Correlation between ImPACT reaction time and CRTT efficiency score in concussed athletes

The management of sports related concussion is dependent upon a standardized assessment. Reaction time is the most sensitive measure of a concussion when using the ImPACT battery, which was standardized on concussed athletes. However, an athlete’s auditory comprehension is rarely assessed systematically. Auditory comprehension status is important in properly managing concussed athletes. The Computerized Revised Token Test (CRTT) measures efficiency time. The purpose of this investigation was to determine the correlation between the ImPACT reaction time and the CRTT-Subtest VIII efficiency score in 51 concussed athletes. These two measures are statistically significantly correlated. Clinical implications are discussed

Relationship between the Romberg Test and the Wii Basic Balance Test and Cognition in Athletes with Concussion

Background: Approximately 30% of individuals with a sport-related concussion present with postural instability. Multiple clinical balance tests exist to diagnose postural instability; yet little is known about the potential relationship between these type of postural assessments and cognition post-concussion. Aim: The purpose of the current study was to assess the relationship between the Romberg test, the Wii Fit basic balance test (WBBT), and the composite scores on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test in a sample of athletes with concussions. Methods: 55 post-concussed athletes (40 male) completed the Romberg Test (RT) (−/+), the WBBT, and ImPACT test. Wii Fit basic balance test performance was operationalized as the number of successfully completed trials (of 5 trials of increasing difficulty) within 30 seconds. Pearson’s and point-biserial correlations examined univariate associations among the variables. Results: The RT and WBBT were not significantly related (r = −0.029, p = 0.832). The RT weakly correlated with ImPACT impairment scores (r= 0.26, p= 0.041), whereas WBBT the number of trials did not (r = − 0.20, p = 0.155). Romberg Test scores were significantly correlated with ImPACT Visual Processing Speed Score (r = 0.27, p = 0.036) and Reaction Time score (r = 0.34, p = 0.006). In contrast, WBBT trials were significantly correlated with the ImPACT Visual Memory Score (r = − 0.41, p = 0.003). Conclusions: These results suggest that the WBBT and RT assess unique aspects of postural control. The RT may relate directly to single sensory cognitive and motor processing, while the WBBT may relate to multi-sensory visually driven cognitive and motor processing. Relevance for patients: Clinical balance tests could point to different cognitive impairments post-concussion

Whatever works: Uncertainty and technological hybrids in medical innovation

The persistent uncertainty that looms over the search for solutions to health problems offers important conceptual insights for the study of technological change. This paper explores the notion of hybridization, namely the embodiment of multiple competing operational principles within a single medical device, as strategy to deal with the practical shortcomings due to said uncertainty. The history of the development of the hybrid artificial disc affords the elaboration of an alternative view of hybridization and, at the same time, the articulation of a dualism between medical science as area of basic research (e.g. what disease is) and as practical knowledge (e.g. how disease can be tackled).Barberá Tomás, JD.; Consoli, D. (2012). Whatever works: Uncertainty and technological hybrids in medical innovation. Technological Forecasting and Social Change. 79(5):932-948. doi:10.1016/j.techfore.2011.12.009S93294879

The diversity and evolution of pollination systems in large plant clades: Apocynaceae as a case study

Background and Aims Large clades of angiosperms are often characterized by diverse interactions with pollinators, but how these pollination systems are structured phylogenetically and biogeographically is still uncertain for most families. Apocynaceae is a clade of >5300 species with a worldwide distribution. A database representing >10 % of species in the family was used to explore the diversity of pollinators and evolutionary shifts in pollination systems across major clades and regions. Methods The database was compiled from published and unpublished reports. Plants were categorized into broad pollination systems and then subdivided to include bimodal systems. These were mapped against the five major divisions of the family, and against the smaller clades. Finally, pollination systems were mapped onto a phylogenetic reconstruction that included those species for which sequence data are available, and transition rates between pollination systems were calculated. Key Results Most Apocynaceae are insect pollinated with few records of bird pollination. Almost three-quarters of species are pollinated by a single higher taxon (e.g. flies or moths); 7 % have bimodal pollination systems, whilst the remaining approx. 20 % are insect generalists. The less phenotypically specialized flowers of the Rauvolfioids are pollinated by a more restricted set of pollinators than are more complex flowers within the Apocynoids + Periplocoideae + Secamonoideae + Asclepiadoideae (APSA) clade. Certain combinations of bimodal pollination systems are more common than others. Some pollination systems are missing from particular regions, whilst others are over-represented. Conclusions Within Apocynaceae, interactions with pollinators are highly structured both phylogenetically and biogeographically. Variation in transition rates between pollination systems suggest constraints on their evolution, whereas regional differences point to environmental effects such as filtering of certain pollinators from habitats. This is the most extensive analysis of its type so far attempted and gives important insights into the diversity and evolution of pollination systems in large clades

The preparticipation sports physical examination and wilderness athletes

Every fifth unintentional injury treated at a healthcare facility in industrialized nations is associated with sports or physical exercise. Though the benefits of exercise on health status are well documented and, for most individuals, far outweigh the risks, participation in sports and exercise programs does carry a risk of injury, illness, or even death. In an effort to decrease these risks most institutions in the United States, and in the industrialized world, require a pre-participation physical examination for all athletes competing in organized or scholastic sports or exercise programs. Over the last ten years the popularity of outdoor or wilderness sports has increased enormously. Traditional outdoor sports such as skiing and hiking are more popular than ever and sports that did not exist 10 to 15 years ago, such as adventure racing or mountain biking, are now multimillion dollar enterprises. This genre of sport appeals to a broad spectrum of individuals and combines the traditional risks of physical activity and exertion with the remoteness and exposure associated with wilderness environments. Wilderness athletes include people of all ages and of both genders. The main causes of morbidity are musculoskeletal injuries and gastrointestinal illnesses; the main causes of mortality are falls and cardiac events. By placing these causes in a Haddon Matrix, preventative strategies have been found and recommendations made specifically for the preparticipation physical examination, which include education about the causes of morbidity and mortality in wilderness athletes, instruction about preventing and treating these injuries and illnesses, and screening of athletes at risk for cardiovascular accidents. Through these measures the risk of injuries, illnesses and deaths in wilderness athletes can be decreased through out the world

Mental Health Disparities and Social Justice on the U.S. Mexico Border Region

Mental health services in the border region lag behind the nation. The situation is aggravated by a difference in the type of treatment individuals from different ethnic groups receive. Although the border is a minority majority region, minorities have less access to mental health services. This chapter discusses mental health disparities prevalent on the US-Mexico border which include access to mental health services, lack of mental health providers, and underutilization rates. Data are presented from major studies on the prevalence of mental health disorders and utilization of mental health services by Hispanics, more specifically Mexican Americans. A discussion is provided about the role of culture in mental health service utilization. The chapter concludes with recommendations for addressing mental health disparities on the US-Mexico border, considering the political context of the region

Treatment with Oral Ondansetron for Ultramarathon-Associated Nausea: The TOO FUN Study

Nausea and vomiting are common for runners during ultramarathons and often contribute to non-finishes. We aimed to determine the efficacy of ondansetron, a commonly used antiemetic, to treat nausea and vomiting in runners during an ultramarathon. Runners who had a previous history of frequent nausea or vomiting during races and entered in 160, 80, and 55 km ultramarathons in 2018 and 2019 were randomized in a double-blind fashion to 4 mg ondansetron or placebo capsules to use if they developed nausea or vomiting during the race with the ability to take three additional doses. Study participants completed a post-race online survey to assess medication use and efficacy. Of 62 study participants, 31 took either ondansetron (20) or placebo (11). In this small study, there were no group differences in those reporting any improvement in nausea and vomiting (p = 0.26) or in the amount of improvement (p = 0.15). We found no evidence that ondansetron capsules improve nausea and vomiting during ultramarathons

Baseline postural control and lower extremity injury incidence among those with a history of concussion

Context: Lower extremity musculoskeletal (LEMSK) injury may be more prevalent among those with a history of sport-related concussion (SRC). Objective: To investigate the relationship between baseline postural control metrics and the LEMSK injury incidence in National Collegiate Athletic Association Division I student-athletes with a history of SRC. Setting: National Collegiate Athletic Association Division I athletes. Design: Cohort study. Patients or Other Participants: Of 84 total athletes (62 males), 42 had been previously diagnosed with an SRC, and 42 were matched controls based on age, sex, height, weight, and sport. Main Outcome Measure(s): During the preseason baseline evaluation, all participants performed 3 trials of eyes-open and eyes-closed upright quiet stance on a force platform. Medical charts were assessed for all the LEMSK injuries that occurred from preseason baseline to 1 year later. Center-of-pressure data in the anteroposterior and mediolateral directions were filtered before we calculated root mean square and mean excursion velocity; the complexity index was calculated from the unfiltered data. Factorial analysis-of-variance models were used to examine differences between groups and across conditions for root mean square; mean excursion velocity, complexity index, and tests of association to examine between-groups LEMSK differences; and logistic regression models to predict LEMSK. Results: Concussion history and injury incidence were related in the SRC group (P ¼ .043). The complexity index of the SRC group was lower with eyes closed (14.08 6 0.63 versus 15.93 6 0.52) and eyes open (10.25 6 0.52 vs 11.80 6 0.57) in the mediolateral direction than for the control participants (P, .05). Eyes-open root mean square in the mediolateral direction was greater for the SRC group (5.00 6 0.28 mm) than the control group (4.10 6 0.22 mm). Logistic regression models significantly predicted LEMSK only in control participants. Conclusions: These findings may suggest that LEMSK after SRC cannot be predicted from postural-control metrics at baseline