The Dynamic Interaction Between Psychological Health and Sleep Symptoms Following Adolescent Concussion.

Objectives: To evaluate changes in psychological symptoms and sleep quality at three clinically relevant milestones following adolescent concussion: while symptomatic, at symptom resolution, and about 2 months after symptom resolution.

Study Design: We conducted a secondary analysis of a multisite, longitudinal investigation of adolescent concussion recovery. Participants enrolled < 21 days following concussion and completed self-report questionnaires (Patient-Reported Outcomes Measurement Information System [PROMIS] Pediatric Global 25 anxiety and depressive symptom domains, and the Pittsburgh Sleep Quality Index [PSQI]) at three time points: visit 1 (symptomatic), visit 2 (<14 days after symptom resolution), and visit 3 (2 months after symptom resolution).

Impacting the rugby tackle: risk factors and mechanisms for concussion and musculoskeletal tackle-related injury - a systematic review and Delphi consensus to inform intervention strategies for risk reduction.

To (1) systematically review the literature to identify which match-related risk factors and mechanisms of rugby tackle events result in musculoskeletal injury, concussion, head injury assessments, and head impacts or head accelerations; and (2) identify the perceived importance and feasibility of potential intervention strategies for tackle-related injury reduction in the rugby codes.A systematic search was performed using Preferred Reporting Systematic Reviews and Meta-Analyses guidelines. Risk factors/mechanisms associated with tackle injuries across the rugby codes were extracted.

Examining muscle synergy composition and segmental coordination during overground walking in individuals with a rotationplasty about the knee.

Rotationplasty is a surgical technique used to salvage the limb following resection of a sarcoma or to address congenital defects. The procedure repurposes the ankle as a new knee, while fusing the thigh and shank musculature to achieve 'knee' flexion/extension. Most unique is the retainment of original innervations of the distal and proximal musculature, thus requiring spinal reorganization to coordinate the separate muscles as a single tensile unit.

Successful Treatment of Primary Central Nervous System T-Cell Lymphoma With Induction Chemotherapy Followed by Consolidation With High-Dose Chemotherapy and Autologous Stem Cell Rescue.

Primary central nervous system T-cell lymphoma (PCNSTL) is an exceptionally rare subtype of non-Hodgkin lymphoma, comprising only 2% of primary CNS lymphoma cases. Due to its rarity, PCNSTL is often misdiagnosed, lacks standardized treatment guidelines, and carries a poor prognosis. We present a unique case of a 59-year-old-woman with a history of hypertension and hyperlipidemia who initially presented with sudden-onset aphasia and right-sided weakness.

Prognostic Utility of Immediate Memory and Delayed Recall Assessments for Adolescent Concussion.

Objective: To evaluate the prognostic utility of 10-word immediate memory and delayed recall assessments at an initial post-concussion evaluation for predicting persisting post-concussion symptom (PPCS) development.

Design: Retrospective cohort study.

Participants: Adolescents (N = 160) seen for concussion at a sports medicine center between June 2018 and November 2019.

Pitfalls in the Pathological Diagnosis of Glomerular Diseases: Why Stop at One?

Background: Renal pathologists face a number of challenges in evaluating kidney biopsies: one that is sometimes overlooked is the presence of multiple pathological processes in a single biopsy. Figuring out the interrelatedness (or lack thereof) of more than one form of renal abnormality can difficult. Several pitfalls in biopsy evaluation also await the unprepared diagnostician.

Comparing Single-Site Fractures with Multisite Injuries in Pediatric Skiers and Snowboarders.

Introduction-The purpose of this study was to evaluate pediatric skiing and snowboarding fracture injuries at a large ski resort, comparing injury patterns in those who sustained fracture injuries at a single site against those with injuries in multiple sites. Given the more serious nature of multisite injuries, this information may give healthcare providers insight into injury patterns when assessing a patient in snow sport settings.Methods-Radiographs of 797 patients aged 3 to 17 y diagnosed with at least 1 skiing- or snowboarding-related fracture at a large ski resort were reviewed by a sports medicine fellowship-trained physician.

Primary myelofibrosis with concurrent MPL and atypical JAK2 mutations.

Distinct bone marrow morphology is considered the primary basis for the diagnosis of BCR::ABL1-negative myeloproliferative neoplasms (MPNs). However, presence of a mutually exclusive classical driver mutation in JAK2, CALR, or MPL aids in diagnosing and determining the prognosis of polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). Few recent studies have reported presence of dual mutations in MPNs and double mutations in patients with PMF have been rarely described.

Metrics of concussion-related vision disorders among children and adolescents with persisting post-concussive symptoms using an objective eye tracking device.

Background: Early identification of concussion-related vision disorders (CRVDs) may improve outcomes by enabling earlier management, referral, and treatment. Objective eye tracking may provide additional data to support the diagnose of CRVDs. The purpose of this study was to determine the utility of objective infrared eye tracking in identifying CRVDs among adolescents experiencing persisting post-concussive symptoms (PPCS) more than 28 days after injury.

The persisting influence of organized sports participation on mental health and wellness: a longitudinal repeated measures study of adolescent female athletes.

Purpose: We examined if female adolescent athletes demonstrated changes on mental health measures 6-months after the end of a sport season compared to an immediate post-season assessment, and whether those who were actively playing sports 6-months after the end of the season reported different mental health ratings compared to athletes who were not.

Methods: Participants underwent three assessments: a pre-season, immediate post-season, and final 6-month post-season assessment on measures of anxiety ratings, depressive symptoms, grit, peer relationships, fatigue, and body appreciation.

Results: Participants reported significantly higher anxiety ratings at 6 months post-season compared to immediately post-season (6.

Re-Evaluating the Impact of Including Patients with Bilateral Conditions in Orthopaedic Clinical Research Studies: When 1 + 1 Does Not Equal 2.

Background: Orthopaedic studies frequently include subjects with bilateral conditions. Failure to account for bilateral conditions can lead to spurious associations. The performance of different methods for addressing this issue, especially in populations that include subjects with unilateral and bilateral conditions, has not been rigorously evaluated.

Clinical Cut Point for the Pittsburgh Sleep Quality Index After Adolescent Concussion.

Background: Concussions can have negative implications for sleep quality. Self-report measures, such as the Pittsburgh Sleep Quality Index (PSQI), have been used in clinical and research settings to identify individuals with sleep impairments. However, the accuracy/applicability of historically established PSQI scoring criteria for differentiating good versus poor sleep quality has not been critically examined in adolescents with concussion.

TRANSCENDENT (Transforming Research by Assessing Neuroinformatics across the Spectrum of Concussion by Embedding iNterdisciplinary Data-collection to Enable Novel Treatments): protocol for a prospective observational cohort study of concussion patients with embedded comparative effectiveness research within a network of learning health system concussion clinics in Canada.

Introduction: Concussion affects over 400 000 Canadians annually, with a range of causes and impacts on health-related quality of life. Research to date has disproportionately focused on athletes, military personnel and level I trauma centre patients, and may not be applicable to the broader community. The TRANSCENDENT Concussion Research Program aims to address patient- and clinician-identified research priorities, through the integration of clinical data from patients of all ages and injury mechanisms, patient-reported outcomes and objective biomarkers across factors of intersectionality.

Pulling the Flag: The Physical and Mental Health Effects of High School Flag Football Among Female Adolescents.

Objective: The purposes of this study were to (1) describe the physical effects (injuries) and associated risk factors during flag football season and (2) evaluate in-season mental health of female flag football athletes.

Design: Prospective cohort study.

Participants: We conducted a 4-month longitudinal pilot study of female adolescents participating in a season of high school flag football and nonathlete controls.

Hidden in the Absence: Clinicopathologic Insights on Kidney Diseases Associated With Selective IgA Deficiency.

Selective IgA deficiency (sIgAD) is the most common type of primary immunodeficiency. The diagnosis of sIgAD has occasionally been suggested when a complete absence of background IgA immunofluorescent staining on renal biopsies was observed, but such findings have been described in only 2 patients to date. In this study, the clinical, demographic, and renal biopsy findings of 15 patients with suspected sIgAD, based on a total lack of immunofluorescence for IgA, were collected.

Sport Concussion Assessment Tool-5th Edition (SCAT5) normative reference values for professional men's rugby league players.

Objectives: To provide normative reference values for the Sport Concussion Assessment Tool - 5 Edition for elite-level male rugby league players.

Design: A descriptive cross-sectional study.

Methods: Baseline Sport Concussion Assessment Tool - 5 Edition scores were obtained from 1005 National Rugby League players during the 2018 and 2019 preseasons.

Anxiety, pain, and fear of pain: predictors of postural stability after a concussion.

A concussion can lead to anxiety, pain, kinesiophobia, and/or postural control deficits. We conducted a cross-sectional study evaluating adolescents with a recent concussion. We hypothesized that those reporting higher levels of anxiety, pain-interference, and kinesiophobia would perform worse on postural control tests.

Adolescent female athletes with menstrual dysfunction report worse sleep and stress than those without menstrual dysfunction.

Context: Menstrual dysfunction among adolescent female athletes is associated with both an increased musculoskeletal injury risk and poor psychological health. Objective: To examine if adolescent flag football athletes with menstrual dysfunction report different levels of energy, mood, sleep, and stress during the season compared to those without menstrual dysfunction. Design: Prospective cohort study Setting: A series of questionnaires pre-season, in-season weekly, and post-season to athletes in Denver Metro Area Patients or Other Participants: Female athletes with and without self-reported menstrual dysfunction who participated in a high school flag football season.

Concussion and depressive symptoms in high school students: impact of physical activity and substance use.

Objective: To investigate the association between concussion history and depressive symptoms after adjusting for physical activity, substance use, and illicit drug use.

Methods: We analysed data from the Adolescent Behaviour and Experiences Survey, a nationally representative survey of adolescents in the USA. Our independent variables were history of concussion in the 12 months preceding survey completion; self-reported weekly physical activity (days per week with >60 min of physical activity, 0-7 scale); substance use over the past 30 days (yes vs no) and illicit drug use throughout lifetime (yes vs no).

Targeting allograft inflammatory factor 1 reprograms kidney macrophages to enhance repair.

The role of macrophages (MΦs) remains incompletely understood in kidney injury and repair. The plasticity of MΦs offers an opportunity to polarize them toward mediating injury resolution in both native and transplanted kidneys undergoing ischemia and/or rejection. Here, we show that infiltrating kidney MΦs augmented their own allograft inflammatory factor 1 (AIF-1) expression after injury.

Comparing peer relationship ratings among adolescents with sport and non-sport related concussions.

Objective: To evaluate if peer relationship ratings differ among adolescents who sustain a sport-related concussion compared to those who sustain a non-sport-related concussion.

Study Design: We conducted a cross-sectional investigation of 123 adolescents who sustained a concussion within 21 days before their initial post-injury evaluation (mean = 9.2 ± 3.

Feasibility of at-Home Sleep Monitoring in Adolescents with and without Concussion.

Background: Poor sleep is associated with longer recovery following adolescent concussion, making the longitudinal assessment of sleep important for monitoring recovery and identifying sleep disruptions. An important consideration for successful monitoring of sleep following concussion is the feasibility and adherence of a given sleep monitoring tool when used in an at-home environment. Understanding the usability of different sleep monitoring tools is essential for determining their applicability for longitudinal assessment in an ecologically valid environment.

Clinical Measures Associated with Subsequent Injury after Adolescent Concussion: A Prospective Cohort Study.

Purpose: This study aimed to examine associations between clinical measures (self-reported and clinician administered) and subsequent injury rates in the year after concussion return to play (RTP) among adolescent athletes.

Methods: We performed a prospective, longitudinal study of adolescents ages 13-18 yr. Each participant was initially assessed within 21 d of concussion and again within 5 d of receiving RTP clearance from their physician.

Examination of Sex Differences in Energy Availability, Disordered Eating, and Compulsive Exercise Among Male and Female Adolescent Athletes.

Objective: The primary aim of this study was to examine sex differences in energy availability (EA) and its relationships with disordered eating, compulsive exercise, and body mass index (BMI) among adolescent athletes.

Design: Cross-sectional study.

Setting: University hospital pediatric sports medicine center.