bluuebunny/crossref_metadata_2025 huggingface dataset:
Statin‐associated immune‐mediated necrotising myopathy: a New Zealand case series showing possible overrepresentation in Pacific Islanders
Authors: Woolley Michelle , Stebbings Simon , Highton John
Published: August 2017

Background

Statin‐associated immmune‐mediated necrotising myopathy (IMNM) is an emerging entity. Being an uncommon condition, our knowledge and understanding is largely based on case series.

Aim

To review incident cases of statin‐associatedIMNMassociated with anti‐3‐hydroxy‐3‐methyl‐glutaryl‐coenzyme A reductase (HMGCR) antibodies in a single New Zealand centre over a 2‐year period.

Methods

Four incident cases of statin‐associatedIMNMwere seen between 2014 and 2016. Their presentation, investigation, treatment and current response to treatment are summarised. Two of the four patients were Pacific Islanders despite a small Pacific Island population in the southern district health board. A literature search was performed focusing on the presentation, investigation and treatment of statin‐associatedIMNMand also genetic associations with this entity to determine whether Pacific Islanders may be at increased risk

Results

All four patients presented with profound weakness and recent exposure to atorvastatin. All proceeded to muscle biopsy. Two biopsies showed typicalIMNM. One biopsy had mild changes, reported as possibly being compatible with anti‐HMGCRantibodies. The final biopsy had features consistent withIMNM, with some features suggestive of polymyositis. Two recent studies have shown an association between anti‐HMGCRantibodies and theHLA‐DRB1*11:01haplotype. Interestingly,HLA‐DRB1alleles (includingHLA‐DRB1*11:01) were observed to be among the most frequent alleles in a Pacific Island population study.

Conclusion

This is the first case series of statin‐associatedIMNMwith a focus on Pacific Islanders and raises the possibility that Pacific Islanders exposed to statins may be at increased risk of developing an immune‐mediated myopathy.
The Negative Effect Fallacy: A Case Study of Incorrect Statistical Reasoning by Federal Courts
Authors: Enos Ryan D. , Fowler Anthony , Havasy Christopher S.
Published: August 2017

This article examines the negative effect fallacy, a flawed statistical argument first utilized by the Warren Court in Elkins v. United States. The Court argued that empirical evidence could not determine whether the exclusionary rule prevents future illegal searches and seizures because “it is never easy to prove a negative,” inappropriately conflating the philosophical and arithmetic definitions of the word negative. Subsequently, the Court has repeated this mistake in other domains, including free speech, voting rights, and campaign finance. The fallacy has also proliferated into the federal circuit and district court levels. Narrowly, our investigation aims to eradicate the use of the negative effect fallacy in federal courts. More broadly, we highlight several challenges and concerns with the increasing use of statistical reasoning in court decisions. As courts continue to evaluate statistical and empirical questions, we recommend that they evaluate the evidence on its own merit rather than relying on convenient arguments embedded in precedent.
Overview of infectious salmon anaemia virus (ISAV) in Atlantic Canada and first report of an ISAV North American‐HPR0 subtype
Authors: Gagné N , LeBlanc F
Published: August 2017

The infectious salmon anaemia virus (ISAV) is an important viral disease of farmed Atlantic salmon that has caused considerable financial losses for salmon farmers around the world, including Atlantic Canada. It is listed as a notifiable disease by the World Organization for Animal Health, and to this day, culling of infected cages or farms remains the current practice in many countries to mitigate the spread of the virus. In Atlantic Canada, ISAV was first detected in 1996 and continues to be detected. While some outbreaks seemed to have arisen from isolated infections of unknown source, others were local clusters resulting from horizontal spread of infection. This study provides a description of the detected ISAV isolates in Atlantic Canada between 2012 and 2016, and explores the phylogenetic relatedness between these ISAV isolates. A key finding is the detection for the first time of a North American‐HPR0 ISAV subtype, which was predicted to exist for many years. Through phylogenetic analysis, a scenario emerges with at least three separate incursions of ISAV in Atlantic Canada. An initial ISAV introduction follows a genotypic separation between North America and Europe which resulted in the NA and EU genotypes known today; this separation predates the salmon aquaculture industry. The second incursion of ISAV from Europe to North America led to a sublineage in Atlantic Canada consisting of EU‐HPR∆ isolates detected in Nova Scotia and New Brunswick, and the predominant form of ISAV‐HPR0 (EU). Finally, we observed what could be the third and most recent incursion of ISAV in Newfoundland, in the form of an isolate highly similar to ISAV EU‐HPR0 isolates found in the Faroe Islands and the one isolate from Norway.
Risk factors for neck and shoulder pain among schoolchildren and adolescents
Authors: Dianat Iman , Alipour Arezou , Asgari Jafarabadi Mohammad
Published: August 2017

Aim

To evaluate the potential risk factors for neck and shoulder pain among schoolchildren.

Methods

Demographic, physical/leisure activity, school‐related and psychosocial factors for neck/shoulder pain were evaluated in a cross‐sectional study of 1611 schoolchildren aged 11–14 years.

Results

Neck and shoulder complaints were reported in 27.9 and 19.0% of the sample, respectively. According to multivariate logistic regression models, high desk height (odds ratio (OR) = 2.23, 95% confidence interval (CI): 1.22–4.07), forward‐inclined seat pan (OR = 2.38, 95% CI: 1.40–4.05), time spent (30–60 min/day) carrying school bag (OR = 1.61, 95% CI: 1.16–2.23) and psychosocial factors (OR = 1.95, 95% CI: 1.03–3.72) independently increased the risk of neck pain, while low body mass index (OR = 0.63, 95% CI: 0.42–0.95) decreased it. Time spent on watching TV (OR = 1.45, 95% CI: 1.02–2.06), backward‐inclined seat backrest (OR = 1.62, 95% CI: 1.02–2.58), curved seat backrest (OR = 1.80, 95% CI: 1.05–3.08), too much homework (OR = 1.45, 95% CI: 1.03–2.03) and psychosocial factors (conduct problems) (OR = 1.63, 95% CI: 1.07–2.46) independently increased the risk of shoulder pain, while prosocial behaviour (OR = 0.56, 95% CI: 0.35–0.90) decreased it.

Conclusion

Both physical and psychosocial factors influenced the risk for neck/shoulder pain in school‐aged children, suggesting that they should be considered in assessment and treatment of such symptoms in this population.
Dynamics of cerebral responses to sustained attention performance during one night of sleep deprivation
Authors: Zhu Yuanqiang , Xi Yibin , Fei Ningbo , Liu Yuchen , Zhang Xinxin , Liu Lin , Xu Ziliang , Sun Jinbo , Yang Xuejuan , Yin Hong , Tian Jie , Qin Wei
Published: August 2017

Total sleep deprivation (TSD) is increasingly common in modern society bringing various neurobehavioural effects. Dynamic changes of behaviour performances during TSD have been reported extensively, while the cerebral activation underlying such changes have not been elucidated clearly. This study aimed to investigate dynamic changes in cerebral responses to the fastest and slowest psychomotor vigilance task (PVT) trials during TSD. Thirty‐six healthy subjects with intermediate chronotype performed the PVT while undergoing functional magnetic resonance imaging every 2 h from 22:00 hours on the first day to 06:00 hours on the second day (i.e. 22:00, 12:00, 02:00, 04:00 and 06:00 hours; a total of five imaging sessions). Behaviourally, significant time effects were found for the PVT performance. For imaging results, significant activation alterations were found in the cognitive control network and the default mode network (DMN) for the fastest and slowest PVT trials, respectively. Time–course analysis indicated that the largest differences for behavioural results and imaging results happened in session 4 and became more prominent in session 5. Our findings provide more detailed information about the process of sustained attention activation during one night of TSD and add information regarding the effect of circadian rhythmicity and homeostatic sleep pressure on regional brain responses.
Hybrid Exponential‐Hyperbolic Discounting and Growth Without Commitment
Authors: Tsoukis Christopher , Tournemaine Frédéric , Gillman Max
Published: August 2017

We analyse the time‐consistent intertemporal behaviour of an individual who discounts the future hyperbolically (HD) in the absence of commitment. In continuous‐time, we extend Barro's (Quarterly Journal of Economics, Vol. 114 (1999), pp. 1125–1152) analysis of a ‘sophisticated’ present‐bias in a deterministic setup and characterize consumption in an analytically tractable way. Furthermore, we embed this analysis into a ‘flexible AK’ model. Greater present bias increases the consumption‐capital ratio, decreases the steady‐state growth rate, while it increases the interest rate‐growth rate wedge. Dynamically, as the interest rate fluctuates over the business cycle, a greater present bias causes the consumption‐output ratio to be more procyclical and volatile, thus helping to resolve the ‘consumption‐output puzzle’. In the transitional dynamics, greater present bias causes a lower steady state capital stock. All of these effects are only present or at least more pronounced under HD than present value‐equivalent exponential discounting.
Combining anti‐IgE with oral immunotherapy
Authors: Lin Chunrong , Lee Ivan T. , Sampath Vanitha , Dinakar Chitra , DeKruyff Rosemarie H. , Schneider Lynda C. , Nadeau Kari Christine
Published: August 2017

Food allergy is a significant medical problem that affects up to 8% of children in developed countries. At present, there are no curative therapies available in routine practice and management of food allergy involves strict allergen avoidance, education, and prompt treatment upon accidental exposure. Oral immunotherapy (OIT) is an efficacious experimental approach to food allergy and has been shown to provide a substantial benefit in terms of allergen desensitization. However, OIT is associated with high rates of allergic reactions, and the period of protection offered by OIT appears to be limited and highly variable. Recurrence of allergen sensitivity after a period of treatment discontinuation is commonly observed. With the aim of overcoming these limitations of OIT, several trials have studied omalizumab (anti‐IgE monoclonal antibody) as an adjuvant treatment for patients undergoing OIT. Results from these trials have shown that the addition of omalizumab to OIT leads to a significant decrease in the frequency and severity of reactions, which allows for an increase in the threshold of tolerance to food allergens. This review provides a summary of the current literature and addresses some of the key questions that remain regarding the use of omalizumab in conjunction with OIT.
Sensory Over‐Responsiveness among Healthy Subjects is Associated with a Pronociceptive State
Authors: Weissman‐Fogel Irit , Granovsky Yelena , Bar‐Shalita Tami
Published: August 2017

Objective

Chronic pain patients show hypersensitivity to sensory nonpainful stimuli. Sensory over‐responsiveness (SOR) to innocuous daily stimuli, experienced as painful, is prevalent in 10% of the healthy population. This altered sensory processing may be an expression of overfacilitation, or a less efficient pain‐inhibitory process in the pain pathways. We therefore aimed to investigate specifically the pain‐inhibitory system of subjects with SOR who are otherwise healthy, not studied as of yet.

Methods

Thirty healthy subjects, divided into an SOR group (n = 14) and a non‐SOR group (n = 16) based on responses to the Sensory Responsiveness Questionnaire, were psychophysically tested in order to evaluate (1) hyperalgesic responses; (2) adaptation/sensitization to 14 phasic heat stimuli; (3) habituation; (4) 6‐minute after‐sensations; and (5) conditioned pain modulation (CPM) (ie, phasic heat stimuli applied with and without hand immersion in a hot water bath).

Results

The SOR group differed from the non‐SOR group in (1) a steeper escalation in NPS ratings to temperature increase (P = 0.003), indicating hyperalgesia; (2) increased sensitization (P < 0.001); (3) habituation responses (P < 0.001); (4) enhanced pain ratings during the after‐sensation (P = 0.006); and (5) no group difference was found in CPM.

Conclusions

SOR is associated with a pronociceptive state, expressed by amplification of experimental pain, yet with sufficient inhibitory processes. Our results support previous findings of enhanced facilitation of pain‐transmitting pathways but also reveal preserved inhibitory mechanisms, although they were slower to react.
Dermoscopic and reflectance confocal microscopic presentation of Hailey‐Hailey disease: A case series
Authors: Oliveira A. , Arzberger E. , Pimentel B. , de Sousa V. C. , Leal‐Filipe P.
Published: August 2017

Background/purpose

Hailey‐Hailey disease is a rare inherited acantholytic skin disorder characterized by heterogeneous clinical presentation. Its differential diagnosis might be wide, including other genodermatoses, inflammatory, and infectious skin diseases. Although histopathology remains as diagnostic gold standard, noninvasive techniques such as dermoscopy and reflectance confocal microscopy may assist clinical examination. Herein, we aim to further characterize the dermoscopic and reflectance confocal microscopic presentation of Hailey‐Hailey disease with histologic correlation.

Methods

Eight patients with Hailey‐Hailey disease were consecutively recruited. All patients were examined using dermoscopy and reflectance confocal microscopy.

Results

In all cases, dermoscopy enabled the visualization of polymorphous vessels, including glomerular and linear‐looped vessels, within a pink‐whitish background. Reflectance confocal microscopy revealed wide suprabasilar partial acantholysis and clefting, crusts, dilated papillae with tortuous vessels, and inflammatory cells. Dyskeratosis, uplocated papillae, and adnexal sparing were also observed.

Conclusion

Although definite diagnosis was obtained by histopathology in all cases, dermoscopy and reflectance confocal microscopy allowed the identification of common features (even in cases with dissimilar clinical presentation) that may support an early diagnosis of Hailey‐Hailey disease, and its differentiation from other more frequent skin disorders.
WHAT'S BEYOND MUSCULOSKELETAL INJURIES IN PROFESSIONAL FOOTBALL? A 1-YEAR PROSPECTIVE STUDY ON MENTAL WELL-BEING
Authors: Gouttebarge Vincent , Aoki Haruhito , Kerkhoffs Gino
Published: August 2017

Background

In contrast to the extensive amount of information available about their physical health, scientific knowledge about the mental well-being of professional footballers is scarce. In addition, the potential relation of musculoskeletal injuries with the mental well-being of professional footballers has not been studied yet.

Objective

To explore the mental well-being (distress, anxiety depression, sleep disturbance, adverse alcohol use) of professional footballers over twelve months and to assess its relation with musculoskeletal injuries.

Design

Observational prospective cohort study with a follow-up period of twelve months was conducted.

Setting

Professional football in five European countries: Finland, France, Norway, Spain and Sweden.

Patients (or Participants)

A total of 540 professional footballers were enrolled (mean age at recruitment was 27 years; mean career duration was 8 years; 55% from the highest national level).

Interventions (or Assessment of Risk Factors)

The total number of time-loss (>4 weeks) injuries occurred during a player's career was examined by a single question.

Main Outcome Measurements

Distress, anxiety depression, sleep disturbance, adverse alcohol use were self-reported through validated scales.

Results

Among professional footballers, twelve-month incidence was 12% for distress, 37% for anxiety/depression, 19% for sleep disturbance and 14% for adverse alcohol use. At baseline, professional footballers who had sustained two or more time-loss injuries during their career were 2.5 to 3.5 times more likely to report distress, anxiety depression, sleep disturbance or adverse alcohol use.

Conclusions

A professional football team typically drawn from a squad of 25 players can expect in one season at least three players to struggle with their mental well-being. This study empowers the need of an interdisciplinary approach to the clinical care and support in professional football.
RECRUITMENT OF BICEPS FEMORIS MUSCLE REGIONS AT DIFFERENT RUNNING SPEEDS
Authors: Hegyi András , Gonçalves Basílio , Finni Taija , Cronin Neil
Published: August 2017

Background

The majority of hamstring strain injuries (HSIs) occur in the late swing phase of high-speed running when hamstrings work eccentrically. The proximal region of the biceps femoris (BF) seems to be the most common site of injury. Elongation of the fascicles in eccentric contractions is higher in the proximal region compared to the distal region of BF, but the neural background to this phenomenon is not clear.

Objective

To examine the region-specificity of BF muscle activity at different running speeds.

Design

Observational study. Running speeds were randomized.

Setting

Laboratory, amateur level.

Participants

Football players without acute injury/illness, and without HSI history were recruited. Data collection is ongoing; six players have been measured and analysed so far.

Assessment

After warm-up, players ran on a treadmill at 12, 15, 18 km/h, and maximum speed. Electromyographic activity (EMG) along the BF and joint angular displacements were recorded with a 16-channel high-density EMG array and 3-D motion analysis, respectively. EMG data were normalized to maximal voluntary isometric contraction.

Main Outcome Measures

Normalized root-mean-square activity was calculated in the proximal, middle and distal muscle regions, and BF elongation was calculated using musculoskeletal modelling.

Results

Higher BF elongation and activity were observed in all regions with increasing speed. Activity in the proximal region was lower compared to the distal region at 15, 18 km/h and maximum speed, by 12, 18, and 35%, respectively.

Conclusions

Lower relative activity in the proximal region and greater proximal-distal differences in activity with increasing speed may indicate why HSIs occur at higher speeds, and mainly in the proximal region. Lower proximal activity may be associated with the higher elongation in this region during eccentric contractions that has been reported previously. Future studies are needed to examine whether players with higher within-muscle heterogeneity in muscle recruitment are at higher risk for HSI.
THE RELATIONSHIP BETWEEN TACKLE COACHING METHODS AND PLAYERS' TACKLE TRAINING ATTITUDES AND BEHAVIOURS
Authors: Hendricks Sharief , Starling Lindsay , Jones Ben , Till Kevin , Lambert Mike
Published: August 2017

Background

The tackle event in rugby is a technical and physical contest between opposing players.

A player's ability to tolerate and contest during a tackle is a prerequisite for safe participation and success in rugby. The attitude and behaviour of players towards safety have been identified as risk factors for injury. How a skill is coached may influence the player's attitude and actions when executing the skill in training and match play.

Objective

The purpose of this study was to investigate the relationship between tackle coaching methods and players' tackle training attitudes and behaviours.

Design

Cross-sectional Survey.

Setting

High Schools.

Participants

164 Under-19 rugby male players.

Assessment of Risk Factors

Questionnaire using a 5-point Likert scale for importance (attitude), quantity (behaviour) and frequency (behaviour).

Main Outcome Measurements

Associations between tackle coaching methods and players' tackle training attitudes and behaviours using the χ2test and Cramer's V.

Results

The more time spent on coaching proper technique to prevent injuries, the higher players rated the importance of injury prevention (28% somewhat important-very important, χ2(16)=29.13, p<0.05, Cramer's V=0.21, moderate). Verbal instruction from the coach, whether to the individual player (29% somewhat important-very important, χ2(16)=30.41, p<0.05, Cramer's V=0.22, moderate) or team (34% somewhat important-very important, χ2(16)=34.04, p<0.01, Cramer's V=0.23, moderate) was positively associated with how important players rated injury prevention.

Conclusions

This is the first study to report on the relationship between tackle coaching methods and players' tackle training attitudes and behaviours. When coaches offered verbal instruction and spent more time coaching proper technique to prevent injuries, players tended to have a more positive attitude toward injury prevention when training the tackle.
FRICTION OF SPORTS FLOORS IN GERMAN MEN'S PROFESSIONAL BASKETBALL AND HANDBALL COMPETITIONS
Authors: Henke Thomas , Patrick Luig
Published: August 2017

Background

With regard to sliding friction sports floor manufacturers focus on comfort and performance aspects of athletes. In relation to safety aspects standardisation bodies rather concentrate on slippery than on dull floors. Thus, sliding friction coefficients from 0.4 to 0.6 (DIN 18032) are recommended. Biomechanical analyses have shown that higher sliding friction values produce higher joint moments and thereby probably increase the risk of acute and chronic injuries to the lower extremities.

Objective

Evaluation of the floor conditions of sports floors used in German men's professional basketball and handball with specific regard to sliding friction.

Design

Pilot study.

Setting

Two highest professional leagues in German men's basketball and handball.

Participants

Overall, eight out of 53 sports floors used in regular league basketball and handball competition, two floors from first and second league respectively, were randomly picked for sample measurement of the floor conditions.

Assessment of Risk Factors

Determination of the friction coefficient by tribometric method (GTE, GMG 200) in four different areas of the playgrounds in each case.

Main Outcome Measurements

Friction coefficient in accordance to DIN 18032 (sports floors), DIN 51131, EN 13893.

Results

In basketball the mean sliding friction coefficient was 0.41, ranging from 0.37 to 0.43. By contrast, in handball the observed mean value was 0.95, ranging from 0.78 to 1.06.

Conclusions

In view of sliding friction, all sample measured basketball floors were in accordance with the DIN 18032 but neither of the evaluated handball floors met these criteria. High sliding friction values were likely to result from intense resin use in handball. With regard to players' safety sports floor manufacturers, clubs and cleaning companies should be aware of this problem and develop targeted cleaning regimes for sports floors used in professional handball competitions. In handball, especially in view of resin use, rather than to the floor type.
CAN WE LIMIT TRAINING DAYS LOST DUE TO OSGOOD SCHLATTERS DISEASE IN JUNIOR SQUASH ATHLETES?
Authors: Horobeanu Cosmin , Jones Thomas , Johnson Amanda
Published: August 2017

Background

High-intensity sports like Squash expose immature athletes to the risk of developing Osgood-Schlatter's (OSD) disease during critical periods of growth. Acute OSD episodes have been associated with changes in training load and recognized as a common cause of lost training days.

Objective

To investigate the influence of periodic OSD monitoring and any subsequent alterations in training load on the number of training days lost.

Design

Prospective data analysis over 2 seasons (80 weeks), repeated measures.

Setting

Elite youth sports academy.

Patients (or Participants)

Highly-trained adolescent Squash athletes (n=9) who were identified as being “at risk” based on; previous episodes of OSD, chronological age (12–15 years) and maturity status.

Interventions (or Assessment of Risk Factors)

On a weekly basis a physiotherapist graded each athlete on a scale of 5 (“free of OSD symptoms”) to 1 (“unable to train”). The grading was based on clinical assessments including; pain level over the tibial tuberosity during palpation, functional movements, and strength assessments of the Quadriceps and Hamstrings. When an athlete was rated ≤3 coaching staff were advised to reduce the training load for the subsequent week. Training load was quantified using Edwards Training Impulse calculated from heart rate data.

Main Outcome Measurements

The number of training days lost due to OSD. Any alterations in training load following a rating of ≤3.

Results

Over the intervention period there were 24 ratings of ≤3. Weekly training load following a rating of ≤3 was significantly lower than the average weekly load (245.4±231.2 Vs. 658.5±154.7 arbitrary units, P<0.001). Five training days lost due to OSD were recorded during the intervention period.

Conclusions

Periodic monitoring of OSD symptoms, with basic clinical tests, appear to alert the medical staff about potential acute onsets. Subsequent recommendations to reduce training load resulted in low training days lost due to OSD.
LOW BACK PAIN PAIN RISK FACTORS IN OLYMPIC CLASS SAILORS OCCUR PRE-REGATTA AND WITHIN THE REGATTA
Authors: Hunt Shawn , Roach Kathryn , Fiebert Ira
Published: August 2017

Background

Hiking activity during sailing involves the hips, trunk, head, and upper extremities held in sustained, unsupported positions over the side of a boat to stabilize it at an optimal angle to the water, preventing velocity loss and overturn. Hiking requires high forces generated by lower extremities and trunk, potentially producing high lumbar spine compression and shear loads linked to acute Low Back Pain.

Objective

This study examined if competitive sailors performing hiking were at increased risk of developing low back pain (LBP) compared to non-hikers over the course of an Olympic class regatta.

Design

Prospective Cohort.

Setting

World Cup Regatta.

Patients (or Participants)

172 Olympic class sailors completed a questionnaire concerning sailing activities, previous history of, and new LBP following a 6-day regatta. 152 subjects without LBP at the beginning of the regatta were classified as exposed (hikers) and unexposed (non-hikers) and new LBP cases were recorded for both groups.

Interventions (or Assessment of Risk Factors)

Relative risk ratios (RR) and CI95%were calculated compared risk of new LBP in hikers and non-hikers.A priorihypothesis tested: hiking sailors are at increased risk for incident LBP versus non-hikers.

Main Outcome Measurements

Self-report LBP limiting sailing.

Results

Twenty-two subjects reported new LBP, 18 from hiking exposure group. Exposed (n=84) and unexposed (n=68) were no different in demographic/anthropometric variables across exposure and disease groups. Boat/equipment unloading time differences persisted across groups (P=0.0016, P=0.0022 respectively). Hikers' raw RR was 3.64 (CI 95% 1.29,10.26) times greater than non-hikers' for developing new LBP. Hikers' risk controlled for unloading time levels yielded an adjusted RR of 2.73 (CI 95% 1.05, 7.08). Hikers exposed to high unloading levels (>2 hours) RR was 8.3 (CI 95% 1.05, 65.76) versus non-hikers.

Conclusions

Hiking and unloading forces may be risk factors for LBP prior to and during Olympic class regattas. Further study recommended.
GOOD EYESIGHT – A BASIC PRECONDITION FOR SAFETY AND PERFORMANCE IN SPORTS
Authors: Jendrusch Gernot , Oertzen-Hagemann Vanessa
Published: August 2017

Background

Good eyesight is a basic precondition for safety but also for performance in sports. Vision has a crucial importance for movement control and balance regulation. Vision helps anticipating, e.g. fast movements in ball games as well as potential accident risks e.g. in one-on-one-situations in football or handball. Investigations show that about 20% of all elite athletes exert their sport ametropic. Nevertheless regular and meaningful visual tests for the analysis of the multidimensional visual performance and the detection of ametropia are only integrated in the health diagnostics of a few sports.

Objective

Aim of the study was to analyze current data of German elite athletes concerning ametropia or different parameters of visual performance; especially considering parameters that are also tested by optometrists or ophthalmologists.

Participants

The study is based on a retrospective analysis of cross-sectional eye test data from different national teams (n=553; age: 21.0±4.0 years) which were collected in the annual routine health check in the last three years (2013–2015).

Results

About 27.5% of athletes use visual aids in daily life, whereas 33.3% of athletes with ametropia are practicing their sports without an optical correction. The median of the (monocular) visual acuity is about 1.85 for men and 1.80 for women (maximum-values considerably above 2.50). Altogether there are 22.6% athletes that are detected as ametropic and thus in need of correction.

Conclusions

All results mentioned and further literature searches show that good eyesight is important from the perception physiology and injury prevention point of view. Visual acuity, contrast sensitivity, depth and motion perception etc. have a significant influence on performance and quality of sports – depending on the specific demands of the discipline. Visual function tests should be included in health diagnostics in order to be able to detect and subsequently correct visual deficiencies at an early stage.
SELF-REPORTED INJURY MECHANISMS IN CLIMBERS
Authors: Jones Gareth , Woodard Cara , Sharples Paul , Johnson Mark
Published: August 2017

Background

Climbing is an increasingly popular sport worldwide. However relatively little is known about the mechanisms of injury sustained by climbers.

Objective

To investigate mechanisms of injury in a representative sample of British climbers.

Design

Retrospective cross-sectional study.

Setting

Online survey of active climbers.

Patients (or Participants)

369 active climbers (men n=307, mean±SD, age=37.66 ±14.38 years; Women n=62, mean ±SD, age=34.63 ±12.19 years).

Interventions (or Assessment of Risk Factors)

Epidemiological incidence proportion (IP) and mechanism of injury.

Main Outcome Measurements

Injuries that resulted in medical intervention and/or withdrawal from participation for ≥1 day.

Results

Of 369 climbers surveyed, 299 sustained at least 1 injury in the last 12 months resulting from climbing. The IP was 0.810 (95% CI: 0.770–0.850). Thus the average probability of sustaining at least one injury was 81% (95% CI: 77–85). The total number of injuries sustained was 1088 providing a clinical incidence of 2.95 injuries per climber. 94 climbers sustained an acute injury as a result of impact with the climbing surface and/or ground, 212 climbers sustained an injury resulting from chronic overuse and 166 climbers sustained injuries resulting from a non-impact acute trauma. The average probabilities of sustaining injury per mechanism were: impact injury 25.5% (95% CI: 23.2–27.8); acute non-impact injury 45.1% (95% CI: 42.5–47.7) and chronic overuse injury 57.5% (95% CI: 54.9–60.1). Injury from chronic overuse was positively associated with indoor lead operating standard (P=0.007), bouldering operating standard (P< 0.001) and bouldering frequency (P< 0.001). The most common injury site was the fingers with 180 participants (60%) sustaining at least one finger injury. 85 participants sustained at least 1 chronic overuse reinjury.

Conclusions

The most commonly reported injury mechanism was chronic overuse. The most common site was the fingers. Chronic overuse injuries due to repetitive loading may have been historically preceded by a non-impact acute trauma.
THE PSYCHOLOGICAL IMPACT OF ELECTROCARDIOGRAM SCREENING IN NATIONAL COLLEGIATE ATHLETIC ASSOCIATION ATHLETES
Authors: Asif Irfan , Annett Scott , Ewing Alex , Abdelfattah Ramy , Rothmier Justin , Harmon Kimberly , Drezner Jonathan
Published: August 2017

Background

Cardiovascular screening is a means to prevent sudden cardiac death in athletes. The American Heart Association has raised concerns that false-positive electrocardiogram (ECG) screening may cause undue anxiety.

Objective

Determine the psychological impact of false-positive ECG screening in NCAA athletes and to stratify experiences based on screening outcome, race, gender, sport, and division of play.

Design

Prospective, multi-site investigation.

Setting

Seven NCAA institutions.

Patients (or Participants)

1192 student-athletes (55.4% male, median age 19 years, 80.4% Caucasian).

Assessment of Risk Factors

Pre-participation screening with a standardized history, physical examination, and ECG.

Main Outcome Measurements

Pre- and post-screen validated assessments for health attitudes, anxiety, and impact of screening on sport.

Results

96.8% of athletes had a normal cardiovascular screen (96.8%), 2.9% had a false-positive ECG, and 0.3% were diagnosed with a serious cardiac condition. Prior to screening, 4.5% worried about cardiac risk and 70.1% preferred knowing about an underlying condition, rather than play sports without this knowledge. There was no difference in anxiety described by athletes with a normal versus false-positive screen (p=0.369). Reported anxiety levels during screening also did not differ when analyzed by different gender, race, division of play, or sport. Athletes with normal and false-positive screens had similar levels of satisfaction (p=0.714) and would recommend ECG screening to other athletes at similar rates (p=0.322). Compared to athletes with a normal screen, athletes with false-positive results also reported feeling safer during competition (p>0.01). In contrast, athletes with false-positive screens were more concerned about the possibility of sports disqualification (p<0.001) and the potential for developing a future cardiac condition (p<0.001).

Conclusions

False-positive results from ECG screening do not cause excessive anxiety in NCAA athletes. Further understanding of athlete experiences could better prepare the practicing physician on ways to counsel athletes with an abnormal ECG in order to address additional concerns.
MECHANISMS OF ANTERIOR CRUCIATE LIGAMENT INJURIES IN VOLLEYBALL
Authors: Karita Yukiko , Kimura Yuka , Yamamoto Yuji , Naraoka Takuya , Sasaki Shizuka , Miura Kazutomo , Tsuda Eiichi , Ishibashi Yasuyuki
Published: August 2017

Background

Knee injuries were common in volleyball players, and ACL injury is a serious injury for athletes.

Objective

The purpose of this study was to investigate the mechanism of ACL injury in volleyball players using a questionnaire.

Design

Research study using a questionnaire.

Setting

Volleyball players who had ACL reconstruction at our institution.

Patients

Twenty-five females and 1 male (mean age; 24.6±11.0 years-old) volleyball players who ruptured their ACL during volleyball and underwent ACL reconstruction.

Assessment of Risk Factors

They were asked about their position, dominant hand defined as the spiking hand, side of injury, event during which the injury occurred (game or practice), the circumstance of injury (the situation in which the injury occurred, the specific motion at the time of injury) and player position and court location where the injury occurred.

Results

There were 19 wing spikers (left 13, right 6). Twenty-four players were right-handed and 2 players were left-handed, and 23 players injured the knees opposite to dominant hand. The 65.4% of injuries were prevalent during game. Twenty players (76.9%) were injured during spiking. Twenty-one players (80.8%) receive injured during landing, and 16 of them injured with single-leg landing after spiking. Most of ACL injuries (84.6%) occurred in front of the attack line near the net.

Conclusions

Single leg landing after spiking close to the net was the most common cause of injury, and most of wing spikers injured the knee opposite to their dominant hand. It suggests that wing spikers need to consider prevention strategies focusing on spiking movement.
THE EPIDEMIOLOGY OF US HIGH SCHOOL FOOTBALL (SOCCER) INJURIES, 2005–06 THROUGH 2013–14
Authors: Khodaee Morteza , Currie Dustin W , Asif Irfan , Comstock R. Dawn
Published: August 2017

Background

Despite the worldwide popularity of football, research on epidemiology of high school injury is sparse.

Objective

To describe high school football injury rates and patterns by type of athletic exposure and gender.

Design

This descriptive epidemiologic study used retrospective analysis of high school sports injury data from a multi-year US surveillance program capturing data from a large national cohort of schools.

Setting

Annually, this prospective surveillance study recruits 100 US high schools with National Athletic Trainers' Association affiliated, athletic trainers to report exposure and injury data for athletes participating in school-sanctioned high school sports.

Participants

Student football players from these nationally representative high schools from 2005–06 through 2013–14.

Assessment of Risk Factors

Independent variables included gender, mechanism of injury, playing position, and field location.

Main Outcome Measurements

Rates and patterns of football-related injuries.

Results

Overall 6154 football injuries occurred during 2,985,991 athlete exposures (AEs); injury rate of 2.06 per 1000 AEs. This corresponded to a national estimate of 3,381,189 US high school football-related injuries. Injury rates were higher in girls (2.33) than boys (1.83) (RR=1.27, 95% CI 1.21–1.34). Player-player contact more commonly resulted in competition injuries (injury proportion ratio [IPR]=2.87; 95% CI 2.57–3.21), while noncontact mechanisms were more common among practice injuries (IPR=2.10; 95% CI 1.86–2.38). Most injuries occurred to midfielders (37.6%), followed by forwards (28.9%), and defenders (23.6%).. The most common activities leading to injuries were general play (24%), defending (13%), and chasing a loose ball (11%). Injury patterns were similar between genders with respect to position played and location on the field at the time of injury.

Conclusions

High school football injury rates vary by gender and type of exposure while injury patterns are more similar across genders. These findings should drive additional research into development, implementation, and evaluation of targeted injury prevention efforts.
THREE-DIMENSIONAL IN-VIVO SCAPULAR KINEMATICS AND SCAPULOHUMERAL RHYTHM: A COMPARISON BETWEEN ACTIVE AND PASSIVE MOTION
Authors: Kim Doo-Sup
Published: August 2017

Background

This study set out to offer a three-dimensional description of scapular kinematics and scapulohumeral rhythm (SHR) of healthy subjects during arm elevation and lowering, as well as to compare and analyse the differences between active and passive motion of the shoulder.

Methods

The study examined the shoulders of ten healthy males (mean age: 23.5 years). The shoulders of the ten healthy participants were elevated and lowered while fluoroscopic images were taken, and three-dimensional bone models were created from 2D to 3D using model registration techniques. The Euler angle sequences of the models' scapular kinematics and SHR were compared during active and passive shoulder motion.

Results

The scapula presented three-way movements of upward rotation, posterior tilting, and external rotation during arm elevation and lowering. During arm elevation, upward rotation showed a statistically significant difference between active and passive shoulder movements (p<0.05). Upward rotation between 45° and 90° showed a statistically significant difference (p<0.05). The scapular posterior tilting from the active motion resulted in more tilting in the high-degree range of motions. Additionally, statistically significant differences were found between active and passive motion (p<0.05). There was no statistically significant difference between the two groups during external rotation. However, during arm lowering, the scapular upward rotation showed a statistically significant difference between active and passive motion (both p<0.05).

Conclusions

In healthy subjects, scapular kinematics showed a statistically significant difference between active and passive motion during elevation in the higher range of motion, but not during lowering. In terms of upward rotation, active shoulders rotated more upward during arm elevation. There was more upward rotation in active shoulders during arm elevation. With regard to passive motion, there was more posterior tilting during arm elevation. The scapular kinematics of upward rotation and posterior tilting showed a linear rotation during arm lowering.
HIGH PREVALENCE OF SUBSTANTIAL SHOULDER PROBLEMS AMONG ELITE ADOLESCENT HANDBALL PLAYERS: THE KAROLINSKA HANDBALL STUDY
Authors: Asker Martin , Holm Lena W , Källberg Henrik , Waldén Markus , Skillgate Eva
Published: August 2017

Background

Recent studies report a high prevalence of shoulder problems in senior team handball players but studies in adolescent players are lacking.

Objective

To measure the season prevalence of substantial shoulder problems (SSP) in elite adolescent handball players.

Design

Longitudinal cohort study with weekly online follow-ups.

Setting

Elite adolescent male and female handball players at handball-profiled high schools in Sweden.

Participants

471 (54% females, mean age 16) were recruited from 10 of 15 national handball-profiled high schools.

Assessment of Risk Factors

The prevalence of SSP, stratified by age, was assessed through repeated online questionnaire data.

Main Outcome Measurements

Season prevalence of SSP during the previous handball season was measured during the pre-season (baseline), and was studied prospectively during the current season via weekly reports using the OSTRC Overuse Injury Questionnaire. SSP was defined as problems leading to moderate or severe reductions in handball participation or performance, or to time-loss.

Results

The weekly response rate was 86–96% and 83% of the players responded to at least 90% of the weekly reports. The previous season prevalence measured at baseline was 8% (95% CI 5–11%) among players in the 1st grade and 20% (95% CI (15–26%) in the 2nd and 3rd grades. During the prospective season, 22% (95% CI 17–27%) of players in the 1st grade reported having SSP, and 27% of players in the 2nd and 3rd grades. Of those with SSP at some point during the previous season, 67% (95% CI 54–77%) also reported SSP at least once during the prospective season.

Conclusions

The season prevalence of SSP is high among adolescent handball players and the prevalence increases when the players start high school. A majority of players with previous SSP also report subsequent SSP problems indicating that the pre-high school period is where prevention strategies preferably should be implemented.
LOWER LEG BIOMECHANICS ASYMMETRIES DURING LANDING AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Authors: Kimura Yuka , Yamamoto Yuji , Naraoka Takuya , Karita Yukiko , Tsuda Eiichi , Ishibashi Yasuyuki , Makino Misato
Published: August 2017

Background

Asymmetries in knee motion have been identified as a risk factor for second anterior cruciate ligament (ACL)injury.

Objective

To investigate the kinematics and kinetics of knee joint and ground reaction force during landing after ACL reconstruction (ACLR).

Design

Controlled laboratory study.

Setting

The patients after ACLR and being cleared to return to competitive sports.

Patients

Four males and 8 females (23.2 years) at 43 (8–152) months postoperatively.

Assessment of Risk Factors

The subjects performed a drop vertical jump by dropping directly down off a box, and immediately performing a maximum vertical jump. The kinematic and kinetic data of the knee joint during landing were measured using 3-dimensional motion analysis system. The concentric peak torque of the quadriceps and hamstring muscle were measured using a dynamometer. KOOS were used to measure patient-reported outcomes.

Main Outcome Measurements

The knee flexion and varus/valgus angle, maximum knee valgus moment and peek vertical ground reaction force (VGRF) during landing were measured.

Results

The knee kinematics was not significantly difference between reconstructed and intact knees. Maximum knee valgus moment of reconstructed knees during landing was 0.2±0.1 Nm/kg/m, and that of intact knees was 0.4±0.2 Nm/k/m. Peek VGRF of reconstructed knees was 1.2±0.2 N/BW, and that of intact knees was 1.7±0.3 N/BW. There was significant difference in maximum knee valgus moment and peak VGRF between reconstructed and intact knees (p<0.05). Normalized muscle strength was above 80%. There were no significant correlations between knee valgus moment, VGRF, muscle strength and KOOS.

Conclusions

Significant asymmetry of knee valgus moment and VGRF has still been observed in ACL reconstructed patients who were satisfied to return to sports, and these were difficult to be predicted by muscle strength and subjective knee function. Assessments of biomechanical asymmetry may support a safer return to sports minimizing re-injury and contralateral injury rate for athletes.
INJURIES AND ILLNESS DURING MASS-PARTICIPATION TRIATHLON RACES: OPTIMISING COMPETITOR SAFETY
Authors: Kipps Courtney , Smith Ralph , Knight Nick , Parkin James
Published: August 2017

Background

Triathlon is an increasingly popular mass-participation endurance sport which incorporates swimming, cycling and running stages over a variety of distances. Overuse injuries during triathlon training are common (Zwingenbergeret al. 2014; Korkiaet al. 1994) however the incidence of illness and injury during triathlon races is less well described. A clear understanding of this data is valuable in planning medical care for mass-participation triathlon races.

Objective

To describe the epidemiology of illness and injuries during triathlon races in the UK.

Design

Retrospective analysis of competitors' medical records (CMRs).

Setting

Two large summer triathlons over 5 years.

Participants

All triathlon competitors requiring treatment by the triathlon medical team (TMT) for illness or injury (excluding first aid).

Assessment of Risk Factors

Age, gender, race distance, race experience, mechanism of injury, co-morbidities, and medical management was recorded.

Main Outcome Measurements

Number of cases of medical illness, musculoskeletal (MSK) injury, and topical injury (e.g. abrasions) treated by the TMT.

Results

There were 68557 starters and 67270 finishers across Supersprint, Sprint, Olympic and OlympicPlus distances (2.3% did not finish) from 11 consecutive events. The TMT treated 429 competitors (0.62%, 1/161 starters) for complaints including falls, fractures, breathlessness and collapse. Medical illness was the most common complaint (44.1%), followed by MSK injury (27.1%) and topical injury (24.8%). There were three cardiorespiratory arrests during the swim leg including two successful resuscitations (1/34279 starters) and one fatality (1/68557). The run leg was responsible for most MSK injuries (41.4% of all injuries) and nearly a third (11/38) of all hospital transfers.

Conclusions

Triathlons have a high incidence of both illness and injury. The swim leg had the most serious medical conditions whilst the run accounted for most injuries. Triathlon organisers should be aware of these findings to ensure optimal medical care and competitor safety at mass-participation triathlon races.