Factors associated with failure to undergo health check-ups in Nagasaki Prefecture, Japan / Journal of Rural Medicine

Objective: Municipal National Health Insurance (NHI) in Nagasaki Prefecture in Japan struggles with poor attendance of health check-ups, which was only 39.6% in 2018. This study aimed to evaluate factors that encourage healthy behaviors, including opting for health check-ups, and the characteristics of middle-aged and older individuals who did not undergo health check-ups.Materials and Methods: This cross-sectional study, using a self-administered questionnaire, was conducted in August 2020 in three municipalities of Nagasaki Prefecture. In addition to questions regarding sociodemographic information, such as sex, age, educational status, self-rated economic status, and family structure, the questionnaire included questions on daily lifestyle habits such as alcohol intake and exercise, current medical treatment, self-rated health, and information related to health check-ups. Of the 18,710 questionnaires distributed in the three municipalities, 8,756 (46.8%) were collected by the end of December 2020, of which 7,840 were valid for analysis. The compliance rate for health check-ups was obtained from the Public Health and Welfare Bureau of Nagasaki Prefecture. Statistical analyses were performed according to two age groups: 40−59 and 60−74 years.Results: Among the respondents who did not undergo health check-ups in the year prior to this study, “lack of time” and being “too bothersome” were the most popular reasons for not attending health check-ups. “Living alone” and “low self-rated economic status” were negative factors for receiving health check-ups regardless of age group.Conclusions: Vulnerable middle-aged and older persons, such as those living alone and with low economic status, were less likely to undergo health check-ups. Emphasis on home visits by public health nurses may also be needed to increase awareness of individual health conditions, especially for people living alone and those who are socioeconomically disadvantaged.

TRIB3 promotes pulmonary fibrosis through inhibiting SLUG degradation by physically interacting with MDM2

Pulmonary fibrosis (PF) is the pathological structure of incurable fibroproliferative lung diseases that are attributed to the repeated lung injury-caused failure of lung alveolar regeneration (LAR). Here, we report that repetitive lung damage results in a progressive accumulation of the transcriptional repressor SLUG in alveolar epithelial type II cells (AEC2s). The abnormal increased SLUG inhibits AEC2s from self-renewal and differentiation into alveolar epithelial type I cells (AEC1s). We found that the elevated SLUG represses the expression of the phosphate transporter SLC34A2 in AEC2s, which reduces intracellular phosphate and represses the phosphorylation of JNK and P38 MAPK, two critical kinases supporting LAR, leading to LAR failure. TRIB3, a stress sensor, interacts with the E3 ligase MDM2 to suppress SLUG degradation in AEC2s by impeding MDM2-catalyzed SLUG ubiquitination. Targeting SLUG degradation by disturbing the TRIB3/MDM2 interaction using a new synthetic staple peptide restores LAR capacity and exhibits potent therapeutic efficacy against experimental PF. Our study reveals a mechanism of the TRIB3-MDM2-SLUG-SLC34A2 axis causing the LAR failure in PF, which confers a potential strategy for treating patients with fibroproliferative lung diseases.

The Effect of Low Tidal Volume Ventilation on Inflammatory Cytokines During Cardiopulmonary Bypass

Abstract Introduction: Halting ventilation during cardiopulmonary bypass (CPB) is implemented to operate in a less bleeding setting. It sustains a better visualization of the operation area and helps to perform the operation much more comfortably. On the other hand, it may lead to a series of postoperative lung complications such as atelectasis and pleural effusion. In this study, we investigated the effects of low tidal volume ventilation on inflammatory cytokines during CPB. Methods: Twenty-eight patients undergoing cardiovascular surgery were included in the study. Operation standards and ventilation protocols were determined and patients were divided into two groups: patients ventilated with low tidal volume and non-ventilated patients. Plasma samples were taken from patients preoperatively, perioperatively from the coronary sinus and postoperatively after CPB. IL-6, IL-8, TNF-α and C5a levels in serum samples were studied with enzyme-linked immunosorbent assay (ELISA) kits. Results: C5a, IL-6, IL-8 and TNF-α were similar when compared to the low tidal volume ventilated and non-ventilated groups (P>0.05) Comparing the groups by variables, IL-6 levels were increased during CPB in both groups (P=0.021 and P=0.001), and IL-8 levels decreased in the ventilation group during CPB (P=0.018). Conclusion: Our findings suggest that low tidal volume ventilation may reduce the inflammatory response during CPB. Although the benefit of low tidal volume ventilation in CPB has been shown to decrease postoperative lung complications such as pleural effusion, atelectasis and pneumonia, we still lack more definitive and clear proofs of inflammatory cytokines encountered during CPB.

F-box motif encoding genes as targets for the development of stress-tolerant traits in Saccharomyces cerevisiae

Stress tolerance is a useful trait actively sought by the bioprocess industry for biofactories dealing with bioconversion of varied raw materials or carbon sources. Fungal or yeast species are useful in bioconversion and are sustainable bioresources for biochemicals and biofuel production. Genetic manipulation strategies are in practice to enhance the tolerance against stress agents for the improved bioconversion process. In this review, we highlight the importance of the F-box motif encoding genes and their interactions in imparting the stress tolerance phenotype to the yeast species. The F-box motif proteins constitute a part of the SCF-E3 ligase complex and are involved in the recruitment, and ubiquitination, followed by degradation of the substrate proteins by the 26S proteasome. It highlights the current scenario on the F-box motif encoding genes and their interaction partners as targets for the stress tolerance phenotype in the yeast and plant species and their utility in the bioconversion processes.

Abstaining from annual health check-ups is a predictor of advanced cancer diagnosis: a retrospective cohort study

BACKGROUND@#Cancer prevention is a crucial challenge in preventive medicine. Several studies have suggested that voluntary health check-ups and recommendations from health professionals are associated with increased participation in cancer screening. In Japan, it is recommended that individuals aged 40-74 years should undergo annual health check-ups; however, the compliance to this recommendation is approximately <50%. According to the national survey, individuals who do not undergo annual health check-ups are at a higher risk for cancer. However, to the best of our knowledge, no previous study has investigated the association between the use of health check-ups and the incidence rate of cancer. We hypothesised that not undergoing periodic health check-ups and/or less use of outpatient medical services are predictors for advanced cancer.@*METHODS@#To explore the relationship between health check-up or outpatient service utilisation and cancer incidence, this retrospective cohort study used data at two time points-baseline in 2014 and endpoint in 2017-from the National Health Insurance (NHI) claims and cancer registry. A multivariable logistic regression analysis was performed to investigate whether cancer diagnosis was associated with health check-up or outpatient service utilisation.@*RESULTS@#A total of 72,171 participants were included in the analysis. The results of the multivariable logistic regression showed that individuals who skipped health check-ups had a higher risk of cancer diagnosis (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04-1.40). Moreover, not undergoing health check-ups increased the risk of advanced-stage cancer (OR, 1.78; 95% CI, 1.29-2.44). Furthermore, increased rate of outpatient service utilisation was negatively associated with advanced cancer diagnosis.@*CONCLUSIONS@#This is the first study reporting that not undergoing health check-ups is a predictor of cancer diagnosis and advanced cancer stage. Primary prevention strategies for NHI members who do not undergo health check-ups must be reassessed. Moreover, future research should examine secondary prevention strategies, such as health education and recommendations from health professionals to facilitate adequate utilisation of preventive health services.

Psicodrama on-line / Online psycodrama / Psicodrama on-line

RESUMEN Hago un breve recorrido por mi experiencia a lo largo de la pandemia. En ella se han mezclado los cambios profesionales y su paso a la modalidad online, las vivencias emocionales personales y las colectivas. Aporto unas ideas, cara a la evolución emocional colectiva a lo largo de la pandemia hasta este momento. Abordo mi actitud ante posiciones negacionistas y como he podido aproximarme emocionalmente a ellas, gracias al psicodrama. Hago referencia la ejercicio que me ayudó a empatizar con esas posiciones, algo particular mente difícil, dentro de un movimiento internacional de psicodramatistas iniciado en Argentina. Me detengo en algunos elementos que cambian al cambiar del espacio presencial al espacio online. Doy algunas ideas de caldeamientos, elección de protagonista y cierres.

ABSTRACT I take a brief tour of my experience throughout the pandemic. In it, professional changes and their transition to online mode, personal and collective emotional experiences have been mixed. I contribute some ideas, facing the collective emotional evolution throughout the pandemic up to this moment. I address my attitude to denialist positions and how I have been able to emotionally approach them, thanks to psychodrama. I refer to the exercise that helped me empathize with those positions, something particularly difficult, within an international movement of psychodramatists started in Argentina. I stop at some elements that change when changing from the face-to-face space to the online space. I give some ideas of warm-ups, choice of protagonist and closings.

RESUMO Faço um breve tour pela minha experiência durante a pandemia. Nele, as mudanças profissionais e sua transição para o modo online, experiências emocionais pessoais e coletivas se misturaram. Contribuo com algumas ideias, voltadas para a evolução emocional coletiva ao longo da pandemia até o momento. Eu abordo minha atitude em relação às posições negacionistas e como fui capaz de abordá-las emocionalmente, graças ao psicodrama. Refiro-me ao exercício que me ajudou a ter empatia por essas posições, algo particularmente difícil, dentro de um movimento internacional de psicodramatistas iniciado na Argentina. Detenho-me em alguns elementos que mudaram na transição do espaço presencial para o espaço online. Dou algumas ideias de aquecimento, escolha do protagonista e encerramentos.

Effect of Advanced Strengthening Program on Physical Fitness Test Performance in Injury Prone Pre-Military Trainee Cadets.

The pre military trainee cadets are mostly unaware about proper training techniques and because of their lack of knowledge they are prone to have musculoskeletal problems especially their shoulder, spine, and knee joint are more prone to any injury. So, in order to avoid injuries, effort was made to make them aware about the risk of getting injured and proper fitness techniques which will prevent their injuries as well as help them to improve fitness level and field performance also. We wanted to evaluate the effect of advance strengthening program on physical fitness test performance in pre-military trainee cadets.METHODSIn this comparative study, injury prone trainee cadets were randomly allocated in to two groups of 25 each with advanced training program. Group one did conventional type of routine exercise; group two followed advanced training protocol. Physical fitness test performance was assessed and compared between the two groups. Outcome measures were Burpees test, shoulder press, chin-ups, planks, leg press, 1600 meters running.RESULTSIn Burpees test, 37% improvement was seen by conventional exercise program; whereas, it was 63% for advanced strengthening exercise program. In shoulder press, 38% improvement was seen for conventional exercise program; whereas, it was 62% for advanced strengthening exercise program. In chin ups, 34% improvement was seen for conventional exercise program; whereas, it was 66% for advanced strengthening exercise program. In planks, 45% improvement was seen with conventional exercise program; whereas, it was 55% for advanced strengthening exercise program. In leg press, 39% improvement was seen with conventional exercise program; whereas, it was 61% with advanced strengthening exercise program. In 1600 meters running, 37% improvement was seen with conventional exercise program; whereas, it was 63% by advanced strengthening exercise program. P value was <0.0001 which is significant.CONCLUSIONSA significant improvement was found in muscle performance, and occurrence of injury was seen to be reduced with advanced training program in injury prone trainee cadets.

Cellular metabolism and homeostasis in pluripotency regulation

Pluripotent stem cells (PSCs) can immortally self-renew in culture with a high proliferation rate, and they possess unique metabolic characteristics that facilitate pluripotency regulation. Here, we review recent progress in understanding the mechanisms that link cellular metabolism and homeostasis to pluripotency regulation, with particular emphasis on pathways involving amino acid metabolism, lipid metabolism, the ubiquitin-proteasome system and autophagy. Metabolism of amino acids and lipids is tightly coupled to epigenetic modification, organelle remodeling and cell signaling pathways for pluripotency regulation. PSCs harness enhanced proteasome and autophagy activity to meet the material and energy requirements for cellular homeostasis. These regulatory events reflect a fine balance between the intrinsic cellular requirements and the extrinsic environment. A more complete understanding of this balance will pave new ways to manipulate PSC fate.

Cellular metabolism and homeostasis in pluripotency regulation

Pluripotent stem cells (PSCs) can immortally self-renew in culture with a high proliferation rate, and they possess unique metabolic characteristics that facilitate pluripotency regulation. Here, we review recent progress in understanding the mechanisms that link cellular metabolism and homeostasis to pluripotency regulation, with particular emphasis on pathways involving amino acid metabolism, lipid metabolism, the ubiquitin-proteasome system and autophagy. Metabolism of amino acids and lipids is tightly coupled to epigenetic modification, organelle remodeling and cell signaling pathways for pluripotency regulation. PSCs harness enhanced proteasome and autophagy activity to meet the material and energy requirements for cellular homeostasis. These regulatory events reflect a fine balance between the intrinsic cellular requirements and the extrinsic environment. A more complete understanding of this balance will pave new ways to manipulate PSC fate.

Cellular metabolism and homeostasis in pluripotency regulation

Pluripotent stem cells (PSCs) can immortally self-renew in culture with a high proliferation rate, and they possess unique metabolic characteristics that facilitate pluripotency regulation. Here, we review recent progress in understanding the mechanisms that link cellular metabolism and homeostasis to pluripotency regulation, with particular emphasis on pathways involving amino acid metabolism, lipid metabolism, the ubiquitin-proteasome system and autophagy. Metabolism of amino acids and lipids is tightly coupled to epigenetic modification, organelle remodeling and cell signaling pathways for pluripotency regulation. PSCs harness enhanced proteasome and autophagy activity to meet the material and energy requirements for cellular homeostasis. These regulatory events reflect a fine balance between the intrinsic cellular requirements and the extrinsic environment. A more complete understanding of this balance will pave new ways to manipulate PSC fate.

Comparative analysis of myocardial protection with htk solution and hypothermic hyperkalemic blood solution in the correction of acyanogenic congenital cardiopathies - a randomized study

Abstract Objective: The goal of the present study was to compare the myocardial protection obtained with histidine-tryptophan-ketoglutarate (HTK) cardioplegic solution (Custodiol®) and with intermittent hypothermic blood solution. Methods: Two homogenous groups of 25 children with acyanotic congenital heart disease who underwent total correction with mean aortic clamping time of 60 minutes were evaluated in this randomized study. Troponin and creatine kinase-MB curves, vasoactive-inotropic score, and left ventricular function were obtained by echocardiogram in each group. The values were correlated and presented through graphs and tables after adequate statistical treatment. Results: It was observed that values of all the studied variables varied over time, but there was no difference between the groups. Conclusion: We conclude that in patients with acyanotic congenital cardiopathies submitted to total surgical correction, mean aortic clamping time around one hour, and cardiopulmonary bypass with moderate hypothermia, the HTK crystalloid cardioplegic solution offers the same myocardial protection as the cold-blood hyperkalemic cardioplegic solution analyzed, according to the variables considered in our study model.

Awareness And Effect Of Janani Suraksha Yojana On Antenatal Care And Institutional Deliveries In Rural, Urban & Tribal Areas Of Ahmednagar District.

Janani Suraksha Yojana (JSY) is a centrally sponsored scheme which is being implemented with the objective of re-ducing maternal and infant mortality by promoting institutional delivery among pregnant women. The Government of India introduced the JSY (safe motherhood program) based on the principles of CCT. Under JSY, cash assistance was given to pregnant women receiving at least three antenatal check-ups (ANCs) and delivering at institutions. The study is undertaken to establish if there is any co-relation of level of awareness about the scheme and its impact on ANC and institutional deliveries in the rural, urban and tribal area of Ahmednagar district. Method: The JSY beneficiaries were asked demographic characteristics, area of residency, educational levels, Category and place of delivery were noted. A set of question (self-designed and pretested) and their responses were noted. Result: Out of 825 JSY beneficiaries, there were total 781 (94.7%) Hindu, Muslim 23(2.8%) and Christian 21 (2.5%) beneficiaries. Majority of Hindu reli-gion JSY beneficiaries. Only few member from BPL JSY beneficiaries have opted for delivery at private hospital. Maximum deliveries taking place in civil hospital are from BPL category. It was observed that the awareness level about JSY is low in tribal area compared to the rural and urban area. It was also seen that 648 (78.54%) JSY benefi-ciaries availed free transport facility out of which 358 (55.24%) fall in high level of awareness category. There is a positive relation between age group and awareness about JSY. Conclusion: 46.8% women with high awareness about JSY scheme, it is a programme for pregnant women which aims at safe institutional delivery. Other factors such as education of mother, religion, culture, area of residence, family type played important role in utilization of available maternal health scheme.

Factors Related to Physical Health Monitoring in Community-Dwelling Patients with Schizophrenia Spectrum Disorder / 대한정신분열병학회지

OBJECTIVES: To identify factors related to physical health monitoring of patients with schizophrenia spectrum disorder. METHODS: A total of 172 patients with schizophrenia spectrum disorder registered in mental health welfare centers and rehabilitation facilities in Gwangju were recruited. Physical health monitoring was defined by two health behaviors; fasting blood tests within recent 2 years in all participants and routine medical check-ups covered by national insurance within recent 5 years in participants aged 40 years or older. Demographic and clinical characteristics including overweight, metabolic syndrome and knowledge about physical illness were compared according to physical health monitoring. RESULTS: Prevalence of overweight and metabolic syndrome were 62.8% and 40.1%, respectively. The rates of fasting blood tests and routine medical check-ups were 34.9% and 67.9%, respectively. The rates of fasting blood tests were significantly higher in general hospital and university hospital compared to mental hospital or private clinic. Rates of routine medical check-ups were significantly lower in individuals using daily rehabilitation service and smokers. Knowledge about cancer and chronic illness were significantly better in individuals receiving routine medical check-ups compared with those not receiving it. CONCLUSION: Education about physical health should be integrated to mental health service in community mental health center.

Genome-wide identification, characterisation and expression profiling of the ubiquitin-proteasome genes in Biomphalaria glabrata

BACKGROUND Biomphalaria glabrata is the major species used for the study of schistosomiasis-related parasite-host relationships, and understanding its gene regulation may aid in this endeavor. The ubiquitin-proteasome system (UPS) performs post-translational regulation in order to maintain cellular protein homeostasis and is related to several mechanisms, including immune responses. OBJECTIVE The aims of this work were to identify and characterise the putative genes and proteins involved in UPS using bioinformatic tools and also their expression on different tissues of B. glabrata. METHODS The putative genes and proteins of UPS in B. glabrata were predicted using BLASTp and as queries reference proteins from model organism. We characterised these putative proteins using PFAM and CDD software describing the conserved domains and active sites. The phylogenetic analysis was performed using ClustalX2 and MEGA5.2. Expression evaluation was performed from 12 snail tissues using RPKM. FINDINGS 119 sequences involved in the UPS in B. glabrata were identified, which 86 have been related to the ubiquitination pathway and 33 to proteasome. In addition, the conserved domains found were associated with the ubiquitin family, UQ_con, HECT, U-box and proteasome. The main active sites were lysine and cysteine residues. Lysines are responsible and the starting point for the formation of polyubiquitin chains, while the cysteine residues of the enzymes are responsible for binding to ubiquitin. The phylogenetic analysis showed an organised distribution between the organisms and the clades of the sequences, corresponding to the tree of life of the animals, for all groups of sequences analysed. The ubiquitin sequence was the only one with a high expression profile found in all libraries, inferring its wide range of performance. MAIN CONCLUSIONS Our results show the presence, conservation and expression profile of the UPS in this mollusk, providing a basis and new knowledge for other studies involving this system. Due to the importance of the UPS and B. glabrata, this work may influence the search for new methodologies for the control of schistosomiasis.

Analysis of Factors that Affect the Follow-up Pattern after Dental Treatment under Conscious Sedation in Children / 대한소아치과학회지

Children need regularly dental check-ups after dental treatment because there are a lot of changes of oral conditions such as tooth exfoliation and eruption, occlusion, and recurrence of dental caries. The purpose of this study is to determine the factors that affect the follow-up pattern after dental treatment under conscious sedation.Patients who were treated under sedation at the department of pediatric dentistry of Ewha Womans University Mokdong Hospital from 2009 to 2013 were included in this study. The final samples comprised of 562 patients that were classified into 4 groups according to the number of visits during 3 years. The chi-square test was used to determine the factors affecting regular follow-up.There were statistically significant differences between each treatment groups and factors such as the change of doctor, overall treatment time, the number of treated teeth under sedation, restorative treatment, minor operation, and preventive treatment (p < 0.05).This study identified factors that affect regular follow-up after dental treatment under conscious sedation. It is recommended to educate the importance of regular check-ups to parents who are less likely to return.

Effect of Pantoprazole on Skeletal Muscle Loss in a Mouse Model of Cancer Cachexia / 中山大学学报(医学科学版)

[Objective]To investigate the effect of pantoprazole on skeletal muscle wasting in cancer cachexia and the possible mechanism.[Methods]24 male BALB/c mice were randomly divided into control group(NN),cancer cachexia group(CC),pantrop?razole treatment group(PPI). The mice in CC and PPI were inoculated subcutaneously with mouse colon adenocarcinoma C26 cells to establish a model of cancer cachexia. The mice in PPI group were gavaged with 75 mg/kg pantoprazole dissolving in physiological saline,while those in NN and CC group were gavaged with 0.1 mL/10 g physiological saline. The mice were killed 12d after treatment. The weight of gastrocnemius and tumour and the size of tumour were measured. The morphological change of skeletal muscle were evalu?ated by the method of stain with hematoxylin and eosin(H&E). The levels of IL-6 and TNF-αin serum were tested by ELISA. qRT-PCR was used to assess the expression of mRNA of Myod1 and myf5 in skeletal muscle. The protein expressions of MuRF1,MAFBx, Myod1 and myf5 were measured by Western blot.[Results]Compared with CC group ,pantoprazole can increase the weight of mice and gastrocnemius(39.8% and 24.2%,respectively),cross section area(25.4%),levels of mRNA and protein of Myod1 and myf5(P<0.05),while the levels of IL-6 and TNF-αdecreased(30.7%and 18.9%,respectively),as well as the levels of protein ex?pression of MuRF1 and MAFBx(P < 0.05).[Conclusion]Pantoprazole can attenuate the wasting of skeletal muscle,the potential mechanism may be related to the inhibition of inflammatory factors and UPS ,and up-regulation of Myod1 and myf5.

Overview on application of metabonomics in study on Chinese materia medica property theory / 中草药

Metabonomics as an important component of systems biology, the research idea is similar to the overall concept in the research of traditional Chinese medicine (TCM). In recent years, with the vigorous development of metabonomics, its application is more and more widely in modern research of Chinese material medica (CMM). In this paper, based on the introduction of origin, development, research content, and method of metabonomics, and at the same time its application on medicinal properties in TCM theory, including four Qi, five tastes, meridian entry, direction of medicinal actions (upward, downward, outward, and inward), toxicity, compatibility of medicines, and the contraindication of application, are summarized. The preliminary analysis and sums up of research problems and development trend on the metabonomics applying in TCM property theory have been brought forward.

The quality of life and curative effect among elder patients after total knee replacement surgery for severe knee osteoarthritis / 中国组织工程研究

BACKGROUND:Total knee replacement is regarded an effective treatment of knee osteoarthritis, based on the transformation of biology-psychology-social medicine pattern, the concept of“quality of life”has attracted increasing concerns. OBJECTIVE:To observe the effects of total knee replacement surgery on the pain, function and quality of life among elder patients with severe knee osteoarthritis. METHODA total of 102 elder patients with severe knee osteoarthritis were recruited from the Second Affiliated Hospital of Inner Mongolia Medical University between January 2010 and January 2013. The clinical manifestations and 12-month fol ow-up outcomes were observed and recorded. The involved patients were randomly divided into two grouptreatment group (59 cases, receiving total knee replacement) and control group (43 cases, receiving expectant treatment such as drugs, but no surgery). Patients were evaluated using HSS scale and WHOQOL-100 scale before surgery and 12 months after surgery. Furthermore, the correlation between influencing factors and HSS and WHOQOL-100 scores was analyzed. RESULTS AND CONCLUSION:At 12 months postoperatively, the HSS scores of patients in treatment group was (82.03±10.17) points, which was obviously higher than that in control group (P0.50). The regression analysis shows that marital status (β=1.988), complication (β=2.035) and HSS scores (β=2.108) are the main influencing factors for the quality of life among patients undergoing replacement. Experimental findings indicate that, HSS score is an effective indicator to assess the effect of total knee replacement on the pain and function of elder patients with severe knee osteoarthritis. WHOQOL-100 is introduced to further improve the assessment of quality of life after total knee replacement surgery in severe knee osteoarthritis. The marital status, complication and HSS scores are the key influencing factors for the quality of life among severe knee osteoarthritis patients. Deep vein thrombosis affects the out-of-bed time, and the mate-accompanying during the fol ow-ups plays a positive role on the quality of life and mental state of patients.

U.S. Coast Guard Academy Injury and Risk Factor Study.

Purpose: Injury rates and injury risk factors were examined for the first time among cadets undergoing Summer Warfare Annual Basic (SWAB) training at the U.S. Coast Guard Academy (USCGA). Methods: Participants were 778 men and 286 women from four years of SWAB training. Before SWAB training, the subjects were administered a Physical Fitness Assessment (PFA) (2-minute maximal effort sit-ups and 1.5 mile run) and functional movement screening (FMS) test. Height and weight were measured and, gender, age and ethnicity were obtained from administrative records. Training-related injuries were compiled from student medical records. The diagnosis, body part location, disposition, and limited duty days were recorded for each clinic visit. Results: During the 8 weeks of SWAB training, 23.8% of the women and 18.4% of the men were injured at least once. Compared to the men, the odds of an overall injury among women was 1.39 (95% confidence interval= 1.00-1.92). The odds of an overuse injury among women was 1.72 (95%confidence interval= 1.21-2.43) times higher than the men and the number of limited duty days for overuse injuries was also higher among the women (p <0.01). Independent risk factors for injuries among both men and women included lower aerobic fitness and lower functional movement screening scores. Conclusions: Female USCGA cadets were at higher risk of injuries, especially overusetype injuries. Specific factors that put cadets at higher injury risk included lower aerobic capacity and inefficient movement strategies. Future injury studies should focus on females, aerobic fitness, and movement strategies. Prevention strategies should be tested to reduce injuries to limit lost training time.