Elevated Risk Of Injury Research Articles

Drug-Resistant Epilepsy and Gut-Brain Axis: an Overview of a New Strategy for Treatment.

Drug-resistant epilepsy (DRE), also known as intractable epilepsy or refractory epilepsy, is a disease state with long-term poorly controlled seizures attack. Without effective treatment, patients are at an elevated risk of injury, premature death, mental disorders, and poor quality of life, increasing the need for a fresh perspective on the etiology and treatment of DRE. The gut is known to harbor a wide variety of microorganisms that can regulate the host's response to exogenous signals and participate in various physiological and pathological processes in the human body. Interestingly, emerging evidence has uncovered the changes in gut microbiota in patients with epilepsy, particularly those with DRE. In addition, both dietary interventions and specific antibiotic therapy have been proven to be effective in restoring the microecological environment and, more importantly, reducing seizures. Here, we reviewed recent studies on DRE and the involvement of gut microbiota in it, describing changes in the gut microflora composition in patients with DRE and corresponding animal models. Furthermore, the influence of the ketogenic diet, probiotics, fecal microbiota transplantation (FMT), and antibiotics as microbiome-related factors on seizure control and its possible mechanisms are broadly discussed. Finally, we highlighted the significance of gut microbiome in DRE, in order to provide a new prospect for early identification and individualized treatment of patients with DRE.

Conservative Concussion Management in Youth Athletes Can Avoid Increased Injury Rates After Return to Sport: Initial Evidence

Objective: To evaluate whether injury rates are elevated after return to sport after concussion clearance in youth athletes and examine differences between concussed athletes who sustain injury after return to play and those who remain uninjured. Design: Prospective cohort study. Setting: Large metropolitan hospital. Participants: Twenty-four youth athletes cleared for return to play after a concussion and 84 pediatric athletes without concussion. Independent Variables/Interventions: Concussion (with return to play clearance) versus no concussion; age, sex, hours of sleep, and sports participation. Main Outcome Measures: Injury for a 12-week period. Results: Injury rates were similar between the concussed (5/24 = 21%) and nonconcussed (15/84 = 18%) athletes (P = 0.77). Within the concussion group, there was no significant difference between the noninjured and injured participants in time to return to play, time from concussion to initial evaluation, age, sex, hours of sleep per night, or hours of sports participation per week (P ≥ 0.19). The median time to clearance for the concussed athletes was 34 (range: 18–61) days. Conclusions: This study provides preliminary evidence suggesting that when current guidelines for return to play are followed, concussed pediatric athletes can resume activity without facing an elevated risk of injury. Time to achieve clearance in pediatric and adolescent athletes can be expected to be longer than the 7 to 14 days typical for older athletes.

The Effects of Angiotensin II versus Norepinephrine on Pulmonary Vascular Resistance in Cardiac Surgery: Post Hoc Analysis of a Randomized Controlled Trial

ObjectivesTo assess whether angiotensin II infusion increases pulmonary vascular resistance (PVR) relative to norepinephrine. DesignSecondary analysis of a double-blinded randomized feasibility study. SettingTwo tertiary metropolitan hospitals in Melbourne, Australia. ParticipantsAdult patients having cardiac surgery using cardiopulmonary bypass with an elevated risk of acute kidney injury (AKI). InterventionsAngiotensin II infusion compared with norepinephrine infusion. Measurements and main resultsWe studied 58 patients. There was no significant difference in the primary outcome of PVR both intraoperatively and postoperatively between the angiotensin II and norepinephrine groups. The study drug (angiotensin II or norepinephrine) infusion rate was associated with a small increase in PVR (Β=0.08, p=0.01). The strongest association with PVR was the random effect (patient effect) (p<0.001), This effect was consistent across secondary outcomes. Randomization to norepinephrine (but not angiotensin II) was associated with reduced mean systemic arterial to mean pulmonary arterial pressure ratio postoperatively (Β=-0.65, p=0.01). ConclusionsThe results of this study suggest that, in cardiac surgery patients and compared with norepinephrine, at doses used in the prior feasibility study, angiotensin II did not have significant effects on the pulmonary vasculature. Moreover, at doses used in this study, neither drug appeared to have a substantial effect on the pulmonary circulation relative to surgical and patient factors.

Do they really return to early? Investigating the causal effect of rehab time on injury risk after return to play in elite football

In elite football, injury risk is considerable. Consequently, optimal rehabilitation and an adequate time point of return-to-play (RTP) are crucial. The elevated injury risk in the weeks after RTP (e.g. Orchard &amp; Best, 2002; Wangensteen et al., 2016) and the time course of biological healing processes (Orchard &amp; Best, 2002) nourished the speculation that players generally return to early. While the previously reported negative association between rehab time and injury risk after RTP (e.g. Beischer et al., 2020; Della Villa et al., 2021; Orchard &amp; Best, 2002) points in the same direction, the truism “Correlation does not imply causation.” must be considered. To the best of our knowledge, the causal effect of rehab time on injury risk has not been investigated so far. This work aims to contribute towards closing this gap in knowledge. Specifically, to scrutinize if a reduction in injury risk may be expected when RTP is delayed. Previous time-loss injuries and match exposures of players currently playing in the European top leagues (Germany, Austria, France, Spain, Italy, Netherlands, United Kingdom) were collected from public sources and episodes (index injury-RTP-subsequent injury) constructed. Data analysis was conducted in R. Considering the time dependence of the excess injury risk after RTP, we analyzed injury occurrence after RTP within a fixed time frame (28 days). A robust scaling approach was used for making rehab time comparable between index injury diagnoses. Exposure within the 28-day period was adjusted for eventual time loss due to subsequent injury. The association between rehab time and injury was analyzed using logistic regression. Odds ratios (OR) were calculated from regression coefficients and adjusted for baseline probability to avoid overestimation of relative risk (RR). Two approaches were used to delineate a potential causal effect: (a) sensitivity analysis for the putative confounder (using Cornfield’s inequality) and (b) path analysis which due to the simple causal diagram could be implemented by including exposure in the logistic regression model. Eight thousand six hundred and forty-four episodes could be included among which 1,245 (14 %) had a subsequent injury within 28 days. There was a highly significant negative association between scaled rehab time and injury risk (RR 0,896), which was more pronounced for recurrences (RR 0,815). Cornfield’s inequality indicates that exposure would have to be lower by at least ~10% for every interquartile range of rehab time of the respective index injury to account for the observed association. While this is substantial, early return is in fact closely associated with higher exposure and this association accounts entirely for the observed association between rehab time and injury risk (Figure 1). Note that Figure 1 also shows that high exposures are observed exclusively after an early return. We conclude that the negative association between rehab time and injury risk is largely accounted for by higher exposures after early return. However, following from the limitations associated with predicting outside the range of previously observed values, the virtual absence of high exposures after long rehab (for the respective diagnosis) impedes on predicting the effect of prolonging rehab time.

Comparison of radiography and computed tomography for identification of third metacarpal structural change and associated assessment of condylar stress fracture risk in Thoroughbred racehorses.

Catastrophic injury has a low incidence but leads to the death of many Thoroughbred racehorses. To determine sensitivity, specificity, and reliability for third metacarpal condylar stress fracture risk assessment from digital radiographs (DR) and standing computed tomography (sCT). Controlled ex vivo experiment. A blinded set of metacarpophalangeal joint DR and sCT images were prepared from 31 Thoroughbreds. Four observers evaluated the condyles and parasagittal grooves (PSG) of the third metacarpal bone for the extent of dense bone and lucency/fissure and assigned a risk assessment grade for condylar stress fracture based on imaging features. Sensitivity and specificity for detection of subchondral structural changes in the condyles and PSG, and for risk assessment for condylar stress fracture were determined by comparison with a reference assessment based on sCT and joint surface examination. Agreement between observers and the reference assessment and reliability between observers were determined. Intra-observer repeatability was also assessed. Sensitivity for detection of structural change was lower than specificity for both imaging methods and all observers. For agreement with the reference assessment of structural change, correlation coefficients were generally below 0.5 for DR and 0.49-0.82 for sCT. For horses categorised as normal risk on reference assessment, observer assessment often agreed with the reference. Sensitivity for risk assessment was lower than specificity for all observers. For horses with a reference assessment of high risk of injury, observers generally underestimated risk. Diagnostic sensitivity of risk assessment was improved with sCT imaging, particularly for horses categorised as having elevated risk of injury from the reference assessment. Assessment repeatability and reliability was better with sCT than DR. The ex vivo study design influenced DR image sets. Risk assessment through screening with diagnostic imaging is a promising approach to improve injury prevention in racing Thoroughbreds. Knowledge of sensitivity and specificity of fetlock lesion detection provides the critical guidance needed to improve racehorse screening programs. We found improved detection of MC3 subchondral structural change and risk assessment for condylar stress fracture with sCT ex vivo.

Assessing Kinematic Variables in Short-Track Speed Skating Helmets: A Comparative Study between Traditional Rigid Foam and Anti-Rotation Designs

Purpose: Short-track speed skating results in high-energy crashes with an elevated risk of head injury. The goal of this study was to evaluate the resulting kinematics of an anti-rotation helmet technology for speed skating. Methods: Two traditional rigid foam speed-skating helmets (BT and ST) were compared with one anti-rotation speed skating helmet (MIPS). Each helmet was impacted with a pneumatic device across three locations. The resulting linear or rotational accelerations (PLA or PRA) and rotational velocities (PRV) were measured with accelerometers placed on a Hybrid III head form. Additionally, the head impact criterion (HIC) was calculated from accelerations and the brain injury criterion (BrIC) was obtained from rotational velocities. Results: MIPS showed significantly higher values of accelerations (PLA = 111.24 ± 9.21 g and PRA = 8759.11 ± 2601.81 rad/s2) compared with the other helmets at all three impact locations (p &lt; 0.01, ES = 3.00 to 4.11). However, velocities were lowest, but not significantly different, for the MIPS helmet (25.77 ± 1.43 rad/s). Furthermore, all resulting kinematics except peak linear accelerations were significantly different across impact locations. Conclusion: Helmet designs specific to the collision characteristics of speed skating may still be lacking, but would decrease the risk of sport-related concussions.

The Influence of Induced Head Acceleration on Lower-Extremity Biomechanics during a Cutting Task.

Sports-related concussions are caused by one substantial impact or several smaller-magnitude impacts to the head or body that lead to an acceleration of the head, causing shaking of the brain. Athletes with a history of sports-related concussion demonstrate lower-extremity biomechanics during landing tasks that are conducive to elevated injury risk. However, the effect of head acceleration on lower-extremity biomechanics during landing tasks is unknown. Twenty participants were evenly separated into a vertical hopping group and a lateral hopping group. Participants performed several land-and-cut maneuvers before and after a hopping intervention. Vertical head acceleration (g) was measured via an accelerometer during the hopping interventions. Comparisons in head acceleration during the hopping tasks were made between groups. Additionally, kinematic and kinetic variables were compared pre- and post-intervention within groups as well as post-intervention between groups. The vertical hopping group demonstrated greater vertical head acceleration compared to the lateral hopping group (p = 0.04). Additionally, the vertical hopping group demonstrated greater knee abduction angles during landing post-intervention compared to the lateral hopping group (p < 0.000). Inducing head acceleration via continuous hopping had an influence on lower-extremity biomechanics during a landing task.

A Contemporary analysis of tackle height: Implications for head injury risk and tackler technique in Rugby Union

Rugby tackles pose significant head injury risks, raising concerns for players' well-being. Despite advocating for lower tackle heights for safety, limited research exists explaining how tackle height influences head characteristics and tackler technique. This study aimed to investigate the effects of two tackle heights, aligned with recent law changes in the community game, on head and joint kinematics for both tackler and the ball carrier. To strengthen ecological validity, innovative techniques were employed, including markerless motion capture and Inertial Measurement Units (IMUs), for tracking of the tackler's joint kinematics and head accelerations until ground contact, addressing a key limitation in previous research. Ethical approval was granted by Cardiff Metropolitan University. Ten male participants (mean ± SD age: 22 ± 3 years, stature: 184 ± 10 cm, mean mass: 94 ± 15 kg) alternated between tackler and ball carrier roles, executing upper and lower body tackles. Theia3D markerless motion capture software (Theia3Dv2022.1.0.2309, Theia Markerless, Inc., Kingston, ON, Canada) and Vicon IMeasureU Blue Trident dual-G IMUs measured tackle height's impact on head and joint kinematics. Discrete joint angles at key events and continuous joint angles normalised from 0% at Step 1 to 100% at Contact were exported. Peak head accelerations and continuous normalised head acceleration data were exported. Statistical analyses included a paired t-test for discrete joint angle data and the Wilcoxon Rank Sum Test for peak linear and angular accelerations. Cohen’s d and effect sizes were calculated for respective analyses. One-dimensional statistical parametric mapping (SPM) and one-dimensional statistical non-parametric mapping (SnPM) facilitated statistical differences across continuous variables of interest. Significant increases (P &lt; 0.05) were noted in ball carriers' inertial head kinematics in the upper body tackle, while no such distinctions were observed for tacklers. The low tackle condition consistently exhibited substantial reductions in bilateral hip flexion, particularly during contact (Effect size; lead: −1.866; rear: −1.977). Lumbopelvic flexion significantly decreased in each event for the low tackle condition, with the largest effect size during contact (−3.91). These findings underscore the heightened inertial loading with higher tackles, indicating an elevated risk of head injury, despite current tackle height regulations. The adjustments made by the tackler in response to varying tackle heights are not evident in knee flexion. Increased knee flexion during the preparatory phase could alleviate the necessity for such a flexed lumbopelvic angle. This study, utilising innovative techniques, highlights the potential for more ecologically valid approaches to biomechanical research in rugby tackling.

Either Autonomy Support or Enhanced Expectancies Delivered Via Virtual-Reality Benefits Frontal-Plane Single-Leg Squatting Kinematics.

Our purpose in this study was to determine the effects of a virtual reality intervention delivering specific motivational motor learning manipulations of either autonomy support (AS) or enhanced expectancies (EE) on frontal plane single-leg squatting kinematics. We allocated 45 participants (21 male, 24 female) demonstrating knee, hip, and trunk frontal plane mechanics associated with elevated anterior cruciate ligament injury risk to one of three groups (control, AS, or EE). Participants mimicked an avatar performing five sets of eight repetitions of exemplary single-leg squats. AS participants were given the added option of choosing the color of their avatar. EE participants received real-time biofeedback in the form of green highlights on the avatar that remained on as long as the participant maintained pre-determined 'safe' frontal plane mechanics. We measured peak frontal plane knee, hip, and trunk angles before (baseline) and immediately following (post) the intervention. The control group demonstrated greater increases in knee abduction angle (Δ = +2.3°) than did the AS (Δ = +0.1°) and EE groups (Δ = -0.4°) (p = .003; η2p = .28). All groups demonstrated increased peak hip adduction (p = .01, ηp2 = .18) (control Δ = +1.5°; AS Δ = +3.2°; EE Δ = +0.7°). Hip adduction worsened in all groups. AS and EE motivation strategies appeared to mitigate maladaptive frontal plane knee mechanics.

Benzodiazepine Initiation and the Elevated Risk of Falls and Fall-related Injuries in Older Adults Following Acute Ischemic Stroke (P2-5.008)

Benzodiazepine Initiation and the Elevated Risk of Falls and Fall-related Injuries in Older Adults Following Acute Ischemic Stroke (P2-5.008)

Neuromuscular Response Disparities in Non-Professional Athletes during Side-Cutting: Exploring Sex Differences through Electromyographic Analysis

This study aims to fill a knowledge gap by investigating electromyographic disparities in anterior and posterior muscle activation and coactivation ratios among non-professional men and women during side-cuttings. A cohort of 162 non-professional athletes participated in directional change maneuvers. Electromyographic assessments focused on coactivation ratios during the initial 50, 100, 150, and 200 ms of contraction, analyzing thigh muscle activations and exploring sex-based differences. Findings revealed higher quadriceps than hamstring muscle activation during directional changes, emphasizing the pivotal role of timing and coactivation ratios. Although the coactivation ratio, indicative of protective muscle control, approached 1 in all directional changes, 40% of subjects exhibited ratios below 0.8, suggesting an elevated injury risk. During open side-cutting at 30°, no significant sex differences were observed in anterior and posterior thigh muscle activation. However, in explosive ratios, women outperformed men, potentially attributable to uncontrolled motor unit recruitment. In open side-cutting at 45° and closed side-cutting at 45°, women displayed significantly higher H/Q ratios, indicating a nuanced sex-specific response. The study underscores the importance of an innovative coactivation ratio approach, revealing its early association with injury risk. Although anterior thigh muscle activation generally exceeded posterior, women exhibited poorer coactivation, potentially heightening knee injury risks during directional changes. This research contributes valuable insights into neuromuscular responses among non-professional athletes, particularly within the context of sex-specific differences.

Concussion history and virtual reality metrics predict core or lower extremity injury occurrence among high school athletes.

A history of concussion is recognized as a risk factor for musculoskeletal injury, which is likely associated with physiological effects that warrant better understanding. This study aimed to assess the potential of measurements obtained from an immersive virtual reality (VR) test to identify a subtle perceptual-motor impairment that may be prospectively associated with the occurrence of a core or lower extremity sprain or strain. A cohort of 68 high school athletes (41 female soccer players and 27 male football players) provided survey responses and completed an immersive VR test several days prior to the initiation of preseason practice sessions. Measurements of eye, neck, arm, and whole-body displacements were obtained during 40 successive lunging/reaching responses to visual stimuli moving horizontally across the VR headset display. Injury occurrences were electronically documented from the initial preseason practice session to the final game of the season. A statistically significant and intrinsically credible two-factor prediction model for core or lower extremity injury occurrence included an interaction between female sex and a self-reported history of two or more concussions, along with slow response time (RT) for arm reach (OR = 4.67; 95% CI, 1.51-14.43). Follow-up analyses identified sex-specific cut points for arm reach RT associated with elevated injury risk, which were ≥1.385 s for females and ≥1.257 s for males. High school female soccer players who have sustained more than one concussion appear to be highly vulnerable to core or lower extremity sprain or strain, with the risk of injury compounded by a slow arm reach RT. Male football players as a group demonstrated significantly faster arm reach RT than that of female soccer players, but slow perceptual-motor RT for arm reach was also identified as a potentially important injury risk factor for male players. Immersive VR appears to provide precise measurements of behavioral performance characteristics that depend on brain processing efficiency. Given that the speed, accuracy, and consistency of perceptual-motor responses may be modifiable, future research should explore the potential benefits of VR training for reducing the risk of sport-related injuries.

Evaluation of Fall and Winter Trinexapac-ethyl Applications on Ultradwarf Bermudagrass Putting Green Color, Quality, and Green Cover

Ultradwarf bermudagrass (UDB) putting greens grown in subtropical and temperate climates can face elevated risk of winter injury from cold temperatures. Trinexapac-ethyl (TE) inhibits UDB growth potentially reducing spring green-up and overexertion of carbohydrate reserves for UDB during the cold de-acclimation period. A field study was conducted to determine the effect of fall and winter TE applications on the visual quality and color of UDB putting greens in Virginia from the cold acclimation phase through the cold de-acclimation phase. A second controlled-environment study was conducted to determine how TE applications to UDB during cold acclimation affected UDB cold tolerance. In the first study, plots were treated with 0.026 kg⋅ha−1 a.i. every 14 days, 0.013 kg⋅ha−1 a.i. every 14 days, or 0.013 kg⋅ha−1 a.i. every 7 days either in the fall only or in the fall and winter. A nontreated control was included for comparison. For the second study, cup-cutter plugs (10.8-cm diameter) of UDB were treated with 0.026 kg⋅ha−1 a.i. every 14 days from the time growth resumed after green-up through cold acclimation or not treated with TE. Plugs were then exposed to −9.4 °C for 4, 6, 8, or 10 hours and placed into a greenhouse to green up. The GC50 values (exposure time to reduce bermudagrass green cover by 50% 6 days after exposure to −9.4 °C) for the treatments were then calculated based on exposure time and percent green-up. In the first study, TE applications improved UDB quality &gt;3.8%. However, TE applications reduced UDB color, and trends exhibited this reduction in color particularly during the late cold acclimation, winter dormancy, and early cold de-acclimation phases. In the second study, TE applications reduced GC50 values by &gt;10.9% compared with nontreated plugs, suggesting TE reduces UDB cold tolerance during the cold acclimation phase.

Jumping Asymmetries and Risk of Injuries in Preprofessional Ballet

Background: Preprofessional ballet dancers are exposed to the risk of injuries, primarily in the lower extremities, with most injuries occurring during jumping and landing activities. Interlimb asymmetry during jumping and landing activities has been associated with the injury risk in adolescent athletes, but this has not been examined in dancers. Purpose: To investigate associations between interlimb asymmetry during a double-leg countermovement jump (DL-CMJ) and single-leg jump (SLJ) and the injury risk in adolescent preprofessional ballet dancers. Study Design: Cohort study; Level of evidence, 2. Methods: Adolescent preprofessional ballet dancers (N = 255) performed 3 DL-CMJs and 3 SLJs on force plates during annual screening. Absolute and directional (separate values for left and right limb dominance) asymmetries in a set of kinetic variables during a DL-CMJ and in jump height during an SLJ were calculated. Each variable was characterized as having “high” or “normal” asymmetry according to the percentage of asymmetry (greater than or less than or equal to, respectively, the mean ± 0.5 SD) based on the present sample. Risk ratios (RRs) and 95% CIs were calculated based on the injury incidence in the subsequent academic year. Results: Of the 242 dancers that satisfied the inclusion criteria, 128 injuries were observed in the subsequent academic year. In the whole sample, 3 absolute, 7 left limb–dominant, and 1 right limb–dominant kinetic asymmetry in the eccentric, concentric, and landing phases of the DL-CMJ as well as left limb–dominant jump height asymmetry in the SLJ were associated with a significant (P < .001) increase in the injury risk (RR, 1.28-1.69 [95% CI, 1.02-2.37]). Separating by sex, asymmetries in the eccentric and landing phase of the DL-CMJ were not significant in boys, while in girls, RRs for asymmetries in the eccentric and landing phase of the DL-CMJ increased, and SLJ jump height asymmetry was not significant. Conclusion: Higher asymmetries in certain kinetic variables during the DL-CMJ and in jump height during the SLJ were associated with an elevated risk of injuries in elite preprofessional ballet dancers with some sex-specific differences. Associations were mainly identified for high left limb–dominant asymmetry in the takeoff phase, suggesting that the injury risk may be specific to a relative right limb deficit.

Does chronic ankle instability patients lead to changes in biomechanical parameters associated with anterior cruciate ligament injury during landing? A systematic review and meta-analysis.

This study aimed to determine if patients with chronic ankle instability (CAI) exhibit biomechanical changes associated with the increased risk of anterior cruciate ligament (ACL) injury during landing tasks. This study was conducted through systematic review and meta-analysis. Searches were conducted in May 2024 across five electronic databases, including Web of Science, Scopus, PubMed, SPORTDiscus, and Cochrane Library. Studies were included if they (1) involved subjects with CAI and healthy controls and (2) assessed biomechanical variables such as ground reaction forces, joint angles, and joint torques. Of the 675 identified studies, 171 were included in the review, and 13 were eligible for meta-analysis. The reviewed studies clearly defined research objectives, study populations, consistent participant recruitment, and exposures, and they used valid and reliable measures for outcomes. However, areas such as sample size calculation, study sample justification, blinding in assessments, and addressing confounders were not robust. This meta-analysis involved 542 participants (healthy group: n = 251; CAI group: n = 291). Compared with healthy individuals, patients with CAI exhibited a greater peak vertical ground reaction force (peak VGRF; SMD = 0.30, 95% CI: 0.07-0.53, p = 0.009), reduced hip flexion angles (SMD = -0.30, 95% CI: -0.51 to -0.17, p < 0.0001), increased trunk lateral flexion (SMD = 0.47, 95% CI: 0.05 to 0.9, p = 0.03), greater hip extension moments (SMD = 0.47, 95% CI: 0.09-0.84, p = 0.02), and increased knee extension moments (SMD = 0.39, 95% CI: 0.02-0.77, p = 0.04). During landing tasks, patients with CAI demonstrate increased hip extension moments and knee extension moments, decreased hip flexion angles, increased peak VGRF, and increased trunk lateral flexion angles. These biomechanical variables are associated with an elevated risk of ACL injuries.

Factors Associated with Medium Trucks Casualties in the Special Region of Yogyakarta, Indonesia

Abstract With medium-duty freight trucks accounting for 37.39% of all freight truck crashes in DI Yogyakarta (the Special Region of Yogyakarta) Province, Indonesia, this study investigates the factors contributing to these accidents and quantifies their association with crash outcomes. Logistic regression analysis is used to predict the probability of a fatal crash based on various factors, including crash severity and potential causal relationships. The model examines the association between categorical variables and the odds of a fatal versus non-fatal crash, explicitly focusing on medium-duty freight truck involvement. The findings indicate that non-freight vehicle drivers experience 1.215 times higher odds of fatality compared to freight vehicle drivers. Additionally, passengers in truck crashes, including those involving medium-duty trucks, face an elevated risk of severe injuries. This study provides crucial insights into the factors influencing crash outcomes in accidents involving medium-duty freight trucks, necessitating targeted safety interventions.

Does Neuromuscular Training Reduce the Risk of Lower-Extremity Musculoskeletal Injury in High School Female Athletes With a History of Sport-Related Concussion?

There is a well-established increased risk of lower-extremity (LE) musculoskeletal (MSK) injury following a sport-related concussion (SRC). Neuromuscular training programs improve biomechanics associated with LE MSK injury and reduce LE MSK injury incidence, but their relative effectiveness in athletes with history of SRC is unknown. The purpose of this study was to evaluate LE MSK injury incidence in female adolescent athletes with history of SRC following a neuromuscular training intervention. Prospective case-control. Seventy-seven adolescent female athletes aged 12-18years who participated in soccer, volleyball, or basketball were recruited from a single institutional sports medicine research and performance center to complete a 6-week neuromuscular training program prior to competitive athletic season. Group (Control, History of SRC) comparisons of athlete exposure and relative LE MSK injury risk and rates during the competitive athletic season were assessed. Ten injuries were recorded by 9 athletes. Female athletes who reported history of SRC had increased injury risk (Risk Ratio 3.9, 95% CI, 1.1-13.8, P = .01) and increased injury rate (rate ratio 4.1, 95% CI, 1.1-15.8, P = .03) compared with female athletes without history of SRC. Female adolescent athletes with history of SRC showed a greater risk of LE MSK injury compared with athletes with no history of SRC. Future work is still needed to understand the underlying mechanisms associated with future LE MSK injury following SRC and interventions that ameliorate elevated injury risk.

Kinematic characteristics of gait with different myopia: a cross-sectional study.

Myopia, a condition affecting approximately one-quarter of the world' s population, has been projected to double in prevalence by the year 2050. It can have an impact on postural control during walking and can increase the risk of falls and injuries. (1) To examine the abnormal performance of postural control during walking in male college students who used convex lenses for myopia intervention from a kinematic perspective; (2) to establish theoretical foundation for preventing falls and injuries in the myopic population. A total of 22 male college students participated in this study. The center of gravity (COG), the percentage of gait cycle (PGC) and the joint angle(JT) were collected as indications of postural control during walking. A quantitative analysis was conducted using a One-Way Repeated Measures ANOVA to examine the variations among the three groups. During myopic interventions, (1) the range of vertical COG changes is significant to be greater compared with normal vision (P < 0.05). (2) there was an significant increase in the PGC in single-legged support, accompanied by a decrease in the PGC in double-legged support, compared with normal vision (P < 0.05). (3) The myopic intervention leads to increased variability in JT of the hip and the knee during the single-leg support and swing, as compared to individuals with normal vision (P < 0.05). Severe myopic interventions result in more changes in JT of ankle. Myopia has been found to have a negative impact on postural control during walking, leading to changes in balance, increased instability, and an elevated risk of injury.

Incidence of nerve injury following acupuncture treatments in Taiwan

ObjectiveAcupuncture, a widely employed traditional therapeutic modality known for its efficacy in pain alleviation and diverse condition management, may inadvertently result in mechanical nerve injury due to its invasive nature. This research aimed to ascertain the incidence of nerve injuries post-acupuncture, identify associated risk factors, and map the distribution of nerve injury sites. MethodsA case-control study nested in the National Health Insurance Research Database (NHIRD) 2000–2018 two million cohort was conducted. Patients previously diagnosed with nerve injury, surgery, or degeneration before acupuncture were excluded. Cases were defined as patients receiving acupuncture and seeking medical attention for nerve injury (ICD9-CM code 950–957) within 14 days post-procedure, while control groups comprised patients undergoing acupuncture without subsequent adverse events. Invasive treatments prior to adverse events and adverse events occurring more than 14 days post-acupuncture were excluded. To ensure case-control comparability, factors such as age, gender, socioeconomic status, and medical facility environment were controlled using propensity score matching. ResultsThe study encompassed 14,507,847 acupuncture treatments administered to 886,753 patients, with 8361 instances of post-acupuncture nerve injury identified, representing an incidence rate of approximately 5.76 per 10,000 procedures. Age emerged as a significant risk factor, with the adjusted odds ratios escalating with age. Several comorbidities including diabetes, hypothyroidism, liver cirrhosis, chronic kidney disease, herpes zoster, hepatitis virus, rheumatoid arthritis, systemic lupus erythematosus, dementia, and cerebrovascular accidents were associated with an elevated risk of nerve injury post-acupuncture. ConclusionThis study underscores the importance of meticulous patient profiling and cautious therapeutic approach in acupuncture, considering the evident influence of various demographic, systemic, and treatment-related factors on the incidence of nerve injuries.

Quantifying the effect of cerebral atrophy on head injury risk in elderly individuals: Insights from computational biomechanics and experimental analysis of bridging veins

The objective of this study was to quantitatively investigate the relationship between cerebral atrophy and the risk of injury in elderly individuals. To achieve this, a sophisticated computational biomechanics approach utilizing finite element analysis was employed to simulate the mechanical behavior of the brain and skull under various conditions. In addition, particular emphasis was placed on understanding the role of cerebral bridging veins (BVs) and their mechanical properties at different ages in the occurrence of head injuries.Head models representing healthy brains and five atrophy models were developed based on imaging data. After validation, the models underwent the identical impact loading conditions to enable the simulation of brain damage. The resulting outcomes of the models with brain atrophy were then compared to the results obtained from the healthy model, allowing for a comparative analysis. Simulations showed increased relative displacement with worsening brain atrophy, particularly in the frontal and occipital regions. Compared to the healthy brain model, relative displacement increased by 2.36 %–9.21 % in the atrophy models, indicating an elevated risk of injury. In severe brain atrophy (FEM 6), the strain reached 83.59 % in local model simulations, leading to damage and rupture of cerebral BVs in both young and elderly individuals. Mechanical tests on cerebral BVs demonstrated a negative correlation between age and ultimate force, stress, and strain, suggesting increased susceptibility to damage with age. An observed sharp decline of approximately 50 % in ultimate stress and 35 % in ultimate strain was noted as age increased. We implemented a 50 % reduction in the intensity of head impact forces; nevertheless, vascular damage continues to manifest in the elderly population. To establish a truly safe zone, it is imperative to further decrease the intensity of the impact. This investigation represents a significant step forward in our understanding of the complex interplay between cerebral atrophy, the mechanical properties of BVs at different age, and the risk of head injury in the elderly. Through continued research in this field, we can strive to improve the quality of care, enhance prevention strategies, and ultimately enhance the well-being and safety of the elderly population.