High School Contact Research Articles

Generative hypergraph models and spectral embedding

Many complex systems involve interactions between more than two agents. Hypergraphs capture these higher-order interactions through hyperedges that may link more than two nodes. We consider the problem of embedding a hypergraph into low-dimensional Euclidean space so that most interactions are short-range. This embedding is relevant to many follow-on tasks, such as node reordering, clustering, and visualization. We focus on two spectral embedding algorithms customized to hypergraphs which recover linear and periodic structures respectively. In the periodic case, nodes are positioned on the unit circle. We show that the two spectral hypergraph embedding algorithms are associated with a new class of generative hypergraph models. These models generate hyperedges according to node positions in the embedded space and encourage short-range connections. They allow us to quantify the relative presence of periodic and linear structures in the data through maximum likelihood. They also improve the interpretability of node embedding and provide a metric for hyperedge prediction. We demonstrate the hypergraph embedding and follow-on tasks—including quantifying relative strength of structures, clustering and hyperedge prediction—on synthetic and real-world hypergraphs. We find that the hypergraph approach can outperform clustering algorithms that use only dyadic edges. We also compare several triadic edge prediction methods on high school and primary school contact hypergraphs where our algorithm improves upon benchmark methods when the amount of training data is limited.

MOCMIN: convex inferring of modular low-rank contact networks over COVID diffusion data

SEIR (which consists of susceptible, exposed, infected, and recovered states) is a common diffusion model which could model different disease propagation dynamics across various domains such as influenza and COVID diffusion. As a motivation, across these domains, observing the node states is relatively easier than observing the network edges over which the diffusion is taking place, or it may not even be possible to observe the underlying network. This paper focuses on the problem of predicting modular low-rank human contact network edges only if a SEIR diffusion dynamics spreading among the human on their contact network can be observed. Such contact networks exhibit high modularity where the graph has dense connections between the vertices within modules, but sparse connections between vertices in different modules. We first formulate such inference problem as an optimization problem, discuss its convexity, and propose MOCMIN to optimally infer such unknown contacts of modular human contact network from COVID diffusion data. This modular contact network inference problem is important in the general case where human states such as infected with virus and recovered from virus can be identified more easily than the contacts between humans. Our contributions can be summarized as follows: (1) MOCMIN can handle noisy, incomplete, or undersampled diffusion data while inferring the unknown contact network; (2) The inferred contact networks are highly modular which cannot be ensured by the existing methods; (3) This paper applies MOCMIN to better understand COVID diffusion on contact network. We found MOCMIN to be accurate in modular real human contact network inference from COVID diffusion data under a number of challenging scenarios. As an example, such high school contact network can be inferred by tracking COVID diffusion among humans approximately 5% better than the compared methods by MOCMIN's ability to model modularity of the network. Via such inference, we can also understand the details of COVID diffusion dynamics in real human contact network. Additionally, inferred human contact graphs nearly mimic the true contact network's known graphical properties. Lastly, MOCMIN outperforms the competing approaches while estimating the synthetic networks.

Seroprevalence and risk factors for COVID-19 in the metropolis of the Brazilian Amazon

The devastating effect of health system overload was observed after cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) peaked in April 2020 in Belém, a capital metropolis in the Brazilian Amazon. Our results showed a high seroprevalence (39.24%) of anti-SARS-CoV-2 IgG antibodies among the population of the capital of the state of Pará after the first wave of the pandemic. Old age, mixed race, a high school education level, low income and contact with infected individuals are risk factors and may be driving seropositivity and exposure to SARS-CoV-2 in this population. This study is one of the first to provide important information to understand the socioeconomic inequalities, behavioral characteristics and viral transmission dynamics associated with the risk of SARS-CoV-2 infection in the capital of the state of Pará, northern Brazil.

High School Sports-Related Concussion and the Effect of a Jugular Vein Compression Collar: A Prospective Longitudinal Investigation of Neuroimaging and Neurofunctional Outcomes.

Sports-related concussion (SRC) can exert serious acute and long-term consequences on brain microstructure, function, and behavioral outcomes. We aimed to quantify the alterations in white matter (WM) microstructure and global network organization, and the decrements in behavioral and cognitive outcomes from pre-season to post-concussion in youth athletes who experienced SRC. We also aimed to evaluate whether wearing a jugular compression neck collar, a device designed to mitigate brain "slosh" injury, would mitigate the pre-season to post-concussion alterations in neuroimaging, behavioral, and cognitive outcomes. A total of 488 high school football and soccer athletes (14-18 years old) were prospectively enrolled and assigned to the non-collar group (n = 237) or the collar group (n = 251). The outcomes of the study were the pre-season to post-concussion neuroimaging, behavioral, and cognitive alterations. Forty-six participants (non-collar: n = 24; collar: n = 22) were diagnosed with a SRC during the season. Forty of these 46 athletes (non-collar: n = 20; collar: n = 20) completed neuroimaging assessment. Significant pre-season to post-concussion alterations in WM microstructural integrity and brain network organization were found in these athletes (corrected p < 0.05). The alterations were significantly reduced in collar-wearing athletes compared to non-collar-wearing athletes (corrected p < 0.05). Concussion and collar main effects were identified for some of the behavioral and cognitive outcomes, but no collar by SRC interaction effects were observed in any outcomes. In summary, young athletes exhibited significant WM microstructural and network organizational, and cognitive alterations following SRC. The use of the jugular vein compression collar showed promising evidence to reduce these alterations in high school contact sport athletes.

The accumulation of subconcussive impacts on cognitive, imaging, and biomarker outcomes in child and college-aged athletes: a systematic review

Examine the effect of subconcussive impact accumulation on cognitive/functional, imaging, and biomarker outcomes over the course of a single season, specifically in contact sport athletes at collegiate level or younger. Systematic review following PRISMA guidelines and using Oxford Center for Evidence-Based Medicine 2011 Levels of Evidence and Newcastle Ottawa Assessment Scale. PubMed MEDLINE, PsycInfo, SPORT-Discus, Web of Science. Original research in English that addressed the influence of subconcussive impacts on outcomes of interest with minimum preseason and postseason measurement in current youth, high school, or college-aged contact sport athletes. 796 articles were initially identified, and 48 articles were included in this review. The studies mostly involved male football athletes in high school or college and demonstrated an underrepresentation of female and youth studies. Additionally, operationalization of previous concussion history and concussion among studies was very inconsistent. Major methodological differences existed across studies, with ImPACT and diffusion tensor imaging being the most commonly used modalities. Biomarker studies generally showed negative effects, cognitive/functional studies mostly revealed no effects, and advanced imaging studies showed generally negative findings over the season; however, there was variability in the findings across all types of studies. This systematic review revealed growing literature on this topic, but inconsistent methodology and operationalization across studies makes it challenging to draw concrete conclusions. Overall, cognitive measures alone do not seem to detect changes across this timeframe while imaging and biomarker measures may be more sensitive to changes following subconcussive impacts.

Epidemiology of Injuries Sustained in Boys' High School Contact and Collision Sports, 2008-2009 Through 2012-2013.

Background:Injury epidemiology for boys’ high school contact and collision sport has been described in several overlapping but fragmented studies. Comprehensive comparisons of injuries sustained in boys’ soccer, wrestling, football, ice hockey, and lacrosse are lacking.Purpose:To describe patterns of injury by severity, body site, and diagnosis among high school boys’ contact and collision sports in the United States.Study Design:Descriptive epidemiology study.Methods:Injury rates and rate ratios (RRs) were calculated for injuries sustained in boys’ high school soccer, wrestling, football, ice hockey, and lacrosse through use of the High School RIO (Reporting Information Online) surveillance data from 2008-2009 through 2012-2013. Injury patterns were described by site, diagnosis, time loss, and severity. Severe injury was defined as an injury that resulted in 21 days or more of time loss from sport participation. Risk of sustaining a concussion was compared between sports.Results:The risk of sustaining an injury was higher in competition compared with practice overall (RR, 4.01; 95% CI, 3.90-4.12); the same pattern was true for severe injuries (RR, 4.61; 95% CI, 4.34-4.90). Football players experienced the highest injury rate (3.87 per 1000 athlete-exposures [AEs]) and the highest severe injury rate (0.80 per 1000 AEs). Overall, the most commonly injured body site was the head/face (22.5%), and the most prevalent injury diagnosis was ligament sprain not requiring surgery (23.5%). The most frequently injured body site from severe injury was the knee (24.6%), and fracture or avulsion was the most prevalent severe injury diagnosis (37.0%). Football players had a significantly higher risk of sustaining a concussion compared with other contact or collision sport athletes (P < .05).Conclusion:Injuries rates were higher in competition than those in practice for boys’ high school contact and collision athletes. Football players sustained the highest injury rate, the highest severe injury rate, and the highest concussion rate among the sports included in this analysis. Understanding these patterns of injury can generate policy and rule changes to make sports safer and maintain high levels of participation.

Influence of Concussion Education Exposure on Concussion-Related Educational Targets and Self-Reported Concussion Disclosure among First-Year Service Academy Cadets.

Concussion disclosure is often essential for military personnel to receive appropriate care following concussive injury. Concussion-related education and training may play a role in improving disclosure and recognition among peers, allowing for more timely concussion identification and treatment. The objectives of this study were to: (1) describe concussion education exposure among first-year service academy cadets and (2) examine the association between exposure to concussion education sources (multiple vs. only one) and concussion-related knowledge, attitudes, perceived social norms, intention to disclose symptoms, and disclosure behaviors. First-year service academy cadets completed a cross-sectional survey to assess perceptions of concussion disclosure during preseason concussion baseline testing sessions. Associations between key cadet characteristics and exposure to multiple concussion education sources were examined using odds ratios and 95% confidence intervals. Linear regression was used to model the continuous measures of concussion-related knowledge, attitudes, and perceived social norms. Log-binomial regression was used to model the categorical outcomes of high perceived control over concussion disclosure (higher vs. lower), intention to disclose (higher vs. lower), and disclosure of all possible concussive events at the time of injury (yes vs. no). The primary predictor for all models was exposure to multiple sources of concussion education (video, coach, medical professional, or other) vs. exposure to only one educational source. All models were adjusted for gender, high school contact sport participation, and previous concussion history. Of the 972 first-year cadets (85% response; age=18.4±0.9years; 21.7% female, 29.0% NCAA student-athlete), 695 (71.5%) reported receiving some type of previous concussion education and 229 (23.6%) reported a previous concussion history (206/229 reported the actual number they experienced). Of those reporting previous concussion-related education (n=695), 542 (78.0%) watched a video, 514 (74.0%) talked with a coach about concussion, 433 (62.3%) talked with a medical professional, and 61 (8.8%) reported other sources of education ranging from anatomy teachers to brochures. Overall, 527 (75.8%) reported receiving more than one source of concussion education. Having played a contact sport in high school and having a history of concussion were associated with having multiple concussion education exposures. Being female was associated with lower odds of multiple exposures. Exposure to multiple sources of concussion education was not associated with knowledge, attitudes, perceived norms, or higher intention to disclose concussion symptoms. However, among those with a concussion history, exposure to multiple sources of concussion education was associated with a nearly 40% higher prevalence of disclosing all concussions at the time of injury compared to only one source of educational exposure (67.1% vs. 48.3%; prevalence ratio=1.4; 95% confidence interval: 0.9, 2.1). Thus, although multiple sources of education may not influence intermediate variables of knowledge, attitudes, perceived norms and intentions, exposure to multiple sources of concussion education may influence actual decision-making around concussion disclosure among first-year service academy cadets. These data suggest disparities in concussion education exposure that can be addressed in first-year cadets. Additionally, findings support the importance and use of multiple sources of concussion education in improving cadet's concussion-related decision-making.

High prevalence of prior contact sports play and concussion among orthopedic and neurosurgical department chairs.

OBJECTIVE Increased understanding of the consequences of traumatic brain injury has heightened concerns about youth participation in contact sports. This study investigated the prevalence of high school and collegiate contact sports play and concussion history among surgical department chairs. METHODS A cross-sectional survey was administered to 107 orthopedic and 74 neurosurgery chairs. Responses were compared to published historical population norms for contact sports (high school 27.74%, collegiate 1.44%), football (high school 10.91%, collegiate 0.76%), and concussion prevalence (12%). One-proportion Z-tests, chi-square tests, and binary logistic regression were used to analyze differences. RESULTS High school contact sports participation was 2.35-fold higher (65.3%, p < 0.001) for orthopedic chairs and 1.73-fold higher (47.9%, p = 0.0018) for neurosurgery chairs than for their high school peers. Collegiate contact sports play was 31.0-fold higher (44.7%, p < 0.001) for orthopedic chairs and 15.1-fold higher (21.7%, p < 0.001) for neurosurgery chairs than for their college peers. Orthopedic chairs had a 4.30-fold higher rate of high school football participation (46.9%, p < 0.001) while neurosurgery chairs reported a 3.05-fold higher rate (33.3%, p < 0.001) than their high school peers. Orthopedic chairs reported a 28.1-fold higher rate of collegiate football participation (21.3%, p < 0.001) and neurosurgery chairs reported an 8.58-fold higher rate (6.5%, p < 0.001) compared to their college peers. The rate at which orthopedic (42.6%, p < 0.001) and neurosurgical (42.4%, p < 0.001) chairs reported having at least 1 concussion in their lifetime was significantly higher than the reported prevalence in the general population. After correction for worst possible ascertainment bias, all results except high school contact sports participation remained significant. CONCLUSIONS The high prevalence of youth contact sports play and concussion among surgical specialty chairs affirms that individuals in careers requiring high motor and cognitive function frequently played contact sports. The association highlights the need to further examine the relationships between contact sports and potential long-term benefits as well as risks of sport-related injury.

Sport and Sex-Specific Reporting Trends in the Epidemiology of Concussions Sustained by High School Athletes.

Approximately 300,000 U.S. adolescents sustain concussions annually while participating in organized athletics. This study aimed to track sex and sport-specific trends among high school sports-related concussions over time, to identify whether a particular sport predisposes athletes to a higher risk, and to assess whether traumatic brain injury law enactments have been successful in improving recognition. Injury data for academic years 2005 to 2014 were collected from annual reports generated by High School RIO (Reporting Information Online). The relative proportions of total estimated concussions to total estimated injuries were compared using an injury proportion ratio. The concussion rate was defined as the number of concussions per 10,000 athlete exposures (1 athlete participating in 1 practice or competition), with rates compared using a rate ratio. To evaluate the impact of legislation on sports-related concussions in this population, trends in concussion rates and proportions were analyzed before enactment (academic years 2005-2009) and after enactment (academic years 2010-2014). Between 2005-2006 and 2014-2015, a significant increase (p < 0.0001) in the overall number of concussions for all sports combined, the overall concussion rate (rate ratio, 2.30 [95% confidence interval, 2.04 to 2.59]), and the overall proportion of concussions (injury proportion ratio, 2.68 [95% confidence interval, 2.66 to 2.70]) was seen. Based on the injury proportion ratio, during the 2014-2015 academic year, concussions were more common in girls' soccer than in any other sport (p < 0.0001). Because of potentially devastating consequences, concussion prevention and recognition measures continue to be emphasized in high school contact sports. The data in our study suggest that significant increases in the overall rate and proportion of reported concussions during the past decade could have been affected by traumatic brain injury legislation. To our knowledge, this is the first study to show that girls' soccer players may have an even greater risk of sustaining a concussion than all other sports. Sports-related concussions in adolescent athletes can have devastating consequences, and we now know that female athletes, especially girls' soccer players, may be at an even greater risk for sustaining this injury than all other athletes. Knowledge of the trends identified by this study may help lead to policy and prevention measures that can accommodate each sport effectively and potentially halt these trends.

Epidemiology of Contact Injuries in High School Athletes in the United States

Objectives:Lacrosse and ice hockey are fast growing youth sports in the United States. Football remains the most popular and is the leading cause of sports-related injuries among high school students. Injuries remain a concern given the physical nature of these three contact sports. The objective of this study was to compare the rates and patterns of injury in boys’ football, ice hockey, and lacrosse.Methods:We conducted a secondary analysis of High School RIO (Reporting Information Online) data including exposure and injury data collected from a large sample of high schools in the United States from 2005/2006-2015/2016. In High School RIO, athletic trainers submitted exposure and injury information weekly. In this study data was analyzed to calculate rates, assess patterns, and evaluate potential risk factors for player-player contact injuries.Results:A total of 34,532 injuries in boys’ football, ice hockey, and lacrosse occurred during 9,078,902 exposures for a rate of 3.80 injuries per 1,000 AE in the three contact sports of interest. The rate of injury was found to be higher in competition compared to practice for all three sports, with the largest difference in ice hockey (RR = 8.28; 95% CI = 7.74-8.86). In football, 46.6% of injuries were due to tackling or being tackled, 41.1% of injuries in ice hockey and 15.3% of injuries in lacrosse were due to checking or being checked. In football and lacrosse, a greater percentage of injuries were due to being tackled or checked, respectively. Similarly, in ice hockey, a greater percentage of injuries occurred due to being checked compared to checking, but surprisingly the proportion was much higher (81.6% vs 18.4%). In addition, a smaller proportion of hockey athletes injured while being checked were able to return to play in less than a week compared with both being tackled in football (IPR = 0.41) and being checked in lacrosse (IPR = 0.47). A significantly greater proportion of concussions sustained in football were the result of tackling compared to being tackled (28.3% vs 24.8%; IPR = 1.17; 95% CI = 1.11-1.24). Conversely, in ice hockey, a greater proportion of concussions were sustained while being checked compared to checking (33.8% vs. 20.5%; IPR = 1.65; 95% CI = 1.04-2.61). There was a significantly higher concussion rate in competition compared to practice for all three sports with no concussions sustained in ice hockey practice due to checking.Conclusion:While all three sports studied were similar in regards to a higher injury rate associated with being on the receiving end of intentional contact (being tackled or checked), the proportion was much higher in ice hockey and the injured ice hockey players were less likely to return to play in less than one week. Also of note, concussions were sustained equally while tackling and being tackled, however in ice hockey, no concussions were sustained while checking opposing players during practice. Future studies are needed to further investigate these patterns in high school contact athletes, with particular emphasis placed on understanding the lack of concussions during ice hockey practice in an attempt to translate similar practices to other contact sports.

Epidemic extinction paths in complex networks.

We study the extinction of long-lived epidemics on finite complex networks induced by intrinsic noise. Applying analytical techniques to the stochastic susceptible-infected-susceptible model, we predict the distribution of large fluctuations, the most probable or optimal path through a network that leads to a disease-free state from an endemic state, and the average extinction time in general configurations. Our predictions agree with Monte Carlo simulations on several networks, including synthetic weighted and degree-distributed networks with degree correlations, and an empirical high school contact network. In addition, our approach quantifies characteristic scaling patterns for the optimal path and distribution of large fluctuations, both near and away from the epidemic threshold, in networks with heterogeneous eigenvector centrality and degree distributions.

Fitness networks for real world systems via modified preferential attachment

Complex networks are virtually ubiquitous, and the Barabási and Albert model (BA model) has became an acknowledged standard for the modelling of these systems. The so-called BA model is a kind of preferential attachment growth model based on the intuitive premise that popularity is attractive. However, preferential attachment alone is insufficient to describe the diversity of complex networks observed in the real world. In this paper we first use the accuracy of a link prediction method, as a metric for network fitness. The link prediction method predicts the occurrence of links consistent with preferential attachment, the performance of this link prediction scheme is then a natural measure of the ”preferential-attachment-likeness” of a given network. We then propose several modification methods and modified BA models to construct networks which more accurately describe the fitness properties of real networks. We find that all features assortativity, degree distribution and rich-club formation can play significant roles for the network construction and eventual structure. Moreover, link sparsity and the size of a network are key factors for network reconstruction. In addition, we find that the structure of the network which is limited by geographic location (nodes are embedded in a Euclidean space and connectivity is correlated with distances) differs from other typical networks. In social networks, we observe that the high school contact network has similar structure as the friends network and so we speculate that the contact behaviours can reflect real friendships.

Educating Parents on Sports-Related Concussions.

Approximately 30 million children and adolescents in the United States participate in various forms of organized sports, and incidents of traumatic brain injuries in emergency departments have increased to 62% from 2001 to 2009. Knowledge, information, and preventive interventions appear to have been well disseminated among athletic personnel at the professional, collegiate, and high school levels. Research regarding parents' perceptions and knowledge of sports-related concussions (SRCs) however is lacking. This project aims to determine the impact of interventions designed to improve parental awareness of SRCs. The study used a demographic information sheet and a postintervention survey design. These surveys were to determine the impact of three distinct educational tools presented on the perceptions and knowledge of SRCs in a group of parents with children actively involved in sports. Forty-seven participants completed the demographic information sheet, most of them African American and have at least one child competing in high school contact sports. Furthermore, 85.1% of the parents felt that SRCs are a critical issue, although only 46.8% of the parents have ever sought out information to learn more about SRC. Twenty-nine individuals participated in the posteducational survey after the intervention, and most parents perceived that all three educational tools were written and presented in a fashion that changed their perception, awareness, and knowledge base of SRCs. These parents however stated that none of the interventions captured their attention enough to want to go to a professional for further information. Findings from this study suggest that parents know what educational approaches work best for them. However, it also suggests that a one-time educational intervention is not sufficient to move many parents to be proactive. The scarcity of published studies speaks to the need for further research to determine the most effective approaches to engage all involved groups in an integrated approach to ensure that children can be safely involved in sports without jeopardizing their future.

Positive Network Assortativity of Influenza Vaccination at a High School: Implications for Outbreak Risk and Herd Immunity

Schools are known to play a significant role in the spread of influenza. High vaccination coverage can reduce infectious disease spread within schools and the wider community through vaccine-induced immunity in vaccinated individuals and through the indirect effects afforded by herd immunity. In general, herd immunity is greatest when vaccination coverage is highest, but clusters of unvaccinated individuals can reduce herd immunity. Here, we empirically assess the extent of such clustering by measuring whether vaccinated individuals are randomly distributed or demonstrate positive assortativity across a United States high school contact network. Using computational models based on these empirical measurements, we further assess the impact of assortativity on influenza disease dynamics. We found that the contact network was positively assortative with respect to influenza vaccination: unvaccinated individuals tended to be in contact more often with other unvaccinated individuals than with vaccinated individuals, and these effects were most pronounced when we analyzed contact data collected over multiple days. Of note, unvaccinated males contributed substantially more than unvaccinated females towards the measured positive vaccination assortativity. Influenza simulation models using a positively assortative network resulted in larger average outbreak size, and outbreaks were more likely, compared to an otherwise identical network where vaccinated individuals were not clustered. These findings highlight the importance of understanding and addressing heterogeneities in seasonal influenza vaccine uptake for prevention of large, protracted school-based outbreaks of influenza, in addition to continued efforts to increase overall vaccine coverage.

Practice Effects Reveal Visuomotor Vulnerability in School and University Rugby Players

This article reports on three pre- versus post-season prospective studies in which male university and high school contact sport players predominantly of Rugby Union (hereafter rugby) were compared with age, education, and IQ equivalent non-contact sport controls on the ImPACT (Immediate Postconcussion Assessment and Cognitive Testing) test. All analyses revealed a relative absence of practice effects on the Visual Motor Speed (VMS) composite for contact sport groups compared with controls. The VMS data for rugby players from each study were pooled and subjected to additional analysis (Rugby, n = 145; Controls, n = 106). Controls revealed significant improvement over the season (p < .001), whereas no learning effect was in evidence for rugby players whose performance remained the same (interaction effect, p = .028). It is apparent that practice effects have diagnostic potential in this context, implicating vulnerability on speeded visuomotor processing in association with participation in rugby. Pointers for further research and concussion management in the individual case are explored.

High school contact among persons with leukemia and lymphoma.

We studied frequency of contact among Connecticut high school students and teachers with leukemia and lymphoma diagnosed during or after high school from 1960 through 1971. Risk of having attended the same grade at the same school during the same year was greater among students with Hodgkin's disease (HD) than among simulated controls drawn in proportion to school enrollment (relative risk = 1.44; approximate 95% lower confidence limit = 1.05). Risk of developing HD was also greater among students enrolled simultaneously at the same school as students already diagnosed with HD than among students not so enrolled (relative risk = 2.05; 95% lower confidence limit = 1.39). However, fewer HD cases (16) were diagnosed from 1965 through 1970 at schools that formerly had patients enrolled (1959-64) than at matched schools without such patients (24). We found no evidence of increased contact among persons with non-HD lymphomas or leukemias, except between HD and non-HD lymphomas (relative risk = 1.41; approximate 95% lower confidence limit = 1.11).