at our institution from 2010–2017. Patients were categorized by body mass index (BMI) and Revised International Staging System (R-ISS) score. Patients were followed from time of first transplant until death. Surviving patients and those lost to follow-up were censored at last point of contact. Cox proportional hazard regression models and associated log-rank tests were used to assess whether age, BMI, lag time between diagnosis and transplant, and R-ISS score were associated with risk of death. Post-transplant hospital length of stay (LOS) was evaluated using generalized linear models with response following a gamma distribution. Results: 314 patients (59.2% male) were included. BMI was categorized as nonobese ([16, 30) kg/m2; n=178, 56.7%), obese ([30, 35) kg/m2; n=72, 22.9%) or severely obese ([35, 55) kg/m2; n=64, 20.4%) and was not found to be associated with risk of death following transplant, either independently (P=.17) or when adjusting for age, sex, lag, and R-ISS (P=.26). As expected, R-ISS score was associated (P=.006) with risk of death after transplant. No association was found between mean LOS and BMI (P=.875). Kaplan-Meier mortality estimates are shown in Figure 1. Conclusions: Obesity and severe obesity were not associated with an increased risk of mortality for MM patients receiving autoPBSCT. Although severe obesity is a health hazard, this should not be used to exclude patients from transplant.

Disability burden in patients with tenosynovial giant cell tumors in the United States from employer perspective.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 92-92
Author(s):  
Feng Lin ◽  
Raluca Ionescu-Ittu ◽  
Irina Pivneva ◽  
Willy Wynant ◽  
Sherry Shi ◽  
...  
Keyword(s):  
Giant Cell ◽  
Linear Models ◽  
Joint Destruction ◽  
Unmet Need ◽  
The United States ◽  
Work Loss ◽  
Giant Cell Tumors ◽  
Limited Mobility ◽  
Comorbidity Burden

92 Background: Tenosynovial giant cell tumor (TGCT) is a rare locally aggressive tumor causing pain, swelling, joint destruction, and limited mobility. This study assessed the disability burden and the associated costs in TGCT patients from an employer’s perspective. Methods: A retrospective analysis was performed using medical and disability claims from the OptumHealth database. Incident patients 18-64 years old with a diagnosis of TGCT (as identified by ICD-9: 727.02, 719.2x; ICD-10: D48.1, D21.x, M12.2) were matched 1:10 to controls without TGCT based on age, gender, index year, and follow-up duration. Patients without earning and disability data were excluded. Days of work loss due to disability claims and absenteeism associated with medical visits were compared using Poisson regression models. Costs were compared using generalized linear models. Results: A total of 1,395 eligible TGCT patients were matched with 13,950 controls without TGCT. Despite similar demographics (36% female, mean age 45-47) and only slightly higher comorbidity burden (mean Charlson Comorbidity Index (CCI): 0.3 versus 0.2), TGCT patients had increased usage of analgesic drugs (44% versus 20%) and MRI tests (37% versus 3%), prior to their diagnosis, compared with controls. During follow-up, TGCT patients were more likely to have disability claims (15.1% vs. 5.6%; p < 0.001), had more disability claim days (9.5 versus 2.0; p < 0.001), medically related absenteeism days (9.9 versus 4.3; p < 0.001), and total days of work loss (19.4 versus 6.3; p < 0.001) per person-year compared with their matched controls. After adjusting for age, gender, index year and CCI score, the average annual indirect cost per person was greater for patients with TGCT than controls ($4,653 versus $1,902; p < 0.001). Conclusions: In addition to the known problems of pain, limitation of mobility, and eventual joint destruction, TGCT patients had substantial indirect costs associated with increased work absenteeism and disability. These findings highlight the unmet need for more effective treatments to reduce not only the medical, but also the economic burden of TGCT.

Inpatient burden of cervical and uterine cancer in the United States.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17009-e17009
Author(s):  
Shelby Corman ◽  
Chizoba Nwankwo ◽  
Nehemiah Kebede ◽  
Ruchit Shah
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Linear Models ◽  
Uterine Cancer ◽  
The United States ◽  
Hospital Charges ◽  
Inpatient Mortality ◽  
Hospital Size ◽  
Logistic Regression Models ◽  
Similar Patient

e17009 Background: Limited data on the inpatient burden of cervical and uterine cancer exist. Therefore, this study assessed inpatient mortality, length of stay (LOS), and costs among hospitalized cervical and uterine cancer patients. Methods: This was a retrospective analysis of the 2006–2015 Healthcare Cost and Utilization Project – Nationwide Inpatient Sample (HCUP-NIS). Cervical and uterine cancer cases were identified using ICD-9 codes of 180.9 and 182.0 respectively. Patient demographics, hospital characteristics, and hospital outcomes (hospitalization rates, inpatient mortality, LOS, and costs) were examined. Multivariate logistic regression models were used to determine predictors of inpatient mortality. Generalized linear models were used to determine predictors of LOS and costs. Results: The analytic cohort included 67,429 cervical cancer and 74,394 uterine cancer cases resulting in 55.92 (±1.51) and 61.69 (±1.78) annual hospitalizations (per 100,000 women), respectively. The highest proportion of hospitalizations related to cervical and uterine cancer were among patients aged 45-65 years (38.9%, 45.7%), Caucasians (70.3%, 78.1%), having public insurance (59.6%, 67.4%), and admitted at large (63.3%, 63.1%), urban teaching (54.8%, 56.5%) hospitals. The mean LOS, proportion of patients who died during hospitalization, and hospital charges per stay were 4.22 (±0.02) days, 1.02%, and $9,646 (±$63.06) for cervical cancer and 4.39 (±0.02) days, 1.43%, and $10,790 (±65.47) for uterine cancer related hospitalizations. Age > 65 years (vs 18-45 years) (OR: 3.656; 95% CI: 2.99 – 4.47), and higher Elixhauser mortality score (OR: 1.097; 95% CI: 1.09 – 1.10) were associated with higher inpatient mortality among cervical cancer patients. Predictors of inpatient mortality for uterine cancer were similar. Patient age, insurance, race, hospital size, urban (vs rural) location, region of the country, and Elixhauser mortality score emerged as significant predictors of LOS and cost per hospital discharge across both cancers. Conclusions: Cervical and uterine cancer are associated with considerable inpatient burden. There was considerable variation in inpatient mortality, LOS, and costs based on patient, hospital, and discharge level characteristics.

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