Incidence Of Injury Research Articles

Are isokinetic muscle function related to lower extremity sports injuries in elite taekwondo athletes?

This study assessed the influence of knee and ankle muscle strength and endurance on lower extremity injury patterns (Injury incidence rate, injury type, and return-to-sport period) in elite taekwondo athletes. The study involved 60 elite taekwondo athletes (male and female 30, respectively) aged 18 and older, who trained intensively at a training institution for two years, from January 2022 to December 2023. The injury incidence rate per 1000 hours of training was calculated using a 95% Poisson confidence interval. We also employed simple linear regression analysis to identify the factors that muscle strength and endurance affect injury. All statistical significance levels were set at α=0.05, and we used SPSS version 27.0 for Windows for our analysis. In both male and female Taekwondo athletes, there was no significant association between the injury incidence rate of lower extremity and the muscle strength and endurance of the knee and ankle. However, the ratio of muscle endurance to the agonist and antagonist muscles in the knee and ankle was found to be associated with lower extremity injury incidence rates. This is also associated with ligament injury incidence rates. Effectively managing lower extremity injuries in taekwondo athletes necessitates a proper balance of muscle endurance between the agonist and antagonist muscles in the knee and ankle. Therefore, it is essential to develop an exercise program that addresses the imbalance between these muscle groups for taekwondo athletes.

CHARACTERISTICS OF THE CIRCUMSTANCES OF FORMATION, CLINICAL AND MORPHOLOGICAL MANIFESTATIONS, COURSE AND ASSESSMENT OF THE DEGREE OF GRAVITY OF DAMAGE IN CASES OF FACIAL INJURIES IN CHILDREN AND ADOLESCENTS

This study aims to examine the characteristics of facial injuries in children and adolescents by analyzing age- and gender-specific variations to enhance forensic medical assessments. Pediatric maxillofacial injuries differ significantly from adult cases in mechanism, clinical presentation, and long-term outcomes. These differences necessitate the establishment of age-specific criteria for determining the severity of injuries. The significance of this research stems from its focus on incorporating the unique physiological and anatomical aspects of children's bodies into forensic evaluations of facial injuries, considering their potential to cause not only temporary health impairments but also long-lasting functional and cosmetic consequences. Objective. To investigate the circumstances, clinical and morphological patterns, progression, and severity assessment of facial injuries in children and adolescents, with attention to age and gender differences. Materials and Methods. The research encompassed 203 Expert Conclusions from the archives of the Kyiv Regional and Kyiv City Clinical Bureau of Forensic Medical Examination, 177 Expert Conclusions from the Dnipro Regional Bureau of Forensic Medical Examination, and 123 inpatient records from the Department of Maxillofacial Surgery at Kyiv Children's Hospital No. 7. These data pertained to forensic investigations of facial trauma cases in pediatric populations. The study design incorporated a detailed analysis based on both gender and age groups to explore relevant patterns. Results The findings revealed that males were more frequently affected by facial injuries, comprising 350 cases (69.6%) out of 503 analyzed, compared to 153 cases (30.4%) involving females. Among all pediatric cases, younger school-aged children (3–6 years) accounted for 132 cases (26%), while older school-aged children (12–18 years) comprised the largest subgroup with 197 cases (40%). Morphological analysis showed that in children under 3 years, injuries were primarily confined to the soft tissues of the face and oral cavity. Conversely, children aged 7–11 years and adolescents were more prone to maxillofacial traumas, including fractures of the facial skull bones, often accompanied by mild to severe traumatic brain injuries. Statistical analysis demonstrated no significant differences in the average healing times among contused, bite-related, and lacerated facial wounds across different pediatric age groups (p > 0.05). Conclusions. Facial injuries in children and adolescents demonstrate distinct age-related patterns. In children under 3 years and preschoolers, soft tissue injuries of the face and oral cavity are predominant. In contrast, school-aged children (7–11 years) and adolescents experience higher incidences of maxillofacial injuries, including fractures to the facial skeleton, often in conjunction with traumatic brain injuries. Subperiosteal fractures—commonly involving the alveolar processes of the lower jaw—are characteristic among younger children, whereas fractures of nasal bones, upper maxillary processes, orbital walls, mandibular structures, and dental injuries are prevalent in older age groups. In assessing injury severity across pediatric populations, criteria such as health disorder duration, risk of unfavorable outcomes, and potential for permanent disability should be prioritized. Particular attention should be given to bite-related and lacerated wounds, as they frequently result in disfiguring scars and functional impairments (e.g., nasal breathing difficulties, chewing issues, asymmetry, salivation disturbances). This underscores the need for evaluating permanent disabilities when assessing forensic implications for pediatric facial trauma.

Relationship between the abdominal wall and chronic ankle instability.

Handball is one of the Olympic sports with the highest incidence of injury and chronic ankle instability is a common injury among handball players. Strong evidence shows the relevance of the core system in lower limb biomechanics and injury risk; however, few research has been published regarding the role of the active subsystem of the core on chronic ankle instability. The objective has been to compare abdominal wall morphology and function between young handball players with and without chronic ankle instability. Case-control study with 100 young handball players, 50 males participants and 50 females participants, was recruited and divided into athletes with chronic ankle instability (case group, n = 50) and healthy athletes (control group, n = 50). Main outcome measures were morphology and function of abdominal muscles and the inter-recti distance assessed by ultrasound examination. Significant between-group differences were found in the resting assessment of right rectus abdominis (case group 1.12cm; control group 1.04cm; p = 0.049), left rectus abdominis (case group 1.16cm; control group 1.06cm; p = 0.037), left internal oblique (case group 1.00cm; control group 0.88cm; p = 0.012), left transversus abdominis (case group 0.38cm; control group 0.34cm; p = 0.039) and inter-recti distance (case group 1.20cm; control group 1.40cm; p = 0.049). Moreover, significant between-sex differences were found in almost all morphological outcomes; muscle size at rest was larger in male handball players than in women counterparts. By contrast, no significant differences were found for function outcomes. Young handball players with chronic ankle instability had greater resting thickness of some abdominal muscles and lower inter-recti distance when compared to healthy athletes.

Occupational injury of Vietnamese seafarers on aboard merchant vessels.

Seafaring is an arduous and highly specialized profession, with many potential risks of accidents and injuries to the working seafarers. This study aims to describe the characteristics of occupational injuries and some related factors of Vietnamese seafarers on board merchant vessels. Injured seafarers working on ships of 3 shipping companies in Hai Phong, Vietnam for 2 years, from January 2021 to December 2022, were considered in the study. The retrospective descriptive method was used to collect data on occupational injuries. Forty-six injured seafarers out of a total of 1250 seafarers were included. The incidence of occupational injuries among seafarers was 46 per 1250 (3.7%). The overall injury incidence was 18.4 per 1000 seafarers per year over the 2-year study period. The most common time for injury accidents was at night (54.3%) and the place where injuries occurred was mainly on the deck of the ship (71.7%). Causes of occupational injuries included slipping (32.6%), closing cargo hatch covers (13.0%), unloading cargo (13.0%), and repairing ship engines (10.9%). The nature of injuries was mainly soft tissue injuries (52.2%); sprains, dislocations (15.3%); fractures (10.9%); burns (6.5%). Injuries to the shoulder, forearm, and hand (52.2%); thighs, legs, feet (32.6%); head (6.5%). Some factors related to injury include working experience less than 10 years, OR = 2.45 (95%CI: 1.36-4.42); intermediate education level, OR = 2.30 (95%CI: 1.17-4.54); non-officer, OR = 2.76 (95%CI: 1.36-5.59). Deck group crew, OR = 2.19 (95%CI: 1.14- 4.18); deadweight tonnage of ships under 10 thousand tons, OR = 5.88 (95%CI: 2.07-16.73) compared to ships over 50 thousand tons. Occupational injuries are a major health problem among Vietnamese seafarers. To prevent occupational injuries, it is necessary to improve living and working conditions on board ships and strengthen training and practice of occupational safety and hygiene on board ships.

Prevalence, Appropriateness, and Outcomes of Colistin Use in Multidrug-Resistant Pseudomonas aeruginosa Infections: Insights from Hospital Data

Background and Objectives: This study aimed to assess the prevalence of colistin prescriptions among patients with multidrug-resistant (MDR) Pseudomonas aeruginosa (P. aeruginosa) infections admitted to a tertiary teaching hospital in Jordan. Additionally, the study evaluated the appropriateness of colistin prescriptions and assessed resistance levels of this strain. Materials and Methods: In this retrospective study, adult patients who were infected with MDR P. aeruginosa and were admitted to Jordan University Hospital between January 2018 and March 2024 were included. Data on demographics, clinical characteristics, sources of infection, antibiotic therapy, and clinical outcomes were collected. Results: Out of the 85 patients who met the inclusion criteria for having MDR P. aeruginosa, colistin was administered to 16 patients (18.8%). Notably, approximately two-thirds (68.7%) of the isolates from patients who received colistin were classified as extensively drug-resistant (XDR). Among the isolates, 15 out of 16 (93.8%) were resistant to both ciprofloxacin and imipenem. Among the patients requiring colistin, five (31.3%) discontinued therapy, while two (12.5%) remained on colistin despite the availability of safer alternatives. No significant difference was observed in 30-day all-cause mortality between patients treated with colistin (0%) and those who were not (4.3%, p = 1.00). Similarly, the incidence of acute kidney injury did not differ significantly between the colistin group (0%) and the non-colistin group (p = 1.00). No significant difference was found in the hospital stay between colistin-treated patients (median 10.5 days, IQR [5.0–14.0]) and those not treated with colistin (median 13.0 days, IQR [7.0–21.0]), (p = 0.22). Conclusions: This study demonstrated that colistin was selectively initiated in high-risk patients, particularly those with XDR P. aeruginosa. However, its inappropriate continuation despite safer alternatives, as well as its discontinuation when no other options existed, raise concerns about antibiotic de-escalation practices. Interestingly, no significant differences in mortality or acute kidney injury were observed between patients who were treated with colistin and those who were not. These findings emphasize the need for antimicrobial stewardship programs and highlight the importance of large-scale trials to evaluate colistin’s efficacy and safety in MDR infections.

Assessing Efficacy of Interleukin-1 Blockade in Patients with Alcoholic Hepatitis: A Comprehensive Systematic Review of Emerging Evidence

Background and Objectives: Alcoholic hepatitis (AH) is a growing public health concern with its rising incidence and its contribution to nearly half of all cirrhosis-related deaths in the United States. In this systematic review, we aimed to comprehensively evaluate the current evidence and trials on the use of anti-interleukin-1 (anti-IL-1) drugs in patients with AH, assessing their efficacy and adverse events compared to routinely prescribed drugs like corticosteroids. Materials and Methods: A comprehensive literature search was conducted across five databases to identify randomized controlled trials (RCTs) evaluating the role of anti-IL-1 agents like canakinumab and anakinra among patients diagnosed with AH. Data was extracted and pooled in the form of mean and standard deviation for continuous variables and event and total for dichotomous variables. Results: Three RCTs were included for quantitative synthesis, encompassing 307 patients. Using canakinumab, 58% of patients showed improvement in histology. Prednisolone was associated with higher 90-day survival (90% vs. 70%; hazard ratio for death = 0.34, 95% CI 0.14–0.83, p = 0.018) and transplant-free survival. Overall, a higher incidence of acute kidney injury and new-onset cardiac disorders was noted in the anti-IL-1 arm when compared to placebo. Conclusions: This study concludes the lack of efficacy of anti-IL-1 agents in causing improvement in patient outcomes when compared to standard therapies. A higher incidence of adverse events was also noted in the anti-IL-1 arm. These results emphasize the need for future clinical trials to evaluate the use of anti-IL-1 agents in AH objectively.

Translation, Cultural Adaptation, and Content Validity of a Modified Italian Version of the Jackson/Cubbin Pressure Injury Risk Assessment Scale for ICU Patients

Background/Objectives: The Jackson/Cubbin scale is a recommended tool to assess the risk of pressure injury in intensive care unit (ICU) patients. This scale is deemed to have superior predictive validity compared to the Braden scale. Many Italian nurses struggle with reading and applying the tool in English. This language barrier results in a lack of use of the Jackson/Cubbin scale clinically, meaning that patients potentially experience worse outcomes. This study aims to translate the original English version of the Jackson/Cubbin scale into the Italian language, conduct a cultural adaptation, and verify its content validity. Methods: An observational study was conducted using Beaton’s five-step methodology: (1) forward translation, (2) synthesis, (3) back-translation, (4) expert committee approval using Fleiss’ Kappa (κ) index, and (5) pre-testing, where participants assessed item clarity on a dichotomous scale (clear/unclear). Items deemed unclear by 20% or more of the sample were revised. Content validity was assessed using the Content Validity Index (CVI). Results: Fleiss’ κ index was 0.74. Item 3 “PMH-affecting condition” was unclear to 36% of the sample and required revision. The item-level CVI (I-CVI) was >0.78 for each item. The scale-level CVI (S-CVI) and the scale-level CVI using the average method (S-CVI-Ave) were 0.92 and 0.94, respectively. Conclusions: The translation process resulted in a linguistically accurate scale requiring content modifications to reflect current evidence and reduce inter-rater variability. This may improve implementation of the Jackson/Cubbin scale in clinical practice for Italian nurses and reduce the incidence of pressure injury for ICU patients.

Anterior Cruciate Ligament Injury Incidence Across Sex, Sport, and Competition Level: A Systematic Review and Meta-Analysis

ABSTRACT Context: Despite the efficacy of injury prevention programs, ACL injury rates have remained steady, which may be due to limited knowledge of which groups/athletes are greatest at risk of sustaining an ACL injury. Objective: The purpose of our study was to characterize ACL injury rate (IR) across sports, sex, and levels of play to identify high-risk groups per season. Data Sources: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched electronic databases of PubMed and EBSCohost. Study Selection: Inclusion criteria required that studies noted level of play, number of ACL injuries, and total number of athletes. We excluded studies if the injury was a secondary one, the total population was unclear or noted only cases of reconstruction. Data Extraction: We extracted data on sport, sex, level of play, number of ACL injuries, and total number of athletes. Data Synthesis: The electronic literature search yielded 9469 studies for initial review, and at the end of the search, a total of 89 studies were included in our meta-analysis. The highest risk sports were female semi-pro handball (IR=0.045/athlete-year), female professional basketball (IR=0.027/athlete-year), and female professional alpine skiing (IR=0.025/athlete-year). Across all the sports, sex and levels there were large gaps in the data and variability in the injury rates. Conclusions: There was variability in injury risk rates across competition level, sex and sport, with the highest risk of ACL injury in semi-professional and professional sports. While female athletes demonstrated greater risk of ACL injury than male athletes, it’s unknown if this was true in every sport or level due to gaps in the data. Practitioners should understand the impact of sex and sport differences in ACL injury risk to guide the best evidenced-based risk reduction strategies.

Expert consensus on diagnosis and treatment of lung cancer complicated with interstitial lung disease

The prevalence and incidence of lung cancer combined with interstitial lung disease is high. The comorbidity of lung cancer and interstitial lung disease has attracted extensive attention in recent years. If patients with ILD are definitely diagnosed, high-resolution thin-layer lung CT should be performed every year to detect the comorbid patients with lung cancer as soon as possible. On the premise of stable ILD condition, the most suitable anti-tumor treatment should be selected according to the pathological type, clinical stage, physical status, driver gene status, immune status, and comprehensive efficacy and safety considerations of patients with lung cancer. In patients with early lung cancer complicated with ILD, perioperative risk assessment should be fully carried out, and the surgical method and resection scope should be determined through MDT discussion. The incidence of radiotherapy related lung injury in lung cancer patients with ILD is high. It is suggested that multidisciplinary discussion should be conducted to select the appropriate radiotherapy regimen and dose. Chemotherapy is an effective treatment for patients with lung cancer complicated with ILD. It is recommended to select the appropriate chemotherapy according to the pathological type, clinical stage and PS score of lung cancer on the premise of stable ILD. Patients with lung cancer complicated with ILD have a low mutation rate of driver genes, and there is a risk of TKI related ILD. For lc-ild patients with positive driver gene mutations, targeted drugs with low pulmonary toxicity should be selected as cautiously as possible. Patients with lung cancer and ILD can benefit from immunotherapy. Patients with mild ILD and lung cancer can choose immunotherapy. Patients with moderate severe ILD and lung cancer should weigh the advantages and disadvantages and use immunotherapy cautiously. At the same time, the occurrence of adverse reactions of immunotherapy should be closely monitored. In the future, large-scale prospective randomized controlled clinical trials need to be carried out to explore the most suitable treatment scheme for lung cancer complicated with ILD, and improve the survival and prognosis of patients with comorbid diseases.

Equestrian-related maxillofacial injuries-a five-year retrospective review.

Equestrian-related activities inherently involve the risk of serious injury. There are few reports of maxillofacial injury patterns and management arising from equestrian activities in the literature. To investigate maxillofacial fracture presentations at a tertiary trauma centre to identify injury profiles of patients who have sustained equine-based injuries over 5years. This work involved a retrospective review of all trauma presentations to our unit over 5years. The data collected included patient demographics, injury mechanisms and patterns, and management of fractures. The study identified 73 patients with facial fractures resulting from activity with horses between 2020 and 2025. A total of facial fractures were recorded. The mean age was 39.5 (11-86) years. There were 40 (55%) males and 33 (45%) females. Mounted riders accounted for 41% of cases, with 59% being unmounted. The incidence of head injury was 5%. A further 5% had an associated spinal injury. The most common specific mechanism of maxillofacial injury was a direct kick, in 55% of cases. The most commonly affected facial region was the middle third (81%), with zygomaticomaxillary complex fractures most commonly recorded (39%). There was a statistically significant increase in the risk of head injury associated with frontal bone fracture in this group. Activities involving horses pose a high risk of maxillofacial injury. Education should be promoted to increase the usage of helmets with a particular design to protect the facial skeleton, whether mounted or unmounted.

A graft-to-recipient weight ratio of less than 0.7% under portal venous hemodynamics monitoring is a risk factor for early graft loss after living donor liver transplantation.

To investigate the interaction between graft-to-recipient weight ratio (GRWR) and portal venous hemodynamics (PVH), with a net impact on the perioperative outcomes of living donor liver transplantation (LDLT). We analyzed, retrospectively, adult LDLT recipients divided into three groups according to their GRWR: Group 1, > 1.0% (n = 124); Group 2, 0.8 ~ 1.0% (n = 70); and Group 3, < 0.8% (n = 31). The intraoperative PVH parameters did not differ significantly among the groups, but Group 3 had the highest number of patients needing portal inflow modulation to achieve optimal final portal pressure. Group 3 was also more prone to delayed recovery of liver function, a higher incidence of posttransplant kidney injury necessitating dialysis (16.1% vs. 3.2% for Group 1 and 4.3% for Group 2, p = 0.015) and a higher incidence of liver graft loss within 3months post-LDLT (22.6% vs. 7.3% for Group 1 and 4.3% for Group 2, p = 0.007). Logistic regression analysis revealed that extremely small liver grafts (GRWR < 0.7%) were the most significant risk factor for early graft loss (HR: 16.951, 95% CI: 3.961 ~ 72.535). Survival analysis revealed comparable outcomes between patients who received liver grafts with a GRWR of 0.7 ~ 0.8% and those who received liver grafts with a GRWR > 0.8%. Patients with extremely small liver grafts had significantly lower graft survival rates (1-month, 3-months, and 1-year post-LDLT, of 66.7%, 50.0%, and 50.0%, respectively (p < 0.01). Under intraoperative PVH monitoring, the accepted GRWR in LDLT could be extended to 0.7%, but a GRWR < 0.7% remains a risk factor for early graft loss.

Preemptive left stellate ganglion block reduces the incidence and severity of cardiac surgery-associated acute kidney injury: a randomized clinical trial.

Acute kidney injury is a common and severe complication of cardiac surgery. A connection might exist between renal sympathetic nerves and left stellate ganglion. It remains unclear whether preemptive left stellate ganglion block (SGB) can effectively prevent cardiac surgery-associated acute kidney injury (CSA-AKI) in clinical practice. Participants were randomly assigned to SGB group with 0.375% ropivacaine 5ml performed post-general anesthesia induction or control group (no SGB). The primary outcomes were incidence and severity of CSA-AKI within 7days postoperatively. Secondary outcomes were intraoperative resistive index (RI) and pulsatility index (PI) of left renal artery via TEE and perioperative IL-6, CRP, and norepinephrine. RR and 95% CI were calculated to compare outcomes between groups. Sensitivity analyses were performed to confirm robustness of findings. Totally 138 participants were randomized for intention-to-treat (ITT) analysis (69 SGB, 69 control) and 119 for per-protocol (PP) analysis (59 SGB, 60 control). In the ITT analysis, the incidence of CSA-AKI was significantly lower in the SGB group than the control group (14.5% [10/69] vs. 40.6% [28/69], RR 0.351, 95% CI: 0.169-0.728, P=0.005). The PP analyses (13.6% [8/59] vs. 41.7% [25/60], RR 0.325, 95% CI: 0.160-0.660, P=0.001) demonstrated similar results. The severity of CSA-AKI was significantly lower in the SGB group than the control group (ITT and PP: P < 0.001). The RI and PI were significantly lower in the SGB group than the control group at post-CPB cessation (P < 0.001 and P=0.005, respectively). Postoperatively, the SGB group demonstrated significant reductions in IL-6, CRP, and norepinephrine (all P < 0.05). The sensitivity analysis confirmed the robustness of the observed effects, yielding an unadjusted benefit ratio of 0.244 (95% CI: 0.096-0.620, P=0.003) for the incidence of CSA-AKI and 0.197 (95% CI: 0.082-0.468, P < 0.001) for its severity. Preemptive left SGB effectively reduces the incidence and severity of CSA-AKI in patients undergoing cardiac surgery under CPB.

A systematic review and meta-analysis of various injury prevention programs in youth soccer players

BackgroundConsidering injuries as a serious problem which affects player availability and performance, soccer clubs have strong incentives to develop and implement various injury prevention programs (IPPs). The aim of this systematic review and meta-analysis was to examine, consolidate and summarize the research on the effects of various IPPs on injury incidence in youth soccer players.MethodsA search was conducted in Cochrane Library, PubMed (MEDLINE), Scopus and Web of Science. A total of 3827 records were identified through database searches which were filtered to 19 studies that met the selection and inclusion criteria. The search was concluded in December 2024. A methodological quality scale was also employed as a valuable tool to assess the risk of bias in the selected studies.ResultsA total sample of 28,200 youth soccer players were analyzed in the included studies. 12 studies reported positive effects of the IPP on overall injury incidence, while four studies found no significant effects. Moreover, most studies showed increasing effectiveness with higher adherence or compliance. Overall, injury prevention programs were shown to significantly decrease the likelihood of injury (RR = 0.615 [95% CI = 0.512; 0.739]; z = -5.20; p < 0.001). Subgroup analyses conducted for age (Q (1) = 2.84, p = 0.092), duration of intervention (Q (1) = 1.87, p = 0.172), type of injury prevention program (Q (1) = 0.00, p = 0.955) did not reveal significant differences in injury incidence, suggesting that the overall effect of injury prevention programs is not significantly influenced by these factors.ConclusionsThis systematic review and meta-analysis suggest that different injury prevention programs are likely effective in reducing injury risk and lowering the injuries among youth soccer players, suggesting their potential protective effect in injury prevention.

Analysis of Differences in Injuries in Padel Players According to Sport-Specific Factors, Level of Physical Activity, Adherence to the Mediterranean Diet, and Psychological Status

The available scientific evidence on padel injuries is scarce and inconclusive. For this reason, the main aim was to analyze the differences in injury incidence in padel according to specific factors of the sport, as well as to the level of physical activity, adherence to the Mediterranean diet, and the psychological state of the players. A sample of 216 padel players (mean age: 30.05 ± 9.50 years old) participated in this study. The participants completed a sociodemographic questionnaire that included padel-specific variables, a sports injury questionnaire, the IPAQ, the MEDAS, and the CPRD. A higher incidence of injuries was observed in players with more experience (p &lt; 0.001), more hours of play (p &lt; 0.001) and at amateur or professional levels (p &lt; 0.001). Mild and moderate injuries were common with mixed or herringbone soles; severe (p = 0.031), muscle, tendon and ligament injuries were common with herringbone soles (p = 0.023). Muscle and ligament injuries occurred more frequently on sand courts (p = 0.037), and with 350–370 g racquets (p = 0.029). Tendon injuries were associated with less mental ability (p = 0.014). There were no significant differences with the Mediterranean diet or level of physical activity. Injury in padel is related to sport-specific factors and psychological state but does not seem to be related to level of physical activity or diet. However, due to the cross-sectional design, causal relationships cannot be established, so future research in this field is needed.

Anterior Cruciate Ligament Injuries in National Football League Players from 2012 to 2022: A Descriptive Epidemiology Study.

There is a high incidence of anterior cruciate ligament (ACL) tears in National Football League (NFL) players. There is a relative paucity of long-term data characterizing the effects of artificial versus natural playing surfaces on ACL tear incidence. A comprehensive search of publicly available data identified any NFL player who sustained an ACL injury from 2012 to 2022. The publicly available databases allowed for characterization of playing surface, player position, timing of injury in season, mechanism of injury, and player age. Incidence of ACL injuries by playing surface, player position, and position group relative to all other positions or position groups were compared by chi squared test. Correlates of in-game ACL injury were determined by stepwise multivariate logistic regression. There were 520 NFL players who experienced an ACL tear between seasons 2012-13 and 2022-23. There was no significant difference in incidence of ACL tears on artificial turf versus natural playing surfaces (265 versus 255, p=0.670). Wide receivers (p=0.027) were associated with a significantly higher incidence of ACL tears compared to other positions. Receivers (wide receivers and tight ends) (p=0.007) were associated with significantly higher incidence of ACL tears compared to other position groups, while specialists (punters, kickers, and long snappers) (p<0.001) were associated with significantly lower incidence of ACL tears compared to other position groups. No significant difference between mechanism of injury between playing surfaces was found (p=0.765). More ACL tears occurred before week 9 than on or after week 9 in-season, and the proportion of ACL tears occurring during a game (67%) was significantly higher than those occurring during practice. There was no statistically significant difference in incidence of ACL tears in NFL players from the 2012-13 to 2022-23 seasons based on playing surface (artificial versus natural). Wide receivers had a significantly higher incidence of ACL tears compared to other positions and tears were more common during games and before week 9 in-season.

Incidence and Predictors of Acute Kidney Injury and Acute Kidney Disease After Robot-assisted Radical Prostatectomy in Prostate Cancer Patients.

Incidence and Predictors of Acute Kidney Injury and Acute Kidney Disease After Robot-assisted Radical Prostatectomy in Prostate Cancer Patients.

Safety and efficacy of cerebral robot assisted angiography: randomized comparison of robotic versus manual procedures.

While robotic assisted technology has advanced in cardiovascular interventions, neurovascular applications still lack a robotic system. To assess the safety and efficacy of novel robotic systems designed for cerebral angiography, we conducted a multicenter, randomized controlled non-inferiority trial. 130 patients were recruited who received cerebral angiography in four centers. After identifying the target vessels, patients were randomly allocated to an experimental group for robotic procedures and a control group for manual procedures in a 1:1 ratio. Clinical success rate, technical success rate, overall surgery time, pre-puncture set-up time, puncture-to-unsheathed time, mean catheterization time per target vessel, X-ray fluoroscopy time, and primary operator's radiation dose were compared. The safety endpoints were incidence of perioperative vascular injuries, any adverse events, and device malfunctions. 64 patients were assigned to the experimental group and 66 to the control group. Both groups achieved 100% clinical success and a 100% technical success. Significantly, the primary operator's radiation dose in the robotic group was lower than that in the manual group (1.67±3.49 μSv vs 43.63±38.95 μSv, P<0.001). The puncture-to-unsheathed time (P=0.882), mean catheterization time per target vessel (P=0.247), and fluoroscopy time (P=0.701) were comparable. The pre-puncture set-up time in the robotic group was longer (P<0.001), attributed to prolonged robotic instrument set-up. No robot related adverse events were observed. The trial showed that the robotic system was safe and effective for assisting cerebral angiography, notably reducing primary operators' radiation exposure. ClinicalTrials.gov NCT05778214.

Intravenous combined with nebulized polymyxin B may be effective in treating carbapenem-resistant gram-negative bacilli hospital-acquired pneumonia: a retrospective cohort study.

To compare the clinical efficacy and safety of intravenous polymyxin B versus the combination of intravenous and nebulized polymyxin B for treating carbapenem-resistant gram-negative bacilli hospital-acquired pneumonia (CRGNB-HAP), and to explore the risk factors affecting 28-day all-cause mortality. Our retrospective analysis was conducted on data from CRGNB-HAP patients treated in the intensive care unit (ICU) with either intravenous polymyxin B alone or in conjunction with nebulized polymyxin B between November 28, 2018 and May 6, 2024. The primary endpoint was 28-day all-cause mortality, while safety outcomes were also assessed. Logistic regression analysis was utilized to identify the risk factors associated with 28-day all-cause mortality. A total of 82 CRGNB-HAP patients were enrolled, including 38 patients in the intravenous plus nebulized (IV + NL) polymyxin B group and 44 patients in the intravenous (IV) polymyxin B group. The 28-day mortality rate of the IV + NL polymyxin B group was significantly lower than that of the IV polymyxin B group (23.7% vs 61.4%, p < 0.001), and there was no statistically significant difference in the incidence of acute kidney injury between the two groups. Multivariate logistic regression analysis indicated that IV + NL polymyxin B administration was a significant factor in reducing the 28-day mortality rate of CRGNB-HAP patients. Our study found that intravenous combined with nebulized polymyxin B therapy is superior to intravenous monotherapy in the treatment of CRGNB-HAP, resulting in reduced 28-day mortality without increasing renal toxicity.

Neurobiomechanical Effects of Fatigue on Climbing Performance and Injury Risk

Introduction and Purpose:Sport climbing poses significant physical and neuromuscular demands, with muscular fatigue representing a critical factor affecting performance, technique, and injury susceptibility. As climbing participation increases, understanding the medical implications of fatigue becomes essential. This review explores how central and peripheral muscle fatigue influence motor coordination, climbing biomechanics, and injury risk, from a neurophysiological and biomechanical perspective. Current Knowledge:Central fatigue disrupts motor unit recruitment by impairing central nervous system output, while peripheral fatigue compromises muscle fiber contractility. Both forms of fatigue degrade proprioception, coordination, and postural control, leading to inefficient movement and increased mechanical load on joints and tendons. Fatigue-related motor impairments contribute to a higher incidence of overuse injuries—particularly affecting the fingers, shoulders, and knees—and increase the likelihood of falls due to delayed reaction time and impaired decision-making. Although experienced climbers exhibit compensatory strategies, these adaptations are not sufficient to mitigate all health risks. Conclusion:Muscle fatigue is a significant medical concern in sport climbing, with direct implications for musculoskeletal injury and neuromotor control. Preventive strategies should involve targeted conditioning, fatigue monitoring (e.g., HRV, RPE), and early identification of biomechanical compensations. Further interdisciplinary research is needed to inform evidence-based guidelines for injury prevention, especially in novice and youth climbers.

Epidemiology of Paediatric Injuries Related to Scooter Use in 2020.

Powered, or electric, scooters (e-scooters) have recently increased in popularity, resulting in more e-scooter-related trauma. Paediatric e-scooter injuries are of particular concern. Motorised scooter injuries are logged in the National Electronic Injury Surveillance System (NEISS). There are specific codes for powered versus unpowered scooters, allowing for differentiation of scooter-related injuries. Our primary objective was to describe e-scooter injury epidemiology for the year 2020 amongst e-scooter riders to best inform medical providers and public health officials of the most common injuries. Secondary objectives compare powered versus unpowered scooter injuries. We queried the US Consumer Product Safety Commission's (CPSC) NEISS database for incidents involving powered and unpowered scooters during 2020. We included patients 0 through 18 years old. We excluded patients without known injury and those who left without being seen. Two-hundred and thirty one patients with powered scooter injuries and 324 with unpowered scooter injuries met the inclusion criteria. Within the powered cohort, 66.7% (154/231) were male and the average age at injury was 11.4 years. Patients using powered scooters were older than those using unpowered scooters (11.4 ± 4.1 versus 7.6 ± 3.6; p < 0.0001) and experienced more head injuries (18.1% versus 13.7%; p < 0.0001). An estimated 5268 patients (CI: 3818, 6718) were treated for powered and 7526 (CI: 4921, 10 132) for unpowered scooter injuries in the US in 2020. E-scooters continue to be popular amongst children, with increasing injury prevalence and severity. Given the increasing incidence of severe e-scooter injuries in the paediatric population, we support continued efforts to educate and legislate regarding paediatric e-scooter use. Level III.