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1.  Seminoma Presenting as Renal Mass, Inferior Vena Caval Thrombus, and Regressed Testicular Mass 
Case Reports in Urology  2015;2015:835962.
Testicular cancer is the most common malignancy of men aged 15–40. Metastatic spread classically begins with involvement of the retroperitoneal lymph nodes, with metastases to the liver, lung, bone, and brain representing advancing disease. Treatment is based on pathologic analysis of the excised testicle and presence of elevated tumor markers. We report a case of a 34-year-old male presenting with back pain who was found to have a right renal mass with tumor extension into the inferior vena cava. Subsequent biopsy was consistent with seminoma. We review this rare case and discuss the literature regarding its diagnosis and management.
PMCID: PMC4325215
2.  Adverse Pregnancy Outcomes Following Motor Vehicle Crashes 
American journal of preventive medicine  2013;45(5):10.1016/j.amepre.2013.06.018.
Motor vehicle crashes are a leading cause of serious trauma during pregnancy, but little is known about their relationships with pregnancy outcomes.
To estimate the association between motor vehicle crashes and adverse pregnancy outcomes.
A retrospective cohort study of 878,546 pregnant women, aged 16–46 years, who delivered a singleton infant in North Carolina (NC) from 2001 to 2008. Pregnant drivers in crashes were identified by probabilistic linkage of vital records and crash reports. Poisson regression modeled the association among crashes, vehicle safety features, and adverse pregnancy outcomes. Analyses were conducted in 2012.
In 2001–2008, 2.9% of pregnant NC women were drivers in one or more crashes. After a single crash, compared to not being in a crash, pregnant drivers had slightly elevated rates of preterm birth (adjusted rate ratio, aRR=1.23, 95% CI=1.19, 1.28); placental abruption (aRR=1.34, 95% CI=1.15, 1.56); and premature rupture of the membranes (PROM; aRR=1.32, 95% CI=1.21, 1.43). Following a second or subsequent crash, pregnant drivers had more highly elevated rates of preterm birth (aRR=1.54, 95% CI=1.24, 1.90); stillbirth (aRR=4.82, 95% CI=2.85, 8.14); placental abruption (aRR=2.97, 95% CI=1.60, 5.53); and PROM (aRR=1.95, 95% CI=1.27, 2.99). Stillbirth rates were elevated following crashes involving unbelted pregnant drivers (aRR=2.77, 95% CI=1.22, 6.28) compared to belted pregnant drivers.
Crashes while driving during pregnancy were associated with elevated rates of adverse pregnancy outcomes, and multiple crashes were associated with even higher rates of adverse pregnancy outcomes. Crashes were especially harmful if drivers were unbelted.
PMCID: PMC3859429  PMID: 24139777
3.  Clinical Implications of Daytime Sleepiness for the Academic Performance of Middle School Age Adolescents with ADHD 
Journal of sleep research  2013;22(5):542-548.
This study investigated the relative impact of total time slept per night and daytime sleepiness on the academic functioning of 100 middle school age youth (Mage = 11.9) with Attention-Deficit/Hyperactivity Disorder (ADHD). The primary goal of the study was to determine if total time slept per night and/or daytime sleepiness, as measured by youth self-report on the Pediatric Daytime Sleepiness Scale (PDSS), predicted academic functioning above and beyond symptoms of ADHD and relevant covariates, such as intelligence, achievement scores, and parent education level. Self-reported daytime sleepiness but not self-reported total time slept per night was significantly associated with all academic outcomes. When examined in a hierarchical regression model, self-reported daytime sleepiness significantly predicted parent-rated homework problems and academic impairment and teacher-rated academic competence above and beyond symptoms of ADHD and relevant covariates but did not predict GPA or teacher-rated academic impairment. The implications of these findings for better understanding the association between ADHD and sleep and the functional implications of this relationship are discussed.
PMCID: PMC3690160  PMID: 23509927
ADHD; Sleep; Daytime Sleepiness; Academics; School Grades
4.  Knowledge, Attitude, and Concussion-Reporting Behaviors Among High School Athletes: A Preliminary Study 
Journal of Athletic Training  2013;48(5):645-653.
Many athletes continue to participate in practices and games while experiencing concussion-related symptoms, potentially predisposing them to subsequent and more complicated brain injuries. Limited evidence exists about factors that may influence concussion-reporting behaviors.
To examine the influence of knowledge and attitude on concussion-reporting behaviors in a sample of high school athletes.
Cross-sectional study.
Participants completed a validated survey instrument via mail.
Patients or Other Participants:
A total of 167 high school athletes (97 males, 55 females, 5 sex not indicated; age = 15.7 ± 1.4 years) participating in football, soccer, lacrosse, or cheerleading.
Athlete knowledge and attitude scores served as separate predictor variables.
Main Outcome Measure(s):
We examined the proportion of athletes who reported continuing to participate in games and practices while symptomatic from possible concussion and the self-reported proportion of recalled concussion and bell-ringer events disclosed after possible concussive injury.
Only 40% of concussion events and 13% of bell-ringer recalled events in the sample were disclosed after possible concussive injury. Increased athlete knowledge of concussion topics (increase of 1 standard deviation = 2.8 points) was associated with increased reporting prevalence of concussion and bell-ringer events occurring in practice (prevalence ratio [PR] = 2.27, 95% confidence interval [CI] = 1.60, 3.21) and the reporting prevalence of bell-ringer-only events overall (PR = 1.87, 95% CI = 1.38, 2.54). Athlete attitude scores (increase of 1 standard deviation = 11.5 points) were associated with decreases in the proportion of athletes stating they participated in games (PR = 0.74, 95% CI = 0.66, 0.82) and practices (PR = 0.67, 95% CI = 0.59, 0.77) while symptomatic from concussions.
Most recalled concussion events in our study were not reported to a supervising adult. Clinicians should be aware that knowledge and attitude influence concussion reporting. Clinicians and administrators should make concussion education a priority and encourage an optimal reporting environment to better manage and prevent concussive injuries in young athletes.
PMCID: PMC3784366  PMID: 23848520
education; brain injuries; care seeking
5.  Modeling Social Dimensions of Oral Health Among Older Adults in Urban Environments 
In both developed and developing countries, population aging has attained unprecedented levels. Public health strategies to deliver services in community-based settings are key to enhancing the utilization of preventive care and reducing costs for this segment of the population. Motivated by concerns of inadequate access to oral health care by older adults in urban environments, this article presents a portfolio of systems science models that have been developed on the basis of observations from the ElderSmile preventive screening program operated in northern Manhattan, New York City, by the Columbia University College of Dental Medicine. Using the methodology of system dynamics, models are developed to explore how interpersonal relationships influence older adults’ participation in oral health promotion. Feedback mechanisms involving word of mouth about preventive screening opportunities are represented in relation to stocks that change continuously via flows, as well as agents whose states of health care utilization change discretely using stochastic transitions. Agent-based implementations illustrate how social networks and geographic information systems are integrated into dynamic models to reflect heterogeneous and proximity-based patterns of communication and participation in the ElderSmile program. The systems science approach builds shared knowledge among an interdisciplinary research team about the dynamics of access to opportunities for oral health promotion. Using “what if” scenarios to model the effects of program enhancements and policy changes, resources may be effectively leveraged to improve access to preventive and treatment services. Furthermore, since oral health and general health are inextricably linked, the integration of services may improve outcomes and lower costs.
PMCID: PMC4088340  PMID: 24084402
agent-based modeling; aging and health; community health promotion; dynamic modeling; health promotion; social influence; systems science
6.  Pregnant Driver-Associated Motor Vehicle Crashes in North Carolina, 2001–2008 
Motor vehicle crashes are the leading cause of maternal injury-related mortality during pregnancy in the United States, yet pregnant women remain an understudied population in motor vehicle safety research.
We estimated the risk of being a pregnant driver in a crash among 878,546 pregnant women, 16–46 years, who reached the 20th week of pregnancy in North Carolina (NC) from 2001–2008. We also examined the circumstances surrounding the crash events. Pregnant drivers in crashes were identified by probabilistic linkage of live birth and fetal death records and state motor vehicle crash reports.
During the eight-year study period, the estimated risk of being a driver in a crash was 12.6 per 1,000 pregnant women. Pregnant women at highest risk of being drivers in serious crashes were 18–24 years old (4.5 per 1,000; 95% confidence interval, CI, 4.3, 4.7), non-Hispanic black (4.8 per 1,000; 95% CI=4.5, 5.1), had high school diplomas only (4.5 per 1,000; 95% CI=4.2, 4.7) or some college (4.1 per 1,000; 95% CI=3.9, 4.4), were unmarried (4.7 per 1,000; 95% CI=4.4, 4.9), or tobacco users (4.5 per 1,000; 95% CI=4.1, 5.0). A high proportion of crashes occurred between 20–27 weeks of pregnancy (45%) and a lower proportion of crashes involved unbelted pregnant drivers (1%) or airbag deployment (10%). Forty percent of crashes resulted in driver injuries.
NC has a relatively high pregnant driver crash risk among the four U.S. states that have linked vital records and crash reports to examine pregnancy-associated crashes. Crash risks were especially elevated among pregnant women who were young, non-Hispanic black, unmarried, or used tobacco. Additional research is needed to quantify pregnant women’s driving frequency and patterns.
PMCID: PMC3653413  PMID: 23545268
motor vehicle; driver; pregnancy; linkage
7.  Development of a Family-School Intervention for Young Children With Attention Deficit Hyperactivity Disorder 
School psychology review  2012;41(4):447-466.
Although numerous studies have evaluated the effectiveness of multi-modal psychosocial interventions for children with attention deficit hyperactivity disorder, these programs are limited in that there has not beeti an explicit focus on the connection between fatnily and school. This study was designed to develop and pilot test a family-school ititervention, Family-School Success—Early Elementary (FSS-EE), for kindergarten and first-grade studetits with attention deficit hyperactivity disorder. Key components of FSS-EE were family-school behavioral consultatioti, daily report cards, and strategies to improve parent-child relationships atid family involvement in educatioti. FSS-EE was developed using a multistep iterative process. The piloted version consisted of 12 weekly sessions including 6 group meetings, 4 individualized family sessions, and 2 school-based consultations. Families participating in the study were given the choice of placing their childreti on medication; 25% of children were on medication at the time of random assignmetit. Childreti (n = 61) were randomly assigned to FSS-EE or a comparison group controlling for nonspecific treatment effects. Outcomes were assessed at post interventioti and 2-month follow-up. Study findings indicated that FSS-EE was feasible to implement and acceptable to paretits atid teachers. In addition, the findings provided preliminary evidence that FSS-EE is effective in improving parenting practices, child behavior at school, and the student-teacher relationship.
PMCID: PMC3864191  PMID: 24353368
8.  Adolescent Expectations of Early Death Predict Young Adult Socioeconomic Status 
Social science & medicine (1982)  2012;74(9):10.1016/j.socscimed.2012.01.006.
Among adolescents, expectations of early death have been linked to future risk behaviors. These expectations may also reduce personal investment in education and training, thereby lowering adult socioeconomic status attainment. The importance of socioeconomic status is highlighted by pervasive health inequities and dramatic differences in life expectancy among education and income groups. The objectives of this study were to investigate patterns of change in perceived chances of living to age 35 (Perceived Survival Expectations; PSE), predictors of PSE, and associations between PSE and future socioeconomic status attainment. We utilized the U.S. National Longitudinal Study of Adolescent Health (Add Health) initiated in 1994-95 among 20,745 adolescents in grades 7-12 with follow-up interviews in 1996 (Wave II), 2001-02 (Wave III) and 2008 (Wave IV; ages 24-32). At Wave I, 14% reported ≤ 50% chance of living to age 35 and older adolescents reported lower PSE than younger adolescents. At Wave III, PSE were similar across age. Changes in PSE from Wave I to III were moderate, with 89% of respondents reporting no change (56%), one level higher (22%) or one level lower (10%) in a 5-level PSE variable. Higher block group poverty rate, perceptions that the neighborhood is unsafe, and less time in the U.S. (among the foreign-born) were related to low PSE at Waves I and III. Low PSE at Waves I and III predicted lower education attainment and personal earnings at Wave IV in multinomial logistic regression models controlling for confounding factors such as previous family socioeconomic status, individual demographic characteristics, and depressive symptoms. Anticipation of an early death is prevalent among adolescents and predictive of lower future socioeconomic status. Low PSE reported early in life may be a marker for worse health trajectories.
PMCID: PMC3846180  PMID: 22405687
adolescent behavior/psychology; adolescent health; perceptions of mortality; expectation of early death; socioeconomic status; hopelessness; United States
9.  Association between serum and urine biomarkers and lumbar spine individual radiographic features: The Johnston County Osteoarthritis Project 
1) To determine associations between radiographic features of lumbosacral spine disc space narrowing (DSN) and osteophytes (OST) and joint metabolism biomarkers (serum cartilage oligomeric matrix protein (COMP), hyaluronic Acid (HA), collagen neoepitope (C2C), C-propeptide of type II procollagen (CP-II), urine C-terminal cross-linking telopeptide (CTX-II) and N-terminal telopeptide (NTX-I)). 2) To explore interactions with race, gender and low back symptoms.
Cross-sectional analysis of 547 participants enrolled in the Johnston County Osteoarthritis Project from 2003–2004. Mean biomarker levels were estimated with linear regression. Proportional and partial proportional odds models were used to estimate associations. Interactions were tested with likelihood ratio tests at a p-value<0.10. Biomarkers were natural log (ln) transformed.
Significant differences in mean biomarker levels were found across severity of DSN for lnHA and lnC2C and lnCTX-II across severity of both DSN and OST. Moderate to strong associations were found between biomarkers of type II collagen and DSN, whereas associations with OST were weak. An association between lnHA and DSN was seen in women (adjusted odds ratio [aOR]=1.34 (95% CI 1.08, 1.65)) but no association among men (aOR=0.90 (95% CI 0.63, 1.26)). In Caucasians there was a decreased association with NTX-I and OST (aOR=0.67 (95% CI 0.49, 0.91)) and no association in African Americans (aOR=1.06 (95% CI 0.76, 1.47)). There was a positive association of lnCOMP with DSN among those with low back symptoms (aOR=1.82 (95% CI 1.02, 3.27)), but no association in those without low back symptoms (aOR=0.65 (95% CI 0.35, 1.20)).
Joint metabolism biomarkers suggest biological differences in the pathologic process involved in DSN and OST that may be gender (HA) and ethnicity (NTX-I) specific.
PMCID: PMC3608522  PMID: 22890183
10.  Lumbar spine radiographic features and demographic, clinical, and radiographic knee, hip and hand osteoarthritis: The Johnston County Osteoarthritis Project 
Arthritis care & research  2012;64(10):1536-1544.
1) To determine the prevalence of lumbar spine individual radiographic features (IRF) of disc space narrowing (DSN), osteophytes (OST) and facet joint osteoarthritis (FOA). 2) To describe the frequencies of demographic, clinic and radiographic knee, hip and hand osteoarthritis (OA) across lumbar spine IRF. 3) To determine factors associated with lumbar spine IRF.
A cross-sectional study of 840 participants enrolled in the Johnston County OA Project (2003-4). Sample-based prevalence estimates were generated for each lumbar spine IRF. Associations between lumbar spine IRF and demographic, clinical and peripheral joint OA were determined with logistic regression models.
Sample-based prevalence estimates were similar for DSN (57.6%) and FOA (57.9%) but higher for OST (88.1%) with significant differences across race and gender. Hand and knee OA frequencies increased across IRF whereas the effect was absent for hip OA. African Americans had lower odds of FOA (adjusted odds ratio [aOR]=0.45 (95% CI 0.32, 0.62)) while there was no racial association with DSN and OST. Low back symptoms were associated with DSN (aOR=1.37 (95% CI 1.04, 1.80)) but not OST or FOA. Knee OA was associated with OST (aOR=1.62 (95% CI 1.16, 2.27)) and FOA (aOR=1.69 (95% CI 1.15, 2.49)) but not DSN. Hand OA was associated with FOA (aOR=1.67 (95% CI 1.20, 2.28)) but not with DSN or OST. No associations were found with hip OA.
These findings underscore the importance of analyzing lumbar spine IRF separately as the associations with demographic, clinic and radiographic knee, hip and hand OA differ widely.
PMCID: PMC3427717  PMID: 22556059
lumbar spine; knee osteoarthritis; hip osteoarthritis; hand osteoarthritis
11.  Integrating Oral and General Health Screening at Senior Centers for Minority Elders 
American journal of public health  2013;103(6):1022-1025.
Racial/ethnic and socioeconomic disparities regarding untreated oral disease exist for older adults, and poor oral health diminishes quality of life. The ElderSmile program integrated screening for diabetes and hypertension into its community-based oral health activities at senior centers in northern Manhattan. Findings were that minority seniors were willing to be screened for primary care sensitive conditions by dental professionals, and a high level of unrecognized disease was found (7.8% and 24.6% of ElderSmile participants had positive screening results for previously undiagnosed diabetes and hypertension, respectively). Dental professionals may screen for primary care sensitive conditions and refer patients to health care providers for definitive diagnosis and treatment. The ElderSmile program is a replicable model for community-based oral and general health screening.
PMCID: PMC3670655  PMID: 23597378
12.  Family-School Intervention for Children with ADHD: Results of Randomized Clinical Trial 
Accumulating evidence highlights the importance of using psychosocial approaches to intervention for children with ADHD that target the family and school, as well as the intersection of family and school.
This study was designed to evaluate the effectiveness of a family-school intervention, referred to as Family-School Success (FSS), designed to improve the family and educational functioning of students in grades 2 through 6 who meet criteria for ADHD combined and inattentive types. Key components of FSS were conjoint behavioral consultation, daily report cards, and behavioral homework interventions.
FSS was provided over the course of 12 weekly sessions, which included 6 group sessions, 4 individualized family sessions, and 2 school-based consultations. Families participating in the study were given the choice of placing their children on medication; 43% of children were on medication at the time of random assignment. Children (n=199) were randomly assigned to FSS or a comparison group controlling for non-specific treatment effects. Outcomes were assessed at post intervention and 3-month follow-up. The analyses controlled for child medication status.
Study findings indicated that FSS had a significant effect on the quality of the family-school relationship, homework performance, and parenting behavior.
The superiority of FSS was demonstrated even though about 40% of the participants in FSS and CARE were on an optimal dose of medication and there were significant Time effects on each measure. This relatively brief intervention was able to produce effect sizes that were comparable to those of the more intensive MTA behavioral intervention.
PMCID: PMC3404236  PMID: 22506793
ADHD; intervention; behavioral; family; school
13.  Exploring the role of peer density in the self-reported oral health outcomes of older adults: A kernel density based approach 
Health & place  2012;18(4):782-788.
Previous research has documented that oral health is inextricably linked with overall health and is an important component of successful aging. Additionally, peer social interactions are known to improve older adults' general well-being by increasing social opportunities and knowledge of local resources. This study examines the relationship between peer density of participants aged 50 and older in the ElderSmile program and self-reported oral health in northern Manhattan. Results from logistic regression models found that higher peer kernel density estimation values are associated with better self-reported oral health. This reinforces the need for place-based health interventions, and provides new evidence of the importance of peer communities for older adults.
PMCID: PMC3372621  PMID: 22542440
14.  Tooth loss and dental caries in community-dwelling older adults in northern Manhattan 
Gerodontology  2011;29(2):e464-e473.
To examine tooth loss and dental caries by sociodemographic characteristics from community-based oral health examinations conducted by dentists in northern Manhattan.
The ElderSmile programme of the Columbia University College of Dental Medicine serves older adults with varying functional capacities across settings. This report is focused on relatively mobile, socially engaged participants who live in the impoverished communities of Harlem and Washington Heights/Inwood in northern Manhattan, New York City.
Materials and Methods
Self-reported sociodemographic characteristics and health and health care information were provided by community-dwelling ElderSmile participants aged 65 years and older who took part in community-based oral health education and completed a screening questionnaire. Oral health examinations were conducted by trained dentists in partnering prevention centres among ElderSmile participants who agreed to be clinically screened (90.8%).
The dental caries experience of ElderSmile participants varied significantly by sociodemographic predictors and smoking history. After adjustment in a multivariable logistic regression model, older age, non-Hispanic Black and Hispanic race/ethnicity, and a history of current or former smoking were important predictors of edentulism.
Provision of oral health screenings in community-based settings may result in opportunities to intervene before oral disease is severe, leading to improved oral health for older adults.
PMCID: PMC3189437  PMID: 21718349
elderly; oral health; dental caries; tooth loss; ageing; geriatric dentistry
15.  What contributes to self-rated oral health among community-dwelling older adults? Findings from the ElderSmile program 
As part of ongoing efforts by the Columbia University College of Dental Medicine to devise community-based models of health promotion and care for local residents, we sought to answer the following query: “What contributes to self-rated oral health among community-dwelling older adults?”
The present study is cross sectional in design and centrally concerned with baseline data collected during community-based screenings of adults aged 50 years and older who agreed to participate in the ElderSmile program in northern Manhattan, New York City. The primary outcome measure of interest is self-rated oral health, which was assessed as follows: “Overall, how would you rate the health of your teeth and gums – excellent, good, fair, or poor?”
More than a quarter (28.5 percent) of ElderSmile participants aged 50 years and older reported that their oral health was poor. After adjustment for age (in years), place of birth, educational level, and dental insurance status in a logistic regression model, recent visits to the dentist (within the past year versus more than a year ago) contributed to better self-rated oral health and non-Hispanic Black race/ethnicity, dentate (versus edentulous) status, tooth decay as measured by decayed missing filled teeth, and severe periodontal inflammation contributed to worse self-rated oral health in this population.
Recent dental care contributed to better self-rated oral health among community-dwelling older adults living in northern Manhattan. Significant gradients were evident in the caries experience and periodontal inflammation of dentate adults by self-rated oral health, suggesting that untreated oral disease contributes to poor self-rated oral health.
PMCID: PMC3614486  PMID: 22316102
self-rated oral health; older adults; community-based oral health care; edentulism; untreated dental caries; periodontal inflammation; oral pain; access to oral health care; oral health-related quality of life; oral health disparities
16.  Phylogeny of the Archiborborinae (Diptera: Sphaeroceridae) Based on Combined Morphological and Molecular Analysis 
PLoS ONE  2013;8(1):e51190.
The Archiborborinae is a diverse Neotropical subfamily of Sphaeroceridae, with many undescribed species. The existing generic classification includes three genera consisting of brachypterous species, with all other species placed in the genus Archiborborus. We present the first phylogenetic hypothesis for the subfamily based on morphological, molecular, and combined datasets. Morphological data include 53 characters and cover all valid described taxa (33 species in 4 genera) in the subfamily, as well as 83 undescribed species. Molecular data for five genes (mitochondrial 12S rDNA, cytochrome c oxidase subunit I, and cytochrome B, and nuclear alanyl-tRNA synthetase and 28S rDNA) were obtained for 21 ingroup taxa. Data support the separation of the Archiborborinae from the Copromyzinae, with which they were formerly combined. Analyses support consistent groups within the subfamily, but relationships between groups are poorly resolved. The validity of the brachypterous genera Penola Richards and Frutillaria Richards is supported. The former genus Archiborborus Duda is paraphyletic, and will be divided into monophyletic genera on the basis of this work. Aptery and brachyptery have evolved multiple times in the subfamily. Antrops Enderlein, previously including a single brachypterous species, is a senior synonym of Archiborborus.
PMCID: PMC3548823  PMID: 23349671
17.  Fecal indicators in sand, sand contact, and risk of enteric illness among beachgoers 
Epidemiology (Cambridge, Mass.)  2012;23(1):95-106.
Beach sand can harbor fecal indicator organisms and pathogens, but enteric illness risk associated with sand contact remains unclear.
In 2007, visitors at two recreational marine beaches were asked on the day of their visit about sand contact. Ten to 12 days later, participants answered questions about health symptoms since the visit. F+ coliphage, Enterococcus, Bacteroidales, fecal Bacteroides, and Clostridium spp. in wet sand were measured using culture and molecular methods.
We analyzed 144 wet sand samples and completed 4,999 interviews. Adjusted odds ratios (aORs) were computed, comparing those in the highest tertile of fecal indicator exposure with those who reported no sand contact. Among those digging in sand compared with those not digging in sand, a molecular measure of Enterococcus spp. (calibrator cell equivalents/g) in sand was positively associated with gastrointestinal (GI) illness (aOR = 2.0 [95% confidence interval (CI) = 1.2–3.2]) and diarrhea (2.4 [1.4–4.2]). Among those buried in sand, point estimates were greater for GI illness (3.3 [1.3–7.9]) and diarrhea (4.9 [1.8–13]). Positive associations were also observed for culture-based Enterococcus (colony-forming units/g) with GI illness (aOR digging = 1.7 [1.1–2.7]) and diarrhea (2.1 [1.3–3.4]). Associations were not found among non-swimmers with sand exposure.
We observed a positive relationship between sand contact activities and enteric illness as a function of concentrations of fecal microbial pollution in beach sand.
PMCID: PMC3240855  PMID: 22157306
18.  Hip Kinematics During a Stop-Jump Task in Patients With Chronic Ankle Instability 
Journal of Athletic Training  2011;46(5):461-467.
Chronic ankle instability (CAI) commonly develops after lateral ankle sprain. Movement pattern differences at proximal joints may play a role in instability.
To determine whether people with mechanical ankle instability (MAI) or functional ankle instability (FAI) exhibited different hip kinematics and kinetics during a stop-jump task compared with “copers.”
Cross-sectional study.
Sports medicine research laboratory.
Patients or Other Participants:
Sixty-three recreational athletes, 21 (11 men, 10 women) per group, matched for sex, age, height, mass, and limb dominance. All participants reported a history of a moderate to severe ankle sprain. The participants with MAI and FAI reported 2 or more episodes of giving way at the ankle in the last year and decreased functional ability; copers did not. The MAI group demonstrated clinically positive anterior drawer and talar tilt tests, whereas the FAI group and copers did not.
Participants performed a maximum-speed approach run and a 2-legged stop jump followed by a maximum vertical jump.
Main Outcome Measure(s):
An electromagnetic tracking device synchronized with a force plate collected data during the stance phase of a 2-legged stop jump. Hip motion was measured from initial contact to takeoff into the vertical jump. Group differences in hip kinematics and kinetics were assessed.
The MAI group demonstrated greater hip flexion at initial contact and at maximum (P = .029 and P = .017, respectively) and greater hip external rotation at maximum (P = .035) than the coper group. The MAI group also demonstrated greater hip flexion displacement than both the FAI (P = .050) and coper groups (P = .006). No differences were noted between the FAI and coper groups in hip kinematic variables or among any of the groups in ground reaction force variables.
The MAI group demonstrated different hip kinematics than the FAI and coper groups. Proximal joint motion may be affected by ankle joint function and laxity, and clinicians may need to assess proximal joints after repeated ankle sprains.
PMCID: PMC3418949  PMID: 22488131
motion analysis; landings; ankle sprains
20.  Validity of Soccer Injury Data from the National Collegiate Athletic Association's Injury Surveillance System 
Journal of Athletic Training  2011;46(5):489-499.
Few validation studies of sport injury-surveillance systems are available.
To determine the validity of a Web-based system for surveillance of collegiate sport injuries, the Injury Surveillance System (ISS) of the National Collegiate Athletic Association's (NCAA).
Validation study comparing NCAA ISS data from 2 fall collegiate sports (men's and women's soccer) with other types of clinical records maintained by certified athletic trainers.
A purposive sample of 15 NCAA colleges and universities that provided NCAA ISS data on both men's and women's soccer for at least 2 years during 2005–2007, stratified by playing division.
Patients or Other Participants:
A total of 737 men's and women's soccer athletes and 37 athletic trainers at these 15 institutions.
Main Outcome Measure(s):
The proportion of injuries captured by the NCAA ISS (capture rate) was estimated by comparing NCAA ISS data with the other clinical records on the same athletes maintained by the athletic trainers. We reviewed all athletic injury events resulting from participation in NCAA collegiate sports that resulted in 1 day or more of restricted activity in games or practices and necessitated medical care. A capture-recapture analysis estimated the proportion of injury events captured by the NCAA ISS. Agreement for key data fields was also measured.
We analyzed 664 injury events. The NCAA ISS captured 88.3% (95% confidence interval = 85.9%, 90.8%) of all time-lost medical-attention injury events. The proportion of injury events captured by the NCAA ISS was higher in Division I (93.8%) and Division II (89.6%) than in Division III (82.3%) schools. Agreement between the NCAA ISS data and the non–NCAA ISS data was good for the majority of data fields but low for date of full return and days lost from sport participation.
The overall capture rate of the NCAA ISS was very good (88%) in men's and women's soccer for this period.
PMCID: PMC3418955  PMID: 22488136
capture-recapture analysis; injury epidemiology; time loss; collegiate athletes
21.  Toward interoperable bioscience data 
Nature genetics  2012;44(2):121-126.
To make full use of research data, the bioscience community needs to adopt technologies and reward mechanisms that support interoperability and promote the growth of an open ‘data commoning’ culture. Here we describe the prerequisites for data commoning and present an established and growing ecosystem of solutions using the shared ‘Investigation-Study-Assay’ framework to support that vision.
PMCID: PMC3428019  PMID: 22281772
22.  Biomarkers of incident radiographic knee osteoarthritis: Do they vary by chronic knee symptoms? 
Arthritis and rheumatism  2011;63(8):2276-2283.
To explore prognostication of incident radiographic knee osteoarthritis (OA) with OA-related biomarkers in a large sample of African-American and Caucasian men and women.
Baseline serum cartilage oligomeric matrix protein (COMP), hyaluronan (HA), high-sensitivity C-reactive protein (hsCRP), and keratan sulfate (KS) and baseline and follow-up radiographs were available for 353 knees without baseline osteophyte formation (OST), and 446 knees without baseline joint space narrowing (JSN). Cox models estimated the hazard ratio (HR) for incident knee OA for a 1-unit increase in the natural log (ln) of each biomarker, adjusting for age, race, gender, body mass index, and knee OA of the contralateral limb. Report of chronic knee symptoms was explored as a modifier of the association.
The hazard of incident knee OST (HR= 2.16, 95% CI =1.39-3.37) and incident JSN (HR=1.82, 95% CI = 1.15-2.89) increased with higher baseline lnCOMP levels. The hazard of incident knee JSN increased with higher lnHA levels (HR=1.46, 95% CI= 1.14-1.87). Baseline lnhsCRP and lnKS did not predict incident knee outcomes. HRs per unit increase in lnCOMP, lnHA, and lnKS were higher among knees with chronic symptoms than those without symptoms.
Higher baseline lnCOMP and lnHA levels were associated with incident knee OA over an average follow-up period of 6.3 years. These results represent detection of a molecular stage of OA prior to radiographic manifestations. Chronic knee symptoms as a modifier of the biomarker-incident knee OA association requires further exploration.
PMCID: PMC3149729  PMID: 21506100
23.  Adolescent Expectations of Early Death Predict Adult Risk Behaviors 
PLoS ONE  2012;7(8):e41905.
Only a handful of public health studies have investigated expectations of early death among adolescents. Associations have been found between these expectations and risk behaviors in adolescence. However, these beliefs may not only predict worse adolescent outcomes, but worse trajectories in health with ties to negative outcomes that endure into young adulthood. The objectives of this study were to investigate perceived chances of living to age 35 (Perceived Survival Expectations, PSE) as a predictor of suicidal ideation, suicide attempt and substance use in young adulthood. We examined the predictive capacity of PSE on future suicidal ideation/attempt after accounting for sociodemographics, depressive symptoms, and history of suicide among family and friends to more fully assess its unique contribution to suicide risk. We investigated the influence of PSE on legal and illegal substance use and varying levels of substance use. We utilized the National Longitudinal Study of Adolescent Health (Add Health) initiated in 1994–95 among 20,745 adolescents in grades 7–12 with follow-up interviews in 1996 (Wave II), 2001–02 (Wave III) and 2008 (Wave IV; ages 24–32). Compared to those who were almost certain of living to age 35, perceiving a 50–50 or less chance of living to age 35 at Waves I or III predicted suicide attempt and ideation as well as regular substance use (i.e., exceeding daily limits for moderate drinking; smoking ≥ a pack/day; and using illicit substances other than marijuana at least weekly) at Wave IV. Associations between PSE and detrimental adult outcomes were particularly strong for those reporting persistently low PSE at both Waves I and III. Low PSE at Wave I or Wave III was also related to a doubling and tripling, respectively, of death rates in young adulthood. Long-term and wide-ranging ties between PSE and detrimental outcomes suggest these expectations may contribute to identifying at-risk youth.
PMCID: PMC3411584  PMID: 22870260
24.  New species and distributional records of Aleocharinae (Coleoptera, Staphylinidae) from Ontario, Canada, with a checklist of recorded species 
ZooKeys  2012;119-206.
The Aleocharinae (Coleoptera: Staphylinidae) of Ontario were reviewed in the context of recently studied material, primarily from insect surveys conducted by the University of Guelph Insect Collection (Ontario, Canada). Aleochara daviesi Klimaszewski & Brunke sp. n., Agaricomorpha websteri Klimaszewski & Brunke sp. n., Atheta (Microdota) alesi Klimaszewski & Brunke sp. n., Dinaraea backusensis Klimaszewski & Brunke sp. n., and Strigota obscurata Klimaszewski & Brunke sp. n. are described as new to science. We also report 47 new Ontario records and 24 new Canadian records. Callicerus rigidicornis (Erichson) and Alevonota gracilenta (Erichson) are newly reported from North America as adventive species. A checklist, with Canadian distributions by province, of the 224 species of Aleocharinae known from Ontario is given. The following species are placed in subjective synonymy with Dexiogyia angustiventris (Casey): (Dexiogyia asperata (Casey) syn. n., Dexiogyia abscissa (Casey) syn. n., Dexiogyia tenuicauda (Casey) syn. n., Dexiogyia intenta (Casey) syn. n., Dexiogyia alticola (Casey) syn. n.). The following species are placed in subjective synonymy with Acrotona subpygmaea (Bernhauer): (Acrotona avia (Casey) syn. n., Acrotona puritana (Casey) syn. n.). Lectotypes are designated for Thiasophila angustiventris Casey, Thiasophila asperata Casey, Ischnoglossa intenta Casey, Oxypoda rubescans Casey, Chilopora americana Casey, Chilopora fuliginosa Casey, Coprothassa smithi Casey, Atheta subpygmaea Bernhauer, Colpodota puritana Casey, Strigota seducens Casey, Trichiusa compacta Casey, Trichiusa hirsuta Casey and Trichiusa robustula Casey.
PMCID: PMC3349194  PMID: 22577320
Canada; Ontario; biodiversity; taxonomy; distributional records; Aleocharinae
25.  Physical activity and injuries during pregnancy 
Although physical activity can provide health benefits to pregnant women, population-based research on the circumstances surrounding injuries from physical activity during pregnancy is lacking.
Physical activity and subsequent injuries among a cohort of 1,469 pregnant women in North Carolina were examined prospectively from the third phase of the Pregnancy, Infection, and Nutrition Study between 2001 and 2005. Chi-square analyses were used to compare distributions of maternal characteristics among women who sustained injuries from physical activity and women who reported no injuries during pregnancy. Injury incidence rates were calculated.
Few pregnant women (N=34) reported a physical activity-related injury during pregnancy. The rates of physical activity-related and exercise-related injuries during pregnancy were 3.2 per 1,000 physical activity hours and 4.1 per 1,000 exercise hours, respectively. The most common types of injuries were bruises or scrapes (55%). Among all injuries, 33% resulted from exercise and 67% resulted from non-exercise physical activities. Sixty-four percent of all injuries were due to falls.
The incidence of injury from physical activity was low during pregnancy. Women should continue to be encouraged to maintain involvement in physical activity during pregnancy, while being aware of the potential for injury, particularly falls, from these activities.
PMCID: PMC3319730  PMID: 21088307
exercise; leisure activities; women; cohort

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