Greater Risk Of Injury Research Articles

Risk factors for groin injury in sport: an updated systematic review

BackgroundThe identification of risk factors for groin injury in sport is important to develop and implement injury prevention strategies.ObjectiveTo identify and evaluate the evidence examining risk factors for groin injury...

The relationship between Taekwondo training habits and injury: a survey of a collegiate Taekwondo population.

ObjectiveTo correlate training habits of Taekwondo (TKD) athletes to risk for injury.BackgroundTKD is a Korean marital art that has been growing in popularity, with nearly 2 million individuals practicing the sport in the United States. Because of the combative nature of the sport, injuries are an inherent risk. However, data on proper training habits, types of injuries sustained during training, and recommendations for athletes to avoid injury are lacking. Frequently, studies of TKD evaluate athletes’ injuries during tournaments, but most do not evaluate athletes in training.HypothesisIncreased training would potentially create more injuries secondary to increased exposure.MethodsThis is a cross-sectional observational survey of 72 collegiate TKD athletes from the Pacific West Sanctioned Taekwondo Tournaments in the 2008–2009 season. Variables analyzed during training and competitions were training sessions per week, workout habits, belt level, years of experience, and characteristics of injury (location, type, mechanism, situation, treatment, and days missed).ResultsTKD training habits of individuals who practiced four or more times per week (odds ratio [OR], 4.5; P=0.005) or sparred for more than 2 hours (OR, 8.7; P=0.003) were associated with significantly increased odds (risk) of sustaining an injury. Those who had more than 3 years of tournament experience were more likely to sustain an injury (OR, 0.198; P=0.020).ConclusionIncreased risk for injury with more frequent practice and longer sparring should remind coaches and trainers that monitoring and adjusting the athletes’ training schedules and exposure time could decrease the chance of injury. An athlete that has spent more years in tournaments along with high-frequency and long-duration training was associated with greater risk for injuries. Prevention and education about the risk for exposure to injury may may help athletes and trainers promote prevention strategies and adjust an athletes’ training and tournament schedules to decrease the risk for injury.

Risk factors for injuries in competitive Irish dancers enrolled in dance schools in Calgary, Canada.

Irish dancing has become a popular activity following international exposure to touring dance companies. Previous studies have reported high injury incidence rates in dancers. The objective of this study was to examine risk factors for injuries in competitive Irish dancers in Calgary, Canada. This is a cross-sectional study. Competitive dancers over 12 years of age in Calgary, Canada, were eligible to participate. A pen-and-paper survey was administered to gather information on demographics, risk factors for injury, and injuries in the past year. Potential risk factors included age, competitive level, participation in other physical activities, years of participation in Irish dance, and performing a warm-up or cool-down. Incidence proportions (IP) and odds ratios (OR) were estimated. Three of the five accredited dance schools in Calgary participated and a total of 36 questionnaires were completed. Twenty-six dancers (IP=72.2%; 95% CI 54.8-85.8%) reported at least one Irish dance-related injury in the past year. There were 60 injuries reported and the majority (57%) were foot or ankle injuries. Elite level dancers (OR= 6.33; CI 1.27-31.57) and dancers over 18 years of age (OR= 24.43; CI 2.60-229.56) were at greater risk of injury in the past year than non-elite and younger dancers. Elite dancers and dancers over 18 years of age are at the greatest risk of injury in Irish dance in Calgary, Canada.

Injuries in runners; a systematic review on risk factors and sex differences.

BackgroundThe popularity of running continues to increase, which means that the incidence of running-related injuries will probably also continue to increase. Little is known about risk factors for running injuries and whether they are sex-specific.ObjectivesThe aim of this study was to review information about risk factors and sex-specific differences for running-induced injuries in adults.Search StrategyThe databases PubMed, EMBASE, CINAHL and Psych-INFO were searched for relevant articles.Selection CriteriaLongitudinal cohort studies with a minimal follow-up of 1 month that investigated the association between risk factors (personal factors, running/training factors and/or health and lifestyle factors) and the occurrence of lower limb injuries in runners were included.Data Collection and AnalysisTwo reviewers’ independently selected relevant articles from those identified by the systematic search and assessed the risk of bias of the included studies. The strength of the evidence was determined using a best-evidence rating system. Sex differences in risk were determined by calculating the sex ratio for risk factors (the risk factor for women divided by the risk factor for men).Main ResultsOf 400 articles retrieved, 15 longitudinal studies were included, of which 11 were considered high-quality studies and 4 moderate-quality studies. Overall, women were at lower risk than men for sustaining running-related injuries. Strong and moderate evidence was found that a history of previous injury and of having used orthotics/inserts was associated with an increased risk of running injuries. Age, previous sports activity, running on a concrete surface, participating in a marathon, weekly running distance (30–39 miles) and wearing running shoes for 4 to 6 months were associated with a greater risk of injury in women than in men. A history of previous injuries, having a running experience of 0–2 years, restarting running, weekly running distance (20–29 miles) and having a running distance of more than 40 miles per week were associated with a greater risk of running-related injury in men than in women.ConclusionsPrevious injury and use of orthotic/inserts are risk factors for running injuries. There appeared to be differences in the risk profile of men and women, but as few studies presented results for men and women separately, the results should be interpreted with caution. Further research should attempt to minimize methodological bias by paying attention to recall bias for running injuries, follow-up time, and the participation rate of the identified target group.

ACL Injury Risk in the Physically Active: Why are Females More Susceptible?

Despite extensive research, we still do not fully understand the biological mechanisms that underlie a female's increased susceptibility for suffering a noncontact ACL injury. While sex differences in neuromuscular control are often implicated, prevention efforts addressing these differences have not resulted in a profound or sustainable reduction in injury rates. This paper will explore two likely scenarios that explain this greater susceptibility in females: (1) females have a structurally weaker ligament that is more prone or susceptible to failure at a given load (scenario #1), or (2) females develop less knee protection and experiences higher relative loads on the ACL (scenario #2). While we have learned much over the last two decades about ACL injury risk in females, much remains unknown. Continued research is of paramount importance if we are to effectively identify those females who are at greatest risk for injury and effectively reduce their susceptibility through appropriate interventions.

Risk of sural nerve injury during lateral distal Achilles tendinoscopy: A Cadaver Study

BackgroundThe risk of damage to cutaneous sensory nerves located near portals has been evaluated for both conventional arthroscopy and extra-articular posterior ankle endoscopy. The objective of the anatomic study reported here was to assess the risk of injury to the sural nerve or lateral calcaneal nerve while using the distal lateral portal for the Achilles tendinoscopy procedure described by Vega et al. in 2008. Materials and methodsWe dissected the sural nerve and its branch, the lateral calcaneal nerve, of 13 human cadaver ankles in the prone position. We defined P as the point where the Achilles peritendon was opened during the distal lateral approach used for the study technique. P was adjacent to the lateral edge of the Achilles tendon, 2cm proximal to the postero-superior edge of the calcaneal tuberosity. T was defined as the attachment site of the most lateral fibres of the Achilles tendon to the postero-superior edge of the calcaneal tuberosity. We evaluated the origin of the lateral calcaneal nerve relative to T and we measured the shortest distances separating P from the sural nerve and lateral calcaneal nerve. ResultsA lateral calcaneal nerve was identified in 10 (77%) ankles and originated a mean of 39.1mm (range, 25.0–65.0mm) proximal to T. P was at a mean distance from the sural nerve of 12.3mm (range, 5.0–18.0mm) and from the lateral calcaneal nerve of 6.8mm (range, 4.0–9.0mm). The median difference between these two distances was statistically significant (P=0.002). DiscussionWhile using the distal lateral portal for Achilles tendinoscopy, the lateral calcaneal nerve is at greater risk for injury than is the sural nerve. Level of evidenceLevel IV. Anatomic Study.

Blunt renal trauma in children with pre-existing renal abnormalities.

The kidneys are the most commonly injured genitourinary organ in children following blunt abdominal trauma. Though the retroperitoneal location affords the kidneys some protection from the forces experienced in blunt abdominal trauma, the kidneys are at greater risk of injury when a disease process exposes them from their normal shielded location. In such cases, the injuries may appear to be disproportionate in relation to the severity of the trauma history, confusing the imaging findings. Recognition of both the underlying disease process as well as the manifestations of acute trauma is important; therefore, we present a pictorial essay of traumatized kidneys in children with pre-existing renal abnormalities.

Visuo-Motor Processing Impairments Following Concussion in Athletes

Visuo-Motor Processing Impairments Following Concussion in Athletes Objective: Conduct a pilot study to determine if visuo-motor processing is altered in athletes following sports-related concussion. Research design: A longitudinal matched cohort was used to assess 7 concussed and 7 matched control subjects. Interventions: All subjects completed a simple visuo-motor processing task (SVMP). Each subject completed 120 randomized trials. Subjects were asked to identify which direction the motion occurred in (left/right). Repeated testing was conducted 10 days following initial testing. Main outcome measures: Reaction time (overall, each grouping of 20 trials, ambiguous and unambiguous trials right/left), number of correct responses, and number of incorrect responses. A repeated measures ANOVA was conducted to determine differences between groups (concussed/control) and sessions (10 days apart). Results: Concussed athletes has significantly delayed visuo-motor reaction time compared to control subjects and between days of testing. Conclusions: Visuo-motor processing is impaired during the initial 10 days following a sports-related concussion. Concussed athletes demonstrate functional differences in SVMP task performance between testing days. An athlete may be placed at greater risk of injury if returned to sports participation with an impaired ability to quickly make decisions regarding direction of movement. Visuomotor processing should be a routine component of concussion assessment and RTP decision making.

The Frequency, Causes and Prevention of Needlestick Injuries in Nurses of Kerman: A Cross-Sectional Study.

The needlestick injuries can cause the transmission of infectious diseases. Compared to other members of the community of health care nurses are at great risk of needle stick injury because of their frequent performance with vein punctures and taking care of patients suffering from different infectious diseases. The main aim of this study was to assess Prevalence, causes and preventive of Needle Sticks injuries among nurses in Kerman (south of Iran). This cross-sectional study was conducted from December 2014 to March 2015 on 240 nurses employed in two hospitals of Kerman. Sampling was performed through simple random sampling. Data gathered through a researcher made questioner. Data analysed by use descriptive analytical testes. From the nurses' perspective the main physical and human causes of needlestick injuries were syringe needles (82) and crowded wards (74). The majority of the nurses believed the most effective method to prevent needlestick were training (82). Due to the high prevalence of injuries caused by sharp objects in nurses, needlestick injuries are suggested to be recorded in special forms and their causes to be checked by the Infection Control Committee. Since syringe needle heads and angiocatheter are the main causes of needlestick injuries, providing safe medical equipment should also be emphasized.

Effect of hood periphery shape parameters and hood-fender interface characteristics on pedestrian head injury criterion

A number of studies have focused on optimising the hood structure to improve pedestrian safety. Most of these studies are limited to the central region of the hood but the central region of the hood is of lower risk to head injuries if proper packaging methodology for under-hood components is used. But the hood edges supported by other vehicular structures (fender and shotgun) are of higher stiffness and may possess a greater injury risk. This study investigated several shape parameters along hood edges and hood-to-vehicle interface which could help to reduce the Head Injury Criterion (HIC) during impact with hood. The proposed passive structural change for hood edges and hood-to-vehicle interface showed significant improvement in HIC along hood edges. These shape parameters helped in reducing the HIC up to 70% on different impact points on hood and along hood edges and helped in meeting legal requirements for pedestrian safety.

Shorter time to first injury in first year professional football players: A cross-club comparison in the Australian Football League

Australian Football League (AFL) players have a high risk of injury. Anecdotally, this injury risk is greater in emerging players (i.e. those in their first year), compared with established players (with 3+ years of experience). This study aimed to conduct the first comparison of injury risk and playing experience in these two player groups across a large number of AFL clubs. Prospective, cohort. Injuries, game participation and training participation were collected weekly by 8 AFL clubs for 61 emerging and 64 established players. Injury incidence rates (IIR) and Cox proportional hazard models for time to first injury, separately for games and training, were computed. The game IIR was significantly higher for emerging than established players: 45.6 (95% CI: 35.7, 57.6) versus 18.3 (95% CI: 13.1, 24.9) per 1000 game-hours. Emerging players also had a higher training IIR than did the established players: 9.6 (95% CI: 7.6, 11.9) versus 8.9 (95% CI: 7.0, 11.1) per 1000 training-hours. Emerging players were significantly less likely to remain injury free in games than established players (HR=3.46, 95% CI: 1.27, 9.45). A similar outcome was seen in training sessions, although to a lesser degree (HR=1.41, 95% CI: 1.19, 1.69). Despite efforts to modify the playing/training program of emerging players, this group remain at greater risk of injury in games and training sessions, compared with established players. Continued efforts should be made toward understanding reasons for this increased risk to better prevent injury during the early years of a professional football career.

Junior cricketers are not a smaller version of adult cricketers: A 5-year investigation of injuries in elite junior cricketers

Background. Injury surveillance is fundamental to preventing and reducing the risk of injury. Objectives. To determine the incidence of injuries and the injury demographics of elite schoolboy cricketers over five seasons (2007 - 2008, 2008 - 2009, 2009 - 2010, 2010 - 2011 and 2011 - 2012). Methods. Sixteen provincial age group cricket teams (under (U) 15 , U17 and U18) competing in national age-group tournaments were provided a questionnaire to complete. The questionnaires gathered the following information for each injury sustained in the previous 12 months: (i) anatomical site; (ii) month; (iii) cause; (iv) whether it was a recurrence of an injury from a previous season; (v) whether the injury had reoccurred during the current season; and (vi) biographical data. Injuries were grouped according to the anatomical region injured. All players were invited to respond, irrespective of whether an injury had been sustained, resulting in a response rate of 57%. The sample Statistical Analysis System was used to compute univariate statistics and frequency distributions. Results. Of the 2 081 respondents, 572 (27%) sustained a total of 658 injuries. The U15 and U17 groups sustained 239 (36%) and 230 (35%) injuries, respectively, more than the 189 injuries sustained by the U18 group (29%). These injuries were predominantly to the lower limbs (38%), back and trunk (33%) and upper (26%) limbs, with 3% occurring to the head and neck. The injuries occurred primarily during 1-day matches (30%), practices (29%) and with gradual onset (21%). The primary mechanism of injury was bowling (44%) and fielding (22%). The injuries were acute (49%), chronic (41%) and acute-on-chronic (10%), with 26% and 47% being recurrent injuries from the previous and current seasons, respectively. Some similar injury patterns occurred in studies of adult cricketers, with differences in the nature and incidence of injuries found for the various age groups. The youth cricketers sustained more back and trunk injuries, recurrent injuries and more match injuries than the adult cricketers. The U15 group sustained less-serious injuries, which resulted in them not being able to play for between 1 and 7 days (58%), with more injuries occurring in the preseason period (24%) and fewer during the season (60%) compared with other age groups. The U15 and U17 groups sustained the most lumbar muscle strains, while the U18 groups sustained more serious injuries, resulting in them not being able to play for >21 days. Conclusion. Young fast bowlers of all ages remain at the greatest risk of injury. Differences in the nature and incidence of injuries occurred between youth and adult cricketers, as well as in the different age groups. It is recommended that cricket administrators and coaches implement an educational process of injury prevention and management

An Increase in Baseline Level of Urinary Liver-Type Fatty Acid-Binding Protein Linked with Poor Prognosis after Allogeneic Hematopoietic Stem Cell Transplantation

▪Introduction: Stem cell transplantation (SCT) involves a great risk of acute kidney injury (AKI), which is largely committed to fatality derived from SCT. Liver-type fatty acid-binding protein (L-FABP) is a 15kDa protein expressed in human renal proximal tubular cells, and is shed into urine in response to renal tissue ischemia or oxidative stress. Urinary L-FABP (uL-FABP) has been reported to be not only a sensitive biomarker to detect incipient AKI but also a potential marker for something more than a measure of renal insult. This study addressed utility of uL-FABP, as it has not been fully understood on the clinical platform of SCT.Patients and Methods: A prospective cohort study was conducted in 81 patients who received allogeneic SCT in our hospital from April 2009 to March 2012 (median age, 49 years; median [range] follow-up period, 771 [2-1923] days). All had hematological malignancies, and were recipients of the first SCT. Associations of increased uL-FABP before executing conditioning therapy (at baseline) and clinical outcomes including incidence of AKI, non-relapse mortality (NRM), and overall survival (OS) were investigated. AKI was defined, based on the creatinine (Cr) criteria of the 2013 Kidney Disease Global Outcomes. AKI that developed within the first 30 days after SCT was considered in this study. The recipients were stratified into an elevated and a normal uL-FABP group at baseline, according to the reference value for healthy adult individuals (8.5µg/gCr). Hazard ratio (HR) with its 95% confidence interval (CI) of uL-FABP elevation was calculated for OS using the Cox proportional hazard model and for NRM using the Fine-Gray proportional hazards model, adjusted for confounders which had P -values ≤ 0.2 in univariate analyses.Results: Patients had been diagnosed with acute myeloid leukemia (n = 36), acute lymphoid leukemia (n = 23), myelodysplastic syndrome (n = 17), and myeloproliferative neoplasm (n = 5). The elevated and normal uL-FABP groups included 17 (21%) and 64 (79%) patients, respectively. The proportion of high disease risk was significantly greater in the elevated than in the normal uL-FABP group (70.6 % vs. 31.3%, P = 0.005). There were no significant differences in age, serum Cr level, and the proportion of gender, hematopoietic cell transplantation comorbidity index (HCT-CI) ≥3, myeloablative conditioning regimen, stem-cell sources (bone marrow, peripheral blood, cord blood), related donor type and matched human leukocyte antigen compatibility. AKI emerged in 28 recipients (34.6%) at day 30? following SCT (median [range], 14 [0-30] days). The cumulative incidence [95% CI] of AKI was significantly greater in the elevated than in the normal uL-FABP group (64.7% [36-83.1 %] vs. 26.6% [16.4-37.8 %], P<0.001), shown in Figure 1. A total of 35 patients (43.2%) died within 2 years after SCT: 13 (37.1%) died of relapse or progression of disease and 22 (62.9%) died of non-relapse death. The OS at the time of 2 year was significantly lower in the elevated than in the normal uL-FABP group (23.5% vs. 64.7%, P<0.001), shown in Figure 2. NRM was significantly greater in the elevated than in the normal uL-FABP group (58.8% vs. 19.2%, P<0.001) at the time of 2 year, as shown in Figure 3. Multivariate analysis revealed that the presence of elevated uL-FABP at baseline was significantly associated with OS (HR [95% CI]; 2.99 [1.3-6.87], P =0.01) and NRM (HR [95% CI]; 4.75 [1.83-12.3], P=0.001). In addition, high age, unrelated donor type, high disease risk, HCT-CI ≥3, and the development of veno-occlusive disease were involved in either OS or NRM. There was no significant difference in the relapse or progression rate within 2 years between the elevated and normal uL-FABP groups (20.7% vs. 29.4%, P=0.43)Conclusions: uL-FABP is a simple and non-invasive measurement to target patients at increased risk of AKI, NRM and OS following allogeneic SCT. The presence of antecedent subclinical renal injury, which can be detected by uL-FABP elevation at baseline, may provide prognostic information beyond renal outcome after allogeneic SCT. [Display omitted] [Display omitted] [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Physical training risk factors for musculoskeletal injury in female soldiers.

Musculoskeletal injuries (MSIs) result in the most medical encounters, lost duty days, and permanent disability. Women are at greater risk of injury than men and physical training is the leading cause of injury. The purpose of this study was to investigate the demographic, body composition, fitness, and physical training risk factors for injuries in female Soldiers serving in garrison Army units over the past 12 months. Self-report survey was collected from 625 women. The ankle was the most frequently injured body region, 13%. Running was the activity most often associated with injury, 34%. In univariate analysis lower rank, older age, history of deployment, no unit runs, weekly frequency of personal resistance training, and history of injury were all associated with injury. In multivariate analysis rank, history of injury, weekly frequency of unit runs, and weekly frequency of personal resistance training were the best combination of predictors of injury. Running once or twice a week with the unit protected against MSIs, whereas participating in personal resistance training sessions once or twice a week increased the risk of MSIs. With more emphasis on running and resistance training, the U.S. Army could reduce injuries and save billions of dollars in training and health care costs.

Injuries in competitive boxing. A prospective study.

Boxing remains a subject of controversy and is often classified as dangerous. But the discussion is based mostly on retrospective studies. This survey was conducted as a prospective study. From October 2012 to September 2013, 44 competitive boxers were asked to report their injuries once a month. The questionnaire collected general information (training, competition) and recorded the number of bouts fought, injuries and resulting lost days. A total of 192 injuries were recorded, 133 of which resulted in interruption of training or competition. Each boxer sustained 3 injuries per year on average. The injury rate was 12.8 injuries per 1 000 h of training. Boxers fighting more than 3 bouts per year sustain more injuries (p=0.0075). The injury rate does is not a function of age (age≤19 vs. > 19a, p=0.53). Injuries to the head and the upper limbs occur most frequently. The most common injuries are soft tissue lacerations and contusions. Head injuries with neurological symptoms rarely occur (4.2%). Boxing has a high injury rate that is comparable with other contact sports, but most injuries are minor. Injury frequency is not a function of whether the boxer competes in the junior or adult category. Athletes fighting many bouts per year have a greater risk of injury.

Active and safe transportation of elementary-school students: comparative analysis of the risks of injury associated with children travelling by car, walking and cycling between home and school

Elementary school active transportation programs aim to address physical inactivity in children by prompting a modal shift from travel by car to walking or cycling among children living a distance from school conducive to walking or cycling. The objectives of this study are to evaluate the risk of injury related to walking, cycling and travelling by car between home and school among elementary-school students in the Montréal area and to evaluate the impact on number of injuries of a modal shift from travel by car to walking or cycling. The risk of injury was estimated for the 2003-2007 period by calculating the average annual rate of injury in children aged 5 to 12 years walking, cycling or being driven in a car, per 100 million kms travelled during the normal hours of travel between home and school. The impact of a modal shift from travel by car was evaluated for children living a distance from school conducive to walking and cycling (under 1.6 km), that is, the targets of active transportation programs. This evaluation was done using the regional rate of injury calculated for each travel mode. Between 2003 and 2007, an average of 168 children aged 5 to 12 years were injured each year while walking (n = 64), cycling (n = 28) and being driven in a car (n = 76) during the normal hours of travel between home and school in the Montréal area. The rate of injury was 69 children injured per 100 million kms for travel by car (reference group), 314 pedestrians (relative risk [RR] = 4.6; 95% confidence interval [CI]: 4.3-5.1) and 1519 cyclists (RR = 22.2; 95% CI: 14.3-30.0). A shift of 20% in the distance travelled by car to walking by children living less than 1.6 km from their school is estimated to result in an increase of 2.2% (n = 3.7) in the number of children injured each year in the area. In the case of a shift to cycling, the number of resulting injuries is estimated to be 24.4, an increase of 14.5%. The risk of injury among elementary-school students during the normal hours of travel between home and school is higher for walking and cycling than for travel by car, and cyclists are at greater risk of injury than pedestrians. A modal shift from travel by car would increase the number of children injured in the area (minor injuries, for the most part) if no action were taken to reduce the risk of injury to pedestrians and cyclists.

Soccer-specific Fatigue Decreases Reactive Postural Control with Implications for Ankle Sprain Injury

To quantify the influence of soccer-specific fatigue on reactive dynamic balance, ten male professional soccer players (age 24.7 ± 4.4 yr, body mass 77.1 ± 8.3 kg, VO2max 63.0 ± 4.8 ml·kg·min–1) completed an exercise protocol replicating the activity profile of match-play. Pre-exercise, and at 15 min intervals, players completed three balance tasks requiring response to a system perturbed to induce either plantar flexion of the ankle or inversion of the ankle (by rotation or translation). ANOVA revealed a significant main effect for exercise duration in each task, with both reaction time and total centre of gravity displacement tending to increase during each half. In all three trials there was a significant increase in medio-lateral and anterior-posterior displacement, the planar perturbation of the platform evoking a multi-angular response. Dynamic balance performance decreased as a function of time during each half, suggesting a greater risk of injuries at these specific times, in accord with epidemiological observations of ankle sprain injury.

Urinary Liver-Type Fatty Acid-Binding Protein Linked with Increased Risk of Acute Kidney Injury after Allogeneic Stem Cell Transplantation

Stem cell transplantation (SCT) involves a great risk of acute kidney injury (AKI). Urinary liver-type fatty acid-binding protein (uL-FABP) is a sensitive biomarker to detect kidney damage before an increase in serum creatinine (Cr); however, the utility of uL-FABP is not fully understood in the platform of SCT. A prospective study was conducted in 84 allogeneic SCT recipients to ascertain a link between the uL-FABP level before preparative procedures and AKI incidence after SCT. The association between them was analyzed using Gray's method and a multivariate Fine-Gray proportional hazards regression model. The recipients were stratified into high and low uL-FABP groups, according to the reference value for healthy subjects (8.4 μg/g Cr). AKI developed more frequently in the high (n = 20) than low (n = 64) group (55.0% versus 26.6% at day 30, P = .005), and high uL-FABP was an independent risk for the emergence of AKI (hazard ratio, 2.78; 95% confidence interval, 1.24 to 6.22, P = .01). In conclusion, increased baseline uL-FABP, which may indicate previous incipient kidney injury, is linked with a high risk of AKI after allogeneic SCT.

Injuries Among Children With Autism Spectrum Disorder

ObjectiveWe compared risk of injury among children with autism spectrum disorder (ASD) to those without ASD, adjusting for demographic and clinical characteristics. MethodsWe used claims data from 2001 to 2009 from a commercial health plan in the United States. A validated ASD case identification algorithm identified 33,565 children (ages 0–20 years) with ASD and 138,876 children without. Counting process models tested the association between ASD status and injury episodes with separate regressions run for children during different age periods. ResultsUnadjusted results demonstrated that children with ASD had a 12% greater injury risk than children without ASD (hazard ratio [HR] = 1.119; P < .001). After including demographic variables, the HR was 1.03 (P < .05); after controlling for co-occurring conditions, such as seizures, depression, etc, HR decreased to 0.889 (P < .001). For the age period analysis, HR values were as follows: for 0 to 2 years, HR 1.141; 3 to 5 years, HR 1.282; 6 to 10 years, HR not significant; and 11 to 20 years, HR 0.634 (P < .05 for all significant results). ConclusionsChildren with ASD have more injuries than children without ASD. After controlling for demographic factors and co-occurring conditions, children with ASD are at lower risk of injury, suggesting that co-occurring conditions or the ways these conditions interact with ASD is related to injuries. Clinicians should understand that injury risk in children with ASD may be driven by co-occurring conditions. Treating these conditions could thus decrease injury risk as well as have other benefits. Injury prevention interventions are especially warranted for younger children with ASD and those with seizures, depression, visual impairment, or attention-deficit disorders.

Influences of Obesity on Job Demands and Worker Capacity.

Evidence suggests that the growing prevalence of obesity in the workforce has resulted in an increase in the incidence and cost of musculoskeletal injuries. Obesity can modify job demands and affect worker capacity in terms of anthropometry and occupational biomechanics, which may place workers at greater risk of injury. This paper presents a review of studies quantifying the work-relevant impacts of obesity, specifically related to work task demands, capacities, and their potential imbalance. The increased body fat that accompanies obesity leads to larger anthropometric dimensions and inertial parameters, particularly in the trunk and thigh areas. Consequently, individuals who are obese adjust their work postures and motions as an accommodation. These changes may affect the biomechanical demands on the joints and increase the burden on the musculoskeletal system. Independent of job demands, obesity-related differences also occur with respect to strength, fatigue, and task performance. Directions for future research are provided, focusing on the need for workplace redesign to account for changing workforce demographics.