Search Results (6,408)

Monitoring eccentric hamstring strength is critical for reducing injury risk in soccer players, yet laboratory-based technologies such as isokinetic dynamometry remain costly and impractical for field use. The purpose of this study was to examine the association and exploratory predictive relationship between variables derived from a smartphone application (My Jump Lab) and eccentric hamstring strength outputs obtained with an instrumented field device (NordBord, Vald Performance, Australia), while also quantifying their absolute agreement during the Nordic hamstring exercise (NHE). Thirty-one professional soccer players from a second-division United Arab Emirates team performed the NHE on the NordBord, while a simultaneous two-dimensional (2D) kinematic analysis was conducted using the My Jump Lab app (version 5.0 for iOS; My Jump Lab, Madrid, Spain). Pearson correlations, linear regression models, and Bland–Altman analyses were used to distinguish linear association/prediction from agreement/interchangeability. Results revealed a very large association between My Jump Lab-derived torque estimates and NordBord peak torque (r = 0.77, p < 0.001), with moderate associations for breakpoint angle (r = 0.42–0.43). A combined regression model using My Jump Lab torque and breakpoint angle explained 69.2% of the variance in NordBord torque (SEE = 15.30 N·m), although this predictive result should be interpreted as exploratory because the variables are task-specific and partly share anthropometric and mechanical determinants. Bland–Altman analysis revealed poor agreement, with a large systematic difference and proportional bias, indicating that My Jump Lab overestimated torque values at higher strength levels (mean bias = +511.9 N·m). Therefore, torque values derived from the app should be interpreted as relative indicators rather than absolute equivalents to instrumented measurements. From a practical perspective, My Jump Lab may offer a low-cost option for broad screening or relative group profiling when instrumented devices are unavailable, but it should not be used as a substitute for instrumented devices or for individual longitudinal monitoring based on absolute torque values. Full article

Background/Objectives: Traumatic brain injury (TBI) is increasingly understood as a chronic condition, but the role of early post-injury lifestyle behaviors in later cardiometabolic risk remains unclear. We examined whether lifestyle behaviors reported 1 year after injury were associated with the accumulation of common cardiometabolic risk factors by 5 years in the Traumatic Brain Injury Model Systems (TBIMS) National Database. Methods: This retrospective cohort secondary analysis included adults with followed 1-year and 5-year interviews, complete 1-year data on four behaviors, and the complete ascertainment of hypertension, diabetes or high blood sugar, and high cholesterol at both waves. The exposure was a favorable lifestyle count based on not smoking, non-heavy alcohol use, non-obese body mass index, and sports or exercise at least 10 times per month. The primary endpoint was the incident accumulation of at least two new common cardiometabolic conditions between years 1 and 5. The analytic cohort was an observed-data subset defined by follow-up retention, complete behavior data, paired outcome ascertainment, and baseline at-risk status rather than a random sample of all TBIMS participants. Results: Among 10,057 linked participants with followed interviews at both waves, 9593 were adults, 3182 had complete four-behavior exposure data, 689 had complete cardiometabolic ascertainment, and 581 formed the primary at-risk observed-data cohort. The primary endpoint occurred in 39 participants (6.7%). Each additional favorable behavior was associated with lower odds of the primary endpoint in the adjusted model (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.41–0.98; p = 0.040). The results were similar after adjustment for the 1-year Functional Independence Measure cognitive score and in Firth logistic regression. Because the final cohort was selected and the number of primary events was small, the estimates should be interpreted as exploratory and may not generalize to the broader TBI population. Conclusions: More favorable 1-year lifestyle profiles were associated with lower 5-year cardiometabolic risk factor accumulation after TBI. These findings support prevention-oriented follow-up but do not establish causality or validate a prognostic score. Full article

Radiotherapy remains one of the main pillars of cancer treatment and is used in more than half of all oncological patients. Despite continuous technological improvements, ionizing radiation inevitably causes damage to surrounding healthy tissues, leading to acute and chronic complications affecting multiple organs, including the skin, mucosa, heart, lungs, bones and gastrointestinal tract. Radiation-induced injuries significantly impair patients’ quality of life, limit therapeutic doses, and represent a major unmet clinical challenge. Hydrogels have emerged as promising biomaterials for managing radiation-induced damage due to their high content of water, tunable mechanics, and ability to mimic the extracellular matrix. Recent innovations have introduced functional systems, including stimuli-responsive, injectable, and bioactive hydrogels, capable of delivering antioxidants, growth factors, or living cells. Unlike traditional material-based reviews, this work proposes a novel classification framework based on the hydrogel’s mechanism of action within the pathophysiology of radiation injury. We evaluate how specific designs, such as ROS-scavenging matrices, barrier-forming injectable shields, and bioactive delivery vehicles, address distinct phases of inflammation and fibrosis. By providing a comprehensive overview of radiation-induced injuries across different organs, this review summarizes current hydrogel-based strategies for both prevention and therapy. We highlight the potential of these mechanistically aligned systems to protect healthy tissues, suppress chronic inflammation, and promote effective tissue regeneration. Full article

Background/Objectives: Low back and neck pain are common musculoskeletal complaints among healthcare workers, including anesthesia providers. This study aims to quantify the prevalence of back and neck pain amongst anesthesiology providers to identify risk factors, mechanisms of injury, and recovery practices to guide preventative measures. Methods: A cross-sectional survey of anesthesiology clinicians in a multi-site academic healthcare system in New York City was administered using REDCap version 12.5.9. The recorded survey results were aggregated to determine percentages for each question. Descriptive statistics were used to determine the nature of low back and neck pain and detail causes. Oswestry Disability Index (ODI) and Neck Disability Index (NDI) scores were calculated. Results: The survey instrument was distributed to 380 anesthesiology clinicians at four separate institutions and yielded 191 responses for a response rate of 50.3%. Fifty-three-point-nine percent of survey respondents reported having current back or neck pain, with the majority reporting that it was chronic (87.4%). A substantial proportion of respondents reported not having back or neck pain prior to training (58.3%), and the majority reported that their back or neck pain was work-related (54.1%). Only 14.1% of respondents reported having had training in back or neck pain prevention. The most common location of pain was lumbar (81.6%). The most common inciting event for work-related pain was patient transfer/transport (68.6%). For ODI scoring, 98% of clinicians within the health system were classified as minimal disability and 2% of clinicians as moderate disability. For NDI scoring, 95.8% of clinicians were classified as minimally disabled, with 2.6% classified as moderate disabled. Conclusions: Back and neck pain are common pathologies amongst anesthesia providers. For most clinicians, the pain began to occur during training. Common inciting events include patient transfer/transport, procedure performance, and room setup. This provides a framework with which preventative practices can take place to reduce the prevalence of back and neck pain in anesthesiology and other related health care disciplines. Full article

Elite women’s rugby has often been analysed using the male performance model as a reference, despite evidence that women’s rugby presents distinct game demands and potentially different risk profiles. This study aimed to compare the frequency of key contact-related events between elite men’s and women’s rugby. An observational, retrospective, comparative cohort study was conducted using official performance data from 135 international matches from the men’s and women’s Six Nations Championships. Variables were grouped into three categories: Open-Play, Static Phases, and Discipline. Independent samples t-tests, Mann–Whitney U tests, and Linear Discriminant Analysis were used to identify sex-based differences. The results showed that men presented a higher frequency of rucks lasting more than 6 s (p < 0.001), whereas no significant differences were found in total tackles (p = 0.378) or total rucks (p = 0.634). In Static Phases, women’s teams recorded significantly more scrums (p < 0.001). In Discipline, women conceded fewer free kicks (p = 0.003) but received more red cards (p = 0.020). In conclusion, elite women’s rugby shares some open-play characteristics with the men’s game but differs in scrum frequency and disciplinary profile, supporting the existence of a distinct contact and risk exposure profile that should be considered when designing training and prevention strategies. Full article

Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) play essential roles in the brain, influencing neuronal and dendritic growth, as well as neurotransmission. These effects persist throughout life. Numerous studies in animals and humans have demonstrated the beneficial effects of GH therapy on memory and cognitive function, as well as on the restoration of neuronal function following injury. All nerve cells, including neurons, glia, endothelial, epithelial, and perivascular cells, are affected by the actions of GH/IGF-1. IGF-1, in particular, has been associated with cognitive function. The GH-IGF-1 axis increases the proliferation of neuronal progenitor cells and the formation of new neurons, oligodendrocytes, and astrocytes. In this study, we searched databases such as PubMed, Google Scholar, and Embase for human clinical trials evaluating the effect of growth hormone (GH) therapy on dementia, Alzheimer’s disease (AD), post-traumatic brain injury (PTI), and stroke. The following search terms were used: “GH and dementia,” “GH and Alzheimer’s disease,” “GH and TBI,” and “GH and stroke.” Inclusion criteria were all randomized controlled trials and observational studies. Exclusion criteria included the lack of cognitive and memory assessments. We found 28 articles. Most studies show the beneficial effects of GH therapy on memory and recovery of brain function after traumatic injury and stroke; however, consistent data are still lacking. The limited number of clinical trials, the small number of patients, and the lack of data on plasma levels of sex hormones that clearly contribute to brain function are limiting factors. This is the case, for example, with androgens. Other critical factors are dosage and treatment duration. Prolonged administration and supraphysiological doses are more effective in inducing positive clinical changes. Growth hormone (GH) therapy is a very promising intervention for preventing and treating dementia and early-stage Alzheimer’s disease, and it contributes significantly to the recovery of brain function in patients after traumatic injury and stroke. Further studies with more robust methodologies are needed to confirm these results. Full article

Background/Objectives: Dog tethering remains a common containment practice in several regions despite increasing concerns about its implications for animal welfare. This study aimed to assess veterinary professionals’ perceptions in Portugal about the impact of dog tethering on canine health, behavior, and welfare, as well as their views on its regulation. Methods: An anonymous, structured questionnaire was distributed online to veterinary professionals to collect data on clinical exposure to chained dogs, observed health and behavioral outcomes, and attitudes toward criminalizing the practice. Results: A total of 331 veterinarians participated, of whom 71.9% reported encountering chained dogs during their professional activities, particularly in rural areas. Most respondents perceived the tethering conditions as inadequate, particularly regarding freedom of movement and the fulfillment of behavioral needs. Frequently reported consequences included alopecia at the restraint site, poor muscle condition, physical injuries, fear-related behaviors, reduced socialization, and increased aggression. Preventing escape was identified as the primary perceived motivation for tethering. The majority of veterinarians supported some degree of criminalization, particularly when welfare impairment was evident. Conclusions: These findings reflect veterinary professionals’ perceptions of the welfare risks associated with prolonged tethering and underscore the need for integrated strategies combining regulation, education, and accessible, humane containment alternatives. Full article

Background/Objectives: The purpose of this study was to analyze the demographics and injury patterns of children with transportation-related non-fatal injuries occurring on public roads, streets and highways using a nationwide emergency department (ED) database. Methods: Data from the National Electronic Injury Surveillance System (NEISS) All Injury Program (AIP) 2005–2021 was used. Five transportation methods (motor vehicle occupant, bicyclist, pedestrian, motorcyclist, other) occurring on a public highway, street, or road were analyzed. Statistical analyses were performed with SUDAAN 11.0.01™ software to obtain national estimates. Results: There were an estimated 8,188,810 ED visits for traffic-related injuries in children; the median age is 14.3 years. Sex distribution was equal; 93.4% were discharged from the ED, and the head/neck was the most injured area (51.9%). The most common diagnoses were contusion (35.7%), strain/sprain (28.0%), internal organ injuries (13.3%), fracture (8.4%), lacerations (7.4%) and concussions (4.1%). Predictor variable of not being discharged from the ED was the presence of a fracture (OR = 119.7 [71.3, 200.7], p < 0.0001), injury to the trunk (OR = 3.2 [2.7, 3.8], p < 0.0001), a pedestrian (OR = 3.9 [2.8, 5.3], p < 0.0001), those < 1.5 years old (OR = 4.3 [2.8, 6.6], p < 0.001), and males (OR 1.5 [1.4, 1.6], p <0.0001). The greatest prevalence of head/neck fractures was in motor vehicle occupants (23.3%), upper extremity fractures in bicyclists (73.1%) and motorcyclists (49.2%), and lower extremity fractures in pedestrians (56.6%). Conclusions: This detailed study can be used to compare/contrast these injuries to other countries regarding road traffic injuries in children. This data can be used to assess the outcomes of prevention strategies introduced in the future. Full article

Background/Objectives: Foreign-body aspiration (FBA) is a common and largely preventable pediatric emergency, yet current safety standards and risk assessments rely predominantly on object size and on anecdotal descriptions and bronchoscopy findings. We propose a clinically oriented proof-of-concept workflow that combines high-resolution three-dimensional (3D) scanning and calibrated two-dimensional (2D) imaging of retrieved objects with radiomic shape descriptors and large language model (LLM) reasoning to support aspiration risk assessment and guide prevention. Methods: Objects were obtained from the Susy Safe registry and historical series from the University Clinical Centre Tuzla. Each object was digitized with 3D scanning and photographed with a ruler. Morphometric descriptors—including volume, surface area, sphericity, elongation, flatness, curvature and convexity—were computed from stereolithography (STL) meshes; silhouette area, perimeter and Feret diameters were extracted from 2D photographs. Normative airway dimensions from radiographic and computed tomography (CT) studies provided anatomical context. A sharp, irregular metallic object recovered from a child’s laryngo-tracheal tract served as an illustrative case. Results: The object’s major axis approximated the anteroposterior glottic diameter, suggesting potential traversal when longitudinally oriented, whereas its irregular shape increased the likelihood of mucosal laceration and lodging. LLM-based synthesis provided a structured narrative interpretation consistent with a high-risk profile and highlighted preventive implications. Conclusions: Combining 2D/3D morphometry with LLM reasoning provides objective assessment of FBA hazards and may support safer product design, injury-prevention policies, and caregiver education. Full article

Background: Recreational motorized vehicles, including all-terrain vehicles (ATVs), dirt and motor bikes, snowmobiles, and e-scooters, are an increasingly recognized source of severe trauma among children. Adult provincial data from Alberta demonstrate high morbidity, mortality, and more than $6 million in acute care costs from ATV-related injuries over a decade; however, pediatric injury patterns remain under-characterized despite rising exposure. Methods: We conducted a retrospective cohort study of pediatric patients presenting with major trauma (Injury Severity Score > 12) to the Stollery Children’s Hospital between December 2019 and June 2023. Recreational motorized vehicle-related cases were analyzed for demographics, injury mechanisms, injury severity, hospital resource utilization, and clinical outcomes. Available Abbreviated Injury Scale data were reviewed descriptively for a subset of ATV-related injuries. Results: Of 345 pediatric major trauma cases, 55 (16%) involved recreational motorized vehicles, accounting for 17% of major blunt trauma presentations. ATVs were the most common mechanism (58%), followed by dirt/motor bikes (23.6%), snowmobiles (14.5%), and e-scooters (3.6%). Patients were predominantly male (72.7%) with a mean age of 13.1 years. Operative intervention was required in 58.2% of cases, 30.9% required pediatric intensive care unit admission, and mortality was 5.5%. Helmet status was incompletely documented; only 36.4% of patients were recorded as wearing helmets. Children from rural regions accounted for 43.6% of injuries. In the ATV subset with available AIS data, head, facial, and extremity injuries were most common, and all patients sustained at least one serious injury (AIS ≥ 3). Conclusions: Recreational motorized vehicles represent a substantial and preventable cause of severe pediatric trauma in Alberta. When contextualized with adult provincial data demonstrating significant mortality and healthcare costs, these findings support strengthened injury-prevention strategies, improved safety enforcement, and evidence-informed policy approaches. Full article

Background: The importance of evidence-based practice (EBP) is well recognized, yet its implementation remains challenging across healthcare systems, especially in low- and middle-income countries, where resource constraints, workforce turnover, and organizational barriers can hinder practice change. The traditional approach to implementation has focused on training, guidelines, and leadership support; however, these strategies do not always sustain frontline staff engagement. Objective: This descriptive case study examined how social movement strategies supported a multi-year EBP implementation initiative within a Philippine academic–clinical partnership. Methods: Program documents, training records, implementation reports, curriculum materials, and internal records of guideline-related activities were reviewed. Data were organized using the Social Movement Action Framework, with attention to preconditions for change, social movement mechanisms, and implementation outcomes. Results: The initiative included champion training, guideline integration, awareness activities, academic–clinical collaboration, and practice-focused implementation efforts related to breastfeeding, vascular access device management, and pressure injury prevention. These activities provided observable process indicators of stakeholder engagement, shared ownership, and continued use of guideline-informed practices. Conclusions: Social movement strategies may offer a useful complementary lens for understanding how EBP implementation gains momentum in real-world healthcare settings. Additional studies should explore their relationship to implementation outcomes and clinical care processes. Full article

Background: Cannabis legalization has raised concerns regarding its potential influence on injury patterns, particularly among children. However, evidence on pediatric trauma remains limited. Objective: To examine trends in pediatric trauma incidence, injury mechanisms, healthcare utilization, and socioeconomic characteristics before and after recreational cannabis legalization in Nevada. Methods: A retrospective repeated cross-sectional study of trauma registry data was conducted using pediatric trauma activations recorded between 2013 and 2023. Incidence rates per 100,000 population were calculated using census data. Pre-legalization (2013–2016) and post-legalization (2017–2023) periods were compared using incidence rate ratios (IRRs) and bivariate tests. Socioeconomic status was assessed using the Distressed Communities Index (DCI). Results: Among 1772 pediatric trauma activations, overall incidence remained stable (21.6 vs. 21.4 per 100,000; IRR = 0.99, 95% CI: 0.90–1.09). Post-legalization, motor vehicle collision-related injuries increased (49.3% vs. 41.3%, p = 0.002), while pedestrian injuries declined (25.5% vs. 32.4%). ICU admissions decreased (19.5% vs. 27.3%, p < 0.001), although ICU length of stay increased (5.9 vs. 4.0 days, p = 0.005). A higher proportion of patients originated from less distressed communities post-legalization (p = 0.021), alongside shifts in insurance coverage (p < 0.001). Conclusions: Pediatric trauma incidence remained stable following cannabis legalization in Nevada; however, shifts in injury mechanisms, healthcare utilization, and socioeconomic patterns were observed. Because cannabis legalization was assessed at the population level and individual cannabis exposure was not directly measured, findings should be interpreted as temporal associations rather than causal effects. These findings highlight the need for ongoing surveillance and targeted, equity-focused injury prevention strategies. Full article

Background and Clinical Significance: Vitamin B12 deficiency in infancy is an uncommon but reversible cause of severe hematologic abnormalities and potential neurologic injury, particularly in exclusively breastfed infants whose vitamin B12 status depends on maternal stores. Because its clinical presentation may mimic bone marrow failure syndromes or hematologic malignancies, diagnosis can be challenging and delayed; Case Presentation: We report a case of early infantile pancytopenia ultimately attributed to profound vitamin B12 deficiency secondary to maternal celiac disease. Prompt recognition and treatment with cobalamin supplementation resulted in rapid hematologic recovery and a favorable clinical outcome; Conclusions: This case underscores the importance of considering vitamin B12 deficiency in the differential diagnosis of unexplained cytopenias in infants and highlights the critical role of maternal nutritional status in neonatal health. Improved awareness and targeted screening of at-risk mothers during pregnancy and lactation may prevent severe but readily treatable complications in affected infants. Full article

This narrative review explores the potential role of cognitive–motor dual-task training (CMDT) approaches within training methods used in sports clubs, with particular emphasis on soccer clubs, to support performance enhancement, recovery, and injury prevention; improve agility, decision making, and functional readiness; and enhance training quality and specificity. The review discusses how CMDT may be integrated as part of the broader and more comprehensive planning of the club’s full training program, including during the preseason period, as part of preparation for training and competition, within recovery sessions, during periods of high load, and throughout the rehabilitation process and the transition back to team training and contact exposure, while also potentially contributing to variety, mental stimulation, enjoyment, and player engagement. The review also emphasizes the importance of implementing CMDT within a coordinated professional framework, through collaboration and synchronization within the professional and medical staff of the club, and in broad alignment with club goals, player characteristics, and sport-specific demands. The key insight is that CMDT has the potential to serve as a practical, complementary approach that helps bridge the gap between controlled training and rehabilitation settings and the dynamic demands of soccer participation. Based on this review, practical recommendations and future research directions are presented, while emphasizing that CMDT should be applied with caution, through gradual and context-specific progression, and in line with established training, recovery, and rehabilitation principles. Full article