Injury Rates Research Articles

Ergonomics in bronchoscopy.

This study examines ergonomic considerations in bronchoscopic procedures, surveying existing research, injury rates, contributing factors, and practical ergonomic controls. The field of ergonomics examines the relationship between workers and their workplace to enhance productivity and minimize injuries. Bronchoscopists may face ergonomic hazards due to extended periods of maintaining fixed positions, repetitive actions, and the design of both tools and procedure spaces. Studies on the ergonomics of bronchoscopy have revealed a wide range of musculoskeletal issues among practitioners. Those new to the field, including trainees and early-career professionals, may be particularly vulnerable to injuries compared to their more experienced counterparts. Implementing a systematic approach, such as that proposed by the National Institute for Occupational Safety and Health, could help reduce physical stress, discomfort, and the likelihood of musculoskeletal disorders for bronchoscopists. Bronchoscopists increasingly face ergonomic issues in their practice. Despite available measures to address these problems, the field lacks uniform ergonomic guidelines for bronchoscopy. To safeguard bronchoscopists' health and safety from the outset of their careers, more studies and training focused on ergonomics in bronchoscopy are needed.

Impact of a newly implemented burn protocol at Tri-Service General Hospital: Outcome analysis of 20-year experience

PurposeTo share our 20-year experience in major burn management and the impact of a newly implemented burn protocol since 2015 at Tri-Service General Hospital (TSGH). Materials and methodsWe performed a retrospective cohort study of severely burned patients who were admitted to the intensive care unit (ICU) at TSGH from January 2003 to September 2023. Data regarding demographics, complications, and mortality were collected and analyzed. We compared the patient data before (pre-implementation) and after 2015 (post-implementation), when the new major burn management protocol was introduced. ResultsNo statistically significant differences were observed in the mean total body surface area of the burns between the groups. The post-implementation group had younger age (34.62 vs 45.06, P < 0.001) and lower rate of inhalation injury (60.8 % vs 82.5 %, P = 0.005). No statistically significant difference was observed in the ICU stays between the groups. The post-implementation group had a statistically significant lower all-cause mortality (8.1 % vs 47.6 %, P < 0.0001) and lower rate of renal replacement therapy (RRT) (20.3 % vs 42.9 %, P = 0.004) but earlier initiation of RRT. ConclusionThe new TSGH Burns Protocol revolutionized the care of major burns by introducing tailored, multidisciplinary burn management and improved patient outcomes.

Epidemiology of Sports-Related Tendon Ruptures Presenting to Emergency Departments in the United States

Background: Participation in recreational and competitive sports can predispose people to musculoskeletal injuries. Chronic overuse with insufficient recovery, overloading, and direct contact can result in acute primary tendon ruptures. There is scarce literature regarding the epidemiology of sports-related acute primary tendon ruptures in the United States (US). Purpose: To identify the incidence rate (IR) of sports-related acute primary tendon ruptures presenting to US emergency departments using the National Electronic Injury Surveillance System (NEISS) database and describe the trends in the IR from 2001 to 2020. Study Design: Descriptive epidemiology study. Methods: The NEISS database was queried using injury case narratives; cases with a clear diagnosis of an acute primary tendon rupture were included in the final analysis. National estimates, estimated IRs (reported as per 1,000,000 person-years at risk), and temporal trends in the annual IR (reported as average annual percent change) of acute primary tendon ruptures were calculated using NEISS sample estimates and US Census Bureau population estimates. Results: An estimated total of 141,382 patients (95% confidence interval [CI], 107,478-175,286) presented to US emergency departments with a sports-related tendon rupture over the study period (IR, 22.9 person-years at risk [95% CI, 17.4-28.3]). The mean age was 37.7 years (95% CI, 37.0-38.5). Of all cases of a tendon rupture identified from 2001 to 2020, 60.1% were secondary to exercise/sports-related injury mechanisms. An Achilles tendon rupture was the most common injury, representing 55.9% of cases. Basketball was the most common sports-related injury mechanism, accounting for 36.6% of cases. The overall injury rate in male patients was 7.7 times that of female patients (IR ratio, 7.7 [95% CI, 4.4-13.5]; P < .05). The annual incidence of all sports-related tendon ruptures in the US increased significantly from 2001 to 2020 (average annual percent change, 1.9 [95% CI, 1.0-2.8]; P < .01). Conclusion: Recreational/competitive sports participation accounted for a large proportion of acute primary tendon ruptures in the US during the study period.

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

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

Ischemic stroke incidence in intermediate or high-risk patients undergoing transcatheter aortic valve replacement versus surgical aortic valve replacement: a comparative systematic review and meta-analysis

Background and purposeThis comparative systematic review and meta-analysis investigated the incidence of ischemic stroke in intermediate-to-high-risk patients undergoing transcatheter aortic valve replacement versus surgical aortic valve replacement.MethodsWe conducted a systematic review and meta-analysis following the PRISMA guidelines, searching PubMed, Google Scholar, Embase, Web of Science, and Cochrane CENTRAL databases from their inception to December 2023. The evaluated outcomes were primarily incidence of stroke and transient ischemic attack (TIA), along with other secondary safety end-points at 30 days and 1 year post-procedure. Odds ratios (ORs) with 95% confidence intervals (CIs) were utilized for each study, employing a random-effects model for data synthesis irrespective of heterogeneity. Statistical heterogeneity was assessed using I2 statistics. All statistical analyses were conducted using Review Manager.ResultsWe screened 8028 articles and included 8 studies consisting of 5 randomized controlled trials and 3 observational studies. The studies examining 30-day and 1-year stroke incidence found no significant difference between TAVR and SAVR patients (OR 0.83, 95% CI 0.59 to 1.17, p = 0.30, OR 0.92, 95% CI 0.64 to 1.33, p = 0.67, respectively). Both TAVR and SAVR also had a comparable risk of having a transient ischemic attack within 30 days (OR 0.93, 95% CI 0.24 to 3.63, p = 0.92, I2 52%) and 1 year (OR 1.15, 95% CI 0.72 to 1.82, p = 0.56, I2 0%) following the procedure. Regarding safety endpoints, TAVR had lower rates of all-cause mortality and acute kidney injury at 1 year post-procedure, but a higher incidence of major vascular complications at both 30 days and 1 year compared with SAVR.ConclusionThe results suggest that TAVR and SAVR have comparable outcomes for both TIA and stroke incidence at 30 days and 1 year post-procedure, but display varying safety profiles in intermediate-to-high surgical risk patients.

Traumatic Aortic Disruption Index is Associated with Mortality and Urgency of Stent Grafting in Blunt Thoracic Aortic (Grade 3) Injuries

ObjectiveDelayed stent grafting for blunt thoracic aortic injuries (BTAI) is current standard of care. However, given the heterogeneity of pseudoaneurysm presentations, it is currently unclear which severe BTAIs require more urgent intervention. We hypothesize that a Traumatic Aortic Disruption Index (TADI) calculation based on sagittal computed tomography angiography (CTA) imaging measurements would correlate with urgency of stent grafting. MethodsAll patients at a level-1 trauma center with BTAIs over a 12-year period were identified. A TADI score was then calculated using the length of pseudoaneurysm (L), maximum width of pseudoaneurysm (W), and normal adjacent aortic diameter (NA) (Figure1). Patient presentation, injury characteristics, timing of stent grafting, and outcomes were then evaluated. ResultsForty-two patients were diagnosed with BTAIs. Mean age was 37.6 years, with a median injury severity score (ISS) of 29. Overall mortality was 11.9%. TADI scores ranged from 3.6 to 158.6. Compared to patients with a TADI<28, patients with TADI>28 had similar median ISS scores (34 vs 29, p=0.16), and rates of both traumatic brain injury (33.3% vs 42.0%, p=0.53) and non-aortic hemorrhage control procedures (44.4% vs 33.3%, p=0.3). TADI>28 patients had a lower initial mean systolic BP (98.5 vs 121.9, p=.003), more severe hypotension (lowest systolic 77.0 vs 91.2, p=.034), lower initial GCS (6 vs 13, p=.039), higher mean admission lactate (4.6 vs 3.3, p=.036), and higher overall mortality (23.8% vs 0%, p=.048). Patients with TADI>28 received stent grafting at significantly shorter median time intervals from injury identification (median 4 hrs vs 14 hrs, p=.001). Overall causes of mortality were aortic hemorrhage related (n=3, 60%) and traumatic brain injury (n=2, 40%). ConclusionThis simple-to-calculate index is independently correlated with mortality and urgency of stent grafting in blunt trauma patients with similar ISS. Patients with TADI scores >28 were more likely to undergo urgent stent grafting, thereby suggesting a trend in practice patterns with higher scores representing injuries that should be considered for expedited operative management. The TADI score should be validated in a larger sample of blunt trauma patients as an injury prioritization tool in the multi-system injured patient.

General unemployment and serious workplace injury rates: Workers compensation claims analysis from the Canadian province of Saskatchewan, 2007-2018.

There is conflicting published evidence that unemployment impacts workplace safety. Some studies suggest that the workplace injury rate decreases during economic contractions, while others propose an increased rate of injuries during periods of economic contractions. This study investigated the association between unemployment rates and traumatic work-related non-fatal injury (WRNFI) in Saskatchewan, 2007-2018, in order to provide new insight into injury prevention. Saskatchewan's retrospective linked workplace claims data from 2007 to 2018 were grouped by year, season, and worker characteristics (e.g., age and sex). Total employment, total labour force, and the number of unemployed workers from the Statistics Canada Labour Force Survey were grouped by year, season, sex, and age. These data were linked to the worker's compensation board injury claim data to determine the number of people at risk, serving as the denominator (offset term) for WRNFI rates, calculated as WRNFI cases per total employed workers. A negative binomial generalized additive model was used to examine the association between unemployment rates and WRNFI, adjusted for age, sex, industry types, and seasons. The WRNFI rate has declined since 2007. On average, workers aged 20-29years had the highest WRNFI rate (541.6 ± 84.8/100,000). Men had 3.2 times higher WRNFI risk than women (RR = 3.2, 95% CI 3.12-3.22), with the highest WRNFI risk observed in the manufacturing (RR = 1.68, 95% CI 1.63-1.73) and construction (RR = 1.67, 95% CI 1.63-1.72) industries. WRNFI risk decreased non-linearly with an increasing unemployment rate, indicating a pro-cyclic pattern. This analysis showed that WRNFI rates tracked unemployment rates. This suggests a need to increase prevention strategies and reduce disincentives for under-reporting during an economic downturn.

Characteristics of Lumbar Pars Interarticularis and Pedicle Stress Injuries by Sport in 902 Pediatric and Adolescent Athletes: A Retrospective Study

Background: Recent studies utilizing magnetic resonance imaging (MRI) for the evaluation of symptomatic lumbar spondylolysis in pediatric and adolescent athletes have indicated that upper level lumbar involvement has a higher incidence than previously reported. There has been a paucity of literature evaluating sport-specific patterns of lumbar spondylolysis, specifically upper versus lower level involvement. Purpose: To assess the potential risk factors for upper level stress injuries of the lumbar spine in pediatric and adolescent athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The medical records of 902 pediatric and adolescent athletes (364 female, 538 male; mean age, 14.5 ± 2.1 years) diagnosed with symptomatic pedicle and pars interarticularis stress injuries at 2 academic medical centers (July 2016 to June 2021) were reviewed. All patients had undergone MRI at the time of diagnosis. Only patients with pars/pedicle edema on MRI were included. Data regarding single-sport specialization, sport participation, sport category by biomechanics (axial rotation vs extension/axial loading), and vertebral level of injury over the 5-year period were analyzed. Stress reaction or active spondylolysis (SRAS) was the terminology used to designate grade 1, 2a, or 3 stress injuries according to the adapted Hollenberg classification system on MRI. Upper level vertebrae were defined as L3 or superior, whereas lower level vertebrae included L4 or inferior. Results: Of the 902 patients with SRAS injuries, most (n = 753 [83.5%]) had exclusively single-level lower stress injuries, while 67 (7.4%) had multilevel stress injuries. There were 82 athletes (9.1%) who had single-level upper stress injuries. Athletes with upper level pars/pedicle stress injuries were older at the time of diagnosis (15.8 ± 1.9 vs 14.3 ± 2.1 years, respectively; P < .001), had a shorter duration of low back pain before presentation (2.50 ± 2.70 vs 4.14 ± 6.73 months, respectively; P < .001), were more likely to specialize in a single sport (43.9% vs 32.3%, respectively; P = .046), and had a lower incidence of active spondylolysis on MRI at the time of diagnosis (42.7% vs 59.8%, respectively; P = .004) compared with athletes with lower level stress injuries. Athletes with lumbar stress injuries who specialized in a single sport had nearly twice the odds of having upper level involvement compared with multiple-sport athletes (adjusted odds ratio, 1.80 [95% CI, 1.06-3.04]; P = .03). Athletes with active spondylolysis on MRI at the time of diagnosis had nearly half the odds of having upper level involvement (adjusted odds ratio, 0.55 [95% CI, 0.33-0.91]; P = .02). Conclusion: Age at the time of diagnosis, duration of low back pain, single-sport specialization, and presence/absence of active spondylolysis on MRI at the time of diagnosis were primary predictors of whether an athlete’s lumbar stress injury was classified as either upper or lower level involvement. Overall, the variables included in multivariate analysis were modest predictors, explaining only 15.1% of the variance in the rates of lumbosacral stress injuries classified by spinal level. These specific biomechanical factors and other potential contributors to these findings warrant further investigation.

Incidence and Outcomes of Pregnant Trauma Patients With Positive Urine Toxicology: A Southern California Multicenter Study.

Background: The use of illicit substances during pregnancy has increased 4-fold in the past two decades, negatively impacting both mother and fetus. The rate and clinical outcomes of substance use in pregnant trauma patients (PTPs) are not well studied. We sought to evaluate clinical outcomes of PTPs with positive urine toxicology, hypothesizing a higher rate of in-hospital maternal complications for PTPs with a positive urine toxicology ((+)Utox) compared to those testing negative ((-)Utox). Methods: PTPs (≥18years old) were included in this multicenter retrospective study between 2016 and 2021. We included patients with known urine toxicology results and compared (+)Utox vs (-)Utox PTPs. Results: From 852 PTPs, 84 (9.8%) had a (+)Utox with the most common illicit substance being THC (57%) followed by methamphetamine (44%). (+)Utox PTPs had higher rates of blunt head injury (9.5% vs 4.2%, P = .028), extremity injury (14.3% vs 6.5%, P = .009), domestic violence (21.4% vs 5.9%, P < .001), suicide attempt (3.6% vs 0.3%, P < .001), and uterine contractions (46% vs 23.5%, P < .001). Abnormal fetal heart tracing, premature rupture of membranes and placental injury were similar between groups (all P > .05). The rate of maternal complications was similar in both groups (all P > .05). Conclusion: In this study, the rate of (+)Utox in PTPs was 9.8%. The (+)Utox group had similar rates of maternal complications but more commonly experienced uterine contractions which may be related to the physiology of drugs such as methamphetamines. PTPs with (+)Utox also more commonly were victims of domestic violence and suicide attempt, which merits further prevention research efforts.

Waveform Analysis To Identify Biomechanical Relationships and Differences Between Softball Pitchers With and Without Pain.

Softball pitchers accrue high rates of injury. Research suggests certain mechanics at discrete pitch events are related with pain. Here, we examine relationships between peak throwing shoulder kinetics and trunk/pelvis kinematics and compare trunk/pelvis kinematics between pitchers who were healthy and those currently experiencing pain. (1) Peak shoulder kinetics would be positively related to greater trunk and pelvis flexion, lateral flexion, and rotation; and (2) pitchers in pain would exhibit greater trunk and pelvis flexion, lateral flexion, and rotation during the pitch than those who were pain-free. Cross-sectional study. A total of 42 high school pitchers (height, 1.71 ± 0.06 m; weight, 75.0 ± 15.9 kg; age, 16 ± 2 years) were separated into 2 groups based on presence or absence of pain. Peak kinetic data from 3 pitches per pitcher were averaged and used as dependent variables. Kinematic data were averaged across 3 trials, and time normalized to 101 datapoints between foot contact and follow-through of the pitch. Statistical parametric mapping regressions were used to assess the relationships between peak shoulder kinetics and waveform of trunk and pelvis kinematics. Pelvic lateral tilt significantly predicted peak throwing shoulder superior (P = 0.05) and lateral (P = 0.04) force. Pelvis rotation predicted peak superior force (P = 0.02). Waveform analyses revealed no waveform differences between healthy pitchers and those currently experiencing pain. Peak shoulder kinetic variables are related with pelvic positioning during the pitch; however, trunk and pelvis kinematics do not differ according to presence of pain. Pitchers in pain do not adopt specific trunk and pelvic alterations during the pitch, potentially concealing the effects of pain from visual identification. Coaches and clinicians need to discuss health status with pitchers versus relying on visual observations to understand pain and injury risk.

Design and Test of Seedling-Picking Mechanism of Fully Automatic Transplanting Machine

The seedling retrieval mechanism is a crucial component of fully automatic transplanting machines, significantly influencing the quality, reliability, and efficiency of the transplanting process. Nonetheless, the existing seedling retrieval mechanisms in current transplanting machines exhibit several deficiencies, including substantial damage to seedlings and inadequate retrieval accuracy. To overcome these challenges, we propose an integrated approach combining pneumatic and mechanical techniques to further improve performance. By employing a lower thimble elevation and clamping mechanism, alongside a mathematical model based on the seedling removal process, this method ensures precise seedling extraction and minimizes damage to the root system and substrate. The novelty of this study lies in its ability to reduce the adhesion between seedlings and the holes of the plug plate, thereby minimizing non-destructive extraction of the seedlings and preserving the integrity of the matrix, which is essential for ensuring healthy seedling growth. Moreover, the optimization of the seedling retrieval trajectory enhances the accuracy of the seedling retrieval mechanism while also meeting the requisite speed requirements. Experimental results indicate that at a rate of 72 seedlings per minute, the extraction success rate reached 94.90%, and the casting success rate was 98.53%. The seedling injury rate was only 1.95%, resulting in an overall success rate of 91.69%. These findings confirm that the device meets operational efficiency requirements and delivers effective performance.

Unintended workplace safety consequences of minimum wages

We investigate the unintended impact of minimum wage increases on workplace safety. Using establishment-level data from the United States and a cohort-based stacked difference-in-differences design, we find that large increases in minimum wages have significant adverse effects on workplace safety. Our findings indicate that, on average, a large minimum wage increase results in a 4.6 percent increase in the total case rate. Event study estimates show that this adverse effect persists in the medium run. Furthermore, we find a more salient effect for firms more likely to be financially constrained or subject to a higher labor market rigidity in firing workers. We provide suggestive evidence that small minimum wage increases might reduce injury rates, highlighting the potential heterogeneity in the impact of minimum wage changes. We do not find evidence that capital-labor substitution could be behind the findings.

Experimental Study on Performance of Cotton Small Arch Shed Recovery Machine

Most of the small-arch-shed-recycling machines in China use manual disassembly and manual recycling, with low recycling efficiency and low mechanization. Therefore, this paper designs a small recovery machine for arch sheds, greatly improving the efficiency of the recycling of arch sheds, which can realize the lifting and collection of the arch shed rod and orderly recycling of the shed film. By performing univariate experimental studies in the field, on the basis of field experiments, we carried out an experimental analysis with machine speed and different soil moisture contents as the influencing factors and took the removal rate of the shed rod, the removal rate of the shed film, and the damage rate of seedlings as the test indexes. The test results show that the optimal parameter combination is a travel speed of 1.1 m/s, at which the operation effect is the best. The results show that under the optimal operation effect, the removal rate of the shed rod was 95.72%, the removal rate of the shed film was 98.63%, the seedling injury rate was only 2.11%, and the removal rate of the shed rod was only 4.01%, which met the requirements of the recovery operation of the arch shed and means that this approach is conducive to the recycling of the arch shed materials and the realization of sustainable development. In actual operation, the parameters should be adjusted according to the actual situation in the field to meet the different recovery needs of arch sheds.

Clinical Measures Associated with Subsequent Injury after Adolescent Concussion: A Prospective Cohort Study

ABSTRACT Purpose To examine associations between clinical measures (self-reported and clinician-administered) and subsequent injury rates in the year after concussion return to play (RTP) among adolescent athletes. Methods We performed a prospective, longitudinal study of adolescents ages 13-18 years. Each participant was initially assessed within 21 days of concussion and again within 5 days of receiving RTP clearance from their physician. Participants completed self-report measures: the Pittsburgh Sleep Quality Index (PSQI) and Tampa Scale of Kinesiophobia (TSK), and clinician-administered measures: single and dual-task tandem gait (TG) and reaction time (RT; simple and clinical) assessments. They then completed monthly surveys for a year after RTP which assessed exposure to injury (sport participation) and subsequent injuries (musculoskeletal or concussions) sustained. We used Poisson regression models to calculate injury rate ratios with number of subsequent injuries sustained as the outcome, adjusted for RTP clearance time and competitive exposures for each measure. Results 41 participants were included (age = 15.5±1.3 years, 56% female, 9.6±4.6 days post-concussion; 38.0±31.5 days to RTP). A higher injury rate per athletic exposure was observed for simple RT≥505 ms vs &lt;505 ms (injury rate ratio = 3.22; 95% confidence interval = 1.56, 7.12; p = 0.002). Injury rates did not significantly differ by PSQI or TSK scores, single/dual-task TG time, or clinical RT. Conclusions Simple reaction time may be one risk factor that is associated with higher rates of subsequent injury after adolescent concussion. A simple reaction time measure incorporated into a comprehensive concussion RTP assessment may identify some individuals at higher risk of subsequent injury in the year following concussion, though further research is needed to better understand this relationship.

Outcomes of Pressure Ulcer Injuries Classified by Race: A 10-Year Nationwide Analysis.

Pressure ulcer injuries (PIs) are ischemic changes to the skin caused by long-term pressure on bony prominences. This study aimed to investigate the prevalence of PIs and their effects on minority groups in the hospital setting in the United States. The National Inpatient Sample (NIS) from 2011 to 2020 was used to identify adults hospitalized in the United States who received a diagnosis of PI. International Classification of Diseases, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) codes were used to select patients. An equal number of random records, stratified by year and without a diagnosis of PI, were selected to serve as controls. Records were analyzed for baseline characteristics using a chi-square test. Adjusted odds ratios (ORs) of developing a pressure ulcer were calculated using multivariate logistic regression, a weighted total of 5,993,667 PI admissions were included in this study, and 5,993,667 non-PI admissions were included. PI patients were more likely than controls to be male (OR = 0.88; 95% confidence interval {CI}: 0.88, 0.89; p < 0.05). PI patients were more likely to be older than non-PI patients (75+ years; OR = 3.46; 95% CI: 3.38, 3.54; p < 0.05). PI patients were more likely to be on Medicare or Medicaid (OR = 1.94; 95% CI: 1.92, 1.97; p < 0.05) than private insurance. PI patients were far more likely to have a high Charlson Comorbidity Index (CCI) of 3+ (OR = 10.44; 95% CI: 10.18, 10.71; p < 0.05) than a lower CCI score. Compared to Whites, African Americans (OR = 1.49; 95% CI: 1.47, 1.51; p < 0.05) were at higher risk of PIs. AmongPI patients, White patients had a lower risk of death compared to African Americans (OR = 1.09; 95% CI: 1.07, 1.11; p < 0.05). African Americans had lower rates of acute kidney injury (AKI) compared to Whites (OR = 0.88; 95% CI: 0.86, 0.91; p < 0.05). Compared to Whites, rates of sepsis were higher for African Americans (OR = 1.40; 95% CI: 1.38, 1.42; p < 0.05). A racial discrepancy in pressure ulcer prevalence was shown in racial minorities, particularly African Americans. It is essential to address this difference in diagnosis to improve outcomes among racial minorities.

Epidemiology of neuromuscular injuries in guitar players living in Portugal: Associated risk factors.

Playing guitar involves several physical demands, most inclusive of which are long hours of practice, which can make musculoskeletal symptoms common. To determine the epidemiology of neuromuscular injuries in guitar players residing in Portugal and risk factors. The sample consisted of 105 guitar players, being 103 (98.10%) men, aged between 30-75 years (29,83±10,23). The measurement instrument used was a digital survey, shared by email, on social networks and in person. Fifty-six (53.30%) guitar players had injuries throughout their musical practice, totaling 132 injuries, 13 (12.40%) guitar players were injured at the time of assessment and 31 (29.5%) guitar players had injuries in the last 12 months, totaling 63 injuries. The value of injury proportion was 0.29 (CI 95% : 0.14-0.44) and the injury rate was 0.42 injuries per 1,000 hours of music practice. The most common types of injury were: tendinopathy (22; 34.92%) and low back pain (9; 14.29%). The most affected anatomical sites were: wrist (18; 28.57%) and lumbar spine (10; 15.87%). Repetitive movement was the injury mechanism most mentioned by guitar players (24; 35.29%) followed by maintaining postures for a prolonged period of time (15; 22.06%). Guitar players who did not warm up before practicing were 0.33 (CI: 0.13-0.79; p = 0.013) more likely to have an injury. There was a high percentage of injuries in guitar players and failure to warm up was a risk factor for the development of injuries. This type of study can help in creating injury prevention strategies in this type of population.

Safety Precaution Mechanism and Evaluation Model

Study’s Excerpt A safety management model tailored to the oil and gas industry, which offers a structured approach to mitigating workplace hazards is developed. Questionnaires to assess the hazardous nature of industry operations and evaluate safety performance across multiple firms are used to identify key areas for improvement. The model could enhance safety practices and reduce injury and fatality rates in this critical sector. Full Abstract The increase in the human population raises some fundamental questions about the human ability to protect and take care of its safety. From the foundation of time, humans have demonstrated skills for sustainability. In doing this, there is always a high level of concern about the hazardous nature of the environment. These hazards have hitherto led to severe injuries or death among workers. One key area of the world economy is the oil and gas of which Nigeria as a nation sustained its yearly budget. This model, as developed, addresses and proffers solutions to the safety of lives as it affects the oil and gas industry staff with a heavy focus on those directly on the field. To solve this, this model employed some research measures, such as a questionnaire, to ascertain the gravity of the hazardous nature of the oil and gas industries. The data obtained were subjected to critical evaluation, as seen in the result table 12, and the result shows an improved performance among the examined oil and gas firms in safety management. The data received aided the design and implementation of a safety precaution execution and evaluation model strong enough to mitigate hazards associated with the operational states of staff in the oil and gas industries.

Upper extremity orthopedic softball injuries presenting to the emergency department: epidemiology across the lifespan

ABSTRACT Background Softball is a popular lifetime sport due to its inclusion of both fastpitch and slowpitch varieties, although associated injuries are common. Objective To compare softball injury rates across patient sex, age, race, injury location, mechanism, and activity. Methods The National Electronic Injury Surveillance System (NEISS) was queried for all upper extremity softball injuries in patients 10–85+ years old presenting to United States emergency departments between 2012 and 2021. Results Significantly more of the 178,303 total weighted upper extremity injuries occurred in female (68.1%) than male (31.9%) athletes (p < .001). Male patients (mean 34.9 ± 13.6 years) were older than female patients (17.4 ± 8.4; p = .019). The average incidence rate of UE injuries from 2012–2021 was 187.9 per 100,000 persons, with a significant decrease in injury incidence across the timespan (p < .001). The lowest annual injury incidence (74.7 per 100,000 persons) occurred in 2020. In patients 10–18 years old, female patients accounted for 95.1% of all injuries, whereas male patients accounted for 72.1% of all injuries in patients aged ≥23. Compared to male patients, females more frequently experienced hand (p < .001), lower arm (p = .007), shoulder (p < .001), and wrist (p < .001) injuries in patients 10–18 years old, finger (p < .001), upper arm (p = .016), and wrist (p < .001) injuries in patients 19–22, and finger injuries (p < .001) in patients aged 23 +. Across all ages, the greatest proportion of injuries were treated and released (p < .001). Most injuries occurred while fielding (41.8%) and due to player-ball contact (36.8%). Conclusion Softball injury ED presentations declined across a decade, including a precipitous drop and rebound effect due to the COVID-19 pandemic. Across the lifespan, upper extremity injuries progressively shifted from female-predominant in younger athletes to male-predominant in adults.

The Incidence of Shoulder and Elbow Injuries in High School and Collegiate Softball Athletes: A Systematic Review.

Despite increased youth and adolescent participation in fast-pitch softball and the reporting of upper extremity injuries, there remains a relative paucity of research examining shoulder and elbow injuries in high school and collegiate softball athletes. To evaluate the reported incidence, setting, and positional factors associated with shoulder and elbow injuries in high school and collegiate fast-pitch softball players. PubMed, Ovid, Medline, EMBASE, Scopus, Cochrane Central, and Clinicaltrials.gov. English-language articles reporting the incidence of shoulder and/or elbow injuries occurring in high school or collegiate fast-pitch softball players were included. Biomechanical studies, review articles, abstract only texts, previous systematic reviews, and meta-analyses were excluded. Systematic review. Level 4. Two reviewers independently evaluated studies. Data related to the reported incidence of shoulder and elbow injuries, injury setting, position, and rate of return to play after injury were recorded. A total of 22 studies were identified. In high school athletes, shoulder injury rates ranged from 0.88 to 1.14 per 10,000 athletic exposures (AE), with elbow injury rates ranging from 0.41 to 0.71 per 10,000 AE. In collegiate athletes, reported injury rates ranged from 3.76 to 5.93 per 10,000 AE for shoulder and 1.5 to 3.39 per 10,000 AE for elbow injuries. Shoulder and elbow injuries were reported more commonly during competition in high school athletes, and with greater frequency in the practice setting in collegiate athletes. No association between injury incidence and position was appreciated at either the high school or collegiate level. Most (81%-96%) athletes were able to return to sport within 3 weeks of injury. The incidence of shoulder and elbow injuries was greater in collegiate softball athletes than in high school athletes.

Efficacy of a burn prevention educational program to diminish the incidence of burn injuries in the pediatric population

BackgroundPediatric burn injuries are a significant public health issue in low- and middle-income countries, leading to substantial morbidity and mortality. This study aimed to evaluate the efficacy of the No+Quema2 educational program, implemented in Aguascalientes, Mexico, in preventing burn injuries among children under nine years old. MethodsThe No+Quema2 program, initiated in 2014, included educational courses for children, training for health workers, and specialized care for children with burn sequelae. Epidemiological data on burn injuries from 2014 to 2022 were retrieved from the National System of Epidemiological Surveillance of the Health Ministry of Mexico. Monthly incidence rates per 100,000 inhabitants were analyzed using the Mann-Kendall trend test and segmentation analysis to detect trends and changes. ResultsThe program trained over 25,000 scholars from 1750 elementary schools and distributed medical kits for immediate burn care. Additionally, 200 children with burn sequelae received scheduled treatment. The analysis showed a significant decrease in the state incidence rate of burn injuries compared to the national mean post-implementation. The estimated number of burn injuries prevented during the study period was approximately 3839, or 604 per year. ConclusionThe No+Quema2 program has made a significant impact on burn prevention among children in Aguascalientes, Mexico. Despite the limitations of relying on government-reported data, the correlation between the program's activities and the observed decrease in burn injuries is promising. These findings underscore the critical importance of the No+Quema2 program's activities in achieving sustained, targeted educational interventions and long-term reductions in burn injury incidence. They also highlight the need for more robust study designs to validate these outcomes, emphasizing the importance of evidence-based strategies in future burn prevention efforts.