High Injury Research Articles

Poricoic acid a ameliorates high glucose-induced podocyte injury by regulating the AMPKα/FUNDC1 pathway.

Poricoic acid A (PAA), a major triterpenoid component of Poria cocos with anti-tumor, anti-fibrotic, anti-inflammatory, and immune-regulating activities, has been shown to induce podocyte autophagy in diabetic kidney disease (DKD) by downregulating FUN14 domain containing 1 (FUNDC1). This study aimed to identify the role of adenosine monophosphate-activated protein kinase alpha (AMPKα) in PAA-mediated phosphorylation of FUNDC1 in podocyte injury occurring in the pathogenesis of DKD. A cellular model of renal podocyte injury was established by culturing MPC5 cells under high-glucose (HG) conditions. MPC5 cells were subjected to transfection with small interfering RNA (siRNA) targeting AMPKα or siRNA targeting FUNDC1, an AMPKα activator, or PAA. PAA treatment induced the phosphorylation of AMPKα in HG-cultured podocytes. AMPKα activation was implicated in the inhibitory effect of PAA on FUNDC phosphorylation in HG-cultured podocytes. Treatment targeting the AMPKα activator also significantly augmented proliferation, migration, mitochondrial membrane potential, and autophagy levels, while reducing apoptosis levels, inhibiting oxidative stress, and suppressing the release of proinflammatory factors in HG-cultured MPC5 cells. In contrast, insufficient expression of AMPKα reversed the effects of PAA on the proliferation, migration, and apoptosis of podocytes and further exacerbated the reduction of phosphorylated FUNDC1 expression in podocytes under HG conditions. AMPKα is involved in the regulation of FUNDC1 phosphorylation by PAA in HG-induced podocyte injury. Furthermore, the AMPKα/FUNDC1 pathway plays a crucial regulatory role in HG-induced podocyte injury. These findings support AMPKα, FUNDC1, and the AMPKα/FUNDC1 pathway as targets for PAA intervention.

Evaluation of a Novel Needle Decompression Device Against Standard of Care: A Cadaveric Model

ABSTRACT Introduction Pneumothorax (PTX) incidence in patients arriving to a trauma center can be as high as 20%. The severity of PTX can range from insignificant to life-threatening. Five percent of combat casualties sustaining thoracic trauma have tension PTX (tPTX) at the time of death. Rapid diagnosis and decompression, traditionally with a needle decompression in the prehospital setting, is essential. However, high iatrogenic injury rates reveal a need for a device with the potential to decrease injury rate without compromising decompression success. The Donaldson Decompression Needle (DDN) is a 10-gauge × 3.25 inch needle with a locking mechanism designed to prevent over-insertion. During insertion, a spring-loaded blunt tip retracts, releasing the lock. After penetration of the parietal pleura, the blunt tip projects forward, which in turn locks the device in place on the chest. The device also contains an integrated 1-way valve (OWV) to prevent causing iatrogenic PTX, if placed into a healthy lung cavity. Materials and Methods We compared the DDN against a standard-of-care (SOC) needle (E-ARS 10 gauge × 3.25”) in a cadaveric randomized crossover design study. Tension pneumothorax was created by inserting a needle adjacent to the sternum and insufflating to 15 mmHg. Data collected included participant demographics/experience, cadaver measurements, and procedure data such as intrathoracic pressures and decompression time. Participants also completed a postprocedure survey. A secondary objective was evaluation of decompression rate with the OWV on vs. off. Results Twenty participants were enrolled in the study. Five participants required exclusion. While there were no differences in set-up times for the 2 procedures (DDN vs. SOC, 33 seconds vs. 28 seconds, P = .63), the decompression times were significantly different between the 2 groups (DDN vs. SOC, 2:06 vs. 1:06, P = .019). Evaluation of the secondary outcome resulted in 18 repetitions. The average decompression time for the OWV on group (n = 9) vs. OWV off group (n = 9) was 44 seconds vs. 10 seconds (P=<.05). Conclusions Despite the similar length and gauge of the DDN compared to the standard of care (SOC), the success rate of thoracic decompression was lower for the DDN when compared to the SOC (46% vs. 87%, P = .077) although statistical noninferiority was not established. Additionally, intradevice comparisons indicated decompression with the OWV on significantly prolonged decompression time when compared to when it was removed. It could be appropriate to consider removing the OWV after placement to decrease the decompression time, followed by reattachment for transport. Further research into the ability of the DDN to decrease iatrogenic injury will follow validation of decompression capabilities.

"Health is Just the Basic Requirement for Optimal Performance and Winning": Stakeholders' Perceptions on Testing and Training in Competitive Alpine Skiing, Snowboarding and Freestyle Skiing.

Competitive alpine skiing, snowboarding and freestyle skiing, all different in nature and risks, are known for their high injury and illness burden. Testing measures and training methods may be considered for athletes' preparation to support performance enhancement while safeguarding their health. We explored the perspectives and perceptions of competitive alpine skiing, snowboarding and freestyle skiing stakeholders regarding testing and training practices in their competitive snow sports. We conducted an exploratory qualitative study based on grounded theory principles through 13 semi-structured interviews about testing and training practices with athletes, on-snow and off-snow coaches, managers and healthcare providers from different national teams. The interviews were inductively analysed through a constant comparative data analysis. Participants described winning as the end goal of testing and training practices, which requires athletes to perform in their best condition. To do so, they mentioned two main targets: performance enhancement and health protection. Participants acknowledged health as a premise to perform optimally, considering testing and monitoring approaches, goal setting, and training to support and protect athlete performance. This continuous cyclic process is driven by communication and shared decision making among all stakeholders, using testing and monitoring outputs to inform goal setting, training (e.g. on-snow and off-snow) and injury prevention. Such an approach helps athletes achieve their goal of winning while being fit and healthy throughout their short-term and long-term athletic career development. The ultimate goal of testing measures and training methods in such competitive snow sports is winning. Performance enhancement and health protection act as pillars in systematic, tailored and flexible processes to guarantee athletes' best preparation to perform. Moreover, athletes' assessments, goal setting, monitoring tools, open communication and shared decision making strongly guide this cyclic process.

HDAC/H3K27ac-mediated transcription of NDUFA3 exerts protective effects on high glucose-treated human nucleus pulposus cells through improving mitochondrial function

Diabetes mellitus (DM) is a well-documented risk factor of intervertebral disc degeneration (IVDD). The current study was aimed to clarify the effects and mechanisms of NADH: ubiquinone oxidoreductase subunit A3 (NDUFA3) in human nucleus pulposus cells (HNPCs) exposed to high glucose. NDUFA3 was overexpressed in HNPCs via lenti-virus transduction, which were co-treated with high glucose and rotenone (a mitochondrial complex I inhibitor) for 48 h. Cell activities were assessed for cell viability, cell apoptosis, reactive oxygen species (ROS) production, mitochondrial membrane potential (MMP) ratio, oxygen consumption rate (OCR) and mitochondrial complexes I activities. High glucose decreased cell viability, increased apoptotic cells, increased ROS production, decreased MMP levels and OCR values in HNPCs in a dose-dependent manner. Rotenone co-treatment augmented the high glucose-induced injuries on cell viability, apoptosis, ROS production and mitochondrial function. NDUFA3 overexpression counteracted the high glucose-induced injuries in HNPCs. HDAC/H3K27ac mechanism was involved in regulating NDUFA3 transcription. NDUFA3 knockdown decreased cell viability and increased apoptotic cells, which were reversed by ROS scavenger N-acetylcysteine. HDAC/H3K27ac-mediated transcription of NDUFA3 protects HNPCs against high glucose-induced injuries through suppressing cell apoptosis, eliminating ROS, improving mitochondrial function and oxidative phosphorylation. This study sheds light on candidate therapeutic targets and deepens the understanding of molecular mechanisms behind DM-induced IVDD.

Injury Assessment of Pedestrians, Bicyclists, and Motorcyclists Utilizing Linkage of Police-Reported Crash Data to EMS Data in Michigan

In Michigan, police crash reports are the primary source of data on traffic crashes. Though many aspects are very reliable, some details are difficult to observe or require subjective judgement. Injury severity, which is central to the road safety issue, unfortunately falls into the second category. The KABCO injury scale used by law enforcement classifies injuries as “possible,” “suspected minor,” and “suspected serious” which may not correspond to determinations made by medical professionals. EMS records can provide a means to improve crash injury data using medical evaluations, but these records are not linked to the police reports. This project explores the linkage of police crash reports and EMS records using both Michigan data sources from 2018 to 2021. Given the association between severity of injuries and person type, three crash subsets with high injury risk were the focus: pedestrians, bicyclists, and motorcyclists. Collectively, these person types represent 25.1% of the police reported fatalities and suspected serious injuries in Michigan in 2022 despite being only 1.2% of the crashing population. Person-level records for pedestrians, bicyclists, and motorcyclists were identified and divided into three separate datasets for each data source. EMS data events were restricted cases believed to be associated with traffic crashes using ICD-10 injury codes. Personal identifiers were not provided, so probabilistic linkage was used to link person crash records to EMS records. Event date, location, ambulance ID, and person demographic variables were utilized. Linkage rates and injury severity agreement was computed to assess differences between the two datasets.

Pain, impairment, medication use and health-related quality of life of retired professional rugby players.

Rugby is a physically demanding sport with a high injury rate. Professional male rugby players have a notably greater risk of sustaining injuries that require hospitalisation or surgery than male athletes from non-contact sports. Retired elite male rugby players experience physical and mental health conditions as well as varying levels of pain, negatively impacting their quality of life. Retired rugby players could use medication or substances as a coping mechanism to deal with chronic pain and a lower quality of life. However, research is scarce on how retired rugby players manage pain and how this affects their quality of life. This study aimed to understand joint pain and impairment, mental and physical quality of life, and pain medication use in retired professional male rugby players. A cross-sectional study was conducted using a questionnaire completed by retired professional male rugby players. Joint pain and impairment were explored through three questions, health-related quality of life was assessed through the PROMIS-GH, and medication use was explored through 12 questions. Retired rugby players (N=142) reported higher scores than matched controls (N=49) for joint pain and impairment, including significantly higher scores for joint impairments for activities of daily living (p=0.047). The global mental health scores of retired rugby players were significantly lower compared to matched controls (p=0.043) and the global physical health scores were also lower in retired rugby players. Most retired rugby players reported not using prescription pain medication (75%) or over-the-counter pain medication (56%). Professional rugby careers have a considerable impact on the joint health and overall well-being of retired players, resulting in unique challenges. The findings of this study emphasise the need for specific after-career support for challenges faced by retired rugby players.

Yiqi Huoxue Tongluo formula-containing serum attenuates high glucose-induced injury in microglia via MAPK pathways: Network pharmacology-based analysis and biological validation

IntroductionThe Yiqi Huoxue Tongluo formula (YQHX), containing Astragalus mongholicus Bunge, Angelica sinensis (Oliv.) Diels, Rehmannia glutinosa Libosch., Pueraria lobata (Willd.) Ohwi, Corydalis yanhusuo W.T.Wang, Spatholobus suberectus Dunn, Clematis chinensis Osbeck, is a proprietary formula of the First Affiliated Hospital of Anhui University of Chinese Medicine, and can attenuate diabetic neuropathy pain (DNP). This study aimed to explore the mechanisms underlying YQHX-mediated DNP alleviation. Additionally, the effects of YQHX on BV2 microglia injured by high glucose via the mitogen-activated protein kinase (MAPK) signaling pathways were investigated. MethodsLiquid chromatography tandem mass spectroscopy (LC-MS/MS) was performed to identify the chemical compounds in YQHX. The potential mechanism of YQHX for treating DNP was explored through network pharmacology analysis. The established glucose-induced BV2 cell injury model was treated with varying concentrations of YQHX-containing serum. The effects of YQHX-containing serum and MAPK pathway inhibitors on microglial cells were assessed by Cell Counting Kit-8 and enzyme-linked immunosorbent assays. The messenger RNA (mRNA) and protein levels of microglial marker OX42 were measured. Additionally, phosphorylated-p38, -c-Jun-terminal kinase, and -extracellular signal-regulated kinase and downstream nuclear factor-κB/p65 and phosphorylated-activating transcription factor 2 (ATF2) proteins were detected by western blotting. ResultsIn total, 503 chemical components were identified in YQHX by LC-MS/MS analysis. Network pharmacology results showed 203 active ingredients and 363 overlapping targets, respectively, as potential therapeutic candidates for YQHX-mediated DNP treatment. Additionally, the Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis yielded a total of 105 signal pathways. Notably, YQHX considerably improved the cell viability of BV2 cells (P < 0.01), remarkably reduced the production of proinflammatory factors (P < 0.01), significantly increased the production of anti-inflammatory factors (P < 0.01), and markedly inhibited the mRNA and protein levels of OX42 (P < 0.01). Furthermore, YQHX treatment inhibited MAPK activation and ATF2 expression. ConclusionsYQHX may protect against high-glucose-induced BV2 microglial cell injury by inhibiting the activation of MAPKs and downstream ATF2, thus, reducing microglial activation and proinflammatory cytokine release. These results provide a foundational theoretical basis for exploring the further mechanism of YQHX in treating DNP, and they provide a novel target for the application of traditional Chinese medicine.

Metformin and intermittent fasting mitigate high fat-fructose diet-induced liver and skeletal muscle injury through upregulation of mitophagy genes in rats

BackgroundHigh fat-fructose diet is a proinflammatory diet that increases risk of hepatocytes and myocytes steatosis and fibrosis. Finding anti-inflammatory strategies to fight these harmful effects is paid attention to nowadays. This study compared the effects of two widely anti-inflammatory interventions—metformin and intermittent fasting on myocytes and hepatocyte injury induced by proinflammatory diet and tracking possible underlying mechanisms. In this work, rats fed high fat-fructose diet were subdivided into untreated group, treated by metformin, and/or intermittent fasting.ResultsMetformin (300 mg/kg/day) and intermittent fasting (3 days/week) specially their combination for 4 weeks showed significant improvement in insulin resistance, lipid profile, antioxidants (p < 0.05), as well as enhanced hepatocytes and myocytes repair and reduced collagen deposition through upregulation of mitophagy-related genes: PINK1, PARKIN, LAMP2, and PPAR-α (p < 0.05).ConclusionsIntermittent fasting has beneficial metabolic and molecular therapeutic effects against proinflammatory diet-induced injury. Their results are like those of metformin sparing its adverse effects. Their combination showed additional effects against diet-induced myocytes and hepatocyte injury by upregulation of mitophagy-related genes without the need of increasing the dose of metformin.Graphic abstract

Paracetamol Dosing Errors in People Aged 12 Years and Over: An Analysis of Over 14,000 Cases Reported to an Australian Poisons Information Centre.

Paracetamol dosing errors can cause acute liver injury, with potentially toxic doses only slightly above the therapeutic range. This study aimed to characterise unintentional paracetamol overdose reported to an Australian poisons centre, including time trends, demographics, types of dosing errors, and outcomes. Records regarding paracetamol dosing errors for individuals aged ≥12 years were extracted from the New South Wales Poisons Information Centre database, January 2017 to June 2023. Data from 2021 underwent an in-depth screening of free text case notes to examine: dose, duration, products involved, reasons for ingestion and outcomes including hospitalisation, treatment, liver transplantations and deaths. Where possible, complete outcome data were obtained from medical records of New South Wales hospitalised cases in 2021. There were 14,380 exposures due to paracetamol dosing errors (predominantly self-administered, median age 43 years, 62.6% female), with an average yearly increase of 2.5% (95% CI 1.6-3.8%; p < 0.0001). The in-depth analysis of exposures recorded during 2021 revealed 1899 exposures (median age 46 years, 63.4% female) with 26.8% requiring hospitalisation. Immediate- and modified-release formulations were highly implicated. Multiple paracetamol-containing products were ingested in approximately 20% of exposures. Hospitalised exposures were associated with paracetamol use for dental pain and ingested higher doses for longer durations. Over half of those hospitalised (52%) were treated with the antidote (N-acetylcysteine), and 6% of exposures developed hepatotoxicity. Paracetamol dosing errors continue to occur, with relatively high rates of hospitalisation and liver injury. Many hospitalisations involved use for dental pain. Possible preventative measures include ingredient name prominence and increased education on appropriate dosing.

Polygala fallax Hemsl. ameliorated high glucose-induced podocyte injury by modulating mitochondrial mPTP opening through the SIRT1/PGC-1α pathway.

This study aimed to investigate the effects and molecular mechanism of PF on high glucose (HG)-induced podocyte injury. Results found that PF increased proliferation activity, decreased apoptosis, LDH, and caspase-3 levels, and increased nephrin and podocin expression in HG-induced cells. Similarly, PF improved HG-induced mitochondrial damage, decreased Ca2+ and ROS content, alleviated oxidative stress, inhibited mPTP opening, increased mitochondrial membrane potential, and decreased the expressions of Drp1, Bak, Bax, and Cytc in cytoplasm, increased the expressions of SIRT1, PGC-1α, HSP70, HK2, and Cytc in mitochondria of podocytes. The use of mPTP agonist/blocker and SIRT1 inhibitor confirmed that PF alleviates HG-induced podocyte injury by regulating mitochondrial mPTP opening through SIRT1/PGC-1α. In addition, PF affected HK2-VDAC1 protein binding to regulate mPTP opening via the SIRT1/PGC-1α pathway. In conclusion, PF-regulated HK2-VDAC1 protein binding affected mitochondrial mPTP opening and improved HG-induced podocyte injury through the SIRT1/PGC-1α pathway.

Abstract 42: Fecal Microbiota Transplantation Decreases Autoantibody Production and Lowers Blood Pressure in an Experimental Model of Autoimmune Disease

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder that disproportionately affects women. It is characterized by a breach of immunological self-tolerance and the expansion of autoreactive T and B lymphocytes, leading to the production of autoantibodies. Autoantibody production leads to downstream chronic inflammation resulting in high rates of hypertension, renal injury, and cardiovascular disease. Gut dysbiosis is associated with many autoimmune diseases, including SLE. In the present study, we hypothesized that gut dysbiosis in SLE may play a role in the development of immune system dysfunction and hypertension in an experimental model of SLE, and that fecal microbiota transplantation (FMT) with microbes from control mice may improve these parameters. To test this hypothesis, we treated 26-week-old female control (NZW, n=10) and SLE (NZBWF1, n=9) mice with broad spectrum antibiotics in drinking water for one week to deplete the existing microbiota. Subsequently, mice were given 0.1 mL of fecal microbes from either control or SLE mice via oral gavage two times per week for four weeks in the following groups (n=9-10 mice/group): Control-vehicle, Control-SLE microbes, SLE-vehicle, SLE-Control microbes. Changes in the gut microbiome after FMT were assessed by metagenomic sequencing of fecal pellets from all four groups. Mean arterial pressure (MAP, mmHg) was higher in SLE mice compared to control mice (Control: 112±3 vs. SLE: 140±2 mmHg, p&lt;0.0001). SLE mice that received FMT with control microbes had lower blood pressure (SLE-FMT: 126±4 mmHg, p=0.03). While there were no changes in circulating and splenic B cell percentages, SLE mice had significantly higher percentages of CD11b + CD11c + autoimmune-associated B cells compared to control mice (Control: 0.41±0.04% vs. SLE: 1.2±0.1%, p=0.0006), which were significantly decreased in SLE-FMT mice (SLE-FMT: 0.76±0.1%, p=0.02). Circulating autoantibodies were also measured at the conclusion of the study. Anti-dsDNA IgG was elevated in SLE mice compared to control (Control: 149±38 vs. SLE: 527±114 kU/mL, p=0.02), and were significantly lower in SLE mice treated with control microbes (SLE-Control microbes: 126±4 mmHg, p=0.03). These data suggest that gut microbiota present in NZBWF1 mice contribute to the accumulation of activated B cells and increased autoantibody production, which are known pathogenic factors in the development of hypertension in SLE.

Daidzein attenuates high glucose-induced inflammatory injury in macrophages by regulating NLRP3 inflammasome signaling pathway

This study aims to explore the inhibitory effect of daidzein on macrophage inflammation induced by high glucose via regulating the NOD-like receptor protein 3(NLRP3) inflammasome signaling pathway. The cell counting kit-8(CCK-8) assay was employed to detect the effects of daidzein at different concentrations on the viability of RAW264.7 cells. Western blot was employed to determine the protein level of tumor necrosis factor(TNF)-α in macrophages exposed to different concentrations of glucose for different time periods as well as the expression levels of proteins involved in the polarization and Toll-like receptor 4(TLR4)-myeloid differentiation factor(MyD88)-NLRP3 inflammasome pathway of the macrophages exposed to high glucose. Enzyme-linked immunosorbent assay was employed to measure the levels of TNF-α, interleukin(IL)-18, and IL-1β secreted by macrophages. The expression level of nuclear factor-kappa B(NF-κB) p65 in macrophages exposed to high glucose was detected by immunofluorescence, and the level of intracellular reactive oxygen species(ROS) was detected by the DCFH-DA fluorescent probe. The mRNA levels of NLRP3, TNF-α, and IL-18 in macrophages were determined by qRT-PCR. The results showed that treatment with 30 mmol·L~(-1) glucose for 48 h was the best condition for the modeling of macrophage injury. Compared with the blank group, the model group showed improved polarization of macrophages, increased secretion of TNF-α, IL-18, and IL-1β, elevated ROS level, and up-regulated expression of NF-κB p65. In addition, the modeling up-regulated the mRNA levels of NLRP3, TNF-α, and IL-18 and the protein levels of TLR4, MyD88, NLRP3, NF-κB p65, p-NF-κB p65, I-κB, p-I-κB, ASC, pro-caspase-1, pro-IL-1β, cleaved IL-1β, and pro-IL-18. Compared with the model group, daidzein(10, 20, and 40 μmol·L~(-1)) lowered the levels of inflammatory cytokines and down-regulated the mRNA levels of NLRP3, TNF-α, and IL-18 as well as the protein levels of TLR4, MyD88, NLRP3, NF-κB p65, p-NF-κB p65, I-κB, p-I-κB, ASC, pro-caspase-1, pro-IL-1β, cleaved IL-1β, and pro-IL-18. In addition, daidzein reduced intracellular ROS. According to the available reports and the experimental results, high glucose can induce the polarization of macrophages and promote the secretion of inflammatory cytokines. Daidzein can inhibit the expression of ROS in macrophages by regulating the NLRP3 inflammasome signaling pathway, thereby reducing the inflammation of macrophages exposed to high glucose.

High rates of respiratory illnesses upon arrival: lessons from Team USA at the Santiago 2023 Pan American and Parapan American Games

ObjectiveTo describe the incidence and characteristics of injuries and illnesses among Team USA athletes competing at the Santiago 2023 Pan American Games (PAG) and Parapan American Games (PPAG), with a...

Comparing the effects of marking techniques on the survival of Piping Plover chicks

AbstractThe use of unique markers in ornithology has a long history and is predicated on the assumption that markers have negligible effects on behavior and survival. The assumption that marks are harmless is particularly important with imperiled species. We studied the effects of two different marking schemes on Piping Plovers (Charadrius melodus), a small shorebird protected under the U.S. Endangered Species Act that is intensively monitored and managed. We used two marking schemes, (1) color bands and (2) uniquely engraved flags during breeding seasons from 2013 to 2023 to determine whether the injuries were causing additive mortality and thus actually limiting populations. We estimated the effect of perceived limping and injury (e.g., swelling, laceration, etc.) on chick and hatch-year survival. We detected injuries in some years and associated with both marking schemes (range 0.0–6.0%, average = 2.7% of marked chicks each year). Interval survival for banded chicks was like that of flagged chicks ($$\beta $$ β = − 0.55, 95% BCI: − 1.30–0.33, f = 0.92). Mean survival to fledging, however, was higher in years where flags were used ($$\overline{\phi }=$$ ϕ ¯ = 0.55 ± 0.14) than when bands were used ($$\overline{\phi }=$$ ϕ ¯ = 0.34 ± 0.14), but we surmise that this difference was partly conflated with negative density-dependent factors ($$\beta $$ β = − 0.49, 95% BCI: − 0.73 to − 0.25, f = 1.00) and predation. Our results show that pre-fledge survival of birds with uniquely coded flags was similar to that of birds receiving color bands. There was also no evidence that injured birds had a significantly lower hatch-year survival than those that were not injured. However, the relatively high (up to 6%) injury rate in some years remains a concern. Injury and survival rates need to be considered and evaluated when deciding on whether to mark individuals. Ultimately, wildlife practitioners should strive to use the best methods for information gathering and management, without negatively impacting the species.

The Impact of Sleep on Athletes Performance and Injury Risk

Introduction and purposeSleep is a critical component of an athlete's health, significantly influencing injury risk, performance, and recovery. It plays a vital role in the healing process, contributing to growth, repair, regeneration, and immunity. Current literature suggests that sleep quality impacts various aspects of athletic performance, including physical and cognitive abilities, recovery, injury risk, and mental well-being. This narrative review aims to explore the impact of sleep on the musculoskeletal system of athletes, particularly focusing on injury risk, performance, and recovery. It seeks to synthesize existing research to highlight the importance of sleep quality and duration in maintaining and enhancing athletic performance.Description of the state of knowledgeThe findings indicate that less than 7 hours of sleep is consistently associated with an increased risk of musculoskeletal injury, with athletes experiencing a 1.7 times higher risk if this sleep pattern persists for at least 14 days. Some studies also highlight that athletes obtaining fewer than 6 hours of sleep per day show significant performance declines and higher injury rates.SummaryWhile evidence clearly links certain sleep behaviors to increased musculoskeletal injury and pain, it is crucial to consider sleep as one aspect of an athlete's overall health and well-being. Adequate sleep is essential for optimal athletic performance, injury prevention, and recovery. Tailored sleep strategies should be integrated into training and recovery protocols to enhance the overall health and performance of athletes.

More Than Just a Pain in the Back: Pain Among American Nurses and Its Relationship to Modifiable Work Factors and Work Performance.

Nursing is a profession with high rates of workplace injuries, hazards, and turnover. Improving the health and safety of nurses at work is vital to retain and grow the workforce to meet future demands. The purpose of this study was to describe the breadth of pain among American nurses and explore the relationships between this pain and modifiable work factors and perceived work performance. We used a cross-sectional descriptive design of 2312 nurses from across the United States. Nurses completed a survey containing questions about demographics, the presence of pain in the past week, the number of pain sites, pain locations, severity, and the impact on work performance. The median number of pain locations reported was 2, back pain was the most reported pain site, and average pain severity ranged from 4 to 5. Significant modifiable work factors associated with pain were average patient load and shift length. Many participants indicated that their pain impacted work performance, while a smaller proportion acknowledged that their pain impacted patient care. Pain among nurses spans multiple locations, is moderately severe, and impacts work performance. Addressing related modifiable work factors may decrease pain and the impact on the health, safety, and work performance of the nursing workforce.

CNS and Thorax Injury and Associated Risks Factors in Equestrian Sports.

Equestrian sports continue to gain popularity in the United States and are associated with a high injury rate, especially involving the central nervous system and thorax. Due to this high rate of injury and the potential for long-term consequences associated with participation, an understanding of the unique risks of this sport is needed. To describe severe injury in equestrian sports and review the role that protective gear plays in injury mitigation. The PubMed Database was searched using the search terms "equestrian" and "horse" combined with "spinal cord injury," "head injury," "traumatic brain injury," "experience levels," and "demographics." A total of 53 papers were selected based on their relevance of epidemiology, risk factors, and management of injuries sustained during equestrian activities. Case studies, randomized controlled trials, prospective studies, and retrospective studies were all included for further review. Systematic review. Level 4. None. Injuries to the thorax, including fractures, pneumothoraces, internal organ contusions, and crush injuries, have been cited in multiple national and international trauma registries as the most prevalent injury location in equestrians; however, head and neck injuries, high cervical spine fractures, and closed head injuries are reported to be associated with the highest rates of mortality. Helmets provide protection against skull fracture and traumatic brain injury. Vests were not associated with diminished rates of spinal cord injuries; however, they may provide protection to the thorax. Riding experience also plays a role in reducing the prevalence of injury. Equestrian-related activities are associated with a high risk of injury despite protective measures. Protective gear can mitigate some injury risk but does not protect against spinal injury. Continued investigation into improving protective equipment, rider education, and preventative strategies to mitigate this risk is needed.

Patterns and correlates of traumatic stress, depression, anxiety, and moral injury in U.S. health care providers late in the COVID-19 pandemic.

Providing health care during the COVID-19 pandemic has been associated with a high mental health burden for health care providers. This study examined patterns of responses and correlates of class membership across commonly assessed mental health symptoms, psychosocial functioning, and moral injury for providers in the United States in Fall 2022. A convenience sample of 1,504 primary care physicians, pediatricians, nurse practitioners, and physician assistants who had been in practice for three or more years (Mage = 46.1 years, SDage = 11.3, 58% male) completed self-report measures in an online, opt-in panel survey from September to November 2022. Using latent class analysis, three classes were identified: No/Low Symptoms (64.8%), High Moral Injury (19.9%), and Elevated Symptoms (15.2%). Several factors were correlated with class membership including age, sex, social support, personal risk of COVID-19, pandemic-related work stressors, proportion of COVID-19 patients seen at the height of the pandemic, and death of a patient due to COVID-19. This study found high levels of mental health symptoms, and problems with psychosocial functioning and moral injury in health care providers well past the pandemic's peak. The results also demonstrated the importance of considering the unique contribution of moral injury to psychosocial functional difficulties experienced by health care providers during the pandemic given their defined role as essential workers. These findings have implications for preventing and managing mental health problems and burnout among providers postpandemic as well as for future pandemics at both the organizational and individual levels. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Banxia Xiexin Tang attenuates high glucose-induced hepatocyte injury by activating SOD2 to scavenge ROS via PGC-1α/IGFBP1.

The online version contains supplementary material available at 10.1007/s13205-024-04060-0.

Evaluating Adolescent Patient Outcomes and Staff Member Injuries at a General Psychiatric Inpatient Unit.

Short-term pediatric psychiatric hospitalization is used to manage acute-crisis behaviors. Few studies have detailed their clinical model and key metrics such as patient behavioral health outcomes and staff experience. This study describes a model which emphasizes group therapy based on dialectical behavior therapy during brief inpatient stays (average length of stay of 8 days). The study variables assessed included patient symptoms of depression, anxiety, and anger at discharge, patient satisfaction, and staff safety. The program produced significant improvements in adolescent depression, anxiety, and anger, and patients reported high satisfaction with the services received. However, there was a high rate of staff injuries, correlated with staffing ratios and the time of day. The key findings from this study demonstrate the effectiveness of brief inpatient programs and highlight variables that may impact staff experiences on these units, which could serve as further discussion points to improve clinical care.