Injury Patterns Research Articles

Injury surveillance in Spanish professional female soccer players: A three-season retrospective study

IntroductionDespite the popularity of soccer at the male elite level, data on the incidence of injuries in female players are limited. The study aimed to evaluate the injury incidence and rates in female soccer players in a professional setting over 3 consecutive seasons. MethodsData compiled from 71 elite female players with different playing positions and belonging to the same team were analyzed. The location and severity of injuries were reported according to international consensus statements on the process of conducting epidemiological studies in professional soccer. The injury incidence rate (IIR) for matches and practices and the rate ratio (RR) were calculated, and time-loss injuries during the season were also recorded. ResultsA total of 53 injuries were documented, with an overall IIR of 1.08 injuries per 1000 h and an overall rate ratio of 0.61. The lower limbs were the most affected region (86,8 %). The majority of these injuries occurred around the thigh and knee and were predominantly traumatic, with markedly higher rates of injury during match play (2.78 injuries per 1000 h) when compared to injury incidence during training (0.79 injuries per 1000 h). Traumatic injuries accounted for 48 (91 %) and 24 (45,3 %) were indirect contact injuries. Reinjuries amounted to 15 % of total injuries and August was the predominant month for injury, being goalkeepers the least injured players (13.2 %). ConclusionsFemale professional soccer players displayed injury incidence rates and patterns comparable to those of male players. This study provides epidemiological information that will help to inform future injury surveillance studies and the development of prevention strategies to reduce the number of injuries in elite female soccer players, focusing specifically on thigh and knee regions. All match involvements should be considered when exploring associations between the type of exposure and injury risk.

High-dimensional proteomic analysis for pathophysiological classification of traumatic brain injury.

Pathophysiology and outcomes after Traumatic Brain Injury (TBI) are complex and heterogenous. Current classifications are uninformative about pathophysiology. Proteomic approaches with fluid-based biomarkers are ideal for exploring complex disease mechanisms, as they enable sensitive assessment of an expansive range of processes potentially relevant to TBI pathophysiology. We used novel high-dimensional, multiplex proteomic assays to assess altered plasma protein expression in acute TBI. We analysed samples from 88 participants from the BIO-AX-TBI cohort (n=38 moderate-severe TBI [Mayo Criteria], n=22 non-TBI trauma, n=28 non-injured controls) on two platforms: Alamar NULISA™ CNS Diseases and OLINK® Target 96 Inflammation. Patient participants were enrolled after hospital admission, and samples taken at a single timepoint up to 10 days post-injury. Participants also had neurofilament light, GFAP, total tau, UCH-L1 (all Simoa®) and S100B (Millipore) data. The Alamar panel assesses 120 proteins, most of which were previously unexplored in TBI, plus proteins with known TBI-specificity, such as GFAP. A subset (n=29 TBI, n=24 non-injured controls) also had subacute (10 days to 6 weeks post-injury) 3T MRI measures of lesion volume and white matter injury (fractional anisotropy). Differential Expression analysis identified 16 proteins with TBI-specific significantly different plasma expression. These were neuronal markers (calbindin2, UCH-L1, visinin-like protein1), astroglial markers (S100B, GFAP), neurodegenerative disease proteins (total tau, pTau231, PSEN1, amyloid-beta-42, 14-3-3γ), inflammatory cytokines (IL16, CCL2, ficolin2), cell signalling (SFRP1), cell metabolism (MDH1) and autophagy related (sequestome1) proteins. Acute plasma levels of UCH-L1, PSEN1, total tau and pTau231 correlated with subacute lesion volume. Sequestome1 was positively correlated, whilst CLL2 was inversely correlated, with white matter fractional anisotropy. Neuronal, astroglial, tau and neurodegenerative proteins correlated with each other, IL16, MDH1 and sequestome1. Exploratory clustering (k means) by acute protein expression identified 3 TBI subgroups that differed in injury patterns, but not age or outcome. One TBI cluster had significantly lower white matter fractional anisotropy than control-predominant clusters, but had significantly lower lesion subacute lesions volumes than another TBI cluster. Proteins that overlapped on two platforms had excellent (r>0.8) correlations between values. We identified TBI-specific changes in acute plasma levels of proteins involved in neurodegenerative disease, inflammatory and cellular processes. These changes were related to patterns of injury, thus demonstrating that processes previously only studied in animal models are also relevant in human TBI pathophysiology. Our study highlights how proteomic approaches might improve classification and understanding of TBI pathophysiology, with implications for prognostication and treatment development.

Sagittal Fragment Rotation and Ogden Type-I Classification Are Hallmarks of Combined Tibial Tubercle Fracture and Patellar Tendon Injury.

Tibial tubercle fractures (TTFs) are uncommon injuries, comprising <3% of all proximal tibial fractures. These fractures occasionally occur in conjunction with a patellar tendon injury (PTI). We aimed to identify risk factors associated with combined TTF and PTI. A retrospective review was performed of patients presenting to a single, tertiary children's hospital with TTF between 2012 and 2023. Demographic data, operative details, radiographs, and injury patterns were analyzed. Radiographs were assessed for the epiphyseal union stage (EUS), Ogden classification, and fracture patterns. Multiple logistic regression models were used to assess the impact of body mass index, comminution, fracture fragment rotation, EUS, bilateral injury, and Ogden classification on injury type. We identified 262 fractures in 252 patients (mean age, 13.9 ± 1.31 years). Of the patients, 6% were female and 48% were Black. Of the 262 fractures, 228 (87%) were isolated TTFs and 34 (13%) were TTFs with PTI. Multivariable analysis demonstrated fragment rotation on lateral radiographs (p < 0.0001) and Ogden Type-I classification (p < 0.0001) to be the most predictive risk factors for a combined injury. Rotation was associated with a substantial increase in the odds of a combined injury, with an odds ratio of 22.1 (95% confidence interval [CI], 6.1 to 80.1). Ogden Type-I fracture was another significant risk factor, with an odds ratio of 10.2 (95% CI, 3.4 to 30.4). The Ogden classification and fragment rotation are the most useful features for distinguishing between isolated TTF and combined TTF with PTI. This is the first study to identify risk factors for TTF combined with PTI. Surgeons may use this information to aid in preoperative planning. Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Evaluating Digital Imaging Technologies for Anogenital Injury Documentation in Sexual Assault Cases

Purpose: Photo-documentation is a critical component of care and an indispensable skill for forensic clinicians treating patients who have experienced violence and trauma. This retrospective study examines the frequency and nature of anogenital injuries identified through colposcope digital imaging in comparison to those detected using a high-resolution camera system. Methods: This retrospective, before-and-after study evaluated genital injuries in all adult women (over 16 years old) who presented to a freestanding Nurse Examiner Clinic (NEC) following sexual assault during a 3-year period. The clinic is supervised by forensic clinicians trained in conducting medical-forensic examinations. In 2016-2017, all injuries were documented using the Cooper Surgical Leisegang© colposcope system, while in 2018, injuries were recorded exclusively with a high-resolution camera system. The primary outcome was the frequency of genital findings documented in sexual assault victims from each group. Results: A total of 367 women were evaluated in the "before" period and 180 in the "after" period. Both groups were similar in terms of demographics, assault history, time to examination, alcohol use, and the occurrence of genital injuries (76.1% vs. 74.9%, p = 0.76). However, patients examined with the high-resolution camera system had a significantly higher number of documented anogenital injuries (2.4 vs. 1.8, p &lt; 0.001). This group also had more anogenital abrasions identified (51.1% vs. 27.0%, p &lt; 0.001). The injury patterns between the two groups were not statistically different. Conclusion: Accurate and reliable photo documentation are the key components of forensic medical documentation. Our findings indicate that the detection of anogenital injuries may differ based on the imaging system used.

Retrospective Analysis of Etiology, Pattern, and Determinants of Pediatric Maxillofacial Injuries

Abstract Context: Children sustain facial skeletal and soft-tissue injuries, which are often seen in the preschool age; however, severe facial injuries involving facial bones occur in ages above 11 years. There have been several postulated reasons for the reduction in the incidence of skeletal fractures in children. These include sutural pliability of pediatric facial bones, increased subcutaneous fat, and a greater ratio of cranial to facial bones. Aims: The study aimed to report our institutional experience of the pattern of presentation in pediatric maxillofacial trauma and report its main etiologies. Methods and Materials: Clinical and demographic information was retrieved from the maxillofacial registers, day clinics, and pathology registers. The etiology of the trauma and associated injuries were also noted. Statistical Analysis: Descriptive statistics were performed on demographic variables such as age, gender, and location of trauma. Categorical variables were analyzed in frequencies and proportions. Association analyses across variables were done using student t-test, ANOVA, and Pearson’s Chi-square after normality test had been conducted. Dunn’s test and Tukey’s post-hoc analysis were conducted after significant observations. Results: The mean age observed in the study was 7.3 years ± 5.3 SD (range: 2.6 months–16 years). There was a slight male predilection with 58.6%. Falls were the most common etiology in the ≤5-years group. RTC accounted for most injuries in children above 11 years. Soft-tissue-only injuries were observed in 51.4% of all cases. In facial bone fractures, mandibular fractures accounted for 40% of all cases. Conclusion: Male children experienced the greatest impact from maxillofacial trauma. The primary factor contributing to this was falls among preschool children. Soft-tissue injuries were found to be more prevalent among preschool children, whereas the incidence of facial fractures increased as age advanced.

Motorcycle riders and pillion passengers injury patterns and in-hospital outcomes based on the National Trauma Registry of Iran

Objective Road traffic injury (RTI) is the second leading cause of death and disability, and motorcycle crashes rank as the first cause of traffic fatality in Iran. We aimed to compare various characteristics between traumatized motorcycle riders and pillion passengers registered with the National Trauma Registry of Iran (NTRI). Methods This is a retrospective study of the NTRI, an ongoing multicenter trauma database built on a registry. This study included injured motorcyclists from six major trauma centers nationwide admitted between February 2017 and November 2023. Motorcyclists should have been hospitalized for RTIs and met the NTRI’s inclusion criteria. We assessed patients regarding their demographics, clinical features, the pattern of injuries, and diverse in-hospital outcomes. Results Of 54,342 registered patients in the NTRI, 7,594 motorcyclists were included. Of them, 6,636 (87.4%) were riders, and 958 (12.6%) were pillion passengers. Among all, 7165 (94.5%) were male, and 420 (5.5%) female (p < 0.001). Only 656 (9.9%) of riders and 24 (2.5%) of pillion passengers were wearing helmets (p < 0.001). Lone motorcyclist crashes led to injuries in 1,394 (21.2%) riders and 332 (35.5%) pillion passengers (p < 0.001). Glasgow Coma Scale (GCS) was 3 to 8 in 204 (3.1%) riders and 16 (1.7%) pillion passengers (p = 0.016). The most frequent pattern of poly-trauma was “head and thorax,” with 43 (32.3%) riders and 5 (25.0%) pillion passengers (p = 0.362). Univariable logistic regression analysis showed that Intensive Care Unit (ICU) admission (OR = 0.78, CI 95% = 0.62 to 0.97, p = 0.028) and mechanical ventilation (OR = 0.58, CI 95% = 0.39 to 0.84, p = 0.004) were significantly lower in pillion passengers compared to motorcycle riders. After adjustment for age, gender, occupational status, and helmet use, being a rider or a pillion passenger didn’t have a significant association with any of the in-hospital outcomes. Conclusions Motorcycle riders and pillion passengers sustain the same injuries in terms of pattern, severity, and in-hospital outcomes. Therefore, healthcare providers can approach them similarly. Since there is a high number of underage riders and helmets are not used commonly, there should be more police enforcement in this case.

Cannabis pollen sources and dispersal in the Iberian Pyrenees during the last century: Preliminary results and proposals for future studies

Meta-analyses of past pollen records have provided insights into the historical biogeography of Cannabis across the Iberian Peninsula (IP), with the southern Pyrenean flank being key to understanding cannabis cultivation and use during the Middle and Modern ages. However, studies on more recent times are rare. This paper offers a high-resolution comparison of the last century, particularly the significant Cannabis pollen peak observed in the mid-elevation Lake Montcortès between 1980 and 2000 CE, which was absent in the nearby highland Lake Sant Maurici. The Montcortès peak is linked to a phase of extensive hemp cultivation (1972–2006 CE) in the southeastern lowlands. The absence of a similar peak in Sant Maurici, despite the presence of other lowland pollen taxa, notably Olea and Quercus, suggests regional differences in pollen origin and dispersal likely influenced by wind patterns and rainfall. Studies on Cannabis pollen sources and dispersal are comparatively scarce and insufficient to provide a regional picture across the IP, similar to Olea or Quercus. However, the available data suggest that cannabis pollen is abundant mostly locally, in the vicinity of cannabis crops. The persistent presence of Cannabis pollen in Montcortès after 2000 CE likely reflects ongoing illegal cultivation. The study recommends combining paleoecological and aerobiological surveys to better understand pollen dynamics in the Iberian Pyrenees, with suggestions for future research based on these findings.

The patterns and prevention of injuries in college table tennis training

This paper conducts a detailed investigation and analysis of injuries among table tennis athletes from college sports academies, and preliminarily explores some general patterns of sports-related injuries that have occurred, summarizing some preventive measures and solutions.

Comparison of Traumatic Brain Injury in Adult Patients with and without Facial Fractures.

Facial fractures and associated traumatic brain injuries represent a worldwide public health concern. Therefore, we aimed to determine the pattern of brain injury accompanying facial fractures by comparing adult patients with and without facial fractures in terms of demographic, clinical, and imaging features. This single-center, retrospective study included 492 polytrauma patients presenting at our emergency department from January 2019 to July 2023, which were divided in two groups: with facial fractures (FF) and without facial fractures (non-FF). The following data were collected: age, sex, mechanism of trauma (road traffic accident, fall, and other causes), Glasgow Coma Scale (GCS), the evolution of the patient (admitted to a medical ward or intensive care unit, neurosurgery performed, death), and imaging features of the injury. Data were analyzed using descriptive tests, Chi-square tests, and regression analyses. A p-value less than 0.05 was considered statistically significant. In the FF group, there were 79% (n = 102) men and 21% (n = 27) women, with a mean age of 45 ± 17 years, while in the non-FF group, there were 70% (n = 253) men and 30% (n = 110) women, with a mean age 46 ± 17 years. There was a significant association between brain injuries and facial fractures (p < 0.001, AOR 1.7). The most frequent facial fracture affected the zygoma bone in 28.1% (n = 67) cases. The most frequent brain injury associated with FF was subdural hematoma 23.4% (n = 44), and in the non-FF group, the most common head injury was intraparenchymal hematoma 29% (n = 73); Conclusions: Both groups shared similarities regarding gender, age, cause of traumatic event, and outcome but had significant differences in association with brain injuries, ICU admission, and clinical status.

L5-S1 facet joint pathology in pelvic ring injuries.

The authors believe that the L5-S1 facet joint injury in the setting of pelvic fractures is underappreciated by orthopedic traumatologists. The purpose of this study was to draw attention to the L5/S1 facet joint in the setting of pelvic ring injuries. This was a retrospective comparative study of all patients greater than or equal to 18years of age with an acute pelvic ring injury (AO/OTA 62 B to C) presenting to a single level I trauma center. The primary objective was to determine demographic and injury characteristics associated with L5-S1 facet joint injuries in patients with pelvic ring injuries. The secondary objective was to determine the proportion of L5-S1 facet joint injuries that were missed on initial radiographic workup. There were 476 patients included in the analysis, 53 (11.1%) of whom had an L5-S1 facet joint injury. Patients with an L5-S1 injury were more likely to be younger (44.1 vs. 53.2years, p = 0.001) and experience a high energy mechanism of injury (95.0% vs. 78.0%, p = 0.002). Certain injury patterns were associated with L5-S1 facet joint injuries: any sacral fracture (96.2% vs. 73.8%, p < 0.001), Denis zone 2 fractures (43.4% vs. 20.1%, p < 0.001), Denis zone 3 fractures (34.0% vs. 4.7%, p < 0.001), bilateral displaced sacral fractures (18.9% vs. 3.5%, p < 0.001), and L5 transverse process fractures (64.2% vs. 18.0%, p < 0.001). Only 16.0% of radiology reports identified an L5-S1 injury. Orthopedic traumatologists should scrutinize imaging for L5-S1 facet joint injuries in the presence of pelvic ring injuries, especially in patients with certain sacral fracture patterns.

Bridging the gap: Mechanistic-based cyclist injury risk curves using two decades of crash data

Objective Injury risk curves are vital in quantifying the relative safety consequences of real-world collisions. Previous injury risk curves for bicycle-passenger vehicle crashes have predominantly focused on frontal impacts. This creates a gap in cyclist injury risk assessment for other geometric crash configurations. The goal of this study was to create an “omnidirectional” injury risk model, informed by known injury causing mechanisms, that is applicable to most geometric configurations. Methods We used data from years 1999–2022 of the German In-Depth Accident Study (GIDAS). We describe the pattern of injuries for cyclists involved in collisions with passenger vehicles, and we developed injury risk functions at various AIS levels for these collisions. A mechanistic-based approach accounting for biomechanically-relevant variables was used to select model parameters a priori. Cyclist age (including children) and sex were regarded as relevant predictors of injury risk. Speed and impact geometry were captured through a novel predictor, Effective Collision Speed, which transforms the vehicle and cyclist speeds into a single value and incorporates frictional considerations observed during side engagements. Cyclist engagement with the vehicle was captured with a variable demonstrating the potential for a normal projection. We additionally present analyses weighted toward German nationwide data. Results We identified 6,576 cyclists involved in collisions with passenger vehicles. AIS3+ cyclist injuries occurred most often in the head, thorax, and lower extremities. Effective Collision Speed was a strong predictor of injury risk. Collisions with a potential for a normal projection were associated with increased risk, though this was only significant at the MAIS2+F severity level. Younger children had slightly higher injury risk compared to young adults, while elderly cyclists had the highest risk of AIS3+ injury. Sex was a significant predictor only for the MAIS2+F injury risk curves. Significance U.S. cyclist fatalities increased 55% from 2010 to 2021. To reduce injuries and fatalities, it is crucial to understand cyclist injury risk. This study builds on previous analyses by including children, incorporating additional mechanistic predictors, broadening the scope of included crashes, and using weighting to generalize these estimates toward national German statistics.

Occupational Injuries and Its Determinants Among Cement Factory Workers: A Cross Sectional Study

Abstract Introduction: Cement manufacturing industry workers face inevitable circumstances and are unintentionally exposed to different injuries at the workplace. The purpose of this study was to establish the pattern of injuries and their related risk factors. Materials and Methods: This cross-sectional study involved 360 workers from different departments within three cement factories in Chhattisgarh, India. Results: 55% of employees had either abrasion (30%) or dust in their eyes (23%). Workers in open areas (unadjusted odds ratio [UOR] = 3.28 [2.08–5.18]) and those who do not have training in personal protective equipment (UOR = 2.19 [1.42–3.39]) were more likely to get injured. Conclusions: A high number of workers suffered from injuries, as reported by this study; therefore, there is a need for thorough training and safety procedures.

Pediatric Cervical Spine Trauma: Injury Patterns, Diagnosis, and Treatment

Pediatric Cervical Spine Trauma: Injury Patterns, Diagnosis, and Treatment

Epidemiology of injuries in united states high school track and field jumping events from 2008 – 2019

ABSTRACT Objectives Reports of injury characteristics of high school track and field athletes participating in jumping events in the United States are limited. In this descriptive epidemiological study, we report injury rates and patterns in these athletes. Methods Injuries and athletic exposures (AE) from the National High School Sports Related Injury Surveillance System, and High School Reporting Information Online (RIO) from 2008-2019 were analyzed. Jumping events included high jump, long jump, triple jump, and pole vault. Injury rate ratios (IRR) and injury proportion ratios (IPR) were examined by sex. Results A total of 727 injuries related to jumping events during 5,486,279 AEs occurred with the highest frequency at the thigh (20.3%) followed by the ankle (18.2%), knee (16.1%), and lower leg (11.0%). The most common types of injuries were muscle strain (29.0%) and ligament sprain (21.2%). Most athletes returned to sport within 1 week (43.1%, n = 312) or 3 weeks (34.7%, n = 243). Few jumping-related injuries resulted in surgery (4.9%, n = 35) or medical disqualification (4.4%, n = 31). The jumping-related injury rate was 1.33 injuries/10,000 AEs from 2008 to 2019. The rate of jumping-related injuries was higher in competition than in practice (IRR = 2.63, 95% confidence interval [CI]: 2.25–3.06). Injury rates were significantly higher in practice for female athletes than for males (IRR = 1.51, 95% CI: 1.23–1.86). Compared to male athletes, female athletes sustained a higher proportion of ankle injuries (IPR = 1.63, 95% CI: 1.15–2.32) and ligament sprains (IPR = 1.55, 95% CI: 1.16–2.09). Conclusions This study describes injury characteristics of high school track and field jumping athletes from 2008 to 2019. We found an overall injury rate of 1.33 injuries per 10,000 AEs. Higher overall rates of jumping-related injuries occurred during competitions than in practice, and female athletes displayed a significantly higher rate of injuries during practices compared to male athletes.

Musculoskeletal Injury in Australian Infantry Personnel: A Cross-sectional Study to Understand Prevention Priorities.

Musculoskeletal injury patterns are under-investigated in the Royal Australian Infantry Corps. Subsequently, more evidence is needed to support injury prevention processes in this population. One difficulty in collecting injury information to monitor injury patterns within combat populations accurately is known injury concealment behaviors in such populations. This study aims to examine musculoskeletal injury epidemiology within Australian infantry battalions using a tailored approach to mitigate reporting avoidance. A cross-sectional study using an anonymous online survey captured musculoskeletal injury information directly from personnel serving within 2 Australian infantry battalions. The survey requested information on participants' injury frequency in the previous 12 months and the context of participants' most severe injury. Injury context was restricted to the most severe during the period to limit recall bias. The applied injury case definition encompassed all injuries that affected an individual's ability to perform in their role. A descriptive analysis of all data recorded across the 2 battalions was conducted. Subgroup statistical difference was assessed by examining the 95% CI overlap between groups. The Department of Defence and Veterans' Affairs Human Research Ethics Committee granted ethical approval for this study. Overall, 166 individuals self-reported at least 1 injury in the past 12 months, representing a period prevalence of 55.5% (95% CI, 49.8-61.0%). No statistically significant prevalence differences existed between employment type, age, or sex. Approximately a quarter of injured participants were medically reclassified because of their injury, impacting their deployment fitness (n = 40, 24.4%). The following results relate to the most severe injury personnel experienced. Most injuries were service-related (n = 152, 91.6%). Field activities (n = 64, 39.3%) and physical training (n = 59, 36.2%) were the most common injury-related activities. Running was the most reported injury mechanism (n = 35, 21.7%), followed by pack marching (n = 29, 18.9%) and fall, slip, or trip (n = 18, 11.2%). Musculoskeletal injuries are common in the Australian infantry and significantly burden the workforce. Physical training and field exercises are most associated with injury and represent opportunities for injury risk-mitigation strategies to support the overall deployability of personnel and the combat effectiveness of their battalions. Future research should more formally explore the injury risk factors related to these activities using more robust study designs to collect injury and exposure information more accurately and reliably. One study strength includes using military-specific international injury surveillance guidelines to inform the survey design, to collect the recommended injury information for effective surveillance, and to enable future research comparison. A second study strength was tailoring the survey to promote participatory engagement, providing a high completion rate. A challenge in conducting this research was coordinating participant recruitment and data collection during domestic operations. Such challenges reflect the reality of conducting research in the military.

Assessing the impact of climate variability on wheat yield in Bloemfontein wheat farms through time series analysis

Climate change, characterized by long-term shifts in global or regional weather patterns, is a consequence of natural processes and human activities. These shifts encompass al-terations in temperature, precipitation, wind patterns, and other climatic variables, all of which exert direct influence on crop growth, development, and overall agricultural productivity. Comprehending the intricate relationship between climate change and crop production is par-amount for formulating strategies to counteract adverse effects and adapt to evolving conditions. This study focuses on assessing the impact of climate variability on wheat yield in Bloemfontein wheat farms through rigorous time series analysis. The research involved the application of various time series models, including SARIMA, ARIMA, Facebook Prophet, LSTM, VAR, and Multiple Linear Regression. The investigation began with forecasting temperature patterns using SARIMA and Facebook Prophet models. SARIMA outperformed Facebook Prophet in this context, as evidenced by lower RMSE and MSE metrics. Subsequently, the study delved into predicting rainfall and precipitation, employing ARIMA and LSTM models. In this case, LSTM demonstrated superior predictive capabilities. Finally, wheat production yield was analyzed using VAR and Multiple Linear Regression, with VAR yielding more accurate predictions. The findings of this study hold profound implications for policymakers, farmers, and stakeholders deeply invested in agriculture and food security. By shedding light on the repercussions of climate change on crop production through the application of time series analysis, this project aspires to contribute to developing sustainable agricultural practices, robust farming systems and proactive policies de-signed to mitigate the adverse effects of climate change on global food production.

Foreign bodies in the rectum: clinical experience

Background: Foreign bodies in the rectum are among the rarest conditions encountered in emergency surgery and can have various etiologies.Aim: To examine the patterns of injury, diagnostic methods, surgical options, and outcomes associated with foreign bodies of the rectum.Materials and methods. A retrospective analysis was conducted on the treatment outcomes of 47 patients with rectal foreign bodies who received care at various surgical hospitals in the Khanty-Mansiysk Autonomous Okrug — Ugra from 2019 to 2023. The study examined factors such as sex and age distribution, etiology, duration of the treatment period, diagnostic features, and types of medical interventions. The results of treatment and length of hospital stay were also assessed. A criminal history was noted in only one patient (2.1 %). The insertion of a foreign body into the rectum for sexual pleasure was reported by 42 patients (89.4 %). Non-sexual causes were responsible for the condition in 4 patients (8.5 %).Results. In the analysed group there were 29 (61.7 %) young people, 9 (19.1 %) middle-aged people, 8 (17.0 %) elderly people, and one (2.2 %) in the senior age group. The average age of the patients was 42 ± 13 years. There were 33 men (70.2 %) and 14 women (29.8 %). In the first 3 hours, 10 (21.3 %) people sought medical treatment, after 1—3 days — 34 (72.3 %) patients, and after 4 days — 3 (6.4 %) patients. In most cases, in 42 (89.3 %) patients, the foreign body was removed transanally. If transanal removal was impossible, laparotomy was performed in 5 (10.6 %) patients.Conclusion. Sexual gratification was the most common reason for the insertion of a foreign body into the rectum. To prevent perforation and improve the prognosis of this pathological condition, timely diagnosis and treatment are necessary

ESR Essentials: imaging of suspected child abuse-practice recommendations by the European Society of Paediatric Radiology.

The goal of this paper is to provide a useful desktop reference for the imaging of suspected child abuse with clear, age-specific pathways for appropriate evidence-based imaging and follow-up. We aim to provide a road map for the imaging evaluation and follow-up of this important and vulnerable cohort of patients presenting with signs and symptoms concerning forinflicted injury. As the imaging recommendations differ for children of different ages, we provide a flowchart of the appropriate imaging pathway for infants, toddlers, and older children, which allows ease of selection of which children should undergo skeletal survey, non-contrast computed tomography (CT) brain with 3-dimensional (D) reformats, and magnetic resonance imaging (MRI) of the brain and whole spine. For ease of review, we include a table of the common intracranial and spinal patterns of injury in abusive head trauma. We summarise search patterns, areas of review, and key findings to include in the report. To exclude skeletal injury, infants and children under 2 years of age should undergo a full skeletal survey in accordance with national guidelines, with a limited follow-up skeletal survey performed 11-14 days later. For children over 2 years of age, the need for skeletal imaging should be decided on a case-by-case basis. All infants should undergo a non-contrast-enhanced CT brain with 3-D reformats. If this is normal with no abnormal neurology, then no further neuroimaging is required. If this is abnormal, then they should proceed to MRI brain and whole spine within 2-5 days. Children older than 1 year of age who have abnormal neurology and/or findings on skeletal survey that are suggestive of inflicted injury should undergo non-contrast CT brain with 3-D reformats and, depending on the findings, may also require MRI of the brain and whole spine. We hope that this will be a helpful contribution to the radiology literature, particularly for the general radiologist with low volumes of paediatrics in their practice, supporting them with managing these important cases when they arise in daily practice. KEY POINTS: The choice of initial imaging (skeletal survey and/or brain CT) depends on the age of the child in whom abuse is suspected. A follow-up skeletal survey is mandatory 11-14 days after the initial survey. If an MRI of the brain is performed, then an MRI of the whole spine should be performed concurrently.

Motorcycle Wheel Spoke Injury to the Ankle and Foot in Children: A Cross-sectional Observational Study.

In developing countries, motorcycles are a widespread transportation method, leading to a notable increase in road traffic injuries, particularly those involving the ankle and foot caused by motorcycle wheel spokes. Our study sought to understand the epidemiological features and characteristics of motorcycle-induced wheel spoke injuries to the ankle and foot in children. The objectives were to comprehend injury patterns, evaluate their severity and pinpoint clinical indicators predicting injury nature and extent, aiming to guide prevention strategies. We conducted a cross-sectional observational study with a retrospective data collection focused on children under the age of 16 years who sustained injuries from motorcycle rear wheel spokes while riding as pillion passengers and were admitted to our department over 11 years, from 1 January 2010 to 31 December 2020, with a minimum follow-up of 2 years. Soft tissue wounds were classified using the Oestern-Tscherne classification. Thirty patients were enrolled in this study. Before 2015, cases ranged from none to one annually, increasing to 2-7 cases per year after 2015. The average age was 6.7 ± 2.1 years. Significantly, more patients were older than 6 years (P < 0.001), injured on the right side (P < 0.001) and suffered the injuries in the afternoon (P < 0.001). All patients were pillion and were injured by the motorcycle's rear wheel. Twenty-five patients (83%) had a Grade 3 injury. There was a tendon rupture in 22 (73%) and a bone fracture in 15 (50%) patients. Loss of soft tissue (P = 0.036) and reduced ankle mobility (P = 0.046) were linked to tendon ruptures. Lengths of wound exceeding 6 cm (P = 0.025) and loss of soft tissue (P = 0.025) were associated with a bone fracture. Children's motorcycle wheel spoke injuries have increased in recent years. Loss of soft tissue and ankle mobility deficit proved to be reliable clinical signs of a tendon rupture. A wound length exceeding 6 cm and a loss of soft tissue were indicative of a related bone fracture.

Pattern of abdominal injuries, organ involved and rate of negative laprotomy in tertiary care hospital

Objective: This study was designed to evaluate the pattern of abdominal injuries the value of the surgery in assisting diagnosis, laparotomy and mortality rate. Methods: Out of 1923 total trauma patients 886 individuals were included in the study from a tertiary care hospital. Demographic , trauma-related traits, laparotomies with their indications, etiology and the organs affected were all collected. With SPSS 23 were used to evaluate data Results: The mean age patients were 27.05 years mostly male. Mortality and negative laparotomy rate were 5.9 and 15.4 percent respectively. Blunt injures were more than penetrating .Spleen was the frequent organ damage. Conclusion: Blunt trauma with spleen mostly involved organ. Mortality and negative laparotmy rate are comparable to other studies