Introduction Healthy and sleep disordered populations show high night-to-night variability of pol... more Introduction Healthy and sleep disordered populations show high night-to-night variability of polysomnographic (PSG) macrostructure metrics, however there is evidence of stability in EEG microstructure. In-laboratory PSG is critical to gold standard measures of sleep physiology but multi-night investigations are resource heavy and burdensome to participants. Given the theoretical link between sleep and Alzheimer's disease (AD) pathology (tau and β-amyloid burden), we assessed the night-to-night reliability of sleep macrostructure and EEG microstructure in a group of cognitively normal elderly participating in aging and memory studies. Methods 107 participants (mean = 67±8 yrs., range [54-84 yrs.], 72% female) attended 2 consecutive nights PSG scored according to AASM guidelines for sleep staging, respiratory and leg movement events. Midline EEG (Fz, Cz and Pz referenced to average mastoid signals) were analyzed in 98 participants using an automatic algorithm (DETOKS) for detecti...
Introduction The WatchPAT®️ is an innovative Home Sleep Apnea Device (HSAT) that utilizes the per... more Introduction The WatchPAT®️ is an innovative Home Sleep Apnea Device (HSAT) that utilizes the peripheral arterial signal (PAT®️) for OSA diagnosis. We examined the diagnostic validity of the WatchPAT and assessed the correlation between its sleep indices and those measured by PSG in a cognitive normal predominantly older Black/African-American sample. Methods Preliminary data analysis on a limited sample of 26 participants without a prior diagnosis of OSA who underwent HSAT and 2-nights of nocturnal polysomnography (NPSG). An apnea-hypopnea index (AHI) ≥ 15 events/h characterized moderate to severe OSA. Pearson correlation statistics (Fisher's z Transformation) for PAT/NPSG indices including respiratory disturbance index (RDI), oxygen desaturation index (ODI), mean oxygen saturation (Spo2), REM Latency (min), awake period during sleep (WASO), and sleep onset latency (SOL) were determined. Results Of the 26 participants, 17 (65.4%) were Black/African-American, 9 (34.6%) were non-...
Objective: To examine the feasibility and acceptability of implementing a family-based mhealth in... more Objective: To examine the feasibility and acceptability of implementing a family-based mhealth intervention tailored for low-income Chinese immigrant families with type 2 diabetes (T2D) in New York City (NYC) . Methods: We recruited 11 patient-family partner adult dyads to receive the intervention. Both the patient and partner were asked to watch 2 brief videos each week for 12 weeks via the social media app WeChat. The culturally and linguistically tailored videos addressed diabetes self-management and provided guidance on how to support the patient’s self-management. Feasibility was evaluated via participant retention and video watch rates. Acceptability was assessed at 12-weeks via a 9-item survey using a 5-point Likert scale (1=strongly agree to 5=strongly disagree) , and a single item on which participants rated satisfaction using an 11-point Likert scale (0=not at all satisfied to 10=totally satisfied) . Participants also were asked about barriers to watching the videos. Resul...
Purpose: Mobile health holds strong promise to increase access to diabetes self-management educat... more Purpose: Mobile health holds strong promise to increase access to diabetes self-management education (DSME) programs in underserved communities. In this report, we examined the preliminary outcomes of a social media-based DSME intervention in low-income Chinese immigrants with type 2 diabetes (T2D) . Methods: We conducted a single-group pilot study in 30 Chinese immigrants with T2D living in NYC in 2020. Over 12 weeks, participants received 2 brief culturally and linguistically tailored DSME videos each week via WeChat, a free and popular social media app among Chinese immigrants. Participants completed baseline and 6-month surveys with self-efficacy, diabetes self-care behaviors, dietary intake, and physical activity measures. Paired t-tests were used to examine changes over time. Results: Of the 30 participants, mean (SD) age was 61.2 (6.7) years, 70.0% were women, 63.3% reported high school education, 84.0% reported annual family income of < $25,000, 63.3% were married, and 86...
Introduction Obstructive sleep apnea (OSA) has been associated with Alzheimer’s disease (AD) prog... more Introduction Obstructive sleep apnea (OSA) has been associated with Alzheimer’s disease (AD) progression but a causal relationship is unclear. We hypothesized that OSA can influence (AD) biomarkers including beta-amyloid (Aβ) and tau, as well as neural filament light chain (NfL). Methods To test this hypothesis, we examined plasma tau, NfL, Aβ42, and Aβ40 in a randomized crossover study of OSA vs. 3-night CPAP withdrawal in 30 subjects with severe OSA adherent to CPAP. We compared the overnight change in evening to morning plasma samples across the untreated night (off) versus CPAP treated night (on). Paired t-tests were used to compare measures across sleep conditions while hierarchical linear regression with difference in the overnight change of each biomarker between conditions were set as dependent variables with age and sex as covariates. Results Of the 30 subjects, mean age was 52 years and 27% were women. As expected, CPAP withdrawal caused sleep disruption and recurrence of ...
Introduction Although racial and ethnic differences in continuous positive airway pressure (CPAP)... more Introduction Although racial and ethnic differences in continuous positive airway pressure (CPAP) adherence for people with obstructive sleep apnea (OSA) are well known, no studies have examined the influence of racial discrimination on CPAP use. The aim of this study was to determine if racial discrimination influenced CPAP use trajectories. Methods Participants with OSA initiating CPAP were enrolled from two sleep centers in New York City. Participants completed questionnaires including sociodemographics, perceived discrimination, daytime sleepiness, and depressive symptoms. Racial discrimination was measured via the validated Everyday Discrimination scale (EDS) , Participants endorsed at least one discriminatory experience “at least once a year” and race was the main reason for this treatment. Sociodemographic and questionnaire comparison were performed between participants reporting the presence and absence of racial discrimination. To examine differences in the trajectory of CP...
Introduction Disturbed sleep measures differentially alter white-matter microstructure. We examin... more Introduction Disturbed sleep measures differentially alter white-matter microstructure. We examined whether obstructive sleep apnea (OSA)-severity, sleep fragmentation and duration measures were associated with gray-matter diffusion tensor-imaging metrics (DTI) (i.e., fractional anisotropy [FA], mean diffusivities [MD] and kurtoses [MK]) in community-dwelling cognitive-normal older-adults. Methods Gray-matter DTI metrics from MRI including mean FA, MD and MK measures of the hippocampus, thalamus, medial prefrontal-cortex (mPC) and Alzheimer’s Disease (AD) vulnerable regions (temporal [inferior, middle, and superior], parietal [inferior and superior], entorhinal cortex, and precuneus) were determined from 85 subjects. OSA-severity measures included AHI3a and AHI4%. Other sleep measures included sleep efficiency (SE), non-rapid eye movement (NREM) slow wave sleep (SWS) duration, percent time spent in SWS (%SWS), slow wave activity (SWA), total sleep time (TST), and wake after sleep on...
Figure S1. Distribution of CSF biomarkers in this cohort. Histograms of CSF Aβ42 (A), T-tau (B),... more Figure S1. Distribution of CSF biomarkers in this cohort. Histograms of CSF Aβ42 (A), T-tau (B), P-tau181 (C) in our cohort of 50 cognitively normal elderly. Figure S2. Sleep quality measures are not associated with either CSF T-tau at cross section. Scatter plots of WASO (min.) (A), Sleep efficiency (%) (B), Arousal Index (#/min. of sleep) (C) or total sleep time (hours by habitual actigraphy, n =â 39) (D) with CSF T-tau show no relationship at cross-section. (PDF 1529 kb)
Table S2. Hierarchical linear regression examining CSF T-tau as a function of N2 spindle density ... more Table S2. Hierarchical linear regression examining CSF T-tau as a function of N2 spindle density with comorbidities (DOCX 15 kb)
Table S1. Hierarchical linear regression examining CSF T-tau/Aβ42 ratio as a function of sleep m... more Table S1. Hierarchical linear regression examining CSF T-tau/Aβ42 ratio as a function of sleep measures (DOCX 15 kb)
The association between Obstructive Sleep Apnea (OSA) and cognition in older‐adults is conflictin... more The association between Obstructive Sleep Apnea (OSA) and cognition in older‐adults is conflicting. We determined to characterize older OSA‐patients using the NIA‐AA Research Framework and test whether OSA accelerates cognitive decline in preclinical Alzheimer’s disease (AD)
American journal of respiratory and critical care medicine, Jan 10, 2017
Recent evidence suggests that Obstructive Sleep Apnea (OSA) may be a risk factor for developing M... more Recent evidence suggests that Obstructive Sleep Apnea (OSA) may be a risk factor for developing Mild Cognitive Impairment and Alzheimer's disease. However, how sleep apnea affects longitudinal risk for Alzheimer's disease is less well understood. To test the hypothesis that there is an association between severity of OSA and longitudinal increase in amyloid burden in cognitively normal elderly. Data was derived from a 2-year prospective longitudinal study that sampled community-dwelling healthy cognitively normal elderly. Subjects were healthy volunteers between the ages of 55 to 90, were non-depressed and had a consensus clinical diagnosis of cognitively normal. CSF Amyloid beta was measured using ELISA. Subjects received Pittsburgh compound B Positron Emission Tomography scans following standardized procedures. Monitoring of OSA was completed using a home sleep recording device. We found that severity of OSA indices (lnAHIall [F1,88=4.26, p<.05] and lnAHI4% [F1,87=4.36,...
International journal of environmental research and public health, Jan 7, 2017
There is a paucity of data related to sports injuries, concussions, and computerized neurocogniti... more There is a paucity of data related to sports injuries, concussions, and computerized neurocognitive testing (CNT) among very young athletes playing sports in recreational settings. The purpose of this study was to report baseline CNT results among male and female children, ages 5-11, playing sports in Hillsborough County, Florida using ImPACT Pediatric, which is specifically designed for this population. Data were collected from 2016 to 2017. The results show that 657 baseline tests were conducted and t-tests and linear regression were used to assess mean significant differences in composite scores with sex and age. Results showed that females scored better on visual memory and in general as age increased, baseline scores improved. The results can be used to build further studies on the use of CNT in recreational settings and their role in concussion treatment, management, and interventions.
Burkitt's Lymphoma (BL) has three peaks of occurrence, in children, adults and elderly, at 10... more Burkitt's Lymphoma (BL) has three peaks of occurrence, in children, adults and elderly, at 10, 40 and 70 years respectively. To the best of our knowledge, no study has been conducted to assess predictors of survival in the three age groups. We hypothesized that survival predictors may differ by age group. We, therefore, sought to determine survival predictors for BL in these three groups: children (<15 years of age), adults (40-70 years of age) and elderly (>70 years of age). Using the Surveillance, Epidemiology, and End Results (SEER) database covering the years 2000-2013, we identified 797 children, 1,994 adults and 757 elderly patients newly diagnosed with BL. We used adjusted Cox proportional hazards regression models to determine prognostic factors for survival for each age group. Five-year relative survival in BL for children, adults and elderly were 90.4%, 47.8% and 28.9%, respectively. Having at least stage II disease and multiple primaries were associated with hig...
Background: To determine whether sleep disturbance (SD) and vascular-risk interact to promote Alz... more Background: To determine whether sleep disturbance (SD) and vascular-risk interact to promote Alzheimer’s disease (AD) stage-progression in normal, community-dwelling older adults and evaluate their combined risk beyond that of established AD biomarkers. Methods: Longitudinal data from the National Alzheimer’s Coordinating Center Uniform-Dataset. SD data (i.e., SD+ vs. SD-), as characterized by the Neuropsychiatric Inventory-Questionnaire, were derived from 10,600 participants at baseline, with at-least one follow-up visit. A subset (n = 361) had baseline cerebrospinal fluid (CSF) biomarkers and MRI data. The Framingham heart study general cardiovascular disease (FHS-CVD) risk-score was used to quantify vascular risk. Amnestic mild cognitive impairment (aMCI) diagnosis during follow-up characterized AD stage-progression. Logistic mixed-effects models with random intercept and slope examined the interaction of SD and vascular risk on prospective aMCI diagnosis. Results: Of the 10,600...
The purpose of this study was to identify the injury rates and mechanisms of sports injuries amon... more The purpose of this study was to identify the injury rates and mechanisms of sports injuries among 5-11-year-old athletes, and to provide preliminary guidance for decreasing injuries in this population. A total of 1511 athletes ages 511 playing football, soccer, baseball and softball participated in our research. One certified athletic trainer (ATC) used Reporting Information Online (RIO) to collect the data on athletic exposure, injuries and injury mechanisms weekly during the 2016-2017 season in Hillsborough County, Florida. A total of 18 injuries occurred in practices or competitions. Football had the leading rate of injuries for both competitions and practices (1.18 and 0.68, per 1000 athlete-exposures respectively). Most injuries occurred during competition (66.7%) and the leading types of injuries were concussions (22.2%) and fractures (22.2%). The leading injury mechanisms were contact with another person (33.3%) and playing apparatus (33.3%). It is advantageous to have ATCs ...
Introduction Healthy and sleep disordered populations show high night-to-night variability of pol... more Introduction Healthy and sleep disordered populations show high night-to-night variability of polysomnographic (PSG) macrostructure metrics, however there is evidence of stability in EEG microstructure. In-laboratory PSG is critical to gold standard measures of sleep physiology but multi-night investigations are resource heavy and burdensome to participants. Given the theoretical link between sleep and Alzheimer's disease (AD) pathology (tau and β-amyloid burden), we assessed the night-to-night reliability of sleep macrostructure and EEG microstructure in a group of cognitively normal elderly participating in aging and memory studies. Methods 107 participants (mean = 67±8 yrs., range [54-84 yrs.], 72% female) attended 2 consecutive nights PSG scored according to AASM guidelines for sleep staging, respiratory and leg movement events. Midline EEG (Fz, Cz and Pz referenced to average mastoid signals) were analyzed in 98 participants using an automatic algorithm (DETOKS) for detecti...
Introduction The WatchPAT®️ is an innovative Home Sleep Apnea Device (HSAT) that utilizes the per... more Introduction The WatchPAT®️ is an innovative Home Sleep Apnea Device (HSAT) that utilizes the peripheral arterial signal (PAT®️) for OSA diagnosis. We examined the diagnostic validity of the WatchPAT and assessed the correlation between its sleep indices and those measured by PSG in a cognitive normal predominantly older Black/African-American sample. Methods Preliminary data analysis on a limited sample of 26 participants without a prior diagnosis of OSA who underwent HSAT and 2-nights of nocturnal polysomnography (NPSG). An apnea-hypopnea index (AHI) ≥ 15 events/h characterized moderate to severe OSA. Pearson correlation statistics (Fisher's z Transformation) for PAT/NPSG indices including respiratory disturbance index (RDI), oxygen desaturation index (ODI), mean oxygen saturation (Spo2), REM Latency (min), awake period during sleep (WASO), and sleep onset latency (SOL) were determined. Results Of the 26 participants, 17 (65.4%) were Black/African-American, 9 (34.6%) were non-...
Objective: To examine the feasibility and acceptability of implementing a family-based mhealth in... more Objective: To examine the feasibility and acceptability of implementing a family-based mhealth intervention tailored for low-income Chinese immigrant families with type 2 diabetes (T2D) in New York City (NYC) . Methods: We recruited 11 patient-family partner adult dyads to receive the intervention. Both the patient and partner were asked to watch 2 brief videos each week for 12 weeks via the social media app WeChat. The culturally and linguistically tailored videos addressed diabetes self-management and provided guidance on how to support the patient’s self-management. Feasibility was evaluated via participant retention and video watch rates. Acceptability was assessed at 12-weeks via a 9-item survey using a 5-point Likert scale (1=strongly agree to 5=strongly disagree) , and a single item on which participants rated satisfaction using an 11-point Likert scale (0=not at all satisfied to 10=totally satisfied) . Participants also were asked about barriers to watching the videos. Resul...
Purpose: Mobile health holds strong promise to increase access to diabetes self-management educat... more Purpose: Mobile health holds strong promise to increase access to diabetes self-management education (DSME) programs in underserved communities. In this report, we examined the preliminary outcomes of a social media-based DSME intervention in low-income Chinese immigrants with type 2 diabetes (T2D) . Methods: We conducted a single-group pilot study in 30 Chinese immigrants with T2D living in NYC in 2020. Over 12 weeks, participants received 2 brief culturally and linguistically tailored DSME videos each week via WeChat, a free and popular social media app among Chinese immigrants. Participants completed baseline and 6-month surveys with self-efficacy, diabetes self-care behaviors, dietary intake, and physical activity measures. Paired t-tests were used to examine changes over time. Results: Of the 30 participants, mean (SD) age was 61.2 (6.7) years, 70.0% were women, 63.3% reported high school education, 84.0% reported annual family income of < $25,000, 63.3% were married, and 86...
Introduction Obstructive sleep apnea (OSA) has been associated with Alzheimer’s disease (AD) prog... more Introduction Obstructive sleep apnea (OSA) has been associated with Alzheimer’s disease (AD) progression but a causal relationship is unclear. We hypothesized that OSA can influence (AD) biomarkers including beta-amyloid (Aβ) and tau, as well as neural filament light chain (NfL). Methods To test this hypothesis, we examined plasma tau, NfL, Aβ42, and Aβ40 in a randomized crossover study of OSA vs. 3-night CPAP withdrawal in 30 subjects with severe OSA adherent to CPAP. We compared the overnight change in evening to morning plasma samples across the untreated night (off) versus CPAP treated night (on). Paired t-tests were used to compare measures across sleep conditions while hierarchical linear regression with difference in the overnight change of each biomarker between conditions were set as dependent variables with age and sex as covariates. Results Of the 30 subjects, mean age was 52 years and 27% were women. As expected, CPAP withdrawal caused sleep disruption and recurrence of ...
Introduction Although racial and ethnic differences in continuous positive airway pressure (CPAP)... more Introduction Although racial and ethnic differences in continuous positive airway pressure (CPAP) adherence for people with obstructive sleep apnea (OSA) are well known, no studies have examined the influence of racial discrimination on CPAP use. The aim of this study was to determine if racial discrimination influenced CPAP use trajectories. Methods Participants with OSA initiating CPAP were enrolled from two sleep centers in New York City. Participants completed questionnaires including sociodemographics, perceived discrimination, daytime sleepiness, and depressive symptoms. Racial discrimination was measured via the validated Everyday Discrimination scale (EDS) , Participants endorsed at least one discriminatory experience “at least once a year” and race was the main reason for this treatment. Sociodemographic and questionnaire comparison were performed between participants reporting the presence and absence of racial discrimination. To examine differences in the trajectory of CP...
Introduction Disturbed sleep measures differentially alter white-matter microstructure. We examin... more Introduction Disturbed sleep measures differentially alter white-matter microstructure. We examined whether obstructive sleep apnea (OSA)-severity, sleep fragmentation and duration measures were associated with gray-matter diffusion tensor-imaging metrics (DTI) (i.e., fractional anisotropy [FA], mean diffusivities [MD] and kurtoses [MK]) in community-dwelling cognitive-normal older-adults. Methods Gray-matter DTI metrics from MRI including mean FA, MD and MK measures of the hippocampus, thalamus, medial prefrontal-cortex (mPC) and Alzheimer’s Disease (AD) vulnerable regions (temporal [inferior, middle, and superior], parietal [inferior and superior], entorhinal cortex, and precuneus) were determined from 85 subjects. OSA-severity measures included AHI3a and AHI4%. Other sleep measures included sleep efficiency (SE), non-rapid eye movement (NREM) slow wave sleep (SWS) duration, percent time spent in SWS (%SWS), slow wave activity (SWA), total sleep time (TST), and wake after sleep on...
Figure S1. Distribution of CSF biomarkers in this cohort. Histograms of CSF Aβ42 (A), T-tau (B),... more Figure S1. Distribution of CSF biomarkers in this cohort. Histograms of CSF Aβ42 (A), T-tau (B), P-tau181 (C) in our cohort of 50 cognitively normal elderly. Figure S2. Sleep quality measures are not associated with either CSF T-tau at cross section. Scatter plots of WASO (min.) (A), Sleep efficiency (%) (B), Arousal Index (#/min. of sleep) (C) or total sleep time (hours by habitual actigraphy, n =â 39) (D) with CSF T-tau show no relationship at cross-section. (PDF 1529 kb)
Table S2. Hierarchical linear regression examining CSF T-tau as a function of N2 spindle density ... more Table S2. Hierarchical linear regression examining CSF T-tau as a function of N2 spindle density with comorbidities (DOCX 15 kb)
Table S1. Hierarchical linear regression examining CSF T-tau/Aβ42 ratio as a function of sleep m... more Table S1. Hierarchical linear regression examining CSF T-tau/Aβ42 ratio as a function of sleep measures (DOCX 15 kb)
The association between Obstructive Sleep Apnea (OSA) and cognition in older‐adults is conflictin... more The association between Obstructive Sleep Apnea (OSA) and cognition in older‐adults is conflicting. We determined to characterize older OSA‐patients using the NIA‐AA Research Framework and test whether OSA accelerates cognitive decline in preclinical Alzheimer’s disease (AD)
American journal of respiratory and critical care medicine, Jan 10, 2017
Recent evidence suggests that Obstructive Sleep Apnea (OSA) may be a risk factor for developing M... more Recent evidence suggests that Obstructive Sleep Apnea (OSA) may be a risk factor for developing Mild Cognitive Impairment and Alzheimer's disease. However, how sleep apnea affects longitudinal risk for Alzheimer's disease is less well understood. To test the hypothesis that there is an association between severity of OSA and longitudinal increase in amyloid burden in cognitively normal elderly. Data was derived from a 2-year prospective longitudinal study that sampled community-dwelling healthy cognitively normal elderly. Subjects were healthy volunteers between the ages of 55 to 90, were non-depressed and had a consensus clinical diagnosis of cognitively normal. CSF Amyloid beta was measured using ELISA. Subjects received Pittsburgh compound B Positron Emission Tomography scans following standardized procedures. Monitoring of OSA was completed using a home sleep recording device. We found that severity of OSA indices (lnAHIall [F1,88=4.26, p<.05] and lnAHI4% [F1,87=4.36,...
International journal of environmental research and public health, Jan 7, 2017
There is a paucity of data related to sports injuries, concussions, and computerized neurocogniti... more There is a paucity of data related to sports injuries, concussions, and computerized neurocognitive testing (CNT) among very young athletes playing sports in recreational settings. The purpose of this study was to report baseline CNT results among male and female children, ages 5-11, playing sports in Hillsborough County, Florida using ImPACT Pediatric, which is specifically designed for this population. Data were collected from 2016 to 2017. The results show that 657 baseline tests were conducted and t-tests and linear regression were used to assess mean significant differences in composite scores with sex and age. Results showed that females scored better on visual memory and in general as age increased, baseline scores improved. The results can be used to build further studies on the use of CNT in recreational settings and their role in concussion treatment, management, and interventions.
Burkitt's Lymphoma (BL) has three peaks of occurrence, in children, adults and elderly, at 10... more Burkitt's Lymphoma (BL) has three peaks of occurrence, in children, adults and elderly, at 10, 40 and 70 years respectively. To the best of our knowledge, no study has been conducted to assess predictors of survival in the three age groups. We hypothesized that survival predictors may differ by age group. We, therefore, sought to determine survival predictors for BL in these three groups: children (<15 years of age), adults (40-70 years of age) and elderly (>70 years of age). Using the Surveillance, Epidemiology, and End Results (SEER) database covering the years 2000-2013, we identified 797 children, 1,994 adults and 757 elderly patients newly diagnosed with BL. We used adjusted Cox proportional hazards regression models to determine prognostic factors for survival for each age group. Five-year relative survival in BL for children, adults and elderly were 90.4%, 47.8% and 28.9%, respectively. Having at least stage II disease and multiple primaries were associated with hig...
Background: To determine whether sleep disturbance (SD) and vascular-risk interact to promote Alz... more Background: To determine whether sleep disturbance (SD) and vascular-risk interact to promote Alzheimer’s disease (AD) stage-progression in normal, community-dwelling older adults and evaluate their combined risk beyond that of established AD biomarkers. Methods: Longitudinal data from the National Alzheimer’s Coordinating Center Uniform-Dataset. SD data (i.e., SD+ vs. SD-), as characterized by the Neuropsychiatric Inventory-Questionnaire, were derived from 10,600 participants at baseline, with at-least one follow-up visit. A subset (n = 361) had baseline cerebrospinal fluid (CSF) biomarkers and MRI data. The Framingham heart study general cardiovascular disease (FHS-CVD) risk-score was used to quantify vascular risk. Amnestic mild cognitive impairment (aMCI) diagnosis during follow-up characterized AD stage-progression. Logistic mixed-effects models with random intercept and slope examined the interaction of SD and vascular risk on prospective aMCI diagnosis. Results: Of the 10,600...
The purpose of this study was to identify the injury rates and mechanisms of sports injuries amon... more The purpose of this study was to identify the injury rates and mechanisms of sports injuries among 5-11-year-old athletes, and to provide preliminary guidance for decreasing injuries in this population. A total of 1511 athletes ages 511 playing football, soccer, baseball and softball participated in our research. One certified athletic trainer (ATC) used Reporting Information Online (RIO) to collect the data on athletic exposure, injuries and injury mechanisms weekly during the 2016-2017 season in Hillsborough County, Florida. A total of 18 injuries occurred in practices or competitions. Football had the leading rate of injuries for both competitions and practices (1.18 and 0.68, per 1000 athlete-exposures respectively). Most injuries occurred during competition (66.7%) and the leading types of injuries were concussions (22.2%) and fractures (22.2%). The leading injury mechanisms were contact with another person (33.3%) and playing apparatus (33.3%). It is advantageous to have ATCs ...
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