Career Longevity Research Articles

COMPREHENSIVE INJURY PREVENTION STRATEGIES FOR FOOTBALL PLAYERS

Injury prevention in football is a critical issue for athletes, coaches, and health professionals, given the sport's dynamic movements that elevate the risk of muscle and joint injuries. Effective strategies should incorporate specialized physical training and physiotherapeutic interventions to optimize player protection and performance. Preventive training programs, emphasizing muscle strengthening and proprioception, are essential for reducing injury risks. Specific exercises targeting the hamstrings, quadriceps, calves, and core enhance joint stability and mitigate overload injuries. Neuromuscular training, which includes balance exercises and plyometrics, improves proprioception and helps prevent falls and twists. Flexibility through regular stretching and dynamic warm-ups, such as the FIFA 11+, is crucial for preparing players physically and lowering injury incidence. Additionally, physiotherapists play a vital role in injury prevention through functional assessments to identify muscle imbalances and develop corrective exercise programs. Manual therapy techniques, joint stabilization exercises, and preventive rehabilitation further contribute to maintaining soft tissue quality and preventing muscle strains. Monitoring training load is another fundamental aspect of injury prevention, as abrupt changes in training intensity can lead to injuries. Using tracking technologies allows for better control of players' physical efforts. Studies indicate that implementing structured injury prevention programs significantly reduces injury rates and enhances athletic performance. Research highlights the importance of a multicomponent approach, individualized training, and load management to lower hamstring injuries. Collaboration among athletes, coaches, and health professionals is crucial to create a safe training environment. As football evolves, prioritizing injury prevention is essential for players' health, success, and career longevity.

EFFECTIVE REHABILITATION STRATEGIES FOR MUSCLE INJURIES IN FOOTBALL PLAYERS

The rehabilitation of muscle injuries in football players is a pivotal area of sports physiotherapy, addressing the intense physical demands and high injury rates associated with the sport. Muscle injuries often arise from factors such as overload, muscle imbalances, and improper techniques, impacting athletes' performance and career longevity. To optimize recovery, evidence-based methodologies are crucial, allowing physiotherapists to create personalized rehabilitation programs tailored to the specifics of each injury. Central to effective rehabilitation is a thorough functional assessment, which identifies specific deficits in players. Techniques such as electrotherapy and therapeutic ultrasound are effective in accelerating healing and reducing pain, while functional taping provides support without restricting movement. Neuromuscular rehabilitation is equally vital, incorporating proprioceptive exercises to enhance stability and prevent future injuries. The multidisciplinary approach, involving collaboration between physiotherapists, medical professionals, nutritionists, and coaches, ensures comprehensive care for athletes. Psychological support also plays a key role in addressing anxiety and fostering a positive mindset during recovery. Recent studies underscore the importance of accurate diagnosis and individualized treatment plans, utilizing frameworks like the PRICE principle and specific rehabilitation protocols that facilitate faster and safer returns to play. The literature indicates a gap in understanding among team managers regarding the role of sports physiotherapy, highlighting the pressure players face to return prematurely, which increases the risk of re-injury. In summary, successful rehabilitation of muscle injuries in football necessitates a comprehensive, personalized approach that integrates physical, nutritional, and psychological elements. As research continues to evolve, these strategies will enhance the effectiveness of rehabilitation programs, ensuring football players can recover fully and maintain optimal performance levels.

Ergonomics in Facial Plastic and Reconstructive Surgery: A Clinical Evaluation.

Surgeons experience a risk for physical strain and injury secondary to physical demands in the workplace. To minimize injury and maximize career longevity, physicians should be aware of ergonomics pitfalls and postural correction methods. This study investigates ergonomic trends in Facial Plastic and Reconstructive Surgery (FPRS) clinic by quantifying surgeons' and trainees' cervicothoracic spine posture. Participants completed a 22-item questionnaire to evaluate current ergonomic practices. A lightweight device was calibrated and attached to the mid-scapular region of participants, providing real-time posture feedback. The percentage of time in upright posture was recorded during clinical and operative workdays. Upright posture was defined as neutral spine positioning with acceptable mild to moderate deviations. Two FPRS attending surgeons, 1 FPRS fellow, and 11 otolaryngology residents participated over 12 months. Discomfort was most commonly reported in the neck, shoulders, and upper back during clinic. Symptoms were self-treated by changing body position, wearing specialized footwear, adjusting height of the chair or examination table, or ignoring discomfort. Eighty-two percent were unaware of ergonomic guidelines or appropriate considerations. Time spent in upright posture was significantly higher in clinic (84.9%) than in the OR (53.5%) (p < 0.001). Upright posture declined after reaching 6 work hours (p = 0.029); no such patterns were observed in the OR (p = 0.946). Although time spent in upright posture was objectively poorer in the OR, these data suggest ergonomics are an important consideration in the outpatient setting, with surgeons experiencing discomfort during and after clinic. Further investigation is warranted to identify actionable changes and promote healthy ergonomics. N/A Laryngoscope, 2024.

Reeducating for the Artificial Intelligence (AI) Century

The age of AI is characterized by significant changes in the realms of work and technology. Rapid technological advances and automation are reshaping industries, highlighting the need for individuals to learn new skills. In the age of AI, upskilling has become an essential strategy to navigate the ever-changing career landscape. Upskilling involves continuous learning and gaining expertise in areas that complement or leverage AI technology. Upskilling has become a necessity, referring to the process of improving one’s skills and knowledge to remain relevant and effective in an environment increasingly dominated by artificial intelligence (AI) and automation. This post discusses the importance of upskilling in the context of the AI era, highlighting its benefits, challenges, and potential options. It enables workers to adapt to AI-driven changes, allowing them to remain relevant and competitive. This change promotes career longevity and nurtures a workforce capable of harnessing the potential of AI. In this study, the authors have attempted to articulate the goal and importance of AI in upskilling employees who can collaborate effectively with AI systems, leading to increased productivity and improved innovation. In addition, recommendations have been made for HR managers on upskilling employees through AI intervention.

A review of ergonomic positions to improve musculoskeletal distress in hepatobiliary pancreatic surgeons according to open, laparoscopic, and robotic surgeries.

Advances in surgical ergonomics are essential for the performance, health, and career longevity of surgeons. Many surgeons experience work-related musculoskeletal disorders (WMSDs) resulting from various surgical modalities, including open, laparoscopic, and robotic surgeries. To prevent WMSDs, individual differences may exist depending on the surgical method; however, the key is to maintain a neutral posture, and avoid static postures. This review aims to summarize the concepts of ergonomics and WMSDs; identify the ergonomic challenges of open, laparoscopic, and robotic surgeries; and discuss ergonomic recommendations to improve them.

The Ergonomic Evaluation of Attendings and Trainees Across the Vitreoretinal Service as Measured by a Wearable Device

Background and Objective: A cross-sectional prospective study to examine ergonomic differences in vitreoretinal settings: surgery, clinic, and dedicated procedure clinic. Patients and Methods: Three vitreoretinal surgeons, three fellows, and one resident at a tertiary eye care facility. Participants wore an Upright Go 2 posture device and posture was recorded in each setting between July 1 to August 31, 2023. Results: Time in upright and poor postures was tracked. Significant differences were found in postural score for attendings between work settings ( P &lt; 0.01). Trainees showed no significant difference between settings. Poor posture in surgery was linked to microscope use and scleral buckle placement; in the clinic, it was associated with pan-retinal photocoagulation and injection minutes; in procedure clinic, it was ophthalmologist-dependent and those performing injections. Conclusions: Ergonomic considerations are crucial in vitreoretinal practice. Attendings and trainees should focus on posture in surgery and clinic settings to enhance career longevity. [ Ophthalmic Surg Lasers Imaging Retina 2024;55:XX–XX.]

Ergonomic Considerations for Practicing Massage Therapists.

The physical demands and repetitive movements performed by massage therapists during a treatment increase the risk for work-related musculoskeletal disorders. While massage therapy meets the level of heavy physical demand, the ergonomic risk of performing a massage was previously unknown. The Massage Therapy Foundation undertook a job task analysis to be used by educators, employers, and clinicians to create an optimal work environment. Data collected via survey were used to create the protocol for an onsite data collection where massage therapists were evaluated on the ergonomic risk factors by trained ergonomists. The results of the job task analysis found the highest variability in movement when the massage therapist was treating the neck prone, neck supine, and leg prone. When the massage therapists did not change positions during a stroke, there was increased forward flexion of the trunk which increased postural stress on the extensors of the back and neck. Strokes such as effleurage which can span the entire length of the body part had the highest cumulative load, requiring postures that put mild biomechanical stress on the shoulders (90% of the time), neck (70% of the time), and trunk (60% of the time). The forward-bending posture of the massage therapist increases the eccentric demands of the therapist's neck and back musculature, thereby increasing fatigue and leading to an increase in the chance of overuse injury. The job task analysis recommends the massage therapist monitor the duration of application in an unsupported position, take more time between sessions, work in an optimum environment, including correct table height, and have a healthy, active lifestyle to maintain career longevity.

Lateral extra-articular tenodesis at primary ACL reconstruction increases career length in professional rugby players.

To assess the effect of preoperative and surgical factors on return to play (RTP) rates and career longevity of professional rugby athletes after primary anterior cruciate ligament (ACL) reconstruction (ACL-R). A retrospective review of a consecutive cohort of professional rugby players undergoing primary ACL-R by the senior author between 2005 and 2019 was undertaken. Athletes were included if they were under contract with a professional rugby team at the time of injury and had a minimum of 2-year follow-up. Univariate and multivariate analyses were performed to determine significant predictors of RTP rate, time and career longevity. One hundred and eighteen rugby players with 125 ACL-Rs were identified. Return to professional rugby was achieved in 115/125 (92%) of cases at an average of 9.6 months and those athletes participated at the professional level for 5.9 ± 3.4 years after ACL-R. Younger age (p = 0.006) and ACL-R with a concomitant lateral extra-articular tenodesis (LET) (p = 0.013) were predictors of a longer career. A Cox proportional hazards model that controlled for age revealed that athletes who underwent ACL-R with an LET had increased career longevity compared to those with an ACL-R without LET (hazard ratio = 2.74, p = 0.021). No factors were significantly associated with RTP rate or RTP time. In professional rugby players undergoing primary ACL-R, those having ACL-R with a concomitant LET and younger age predicted increased career longevity. Rugby players who underwent LET at the time of ACL-R had an 18% greater chance of still playing professionally at 5 years compared to those who underwent ACL-R alone. Level III.

The Effects of Burnout, Team Support, and Perceived Leader Effectiveness on Career Intentions Among JAG Corps Personnel.

Destructive interpersonal relationships at work may result in negative feelings among employees that hinder personal and organizational productivity, which may also result in high levels of job disengagement and subsequent career turnover intentions. Leaders play a key role in creating work environments conducive to optimizing employee performance, organizational culture, and workplace well-being. Social support, which may include support from one's supervisor, colleagues, and loved ones, has been shown to reduce strains and perceived stressors at work. In the Army, the Judge Advocate General's Corps (JAGC) personnel have a unique position as lawyers and legal staff and have been shown to have high rates of burnout. To promote soldier health, well-being, and career longevity, it is important to understand the impact interpersonal relationships have on career intentions. The current study assesses the relationship between perceived leadership effectiveness and career intentions as moderated by burnout measured by job disengagement and team care activities in JAGC personnel. The Walter Reed Army Institute of Research conducted a survey to understand factors affecting the well-being of the JAGC's soldier and civilian personnel as requested by the JAGC. JAGC personnel were administered several questionnaires covering a range of work and mental health topics. Job disengagement, career intentions, team care activities, and general leadership were assessed. A total of 831 JAGC personnel completed the survey, the majority (92%) of which were soldiers. Among soldiers, first lieutenants and captains (∼49%) were the majority. The sample largely consisted of men (∼63%), White individuals (∼76%), married individuals, (70%), and individuals with graduate degrees (∼81%). One in four participants (∼29%) experienced high levels of disengagement, with their work. Over two-thirds of participants agreed that their immediate supervisor is an effective leader. When asked about career intentions, the majority of JAGC participants (54%) indicated that they would probably or definitely stay in the JAGC until retirement. Ordinal logistic regressions were conducted to assess the relationship between perceived leader effectiveness and career intentions, assessing the main effects of job disengagement and team care activities, and the interactions between those variables. No interaction effects were found to be significant, but main effects for perceived leader effectiveness were significant. JAGC personnel reported higher levels of job disengagement for those with career intentions that were undecided or definitely leaving the JAGC after their current obligation. Those who were engaged in more team care activities had lower levels of disengagement. While the majority of the JAGC participants indicated career intentions to stay in the JAGC until retirement, increasing perceived effectiveness of leaders could help increase attrition and career intentions to stay in the JAGC beyond one's current obligation.

Silent Struggles: Traumatic Brain Injuries and Mental Health in Law Enforcement.

To determine the prevalence of head injuries (HIs), posttraumatic stress disorder (PTSD), and depressive symptoms in law enforcement officers (LEOs) and (2) the association between HIs and psychological health conditions. County-level survey administered via Research Electronic Data Capture. A total of 381 LEOs completed the survey (age=43±11years; 40 [11%] females; time as LEO=1-50years, median=15years). Cross-sectional study. We examined the prevalence of HIs (the Ohio State University Traumatic Brain Injury Identification Method), PTSD (PTSD Checklist-Civilian [PCL-C]), and depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]). We used Mann-Whitney U and chi-square analyses to compare PTSD and depressive symptoms between those with and without a HI history. There were 282 (74%) participants who reported a lifetime history of 1 or more HIs; 116 (30%) sustained 1 or more HIs on the job. PCL-C scores ranged 17 to 85 (median=27); 33 (10%) participants met or exceeded the clinical cutoff score of 50 to indicate a positive PTSD screening. Participants with a HI history (median=29) had higher PCL-C scores than those with no HI history (median=24; P <.001), but the proportion of participants who met the clinical cutoff for PTSD was not different between those with (n =28, 11%) and without (n =5, 5%) a HI history (X2=2.52, P =.112, odds ratio=2.18; 95% confidence interval, 0.82-5.83). PHQ-9 scores ranged 0 to 20 (median=3); 124 (36%) participants reported mild or greater depressive symptoms. Participants with a HI history (median=3) had higher depressive symptoms than those with no HI history (median=2; P =.012). The proportion of participants with mild or greater depressive symptoms was higher among those with a HI history (n =99, 39%) than without (n =25, 27%; X2=4.34, odds ratio=1.74; 95% confidence interval, 1.03-2.93). HIs are prevalent in LEOs, which may have consequences for their performance, well-being, and career longevity. PTSD and depressive symptoms are higher in those with a HI history, suggesting LEOs need better traumatic brain injuries and mental health resources.

Career Length After Surgically Treated ACL Plus Collateral Ligament Injury in Elite Athletes

Background: Limited data are available regarding career length and competition level after combined anterior cruciate ligament (ACL) and medial- or lateral-sided surgeries in elite athletes. Purpose: To evaluate career length after surgical treatment of combined ACL plus medial collateral ligament (MCL) and ACL plus posterolateral corner (PLC) injuries in elite athletes and, in a subgroup analysis of male professional soccer players, to compare career length and competition level after combined ACL+MCL or ACL+PLC surgeries with a cohort who underwent isolated ACL reconstruction (ACLR). Study Design: Cohort study; Level of evidence, 3. Methods: A consecutive cohort of elite athletes undergoing combined ACL+MCL and ACL+PLC surgery was analyzed between February 2001 and October 2019. A subgroup of male elite soccer players from this population was compared with a previously identified cohort having had isolated primary ACLR without other ligament surgery. A minimum 2-year follow-up was required. Outcome measures were career length and competition level. Results: A total of 98 elite athletes met the inclusion criteria, comprising 50 ACL+PLC and 48 ACL+MCL surgeries. The mean career length after surgical treatment of combined ACL+MCL and ACL+PLC injuries was 4.5 years. Return-to-play (RTP) time was significantly longer for ACL+PLC injuries (12.8 months; P = .019) than for ACL+MCL injuries (10.9 months). In the subgroup analysis of soccer players, a significantly lower number of players with combined ACL+PLC surgery were able to RTP (88%; P = .003) compared with 100% for ACL+MCL surgery and 97% for isolated ACLR, as well as requiring an almost 3 months longer RTP timeline (12.9 months; P = .002) when compared with the isolated ACL (10.2 months) and combined ACL+MCL (10.0 months) groups. However, career length and competition level were not significantly different between groups. Conclusion: Among elite athletes, the mean career length after surgical treatment of combined ACL+MCL and ACL+PLC injuries was 4.5 years. Professional soccer players with combined ACL+PLC surgery returned at a lower rate and required a longer RTP time when compared with the players with isolated ACL or combined ACL+MCL injuries. However, those who did RTP had the same career longevity and competition level.

Considering the Wellbeing of Those Designing the Built Environment: Attrition Factors Impacting the Career Longevity of Architecture Graduates

Considering the Wellbeing of Those Designing the Built Environment: Attrition Factors Impacting the Career Longevity of Architecture Graduates

Professional Burnout and Career Choice Regret in Urology Residents.

High rates of professional burnout and career choice regret among urology residents may increase professional dissatisfaction, shorten career longevity, and exacerbate urology workforce shortages. Understanding the prevalence of and risk factors for burnout may help develop interventions. Up to 48% of contemporary U.S. urology residents experience burnout symptoms, including up to 70% of second-year residents. Among overlapping personal, professional, institutional, and lifestyle risk factors, barriers to accessing medical and mental health care are frequently cited as an important association in residents. Limited intervention studies suggest that providing basic needs, such as on-call meals, and facilitating physical wellness and social engagement among residents may result in sustained reductions in burnout. Urology residents continue to experience high rates of burnout and career choice regret among medical specialties. Evidence-based interventions and sustainable policies that address primary risk factors are urgently needed.

655 Aching for Change: Musculoskeletal Pain in the Operating Room Amongst KSS Trainees

Abstract Aim Work-related injuries are common among surgeons, with some studies finding up to 70% report difficulties. Given the increasing career longevity expected from today's surgical trainees, injury prevention is more important than ever. However, ergonomics education for surgical trainees in the UK is deficient. We aimed to gauge whether current trainees in Kent, Surrey, and Sussex (KSS) experience pain whilst operating and what strategies, if any, they utilise. Method A questionnaire was distributed to trainees in the KSS School of Surgery collecting data on basic demographics, pain related to operating and pain management strategies. Results 75 trainees across the KSS region responded. Mean age was 32 years (range 26-42) and median training level was ST4. General surgery (n=22), orthopaedics (n=19) and urology (n=13) were the most prevalent specialties. All trainees reported musculoskeletal pain attributed to operating, with 36% (n=27) experiencing pain “frequently” or “always”. 69% (n=52) found this pain “sometimes”, “frequently” or “always” distracted them whilst operating. The most common sites for pain were the lower back (73%), neck (49.3%), upper back (38.7%) and shoulders (37.3%). No participants had received formal ergonomics training and the majority (86.7%) had not discussed pain with their supervisors. Conclusions Musculoskeletal pain from operating was found to be a common issue in this cohort, with the majority reporting distraction while operating. Ergonomics is not currently addressed by any formal training programmes. We have recommended a regional training initiative for trainees in KSS to address and prevent musculoskeletal injuries.

A social science: Using psychoneuroimmunology principles to promote career longevity, productivity, and meaning

Over the past several decades, psychoneuroimmunologists have uncovered key principles (e.g., social support and stress management) that can inform future research content and conduct. That is, psychoneuroimmunology (PNI) can inform how scientists from all disciplines engage in the scientific method in a more sustainable manner. Dr. Janice Kiecolt-Glaser, a PNI pioneer, recently ended her long and celebrated career. Her unique engagement in the scientific method, including her mentorship style, is worthy of closer examination. As her final graduate student, I observed Dr. Kiecolt-Glaser's science and mentorship style at their full maturity. Her scientific content, remarkable in its own right, is the subject of commentaries and accolades; yet, her scientific conduct – the foundation of her success and innovation – deserves further consideration. This article outlines ten research conduct principles that Dr. Kiecolt-Glaser explicitly and implicitly taught: (1) applying the literature to one's own health behaviors; (2) knowing and remembering “the why” behind the science; (3) developing and adhering to a vision; (4) creating a streamlined workflow; (5) embracing team science; (6) pursuing depth and breadth; (7) communicating ideas clearly; (8) engaging in a daily rhythm of science; (9) treating trainees like future primary investigators; and (10) working toward clinical meaningfulness. These principles correspond to PNI findings and account for her health and longevity as a scientist.

Defensive Performance Declines in Ultimate Fighting Championship Fighters Following Anterior Cruciate Ligament Reconstruction

PurposeThe purpose of the present study is to evaluate the impact ACL reconstruction (ACLR) has on strike evasion rates, strike and landing rates, win percentage, and career longevity in UFC fighters. MethodsUFC fighters who underwent ACLR from 1993-2022 were matched 2:1 with uninjured controls. The percentage of each injured fighter’s career that occurred before ACLR was deemed the “index percentage.” Injured fighter performance pre-/post-ACLR was compared to control metrics pre-/post-index percentage. ResultsA total of 82 subjects with documented ACL injuries were identified. There were 48 who met the inclusion criteria. Of these, 27 returned for more than 2 fights and were paired with 54 controls. UFC fighters demonstrate return-to-sport rates of 81.25% and 56.25% for at least one and two fights, respectively. On average, it took 411.85±174.73 (range, 165-879) days for fighters to return. All fighters had significantly lower evasion rates against total significant strikes, distance strikes, and head strikes, post-index; p<0.05 for each. ACLR fighters had significantly lower submission attempts and evasion rates against clinch strikes, ground strikes, and total strikes, post-index; p<0.05 for each. Controls had a significantly lower evasion rate against leg strikes, post-index. Both groups’ win percentages significantly declined (ACLR p=0.001, control p=0.012). No significant difference in total career fights was observed (p=0.873). ConclusionsIn this study, we found that most UFC fighters who undergo ACLR return to sport for at least one fight; however, just over half return for at least two fights. There was not a significant difference in career length between fighters who returned to sport following ACLR for at least two fights and their controls. Defensive performance, but not offensive performance, declined significantly following ACLR. All fighters demonstrated significant declines in their win percentage as their career progressed, irrespective of ACLR.

A qualitative study of final year student veterinary nurses' career plans and expectations

Introduction: The limited longevity of veterinary nurses' clinical careers is a current challenge faced in the veterinary industry. In order for veterinary nurse job vacancies to be filled, it is essential for graduate veterinary nurses to be motivated to seek employment in clinical practice. The aim of this study was to explore the career plans and expectations of final year student veterinary nurses. Method: Online semi-structured interviews with ten final year student veterinary nurses were used to collect qualitative data. Thematic analysis was used to analyse the data. Results: The results revealed that there were aspects of clinical practice the participants were looking forward to and others they perceived would be challenging and may threaten the longevity of their clinical career. An example was the demanding nature of the job role. Discussion: All participants expressed a desire to work in clinical practice following their graduation, but were aware that they were unlikely to have long-term clinical careers. It is recommended that veterinary nurse educators should support students to develop the resilience necessary for them to face the challenges of clinical practice and also help them to gain the transferrable skills they may require for alternative future career paths.

Diagnostic Approach to Equine Testicular Disorders.

Management of breeding stallions is crucial to equine reproduction. The longevity of the breeding career is the ultimate objective, whether the stallion is used for natural cover or for semen collection and artificial insemination. Stud farm veterinarians should be aware of the techniques used to evaluate testicular function and the diagnostic approach to testicular disorders in cases of emergency. This paper presents the clinical methods used to evaluate testicular health, including palpation, ultrasonography, biopsy, and fine-needle aspiration. The discussion of testicular disorders is broken down into four categories: congenital disorders (cryptorchidism, monorchidism, and testicular hypoplasia), differential diagnosis of scrotal enlargement, differential diagnosis of causes of progressive testicular enlargement, and differential diagnosis of testicular asymmetry or reduction in size with an emphasis on testicular degeneration. The sudden increase in testicular size is often accompanied by severe clinical signs and is a major cause for referral of stallion for surgery. Testicular disorders are illustrated with clinical cases seen by the authors.

13 Impact of precision feeding during gestation on the productive career of sows over three reproductive parities

Abstract The aim of this study was to evaluate the impact of precision feeding during gestation on the career performances and longevity of sows, initially gilts, monitored over three successive reproductive cycles. Four isoenergetic treatments were compared: two conventional constant-concentration feeding strategies (0.53 % DIS Lys) with feed supply either constant (flat feeding; FF) or variable (bump feeding; BF), and two precision feeding strategies based on the InraPorc model applied considering either the mean weight by parity (PFP) or the individual weight of each sow at breeding (PFI). Four groups, representing 393 gilts, were followed from breeding to weaning over three cycles. Body weight and backfat depth were measured at breeding, 90 d of gestation, parturition, and weaning. Feed consumption was monitored daily. Litter variables were measured, including birth and weaning weight, mortality, and overall body weight gain. A mixed model was used to analyze differences between the four treatments using the sow as the experimental unit for performance analysis during the third reproductive cycles. For the analysis of the overall productive career over the three reproductive cycles, the performances of the two conventional strategies (with constant Lys DIS concentration feeding, CONV) were compared with the two precision feeding strategies (PF). During the third cycle, PFP and PFI sows had a lighter body weight at the beginning of gestation than the FF sows (P &amp;lt; 0.01), but increased their body weight gain during gestation (P &amp;lt; 0.001). Backfat loss in PFP and PFI sows during lactation was greater compared with BF sows (P = 0.05), FF sow being intermediate. PFP sows had a lower stillborn rate (P = 0.04) and tended to have less total piglet mortality (P = 0.06) than FF and BF sows. Over the three reproductive cycles, the stillborn rate and total piglet mortality were less in PF sows than in CONV sows (respectively -0.9 %; P = 0.02 and -1.5 %; P = 0.03). PF sows weaned more piglets during their three cycles than CONV sows did (+ 0.7; P = 0.03), with weaning litter weight gain also increasing for PF sows (+3.7 %; P = 0.02). The culling rate of gilts after three cycles did not differ significantly among treatments (P = 0.27), but tended to be greater for PF sows after one cycle (+4.9 %; P = 0.08). The results seem to show a lasting benefit of precision feeding for sows, with a decrease in piglet mortality during lactation, suggesting greater piglet viability without significantly decreasing sow longevity.

Fasciotomy and Occupational Separation among US Service Members with Lower Extremity Chronic Exertional Compartment Syndrome.

Lower extremity chronic exertional compartment syndrome (LE-CECS) can limit rigorous physical activity, particularly in the US military, and fasciotomy is a potential treatment. Associations between LE-CECS, fasciotomy, and occupational outcomes appear understudied. We studied active-duty US service members to identify whether LE-CECS diagnoses and fasciotomy for LE-CECS predict military service separation. We conducted a retrospective cohort study of 1,103,417 individuals who entered service during 2011 to 2017. Distributions of separation statuses and independent variables were tabulated, and sex-specific multivariable regression models were computed for separation outcomes. LE-CECS was associated with a 474% medical service separation risk in men (95% confidence interval (CI) for adjusted risk ratio: 5.21 to 6.33) and a 282% increase in women (CI: 2.99 to 4.88). Among 1947 patients with LE-CECS, men saw a 57% nonmedical separation risk increase (CI: 1.27 to 1.93) and women had a 119% increase (CI: 1.10 to 4.35) when anterior and/or lateral compartment procedures occurred. Men with LE-CECS and any posterior procedures saw a 47% nonmedical separation risk increase (CI: 1.17 to 1.86). Men with anterior and/or lateral procedures and any posterior procedures experienced 36% (CI: 1.09 to 1.71) and 78% (CI: 1.40 to 2.26) medical separation risk increases, respectively. No statistically significant risk increases for the outcomes were otherwise seen for women. LE-CECS was associated with increased military service discharge risks. Among the affected patients, positive effects on career longevity were not seen in association with fasciotomy. However, fasciotomy could simply serve as a marker of the most refractory cases that are least likely to continue service. More study is needed to clarify causal pathways and identify patients who may derive career benefits from surgical treatment.