Occurrence Of Injury Research Articles

Hip Muscle Strength Ratios Predicting Groin Injury in Male Soccer Players Using Machine Learning and Multivariate Analysis—A Prospective Cohort Study

Despite ongoing efforts, the relationship between groin strength and injury remains unclear. The challenge of accurately predicting injuries presents an opportunity for researchers to develop prevention strategies to reduce the occurrence of such injuries. Consequently, this issue requires further investigation to obtain insights into effective mitigation strategies. In 120 male soccer players, the maximum isometric strength of the hip muscle groups was measured, and the strength ratios were calculated. Previous injury and anthropometric data were registered. Injury data were collected following the FIFA/UEFA consensus. k-nearest neighbor (k-NN) was used to predict the incidence of injury, while the significant predictive variables of the k-NN algorithm were fitted into a multivariate logistic regression model (LR) to analyze the likelihood of players sustaining a groin injury. The LR model determined two variables as significant predictors of groin injury. Players were less likely to sustain a groin injury by 76% for each decrease of the adductor/abductor isometric strength ratio in the non-dominant limb (OR = 0.238, CI 95% = [(0.098–0.572]). Players with a history of previous injury had a 67% greater risk of sustaining an injury (OR = 0.333, CI 95% = [(0.1068–1.038]). Isometric hip adductor and abductor strength imbalances of the non-dominant lower limb and a history of previous injury were risk factors for groin injury in soccer players.

Clinical Analysis of Myocardial Injury in Highlanders with Pulmonary Hypertension.

Background: Pulmonary hypertension (PH) is a prevalent adverse cardiovascular event at high-altitude environments. Prolonged exposure to high altitudes may result in myocardial injury, which is associated with poor clinical outcomes. This study aims to investigate the clinical characteristics of myocardial injury in patients with PH at high altitude. Methods: Consecutive patients admitted to a general tertiary hospital at the altitude of 3,650 m were selected into this retrospective study. Clinical and biochemical data were collected, as well as based on cardiac troponin I (cTnI) and echocardiography, patients were divided into myocardial injury group and non-myocardial injury group. Results: A total of 231 patients were enrolled, among whom 29 (12.6%) had myocardial injury. We found that body mass index, left ventricular end-diastolic dimension, and serum level of creatine kinase-MB (CK-MB) in myocardial injury group were significantly higher than non-myocardial injury group. Spearman correlation analysis revealed that cTnI has a significant positive correlation with CK-MB and lactic dehydrogenase instead of aspartate aminotransferase. A receiver operating characteristic curve was drawn to demonstrate that CK-MB could significantly predict the occurrence of myocardial injury with an area under the curve of 0.749, and a level of 3.035 (sensitivity = 59.3%, specificity = 90.5%) was optimal cutoff value. Conclusion: The incidence of myocardial injury in highlanders with PH is significant. CK-MB, as a convenient and efficient marker, has been found to be closely associated with cTnI and plays a predictive role in the occurrence of myocardial injury with PH in individuals exposed to high altitude.

Make It or Break It? Injury Impacts More Than Half of Deselected Athletes Who Dropped Out of the High-Performance Pathway System. A 4-Year Retrospective Cohort Study.

To investigate: (1) the injury epidemiology in an Australian academy; (2) how athletes transition through the high-performance sport (HPS) pathway; and (3) why athletes leave this HPS program. This retrospective cohort study was conducted at an Australian HPS academy over a 4-year period. Medical attention injuries were prospectively recorded. Injury incidence rates (IIR) and burden were calculated per 365 athlete-days, according to sport, sex, and pathway level. Athlete pathway levels were mapped to the Foundations, Talent, Elite, and Mastery (FTEM) framework. Reasons for athletes transitioning out were reported. Four hundred and eighty-one injuries were reported across 124 athletes at an IIR of 2.09 injuries per 365 athlete-days (95% CI = 1.91-2.29). Most athletes (103, 83.1%) were injured at least once over the 4-year period. IIRs increased (IRR = 1.17, 95% CI = 1.06-1.29, p = 0.001) as athletes progressed through the pathway. The most common reason for athlete attrition was deselection due to performance (n = 18), with 55.6% of these athletes sustaining an injury in the season prior to deselection. Injury burden was highest at E2 (119.5 days absence per 365 athlete-days (95% CI = 62.18-229.67)) and lowest at T4 (30.47 days absence per 365 athlete-days (95% CI = 21.98-42.24)). Injury occurrence is common across HPS, with IIRs increasing as athletes progressed to higher talent levels. Deselection due to poor performance was the main attrition factor, with more than half the deselected athletes impacted by injury prior to deselection. This study highlights an increased risk of deselection, following injury, and indicates the need for further development of prevention strategies targeting pathway athletes.

Design and application of an extracorporeal membrane oxygenation-specific line fixation device

Extracorporeal membrane oxygenation (ECMO) is an important treatment for extracorporeal cardiopulmonary life support for clinically critical patients. Currently, ECMO tubing is commonly fixed by tie-wraps or tourniquets, which have shortcomings such as easy loosening and potential damage to the tubing. Improper fixation of the catheter can lead to a series of adverse events, such as accidental disconnection of the tubing, rupture of the tubing, tubing folding, and air ingress into the tubing. In order to overcome the above problems, the research team of Zhongda Hospital, Southeast University invented a device for ECMO line fixation and obtained a national utility model patent of China (patent number: ZL 2019 2 2282849.3). The tool is mainly composed of several devices, including a line fixation clamp, a clip fixation device, and a base plate, which is uniquely designed and easy to operate. During ECMO therapy, this device ensures effective stabilization of the ECMO tubing, preventing unexpected incidents due to catheter loosening and facilitating the observation of ECMO catheter insertion markings. Pipeline can be effectively fixed to avoid the occurrence of accidents due to the loosening of the catheter, and at the same time, it is convenient to observe the placement scale of the ECMO catheter. The novelty and uniqueness of the fixation device materials also effectively prevent the occurrence of pressure injuries during its use.

Incidence of medical device-related pressure injuries and identification of risk factors in the neonatal unit

AimThis study was conducted to investigate the incidence of medical device-related pressure injuries (MDRPIs) and the risk factors influencing their occurrence in the neonatal intensive care unit (NICU). MethodThis study is a prospective, descriptive study. The research was conducted with 116 newborns between June 1, 2022, and June 1, 2023. Newborns who stayed in the neonatal intensive care unit for at least 24 h were observed daily for medical device-related pressure injuries under and around each medical device throughout their stay in the intensive care unit. The "Case Report Form," "MDRPIs Monitoring Form," "Braden Q scale for children," National Pressure Injury Advisory Panel (NPIAP) Pressure Grading, and Glasgow Coma Scale were used in the research. ResultsThe incidence of medical device-related pressure injuries is 35.3 % (41/116). It was found that 38.1 % (16/42) of medical device-related pressure injuries developed due to Near-Infrared Spectroscopy (NIRS) probes, and 33.5 % (14/42) developed due to medical devices related to the respiratory system. In terms of anatomical location, 38.1 % occurred on the forehead, and 23.8 % on the arm/leg. The difference between birth weight, gestational age, development of MDRPIs in newborns receiving sedation and inotropes was found to be statistically significant. Regression analysis identified gestational age (p = 0.040, OR = 0.795, 95%CI = [0.632–1.000]) as an independent risk factor for the occurrence of medical device-related pressure injuries. ConclusionsThe incidence of medical device-related pressure injuries in newborns was relatively high in this study, with gestational age being the most significant risk factor for MDRPIs formation. It is crucial for neonatal intensive care nurses to consider associated risk factors while providing newborn care and implement appropriate preventive measures to reduce the incidence of MDRPIs.

Cost-effectiveness of the ‘Stay One Step Ahead’ Home Safety programme for the prevention of injuries among children under 5 years

BackgroundUnintentional injuries are a common cause of morbidity and mortality in the under-5s, but undertaking home safety practices can reduce injury risk. Stay One Step Ahead (SOSA) is an evidence-based...

Serum glucose mediated association of serum lactate with acute kidney injury among AIS patients

BackgroundThe serum lactate level has been confirmed to be an independent risk factor for the occurrence of acute kidney injury (AKI) in many diseases. However, the correlation between serum lactate level and AKI in critical patients with acute ischemic stroke (AIS) has not been clear. Moreover, limited studies have examined the mediating effect of serum glucose on the association between serum lactate and AKI. MethodsWe identified 1,435 AIS patients from the Medical Information Mart for Intensive Care (MIMIC-III) database and divided them into AKI or No-AKI groups. We used a propensity score matching method to reduce confounding factors. Linear regression, logistic regression, and restricted cubic splines (RCS) plots were used to evaluate relationships between serum lactate levels and AKI. Finally, the mediating role of serum glucose on the relationship between serum lactate and AKI was investigated utilizing the mediation analysis. ResultsIn the present study, a total of 634 critical patients aged ≥ 18 years with AIS were included after propensity score matching (1:1). We used RCS plotting to reveal a linear association between serum lactate levels and AKI (P for nonlinearity < 0.001). After full adjustment for potential confounders (Model 3), high lactate levels increased the risk of AKI (odds ratio, 2.216; 95 % confidence interval, 1.559–3.271; P-value < 0.001). Serum glucose explained 14.9 % of the association between serum lactate and AKI among critical patients with AIS (P-value < 0.001), 16.4 % among patients with AIS and diabetes mellitus (DM) (P-value = 0.24), and 19.5 % among patients with AIS and without DM (P-value < 0.001). ConclusionSerum lactate was independently associated with increased risk-adjusted AKI in critical patients with AIS. The increase in serum glucose may have mediated this effect, especially in patients without DM.

Cognitive status, psychological state and needs of caregivers for elderly patients with home-induced pressure injuries: a qualitative study.

Aims/Background Pressure injury stands as a global healthcare concern, primarily affecting elderly individuals. As the ageing of the global population shows no signs of slowing down, both society and the families of the affected individuals continue to bear the brunt of the consequences of pressure injuries. The majority of pressure injury cases are managed at home, and the occurrence and progression of pressure injuries in the elderly are closely associated with informal caregivers. This study aims to qualitatively explore the cognitive status of caregivers for elderly patients with home-induced pressure injuries, as well as their psychological state and needs during the caregiving process. Methods This research is qualitative, descriptive, and phenomenological in nature. A purposive sampling method was used. Eighteen caregivers of elderly patients with pressure injuries were selected from Jiangnan University Medical Centre as interviewees from June 2023 to August 2023. Semi-structured interviews were utilised to collect data regarding the caregivers' cognition, psychological state, and care-related needs while caring for elderly patients with home-induced pressure injuries. The data were then organised and analysed using Colaizzi's phenomenological analysis method and NVivo 11.0. Results Through the analysis of interview data from caregivers of elderly patients with home-induced pressure injuries, three main themes and nine subthemes were identified. The data analysis also revealed that the caregivers surveyed lacked the crucial awareness of preventing pressure injuries and that their caregiving practices were not up to standards. During the caregiving process, they were challenged with substantial stress while also experiencing negative emotions such as anxiety or depression. They had a strong desire for persistent medical support to alleviate the psychological and emotional challenges. Conclusion The findings of this study establish a collaborative relationship network among the hospitals, family, medical staff, and caregivers in the management of pressure injuries, but with a special attention to the caregivers' needs for disease-related knowledge and psychophysical support. Such relationships streamline communication between medical staff, patients, and their caregivers, facilitating the adoption of active and correct methods by caregivers to prevent and care for pressure injuries. This can positively impact the quality of care for pressure injuries, further improving the life quality of patients and their caregivers, controlling the incidence of pressure injuries, and reducing readmission rates.

SCAT Symptom Evolution in the Acute Concussion Phase: Findings From the NCAA-DoD CARE Consortium.

The Sport Concussion Assessment Tool (SCAT) is the most widely used tool following sport-related concussion (SRC). Initial SCAT symptom burden is a strong predictor of recovery in collegiate athletes; however, it is unknown if symptom presentation varies within the acute (<48 hours) post-SRC phase. The purpose of this cohort study was to examine acute SRC symptom presentation among National Collegiate Athletic Association (NCAA) athletes. Concussed NCAA varsity athletes (n=1,780) from thirty universities across the United States that participated in the Concussion Assessment, Research, and Education (CARE) Consortium were included. Time of injury occurrence and SCAT administration data were recorded, from which time-to-SCAT (hours, continuous) was calculated. The main outcome was SCAT total symptom severity [(TSS), 0-126]. Multivariable negative binomial regression was used to examine the association between time (hours) since injury and TSS. Covariates included sex, previous concussion, sport contact level, amnesia/loss of consciousness, immediate reporting of injury, and injury situation. A random effect (person level) accounted for multiple assessments. TSS score ratios (SR) with associated 95% confidence intervals (CI) were provided. The SCAT was administered an average of 14 (25th-75th percentile: 1.2-24) hours post-SRC, and average TSS was 27.35±21.28 across all participants. Time-to-SCAT was associated with a 1% decrease in TSS after adjusting for covariate effects (SR: 0.99, 95% CI: 0.99-0.99, p<0.001). Overall, we observed a small, but significant decrease in TSS with each hour post-SRC. Assessing a concussed athlete once in the acute phase will likely provide a sufficient sense of their symptomatic well-being, as measures did not fluctuate dramatically. Future research should aim to examine how acute symptom evolution influences recovery metrics.

Situation and associated factors of needle stick and sharps injuries among health-care workers in a tertiary hospital: a cross-sectional survey

PurposeThis study aimed to assess the prevalence of and factors associated with needle stick and sharps injuries (NSSIs) among health-care workers (HCWs) in a tertiary hospital in China.Materials and methodsThis retrospective survey was conducted with 562 HCWs at a tertiary hospital in China in July 2023. Information was collected using a self-designed questionnaire, and all enrolled members were required to fill in the demographic characteristics, occurrence of NSSIs and other associated factors in the past year. Logistic analysis was used to identify variables associated with NSSIs.ResultsThe proportion of participants with at least one injury within the year preceding the investigation was 21.2%. Male (AOR = 2.116 [1.265, 3.538]), working hours per week > 40 (AOR = 1.718 [1.056,2.796]), rarely checking blood-borne infections before invasive operations (AOR = 2.219 [1.303,3.782]) were significantly associated with NSSIs.ConclusionThe prevalence of NSSIs was not low in the survey area, especially in male, individuals with longer working hours, and rarely checking blood-borne infections before invasive operations. Therefore, it is necessary to promote educational programs to enhance awareness of standard prevention measures, especially for key populations, and reduce heavy workloads to decrease the occurrence of such injuries.

A dynamic model to predict early occurrence of acute kidney injury in ICU hospitalized cirrhotic patients: a MIMIC database analysis

BackgroundThis study aimed to develop a tool for predicting the early occurrence of acute kidney injury (AKI) in ICU hospitalized cirrhotic patients.MethodsEligible patients with cirrhosis were identified from the Medical Information Mart for Intensive Care database. Demographic data, laboratory examinations, and interventions were obtained. After splitting the population into training and validation cohorts, the least absolute shrinkage and selection operator regression model was used to select factors and construct the dynamic online nomogram. Calibration and discrimination were used to assess nomogram performance, and clinical utility was evaluated by decision curve analysis (DCA).ResultsA total of 1254 patients were included in the analysis, and 745 developed AKI. The mean arterial pressure, white blood cell count, total bilirubin level, Glasgow Coma Score, creatinine, heart rate, platelet count and albumin level were identified as predictors of AKI. The developed model had a good ability to differentiate AKI from non-AKI, with AUCs of 0.797 and 0.750 in the training and validation cohorts, respectively. Moreover, the nomogram model showed good calibration. DCA showed that the nomogram had a superior overall net benefit within wide and practical ranges of threshold probabilities.ConclusionsThe dynamic online nomogram can be an easy-to-use tool for predicting the early occurrence of AKI in critically ill patients with cirrhosis.Graphical

DUSP6 protein action and related hub genes prevention of sepsis-induced lung injury were screened by WGCNA and Venn

During a sepsis infection, the lung is extremely susceptible to damage. A condition known as acute respiratory distress syndrome (ARDS) may develop in extreme circumstances. The primary objective of this research is to identify important genes that are related with both sepsis and lung injury. These genes have the potential to act as novel biomarkers in the investigation of sepsis-induced lung injury prevention strategies. It was possible to download from GEO data both the sepsis-related dataset (GSE64457) and the lung injury-related dataset (GSE40839). In the GSE64457 dataset, using the “limma” package in R revealed 429 differentially expressed genes (DEGs) with logFC values more than or equal to −1 and p values <0.05. There were 266 genes that were up-regulated and 163 genes that were down-regulated. Through the use of Gene Ontology (GO), it was discovered that the majority of the DEGs were associated with the inflammatory response (BP terms), a particular granule lumen (CC terms), and protein binding (MF terms). By doing a pathway enrichment analysis using the Kyoto Encyclopedia of Genes and Genomes (KEGG), researchers were able to identify DEGs that were mostly associated with the NOD-like receptor signalling pathway, the TNF signalling pathway, and Epstein-Barr virus infection. Within the GSE40839 dataset, Weighted Gene Co-Expression Network Analysis (WGCNA) yielded a total of 7 modules, from which it was possible to screen out 2 critical modules and 693 key genes. The important genes and DEGs were both subjected to a Venn analysis. Finally, 14 genes that overlapped (ARL4A, LAIR1, MTHFD2, TSPAN13, DUSP6, PECR, CBS, TES, ASNS, SYNE1, FGF13, LCN2, KLF10, BCAT1) were closely associated to the incidence and development of sepsis-induced lung injury. This indicates that these genes are the essential genes to avoid the occurrence of sepsis-induced lung injury. This study provides novel strategies for preventing lung harm brought on by sepsis.

SRF Facilitates Transcriptional Inhibition of Gem Expression by m6A Methyltransferase METTL3 to Suppress Neuronal Damage in Epilepsy.

A bioinformatics analysis was conducted to screen for relevant expression datasets of the transcription factor SRF knockout mice. The aim was to investigate the relationship between SRF and m6A-related genes, predict how SRF regulates the m6A modification of GEM genes mediated by METTL3, and explore potential molecular mechanisms associated with neurotrauma. Disease gene databases such as GeneCards, DisGeNET, and Phenolyzer, and transcription factor databases TFDB and TRRUST, were used to obtain epilepsy-related genes and transcription factors. The intersection was then selected. Expression data of SRF knockout epilepsy mice were obtained from the GEO database and used to filter differentially expressed genes. Important module genes related to the disease were selected through WGCNA co-expression analysis. The intersection between these genes and the differentially expressed genes was performed, followed by PPI network analysis and GO/KEGG enrichment analysis. Furthermore, the core genes were selected using the cytoHubba plugin of the Cytoscape software. Differential expression analysis was performed on m6A-related factors in the GEO dataset, and the relationship between SRF and m6A-related factors and core genes was analyzed. The m6A binding sites of SRF with the METTL3 promoter and target gene Gem were predicted using the AnimalTFDB and SRAMP websites, respectively. We found that the transcription factor SRF may be a key gene in epilepsy during neuronal development. Further WGCNA analysis showed that 129 module genes were associated with SRF knockout epilepsy, and these differentially expressed genes were mainly enriched in the neuroactive ligand-receptor interaction pathway. The final results indicate that knocking out SRF may inhibit the transcription of METTL3, thereby inhibiting the m6A modification of Gem and leading to upregulation of Gem expression, thereby playing an important role in neuronal damage. Knocking out the SRF gene may inhibit the transcription of m6A methyltransferase METTL3, thereby inhibiting the m6A modification of GEM genes mediated by METTL3, promoting GEM gene expression, and leading to the occurrence of epilepsy-related neuron injury. Further investigation revealed that SRF overexpression can potentially enhance the transcription of METTL3, thus promoting m6A modification of GEM, resulting in downregulation of GEM expression. This process regulates oxidative stress in epileptic mouse neurons, suppresses inflammatory responses, and mitigates associated damage. Additionally, an in vitro neuronal epileptic model was established, and experimental techniques such as qRT-PCR and WB were employed to assess the expression of SRF, METTL3, and GEM in hippocampal tissues and neurons. The experimental results were consistent with our predictions, demonstrating that overexpression of SRF can inhibit the development of epilepsy-related neuronal damage. This study reveals that knockout of the SRF gene may suppress the transcription of m6A methyltransferase METTL3, thereby inhibiting m6A modification of the GEM gene mediated by METTL3 and subsequently promoting the expression of the GEM gene, leading to the occurrence of epilepsy-related neuronal damage.

Research on injury risk of elite male athletes in racing ice sports based on blood indexes.

This study aims to explore the relationship between blood biochemical indexes and injury risk of elite male athletes in racing ice sports. The male athletes compared the demographic indexes, monthly injuries, and longitudinal tracking data. The non-linear relationship was analyzed using an unrestricted cubic spline. Generalized estimating equations estimated the relative risk (OR) of injury occurrence. Receiver operating characteristics and the area under the curve determined diagnostic accuracy. In the snow sledding group, when creatine kinase rises to 489.46 u/L or Testosterone decreases to 41.32 ng/ml, the risk increases by 1.70 times (OR=1.70, p<0.001) and 1.69 times(OR=1.69, p<0.001) with statistical significance. the Creatine kinase (OR=1.01, P=0.007) and Testosterone (OR=1.00, P＜0.001) were included in the injury prediction model. The model exhibits excellent discrimination, with sensitivity and specificity of 82.8% and 86.5%, respectively. In the ice skating group, when Creatine kinase rise to 467.00 u/L, the risk increases by 2.56 times with statistical significance (OR=2.56, p<0.001). Creatine kinase (OR=1.01, P＜0.001) was included in the predictive model. The model demonstrates good discrimination, with sensitivity and specificity of 90.5% and 66.7%, respectively. Creatine kinase and Testosterone are the risk predictors of injury in elite snowmobile male athletes. Creatine kinase is an independent risk factor for injury in elite speed skaters.

Age-related driver injury occurrence from crashes at curve–grade combined segments

Objectives Due to their relatively complex roadway characteristics, horizontal and vertical curve segments are associated with decreased visibility and a higher risk of rollovers. Multiple studies have identified the associated risk of young and older drivers separately in such complicated driving environments. This study investigated the relationship between driver age and injury occurrence from crashes occurring along curve–grade combined segments. Methods Crash data recorded in Ohio State between 2012 and 2017 were used in this study. Driver age was categorized into 3 groups: teen (age <20 years), adult (age 20–64), and older adult (age >64). Descriptive statistics were summarized using random forest, gradient boosting, and extreme gradient boosting (XGBoost) to estimate the probability of a driver incurring an injury in case of a crash at curve–grade combined segments. The area under the receiver operating characteristics curve (AUROC) was used to select the best performing model. Partial dependence plots (PDPs) were used to interpret the model results. Results The probability of injury occurrence is different for older drivers compared to teen and adult drivers. Although teen and adult drivers showed a higher probability of sustaining injuries in crashes with an increase in the degree of curvature, older drivers were more likely to sustain injuries in roadways with higher annual average daily traffic (AADT), steeper grades, and more occupants in the vehicle. Older drivers were observed to have a higher probability of sustaining injuries during peak hours and when unrestrained compared to teen and adult drivers. Conclusions The results emphasize the significance of tailored education and outreach countermeasures, particularly for teen and older drivers, aimed at decreasing the likelihood of injuries in such driving environments. This research adds to the expanding body of knowledge concerning the age-related occurrence of driver injuries resulting from crashes at curve–grade combined segments. The study findings provide insights into the potential over- or underrepresentation of certain age groups in analyzing crash injury occurrence. The insights gained from the machine learning analysis could also assist policymakers, transportation agencies, and traffic safety experts in developing targeted strategies to enhance road safety and protect vulnerable age groups.

Correlation of Player and Imaging Characteristics With Severity and Missed Time in National Football League Professional Athletes With Hamstring Strain Injury: A Retrospective Review

Background: Hamstring strain injuries (HSIs) are prevalent in US National Football League (NFL) players, but there is a paucity of information regarding imaging characteristics, injury severity, and player factors associated with time missed and risk of recurrent injury. Purpose: To describe player, football activity, clinical, and imaging characteristics of NFL players with HSIs, as well as determine player characteristics, clinical examination results, and magnetic resonance imaging (MRI) findings associated with injury occurrence, severity, and missed time. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective cohort of NFL players with acute HSI (n = 180) during the 2018-2019 season was identified. Injury data were collected prospectively through a league-wide electronic health record system. Three musculoskeletal radiologists graded MRI muscle injury parameters using the British Athletics Muscle Injury Classification (BAMIC) system. Player, football, clinical, and imaging characteristics were correlated with HSI incidence and severity and with missed time from sport. Results: Of the 1098 HSIs identified during the 2018-2019 season, 416 (37.9%) were randomly sampled, and 180 (43.3%) had diagnostic imaging available. Game activity, preseason period, and wide receiver and defensive secondary positions disproportionately contributed to HSI. The biceps femoris was the most commonly injured muscle (n = 132, 73.3%), followed by the semimembranosus (n = 24, 13.3%) and semitendinosus (n = 17, 9.4%) muscles. The most common injury site was the distal third of the biceps femoris and semitendinosus muscles (n = 60, 45.5% and n = 10, 58.8%, respectively) and central part of the semimembranosus muscle (n = 17, 70.8%). Nearly half of the injuries (n = 83, 46.1%) were BAMIC grade 2; 25.6% (n = 46), grade 3; and 17.8% (n = 32), grade 4. MRI showed sciatic nerve abnormality in 30.6% (n = 55) of all HSIs and 81.3% (n = 26) of complete tendon injuries. BAMIC grade correlated with both median days and games missed. Combined biceps femoris and semitendinosus injuries resulted in the highest median days missed (27 days). Conclusion: Among NFL players with acute HSIs, the most common injury was a moderate-severity injury of the distal biceps femoris. BAMIC grade was associated with missed time.

Cranial surgery in the North Pontic region during the 3rd millennium BC.

This study examines the development of cranial surgery in the North Pontic region during the Early and Middle Bronze Age (late 4th and 3rd millennium BC according to the Eastern European chronology). 389 skulls from burials of this period were examined for evidence of surgical intervention. Twenty five such cases were identified and analysed for sex, age, temporal and spatial distribution, size and number of lesions, signs of healing, technique, motivation and complications of the surgery. The study indicates that cranial surgery was a well-developed medical practice in the North Pontic region during the period under consideration. Most of the cases are concentrated in the Dnipro steppe area, suggesting the possibility of outlining another centre of cranial surgery on the map of Europe. The predominant trepanation technique used here was scraping, although alternative methods were also practised. Treatment of traumatic injuries is considered to be one of the main reasons for cranial surgery in our sample. The percentage of individuals who underwent cranial intrusions increased significantly from 1.2% in the first half to 10.4% in the second half of the 3rd millennium BC, indicating a chronological shift in the distribution of cranial surgery. This trend is believed to be related to changes in weaponry during the Middle Bronze Age. The introduction of stone battle axes and maces as common weapons led to a significant increase in the occurrence of blunt force injuries, both depressed and penetrating. Trepanation may have been employed as an effective medical treatment for such traumas.

Effects of stiffness-altered sport compression garments on lower-limb biomechanics in cutting maneuvers

Athletes commonly use compression garments (CGs) for perceived effectiveness in preventing injury occurrence. However, limited evidence is available on whether lower-limb CGs reduce the risk of injury. This study aimed at (1) evaluating the effects of CGs on mitigating the risk factors of cutting-related knee injuries; (2) identifying undesirable side-effects of CGs on other joints and cutting performance; and (3) identifying possible interactions between sex and condition. 62 healthy adults performed pre-planned 90˚ cutting tasks under four conditions: control, knee sleeves, placebo leggings and stiffness-altered leggings. Joint angle at initial contact, range of motion, moments, and ground reaction force were measured. A mixed two-way (sex*condition) ANOVA was performed, followed by post-hoc comparisons and subset analyses for sexes. Results showed that the leggings restricted hip sagittal (45.4 ± 1.3 vs. control 50.0 ± 1.3˚, p = 0.001) and rotational (16.8 ± 0.8 vs. control 22.5 ± 1.1˚, p < 0.001) motion. At initial contact, the stiffness-altered leggings reduced knee valgus (0.4 ± 0.8 vs. control −2.1 ± 0.8˚, p = 0.031). However, the altered alignment of lower-limb joints did not reduce multiplanar knee joint moments (p > 0.05). CGs were not effective protective equipment yet. There was no significant difference between knee sleeves and control, nor between leggings conditions (p > 0.05). Force plate measurements, such as increased rate of force development (stiffness-altered 42.6 ± 1.1 & placebo 42.9 ± 1.1 vs. control 39.9 ± 1.0 BW/s, p < 0.028), implied the possibility of performance enhancement through CGs. While further investigations on the optimal compression and stiffness alterations are warranted, athletes are recommended to be aware of the discrepancies between the claimed and actual biomechanical effects of CGs.

The Effect of Aloe Vera and Honey Dressings on Preventing Pressure Injuries in High-Risk Elderly ICU Patients: A Randomized Clinical Trial

Background: Today, due to the challenging treatment of pressure injuries, the preferred approach is prevention and care. One preventive measure is the use of specialized dressings, although very few studies have explored this area. Objectives: This study aimed to investigate the impact of using aloe vera and honey on the prevention of pressure injuries among elderly patients admitted to an intensive care unit in Qazvin, Iran, in 2022. Methods: In this randomized, single-blind clinical trial, 90 elderly patients at moderate to high risk of developing pressure ulcers were divided into three groups. Each group received a different preventive dressing on their sacral area twice a day for one week: The first group received aloe vera gel, the second group received honey, and the third group received plain gauze. Data were collected using a demographic information checklist, the Braden scale for predicting pressure injury risk, and a pressure injury grading tool. The data were analyzed using descriptive and analytical statistical tests and statistical software. Results: The mean Braden scale scores for patients in the aloe vera, honey, and simple dressing groups were 10.83 ± 1.41, 10.40 ± 1.52, and 10.30 ± 1.55, respectively (P = 0.40). Ten patients developed pressure injuries (0 in the aloe vera group, 3 in the honey group, and 7 in the simple dressing group). A statistically significant difference was found in the occurrence of pressure injuries between the aloe vera and honey groups compared to the control group (P = 0.015). Conclusions: The study revealed that aloe vera preventive dressing had a significant and favorable effect on pressure injury prevention. Further studies are recommended to validate these findings.

Analysis of the occurrence and liver function characteristics of arsenic-associated liver injury during the treatment of pediatric patients with acute promyelocytic leukemia.

Liver injury during arsenic treatment for acute promyelocytic leukemia was previously reported in adults, but not comprehensively in children until now. This study aims to investigate liver injury in pediatric patients with APL, changes in liver function during treatment, and compare the effects of Arsenic trioxide (ATO) and Realgar-Indigo naturalis formula (RIF) on liver function. One hundred and eighty-six patients with 3076 patient tests were analyzed, who were enrolled in the Chinese Children's Leukemia Group (CCLG)-APL2016 Protocol database between November 2016 and November 2018 in 38 hospitals across China(ChiCTR-OIN-17011227). Twenty of 164 patients (12.2%) suffered from liver injury after treatment with arsenic. In addition, sixteen (80%) cases of liver injury occurred during the induction period of treatment. What's not disheartening was that 18 (90%) cases of liver injury were transient, occurring at a median time of 17 days after exposure to arsenic. More importantly, the risk of liver injury associated with RIF was not higher than that associated with ATO (RR = 0.854, 95% CI: 0.292-2.495). Otherwise, the ALP of 18 cases of liver injury was not higher than the ULN of ALP. Thus, the incidence of liver injury associated with arsenic in pediatric patients with APL was similar to that in adult patients and the risk of liver injury associated with RIF was not higher than that associated with ATO. Since ALP was not higher in pediatric APL patients with liver injury, further research is needed to explore whether ALP is an index of liver injury in children.