{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T19:44:38Z","timestamp":1768679078625,"version":"3.49.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":49,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100007311","name":"Cleveland Clinic","doi-asserted-by":"publisher","award":["595339680101"],"award-info":[{"award-number":["595339680101"]}],"id":[{"id":"10.13039\/100007311","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007311","name":"Cleveland Clinic","doi-asserted-by":"publisher","award":["597042420101"],"award-info":[{"award-number":["597042420101"]}],"id":[{"id":"10.13039\/100007311","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Cleveland Clinic Neurological Institute","award":["#2012-1034"],"award-info":[{"award-number":["#2012-1034"]}]},{"name":"National Football League Charities","award":["2010-01"],"award-info":[{"award-number":["2010-01"]}]},{"name":"Ohio Department of Development 3rd Frontier TECH","award":["09-024"],"award-info":[{"award-number":["09-024"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["#1R43NS076102-01A1"],"award-info":[{"award-number":["#1R43NS076102-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["#R41HD079158-01A1"],"award-info":[{"award-number":["#R41HD079158-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["#2R44NS076102-02A1"],"award-info":[{"award-number":["#2R44NS076102-02A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["8UL1TR000055"],"award-info":[{"award-number":["8UL1TR000055"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1UL1RR031973-01"],"award-info":[{"award-number":["1UL1RR031973-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006282","name":"Federal Aviation Administration","doi-asserted-by":"publisher","award":["#13-P-022 BIODYNAMICS"],"award-info":[{"award-number":["#13-P-022 BIODYNAMICS"]}],"id":[{"id":"10.13039\/100006282","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000182","name":"USAMRMC","doi-asserted-by":"publisher","award":["W81XWH-12-1-0004"],"award-info":[{"award-number":["W81XWH-12-1-0004"]}],"id":[{"id":"10.13039\/100000182","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Defense Health Program","award":["W81XWH-14-1-0561"],"award-info":[{"award-number":["W81XWH-14-1-0561"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Although concussion continues to be a major source of acute and chronic injuries, concussion injury mechanisms and risk functions are ill-defined. This lack of definition has hindered efforts to develop standardized concussion monitoring, safety testing, and protective countermeasures. To overcome this knowledge gap, we have developed, tested, and deployed a head impact monitoring mouthguard (IMM) system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>The IMM system was first calibrated in 731 laboratory tests. Versus reference, Laboratory IMM data fit a linear model, with results close to the ideal linear model of form y\u00a0=\u00a0x\u00a0+\u00a00, R2\u00a0=\u00a01. Next, during on-field play involving n\u00a0=\u00a054 amateur American athletes in football and boxing, there were tens of thousands of events collected by the IMM. A total of 890 true-positive head impacts were confirmed using a combination of signal processing and National Institute of Neurological Disorders and Stroke\/National Institutes of Health Common Data Elements methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The median and 99th percentile of peak scalar linear acceleration and peak angular acceleration were 20 and 50\u00a0g and 1,700 and 4,600\u00a0rad\/s2, respectively. No athletes were diagnosed with concussion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>While these data are useful for preliminary human tolerance limits, a larger population must be used to quantify real-world dose response as a function of impact magnitude, direction, location, and accumulation. This work is ongoing.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usz334","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T20:14:27Z","timestamp":1582143267000},"page":"190-196","source":"Crossref","is-referenced-by-count":14,"title":["Measuring Blunt Force Head Impacts in Athletes"],"prefix":"10.1093","volume":"185","author":[{"given":"Adam","family":"Bartsch","sequence":"first","affiliation":[{"name":"Prevent Biometrics, 4530 W 77th St, Suite 300, Edina, MN 55435"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajiv","family":"Dama","sequence":"additional","affiliation":[{"name":"Prevent Biometrics, 4530 W 77th St, Suite 300, Edina, MN 55435"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Alberts","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44190"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergey","family":"Samorezov","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44190"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Benzel","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44190"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Miele","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA 15213"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alok","family":"Shah","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Zablocki VA Center, 500 W National Ave, Milwaukee, WI 53295"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Humm","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Zablocki VA Center, 500 W National Ave, Milwaukee, WI 53295"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"McCrea","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Zablocki VA Center, 500 W National Ave, Milwaukee, WI 53295"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Stemper","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Zablocki VA Center, 500 W National Ave, Milwaukee, WI 53295"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"2021021901082165500_ref1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/JES.0b013e318201f53e","article-title":"Biomechanics of sport collision: quest for the elusive injury threshold","volume":"39","author":"Guskiewicz","year":"2011","journal-title":"Exerc Sport Sci Rev"},{"key":"2021021901082165500_ref2","volume-title":"Sports Related Concussions in Youth: Improving the Science, Changing the Culture","author":"Institute of Medicine and National Research Council Committee on Sports Related Concussion in Youth","year":"2014"},{"key":"2021021901082165500_ref3","doi-asserted-by":"crossref","DOI":"10.1115\/1.4026364","article-title":"The mechanics of traumatic brain injury: a review of what we know and what we need to know for reducing its societal burden","volume":"136","author":"Meaney","year":"2014","journal-title":"J Biomech Eng"},{"key":"2021021901082165500_ref4","doi-asserted-by":"crossref","first-page":"3059","DOI":"10.1016\/j.jbiomech.2015.07.026","article-title":"Accounting for sampling variability, injury under-reporting, and sensor error in concussion injury risk curves","volume":"48","author":"Elliott","year":"2015","journal-title":"J Biomech"},{"key":"2021021901082165500_ref5","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1007\/s10439-015-1420-6","article-title":"Laboratory validation of two wearable sensor systems for measuring head impact severity in football players","volume":"44","author":"Siegmund","year":"2016","journal-title":"Ann Biomed Eng"},{"issue":"5","key":"2021021901082165500_ref6","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1007\/s10439-014-1171-9","article-title":"Head rotational acceleration characteristics influence behavioral and diffusion tensor imaging outcomes following concussion","volume":"43","author":"Stemper","year":"2015","journal-title":"Ann Biomed Eng"},{"issue":"3","key":"2021021901082165500_ref7","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1007\/s11517-012-1004-7","article-title":"Experimentally validated three-dimensional finite element model of the rat for mild traumatic brain injury","volume":"51","author":"Lamy","year":"2013","journal-title":"Med Biol Eng Comput"},{"key":"2021021901082165500_ref8","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s10439-011-0402-6","volume":"40","author":"McAllister","year":"2012","journal-title":"Ann Biomed Eng"},{"issue":"6","key":"2021021901082165500_ref9","doi-asserted-by":"publisher","first-page":"e0199238","DOI":"10.1371\/journal.pone.0199238","article-title":"Comparison of video-based and sensor-based head impact exposure","volume":"13","author":"Kuo","year":"2018","journal-title":"PLoS One"},{"key":"2021021901082165500_ref10","article-title":"Common data elements (CDEs) for biomechanical devices used in blunt head impact and blast exposure dynamics: the National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH) and Department of Defense (DOD) version 1.0 recommendations","author":"Gay","journal-title":"Neurology"},{"key":"2021021901082165500_ref11","first-page":"1","article-title":"Validation of an \"Intelligent Mouthguard\" single event head impact dosimeter","volume":"58","author":"Bartsch","year":"2014","journal-title":"Stapp Car Crash J"},{"key":"2021021901082165500_ref12","article-title":"Development of a head impact monitoring \u201cIntelligent Mouthguard\u201d","author":"Hedin","year":"2016","journal-title":"IEEE Med Biol"},{"key":"2021021901082165500_ref13","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1227\/01.neu.0000318162.67472.ad","article-title":"Head impact severity measures for evaluating mild traumatic brain injury risk exposure","volume":"62","author":"Greenwald","year":"2008","journal-title":"Neurosurgery"},{"key":"2021021901082165500_ref14","doi-asserted-by":"publisher","first-page":"2918","DOI":"10.1016\/j.jbiomech.2016.07.00","article-title":"Bandwidth and sample rate requirements for wearable head impact sensors","volume":"49","author":"Wu","year":"2016","journal-title":"J Biomech."}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/Supplement_1\/190\/32524493\/usz334.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/Supplement_1\/190\/32524493\/usz334.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T00:16:16Z","timestamp":1613866576000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/185\/Supplement_1\/190\/5740721"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":14,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2020,2,19]]},"published-print":{"date-parts":[[2020,1,7]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usz334","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,1]]},"published":{"date-parts":[[2020,1]]}}}