Search

BackgroundGlobal surgery research efforts have been criticized for failure to transition from problem identification to intervention implementation. We developed a context-appropriate trauma quality improvement (TQI) bundle to ameliorate care gaps at a regional referral hospital in Cameroon. We determined associations between bundle implementation and improvement in trauma resuscitation practices.MethodsWe implemented a TQI bundle consisting of a hospital-specific trauma protocol, staff training, a trauma checklist, provision of essential emergency trauma supplies in the resuscitation area, and monthly quality improvement meetings. We compared trends in target process measures (e.g., frequency and timing of vital sign collection and primary survey interventions) in the six-month period pre- and post-bundle implementation using Wilcoxon rank-sum and Fisher's exact tests.ResultsWe compared 246 pre-bundle patients with 203 post-bundle patients. Post-bundle patients experienced a greater proportion of all vital signs collected compared to the pre-intervention cohort (0 % pre-bundle vs. 69 % post-bundle, p < 0.001); specifically, the proportion of respiratory rate (0.8 % pre-bundle vs. 76 % post-bundle, p < 0.001) and temperature (7 % pre-bundle vs. 91 % post-bundle, p < 0.001) vital sign collection significantly increased. The post-bundle cohort had vital signs measured sooner (74 % vital signs measured within 15 min of arrival pre-bundle vs. 90 % post-bundle, p < 0.001) and more frequently per patient (7 % repeated vitals pre-bundle vs 52 % post-bundle, p < 0.001). Key primary survey interventions such as respiratory interventions (1 % pre-bundle vs. 8 % post-bundle, p < 0.001) and cervical collar placement (0 % pre-bundle vs. 7 % post-bundle, p < 0.001) also increased in the post-bundle cohort.ConclusionsThe implementation of a context-appropriate TQI bundle was associated with significant improvements in previously identified trauma care deficits at a single regional hospital. Data-derived interventions targeting frontline capacity at the local level can bridge the gap between identifying care limitations and improvement in resource-limited settings.

Pain, detected by nociceptors, is an integral part of injury, yet whether and how it can impact tissue physiology and recovery remain understudied. Here, we applied chemogenetics in mice to locally activate dermal TRPV1 innervations in naive skin and found that it triggered new regenerative cycling by dormant hair follicles (HFs). This was preceded by rapid apoptosis of dermal macrophages, mediated by the neuropeptide calcitonin gene-related peptide (CGRP). TRPV1 activation also triggered a macrophage-dependent induction of osteopontin (Spp1)-expressing dermal fibroblasts. The neuropeptide CGRP and the extracellular matrix protein Spp1 were required for the nociceptor-triggered hair growth. Finally, we showed that epidermal abrasion injury induced Spp1-expressing dermal fibroblasts and hair growth via a TRPV1 neuron and CGRP-dependent mechanism. Collectively, these data demonstrated a role for TRPV1 nociceptors in orchestrating a macrophage and fibroblast-supported mechanism to promote hair growth and enabling the efficient restoration of this mechano- and thermo-protective barrier after wounding.

BACKGROUND: Audit and Feedback (A&F) interventions based on quality indicators have been shown to lead to significant improvements in compliance with evidence-based care including de-adoption of low-value practices (LVPs). Our primary aim was to evaluate the cost-effectiveness of adding a hypothetical A&F module targeting LVPs for trauma admissions to an existing quality assurance intervention targeting high-value care and risk-adjusted outcomes. A secondary aim was to assess how certain A&F characteristics might influence its cost-effectiveness. METHODS: We conducted a cost-effectiveness analysis using a probabilistic static decision analytic model in the Québec trauma care continuum. We considered the Québec Ministry of Health perspective. Our economic evaluation compared a hypothetical scenario in which the A&F module targeting LVPs is implemented in a Canadian provincial trauma quality assurance program to a status quo scenario in which the A&F module is not implemented. In scenarios analyses we assessed the impact of A&F characteristics on its cost-effectiveness. Results are presented in terms of incremental costs per LVP avoided. RESULTS: Results suggest that the implementation of A&F module (Cost = $1,480,850; Number of LVPs = 6,005) is associated with higher costs and higher effectiveness compared to status quo (Cost = $1,124,661; Number of LVPs = 8,228). The A&F module would cost $160 per LVP avoided compared to status quo. The A&F module becomes more cost-effective with the addition of facilitation visits; more frequent evaluation; and when only high-volume trauma centers are considered. CONCLUSION: A&F module targeting LVPs is associated with higher costs and higher effectiveness than status quo and has the potential to be cost-effective if the decision-makers willingness-to-pay is at least $160 per LVP avoided. This likely represents an underestimate of true ICER due to underestimated costs or missed opportunity costs. Results suggest that virtual facilitation visits, frequent evaluation, and implementing the module in high-volume centers can improve cost-effectiveness.

Lumbar intervertebral disc herniation, as a leading cause of low back pain, productivity loss, and disability, is a common musculoskeletal disorder that results in significant socioeconomic burdens. Despite extensive clinical and basic scientific research efforts, herniation etiopathogenesis, particularly its initiation and progression, is not well understood. Understanding herniation etiopathogenesis is essential for developing effective preventive measures and therapeutic interventions. Thus, this review seeks to provide a thorough overview of the advances in herniation-oriented research, with a discussion on ongoing challenges and potential future directions for clinical, translational, and basic scientific investigations to facilitate innovative interdisciplinary research aimed at understanding herniation etiopathogenesis. Specifically, risk factors for herniation are identified and summarized, including familial predisposition, obesity, diabetes mellitus, smoking tobacco, selected cardiovascular diseases, disc degeneration, and occupational risks. Basic scientific experimental and computational research that aims to understand the link between excessive mechanical load, catabolic tissue remodeling due to inflammation or insufficient nutrient supply, and herniation, are also reviewed. Potential future directions to address the current challenges in herniation-oriented research are explored by combining known progressive development in existing research techniques with ongoing technological advances. More research on the relationship between occupational risk factors and herniation, as well as the relationship between degeneration and herniation, is needed to develop preventive measures for working-age individuals. Notably, researchers should explore using or modifying existing degeneration animal models to study herniation etiopathogenesis, as such models may allow for a better understanding of how to prevent mild-to-moderately degenerated discs from herniating.

BACKGROUND: Lumbar spine pathology (LSP) is a common source of low back or leg pain, and paraspinal muscle in these patients demonstrates fatty and fibrotic infiltration, and cellular degeneration that do not reverse with exercise-based rehabilitation. However, it is unclear of this lack of response is due to insufficient exercise stimulus, or an inability to mount a growth response. The purpose of this study was to compare paraspinal muscle gene expression between individuals with LSP who do and do not undergo an acute bout of resistance exercise. METHODS: Paraspinal muscle biopsies were obtained from 64 individuals with LSP undergoing spinal surgery. Eight participants performed an acute bout of machine-based lumbar extension resistance exercise preoperatively. Gene expression for 42 genes associated with adipogenic/metabolic, atrophic, fibrogenic, inflammatory, and myogenic pathways was measured, and differential expression between exercised and non-exercised groups was evaluated for (a) the full cohort, and (b) an age, gender, acuity, and etiology matched sub-cohort. Principal components analyses were used to identify gene expression clustering across clinical phenotypes. RESULTS: The exercised cohort demonstrated upregulation of inflammatory gene IL1B, inhibition of extracellular matrix components (increased MMP3&9, decreased TIMP1&3, COL1A1) and metabolic/adipogenic genes (FABP4, PPARD, WNT10B), and downregulation of myogenic (MYOD, ANKRD2B) and atrophic (FOXO3) genes compared to the non-exercised cohort, with similar patterns in the matched sub-analysis. There were no clinical phenotypes significantly associated with gene expression profiles. CONCLUSION: An acute bout of moderate-high intensity resistance exercise did not result in upregulation of myogenic genes in individuals with LSP. The response was characterized by mixed metabolic and fibrotic gene expression, upregulation of inflammation, and downregulation of myogenesis.

BACKGROUND: Interpersonal violence is a leading cause of morbidity, with potentially severe adverse consequences for the mental health of the injured persons. The extent to which violent injury is associated with subsequent suicidal behavior, however, remains unclear. This study aimed to examine how violent injury was associated with subsequent deliberate self-harm and death by suicide. METHODS: This retrospective cohort study used nationwide longitudinal registry data from Norway to identify all individuals presenting to emergency services in 2010-2018 with a violence-related injury, along with sex- and age-matched control individuals from the general population. The primary outcomes were any emergency visit for deliberate self-harm (DSH) and suicide death, observed through 31 December 2018. Rates of each outcome were compared between violence-injured patients and comparison individuals using stratified multivariable Cox regression models, controlling for sociodemographic characteristics as well as history of psychiatric treatment and DSH. Secondary analyses tested for moderation by sex, age, and prior psychiatric treatment. FINDINGS: Violence-injured patients (n = 28,276) had substantially higher rates of DSH (946.7 per 100,000 person-years) and suicide death (74.5 per 100,000) when compared to controls (n = 282,760; 90.0 and 15.2 per 100,000, respectively). The hazard ratios (HRs) remained significantly higher even after accounting for covariates (HRadj for DSH: 5.11; 95% CI: 4.62, 5.66; HRadj for suicide: 2.40; 95% CI: 1.78, 3.24). Sex differences in this association were negligible, but the association between violence injury and DSH increased with age. Violence-injured patients with prior psychiatric treatment had the highest risk of suicidal behavior. INTERPRETATION: Violence-injured patients experience significantly excess rates of suicidal behavior, a finding with potential to inform both clinical intervention and population-level suicide prevention strategies. FUNDING: Fulbright Norway Scholarship.

Background: The National Hockey League (NHL) saw an unprecedented disruption to the competitive calendar due to the COVID-19 pandemic in March of 2020. Returning to play following an abrupt cessation of activity is a known risk factor for athletes. Purpose: To analyze the occurrence and severity of events (injury and illness) in the NHL and to understand any differences in occurrence and severity between pre-pandemic seasons and seasons that immediately followed. Study Design: Descriptive Epidemiology Study Methods: Using a retrospective cohort inclusive of all players on active rosters in the NHL between 2016-2023, public access injury and illness data were collected. Outcome measures included event incidence, period prevalence, and severity (mean days lost; MDL), as well as incidence rate ratio (IRR) comparing pre- and post-pandemic seasons. Results: IRR for illness peaked in December 2021 (IRR = 62.46; 95% CI 13.65 to 285.91). Incidence of upper body injuries was significantly higher in 2020-21 (IRR = 1.70, p = 0.001) and 2021-22 (IRR = 1.40, p = 0.044) compared to pre-pandemic seasons (Incidence = 17.58 injuries / 1000 player-hours). Injury incidence increased as the 2022-23 season progressed (p = 0.004); injury incidence was stable across all other seasons. Mean days lost (MDL) to injury was higher in 2020-21 (MDL = 18.12, p < 0.001), 2021-22 (MDL = 18.46, p = 0.015), and 2022-23 (MDL = 18.12, p < 0.001) compared to pre-pandemic seasons (MDL = 17.34). Conclusion: Incidence of upper body injuries increased in the 2020-21 and 2021-22 NHL regular seasons while it decreased significantly in the 2022-23 regular season compared with the four pre-pandemic seasons. This suggests a need to examine if modifiable risk factors exist for determining optimal return to play strategies following an abrupt cessation of play. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

Background and Purpose: The prevalence of arm pain in youth baseball players is high with approximately half reporting arm pain during the season, and the number of ulnar collateral ligament reconstructions in youth baseball players is increasing. Few studies have examined the relationship between shoulder strength and passive range of motion (ROM) with arm pain (either shoulder or elbow pain) during throwing, especially in athletes in early adolescence. The purpose of this study was to determine the relationship between shoulder ROM and strength and the presence of arm pain during throwing in youth baseball players. It was hypothesized that less internal rotation (IR) ROM, less total rotational ROM, and lower IR and external rotation (ER) strength would be associated with arm pain. Study Design: Observational cohort study Methods: Sixty-five youth male baseball players between the ages of 12-15 were enrolled. Shoulder strength (ER, IR, ER/IR strength ratio, scaption) and passive ROM (ER, IR, flexion, horizontal adduction) were collected prior to the start of the spring 2021 baseball season. Players self-reported their arm pain frequency during throwing as never, rarely, sometimes, often, or always. The relationship between reported arm pain frequency during throwing and shoulder ROM and strength measurements was examined. Results: ER (ρ= -0.289, p=0.020) and IR strength (ρ= -0.262, p=0.035) were weakly and negatively correlated with reports of arm pain during throwing. No other clinical variables were associated with reports of arm pain (p ≥ 0.124) Conclusion: In youth baseball players, greater IR and ER strength were associated with less arm pain frequency during throwing, while ROM was not associated with arm pain frequency. Future research should explore these variables prospectively to determine if changes in ROM and strength are related to the development of arm pain in youth baseball players. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

Background: There is a large population of young athletes who participate in gymnastics, and the prevention of injury in junior athletes is considered important. However, few studies have prospectively investigated the relationship between physical factors and the occurrence of injury. Purpose: To investigate the physical characteristics that are factors in the injury occurrence in elementary and junior high school gymnasts. Study Design: Prospective observational study. Methods: A total of 36 healthy young gymnasts (at national competition level) were enrolled in the study. Once a week for 23 weeks, injuries were prospectively investigated using self-report questionnaires under the supervision of a research staff. Joint range of motion (hip, ankle, shoulder, and wrist), tightness (Thomas test, Ely test, straight leg raise [SLR], triceps surae, combined abduction test [CAT], horizontal flexion test [HFT]), and muscle elasticity (multifidus) were assessed to compare differences in physical function between injured and non-injured participants. Results: Injuries occurred most commonly in the wrist (42.1%), lower back (30.2%), and foot (9.5%) among males, whereas heel (22.2%), knee (16.0%), and lower back (12.8%) were the most common injury sites among females. Wrist injuries in male athletes showed decreased shoulder joint range of motion, and lower back injuries showed decreased hip and shoulder joint range of motion. Lower back injuries in female athletes showed decreased hip extension mobility. Heel and knee joint injuries in females also showed increased range of motion and decreased tightness. Conclusions: The results of this study indicate that the factors related to flexibility differ according to injury location. Further studies are required to clarify the physical factors that influence injury occurrence by examining the effects of the gymnasts' muscle strength, age, individual factors, and left–right differences. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Despite high burden, significantly less is known about non-fatal drowning. • Using data linkage, cases of non-fatal drowning from the pre-hospital setting were analysed. • For every one drowning fatality, 15 non-fatal drownings were attended by ambulance. • Despite lower fatalities, drowning burden among adolescents and females is revealed when analysing non-fatal drowning data. • Results indicate a need to widen primary prevention efforts across population groups. Introduction : Drowning is a preventable cause of mortality, with 279 unintentional drowning deaths per year in Australia. Despite larger estimated numbers, less is known about nonfatal drowning compared to fatalities. This study aimed to examine the burden of fatal and nonfatal drowning in the Australian state of New South Wales using pre-hospital case capture. Methods: A cross-sectional analysis of individuals attended by an ambulance in NSW for drowning between 2010 and 2021 was conducted. Ambulance data (paper-based and electronic medical records) were linked to emergency department and death registry. Ratios of fatal to nonfatal drowning were constructed overall, by sex, age, and remoteness of incident and residential locations. Results: 3,973 ambulance-attended drowning patients were identified (an annual rate of 4.16/100,000 persons). Six percent (6.1%; n = 243) died within 30 days, 82.7% (n = 201) of which died on the day of incident, including at the scene. Mean survival time for those who died between 2 and 30 days was 4.6 days. The overall ratio of fatal to nonfatal incidents was 1:15. Ratios were highest for 10–19 year-olds (1:77), females (1:22), and in metropolitan incident (1:20) and residential (1:23) locations. Across the study drowning declined by 14 incidents and 0.18 fatalities per year. Discussion: Temporal trends indicate declining drowning incidents and fatalities. However, this study highlights significant numbers of nonfatal incidents among those traditionally seen as lower risk, such as adolescents and females, necessitating a widened focus on improving water safety among these groups. Conclusions: Nonfatal drowning results in significant, yet preventable health system burden in New South Wales. Practical Applications: This study highlights the importance of documenting the full burden of drowning, including health system impacts of a preventable cause of injury and death. Such data may be used to encourage further investment in primary prevention efforts. [ABSTRACT FROM AUTHOR]

Background: Fencing is a unique and increasingly popular sport, but limited data exist regarding related injuries. Purpose: To examine the types of injuries incurred by fencing athletes, and to analyze associations between age, sex, and hand dominance with type and location of injury. Study Design: Cross-sectional Methods: Retrospective chart reviews were performed to evaluate fencing related injuries in athletes evaluated in the sports medicine and orthopedic clinics of a large teaching hospital. Results: One hundred and eighty-six patients (98 male, 88 female) were included. Average age at time of injury was 14.6 years (range 9 - 32 years). 73% of injuries involved the lower extremity, 16% involved the upper extremity and 10% affected the back. In the lower extremity, the knee (49%), ankle (16%) and hip (11%) were most commonly affected. 80% of injuries were treated with physical therapy. Only 5% required surgical intervention. Injuries of both upper and lower extremities were more commonly seen on the athlete's dominant side, and the majority of injuries (77%) occurred in athletes 13 years or older. Conclusion: The majority of injuries in these fencing athletes affected the lower extremity, most commonly the knee. Extensor mechanism dysfunction, primarily patellofemoral pain, was the most common diagnosis. Hand dominance, patient age, and patient sex did affect different injury characteristics. Level of Evidence: 2b [ABSTRACT FROM AUTHOR]

Objective: To determine the incidence rates (IRs) of catastrophic injuries and exertional medical events in lacrosse athletes. Methods: Catastrophic injuries and exertional medical events in lacrosse in the US among youth or amateur, high school and college athletes were analysed from the National Center for Catastrophic Sport Injury Research (NCCSI R) database from 1982/83 to 2019/20. Frequencies, IRs per 100,000 athlete-seasons (AS) with 95% confidence intervals (CIs), and incidence rate ratios (IRRs) with 95% CIs were calculated. Participation data were gathered from the National Federation of State High School Associations (NFHS), National Collegiate Athletic Association (NCAA) and USA Lacrosse. Results: Sixty-nine catastrophic events (16 youth or amateur, 36 high school and 17 college; 84% male) occurred in US lacrosse from 7/1/1982 to 6/30/2020. Thirty-six percent of all incidents were fatal. The overall IR was 0.5 per 100,000 AS (95% CI: 0.4-0.7). There were 15 cases of non-traumatic sudden cardiac arrests (SCA s) and 15 incidents of commotio cordis. Fatality rates from SCA and commotio cordis decreased 95% (IRR = 0.05; 95% CI: 0, 0.2) from 1982/83-2006/07 to 2007/08-2019/20. Incidence rates were higher for collegiate versus high school 1982/83-2019/20 (IRR = 3.2; 95% CI: 1.8, 5.7) and collegiate versus youth 2005/06-2019/20 (IRR = 8.0; 95% CI: 3.0, 21.4) level. Contact with a stick or ball (41%) and contact with another player (20%) were the primary mechanisms of injury. Conclusions: The incidence of catastrophic events during lacrosse was higher among collegiate than high school or youth athletes. SCA from an underlying cardiac condition or from commotio cordis was the most common catastrophic event. Fatality rates from catastrophic injuries have declined significantly over the study period, perhaps driven by protective measures adopted by lacrosse governing bodies. [ABSTRACT FROM AUTHOR]

Background: The optimal treatment for anterior cruciate ligament (ACL) injuries with early-stage symptomless osteoarthritis (OA) remains unclear. This study aimed to compare the clinical outcomes of ACL reconstruction (ACLR) in patients with ACL injury in the presence and absence of early-stage symptomless OA. Methods: Medical records of patients with early-stage symptomless OA who sustained ACL injury and underwent ACLR from January 2018 to December 2020 at a single institution were retrospectively reviewed. Radiography and magnetic resonance imaging were performed preoperatively to identify ACL injury and OA. Patients with ACL injury and early-stage symptomless OA (combined group, n = 14) were matched at a 1:2 ratio with patients with ACL injury (isolated group, n = 32). Data on demographic characteristics, pain and functional outcomes (visual analogue scale, Tegner, Lysholm, and International Knee Documentation Committee scores and range of motion), and imaging outcomes were collected. Complications were recorded, and outcomes were compared between the groups. Results: Forty-six patients (26 males, 20 females) were included in this study, among whom 14 had ACL injury and early-stage symptomless OA, whereas 32 sustained isolated ACL injury (average follow-up duration: 3.4 ± 1.0 years). At the final follow-up, pain and functional outcomes similar to those in patients with isolated ACL-deficient knees were achieved in the combined group; acute-stage ACLR resulted in significantly better outcomes (p < 0.05). No significant radiographic progression of OA or complications were observed. Conclusions: Knee function in patients with ACL injuries and early-stage symptomless OA who underwent ACLR was the same as that in patients with isolated ACL-deficient knees. Furthermore, ACLR had a beneficial effect on knee outcomes. The subgroup analysis revealed that acute-stage ACLR could lead to better outcomes in patients with ACL injuries and early-stage symptomless OA. [ABSTRACT FROM AUTHOR]

To analyze the causes, locations, associated injuries, and relevant factors of lower limb and pelvic fractures in hospitalized children in China to provide a theoretical basis for reducing the incidence of such fractures. A retrospective analysis of children with lower limb and pelvic fractures admitted to 27 tertiary children's hospitals affiliated with China's Futang Research Center of Pediatric Development between December 1, 2015, and December 31, 2019, was conducted. Inpatient cases were analyzed in the following age groups: Infants (< 2 years), Preschool children (2–5 years), School children (6–11 years), and Adolescents (12–18 years). This study included 10,808 pediatric patients (7152 males, 3656 females). The proportion of preschool children of lower limb and pelvic fractures was the highest. The 10,808 patients sustained a total of 14,398 fractures. The shafts of the femur, tibia, and fibula, the distal tibia, distal fibula, and the pelvis were the six most common locations. Of the 734 pelvic fractures in children and adolescents, the top three locations were the ilium, pubic bone, and the ischium. Of the total patients, 9599 underwent surgery, while 1209 received non-surgical treatment. The three most common causes of pediatric lower limb and pelvic fractures were falling over, traffic accidents, and falling from a height. Among the 1806 concomitant traumas, respiratory traumas was the most common, mainly pulmonary contusion. The most common concomitant traumas of nervous, digestive and urinary system were scalp hematoma, liver injury and kidney injury respectively. The analysis of the location, age, causes, and concomitant injuries of lower limb and pelvic fractures showed that the most common fracture requiring hospitalization was tibia fracture, which was most common in preschool children. The most common cause of injury in preschool children was traffic accident. In addition, children are susceptible to accidental injuries from multiple sources in life, which can cause serious consequences of multi-system injuries. [ABSTRACT FROM AUTHOR]

Introduction: The global burden of injury is huge, falling disproportionately on poorer populations. The benefits of qualitative research in injury care are recognised and its application is growing. We used a novel application of focus group discussions with photovoice to rapidly assess barriers at each of three delay stages; seeking (delay-1), reaching (delay-2) or receiving (delay-3) injury care in Northern Malawi. Methods: Three community Focus Group Discussions (FGDs) of individuals with (FGD1) and without (FGD2) recent injury experience and community leaders (FGD3) discussed barriers to seeking, reaching or receiving care following injury. Participants from FGD1 subsequently used a digital camera and, following training in photovoice, took photographs illustrating barriers to injury care. Participants reconvened to discuss images which they believed illustrated important barriers. A framework method analysis compared barriers generated to those identified by an earlier Delphi study. Results: Seven of eight invited adult community members attended each discussion group. Within the FGDs, all prior Delphi derived delay 1 barriers were described. Within delay 2, all but three were discussed by community participants. Those not covered were: 1) "communication" ;2) "prehospital care"; 3) "coordination". Within Delay 3, only "capacity"was not highlighted by participants during the study. Additional health system barriers not identified in the Delphi were inductively derived. Within Delay 1, these were labelled; "religious or other beliefs"; "indecision"; "fear or lacking courage"; and "community/bystander engagement". Within Delay 2, "lack of assistance" was derived. Within Delay 3; "alleged corruption"; "interfacility transfer"; and "police processes" were all identified during analysis. The photovoice group provided 21 photographs evidencing 15 barriers. Delay 1 was the most frequently captured by images (12/21).The individual barriers most frequently described were "transport" and "roads" (6/21 and 5/21, respectively). The photovoice group did not describe any additional barriers not covered in the prior FGDs. Conclusion: We identified several barriers within this health system. Participants illustrated how some barriers impact on multiple phases of delay. The method was quick, low cost and participants grasped the technique and research question effectively. We recommend this approach for future health system assessments. [ABSTRACT FROM AUTHOR]

Background: Most studies on injuries of professional dancers used a medical-attention and/or time-loss definition and did not analyse all health problems. Further, almost all studies included just one company. The aim was to analyse all self-reported health problems of professional ballet and contemporary dancers during one season and compare sexes and five companies in Germany. Methods: Dancers of five professional companies completed weekly health questionnaires during the season (September 2022 to June 2023). Numerical rating scales were used for severity of all health problems, musculoskeletal pain, impairment of the ability to dance at full potential, physical and mental workload in the previous seven days. If the severity of all health problems were rated greater than "0", the dancers were asked to report the type and consequences of their most severe health problem. Results: During 43 weeks, 98 dancers (39.8% male) completed 3123 weekly reports (response rate 74.1%). The season prevalence of any health problem was 100% and of time-loss health problems 74.5%. The average weekly prevalence of any health problem was 62.7%, of musculoskeletal pain 83.4% and of impaired ability to dance at full potential, due to health problem 48.6%. While the season prevalence and type of health problems was similar between sexes, the average weekly prevalence of severe health problems was higher in female than in male dancers (Chi2 = 23.2; p <.001), and female dancers saw a qualified health professional more often than male dancers (Chi2 = 19.5; p <.001). Companies differed in almost all investigated variables, with more health problems in companies where more dancers rated their workload higher than "ideal". Conclusion: Health problems are frequent in professional dancers and affect their ability to dance. Future studies should analyse the impact of physical and mental workload on health problems. Key Points: • Professional dancers reported a health problem more often than in every second week (63%). Almost two thirds of the dancers (n = 63, 64.3%) reported a severe health problem and three quarters (n = 73, 74.5%) felt unable to dance due to a health problem at least one day during the season. • The season prevalence of health problems was similar in female and male dancers, however the average weekly prevalence of severe health problems was higher in female than in male dancers, and female dancers saw a qualified health professional more often than male dancers. • Companies differed significantly in the average weekly prevalence of health problems and the average severity rating of health problems during the season. Health problems were more frequent and more severe in companies where more dancers rated their workload higher than "ideal". [ABSTRACT FROM AUTHOR]

Pain, detected by nociceptors, is an integral part of injury, yet whether and how it can impact tissue physiology and recovery remain understudied. Here, we applied chemogenetics in mice to locally activate dermal TRPV1 innervations in naive skin and found that it triggered new regenerative cycling by dormant hair follicles (HFs). This was preceded by rapid apoptosis of dermal macrophages, mediated by the neuropeptide calcitonin gene-related peptide (CGRP). TRPV1 activation also triggered a macrophage-dependent induction of osteopontin (Spp1)-expressing dermal fibroblasts. The neuropeptide CGRP and the extracellular matrix protein Spp1 were required for the nociceptor-triggered hair growth. Finally, we showed that epidermal abrasion injury induced Spp1-expressing dermal fibroblasts and hair growth via a TRPV1 neuron and CGRP-dependent mechanism. Collectively, these data demonstrated a role for TRPV1 nociceptors in orchestrating a macrophage and fibroblast-supported mechanism to promote hair growth and enabling the efficient restoration of this mechano- and thermo-protective barrier after wounding. [Display omitted] • Activation of cutaneous TRPV1 innervations accelerated hair growth in naive skin • TRPV1 activation induced a rapid apoptosis of dermal macrophages via CGRP • TRPV1 activation triggered the expansion of Spp1-expressing dermal fibroblasts • TRPV1, CGRP, and Spp1 expression control hair regrowth after skin abrasion Ben-Shaanan et al. demonstrate a cellular pathway causally connecting pain-mediating cutaneous TRPV1 innervations with accelerated hair growth in naive skin, as well as hair regrowth after epidermal abrasion. This cellular pathway involves dermal macrophage apoptosis triggered by the neuropeptide CGRP, followed by a macrophage-dependent increase in the frequency of fibroblasts expressing the hair growth-promoting factor Spp1. [ABSTRACT FROM AUTHOR]

The gastrocnemius muscle plays a crucial role in transmitting and generating energy during standing explosive accelerations, and as a consequence, is a muscle with high injury prevalence, especially the medial gastrocnemius (MG). This study aimed to compare the neuromuscular activation of the lateral gastrocnemius (LG) and MG during one of the most common standing explosive accelerations performed in team sports—the false start that occurs in jumps where the leg steps back before moving forward. Forty-two physically active participants (34 males: age = 24 ± 5 years, body mass = 73 ± 10.4 kg; and 8 females: age = 26 ± 5 years, body mass = 57.1 ± 6.8 kg) underwent electromyography analysis of the MG and LG in the four first foot contacts of standing explosive acceleration. The results showed that the third contact differed significantly from others (LG vs. MG: 76.48 ± 3.10 vs. 66.91 ± 2.25, p = 0.01, ES = 0.5), with the LG exhibiting earlier activation and higher peak sEMG activity compared to the MG (LG vs. MG: 0.12 ± 0.01 vs. 0.13 ± 0.01, p = 0.02, ES = 0.4). Additionally, the MG displayed longer duration contractions in all the foot contacts except the third foot contact. In conclusion, the MG showed an earlier activation timing and a longer duration of contraction than the LG in the first foot contact. Additionally, the third foot contact showed a different pattern of neuromuscular activation between the MG and LG compared to the rest of the foot contacts. [ABSTRACT FROM AUTHOR]

Experimental and clinical studies have clearly demonstrated significant sex differences in myocardial structure and function, both under physiological and pathological conditions. The best example are significant sex differences in the cardiac tolerance to ischemia/reperfusion injury: pre-menopausal adult female hearts are more resistant as compared to the male myocardium. The importance of these findings is supported by the fact that the number of studies dealing with this issue increased significantly in recent years. Detailed molecular and cellular mechanisms responsible for sex differences are yet to be elucidated; however, it has been stressed that the differences cannot be explained only by the effect of estrogens. In recent years, a promising new hypothesis has been developed, suggesting that mitochondria may play a significant role in the sex differences in cardiac tolerance to oxygen deprivation. However, one is clear already today: sex differences are so important that they should be taken into consideration in the clinical practice for the selection of the optimal diagnostic and therapeutic strategy in the treatment of ischemic heart disease. The present review attempts to summarize the progress in cardiovascular research on sex-related differences in cardiac tolerance to oxygen deprivation during the last 40 years, i.e. from the first experimental observation. Particular attention was paid to the sex-related differences of the normal heart, sex-dependent tolerance to ischemia-reperfusion injury, the role of hormones and, finally, to the possible role of cardiac mitochondria in the mechanism of sex-dependent differences in cardiac tolerance to ischemia/reperfusion injury. [ABSTRACT FROM AUTHOR]

• Running/training characteristics and health and lifestyle factors, along with morphological and biomechanical aspects, show large effect sizes in increasing the risk for running-related injuries (RRIs). • The review highlights methodological issues in the design, conduction, and reporting of the included systematic reviews, indicating the need for higher quality studies. • Most primary studies and systematic reviews did not focus on specific injuries, complicating the identification of distinct risk factors associated with each injury type. • Biomechanical factors were the main focus of existing meta-analyses, but evidence remains insufficient to conclusively identify biomechanical risk factors. This umbrella systematic review (SR) of SRs and meta-analysis seeks to comprehensively synthesize existing literature to identify and consolidate the diverse range of risk factors contributing to running-related injuries (RRIs). Systematic searches were conducted on June 28, 2023, across Web of Science, SPORTDiscus, Scopus, PubMed, and Cochrane Library. We included SRs, whether accompanied by meta-analyses or not, that focused on investigating risk factors for RRIs within observational studies. The methodological quality of the SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews II. To assess the extent of overlap across reviews, the corrected covered area metric was calculated. From 1509 records retrieved, 13 SRs were included. The degree of overlap between SRs was low (4%), and quality varied from critically low (n = 8) to low (n = 5). Two hundred seven outcomes assessed in 148 primary studies were identified as being associated with the occurrence of RRIs. The effect sizes of the associations for which risk measures were reported (n = 131) were classified as large (n = 30, 23%), medium (n = 38, 29%), small (n = 48, 37%) or no effect (n = 15, 11%). Running/training characteristics, health and lifestyle factors, along with morphological and biomechanical aspects, exhibit large effect sizes in increasing the risk for RRIs. Drawing from the outcomes of the low-quality SRs and associations with large effect sizes, our findings indicate that running/training characteristics and health and lifestyle factors, as well as morphological and biomechanical aspects, are all implicated in elevating the risk of RRIs, emphasizing the multifactorial basis of injury incidence in running. Given the low quality and heterogeneity of SR, individual findings warrant cautious interpretation. [Display omitted] [ABSTRACT FROM AUTHOR]

Recently, star pitchers in Major League Baseball (MLB) have faced devastating elbow injuries, causing some to question whether implementation of the MLB pitch clock during the 2023 season has led to a higher rate of elbow injuries among pitchers. This study aims to determine if implementation of the MLB pitch clock in the 2023 MLB season affected the injury rate in pitchers. Injury data was collected for the 2021, 2022, and 2023 MLB seasons using the fangraphs.com injury database. Incidence rate ratio was calculated to compare the injury rate for the 2023 season to the 2021 and 2022 seasons. A z-test for proportions was used to determine significance levels. The 2023 season showed a decrease in the rate of the total number of injuries when compared to the 2021 (P = 0.01) and 2022 (P = 0.02) seasons. There was no statistical difference in the rate of Tommy John Surgery, Flexor Tendon Injuries, or other cause elbow injuries. Following implementation of the MLB pitch clock during the 2023 season, the total number of injuries decreased, but there was no change in the rate of elbow injuries in pitchers compared with the 2021 and 2022 MLB seasons. Future studies are needed to determine if the pitch clock has a longitudinal effect on injuries. [ABSTRACT FROM AUTHOR]

Background: In 2022, Major League Baseball (MLB) implemented the universal designated hitter (DH) rule, thus allowing the pitcher to focus solely on defense while the DH, who bats for the pitcher, focuses solely on offense. Purpose/Hypothesis: The purpose of our study was to determine if implementation of the universal DH rule affected the incidence of injuries in MLB pitchers when compared with before implementation. It was hypothesized that the shift to the universal DH rule would be associated with a decrease in the rate of offense-related pitcher injuries. Study Design: Descriptive epidemiology study. Methods: Using publicly available data, we identified injuries sustained by MLB pitchers during the 2021 (before the DH rule change) and 2022 (after the rule change) regular seasons. Pitchers placed on the injured list for non–gameplay related reasons were excluded. Statistical analysis was performed with the chi-square and independent t tests. Results: The injury incidence rate decreased significantly from before to after the rule change for MLB pitchers overall (from 6.58 to 5.60 injuries/1000 athlete game-exposures [AGE]; P =.02) and for National League pitchers (from 7.62 to 6.26 injuries/1000 AGE; P =.04). No significant changes were seen in American League pitchers (P =.20). Injury locations that decreased from before to after the rule change were the thigh (from 0.52 to 0.21 injuries/1000 AGE; P =.003) and the hand/finger/wrist (from 0.63 to 0.30 injuries/1000 AGE; P =.01). Total time lost decreased from 9471 days before the rule change to 8857 days after the rule change (P =.00001). Conclusion: Implementation of the universal DH rule was associated with a decrease in pitcher injuries overall and within the National League. Injuries to the thigh and hand/finger/wrist also decreased overall and within the National League. Furthermore, total days lost decreased from before to after the rule change. These findings may be due to the elimination of offensive gameplay requirements for pitchers, which highlights a positive consequence of the universal DH rule, but further studies are needed. [ABSTRACT FROM AUTHOR]

Background: The updated Oslo Sports Trauma Research Questionnaire on Health Problems (OSTRC-H2) has been translated into a limited set of languages and lacks full validation of its new measures. Purpose: To (1) translate, cross-culturally adapt, and evaluate the measurement properties of the OSTRC-H2 for the Slovenian population and (2) investigate the construct validity for the severity score and time lost due to a health problem. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: The OSTRC-H2 was translated from English to Slovenian (OSTRC-H2-SLO) according to international guidelines. A 15-week study was conducted among 188 elite athletes, with a test-retest performed in the 10th week. Internal consistency, reliability, content validity, feasibility, and potential ceiling effects were investigated. Internal consistency was measured using the Cronbach alpha coefficient, while reliability was measured with the intraclass correlation coefficient (ICC). Construct validity was measured with the Spearman rank correlation coefficient (r S). Results: There was a 95% response rate and an 18% mean weekly prevalence of health problems. The OSTRC-H2-SLO showed excellent test-retest reliability (ICC, 0.94 [95% CI, 0.67-0.99]), with a Cronbach α of.93. A strong positive correlation was found between the OSTRC-H2-SLO severity score and days lost due to an acute injury (r S = 0.754), overuse injury (r S = 0.785), and illness (r S = 0.894) (P <.001 for all). Moderate to strong negative correlations were observed between severity score and total load (training and competition load in hours) as well as between days lost and total load (P <.001 for all). Conclusion: The OSTRC-H2-SLO was found to be valid, reliable, and well accepted among Slovenian athletes. The authors confirmed the questionnaire's construct validity and identified total load as an indicator of an increase in the severity score. Registration: NCT05471297 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

This report demonstrates the safety and efficacy of sacrificing a ruptured vertebral artery (VA) due to an air rifle pellet gunshot injury. A 15-year-old male was admitted with a gunshot wound to the neck. He was initially treated at Madiun General Hospital before referral. He exhibited stable vital signs and no neurological deficits. Imaging revealed a pellet in the right transverse foramen of the fifth cervical vertebra, causing a pseudoaneurysm of the right common carotid artery and occlusion followed by rupture of the right VA, with a patent left VA. Open surgery extracted the pellet, and a coil occlusion of the right VA was performed to control bleeding. The case underscores the importance of interdisciplinary collaboration and thorough examination in managing complex injuries, highlighting the safety of sacrificing a ruptured unilateral VA. [ABSTRACT FROM AUTHOR]

Background: Hamstring (HS) strength deficits and imbalances have been identified as risk factors for sustaining anterior cruciate ligament (ACL) injuries and muscular strains, with HS injuries being the most prevalent muscle injuries in soccer athletes. The aim of this study was to investigate HS eccentric strength before and after a soccer match in both male and female soccer athletes. Hypothesis: Soccer athletes have changes in eccentric HS strength after a soccer game. Study Design: Cohort observational study. Level of Evidence: Level 3. Methods: HS eccentric strength (mean and absolute peak torque and total work) was measured in 64 healthy male and female competitive football athletes (14-25 years) with an automatic device during the execution of the Nordic hamstring exercise (NHE) test before and after a 90-minute soccer match. The anterior-knee laxity (AKL) was quantified with an arthrometer. Results: Mean and absolute eccentric HS peak torque decreased by 24.5 N.m (-12.34%; P < 0.01) and 21.9 N.m (-10.08%; P < 0.01) in female athletes, whereas their male peers improved by 19.9 N.m (+9.01%; P = 0.01) and by 20.9 N.m (+8.51%; P = 0.02), respectively. HS total work in female athletes decreased by 831.1 J (P < 0.01) compared with the male athlete reduction of 235.3 J. Both the pre- versus postmatch intersex mean and absolute eccentric HS peak torque changes were significant (P < 0.01), as were the changes in HS total work (P < 0.01). The pre- versus postmatch AKL difference and the dominant versus nondominant limb comparison of the strength parameters were not significantly different. Younger female athletes (14-19 years old) presented a greater decrease in mean and absolute peak HS eccentric strength compared with those in older female athletes and men. Conclusion: HS eccentric strength and work differ based on athlete sex, as measured by the NHE test. Mean peak, absolute peak, and total work showed greater reductions in female athletes than those in their male peers. The subgroup of 14- to 19-year-old female athletes experienced the highest reduction in strength parameters. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study evaluated the impact of night frost incidents on the biochemical, physiological, and reproductive functions of the olive varieties Manzanillo, Coratina, Koroneiki, and Picual. Certain cultivars were more suited to moderate cold night stress than others, based on the changes in the performance of the stressed plants, including vegetative growth, tree yield, fruit physical characteristics, and fruit chemical characteristics. Compared to other tested cultivars, the biochemical responses of the plants in terms of photosynthetic pigments, relative water content (RWC), total phenolic compounds, total flavonoid, and antioxidant enzyme accumulation demonstrated that some cultivars could withstand the applied stress. The conclusion that some cultivars responded differently to cold stress than others was supported by the plant phenology. This research could be a game-changer for farmers. By understanding how olive trees adapt to cold snaps, a common stressor in open fields, they can make informed decisions about breeding and choosing the best cultivars, ultimately leading to more resilient crops. The results showed that all tested olive tree cultivars differ significantly regarding cold stress conditions. Coratina and Koroneiki were the most resistant tested cultivars in terms of biochemical, physiological, and reproductive functions, followed in ascending order by Manzanello and Picual. [ABSTRACT FROM AUTHOR]

Morphological and functional asymmetry of the lower limbs is a well-recognized factor contributing to musculoskeletal injuries among athletes across different levels. However, limited research exists on evaluating foot mobility asymmetry as a potential predictor of such injuries. This study aimed to (1) assess the frequency of foot mobility asymmetries among amateur athletes, (2) investigate the predictive value of foot mobility asymmetry (measured via navicular height drop) for injury risk, and (3) explore the relationship between foot type and injury occurrence. A cross-sectional sampling method was employed to select 45 physically active male amateur athletes (runners and team sports practitioners) from a university. Injury history was retrospectively recorded, and a modified navicular drop test was conducted to classify foot arch height. The predictive power of navicular height drop asymmetry was analyzed using ROC curves, and the relationship between foot type (neutral and defective combinations—pronated or supinated) and injury occurrence was examined using chi-square tests for independence. Multiple logistic regression was applied to calculate injury risk odds ratios across different foot type subgroups. The results revealed a significant frequency (51.1%) of participants with at least one defective foot, including 31.1% with one neutral and one defective foot and 20% with both feet defective. Navicular height drop asymmetry emerged as a valuable predictor of injuries, with a 36% asymmetry identified as the cut-off for increased injury risk (AUC = 0.832, 95% CI: 0.691–0.973, p < 0.001). A significant relationship was found between foot type and injury occurrence. Only one out of 22 participants with neutral feet (4.55%) experienced an injury, compared to 9 out of 14 (64.29%) with one neutral and one defective foot and 5 out of 9 (55.56%) with both feet defective. These differences were statistically significant (χ2 = 16.24, p < 0.001, Cramer's V = 0.60). The odds ratio for injury risk was 37.8 (p = 0.016) for those with asymmetry (one neutral and one defective foot) and 26.3 (p = 0.102) for those with both feet defective, compared to participants with both feet neutral. In clinical practice, these findings suggest that routine screenings for physically active individuals should incorporate foot mobility asymmetry assessment. However, it is essential to integrate this factor with other risk indicators. For individuals exhibiting high asymmetry, general foot defect correction programs may be beneficial, but injury prevention strategies should adopt a more comprehensive approach, focusing on overall fitness and tailored interventions for high-risk individuals. [ABSTRACT FROM AUTHOR]

Background: Adolescents in low-middle-income countries face increasing physical and mental health challenges. The present study aimed to assess status of injury, verbal abuse, substance use, and emotional behavior of adolescents of Uttarakhand, India, and evaluate the importance of each component. Methods: A cross-sectional study was conducted among adolescents in 13 government schools in Uttarakhand using the Global School-based Health Survey (GSHS). Categorical principal component analysis (CATPCA) using Varimax rotation was performed to analyze principal components among two domains of GSHS (substance abuse domain and verbal abuse and emotional behavior domain). Factorability was assessed using Kaiser--Meyer--Olkin and Bartlett's test. Variance Accounted For index was used to evaluate the importance of each component. Results: A total of 634 adolescents completed the questionnaire. 41.3% students suffered from serious injury with a significant difference (P < 0.0001) between both genders. Girls were more likely to report having felt lonely most of the time or always in the past 12 months (11.0% vs 4.6%, P = 0.018). Boys were more likely to miss classes on 3 or more days (9.9% vs 4.9%, P = 0.043). Initiation of smoking cigarettes (9.6% vs 1.2%, P <0.0001) and tobacco chewing (3.4% vs 0.3%, P = 0.001) was more likely in 12--15-year-old boys. One-third of the students reported male guardians to use either alcohol or some form of tobacco. CATPCA yielded an 11-factor model accounting for 58.26% of variances with the most important principal component named "Tobacco (Smoking and Chewing): Initiation, Frequency and Attempt to Stop" (eigenvalue: 4.109). Conclusion: Significant differences in various items of injury, verbal abuse, substance use, and emotional behavior were recorded between boys and girls. CATPCA revealed patterns among injury, verbal abuse, emotional behavior, and substance abuse domains of GSHS by categorizing them into 11 components. On the basis of these patterns, prioritizing and development of appropriate school-based interventions may be implemented by various stakeholders of Uttarakhand. [ABSTRACT FROM AUTHOR]

This study expands previous work examining the effects on fishes from exposure to a single 4.5 kg underwater explosive detonation. Experiments were done in the field, with fish in cages at different distances from the source. Although our earlier work reported high acoustic dosage levels (e.g. based on peak pressure) correlating with severe injuries, dosage levels that result in moderate, or mild injuries were not clearly established. Thus, in this study, caged Pacific mackerel (Scomber japonicus) were placed at targeted ranges of 150–800 m from the source. All procedures were the same as in the earlier study except that animals were left at depth for ∼3 hours post-exposure to determine immediate effects on survival. Fish were then retrieved and assessed for physical damage. The only statistically significant tissue injuries were swim bladder bruising and in a reduction in inner ear sensory hair cell density that lessened with distance from the source. Still, results must be taken with caution since they may vary with different source levels, water depths, location of the fish in the water column, and by species. [ABSTRACT FROM AUTHOR]

Over the years, the construction industry in Malaysia has had more fatalities than any other sector, and the bulk of these incidents have been related to subpar health and safety procedures. Therefore, this research created a model for sustainable health and safety practices that will enhance health and safety standards in the Malaysian construction industry. To achieve this, a comprehensive literature review was carried out to identify the critical success factors for sustainable health and safety practice, which then were categorized under the three sustainable pillars after expert review: 29 factors were grouped under economic sustainability, 27 factors were grouped under social sustainability, and 11 factors were grouped under environmental sustainability. These then were used to develop a closed-ended questionnaire that was administered to construction stakeholders. A total of 158 completed surveys were analyzed using partial least squares structural equation modeling (PLS-SEM). The study found that environmental, social, and economic sustainability all have a significant impact on sustainable health and safety practices. Hence, in order to improve health and safety in the construction industry, there is need to incorporate all these factors in health and safety models. This research is the first to integrate sustainability into health and safety practices in Malaysia. The practical implication of this study is that it provides insight into how construction industry accidents can be minimized by helping construction stakeholders to understand how to enhance health and safety practices. [ABSTRACT FROM AUTHOR]

The jumping action plays a very important role in many sports in athletics. Jumping action depends on explosive force, which is the quality of strength in a short period of time, and is the important basic quality of many sports. Mechanical research on jumping movement can explore ways to improve sports performance from the perspective of mechanics, and can also explore effective measures to prevent sports injuries. Biomedical data analysis can analyze a large amount of data in depth and reveal the rules behind the huge data. In this paper, biomedical analysis technology is used to analyze the mechanical data of track and field jumping movements, to explore the mechanical characteristics of high jumping movements and the intrinsic connection between movements and injuries, and good results are achieved. [ABSTRACT FROM AUTHOR]

tRNA-derived small RNAs (tsRNAs) are a novel class of small noncoding RNAs, precisely cleaved from tRNA, functioning as regulatory molecules. The topic of tsRNAs in injuries has not been extensively discussed, and studies on tsRNAs are entering a new era. Here, we provide a fresh perspective on this topic. We systematically reviewed the classification, generation, and biological functions of tsRNAs in response to stress, as well as their potential as biomarkers and therapeutic targets in various injuries, including lung injury, liver injury, renal injury, cardiac injury, neuronal injury, vascular injury, skeletal muscle injury, and skin injury. We also provided a fresh perspective on the association between stress-induced tsRNAs and organ injury from a clinical perspective. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Since mandibular third molars are frequently impacted, third molar extractions are among the most common procedures performed by oral surgeons (35.9–58.7% of all surgical procedures). Inferior alveolar nerve (IAN) injury is major postoperative complication in 0.81–22% of the cases leading to a permanent injury in 1–4% of the cases. Prior studies have proven that coronectomy, a procedure that involves the removal of the crown and coronal one-third of the roots of the third molar with intentional retention of the two-third apical roots to protect the IAN, can thus prove to be a viable alternative in such cases of close proximity to the IAN. Aim: This study was conducted in India to determine the knowledge, attitudes, and practices of oral and maxillofacial surgeons regarding coronectomy and its role in the prevention of IAN injury. Methodology: The questionnaire entitled: "Coronectomy: A Knowledge, Attitude and Practice (KAP) Survey among Oral and Maxillofacial Surgeons" was sent to 120 oral and maxillofacial surgeons. Five questions in each domain, i.e., knowledge, attitude, and practice were designed to know the level of awareness, acceptance, and current status of the performance of coronectomy among oral and maxillofacial surgeons (OMFS). Teeth with acute infection and mobile teeth were excluded from the consideration of coronectomy procedures. Results: Out of the 120 questionnaires sent, 50 responses were obtained, thus producing a response rate of 41.6%. The male-to-female ratio in the study was 34:16. 52% of the surgeons had performed up to 5 coronectomies during their entire practice, while 16 % had never even attempted the procedure. Only 42% of the respondents preferred coronectomy, but most of the surgeons were in support of practice-oriented continuing. [ABSTRACT FROM AUTHOR]

Melatonin (5-methoxy-N-acetyltryptamine) is an indoleamine compound that plays a critical role in the regulation of circadian rhythms. While melatonin is primarily synthesized from the amino acid tryptophan in the pineal gland of the brain, it can also be produced locally in various tissues, such as the skin and intestines. Melatonin's effects in target tissues can be mediated through receptor-dependent mechanisms. Additionally, melatonin exerts various actions via receptor-independent pathways. In biological systems, melatonin and its endogenous metabolites often produce similar effects. While injuries are common in daily life, promoting optimal wound healing is essential for patient well-being and healthcare outcomes. Beyond regulating circadian rhythms as a neuroendocrine hormone, melatonin may enhance wound healing through (1) potent antioxidant properties, (2) anti-inflammatory actions, (3) infection control, (4) regulation of vascular reactivity and angiogenesis, (5) analgesic (pain-relieving) effects, and (6) anti-pruritic (anti-itch) effects. This review aims to provide a comprehensive overview of scientific studies that demonstrate melatonin's potential roles in supporting effective wound healing. [ABSTRACT FROM AUTHOR]

Abstract Background The optimal treatment for anterior cruciate ligament (ACL) injuries with early-stage symptomless osteoarthritis (OA) remains unclear. This study aimed to compare the clinical outcomes of ACL reconstruction (ACLR) in patients with ACL injury in the presence and absence of early-stage symptomless OA. Methods Medical records of patients with early-stage symptomless OA who sustained ACL injury and underwent ACLR from January 2018 to December 2020 at a single institution were retrospectively reviewed. Radiography and magnetic resonance imaging were performed preoperatively to identify ACL injury and OA. Patients with ACL injury and early-stage symptomless OA (combined group, n = 14) were matched at a 1:2 ratio with patients with ACL injury (isolated group, n = 32). Data on demographic characteristics, pain and functional outcomes (visual analogue scale, Tegner, Lysholm, and International Knee Documentation Committee scores and range of motion), and imaging outcomes were collected. Complications were recorded, and outcomes were compared between the groups. Results Forty-six patients (26 males, 20 females) were included in this study, among whom 14 had ACL injury and early-stage symptomless OA, whereas 32 sustained isolated ACL injury (average follow-up duration: 3.4 ± 1.0 years). At the final follow-up, pain and functional outcomes similar to those in patients with isolated ACL-deficient knees were achieved in the combined group; acute-stage ACLR resulted in significantly better outcomes (p

Abstract Introduction The global burden of injury is huge, falling disproportionately on poorer populations. The benefits of qualitative research in injury care are recognised and its application is growing. We used a novel application of focus group discussions with photovoice to rapidly assess barriers at each of three delay stages; seeking (delay-1), reaching (delay-2) or receiving (delay-3) injury care in Northern Malawi. Methods Three community Focus Group Discussions (FGDs) of individuals with (FGD1) and without (FGD2) recent injury experience and community leaders (FGD3) discussed barriers to seeking, reaching or receiving care following injury. Participants from FGD1 subsequently used a digital camera and, following training in photovoice, took photographs illustrating barriers to injury care. Participants reconvened to discuss images which they believed illustrated important barriers. A framework method analysis compared barriers generated to those identified by an earlier Delphi study. Results Seven of eight invited adult community members attended each discussion group. Within the FGDs, all prior Delphi derived delay 1 barriers were described. Within delay 2, all but three were discussed by community participants. Those not covered were: 1) “communication” ;2) “prehospital care”; 3) “coordination”. Within Delay 3, only “capacity”was not highlighted by participants during the study. Additional health system barriers not identified in the Delphi were inductively derived. Within Delay 1, these were labelled; “religious or other beliefs”; “indecision”; “fear or lacking courage”; and “community/bystander engagement”. Within Delay 2, “lack of assistance” was derived. Within Delay 3; “alleged corruption”; “interfacility transfer”; and “police processes” were all identified during analysis. The photovoice group provided 21 photographs evidencing 15 barriers. Delay 1 was the most frequently captured by images (12/21).The individual barriers most frequently described were “transport” and “roads” (6/21 and 5/21, respectively). The photovoice group did not describe any additional barriers not covered in the prior FGDs. Conclusion We identified several barriers within this health system. Participants illustrated how some barriers impact on multiple phases of delay. The method was quick, low cost and participants grasped the technique and research question effectively. We recommend this approach for future health system assessments.

Abstract To analyze the causes, locations, associated injuries, and relevant factors of lower limb and pelvic fractures in hospitalized children in China to provide a theoretical basis for reducing the incidence of such fractures. A retrospective analysis of children with lower limb and pelvic fractures admitted to 27 tertiary children’s hospitals affiliated with China’s Futang Research Center of Pediatric Development between December 1, 2015, and December 31, 2019, was conducted. Inpatient cases were analyzed in the following age groups: Infants (

Abstract Background Most studies on injuries of professional dancers used a medical-attention and/or time-loss definition and did not analyse all health problems. Further, almost all studies included just one company. The aim was to analyse all self-reported health problems of professional ballet and contemporary dancers during one season and compare sexes and five companies in Germany. Methods Dancers of five professional companies completed weekly health questionnaires during the season (September 2022 to June 2023). Numerical rating scales were used for severity of all health problems, musculoskeletal pain, impairment of the ability to dance at full potential, physical and mental workload in the previous seven days. If the severity of all health problems were rated greater than “0”, the dancers were asked to report the type and consequences of their most severe health problem. Results During 43 weeks, 98 dancers (39.8% male) completed 3123 weekly reports (response rate 74.1%). The season prevalence of any health problem was 100% and of time-loss health problems 74.5%. The average weekly prevalence of any health problem was 62.7%, of musculoskeletal pain 83.4% and of impaired ability to dance at full potential, due to health problem 48.6%. While the season prevalence and type of health problems was similar between sexes, the average weekly prevalence of severe health problems was higher in female than in male dancers (Chi2 = 23.2; p

Background: Musculoskeletal adaptations are common in overhead athletes. As they also are involved in injury prevention, there has been an increase in their evaluation through shoulder screening over the last years. However, for some evaluations, and especially for functional testing, there is a lack of normative values, which limits the interpretation of the values measured. Moreover, the influence of age, gender, and sport on upper limb functional tests remains underexplored. Methods: Five hundred eighty seven athletes (handball players, rugby players, swimmers, tennis players, and volleyball players) performed a battery of upper limb functional tests between 2018 and 2023, including the Modified-Athletic Shoulder Test, the Single Arm Medicine Ball Throw, the Seated Single Arm Shot Put Test, the Upper Limb Rotation Test, the Upper Quarter Y Balance Test, the Modified Closed Kinetic Chain Upper Extremity Stability Test, and the Posterior Shoulder Endurance Test. In total, normative values as well as the influence of age, gender, and sport on upper limb functional performance were obtained for 496 of them. Results: The Modified-Athletic Shoulder Test revealed sport-specific adaptations, with dominant arms significantly outperforming nondominant arms, notably in handball, rugby, and tennis. The Single Arm Medicine Ball Throw and Seated Single Arm Shot Put Test highlighted the influence of age and gender on upper limb power, with males consistently outperforming females. The Upper Limb Rotation Test demonstrated similar rotation in both arms across sports, while gender disparities were still observed. The Upper Quarter Y Balance Test exhibited surprising consistency in upper-quarter balance across sports and age groups (P > .05). The Modified Closed Kinetic Chain Upper Extremity Stability Test showed age-related improvements in stability, while the Posterior Shoulder Endurance Test demonstrated age-related differences in posterior shoulder endurance in swimmers. Conclusion: This study contributes to advances in sports medicine by better understanding functional shoulder performances in upper limb athletes. The differences observed according to the sport, gender, or age underscore the importance of sport-specific assessments and interventions. Moreover, the normative values provided will be essential for primary prevention as well as for determining return-to-play capacity after an injury or surgery.

Purpose: This umbrella systematic review (SR) of SRs and meta-analysis seeks to comprehensively synthesize existing literature to identify and consolidate the diverse range of risk factors contributing to running-related injuries (RRIs). Methods: Systematic searches were conducted on June 28, 2023, across Web of Science, SPORTDiscus, Scopus, PubMed, and Cochrane Library. We included SRs, whether accompanied by meta-analyses or not, that focused on investigating risk factors for RRIs within observational studies. The methodological quality of the SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews II. To assess the extent of overlap across reviews, the corrected covered area metric was calculated. Results: From 1509 records retrieved, 13 SRs were included. The degree of overlap between SRs was low (4%), and quality varied from critically low (n = 8) to low (n = 5). Two hundred seven outcomes assessed in 148 primary studies were identified as being associated with the occurrence of RRIs. The effect sizes of the associations for which risk measures were reported (n = 131) were classified as large (n = 30, 23%), medium (n = 38, 29%), small (n = 48, 37%) or no effect (n = 15, 11%). Running/training characteristics, health and lifestyle factors, along with morphological and biomechanical aspects, exhibit large effect sizes in increasing the risk for RRIs. Conclusion: Drawing from the outcomes of the low-quality SRs and associations with large effect sizes, our findings indicate that running/training characteristics and health and lifestyle factors, as well as morphological and biomechanical aspects, are all implicated in elevating the risk of RRIs, emphasizing the multifactorial basis of injury incidence in running. Given the low quality and heterogeneity of SR, individual findings warrant cautious interpretation.

BackgroundInjury is a major public health issue, and studying the correlation between temperature and injury in the context of climate change is of great significance for injury prevention and control.ObjectiveTo analyze the association between temperature and the volume of emergency medical service response due to injury in Chengdu. MethodsUsing a retrospective ecological study design, weather data in Chengdu were collected from 1 January 2022 to 31 December 2023 from Chengdu Meteorological Office, including daily average temperature, daily average relative humidity, average wind speed, average pressure, sunshine, and rainfall. Emergency medical service data were collected from an emergency medical service center in Chengdu. A distributional lag non-linear model was conducted to calculate the association between temperature and volume of emergency medical service response due to injury, and gender- and age-stratified analyses were followed to identify susceptible groups. ResultsOverall 219685 incidents of emergency medical service dispatching due to injury were collected during the study period. The top three injury causes were traffic accident (90765, 41.32%), poisoning (44101, 20.07%), and falling (44046, 20.05%). When daily average temperature exceeded 17.9 ℃, as the temperature rised, the volume of emergency medical service response for injury increased. In terms of the single-day lag effect, the risk of emergency medical service response for injury elevated on lag1 and persisted until lag6, the maximum daily effectwas observed on lag2, lag3 and lag4, and their relative risks associated with every 1℃ higher above 17.9 ℃ were both 1.08 times, 95%CIs were (1.03, 1.14), (1.04, 1.12), and (1.04, 1.16) respectively. Both men and women were susceptible to temperature, but on the same lag day, the men's RR value was higher than the women's. There was no statistical difference in the lag effect of temperature on the 0-17 age group; the lag effect on the 18-44 age group appeared on lag1, and lasted to lag6; that for the 45-64 age group appeared on lag1, and lasted to lag4; that for the 65 age group and over was only on lag 3 (RR: 1.05, 95%CI: 1.00, 1.10). ConclusionAs the temperature rises, the volume of emergency medical service response due to injury is increased in Chengdu. In particular, the associated impact is significant on males and people aged 18-44 years old.

This study evaluated the impact of night frost incidents on the biochemical, physiological, and reproductive functions of the olive varieties Manzanillo, Coratina, Koroneiki, and Picual. Certain cultivars were more suited to moderate cold night stress than others, based on the changes in the performance of the stressed plants, including vegetative growth, tree yield, fruit physical characteristics, and fruit chemical characteristics. Compared to other tested cultivars, the biochemical responses of the plants in terms of photosynthetic pigments, relative water content (RWC), total phenolic compounds, total flavonoid, and antioxidant enzyme accumulation demonstrated that some cultivars could withstand the applied stress. The conclusion that some cultivars responded differently to cold stress than others was supported by the plant phenology. This research could be a game-changer for farmers. By understanding how olive trees adapt to cold snaps, a common stressor in open fields, they can make informed decisions about breeding and choosing the best cultivars, ultimately leading to more resilient crops. The results showed that all tested olive tree cultivars differ significantly regarding cold stress conditions. Coratina and Koroneiki were the most resistant tested cultivars in terms of biochemical, physiological, and reproductive functions, followed in ascending order by Manzanello and Picual.

Background: Adolescents in low-middle-income countries face increasing physical and mental health challenges. The present study aimed to assess status of injury, verbal abuse, substance use, and emotional behavior of adolescents of Uttarakhand, India, and evaluate the importance of each component. Methods: A cross-sectional study was conducted among adolescents in 13 government schools in Uttarakhand using the Global School-based Health Survey (GSHS). Categorical principal component analysis (CATPCA) using Varimax rotation was performed to analyze principal components among two domains of GSHS (substance abuse domain and verbal abuse and emotional behavior domain). Factorability was assessed using Kaiser–Meyer–Olkin and Bartlett’s test. Variance Accounted For index was used to evaluate the importance of each component. Results: A total of 634 adolescents completed the questionnaire. 41.3% students suffered from serious injury with a significant difference (P < 0.0001) between both genders. Girls were more likely to report having felt lonely most of the time or always in the past 12 months (11.0% vs 4.6%, P = 0.018). Boys were more likely to miss classes on 3 or more days (9.9% vs 4.9%, P = 0.043). Initiation of smoking cigarettes (9.6% vs 1.2%, P

Abstract Based on the characteristics of Kummell’s disease (KD) and related anatomical structures of the thoracolumbar spine, a novel bone cement screw system has been designed to effectively avoid the cement loosening and displacement. This experiment aimed to assess the biological effects of the novel bone cement screw system in KD on fresh cadaveric thoracolumbar spine specimens, thereby discussing its potential application value and providing a foundation for clinical implementation. This study employed a total of 50 fresh female adult cadaver specimens. Each specimen underwent extraction of the T12 to L2 segment followed by the creation of an artificial KD model at the L1 segment and subsequent establishment of five distinct types of bone cement repair models. Model A represents the percutaneous vertebroplasty (PVP) model, Model B combines PVP with unilateral percutaneous pediculoplasty (PPP), Model C combines PVP with bilateral PPP, Model D introduces the novel bone cement screw combined with unilateral PVP, and Model E combines the novel screw with bilateral PVP, each group consists of 10 specimens. Subsequently, the six-axis spine robot was employed to execute cement three-dimensional biomechanical strength tests in six directions, including anterior flexion and posterior extension, left and right lateral bending, as well as left and right rotation. The novel bone cement screw, whether used unilaterally or bilaterally in combination with the PVP model, exhibits significantly reduced bone cement mobility and superior biomechanical stability during anterior flexion, posterior extension, left lateral bending, and right lateral bending (P 0.05).When comparing the novel bone cement screw combined with PVP unilaterally and bilaterally, no statistically significant difference was observed in the stability of bone cement across all six directions of motion (P>0.05). To conclude, this novel bone cement bridging screw system exhibits superior biomechanical stability compared to commonly used treatments. Furthermore, both unilateral and bilateral implementations of the novel bone cement screw system yield without significant differences observed. These findings present a reliable and innovative approach for clinical management of KD.