Mean Time Loss Research Articles

Organ damage is a major determinant of work productivity impairment in Behçet’s syndrome: a post hoc analysis of the BODI validation study

Abstract Objectives To evaluate the prevalence, magnitude and potential determinants of work productivity impairment in patients with Behçet’s syndrome (BS), focusing on the role of irreversible organ damage. Methods A post hoc analysis of the BS Overall Damage Index (BODI) prospective validation study was performed. Demographics and clinical features were recorded in all patients. The Work Productivity and Activity Impairment: General Health (WPAI:GH) questionnaire was administered to assess the work limitation and the BODI to measure organ damage. The independent effect of BS features on WPAI:GH outcomes was evaluated by regression analysis. Results Of 148 patients, 34.5% were unemployed, with age [odds ratio (OR) 1.035] and BODI score (OR 1.313 for a 1-unit increase) as the only factors significantly (P < 0.05) associated with the unemployment state. Overall work impairment was reported in ≈64.2% of the employed patients. Indeed, 22.7% reported missing work hours due to their health (absenteeism), with a mean time loss of 34.4%, whereas 60.2% declared reduced performance at work because of their health (presenteeism), with a mean productivity impairment of 45.4%. Ocular damage was associated with absenteeism (β = 0.225); female sex (β = 0.260), physician global assessment of disease activity (β = 0.502) and an increased BODI score (β = 0.166 for 1-point increase) with presenteeism; and fibromyalgia (β = 0.246), Physician Global Assessment (β = 0.469) and musculoskeletal damage (β = 0.325) with overall work impairment. Conclusions Disease activity and organ damage accrual remarkably affect work productivity in BS patients. Achieving remission and preventing damage accrual are crucial and complementary objectives.

Injury Patterns and Incidence in an Elite Youth Football Academy-A Prospective Cohort Study of 138 Male Athletes.

There is a lack of evidence regarding injury incidence in German elite youth football academies, and the risk of re-injury is unknown. Therefore, the objectives of this study were (1) to determine injury patterns and incidence in an elite youth football academy in Germany, (2) to monitor overuse-/trauma-related injuries over the course of the season, and (3) determine the risk of re-injury. A prospective cohort study was conducted in the 2012/2013 season among 138 male players from an elite youth football academy in Germany. Injuries were recorded according to the consensus statement on injury definitions and data collection in studies of football injuries. Injury incidence was reported as the number of injuries per 1000 h of exposure and the number of injuries per squad season. A total of 109 injuries were reported, resulting in a cumulative time-loss of 2536 days. A squad of 25 players sustained 19.7 injuries per season, with an average of 23.3 days (15.7-30.9; 95% CI lower-upper) of absence per injury. Ligament sprains (28%), muscle strains (19%) and physeal injuries (12%) were the most common causes of time-loss. Physeal injuries were the most common severe type of injury (29%), with a mean time-loss of 29.7 days (18.2-41.2; 95% CI lower-upper). Re-injuries accounted for 3% of all injuries and resulted in significantly more time-loss than non-re-injuries (60 vs. 23 days; p = 0.01). In the youth academies studied, a team of 25 players sustained an average of 19.7 injuries per season, resulting in a cumulative time-loss of 459 days. Physeal injuries are a major contributor to severe injuries and therefore require special attention.

COVID-19 in European Soccer: A Public 2-Year Comparison of COVID-19 Case Management and Case Characteristics between the 1st Bundesliga, La Liga, Serie A and the Premier League.

To evaluate the extent and characteristics of COVID-19 cases in relation to environmental COVID-19 incidences in the four best European soccer leagues (Bundesliga, Premier League, Serie A and La Liga) from the first of January 2020 until the end of January 2022. Methods: A retrospective evaluation of all publicly available COVID-19 cases in the studied cohorts was performed. The 14-day case incidences from epidemiological national data were used as reference values. The leagues studied are the Bundesliga (Germany), Premier League (Great Britain), Serie A (Italy) and La Liga (Spain). For all cases, the duration of time loss and date of case notification were recorded. Results: League-specific mean time loss due to disease or quarantine per COVID-19 case differs significantly between La Liga (11.45; ±5.21 days) and the other leagues studied (Bundesliga 20.41; ±33.87; p 0.0242; Premier League 17.12; ±10.39; p 0.0001; Serie A 17.61; ±12.71; p < 0.0001). A positive correlation between 14-day national incidence with COVID-19 disease occurrence in soccer leagues was found for all leagues studied. The correlations were strong in the Bundesliga (r 0.5911; CI 0.4249–0.7187; p < 0.0001), Serie A (r 0.5979; CI 0.4336–0.7238; p < 0.0001) and La Liga (r 0.5251; CI 0.3432–0.6690; p < 0.0001). A moderate correlation was found for the Premier League (r 0.3308; CI 0.1147–0.5169; p 0.0026). Odds ratios for altered environmental case risk in the cohorts studied could be calculated for four different national COVID-19 incidence levels (<50/100.000 to >500/100.000). A trend towards shorter COVID-19 case duration in the second half of 2021 was shown for all leagues studied. Conclusions: There was a significantly lower mean time-loss caused by a COVID-19 infection for cases occurred in La Liga compared with the other three leagues studied. For all four leagues studied, a positive, significant correlation of national environmental COVID-19 incidence level and the incidence of COVID-19 cases in the cohort of a football league was found.

Soccer players show the highest seasonal groin pain prevalence and the longest time loss from sport among 500 athletes from major team sports

Groin pain is a widely recognized medical issue among athletes. Groin pain can affect both player and team performance and sometimes can be a career-ending injury. The aim of this study was to assess seasonal groin pain prevalence and the average seasonal time loss from sport for each injury in different team sport athletes. The hip and groin functionality at the beginning of the following season was also investigated. A cross-sectional study was undertaken on 600 team sport athletes (soccer, futsal, basketball, volleyball, and water polo players). The seasonal prevalence of groin pain, level of competition (professional and non-professional), time loss, and concomitant injuries in addition to groin pain were reported and analyzed. The Copenhagen Hip and Groin Outcome Score (HAGOS) was used to assess hip and groin pain and function related to sport and activity. Among the 506 (84%) players included, 123 players (24.3%) reported groin pain. Overall, soccer players reported the highest groin pain prevalence (32.5%) followed by futsal (25.5%), basketball (25.2%), water polo (17.6%) and volleyball players (13.6%). Professional soccer, futsal and basketball athletes showed higher groin pain prevalence in comparison with non-professional athletes (p = 0.02, p = 0.005 and p = 0.004, respectively). The mean time loss from sport due to groin pain was 60.3 ± 66days in soccer, 41.1 ± 16.6days in futsal, 31.5 ± 18days in water polo, 37.2 ± 14.2days in basketball and 50.8 ± 24.6days in volleyball. Significantly lower HAGOS values were found in athletes with groin pain for all sports evaluated compared to athletes with no groin pain history (p = 0.0001). Longer time loss from sport was correlated with lower HAGOS values in soccer (p = 0.002) and futsal (p = 0.002) players with groin pain. Concomitant injuries were correlated with lower HAGOS values in water polo players (p = 0.03). Seasonal groin pain occurs in as many as one in four team sport athletes. Soccer players show the highest groin pain prevalence and the longest time loss from sport. Professional athletes report higher prevalence of groin pain in comparison with non-professional athletes. HAGOS appears to be a valid outcome instrument to measure groin pain, correlating with both time loss from sport and concomitant injuries in athletes. Level IV.

Epidemiology of Traumatic Posterior Hip Instability in the National Football League.

Background:There is a paucity of literature regarding injury incidence, mechanism, and return to play in National Football League (NFL) players who have sustained traumatic posterior hip instability.Purpose:To describe the incidence of traumatic posterior hip instability and the rate of return to play in NFL players across 18 seasons.Study Design:Descriptive epidemiology study.Methods:We retrospectively assessed all traumatic posterior hip dislocations/subluxations that occurred during football-related activities in the NFL seasons from 2000 through 2017. Player demographics and injury data (injury mechanism, season of injury, treatment, days missed, and return to play time) were collected from all 32 NFL teams prospectively through a leaguewide electronic health record system. Descriptive statistics are presented.Results:Across the 18 NFL seasons, 16 posterior hip instability injuries in 14 players were reported, with a maximum incidence of 4 (25%) in 2013. Posterior hip instability was predominantly sustained by offensive players (64.3%), with tight ends being the most affected (31.3%). Half of the injuries occurred during the regular season, 43.8% in the preseason, and 6.2% in the offseason. Of all injuries, 37.5% were noncontact, while 56.3% involved contact (direct or indirect), and 6.2% were of unknown mechanism. Among noncontact injuries, 66.7% occurred during cutting and change of direction while sprinting. The time of return to full participation was documented for 11 of the 16 reported injuries (68.8%); among them, the mean time loss was 136.7 ± 83.8 days—143.3 ± 99.6 days if the player underwent surgery (n = 4) and 116.7 ± 76.2 days missed by players without surgery (n = 6)—the treatment modality was unknown in 1 player.Conclusion:Although the incidence of traumatic posterior hip instability during the study period was low, all injured athletes missed time from football activities and competitions. Injuries that required surgery led to more missed time than those that did not. Ongoing research to understand risk factors and mechanisms of this injury, in conjunction with improvements to prevention and rehabilitation protocols, is necessary to ensure the safety of professional American football players.

Hand and wrist injuries among collegiate athletes vary with athlete division

BackgroundThe rates, severity and consequences of hand and wrist injuries sustained by National Collegiate Athletic Association athletes are not well characterized. This study describes the epidemiology of hand and wrist injuries among collegiate athletes competing in different divisions.MethodsThe National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) was accessed from 2004 to 2015 for the following sports: baseball, basketball, football, ice hockey, lacrosse, soccer, wrestling, field hockey, gymnastics, softball and volleyball. The data were used to identify all hand and wrist injuries, the specific injury diagnosis, mean time loss of activity following injury, and need for surgery following injury. These were then stratified by gender. Descriptive statistics were performed to examine the association between sports, event type and division. Student's t test was used to calculate p-values for independent variables. Chi-Square test was used to calculate odds ratio. P < 0.05 was considered significant.Results103,098 hand and wrist injuries were reported in in the studied NCAA sports from 2004 to 2015. Male athletes sustained 72,423 injuries (6.01/10,000 athlete exposure) and female athletes sustained 30,675 injuries (4.13/10,000 athlete exposure). Division I athletes sustained significantly more injuries compared to divisions II and III. Overall, 3.78% of hand and wrist injuries required surgical intervention. A significantly higher percentage of division I athletes (both male and female) underwent surgical intervention compared to divisions II and III. The mean time lost due to hand and wrist injury was 7.14 days for all athletes. Division I athletes missed the fewest days due to injury at 6.29 days though this was not significant.ConclusionsHand and wrist injuries are common among collegiate athletes. Division I athletes sustain higher rates of injuries and higher surgical intervention rates, while tending to miss fewer days due to injury. Improved characterization of divisional differences in hand and wrist injuries can assist injury management and prevention.

Head injuries in professional football (soccer): Results of video analysis verified by an accident insurance registry.

BackgroundVideo analysis is one of the most commonly applied methods for analysing football injuries.PurposeThe objective of this study was to assess the accuracy of video analysis for recording head injuries in professional football from official matches in the four highest men’s professional football leagues in Germany.MethodsIn this cohort study, head injuries detected by means of video analysis of all official matches over one season (2017–18) were compared to head injuries registered with the German statutory accident insurance.ResultsOur video analysis yielded 359 head injuries of 287 players. The comparison of head injuries found in our video analysis to those registered with the accident insurance only yielded a match in 23.1% (n = 83), which presents a rather low verification rate. The verification rates varied between the leagues (7.0–30.8%). All injuries documented in the accident insurance registry were found in the video analysis (100%). The types of head injury most often verified by the accident insurance registry (n = 83) were contusion (43.4%), bone fractures (19.3%) and skin lacerations (18.1%). Only 66 of the 359 head injuries (18.4%) resulted in absence from at least one training session and involved a mean time loss of 18.5 days (1–87 days).ConclusionThe mismatch between the number of head injuries found in the video analysis and head injuries registered with the accident insurance is an important methodological issue in scientific research. The low verification rate seems to be due to the unclear correlation between injury severity and clinical consequences of head injuries detected by means of video analysis and the failure of football clubs to register minor head injuries with the accident insurance.

Sport-related injuries in Iranian basketball players: evidence from a retrospective epidemiologic study (2019–20)

ABSTRACT Objectives Basketball is a contact sport with complex movements that include jumps, turns, and changes in direction, which cause frequent musculoskeletal injuries in all regions of the body. Also, injury patterns among athletes, particularly basketball players, continue to evolve and change. The current retrospective epidemiologic study aimed to investigate the incidence, severity, and sports-related risk factors of injuries in Iranian basketball players from 2019 to 2020. Methods Using the Information Retrospective Injury Questionnaire (online version), data on basketball-related injuries were collected retrospectively for 204 basketball players of the Iranian league (professional super league and first-division league) during the 2019/2020 season. Results A total of 628 injuries were reported, which was equivalent to 6.07 injuries/1000 h. The ankle was the location of most injuries (n = 116 or 26.9%; overuse injuries (n = 40 or 20.3%)), followed by lower back/pelvis injuries (acute injury n = 67 (15.5%) and overuse injuries (n = 23; 11.6%)), knee injuries (acute injury n = 62 (15.7%) and overuse injuries (n = 31 (14.3%)), wrist/fingers injuries (acute injury (n = 85 (13.4%)) and overuse injuries (n = 8; 4.0%)), and shin/calf injuries (acute injury (n = 35; 8.1%) and overuse injuries (n = 28; 14.2%)). Mean time loss in first-division league players was much higher than professional super league players (7.84/1000 h exposure vs. 4.30/1000 h exposure), respectively. Conclusion The ankle sprain was the most common injury in our study. Lower back/pelvis injuries had the longest time loss. Injury was more frequent among first-division league players than those in the professional super league. Injuries during practice were notably more frequent than during competition with different patterns of injuries.

A - 10 Concussion Rates and Sports Participation Time Loss in Sex-Comparable Middle School Sports

Abstract Objective High rates of concussion in sex-comparable sports have been reported at the high school (HS), however, research examining concussion rates and time loss, in middle school (MS) sports is limited; therefore, we investigated concussion rates and time loss (TL) in sex-comparable MS sports. Methods Concussion and athlete exposure (AE) data was collected for all MS sponsored events in a metropolitan public-school division between 2015/16–2019/20. AE was defined as one athlete participating in one sport-event. TL was defined as the number of days between the injury and return to sport dates. Injury rates (IR) per 1000 AEs with 95% confidence intervals (CI) were calculated for sex-comparable sports (baseball/softball, basketball, soccer, &amp; track). Injury rate ratios (IRR) with 95% CIs were compared IR between sexes. CIs excluding 1.0 were considered significant. A Mann–Whitney U test compared mean TL between sexes. Results 76 concussions (IR = 0.35/1000AEs, 95%CI: 0.27–0.43) occurred across 215,074 AEs. Girls had a higher IR (0.48, 95%CI: 0.35–0.62, n = 52) than boys (0.22, 95%CI: 0.13–0.31, n = 24; IRR:2.18, 95%CI:1.34–3.53). Girls had a greater mean TL (20.27 ± 16.96 days) than boys (13.67 ± 5.66 days, U = 282.5, p = 0.04). Conclusions Within sex-comparable sports, girls had nearly twice the IR, and took nearly 7 days longer to recover than boys. IR differences between sexes in MS and HS athletes were consistent, however MS girls needed nearly one-week longer to recover than HS girls, while MS and HS boys were similar. Further inquiry into MS sport concussion rates, sex differences, and subsequent TL is warranted.

A - 09 The Epidemiology of Concussion in Middle School Wrestling

Abstract Objective Wrestling has among the highest concussion incidence in all high school and collegiate sports. Many children begin wrestling in middle school (MS), however, research describing concussion incidence in MS wrestling remains limited. Therefore, we sought to describe the incidence of concussion and subsequent sport time loss (TL) sustained by MS wrestlers. Methods Certified athletic trainers collected concussion and athlete exposure (AE) data for all MS wrestling practices and matches in a large metropolitan public-school division between 2015/16 and 2019/20. AE was defined as one athlete participating in one practice or match. Frequencies and proportions were calculated for diagnosed concussions by event type. TL was the number of days from date of injury to return to sport. Concussion injury rates (IR) per 1000 AEs and injury rate ratios (IRR) to compare IR between practice and matches were calculated with 95% Confidence Intervals (CIs). IRRs with 95% CIs excluding 1.0 were statistically significant. Results 43 concussions occurred across 38,297 AEs (IR = 1.12, 95%CI = 0.79–1.46). No significant difference in the concussion IR between practices (n = 33, IR = 1.11, 95%CI = 0.73–1.49) and matches (n = 10, IR = 1.16, CI = 0.44–1.87; IRR = 1.04, 95% CI = 0.51–2.11) was observed. The mean TL was 18.38 ± 8.25 days. Conclusions We observed higher practice and match concussion rates than those previously reported among middle and high school wrestlers. Additionally, our findings showed that MS wrestlers required approximately 5 more days to return to sport than reported among HS wrestlers. Further investigation of concussion risk factors for concussion and prolonged TL in MS wrestling is needed.

Comparing Roundabouts and Signalized Intersections Through Multiple- Model Simulation

In modern transportation systems, more and more vehicles result in severe traffic congestion, affecting our daily life and modern logistics. Well-designed traffic infrastructures play an important role in implementing safe and efficient traffic systems. From subjective experience, roundabouts are more efficient than conventional signalized intersections because vehicles do not wait for traffic signals, decreasing which is the main reason for time-loss at signalized crossroads. This paper aims to further investigate the differences between intersections and roundabouts in the capacity of vehicle passing and other performance. Two scenarios with different traffic volumes are considered, including a large volume of traffic flow (2.44 vehicles per second) and a small volume of traffic flow (0.52 vehicles per second). In each scenario, we build six junction models including four intersections with different traffic light time and two roundabouts with different numbers of lanes. Multiple evaluation metrics (i.e., number of passing vehicles over time, mean speed of passing vehicles, mean number of halts per vehicle, mean time-loss per vehicle, and total time for all vehicles to pass) are considered to compare these models’ performance. Results illustrate that roundabouts have a higher capability of vehicle passing than intersections, especially for a large traffic volume. But roundabouts bring more halts per vehicle than signalized intersections when the traffic volume is large. When the volume of traffic flow is small, there is no significant efficiency difference between intersections and roundabouts. These results tend to be applied to future traffic junction designs to improve system efficiency.

High Incidence of Hand Injuries From Blocking in Elite Taekwondo Despite the Use of Protective Gear: A 5-Year Descriptive Epidemiology Study.

Background:Hand and wrist injuries are a common but underestimated issue in taekwondo. Detailed data on injury risk, patterns, and mechanism are missing.Purpose:To evaluate (1) the fight time exposure-adjusted injury incidence rate (IIR) and clinical incidence and (2) injury site, type, sport-specific mechanism, and time loss in taekwondo.Study Design:Descriptive epidemiology study.Methods:Athletes from a single national Olympic taekwondo training center were investigated prospectively for hand and wrist injuries during training and competition over 5 years. The Orchard Sports Injury Classification System Version 10 was used to classify injury type, and analysis of the anatomic injury site was performed. The mechanism of injury was classified as due to either striking or blocking techniques.Results:From a total of 107 athletes, 79 athletes (73.8%) with a total exposure time of 8495 hours were included in the final data set. During the study period, 75 injuries of the hand and wrist region were recorded despite the athletes using protective hand gear. The IIR was 13.9 (95% CI, 10.5-17.5) and was significantly higher during competition. The clinical incidence as an indicator for risk of injury was 60.7% (95% CI, 50.9-70.5). Finger rays were the most affected location (68%), and fractures (43%) and joint ligament injuries (35%) were the most common type of injury. Significantly more injuries were found on the dominant hand side (P < .001). Comparison of injury mechanisms demonstrated significantly more injuries at the finger rays deriving from blocking techniques (P = .0104). The mean time loss for all hand and wrist injuries was 15.7 ± 13.5 days (range, 3-45 days) and was highest for distal radial fractures, with a mean of 39.7 ± 4.8 days (range, 32-45 days).Conclusion:There was a significantly higher IIR for acute hand and wrist injuries in elite taekwondo athletes during competition, which resulted in considerable time loss, especially when fractures or dislocations occurred. Significantly more injuries to the finger rays were found during blocking despite the use of protective hand gear. Improvement of tactical skills and blocking techniques during training and improved protective gear appear to be essential for injury prevention.

Restricted Mean Survival Time for Analysis and Interpretation of Clinical Trials for Heart Failure Devices

Introduction Treatment effects in heart failure (HF) clinical trials are typically summarized as hazard ratios (HR). However, a HR alone without a reference value of the hazard from the control arm is difficult to interpret and is valid only when hazards are proportional throughout the trial. The restricted mean survival time (RMST) describes the mean time free from an event and does not require any model assumption. Comparison of RMSTs between treatment and control arms, either by differences or ratios, is a more intuitive summary of treatment effects than HR. Objective Compare RMST with HR in HF device clinical trials. Methods Time-to-event data was reconstructed from published Kaplan-Meier curves from landmark HF trials. We calculated the RMST-differences and restricted mean time loss (RMTL) ratios between treatment groups as measures of treatment effect, and compared statistical testing results to HR. Results We analyzed 4 clinical trials with a total of 5,186 patients. Statistical significance tests were concordant between HR and RMST or RMTL for all outcomes (Table 1). However, RMST analyses provided additional clinically useful information: for instance, in COAPT, percutaneous mitral valve repair extended each patient's life 1.7 months on average compared to medical therapy alone, over 2 years follow up. In MADIT II, implantable cardioverter defibrillator (ICD) implantation extended each patient's life on average by 2.9 months compared to medical therapy, over the 4 years of the trial, and in MADIT-CRT, cardiac resynchronization therapy added on average 3.2 months to each patient's life compared to ICD alone, over 4 years of follow up. Conclusions RMST achieved similar statistical testing results as HR but provides an intuitive estimate of treatment effect. RMST-based analysis may better communicate treatment effects to patients, to assist in patient-preference discussions and shared decision-making.

Evaluation of foot and ankle injuries in professional soccer

Objective: To evaluate the profile of foot and ankle injuries in professional soccer. Methods: Data were collected prospectively during the 2016 São Paulo Soccer Championship using two electronic forms: an initial form (10 variables) and a follow-up form (6 variables). The results were standardized and evaluated in SPSS 23.0. Results: A total of 259 injuries were reported: 106 to the thigh (40.9%), 42 to the foot and ankle (16.2%), 39 to the knee (15.1%), 39 to the head or face (15.1%) and 33 in other locations (12.7%). Of the 42 foot and ankle injuries, 20 were lateral ankle sprains (47.6%), 5 were medial ankle sprains (11.9%), 3 were to the triceps surae (7.1%), 3 were leg contusions (7.1%), 3 were foot contusions (7.1%), 2 were myalgias (4.8%), in addition to 5 other types (11.9%). There was physical contact in 73.8% of the injuries (p &lt;0.001), and six injuries (14.3%) were considered severe, i.e., involving a time loss of at least one month. Of the severe injuries, four were treated surgically (three by osteosynthesis and one by tenorrhaphy). The mean time loss due to injury was 19.7 days, and the overall incidence rate was 3.5 injuries per 1000 hours of exposure, with 2.1 ligament injuries per 1000 hours. X-rays and magnetic resonance imaging were the most requested tests in the follow-up of these patients. Conclusion: Foot and ankle injuries were the second most frequent injury in Brazilian professional soccer, 73.8% of which resulted from physical contact (p&lt;0.001). Lateral ankle sprains accounted for 47.6% of these injuries, which reaffirms their high prevalence and importance for sports medicine. Level of Evidence III; Prognostic Studies; Prospective Study.

Epidemiology of Shoulder Instability Injuries in Collision Collegiate Sports From 2009 to 2014

To describe the types, mechanisms, and severity of shoulder instability injuries in collegiate collision athletes during the 2009-2010 through 2013-2014 academic years using the National Collegiate Athletic Association Injury Surveillance Program; to compare the injury incidence between men's collision sports and their women's non-collision counterparts, when possible; and to compare injury outcomes between Divisions I, II, and III. Data regarding men's football, wrestling, ice hockey, and lacrosse, as well as women's ice hockey and lacrosse, were obtained. Injuries requiring attention from a health care provider were reported. Incidence rates per 100,000 athlete-exposures (AEs) were calculated with 95% confidence intervals (CIs). Analysis of variance was used to compare time loss (TL), and χ2 analysis was used to compare surgery rates between divisions. A total of 445 shoulder instability injuries occurred in 1,421,561 AEs from 2009-2010 to 2013-2014 (incidence rate, 31.30 injuries/100,000 AEs; 95% CI, 28.4-34.21 injuries/100,000 AEs). Subluxation accounted for 59.1% of injuries, with anterior subluxation (35.3%) being the most common injury. Dislocation resulted in the most TL per injury (17.58days). Mean TL for all injuries was 8.17days (standard deviation, 7.21days). When non-time-loss injuries were excluded from analysis, players experienced a mean TL of 18.34days (standard deviation, 8.44days). Divisions I (4.77days), II (20.52days), and III (11.23days) differed significantly in mean TL (P= .01). Of the injuries, 29.3% required surgery. The surgery rates for Divisions I (32.9%), II (38.1%), and III (19.4%) also differed significantly (P= .04). Men's ice hockey and lacrosse players sustained a 2.17-fold (95% CI, 1.04-4.50) higher incidence of shoulder instability than their female counterparts. Anterior subluxation and dislocation accounted for 52.1% of all shoulder instability injuries. Injured athletes missed 8days on average, and nearly 30% of injuries required surgery. Surgery rates and TL were significantly different between Divisions I, II, and III. Female athletes playing non-collision ice hockey and lacrosse experienced significantly lower shoulder instability rates than their male counterparts. Level III, retrospective cohort study.

Quantification of time and fuel losses due to daily traffic congestion in Kuwait

The growing problem of daily urban traffic congestion in Kuwait has been attracted the attention of the public, the private sector, and the authorities at the highest level of national policy making. A ‘floating car’ method was utilised to measure the actual time-delays due to congestion at a representative sample of routes. Nearly, 64% of the sample population included the Kuwaiti national and 71.5% were male. About 1/3 drove their children to school. Nearly 93% either drove, or were driven to work places. Less than 5.5% used the public bus transit system. Approximately 48% spent one hour or less in traffic jams daily. Those who lost more than 2 h each day constituted more than 8%. The mean time-loss due to congestion was nearly 67 min per day. A parking charge of at least $100 per month with the provision of a ‘free transit’ system combined, may possibly shift about 50% of the sample population to public bus transit. Excluding the cost of accidents, carbon dioxide air pollution, stress and fatigue, lower work productivity, and the cost of feeling in accessibility, a total of KD 1960 * 106 (US $6.9 * 109) was estimated as the annual cost of time-loss, fuel-waste and air pollution due to traffic congestion in Kuwait in 2006.

Epidemiology of Contact and Non-Contact Ankle Injuries in Collegiate Athletes

Category:Ankle, SportsIntroduction/Purpose:Ankle injuries can often have profound implication in the potential careers of National Collegiate Athletic Association (NCAA) athletes. Accordingly, a more thorough characterization of these injuries and insight into injury etiology is warranted. In addition, a more comprehensive understanding will allow proper education of athletes when injuries do occur. Here we review the incidence and effect of ankle injuries on NCAA athletes and their athletic season.Methods:Ankle injuries across 16 collegiate sports played by men and women from 2004-05 to 2013-14 academic years were surveyed from the NCAA Injury Surveillance Program (NCAA-ISP). Ankle injury rates per 10,000 athlete-exposures (IR), operative rate, annual injury rate trends, re-injury rates, in-season status (pre/in/post-season) at time of injury, and time loss distributions were perused. In effort to include both male and female atheletes equally, a sub-group analysis of contact sports played by both genders (C-BG) was performed to determine if there was a significant difference in risk when compared to those athletes that did not play contact sports. These sports included basketball, soccer, lacrosse, and ice hockey. Types of ankle injuries (soft tissues or bony) were also sub-classified and counted.Results:Over the course of 10 years, there were 14,080 ankle injures identified (IR=11.9). There were 8,978 (IR=12.1) injuries in males and 5,102 (IR=11.7) injuries in females. The rate of injuries that occurred in C-BG cohort (IR=14.5) was greater than that of the total group of noncontact participants (IR=7.6). When comparing injury rates between all contact sports(IR=14.1) and all noncontact sports (IR=7.6) the difference was found to be statistically significant(p <0 .0001). In the C-BG group, 1.4% of injuries were operative (N=93). The overall mean time loss for C-BG was 10.9 days when excluding patients who had season ending injuries. Across all atheletes, the top three contact sports with season ending ankle injuries were football, basketball, and lacrosse. Importantly,16.8% of all injuries were classified as re-injuries.Conclusion:Ankle injuries represent a common and broad spectrum of injuries in collegiate athletes. A majority of ankle injuries occurred during the regular season with sprains, strains, contusions, and fractures representing the most common types of injuries. Contact sports tend to have higher rates of ankle injuries than noncontact sports. As the consequence of index ankle injury appears to be higher predisposition to reinjury, a better understanding of the kinds of ankle injuries and their respective causes may help elucidate trends useful in the development of various prevention strategies.

Epidemiology of Time-Loss Injuries in Senior and under-18 Portuguese Male Rugby Players.

Rugby union has one of the highest injury incidence rates in team sports, however, most of the available data focus on the epidemiology of injuries in countries where rugby is popular. We aimed to report the incidence rate and relevant epidemiological aspects of injuries occurred in a group of Portuguese male rugby players. A prospective cohort study was conducted with a group of 45 senior and 32 under-18 male players (total of 77 players). Outcome measures included injury incidence, position, type, location and severity of injuries. The match injury incidence for all players was 55.84 per 1000 player match-hours (66.66 for seniors, 42.85 for under-18), while mean time-loss for injury was 20.79 days. No statistical differences were found between groups. Lower limb injuries accounted for 60.5% of all injuries, while joint/ligament injuries were the most prevalent type. Contact events were responsible for 65.1% of injuries. Despite the limitations, the obtained data are consistent with the literature. Time-loss injuries seem highly prevalent in rugby union and the incidence rates found in this Portuguese-based study were lower than the reported for international and senior men’s professional rugby union, but higher than those occurring in community rugby in tier-1 countries. The authors believe these data reinforce the need to develop and implement effective injury surveillance and prevention programs.

An audit of injuries in six english professional soccer academies

ABSTRACTRegulations now state that professional academies in the United Kingdom are required to substantially increase the volume of soccer training. This study assessed the current injury occurrence, providing an update to reports published prior to the introduction of the Elite Player Performance Plan (EPPP). 608 soccer players aged 11–18 years from six professional soccer clubs were prospectively monitored, recording injuries during the 2014–2015 season. An injury rate of 1.32 injuries per player/season was indicated with a mean time loss of 21.9 days per injury. The greatest time loss per injury was in the U14s-U15s, and the highest rate of severe injuries in the U15s. Strains and sprains were the most common injury type, with the knee and ankle the most frequently injured anatomical sites. Seasonal variation indicated two peaks in injury incidence, occurring in September and January. In comparison to a published audit prior to the inception of the EPPP, this study indicates that academy soccer players are three-times more likely to experience an injury. Given that time loss and injury severity also increased during periods that typically follow rapid growth, these players should be considered an important group for training load monitoring and injury prevention strategies.

IGIACP1 predicts the prognosis in multiple myeloma patients

Abstract Objective The aim of this study was to investigate the prognostic relevance of acid phosphatase 1 (ACP1) expression in myeloma patients by using Gene Expression Omnibus (GEO) datasets. Methods A comprehensive search was performed in the GEO database in order to find appropriate datasets. The expression level of ACP1 was extracted from the dataset involving both newly diagnosed and relapsed myeloma patients, and a comparison was made. Clinical follow-up data and ACP1 expression were extracted, and survival analysis of overall survival was performed to compare the high- (top quartile) and low-expression (bottom quartile) groups. Analyses using Kaplan-Meier estimation, log-rank test, and restricted mean survival time (RMST) comparison were performed. Results The GSE 6477 dataset was used to make a comparison of the ACP1 expression levels among patients with newly diagnosed and relapsed myeloma. The ACP1 expression level was significantly higher in the relapsed group than in the newly diagnosed group [mean difference = -262.9, 95% confidence interval (CI) = (-420.2, -105.5), P = 0.002]. The GSE 2658 dataset was used for investigating the prognostic relevance of ACP1 expression in myeloma. The ACP1 high-expression group had a significantly worse prognosis [low vs high: hazard ratio = 0.54, 95% CI = (0.31, 0.95); χ2 = 5.02, log rank P = 0.0314]. The median survival was 55.9 months in the high-expression group and was not reached in the low-expression group. The restricted mean time loss (95% CI) was 11.03 (12.97, 23.11) and 18.04 (12.97, 23.11) for the low- and high-expression groups, respectively. The ratio of RMST (95% CI) between the two groups (high vs low) was 0.87 (0.77, 0.99; P = 0.03). Conclusion Our study, for the first time, showed that ACP1 predicts the prognosis in multiple myeloma patients. Further studies are needed to determine the potential mechanism by which ACP1 is associated with clinical outcomes and should focus on the differential roles of low-molecular-weight protein tyrosine phosphatase (LMWPTP) isoforms.