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Register a new userProtocol for an Observational Study on the Effects of Early-Life Participation in Contact Sports on Later-Life Cognition in a Sample of Monozygotic and Dizygotic Swedish Twins Reared Together and Twins Reared Apart
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Jordan Weiss
Publication date
2018
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Mathematical Statistics
and research's language is
English
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A large body of work links traumatic brain injury (TBI) in adulthood to the onset of Alzheimers disease (AD). AD is the chief cause of dementia, leading to reduced cognitive capacity and autonomy and increased mortality risk. More recently, researchers have sought to investigate whether TBI experienced in early-life may influence trajectories of cognitive dysfunction in adulthood. It has been speculated that early-life participation in collision sports may lead to poor cognitive and mental health outcomes. However, to date, the few studies to investigate this relationship have produced mixed results. We propose to extend this literature by conducting a prospective study on the effects of early-life participation in collision sports on later-life cognitive health using the Swedish Adoption/Twin Study on Aging (SATSA). The SATSA is unique in its sampling of monozygotic and dizygotic twins reared together (respectively MZT, DZT) and twins reared apart (respectively MZA, DZA). The proposed analysis is a prospective study of 660 individuals comprised of 270 twin pairs and 120 singletons. Seventy-eight (11.8% individuals reported participation in collision sports. Our primary outcome will be an indicator of cognitive impairment determined by scores on the Mini-Mental State Examination (MMSE). We will also consider several secondary cognitive outcomes including verbal and spatial ability, memory, and processing speed. Our sample will be restricted to individuals with at least one MMSE score out of seven repeated assessments spaced approximately three years apart. We will adjust for age, sex, and education in each of our models.
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More than 1 million students play high school American football annually, but many health professionals have recently questioned its safety or called for its ban. These concerns have been partially driven by reports of chronic traumatic encephalopathy (CTE), increased risks of neurodegenerative disease, and associations between concussion history and later-life cognitive impairment and depression among retired professional football players. A recent observational study of a cohort of men who graduated from a Wisconsin high school in 1957 found no statistically significant harmful effects of playing high school football on a range of cognitive, psychological, and socio-economic outcomes measured at ages 35, 54, 65, and 72. Unfortunately, these findings may not generalize to younger populations, thanks to changes and improvements in football helmet technology and training techniques. In particular, these changes may have led to increased perceptions of safety but ultimately more dangerous styles of play, characterized by the frequent sub-concussive impacts thought to be associated with later-life neurological decline. In this work, we replicate the methodology of that earlier matched observational study using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). These include adolescent and family co-morbidities, academic experience, self-reported levels of general health and physical activity, and the score on the Add Health Picture Vocabulary Test. Our primary outcome is the CES-D score measured in 2008 when subjects were aged 24 -- 34 and settling into early adulthood. We also examine several secondary outcomes related to physical and psychological health, including suicidality. Our results can provide insight into the natural history of potential football-related decline and dysfunction.
American football is the most popular high school sport and is among the leading cause of injury among adolescents. While there has been considerable recent attention on the link between football and cognitive decline, there is also evidence of higher than expected rates of pain, obesity, and lower quality of life among former professional players, either as a result of repetitive head injury or through different mechanisms. Previously hidden downstream effects of playing football may have far-reaching public health implications for participants in youth and high school football programs. Our proposed study is a retrospective observational study that compares 1,153 high school males who played varsity football with 2,751 male students who did not. 1,951 of the control subjects did not play any sport and the remaining 800 controls played a non-contact sport. Our primary outcome is self-rated health measured at age 65. To control for potential confounders, we adjust for pre-exposure covariates with matching and model-based covariance adjustment. We will conduct an ordered testing procedure designed to use the full pool of 2,751 controls while also controlling for possible unmeasured differences between students who played sports and those who did not. We will quantitatively assess the sensitivity of the results to potential unmeasured confounding. The study will also assess secondary outcomes of pain, difficulty with activities of daily living, and obesity, as these are both important to individual well-being and have public health relevance.
Digital Twin (DT) is a promising technology for the new immersive digital life with a variety of applications in areas such as Industry 4.0, aviation, and healthcare. Proliferation of this technology requires higher data rates, reliability, resilience, and lower latency beyond what is currently offered by 5G. Thus, DT can become a major driver for 6G research and development. Alternatively, 6G network development can benefit from Digital Twin technology and its powerful features such as modularity and remote intelligence. Using DT, a 6G network (or some of its components) will have the opportunity to use Artificial Intelligence more proactively in order to enhance its resilience. DTs application in telecommunications is still in its infancy. In this article we highlight some of the most promising research and development directions for this technology.
The novel coronavirus disease (COVID-19) is a highly contagious respiratory disease that was first detected in Wuhan, China in December 2019, and has since spread around the globe, claiming more than 69,000 lives by the time this protocol is written. It has been widely acknowledged that the most effective public policy to mitigate the pandemic is emph{social and physical distancing}: keeping at least six feet away from people, working from home, closing non-essential businesses, etc. There have been a lot of anecdotal evidences suggesting that social distancing has a causal effect on disease mitigation; however, few studies have investigated the effect of social distancing on disease mitigation in a transparent and statistically-sound manner. We propose to perform an optimal non-bipartite matching to pair counties with similar observed covariates but vastly different average social distancing scores during the first week (March 16th through Match 22nd) of Presidents emph{15 Days to Slow the Spread} campaign. We have produced a total of $302$ pairs of two U.S. counties with good covariate balance on a total of $16$ important variables. Our primary outcome will be the average observed illness collected by Kinsa Inc. two weeks after the intervention period. Although the observed illness does not directly measure COVID-19, it reflects a real-time aspect of the pandemic, and unlike confirmed cases, it is much less confounded by counties testing capabilities. We also consider observed illness three weeks after the intervention period as a secondary outcome. We will test a proportional treatment effect using a randomization-based test with covariance adjustment and conduct a sensitivity analysis.
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