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Introduction: Unlike the most common training approaches for bodybuilding, powerlifting programs are generally based on maximum and submaximal loads, putting enormous stresses on the lumbar spine. The flexion relaxation phenomenon evaluation is a clinical tool used for low back pain (LBP) assessment. This study aimed to evaluate the role of the flexion relaxation phenomenon in the analysis of LBP in the powerlifters. Methods: Healthy professional powerlifters participated in the study. In fact, we divided the participants into a LBP-low-risk group and a LBP-high-risk group, based on a prior history of LBP. Outcome measures included flexion relaxation ratio (FRR) and trough surface electromyography collected during trunk maximum voluntary flexion; furthermore, during a bench press lifting, we measured the height of the arched back (ARCH), using a camera and the Kinovea video editing software, to consider a potential correlation with the risk of LBP. Results: We included a group of 18 male (aged 24–39 y) powerlifters of 93 kg category. We measured a nonsignificant mean difference of ARCH between low-risk LBP group and high-risk LBP subjects. Curiously, maximum voluntary flexions were both above the threshold of 3.2 μV; therefore, with an absence of appropriate myoelectric silence, on the contrary, the FRR ratios were higher than 9.5, considering the presence of the phenomenon, exclusively for the low-risk group. The lumbar arched back measurement data did not report any association with the LBP risk, regarding the maximum voluntary flexion value, and even more than the FRR there is a relationship with the presence or the absence of LBP risk. Conclusions: FRR could be considered as a useful parameter for studying the risk of LBP in powerlifting. The FRR index not only refers to the possible myoelectric silence of the lumbar muscles in trunk maximum forward flexion but also takes into account the energy value delivered by the lumbar muscles during the flexion. Furthermore, we can indicate that the size of the powerlifter ARCH may not be a determining factor in the occurrence of LBP. [ABSTRACT FROM AUTHOR]

Purpose: Injury prevention is a crucial aspect of sports, particularly in high-performance settings such as elite female football. This study aimed to develop an injury prediction model that incorporates clinical, Global-Positioning-System (GPS), and multiomics (genomics and metabolomics) data to better understand the factors associated with injury in elite female football players. Methods: We designed a prospective cohort study over 2 seasons (2019–20 and 2021–22) of noncontact injuries in 24 elite female players in the Spanish Premiership competition. We used GPS data to determine external workload, genomic data to capture genetic susceptibility, and metabolomic data to measure internal workload. Results: Forty noncontact injuries were recorded, the most frequent of which were muscle (63%) and ligament (20%) injuries. The baseline risk model included fat mass and the random effect of the player. Six genetic polymorphisms located at the DCN, ADAMTS5, ESRRB, VEGFA, and MMP1 genes were associated with injuries after adjusting for player load (P <.05). The genetic score created with these 6 variants determined groups of players with different profile risks (P = 3.1 × 10−4). Three metabolites (alanine, serotonin, and 5-hydroxy-tryptophan) correlated with injuries. The model comprising baseline variables, genetic score, and player load showed the best prediction capacity (C-index:.74). Conclusions: Our model could allow efficient, personalized interventions based on an athlete's vulnerability. However, we emphasize the necessity for further research in female athletes with an emphasis on validation studies involving other teams and individuals. By expanding the scope of our research and incorporating diverse populations, we can bolster the generalizability and robustness of our proposed model. [ABSTRACT FROM AUTHOR]

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.

Foot stance and club type's relationship with lead knee joint biomechanics and possible involvement with injury incidences in amateur golfers have not been evaluated. This study included 16 male right-handed amateur golfers who performed golf swings with 2 different foot stances (straight and open) using 4 different club types (driver, 3 iron, 6 iron, and 9 iron) while standing on 2 force plates in a motion capture laboratory. A custom program calculated the kinematics and kinetics of the lead knee. Overall, the open stance reduced most translations, rotations, forces, and torques of the lead knee in all 4 club types when compared with the straight stance. The open stance reduced the rotation motion (−28%), compressive force (−5%), and rotation torque (−9%) when compared with the straight stance, which are the highest contributors to grinding of cartilage. The driver club had significantly larger values in most translations, rotations, forces, and torques when compared among the 4 club types. The open stance reduced the rotation motion, compressive force, and rotation torque in the lead knee joint compared with the straight stance. Lead knee joint biomechanics should be monitored to reduce injury in amateur golfers. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether there are bilateral and interdigit differences in the maximal force production of experienced climbers and whether these differences are mediated by ability level or preferred style of climbing. Methods: Thirty-six male climbers (age 30 [9.4] y) took part in a single-session trial to test their maximal force production on both hands. The tests included a one-arm maximal isometric finger flexor strength test (MIFS) and a one-arm individual MIFS. Bilateral differences were analyzed by strongest hand (defined as the hand that produced the highest MIFS value) and dominance (defined as the writing hand). Results: A pairwise t test found that MIFS was significantly greater for the strongest hand (mean difference = 4.1%, 95% CI, −0.052 to 0.029, P <.001), with handedness explaining 89% of the variation. A 2-way mixed-model analysis of variance determined that there were no interactions between preferred style (bouldering or sport climbing) and MIFS or between ability level (advanced or elite) and MIFS. Conclusions: Climbers have significant finger flexor strength bilateral asymmetries between their strongest and weakest hand. Moreover, when dominance is controlled, this difference in strength is present, with the dominant hand producing more force. Neither preferred style of climbing nor the ability level of the climbers could explain these asymmetries. As such, practitioners should consider regularly monitoring unilateral strength, aiming to minimize the likelihood of large bilateral asymmetry occurring. [ABSTRACT FROM AUTHOR]

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.)

Background: The squat exercise has been shown to improve athletic performance. However, the use of the deep squat has been questioned due to claims that it may cause knee joint injuries. Therefore, the purpose of this scoping review was to synthesize existing literature concerning the impact of deep squats on knee osteoarticular health in resistance-trained individuals. Methods: This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. The original protocol was prospectively registered in Figshare (https://doi.org/10.6084/m9.figshare.24945033.v1). A systematic and exhaustive search was conducted in different databases: PubMed, Scopus, Web of Science, and SPORTDiscus. Additional searches were performed in Google Scholar and PEDro. The main inclusion criteria were the following: (1) Articles of experimental, observational, or theoretical nature, including randomized controlled trials, longitudinal studies, case reports, integrative reviews, systematic reviews, and meta-analyses(Primary studies were required to have a minimum follow-up duration of 6 weeks, whereas secondary studies were expected to adhere to PRISMA or COCHRANE guidelines or be registered with PROSPERO; (2) Peer-reviewed articles published between 2000 and 2024; (3) Publications written in English, Spanish and Portuguese; (4) Studies reporting the effects of deep half, parallel or quarter squats on the knee or evaluating squats as a predictor of injury. Results: The keyword search resulted in 2,274 studies, out of which 15 met all inclusion criteria. These 15 studies comprised 5 cohort studies, 3 randomized controlled trials, 4 literature or narrative reviews, 1 case study, and 2 systematic reviews, one including a meta-analysis. Overall, the risk of bias (ROB) across these studies was generally low. It is worth noting that only one study, a case study, associated deep squats with an increased risk of injury, the remaining 14 studies showed no negative impact of deep squats on knee joint health. Conclusion: The deep squat appears to be a safe exercise for knee joint health and could be included in resistance training programs without risk, provided that proper technique is maintained. [ABSTRACT FROM AUTHOR]

• 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]

Introduction: Hawthorne effect refers to changes in clinician behavior in response to being observed. It has been minimally evaluated in trauma and surgical research, especially in low‐ and middle‐income countries (LMICs). Methods: We used data from the first (control) phase of a randomized clinical trial in Ghana (2020‐21). Trained observers were stationed in emergency units in eight non‐tertiary hospitals to observe the achievement of key performance indicators (KPI) (KPIs) of trauma care. We hypothesized that the observers' presence would create a Hawthorne effect, resulting in clinicians (doctors, nurses) performing above their usual level, with performance highest immediately after the observers were introduced, and with performance then declining over time toward the usual baseline. Results: We enrolled 2067 injured patients. Achievement of 13 out of 16 KPIs declined significantly over the 14 months after the introduction of observers. For example, airway assessment declined from 77% initially to 60% at the end of the phase (p < 0.001). Chest examination declined from 66% to 31% (p < 0.001). Distal pulses checked declined from 45% to 7% (p < 0.001). The slope of decline in KPI achievement ranged from 0.8%/month (mobility assessed) to 15.9%/month (distal pulses checked). Conclusions: The decline in KPI achievement over time is consistent with the hypothesis that clinicians performed above their usual level just after the observers were introduced, with performance then declining toward the usual baseline. This study is among the first to provide quantitative data on the Hawthorne effect for trauma research in LMICs. These data are useful for the design of future observational studies and clinical trials. [ABSTRACT FROM AUTHOR]

Purpose: The anatomy of the deltoid ligament is complex. There is agreement on the presence of superficial and deep layers but the number and frequency of fascicles remains controversial. Identifying injuries to specific components of the deltoid ligament may inform decision‐making on their management. The anatomy was reviewed to establish the number and dimension of fascicles visible with three‐dimensional (3D) volumetric magnetic resonance images (MRI). Methods: Twenty ankles from asymptomatic healthy volunteers were imaged with 3D volumetric MRI. The presence of individual fascicles was recorded and measured in 3D. Results: The median age of participants was 26 years (range: 20–37) of which 13 (65%) were female. All 20 ankles had a deltoid ligament formed of four fascicles in two layers: three fascicles in the superficial layer; tibionavicular (mean dimensions 22.5 × 10.0 × 2.4 mm), tibiospring (16.6 × 6.7 × 1.9 mm) and tibiocalcaneal (23.8 × 4.6 × 1.8 mm) and a deep layer consisting of the tibiotalar fascicle, which could be divided into two parts: anterior tibiotalar (mean dimensions 10 × 5.6 × 4.1 mm) and the significantly larger posterior tibiotalar (14.2 × 13.8 × 17.5 mm, p < 0.01). There were no additional fascicles observed. Conclusions: The deltoid ligament complex was consistently visualised as four fascicles (tibionavicular, tibiospring, tibiocalcaneal, tibiotalar) in two layers (superficial and deep) in all 20 ankles. The posterior part of the tibiotalar fascicle was the thickest of all the fascicles in the deltoid ligament. It is, therefore, possible to accurately identify the components of the deltoid ligament, and 3T MRI can be used to assess fascicle‐specific injury, which will guide treatment and rehabilitation. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Interpersonal violent injury is associated with increased risk of subsequent psychological problems, but pre-existing psychopathology may complicate this association in ways that are poorly understood. Using nationwide longitudinal registry data from Norway, we tested how psychiatric history modified the association between violent injury exposure and subsequent psychiatric disorder, and examined disorder continuity before vs. after violent injury. We identified all individuals presenting to emergency services in 2010–2018 with a violent injury, along with sex- and age-matched comparison individuals from the general population. The primary outcome was subsequent psychiatric disorder, observed through December 31, 2018, with secondary analyses examining psychiatric diagnoses pre- vs. post-injury. Of the 28,276 violence-injured patients, 20% had a history of psychiatric disorder, vs. 6% of the 282,760 comparison individuals. In Cox regression models, violence-injured patients had substantially higher rates of any subsequent psychiatric disorder when compared to matched peers (HR adj : 2.36; 95% CI: 2.29, 2.42), but this association was confounded and modified by psychiatric history. Continuity of psychiatric diagnosis before and after injury was high among violence-injured patients, but they were also more likely than the comparison group to receive a new diagnosis, potentially indicating incident onset of new psychiatric disorder associated with violence exposure. Violence-injured patients face substantial burden of psychiatric disorder, especially for substance use and mood/anxiety disorders; clinical and public health strategies are needed to address this burden, which precedes violent injury in some cases but is likely provoked by it in others. [ABSTRACT FROM AUTHOR]

In this study, the trends and current situation of the injury burden as well as attributable burden to injury risk factors at global, regional, and national levels based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 are presented. To assess the attributable burden of injury risk factors, the data of interest on data sources were retrieved from the Global Health Data Exchange (GHDx) and analyzed. Cause-specific death from injuries was estimated using the Cause of Death Ensemble model in the GBD 2019. The burden attributable to each injury risk factor was incorporated in the population attributable fraction to estimate the total attributable deaths and disability-adjusted life years. The Socio-demographic Index (SDI) was used to evaluate countries' developmental status. Globally, there were 713.9 million (95% uncertainty interval [UI]: 663.8 to 766.9) injuries incidence and 4.3 million (UI: 3.9 to 4.6) deaths caused by injuries in 2019. There was an inverse relationship between age-standardized disability-adjusted life year rate and SDI quintiles in 2019. Overall, low bone mineral density was the leading risk factor of injury deaths in 2019, with a contribution of 10.5% (UI: 9.0 to 11.6) of total injuries and age-standardized deaths, followed by occupational risks (7.0% [UI: 6.3–7.9]) and alcohol use (6.8% [UI: 5.2 to 8.5]). Various risks were responsible for the imposed burden of injuries. This study highlighted the small but persistent share of injuries in the global burden of diseases and injuries to provide beneficial data to produce proper policies to reach an effective global injury prevention plan. [ABSTRACT FROM AUTHOR]

Women experience more saddle-related pain during cycling compared to men. However, there is a lack of research focused on the optimal saddle for this population. Therefore, the aim of this study was to analyze the most used type of saddle (i.e., women's saddles, men's saddles or unisex) and the effect of saddle type on perceived comfort in elite women road cyclists. Sixty national level road cyclists completed a questionnaire about their training characteristics, saddle use background and saddle comfort. The measures of the participants saddles were also obtained. Women's saddles were chosen by the majority of participants, being more comfortable (4.2 vs. 3.8 on a 1–5 comfort scale, respectively) than men's saddles. What is more, among cyclists who had tried both saddles, 55% felt better with the women's saddle, while only 16% preferred the men's saddle. However, more experienced cyclists (i.e., higher weekly and annual training load and years of experience) used men's saddles. Also, 50% of the participants still presented pain, regardless of the type of saddle used. The type of saddle also affected the cyclist's position on the saddle (i.e., at the rear of the saddle with men's saddles) and the location of pain (i.e., higher on the ischial tuberosities with men's saddles). In conclusion, women's saddles are more comfortable for women road cyclists. Saddle type may also have some effect on bike-fit, as woman sit further back when using a men's saddle (i.e., increasing the effective saddle height). [ABSTRACT FROM AUTHOR]

Objective: To evaluate the interaction between whole blood (WB) and blood component resuscitation in relation to mortality after trauma. Background: WB is increasingly available in civilian trauma resuscitation, and it is typically transfused concomitantly with blood components. The interaction between WB and blood component transfusions is unclear. Methods: Adult patients with trauma with a shock index > 1 who received = 4 combined units of red blood cells and/or WB within 4 hours across 501 U.S. trauma centers were included using the American College of Surgeons Trauma Quality Improvement Program database. The associations between (1) WB resuscitation and mortality, (2) WB to total transfusion volume ratio (WB:TTV) and mortality, and (3) balanced blood component transfusion in the setting of combined WB and component resuscitation and mortality were evaluated with multivariable analysis. Results: A total of 12,275 patients were included (WB: 2884 vs component-only: 9391). WB resuscitation was associated with lower odds of 4-hour [adjusted odds ratio: 0.81 (0.68-0.97)], 24-hour, and 30-day mortality compared with component-only. Higher WB:TTV ratios were significantly associated with lower 4-hour, 24-hour, and 30-day mortality, with a 13% decrease in odds of 4-hour mortality for each 10% increase in the WB:TTV ratio [0.87 (95% CI: 0.80-0.94)]. Balanced blood component transfusion was associated with significantly lower odds of 4-hour [adjusted odds ratio: 0.45 (95% CI: 0.29-0.68)], 24-hour, and 30-day mortality in the setting of combined WB and blood component resuscitation. Conclusions: WB resuscitation, higher WB:TTV ratios, and balanced blood component transfusion in conjunction with WB were associated with lower mortality in patients with trauma presenting in shock requiring at least 4 units of red blood cells and/or WB transfusion within 4 hours of arrival. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates the most common online patient questions pertaining to posterior cruciate ligament (PCL) injuries and the quality of the websites providing information. Methods: Four PCL search queries were entered into the Google Web Search. Questions under the 'People also ask' tab were expanded in order and 100 results for each query were included (400 total). Questions were categorized based on Rothwell's Classification of Questions (Fact, Policy, Value). Websites were categorized by source (Academic, Commercial, Government, Medical Practice, Single Surgeon Personal, Social Media). Website quality was evaluated based on the Journal of the American Medical Association (JAMA) Benchmark Criteria. Pearson's chi-squared was used to assess categorical data. Cohen's kappa was used to assess inter-rater reliability. Results: Most questions fell into the Rothwell Fact category (54.3%). The most common question topics were Diagnosis/Evaluation (18.0%), Indications/Management (15.5%), and Timeline of Recovery (15.3%). The least common question topics were Technical Details of Procedure (1.5%), Cost (0.5%), and Longevity (0.5%). The most common websites were Medical Practice (31.8%) and Commercial (24.3%), while the least common were Government (8.5%) and Social Media (1.5%). The average JAMA score for websites was 1.49 ± 1.36. Government websites had the highest JAMA score (3.00 ± 1.26) and constituted 42.5% of all websites with a score of 4/4. Comparatively, Single Surgeon Personal websites had the lowest JAMA score (0.76 ± 0.87, range [0–2]). PubMed articles constituted 70.6% (24/34) of Government websites, 70.8% (17/24) had a JAMA score of 4 and 20.8% (5/24) had a score of 3. Conclusion: Patients search the internet for information regarding diagnosis, treatment, and recovery of PCL injuries and are less interested in the details of the procedure, cost, and longevity of treatment. The low JAMA score reflects the heterogenous quality and transparency of online information. Physicians can use this information to help guide patient expectations pre- and post-operatively. [ABSTRACT FROM AUTHOR]

Introduction: The Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H) is a valid and reliable registration method for self-reported injuries and is regularly used among dancer populations. Monthly questionnaire administration is acceptable in athlete populations but has not been evaluated in dancers. The aim of this exploratory study was to assess the influence of weekly versus monthly administration of the OSTRC-H on estimated injury outcomes among elite adolescent ballet dancers. Methods: Participants (n = 103) were prospectively followed for 6 months and completed the OSTRC-H online, evaluating perceived consequences of self-reported health problems during the previous week and the previous 4 weeks, respectively. Four definitions of dance-related injury were utilized: (1) all complaints, (2) substantial, (3) medical attention, and (4) time-loss injuries. Descriptive statistics estimated: (1) the number of injuries reported (count), (2) average injury prevalence [proportion, 95% confidence intervals (CI)], (3) average severity score (0-100), and (4) days of time loss (count) for each injury definition. The 4 outcome measures were then compared between weekly and monthly registration with paired sample t -tests (P <.05) and overlapping 95% CI. Results: A significant difference between the number of all complaints injuries (weekly: 133; monthly: 94; P <.001) and substantial injuries (weekly: 64; monthly: 45; P =.012) was found. Regardless of injury definition, there were no significant differences between injury prevalence, severity scores, and days of time loss when reported weekly versus monthly. Conclusion: Monthly administration of the OSTRC-H is an acceptable method to estimate injury prevalence, severity scores, and days of time loss amongst elite adolescent ballet dancers. [ABSTRACT FROM AUTHOR]

Background: Ballet, epitomized by iconic seasonal performances such as "The Nutcracker," combines artistic expression with considerable physical demands. This study investigated the physiological and psychological responses of ballet dancers to the demands of intensive training and performance, with a specific focus on "The Nutcracker." Methods: Thirty- eight dancers volunteered for the study, including 6 youths (10.5 + 1.8 years, n = 6 female), 7 adolescents (15.4 + 1.1 years, n = 5 female), and 25 adults (21.1 + 2.1 years, n = 20 female). Employing an uncontrolled observational design, this pilot study tracked key biomarkers such as CK-MM for muscle damage and B-ALP for bone health, alongside psychological measures via PANAS-C/PANAS and DASS-21. Results: Significant findings included a post-performance reduction in cortisol and depression levels. Conclusion: These insights advocate for tailored strategies that address the multifaceted needs of dancers, acknowledging the intricate balance required to maintain peak performance and overall health within the demanding realm of professional ballet. [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]

Introduction: Football is one of the most visited social and sports fields which could be able to allocate a huge amount of the economy’s circulating capital. Football has been changed smoothly by improved science and technology and the transformative atmosphere of the fourth industrial and fifth social revolutions. Cognitive science is one of the topics based on today's technology that monitors concepts such as perception, consciousness, memory, and learning; therefore, football needs cognitive sciences to maintain its dynamics and update its methods and data. Methods: First, football categories based on content analysis were classified in a decision tree. Then, football indicators based on cognitive science were prioritized with the fuzzy hierarchical analysis method. Results: 16 final factors in 5 sections, including cognitive talent identification, technical quality, psychological issues, injury, and the near future as the most important football factors from a cognitive point of view with the help of GAMS software were identified. Also, cognitive talent development, knowledge and skill of the player, mental and psychological issues in the match, recovery, and improvement of the professional conditions of the player were the most important factors of each five categories. Conclusion: Creating a scientific policy in football with focus on cognitive science to organize football in Iran, especially in the toddler, and junior leagues, leads to some opportunities for club owners, managers, coaches, and players’ families to test the skill and quality of a football player in a serious challenge. If the player has enough capacity, he will be ready to get trained and achieve experience also entering the professional life of sports will happen soon. [ABSTRACT FROM AUTHOR]

Acute: chronic workload ratio (ACWR) and training monotony have been criticized as injury risk predictors. Therefore, the use of intensity measures should be oriented to understand the variations of intensity across the season. The aim of this systematic review is to summarize the main evidence about the ACWR and training monotony variations over the season in professional soccer players. The search was made in PubMed, SPORTDiscus, and FECYT according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. From the 225 studies initially identified, 27 were fully reviewed, and their outcome measures were extracted and analyzed. Existing literature revealed a variety of designs, ACWR and training monotony ranges, variables assessed and durations of the studies. Overall, the range values for ACWR were 0.4–3.39 AU, while those focused on monotony were 0.49–5.7 AU. Regarding ACWR, the ratios located around 0.85–1.25 could predict lower risk values and ratios around ≥1.50 could predict higher risk values. On the contrary, with respect to training monotony, the ratios are approximately between 0.5 and 2.00 (low values in the preseason and low competition weeks and high values when soccer players are in highly scheduled competition weeks). Nevertheless, ACWR and training monotony methods should be addressed and considered based on their real value before using this indicator to reduce injury risk. In fact, the data did not conclusively define injured and non-injured players. For this reason, utilizing standardized approaches will allow for more precise conclusions about professional soccer players. [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]

The occurrence of squad rotation in football and its effect on team performance in terms of points have not been comprehensively studied in football performance analysis literature. This study deploys a data-driven approach to examine the occurrence of squad rotation across English, French, Italian and Spanish leagues over multiple seasons. It aims to establish the relationship observed between average squad rotations in starting lineups and end-of-season points. A total of 16,720 matches dating from the 2010/11 to 2021/22 seasons were analysed for average rotations in each team involved and the respective team's end of season points, alongside contextual information such as injury and logarithmic market value. A linear mixed-effects model was used to study this relationship, with each variable as well as interaction of variables being analysed for fixed effects. The results show that a significant relationship exists between team success, average rotation of the team per match and market value of the team, while no significant effects are found for injuries. The results describe how universally deploying squad rotation may not yield higher points over a season, but also shows how the effect of rotations on team success keep increasing as the market value of teams increases. [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]

Models of shift work and health suggest that individual differences in circadian rhythm characteristics may moderate the relationship between night shift work and injury, but this argument has not been directly tested. In this study, we tested the efficacy of two circadian rhythm characteristics—vigour and flexibility—as moderators of the path between shift work and injury. In addition, we aimed to replicate the association between vigour, flexibility, and alertness by time of day, and the measurement properties of the Circadian Type Inventory. We recruited 401 healthcare workers from Australia and Great Britain. After controlling for confounding variables, the results showed that vigour moderated the association between shift work and injury. Participants with values of vigour at the mean (β = 0.5120, p < 0.0013, 95% CI = [0.2018, 0.8223) and one standard deviation below the mean (β = 0.9048, p < 0.0001, 95% CI = [0.4648, 1.3447] reported significantly more injuries. No moderation was found for flexibility. Significant differences in alertness by time of day were observed in participants with higher levels of vigour compared to lower levels of vigour. No differences in alertness were observed for the flexibility scale. These results indicate that vigour may be a robust indicator of shift work tolerance. We replicated the posited two-factor structure of the Circadian Type Inventory, found the scales to have good reliability, and established for the first time, criterion-related validity for the vigour scale. [ABSTRACT FROM AUTHOR]

Female Rugby Union players were affected by contact breast injuries (CBI) and exercise-induced breast pain (EIBP). Hundred and eighty-two female Rugby players from 25 different countries reported incurring a CBI or EIBP which affected sport performance. A higher percentage of 7s players (7s: 64.3%, 15s: 51.9%) reported at least one CBI over a 12-month period. EIBP frequency, during the same period, was notably low for 7s and 15s. Sprinting, jumping and running were the most frequent activities precipitating the severest EIBP. Being tackled or tackling most frequently caused a CBI. Respondents affected by either CBI (57.3%) or EIPB (51.3%) reported always playing-on during matches despite their pain or injury. Between 19.4% and 32.1% of the respondents did not have a CBI or EIBP prevention strategy. A paucity of player knowledge on prevention strategies was noted, indicating a need for education addressing breast pain and injury among players. [ABSTRACT FROM AUTHOR]

BACKGROUND: In recent years, as the popularity of long-distance fitness running continues to rise, more research progress has been made on related scientific issues. Among them, the landing pattern of long-distance running is an important biomechanical research hotspot at the level of running technique. OBJECTIVE: Using CiteSpace to visualize and analyze the relevant literature, the article sorts through the last decade’s literature on the subject to identify the current state, hot spots, and trends in the footprint as well as to further discuss the main research hotspots of the foot strike pattern from a biomechanical perspective. METHODS: “Foot strike pattern,” “Rearfoot strike,” “non-Rearfoot strike,” “Forefoot strike” and “Midfoot strike” were used as keywords to search the Web of Science Core Collection database. RESULTS AND CONCLUSION: A total of 896 relevant papers were finally included. The number of articles published in a year showed an overall upward trend. The top three countries in terms of the number of publications were the United States, China and the United Kingdom; the top three institutions were Harvard University, Shanghai University of Sports and the University of Massachusetts; and the top three authors were Davis Irene S, Hamill Joseph and Fu Weijie. The keywords “barefoot running, runner, injury, footing pattern, kinesiology” appear more frequently, and the keyword clusters include “energy cost, loading rate, footing pattern, risk factors, gait analysis”, and the relevant research still continues to be hot to this day. After analyzing the above data in detail, we found that the overall research intensity of foot strike pattern has remained stable in recent years, and the hotspot mainly focuses on the biomechanical research of foot strike pattern; the trend of this kind of research focuses on the influence and adaptability of different strike patterns (forefoot strike and rearfoot strike) on long-distance runners (barefoot, shoes, distance, speed, injury risk, running economy and energy consumption, etc.). Therefore, there is no “standardized optimal landing,” but there may be “individualized optimal landings.” It is suggested that researchers should select the optimal landing pattern and running technique strategy according to their own habitual way, movement pattern characteristics, exercise level and task attributes. [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]

Objective: Quantifying and managing the matches and training loads of players is important for injury prevention. As rugby union is a full-contact sport and frequent contact injuries occur, it might also be important to quantify and manage players' contact loads. This study aimed to clarify the relationship between contact load and injury incidence in elite rugby union players. Methods: Forty-eight elite rugby union players (27.0 ± 3.5 years) in Japan were monitored during one season (8 months). The contact load, an index of training load, was evaluated as collision count and collision load measured using a global positioning system device, and then calculated using the acute:chronic workload ratio (ACWR) based on the exponentially weighted moving average (EWMA). The association between the EWMA-ACWR of contact load and injury incidence was analyzed using generalized estimating equations. Results: Of the 58 injuries during one season, 70.7% were contact injuries. Collision counts and collision load calculated by EWMA-ACWR were associated with the risk of injury (p < 0.01 both), with the odds ratios were 4.20 [95% confidence interval (CI): 1.74–10.11] and 4.44 (95% CI: 1.95–10.13), respectively. Conclusion: Contact load calculated using EWMA-ACWR was associated with injury in elite rugby union players. [ABSTRACT FROM AUTHOR]

Introduction: The sport of cycling has witnessed phenomenal growth over the past decade. Globally, over 200 million television hours across five continents watched the recent inaugural World Championships in Glasgow, in 2023. The Union Cycliste Internationale (UCI), the world cycling governing body, has highlighted its mission to " promote and support research in cycling epidemiology and medicine, especially for the benefit of lesser-known disciplines" within its 2030 Agenda. This paper outlines a proposed protocol to conduct a systematic review that comprehensively analyses and synthesises the existing literature about cycling-related injuries and illness across all competitive disciplines. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines will be followed through each stage of this systematic review. Cycling is an umbrella term used for many individual disciplines. Investigation of all types of injuries and/or illnesses sustained during training and/or competition among competitive athletes across all disciplines will be included in this review. A computerised, systematic literature search will be conducted in electronic databases MEDLINE, Scopus, Embase, and Cochrane Library. Independent screening by two reviewers in a two-step process: title/abstract screening followed by full-text review. The reference lists of included articles will be searched to identify any other potentially relevant articles. Narrative synthesis and tabular/charted presentation of the extracted data will be included. Discussion: This protocol paper outlines the methodology to conduct a systematic review of injuries and illness across all competitive cycling disciplines. The aims of outlining this systematic review protocol are to aid research transparency, help reduce publication bias, prevent selective publication, and prevent the selective reporting of results. Future systematic reviews based on the proposed protocol will summarise the known prevalence, incidences, locations and burden of injury and illness across the sport of cycling. Trial Registration: This study has been registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42024502703). [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]

Gun violence against children in the United States (U.S.) is a public health crisis which violates the human rights of its victims, resulting in lasting morbidity and death. Firearm-related injury is the leading cause of death for children under eighteen years old in the U.S. We use the United [End Page 712] Nations (UN) Universal Declaration of Human Rights, UN Convention on the Rights of the Child, and UN Sustainable Development Goals to analyze gun violence against children in the U.S. from a human rights perspective. We recommend to 1) ratify the UN Convention on the Rights of the Child, establishing a framework for comprehensive gun law reform, 2) partner with the UN Special Representative for the Secretary-General on Violence Against Children to draft policy, 3) increase gun violence research funding, and 4) implement evidence-based community violence prevention programs. [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]

The objective of this study was to provide novel comparative insights on the contributions of injury deaths to the changes in sex gaps in life expectancy (SGLE) and sex gaps in life disparity (SGLD) across Nordic countries. Retrospective demographic analysis of aggregated mortality data. To compute life expectancy (LE)/life disparity (LD), annual data on age- and sex-specific causes of death from the World Health Organization mortality database were used to construct abridged life tables for two periods: 2000–2002 and 2016–2018 (2014–2016 for Norway). The contributions of injury deaths to the changes in the SGLE and SGLD between these two periods were decomposed by age and cause using a continuous-change model. Females' LE and LD advantages due to injury deaths narrowed by 0.16–0.44 (0.06–0.35) years for LE (LD) over time. While self-inflicted injuries consistently played a predominant role in contributing to the SGLE/SGLD in all countries in both periods, in all countries but Finland, transport accidents had the greatest contributions to the narrowing SGLE/SGLD. Widening SGLE due to self-inflicted injuries in Iceland and due to falls in Sweden were unique to these countries. Accounting for >20% of total contributions of injury deaths, the age group of 20–24 years had the greatest contributions to the narrowing SGLE/SGLD. Deaths due to falls in older ages and assault in younger ages generally contributed to the widening SGLE/SGLD. Injury deaths, particularly transport accidents, contributed significantly to the narrowing SGLE and SGLD across Nordic countries, with cross-country variations in age- and cause-specific patterns. The results suggest the need for injury prevention policies targeting self-inflicted injuries in younger and falls in older males. [ABSTRACT FROM AUTHOR]

Skin injuries are a major healthcare problem that are not well understood or prevented in the critically ill, suggesting that underappreciated variables are contributing. This pilot study tested the hypothesis that perfusion-related factors contribute to skin injuries diagnosed as hospital-acquired pressure injuries (HAPIs). A total of 533 adult patients were followed over 2574 critical care days (mean age 62.4, standard deviation (SD) 14.3 years, mean body mass index 30.4 (SD 7.4) kg/m2, 36.4% female). This was a secondary analysis of prospective, non-randomised clinical data from an intensive care unit at a large urban teaching hospital. Factors related to perfusion, specifically two or more infusions of vasopressors/inotropes, temporary mechanical circulatory support (MCS), extracorporeal membrane oxygenation, and durable MCS, were analysed to determine whether they were more strongly associated with HAPIs than immobility due to prolonged mechanical ventilation (>72 h) or operating room time (>6 h). Patients diagnosed with a HAPI had a statistically significant higher risk of being exposed to variables related to perfusion and immobility (P < 0.05 for each variable). Perfusion-related variables, except durable MCS, had a larger effect on skin breakdown (number needed to harm (NNH) 4–10) than immobility-associated variables (NNH 12–17). The finding that perfusion-related variables predicted HAPIs may warrant consideration of alternative diagnoses, such as skin failure due to impaired perfusion as a pathophysiological process that occurs concurrently with multisystem organ failure. Differentiation of skin injuries primarily from circulatory malfunction, rather than external pressure, may guide the development of more effective treatment and prevention protocols. This pilot study suggests that the contribution of perfusion to skin injuries should be explored further. [ABSTRACT FROM AUTHOR]

Unintentional injury represents a significant health threat to children, and infancy marks a particularly vulnerable stage. This multi-method study (questionnaire, diary) measured parents' (N = 143) use of three popular home-safety practices (teaching about safety, environment modification to reduce access to hazards, supervision) and child injury rates at two stages of motor development during infancy (sitting, walking). Associations between these three safety practices and parental beliefs (protectiveness needed, perceived benefits of the child experiencing minor injuries) were examined, as was the effectiveness of these three practices to prevent injury. Results revealed that different parental beliefs were associated with implementing different safety strategies at each motor development stage. Strategies were differentially effective depending on mobility status of the infant, with supervision being the only strategy that was effective to prevent injury at both motor development stages. Implications for developing safety messages to promote parents' injury-prevention strategies are discussed. [ABSTRACT FROM AUTHOR]

Identification of risk factors for race day injury can improve greyhound welfare. Race day fractures are the most significant injury event and have the greatest negative impact on dog welfare and the industry's social license to operate. This study aimed to describe the incidence and risk factors for race‐related fractures in greyhounds racing in Western Australia. Electronic extracts describing race level data and race day injuries were provided by Racing and Wagering Western Australia (RWWA). The incidence rate (IR) of fractures for all greyhound race starts in Western Australia from 1 January 2017–31/12/2023 was calculated per 1000 starts. Univariable and multivariable models using Poisson regression were used to calculate the IR ratio of fracture type based on race and greyhound‐level factors. There were 198,008 racing starts and 662 (n = 643, 97.1% involving the limbs) fractures resulting in an IR of 3.3 fractures per 1000 starts (95%CI 3.1–3.6). Greyhounds that had an injury in their previous race were 2.3 times (95%CI1.4–4.3) more likely to have a forelimb fracture than greyhounds that did not have an injury (P = 0.013). The risk of tarsal bone fracture was greater in greyhounds older than 30 months and greyhounds that had not raced in the previous 15 days. Risk factors for fractures in the forelimb were associated with trauma after interference or dog collisions, whereas tarsal fractures were associated with strain and cyclic loading from race training/racing. Changes to racing structure, rules and policies based on these risk factors may help to reduce fracture incidence in racing greyhounds. [ABSTRACT FROM AUTHOR]