Roe Kyle L, Giordano Katherine R, Ezzell Gary A, Lifshitz Jonathan
Department of Psychiatry, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, United States.
Phoenix Veteran Affairs Health Care System, Phoenix, AZ, United States.
JMIR Form Res. 2023 Mar 17;7:e39061. doi: 10.2196/39061.
Traumatic brain injury (TBI) is a disruption in normal brain function caused by an impact of external forces on the head. TBI affects millions of individuals per year, many potentially experiencing chronic symptoms and long-term disability, creating a public health crisis and an economic burden on society. The public discourse around sport-related TBIs has increased in recent decades; however, recognition of a possible TBI remains a challenge. The fencing response is an immediate posturing of the limbs, which can occur in individuals who sustain a TBI and can be used as an overt indicator of TBI. Typically, an individual demonstrating the fencing response exhibits extension in 1 arm and flexion in the contralateral arm immediately upon impact to the head; variations of forearm posturing among each limb have been observed. The tonic posturing is retained for several seconds, sufficient for observation and recognition of a TBI. Since the publication of the original peer-reviewed article on the fencing response, there have been efforts to raise awareness of the fencing response as a visible sign of TBI through publicly available web-based platforms, such as Twitter and Wikipedia.
We aimed to quantify trends that demonstrate levels of public discussion and awareness of the fencing response over time using data from Twitter and Wikipedia.
Raw Twitter data from January 1, 2010, to December 31, 2019, were accessed using the RStudio package academictwitteR and queried for the text "fencing response." Data for page views of the Fencing Response Wikipedia article from January 1, 2010, to December 31, 2019, were accessed using the RStudio packages wikipediatrend and pageviews. Data were clustered by weekday, month, half-year (to represent the American football season vs off-season), and year to identify trends over time. Seasonal regression analysis was used to analyze the relationship between the number of fencing response tweets and page views and month of the year.
Twitter mentions of the fencing response and Wikipedia page views increased overall from 2010 to 2019, with hundreds of tweets and hundreds of thousands of Wikipedia page views per year. Twitter mentions peaked during the American football season, especially on and following game days. Wikipedia page views did not demonstrate a clear weekday or seasonal pattern, but instead had multiple peaks across various months and years, with January having more page views than May.
Here, we demonstrated increased awareness of the fencing response over time using public data from Twitter and Wikipedia. Effective scientific communication through free public platforms can help spread awareness of clinical indicators of TBI, such as the fencing response. Greater awareness of the fencing response as a "red-flag" sign of TBI among coaches, athletic trainers, and sports organizations can help with medical care and return-to-play decisions.
创伤性脑损伤（TBI）是由外力撞击头部导致的正常脑功能中断。TBI每年影响数百万人，许多人可能会出现慢性症状和长期残疾，这构成了一场公共卫生危机，并给社会带来经济负担。近几十年来，围绕与运动相关的TBI的公众讨论有所增加；然而，识别可能的TBI仍然是一项挑战。击剑反应是肢体的一种即时姿势，可出现在遭受TBI的个体中，并可作为TBI的明显指标。通常，表现出击剑反应的个体在头部受到撞击后，立即会出现一侧手臂伸展而对侧手臂屈曲的情况；每个肢体的前臂姿势也存在变化。这种强直性姿势会持续数秒，足以用于观察和识别TBI。自从关于击剑反应的首篇经同行评审的文章发表以来，人们一直在努力通过推特和维基百科等公开的网络平台提高对击剑反应作为TBI明显迹象的认识。
我们旨在利用来自推特和维基百科的数据，量化随时间推移公众对击剑反应的讨论水平和认知程度的趋势。
使用RStudio包academictwitteR访问2010年1月1日至2019年12月31日的原始推特数据，并查询文本“击剑反应”。使用RStudio包wikipediatrend和pageviews访问2010年1月1日至2019年12月31日维基百科“击剑反应”文章的页面浏览量数据。数据按工作日、月份、半年（以代表美式橄榄球赛季与非赛季）和年份进行聚类，以确定随时间的趋势。使用季节性回归分析来分析击剑反应推文数量和页面浏览量与一年中的月份之间的关系。
从2010年到2019年，推特上对击剑反应的提及以及维基百科页面浏览量总体上有所增加，每年有数百条推文和数十万次维基百科页面浏览量。推特提及量在美式橄榄球赛季达到峰值，尤其是在比赛日当天及之后。维基百科页面浏览量没有呈现出明显的工作日或季节性模式，而是在不同月份和年份有多个峰值，1月的页面浏览量多于5月。
在此，我们利用来自推特和维基百科的公开数据证明，随着时间的推移，人们对击剑反应的认识有所提高。通过免费公共平台进行有效的科学传播有助于提高对TBI临床指标（如击剑反应）的认识。教练、运动训练师和体育组织对击剑反应作为TBI“警示信号”的认识提高，有助于医疗护理和重返赛场决策。
