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Item Athlete ECG T-wave abnormality interpretation patterns by non-experts(Elsevier, 2022-05) Torabi, Asad J.; Nahhas, Omar D.; Dunn, Reginald E.; Martinez, Matthew W.; Tucker, Andrew M.; Lincoln, Andrew E.; Kovacs, Richard J.; Emery, Michael S.; Medicine, School of MedicineBackground The presence of T-wave abnormalities (TWA) on an athlete's electrocardiogram (ECG) presents as a diagnostic challenge for physicians. Types of TWA patterns classified as abnormal by inexperienced readers have not been systematically analyzed. Methods ECGs from the 2011–2015 National Football League Scouting Combine (initially interpreted by general cardiologists) were retrospectively reviewed by expert sports cardiologists with strict application of the 2017 International Criteria. Patterns of TWA that were altered from the original interpretation were analyzed. Results The study included 1643 athletes (mean age 22 years). There was a 67 % reduction in the number of athletes with any TWA (p < 0.001) with 111 ECGs changed to normal. Inferior TWA was the most common interpreted initial ECG abnormality altered followed by anterior and lateral. Discussion This analysis revealed an initial high rate of TWA by non-expert readers. Tailored education programs to physicians who interpret athlete ECGs should highlight these specific T-wave patterns. We see this as an opportunity to make more clinicians aware of ECG interpretation guidelines as sports trained cardiologists are mostly self-taught.Item Athlete ECG T-wave abnormality interpretation patterns by non-experts(Elsevier, 2022-06-16) Torabi, Asad J.; Nahhas, Omar D.; Dunn, Reginald E.; Martinez, Matthew W.; Tucker, Andrew M.; Lincoln, Andrew E.; Kovacs, Richard J.; Emery, Michael S.; Graduate Medical Education, School of MedicineBackground: The presence of T-wave abnormalities (TWA) on an athlete's electrocardiogram (ECG) presents as a diagnostic challenge for physicians. Types of TWA patterns classified as abnormal by inexperienced readers have not been systematically analyzed. Methods: ECGs from the 2011-2015 National Football League Scouting Combine (initially interpreted by general cardiologists) were retrospectively reviewed by expert sports cardiologists with strict application of the 2017 International Criteria. Patterns of TWA that were altered from the original interpretation were analyzed. Results: The study included 1643 athletes (mean age 22 years). There was a 67 % reduction in the number of athletes with any TWA (p < 0.001) with 111 ECGs changed to normal. Inferior TWA was the most common interpreted initial ECG abnormality altered followed by anterior and lateral. Discussion: This analysis revealed an initial high rate of TWA by non-expert readers. Tailored education programs to physicians who interpret athlete ECGs should highlight these specific T-wave patterns. We see this as an opportunity to make more clinicians aware of ECG interpretation guidelines as sports trained cardiologists are mostly self-taught.Item COVID-19: Return to Youth Sports: Preparing Sports Venues and Events for the Return of Youth Sports(2020-06-02) Pierce, David; Stas, Jessi; Feller, Kevin; Knox, William; Tourism, Conventions, and Event Management, School of Health and Human SciencesCOVID-19 has impacted all areas of life, and youth sports is no exception. States and counties are publishing their own unique guidelines for permitting youth sports to return over designated phases, creating a patchwork of guidelines and dates for returning to practice and games. Governing bodies, sports facilities, and event operators are creating modifications and adaptations for participants and spectators to ensure a safe environment. The Sports Innovation Institute at IUPUI, a partnership between Indiana and Purdue universities in Indianapolis, and Grand Park Sports Campus (Westfield, Ind.) collaborated to better understand how COVID-related adaptations are perceived by parents, athletes, coaches, officials, and administrators. The results provide youth sports facilities and event operators with data on how specific adaptions are received by these stakeholders who are looking to return to youth sports in a timely, but safe manner. Twelve adaptations were identified from a review of documents prepared by states, governing bodies, trade associations, media reports, and feedback from industry and academic experts. The survey questions were designed using the Kano Model (pronounced “kah-no”), which was selected due to its ability to determine how people feel about proposed adaptions during the COVID-19 pandemic. Each adaption comprised three questions that assessed the respondents’ feelings toward the adaptation (functional question), their feelings if the adaptation did not exist (dysfunctional), and their assessment of how important it is for the adaptation to occur (importance). The Kano Model is interpreted based upon these three scores, and each adaptation can be placed into one of five categories on a scatterplot. The survey was distributed to 40 organizations that circulated the survey to their members. The survey reached a national audience that represents the landscape of youth sports. A total of 10,359 people from 45 states completed the entire survey, representing at least 13 different sports. Nearly 92% of respondents were parents, but with the option to select multiple roles, coaches (25%), administrators (10%), athletes (9%), and officials (3%) were also represented. Results indicated that venues and events should invest heavily and visibly in sanitization of the facility, playing areas, and equipment before, during, and after events. Venue operators and event managers can feel confident the recommendations provided by the Centers for Disease Control and Prevention (CDC) and National Federation of State High School Associations (NFHS) to sanitize playing areas and equipment after each use will be well-received and welcomed by users. Promotion and monitoring of social-distancing guidelines, limiting personal contact between players, limiting admission to those under age 65 with no CDC-indicated pre-existing conditions, and completing a health and contact-information questionnaire prior to entering are seen by users as must-be adaptations in order for players and spectators to feel comfortable returning to youth sports during the COVID-19 pandemic. This means their presence does not bring satisfaction, but their lack of presence brings significant dissatisfaction. Respondents felt indifferent toward changing arrival and departure routines, closing amenities, and minimizing the capacity and rearranging bench areas for athletes. The presence or absence of these adaptations do not make a real difference in users’ experiences. User sentiment regarding facemasks was mixed, with strong feelings about the use and non-use of facemasks. Finally, limiting entry to athletes and game personnel but excluding spectators was not well-received by survey respondents, especially parents. Youth sports venues and events should tread lightly when considering not allowing spectators into venues, and expect negative backlash from parents should such policies be adopted. Parents of recreational athletes viewed the adaptations in a more positive light and as a more necessary part of the youth sports experience than parents of travel athletes. A similar trend was found when comparing parents who are less willing to travel during the pandemic than those who do not expect their travel to be impacted. Travel sports parents demonstrated an increasing comfort level in traveling for competitions over the summer months, from 42% in May to 76% in August. The economic turmoil wrought by COVID-19 has touched nearly every component of American life. However, 59% of travel sports parents reported that the pandemic will not negatively impact their sports travel budget. Only 23% will experience a budget decrease greater than 25% related to youth sports travel.Item Epidemiology of National Collegiate Athletic Association Women's Gymnastics Injuries, 2009-2010 Through 2013-2014(National Athletic Trainers' Association, 2015-08) Kerr, Zachary Y.; Hayden, Ross; Barr, Megan; Klossner, David A.; Dompier, Thomas P.; School Of Social SciencesContext Recent injury-surveillance data for collegiate-level women's gymnastics are limited. In addition, researchers have not captured non–time-loss injuries (ie, injuries resulting in restriction of participation <1 day). Objective To describe the epidemiology of National Collegiate Athletic Association (NCAA) women's gymnastics injuries during the 2009–2010 through 2013–2014 academic years. Design Descriptive epidemiology study. Setting Aggregate injury and exposure data collected from 11 women's gymnastics programs providing 28 seasons of data. Patients or Other Participants Collegiate student-athletes participating in women's gymnastics during the 2009–2010 through 2013–2014 academic years. Intervention(s) Women's gymnastics data from the NCAA Injury Surveillance Program (ISP) during the 2009–2010 through 2013–2014 academic years were analyzed. Main Outcome Measure(s) Injury rates; injury rate ratios; injury proportions by body site, diagnosis, and apparatus; and injury proportion ratios were reported with 95% confidence intervals (CIs). Results The ISP captured 418 women's gymnastics injuries, a rate of 9.22/1000 athlete-exposures (AEs; 95% CI = 8.33, 10.10). The competition injury rate (14.49/1000 AEs) was 1.67 times the practice injury rate (8.69/1000 AEs; 95% CI = 1.27, 2.19). When considering time-loss injuries only, the injury rate during this study period (3.62/1000 AEs) was lower than rates reported in earlier NCAA ISP surveillance data. Commonly injured body sites were the ankle (17.9%, n = 75), lower leg/Achilles tendon (13.6%, n = 57), trunk (13.4%, n = 56), and foot (12.4%, n = 52). Common diagnoses were ligament sprain (20.3%, n = 85) and muscle/tendon strain (18.7%, n = 78). Overall, 12.4% (n = 52) of injuries resulted in time loss of more than 3 weeks. Of the 291 injuries reported while a student-athlete used an apparatus (69.6%), most occurred during the floor exercise (41.9%, n = 122) and on the uneven bars (28.2%, n = 82). Conclusions We observed a lower time-loss injury rate for women's gymnastics than shown in earlier NCAA ISP surveillance data. Safety initiatives in women's gymnastics, such as “sting mats,” padded equipment, and a redesigned vault table, may have contributed to minimizing the frequency and severity of injury.Item Methods and Descriptive Epidemiology of Services Provided by Athletic Trainers in High Schools: The National Athletic Treatment, Injury and Outcomes Network Study(National Athletic Trainers' Association, 2015-12) Kerr, Zachary Y.; Dompier, Thomas P.; Dalton, Sara L.; Miller, Sayers John; Hayden, Ross; Marshall, Stephen W.; Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public HealthCONTEXT: Research is limited on the extent and nature of the care provided by athletic trainers (ATs) to student-athletes in the high school setting. OBJECTIVE: To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) project and provide the descriptive epidemiology of AT services for injury care in 27 high school sports. DESIGN: Descriptive epidemiology study. SETTING: Athletic training room (ATR) visits and AT services data collected in 147 high schools from 26 states. PATIENTS OR OTHER PARTICIPANTS: High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011-2012 through 2013-2014 academic years. MAIN OUTCOME MEASURE(S): The number of ATR visits and individual AT services, as well as the mean number of ATR visits (per injury) and AT services (per injury and ATR visit) were calculated by sport and for time-loss (TL) and non-time-loss (NTL) injuries. RESULTS: Over the 3-year period, 210 773 ATR visits and 557 381 AT services were reported for 50 604 injuries. Most ATR visits (70%) were for NTL injuries. Common AT services were therapeutic activities or exercise (45.4%), modalities (18.6%), and AT evaluation and reevaluation (15.9%), with an average of 4.17 ± 6.52 ATR visits and 11.01 ± 22.86 AT services per injury. Compared with NTL injuries, patients with TL injuries accrued more ATR visits (7.76 versus 3.47; P < .001) and AT services (18.60 versus 9.56; P < .001) per injury. An average of 2.24 ± 1.33 AT services were reported per ATR visit. Compared with TL injuries, NTL injuries had a larger average number of AT services per ATR visit (2.28 versus 2.05; P < .001). CONCLUSIONS: These findings highlight the broad spectrum of care provided by ATs to high school student-athletes and demonstrate that patients with NTL injuries require substantial amounts of AT services.Item Mitigation of COVID-19 at the 2021 National Collegiate Athletic Association Men's Basketball Tournament(Springer, 2022-11-10) Dixon, Brian E.; Fadel, William F.; Duszynski, Thomas J.; Caine, Virgina A.; Meyer , Joeseph F.; Saysana , Michele; Epidemiology, Richard M. Fairbanks School of Public HealthBackground Data are lacking regarding the risk of viral SARS-CoV-2 transmission during a large indoor sporting event involving fans utilizing a controlled environment. We sought to describe case characteristics, mitigation protocols used, variants detected, and secondary infections detected during the 2021 National Collegiate Athletic Association (NCAA) Men’s Basketball Tournament involving collegiate athletes from across the U.S. Methods This retrospective cohort study used data collected from March 16 to April 3, 2021, as part of a closed environment which required daily reverse transcription-polymerase chain reaction (RT-PCR) testing, social distancing, universal masking, and limited contact between tiers of participants. Nearly 3000 players, staff, and vendors participated in indoor, unmasked activities that involved direct exposure between cases and noninfected individuals. The main outcome of interest was transmission of SARS-CoV-2 virus, as measured by the number of new infections and variant(s) detected among positive cases. Secondary infections were identified through contact tracing by public health officials. Results Out of 2660 participants, 15 individuals (0.56%) screened positive for SARS-CoV-2. Four cases involved players or officials, and all cases were detected before any individual played in or officiated a game. Secondary transmissions all occurred outside the controlled environment. Among those disqualified from the tournament (4 cases; 26.7%), all individuals tested positive for the Iota variant (B.1.526). All other cases involved the Alpha variant (B.1.1.7). Nearly all teams (N = 58; 85.3%) reported that some individuals had received at least one dose of a vaccine. Overall, 17.9% of participants either had at least one dose of the vaccine or possessed documented infection within 90 days of the tournament. Conclusion In this retrospective cohort study of the 2021 NCAA Men’s Basketball Tournament closed environment, only a few cases were detected, and they were discovered in advance of potential exposure. These findings support the U.S. Centers for Disease Control and Prevention (CDC) guidelines for large indoor sporting events during the COVID-19 pandemic.Item National collegiate athletic association injury surveillance system: review of methods for 2004-2005 through 2013-2014 data collection(National Athletic Trainers’ Association, 2014-07) Kerr, Zachary Y.; Dompier, Thomas P.; Snook, Erin M.; Marshall, Stephen W.; Klossner, David; Hainline, Brian; Corlette, Jill; Department of Health Sciences, School of Health and Rehabilitation SciencesBACKGROUND: Since 1982, the National Collegiate Athletic Association has used the Injury Surveillance System (ISS) to collect injury and athlete-exposure data from a representative sample of collegiate institutions and sports. At the start of the 2004-2005 academic year, a Web-based ISS replaced the paper-based platform previously used for reporting injuries and exposures. OBJECTIVE: To describe the methods of the Web-based National Collegiate Athletic Association ISS for data collection as implemented from the 2004-2005 to 2013-2014 academic years. DESCRIPTION: The Web-based ISS monitored National Collegiate Athletic Association-sanctioned practices and competitions, the number of participating student-athletes, and time-loss injuries during the preseason, regular season, and postseason in 25 collegiate sports. Starting in the 2009-2010 academic year, non-time-loss injuries were also tracked. Efforts were made to better integrate ISS data collection into the workflow of collegiate athletic trainers. Data for the 2004-2005 to 2013-2014 academic years are available to researchers through a standardized application process available at the Datalys Center Web site. CONCLUSIONS: As of February 2014, more than 1 dozen data sets have been provided to researchers. The Datalys Center encourages applications for access to the data.Item Super Bowl 50’s data deluge: How much is too much?(The Conversation US, Inc., 2016-02-06) Moran, Malcolm; Journalism and Public Relations, School of Liberal ArtsItem The World Series of the Apocalypse?(The Conversation US, Inc., 2016-10-27) Lamb, Chris; Journalism and Public Relations, School of Liberal ArtsItem The Tokyo Olympic Games and the Risk of COVID-19(Springer Nature, 2020-10-30) Hoang, Van Thuan; Al-Tawfiq, Jaffar A.; Gautret, Philippe; Medicine, School of MedicinePurpose of review: We reviewed the occurrence of outbreaks at past Olympics and discuss the threat of the COVID-19 pandemic at the Tokyo Games. Recent findings: Evidence for large respiratory tract infection outbreaks at past Olympics is scant. Nevertheless, in order to control the spread of the COVID-19 outbreak, the Tokyo 2020 Olympics were postponed for 2021. Given the high contagiousness of the disease and the epidemiology of COVID-19 in Japan, this decision was appropriate and important in order to safeguard athletes and the public. However, it is a major problem for Japan, involving massive financial losses and a lost opportunity for athletes, coaches, and instructors. Summary: Up-to-date epidemiological data is needed on which to base an appropriate decision regarding the Tokyo 2021 Olympics. The actual effect of cancellations of such events in reducing the spread of COVID-19 needs to be determined.