Increased Risk Of Injury Research Articles

Subregions of the Rotator Cuff Muscles Present Distinct Anatomy, Biomechanics, and Function

Shoulder and elbow injuries are prevalent among baseball players, particularly pitchers, who experience repetitive eccentric loading of the shoulder, leading to muscle damage and increased injury risk. Nearly 40% of shoulder injuries in baseball occur in pitchers, with many facing low rates of return to sport. The rotator cuff (RC) muscles—supraspinatus (SSP), infraspinatus (ISP), subscapularis (SSC), and teres minor (TMin)—are crucial for shoulder stability, movement, and force generation, particularly in overhead sports. Each RC muscle comprises subregions with distinct biomechanical properties, such as strength, moment arm behavior, and activation patterns. These differences allow for a finely tuned balance between joint stability and mobility. For example, the superior subregion of the ISP significantly contributes to external rotation, a function critical in sports like baseball that require precision and power. During pitching, the SSP, ISP, and SSC stabilize the glenohumeral joint through high activation during explosive phases, such as stride, arm cocking, and arm acceleration. Understanding these functional subregional differences is vital for diagnosing and managing shoulder pathologies like RC tears. Despite advancements, clinicians face challenges in predicting re-injury risks and determining return-to-play readiness for athletes with shoulder injuries. Integrating insights into subregional biomechanics with patient care could enhance outcomes. Tailored interventions—whether surgical or rehabilitative—targeting specific subregions could improve recovery times, reduce re-injury risks, and enable more personalized treatment plans. Such approaches are especially beneficial for athletes, older individuals, and those prone to RC injuries, promoting better long-term shoulder health and performance. The present work aims to highlight some of the research on these subregions and their differences, providing insights to enhance treatment approaches for shoulder injuries.

Epidemiology of injuries and illnesses among female cricketers in Bangladesh’s first-class cricket: a retrospective analysis (2015–2021)

ABSTRACT This retrospective study aimed to examine the incidence, types, and patterns of injuries and illnesses among female cricketers in the first-class cricket of Bangladesh between 2015 and 2021. The study was conducted with 250 female cricket players aged 14–28 who had experienced injuries. Participants completed a structured questionnaire that gathered information on injury type, frequency, recurrence, treatment methods, and post-injury performance. Logistic regression analysis was employed to assess the relationship between injury risk and key variables, including playing position (batter, bowler, or fielder), weekly workload (hours spent in training/competition), and injury context (occurring during matches or practice). Descriptive statistics were used to summarize injury patterns and recovery outcomes, while odds ratios (OR) with 95% confidence intervals (CI) were calculated to identify significant predictors of injury risk. Of the participants, 75.2% experienced new injuries, while 24.8% reported chronic injuries. The most common injury sites were the knee/leg (24%) and shoulder (20%). Recurrence was high, with 56% experiencing 5–6 injury recurrences, and 68% reported multiple injuries over their careers. Physiotherapy was the primary treatment, used by 52% of participants, and 76% of players returned to competition post-injury. However, only 8% regained their pre-injury performance levels. Logistic regression revealed that bowlers had a significantly higher injury risk (OR = 2.12, p = 0.055), while high workloads (21+ hours/week) were also associated with increased injury risk (OR = 1.42, p = 0.112), though not statistically significant. The findings highlight the prevalence of injuries in female cricket, particularly in bowlers and those with high workloads. Physiotherapy was effective in promoting recovery, but a significant portion of athletes did not regain their pre-injury performance levels. Comprehensive injury prevention programs, tailored rehabilitation, and ongoing education on injury management are essential to mitigate risks and enhance player recovery.

Functional Vision Questionnaire Detects Near Triad Impairments in Adolescent Athletes With Concussion History.

Concussions are mild traumatic brain injuries that often cause vision problems. They have significant impacts on everyday life, cognitive capacity, and sports performance, and may affect injury prevalence in fast contact sports such as ice hockey. A functional vision questionnaire specifically designed for sports was used here to study the correlation between vision problems and concussion history. In this national cross-sectional concussion study, 860 Finnish elite-level male adolescent ice hockey players (aged 13-21 years) answered a functional vision questionnaire and performed a computerized neurocognitive test, ImPACT. Totally 265 athletes reported a history of at least 1 concussion. All data were statistically compared with age-matched athletes with no concussion history (n = 595). For further analysis, athletes were divided into subgroups by age and number of previous concussions. Previously concussed athletes reported more general and eye-specific symptoms than their healthy controls. Increases in eye fatigue, frontal headaches, and blinking were statistically significant. Also statistically more problems with depth perception and evaluating distances, concentration problems, blurred vision, and losing the object in sight were observed among athletes with concussion history. Concussion history reflects an increase in the prevalence of vision deficits, as determined by multiple disturbances in the near triad. The significant number of vision problems in the concussion history groups strongly suggests that functional vision should routinely be evaluated in athletes. The vision problems observed in the athletes with concussion history may indicate an increased injury risk that should be addressed.

Limb Symmetry Index in Collegiate Dancers Using the Modified Star Excursion Balance Test and Single Leg Hops.

Introduction: Dance is physically demanding and often involves unilateral movements performed within a small base of support. Prior authors have reported that dancers use one leg preferentially over the other (ie, lower extremity asymmetry). Increased leg asymmetry-quantified using the Limb Symmetry Index (LSI), is associated with increased injury risk. Clinicians often use LSI to make return-to-performance decisions (eg, >85% performance on injured vs non-injured limb). However, limited research has examined leg symmetry in collegiate dancers. Purpose: To examine LSI in collegiate dancers using the modified star excursion balance test (mSEBT) and single-leg hop test (SLH). Methods: 120 healthy collegiate dancers (105 females, 15 males; 18.31 ± 0.80 years; 164.18 ± 7.12 cm; 61.18 ± 8.46 kg) performed the mSEBT (normalized to % leg-length: LL) in the anterior, posteromedial, and posterolateral directions and the SLH test (normalized to % body height: BH) across both legs using previously published guidelines. mSEBT scores were averaged for all three directions per leg. SLH scores were averaged per leg. LSI was calculated as (lower value/higher value) × 100 to obtain a percentage. Results: Mean mSEBT scores were 95.7 ± 14.2%LL (lower score) and 96.6 ± 14.3%LL (higher score). Dancers LSI for mSEBT was 99.1 ± 0.9%. Mean SLH scores were 82.8 ± 13.3%BH (lower score) and 86.4 ± 13.5%BH (higher score). Dancers LSI for SLH was 95.9 ± 3.5%. Conclusions: Dancers' LSI% was greater than 90% for mSEBT and SLH, concurrent with the normal values of LSI > 90% in healthy, physically active adults. Dancers displayed lower leg symmetry. Practitioners can thus use the contralateral leg as a reference for return-to-performance decisions following injury in dancers. LSI should be integrated into a comprehensive screening process to identify large (>85%) asymmetries and guide training programs post-injury to assist educators and practitioners' evidence-based return-to-performance decisions. Future researchers should examine LSI in other dance genres and across levels.Level of Evidence: 2C.

Risk Assessment of FMS and YBT on Sports Injuries in Collegiate Athletes

AbstractThis prospective cohort study investigated the predictive validity of the Functional Movement Screen (FMS) and Y Balance Test (YBT) for sports injuries in 458 collegiate athletes across various sports. Preseason screening using FMS and YBT was conducted, followed by injury data collection over the competitive season. Logistic regression analysis examined the relationship between screening scores and subsequent injury risk. Results indicated that lower composite FMS scores (≤14) were associated with increased injury risk (OR=2.32; 95% CI: 1.54–3.48; p<0.001), as were YBT anterior reach asymmetries > 4 cm (OR=2.16; 95% CI: 1.43–3.26; p<0.001). The combination of both risk factors demonstrated the strongest association (OR=3.57; 95% CI: 2.18–5.83; p<0.001) when compared to individuals with FMS scores >14 and YBT asymmetry < 4 cm.The combination of low FMS scores and YBT asymmetries demonstrated the strongest predictive value. These findings underscore the value of the FMS and YBT as screening tools to identify collegiate athletes who may be at elevated risk for sports injuries, potentially guiding the implementation of targeted injury prevention strategies.

Test Re-Test Reliability of Countermovement Jump, Single Leg Countermovement Jump, and Countermovement Rebound Jump Force Plate Metrics in Female Football Players

Female football is growing exponentially. Assessing changes in neuromuscular function enables injury risk profiling using single and multiple countermovement jumps (CMJ) in female footballers who are at greater injury risk. Single leg CMJ (SLCMJ) is sensitive to detect such changes, but test-retest reliability is unknown. The aim of this study was to examine test-retest reliability of phase-specific metrics during CMJ, SLCMJ and countermovement rebound (CMJ-R) in female youth footballers. Twenty-six elite female footballers (15.4±1.6 years, 59.2±2.4 kg, 165.8±4.8 cm) performed three, arms akimbo, CMJ, SLCMJ and CMJ-R trials on two sessions seven days apart, using force plates and associated software. System weight, jump momentum and average braking force had good-excellent reliability. CMJ demonstrated greater reliability followed by CMJ-R, dominant limb (DL: preferred kicking limb) SLCMJ and non-dominant limb (NDL) SLCMJ. Jump height had good-excellent reliability for CMJ and CMJ-R. SLCMJ absolute reliability (upper 95 confidence interval [CI] coefficient of variation) was moderate for both limbs. Relative reliability (lower 95 CI interclass correlation coefficient) was good for DL, but poor for NDL. Considering increased injury risk in female athletes, selecting reliable metrics facilitate accurate neuromuscular function assessment for injury risk profiling. This study describes phase-specific test-retest reliability in female youth footballers.

Analysis of Concussions with Persisting Symptoms Caused by Motor Vehicle Crashes in 136 Vehicle Occupants Shows that Females Are Vulnerable Road Users.

At the Canadian Concussion Centre, we treated 136 patients from 2000 to 2020 who sustained concussion plus persisting concussion symptoms (C+PCS) as motor vehicle occupants involved in motor vehicle crashes (MVCs). This center specializes in the treatment of patients with C+PCS. The objective of the present study was to identify strategies for preventing concussion among vehicle occupants involved in MVC. Indeed, this is the first study focused on C+PCS in MVC occupants, and our main purpose was to evaluate the effectiveness of onboard concussion prevention strategies. In this retrospective, consecutive cohort of 136 patients with C+PCS, we examined the patients' demographic and injury features in relation to the nature of the MVC including speed, direction of impact, and availability, deployment, and effectiveness of onboard occupant safety measures including seatbelts, head restraints, and airbags. The most frequent combination of factors was a belted female driver of an automobile struck from behind by another automobile. Surprisingly, the entire patient cohort comprised more females (69.1%) than males (30.9%), and rear-end collision was the most common type in females. Most injured occupants of both sexes were wearing seatbelts, but only a minority of the crashes caused airbag deployment. The seven most common symptoms were headache (84.6%), anxiety (72.8%), sensitivity to light (70.6%), memory problems (69.9%), sensitivity to noise (66.2%), irritability (56.6%), and depression (55.9%). Whiplash was a frequent associated injury in both sexes. Complete recovery from C+PCS was rare, and most patients with known follow-up continued to suffer from persisting symptoms for months to years. The median symptom duration for all 136 patients was 30.0 months (interquartile range: 16.8-56.0 months). Based on these findings, we conclude that females are indeed vulnerable road users with respect to C+PCS, and our literature search showed that there had been some previous evidence of increased injury risk of other injuries in female occupants. We recommend that additional prevention strategies are required to reduce the post-crash acceleration-deceleration "bobble-head" movement of the head on trunk causing both concussion and whiplash as has been accomplished in auto racing. Also, these prevention measures must be investigated in crash studies that include low-to-high speed rear-end collisions using anthropometrically appropriate models of male and female occupants reflecting the range of sizes of both sexes. There is a need for more concussion brain injury prevention research focusing on the vulnerability of female occupants, which has not been sufficiently addressed even though the deficiency was identified many years ago. The sex inequity of current onboard motor vehicle concussion brain injury prevention measures especially with respect to females should be addressed by governments and the automobile and insurance industries.

Contemporary small-scale subsistence populations offer unique insights into human musculoskeletal health and aging.

Human foragers avoid noncommunicable diseases that are leading causes of mortality, partly because physically active lifestyles promote healthy aging. High activity levels also promote tissue damage accumulation from wear-and-tear, increase risk of injury and disability which compromise productivity, and reduce energetic investments in somatic maintenance given constrained energy expenditure. Constraints intensify when nutrient supply is limited and surplus energy is directed toward pathogen defense and reproduction, as occurred throughout hominin evolution. This paper reviews evidence linking exposomes to musculoskeletal health in subsistence populations, focusing on effects of physical activity, pathogens, diet, and reproduction. Chronic musculoskeletal conditions are common for humans and possibly prehistoric hominins but rarer in quadrupedal apes. We propose that transition to bipedalism ~6 to 8 million years ago constituted an early "mismatch scenario," increasing hominin susceptibility to musculoskeletal conditions vis-à-vis quadrupedal apes due to changes in mechanical loading environments. Mismatched musculoskeletal traits were not targets of selection because of trade-offs favoring bipedal extractive foraging and higher fertility.

No Increased Injury Risk on Artificial Turf in Finnish Premier Division Football.

To compare the injury risk between natural grass and artificial turf in the male Finnish premier division (Veikkausliiga) matches during the 2019 league season. A retrospective reanalysis of prospectively collected season-long injury surveillance cohort study. Finnish elite-level male football. All 12 teams of Veikkausliiga participated in the study. All players were eligible to participate. Two hundred thirty-six players took part in the follow-up between February and November 2019. Matches were played between April and November 2019. Injury data were collected using standard injury reports from the team medicals and weekly player questionnaires. Individual player exposure in matches was collected. Artificial turf was classified as exposure and natural grass as control in the analyses. Match-related injury incidence and incidence rate ratios (IRR) with 95% confidence intervals (CI) on natural grass and artificial turf. A total of 113 injuries (65 on artificial turf, 48 on natural grass) in 167 matches (90 on artificial turf, 77 on natural grass) were included. Injury incidence was 27.2/1000 hours on artificial turf and 23.9/1000 hours on natural grass and (IRR, 1.1; 95% CI, 0.8-1.7). There was no difference in injury types, anatomical regions, injury recurrence, injury severity, or injury contact. Forwards may have had an increased injury incidence on artificial turf compared with natural grass (IRR, 3.4; 95% CI, 1.0-11.8). This study supports previous reports that there is no significant increase in the overall risk of injury in professional football played on artificial turf compared with that on natural grass.

Comparative study of the prevalence of organ injury in placenta accreta spectrum disorder between posterior colpotomy and conventional peripartum hysterectomies at a single referral center in southern Thailand.

To compare the prevalence of adjacent organ injury in placenta accreta spectrum disorder (PAS) between the posterior colpotomy approach and conventional peripartum hysterectomy. This retrospective study analyzed the data of pregnant women diagnosed with PAS who underwent peripartum hysterectomy at Songklanagarind Hospital between January 2006 and December 2021. The patients were divided into two groups: posterior colpotomy and conventional approaches. The characteristics and surgical and obstetric outcomes were compared. Univariate and multivariate logistic regression was used to identify factors and risk of organ injury. Among 174 patients, 64 underwent conventional peripartum hysterectomy, and 110 underwent the posterior colpotomy approach. The overall incidence of adjacent organ injury was 17.82%. Organ injury prevalence was lower in the posterior colpotomy group (10%) than in the conventional group (31.25%), with no difference in operative time. Multivariate analysis showed that posterior colpotomy reduced adjacent organ injury (odds ratio [OR] 0.18, 95% confidence interval [CI] 0.06-0.54, P = 0.002). Placenta percreta was associated with increased injury risk (OR 6.83, 95% CI 2.53-18.44, P < 0.002). Subgroup analysis showed that the posterior approach reduced bladder injury in placenta increta (OR 0.14, 95% CI 0.04-0.57, P = 0.003) and percreta (OR 0.19, 95% CI 0.05-0.77, P = 0.017). Compared with conventional peripartum hysterectomy, the posterior colpotomy approach in patients with PAS reduced the risk of adjacent organ injury, particularly for placenta increta and percreta. This technique should be considered in PAS cases, but further investigations with a prospective study design are needed.

National basketball association slam dunk contest participation does not lead to increased injury risk or adversely affect player performance

Background: The National Basketball Association (NBA) Slam Dunk Contest has declined in popularity in recent years, in large part due to a lack of star-player participation relative to the NBA All Star Game. The purpose of the current study is to evaluate the effect of NBA Slam Dunk Contest participation on subsequent injury risk and player performance. Methods: Participants from twenty NBA Slam Dunk Contests (2000-2019) were identified and matched to a control group consisting of same-year All-Star Game players. Injury data and performance data concerning all major offensive and defensive statistical categories was obtained from publicly available databases. Injury rates and season-long statistical performances were compared between groups both before and after the All-Star Game/Dunk Contest. Logistic regression was used to identify independent risk factors for injury in the second portion of the NBA season. Results: There were 88 players in each group. Injury rates in the second portion of the season were not statistically different between the groups. The dunk contest group did not demonstrate a statistical decline in any of the second half performance metrics. When compared to the control group, no statistically significant second-half differences were noted other than a slight increase in points-per-minute in the dunk contest group (5.6%±20.3% vs. 0.0%±15.8% P=0.04). Conclusions: Participation in the NBA Slam Dunk Contest did not lead to an increased risk for injury or a decline in statistical production when compared to All-Star game players.

Navicular Drop Height Asymmetry as an Intrinsic Risk Factor for Lower Limb Injury in Male Recreational Athletes

Morphological and functional asymmetry of the lower limbs is a well-recognized factor contributing to musculoskeletal injuries among athletes across different levels. However, limited research exists on evaluating foot mobility asymmetry as a potential predictor of such injuries. This study aimed to (1) assess the frequency of foot mobility asymmetries among amateur athletes, (2) investigate the predictive value of foot mobility asymmetry (measured via navicular height drop) for injury risk, and (3) explore the relationship between foot type and injury occurrence. A cross-sectional sampling method was employed to select 45 physically active male amateur athletes (runners and team sports practitioners) from a university. Injury history was retrospectively recorded, and a modified navicular drop test was conducted to classify foot arch height. The predictive power of navicular height drop asymmetry was analyzed using ROC curves, and the relationship between foot type (neutral and defective combinations—pronated or supinated) and injury occurrence was examined using chi-square tests for independence. Multiple logistic regression was applied to calculate injury risk odds ratios across different foot type subgroups. The results revealed a significant frequency (51.1%) of participants with at least one defective foot, including 31.1% with one neutral and one defective foot and 20% with both feet defective. Navicular height drop asymmetry emerged as a valuable predictor of injuries, with a 36% asymmetry identified as the cut-off for increased injury risk (AUC = 0.832, 95% CI: 0.691–0.973, p &lt; 0.001). A significant relationship was found between foot type and injury occurrence. Only one out of 22 participants with neutral feet (4.55%) experienced an injury, compared to 9 out of 14 (64.29%) with one neutral and one defective foot and 5 out of 9 (55.56%) with both feet defective. These differences were statistically significant (χ2 = 16.24, p &lt; 0.001, Cramer’s V = 0.60). The odds ratio for injury risk was 37.8 (p = 0.016) for those with asymmetry (one neutral and one defective foot) and 26.3 (p = 0.102) for those with both feet defective, compared to participants with both feet neutral. In clinical practice, these findings suggest that routine screenings for physically active individuals should incorporate foot mobility asymmetry assessment. However, it is essential to integrate this factor with other risk indicators. For individuals exhibiting high asymmetry, general foot defect correction programs may be beneficial, but injury prevention strategies should adopt a more comprehensive approach, focusing on overall fitness and tailored interventions for high-risk individuals.

Is the Endurance Standardized ACWRHMLD or the Underlying Acute and Chronic Components Related to Injuries?

Acute (AW) and chronic (CW) workload imbalances, including their ratio (ACWR), are largely associated with increased injury risk. However, the inclusion of personal endurance performance (EP) in this calculation as a means of improving accuracy has been neglected in previous studies. The aim of this longitudinal observational study was to evaluate the relevance of the high metabolic load distance (ACWRHMLD) to EP in relation to non-contact injuries. Twenty-three German male first division soccer players (age: 24.5 ± 3.5 years; VO2max: 53.7 ± 4.9 mL/min/kg; v4: 15.2 ± 0.9 km/h) were analyzed. Eleven players with non-contact injuries were identified and matched with players without any injuries within the same time interval. Players were monitored using GPS and LPS tracking to calculate ACWRHMLD on a daily basis over the course of one competitive season. Relationships between different endurance performance parameters (v2, v4, vLT, VO2max) and the ACWRHMLD, AW, CW were established for statistical analysis. An area under the curve analysis (AUC) was performed. Based on the four weeks preceding the non-contact injuries, the CW, especially for the last two weeks before the injury, proved to be the most suitable parameter to estimate the risk of injury. The highest significant AUC value (0.81, 95% CI: 0.59–1.00) was calculated for the CW (last week before injury) in relation to the vLT (suitable cut-off: 0.04 km; sensitivity: 78%, specificity: 80%). With regard to the injury rate, the ACWRHMLD seems to be the most appropriate method of calculation, especially for CW related to EP (vLT). The sole use of ACWR, AW, and CW is not recommended.

How should one design and position straw feeders in group-housed horses? A case study on occupancy and agonistic interactions at straw feeders in a large group of horses

As group housing of horses can be associated with increased injury risk especially when there are limited resources, the aim of this study was to allow initial, scientifically based recommendations regarding the positioning and design of straw feeders. Data collection took place in a Hinrichs Innovation + Technik (HIT) active stable with 50–62 horses kept in one single group. Occupancy, feeding distances, prevalence of agonistic interactions (AIS) as well as the percentage of feeding disturbances at two different straw feeders were analysed. Equine behaviour was recorded for 6 h/day on 15 summer and 15 winter days. Using generalised linear mixed models, considering the fixed effects of feeder, a fresh straw supply and the interaction of observation day and time period delivered the best prediction for the number of feeding events/h and the prevalence of AIS/h. Here, both feeders differed (p < 0.05) with twice as many feeding events/h, but threefold more AIS/h respectively twice as many AIS/horse at the larger feeder, where conspecifics fed side by side. Sixty-five % of the AIS with low risk of injury and 92 % of the AIS with high risk of injury led to feeding disturbances. The latter made up 25 % of all AIS in total with no differences between both feeders. Feeding distances did not differ either. The horses tended to use only every third opening space when feeding simultaneously. This knowledge should be taken into account when making assumptions about the de facto animal:feeding place ratio and the design of straw feeders in the future. Moreover, regarding the smaller feeder, the horses preferred to feed simultaneously with the feeder edge between them, so that the actual animal distances were smaller. Additional research is needed to investigate, how feeding in rectangular position to each other influences threatening behaviour inside a feeder. In this study, a central positioning within a paddock was beneficial with respect to feeder usage, but disadvantageous regarding AIS and displacements. However, the investigation of further straw feeders and farms is essential to allow general statements, as the study also proves that many factors such as season and rank order stability potentially influence equine behaviour at straw feeders.

Detection of a stress related acoustic signature by passive acoustic monitoring in Atlantic salmon farming

Crowding is a necessary operation for moving fish out of or between sea cages in Atlantic salmon farming. These operations consist of gradually reducing available volume in the nets to increase the biomass density. This is known to stress the fish, increase risk of injury, and can in extreme cases increase mortality rates. To reduce the negative impacts of crowding, the operation must be adjusted based on real-time monitoring of fish welfare. Today, this is mainly done by manually monitoring surface activity, as the high fish density limits the use of available tools. In this paper a new approach for monitoring was applied to crowding of meso-scale cages containing 40 fish each, using automatic detection of passive acoustic signatures. Four synchronised hydrophones were deployed and the acoustic signature was defined from the recordings. The automatic detection algorithm recorded an extreme increase in registered acoustic events during crowding, as high as 1000 events per 10 min period, compared to only 20 events per 10 min period on the day following crowding. Correlating the number of acoustic events to recorded heart rate and activity measures from implants in the salmon indicate that automatically registering acoustic events is a promising method for monitoring farmed fish.

Developmental changes in how pedestrians cross streets in single- vs. dual-lane traffic conditions.

Pedestrian injury is a leading contributor to childhood deaths. This study compared the crossing behaviors of children with adults when crossing in virtual single-lane vs. two-lane traffic conditions. Using a fully immersive virtual reality system, children 7-10 years and adults crossed streets with traffic in one lane (near lane) or in two lanes (near and far lane) with 0 offset so cars from opposing directions arrived at the child's crossing line at the same time. On each trial, pedestrians made a decision on when to cross and then completed the crossing, with measures of attention and crossing behaviors automatically recorded by the system as they did so. In comparison to crossing a single lane of traffic, crossing two-lane roads increased injury risk for all pedestrians, though children experienced significantly greater risk than adults. Children predominantly crossed by stopping before entering the far lane, whereas adults showed greater synchronization of self-movement to traffic flow and more often crossed both lanes without stopping. Children experience more high-risk outcomes than adults when crossing single-lane roads. Crossing two-lane roads elevates risk for pedestrians of both ages, though this risk is significantly greater for child than adult pedestrians. The predominant strategy used to cross two lanes of traffic shows significant developmental changes. Implications for injury prevention are discussed.

Assessment of sleep quality, fatigue and its association with occupational injuries among shift workers in an electronic industrial environment

Objectives. This study explores the association between sleep quality, cumulative fatigue and occupational injuries among shift workers in Pakistan’s manufacturing industries. Methods. The study surveyed 200 shift workers using a self-administered questionnaire. Sleep quality was assessed with the Pittsburgh sleep quality index (PSQI), and fatigue with the standard shiftwork index (SSI). Statistical analyses included t tests, χ 2 tests and logistic regression. Results. Night shift employees had higher odds of occupational injuries (odds ratio [OR] 3.591, 95% confidence interval [CI] [1.079, 11.944], p = 0.037) compared to day shift workers. Cumulative fatigue (OR 3.044, 95% CI [1.145, 8.089], p = 0.026) and PSQI global score (OR 1.249, 95% CI [1.002, 1.556], p = 0.048) also indicated an increased injury risk. Conclusion. Night shift workers experienced poorer sleep quality, higher fatigue and increased injuries than day shift workers. Employers should implement artificial intelligence to detect and manage fatigue, set strategic shift schedules for maximum sleep opportunities and train workers to improve sleep quality.

Side differences in upper quarter mobility/stability are not related to serve velocity in tennis players with different levels of training experience

ObjectiveTennis is characterised by repetitive serves and strokes predominately performed with one arm. This can lead to differences in upper quarter mobility/stability between the stroke and non-stroke arm, which could even enlarge with increasing training experience and negatively affect serve velocity. Thus, we determined side differences (i.e., limb symmetry index) in upper quarter mobility/stability and their association with flat and slice serve velocity in advanced (ITN ≤ 4) female and male tennis players (N = 42, mean age = 23.9 ± 9.3 years) with different levels of training experience (< 2 years: n = 14, 2–5 years: n = 17, 6–8 years: n = 11).ResultsY Balance Test-Upper Quarter (YBT-UQ) side difference (i.e., composite score) and performances (i.e., medial reach) were largest in players with the lowest level of training experience (i.e., < 2 years). Further, YBT-UQ performances (i.e., medial reach and composite score) but not side differences were significantly correlated with flat and slice serve velocity, particularly in less experienced players. Our results suggest that significant side differences in upper quarter mobility/stability occur in less experienced players (indicative of increased injury risk) but they are not related to tennis-specific performance (i.e., serve velocity).

A multi-task learning model for clinically interpretable sesamoiditis grading

Sesamoiditis is a common equine disease with varying severity, leading to increased injury risks and performance degradation in horses. Accurate grading of sesamoiditis is crucial for effective treatment. Although deep learning-based approaches for grading sesamoiditis show promise, they remain underexplored and often lack clinical interpretability. To address this issue, we propose a novel, clinically interpretable multi-task learning model that integrates clinical knowledge with machine learning. The proposed model employs a dual-branch decoder to simultaneously perform sesamoiditis grading and vascular channel segmentation. Feature fusion is utilized to transfer knowledge between these tasks, enabling the identification of subtle radiographic variations. Additionally, our model generates a diagnostic report that, along with the vascular channel mask, serves as an explanation of the model’s grading decisions, thereby increasing the transparency of the decision-making process. We validate our model on two datasets, demonstrating its superior performance compared to state-of-the-art models in terms of accuracy and generalization. This study provides a foundational framework for the interpretable grading of similar diseases.

Systematic Review and Meta-Analysis: Iron Deficiency and Iron Deficiency Anemia Among Military Recruits Undergoing Basic Combat Training

ABSTRACT Introduction The first period of military service consists of a physically and mentally challenging basic combat training (BCT) program. Factors like demanding physical exercise, limited recovery time, and restricted diet choice and food intake may challenge iron intake and homeostasis in recruits undergoing BCT. Iron-deficient individuals may experience reduced work capacity, fatigue, weakness, frequent infections, and increased injury risk. Limited knowledge is available on the extent of this potential health risk among military recruits. The aim of the present study was to systematically review published studies on the prevalence and change in prevalence of anemia, iron deficiency (ID), and ID anemia (IDA) among recruits undergoing BCT. Materials and Methods Electronic searches were conducted in the databases Medline (Ovid), Embase (Embase.com), and Web of Science (Clarivate Analytics) from database inception up until April 16, 2024. Inclusion criteria were observational studies with both cross-sectional and observational longitudinal designs that examined the effects of BCT (intervention) on iron status (outcome) in military recruits (population). Extracted data were the number of participants (n), age, sex, country/population, BCT duration, and relevant measures of prevalence and changes in prevalence of anemia, ID, and IDA (primary outcome) and physical performance, mood state, stress fractures, attrition rate, and nutritional supplements (secondary outcomes). The study quality and risk of bias were assessed using the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data and The National Institutes of Health Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group. Meta-analyses were performed using restricted maximum-likelihood models, and the effect size was calculated as Cohen’s h with 95% CI. Results Twenty-two articles were systematically reviewed (n = 111,764 men and 12,650 women), and six of these papers (n = 388 men and 773 women) were included in the meta-analysis. There was a varying prevalence of anemia, ID, and IDA among military recruits at the start of BCT. Results from meta-analyses showed negligible and nonsignificant effects of BCT on the prevalence of anemia, ID, and IDA. The quality of the included cross-sectional studies ranging from fair to good, whereas a large proportion of the included longitudinal studies were classified as poor. No sign of publication bias was found. Conclusions The prevalence of anemia, ID, and IDA in military recruits seems not to be affected by the completion of BCT shorter than 16 weeks, whereas the effects of longer BCT durations remain unclear. Even though body iron homeostasis seems unaffected, adequate energy and nutritional intake should remain a priority. Future research could focus on dietary interventions to determine the optimal diet among female recruits in specifically exposed populations.