Injury incidence and characteristics in adolescent female football players: A systematic review with meta-analysis of prospective studies.

To observe overall, training, and match injury incidence in female youth football. We also aimed to quantify the incidence of injuries by affected tissue and body location. The following databases were examined: PubMed, Web of Science, Scopus, SPORTDiscus, Cochrane and PEDro. Papers that reported overall injury incidence, training or match injury incidence were included. Additionally, studies had to be performed in adolescent female football players (13-19 years of age). The Newcastle-Ottawa Scale and the checklist of items that must be included in epidemiological football reports were used to assess methodological quality of the included articles. For the meta-analyses, a random effect model was used. A total of 13 studies were included. There were 2,333 injuries; incidence was higher during games (12.7/1000 h) compared to training sessions (2.3/1000 h). The injury match-to-training ratio was 5.8. The lower limbs were the region in which the greatest number of injuries occurred, with the ankle (1.2/1000 h) and knee (0.8/1000 h) having the most injuries. In relation to injured tissue, ligament injuries represented an incidence of 1.3/1000 h, followed by muscle injuries (0.9/1000 h). This study represents the first step towards the creation and implementation of preventative measures in female youth football. The results suggest that attention should be focused on ankle and knee injuries, since they are the most frequent and can lead to sport retirement in some cases depending on the severity.

Ethnicity-Based Variations in Focal Adhesion Kinase Signaling in Glioblastoma Gene Expression: A Study of the Puerto Rican Hispanic Population.

Glioblastoma (GBM), an aggressive form of brain cancer, has a higher incidence in non-Hispanics when compared to the US Hispanic population. Using data from RT-PCR analysis of 21 GBM tissue from Hispanic patients in Puerto Rico, we identified significant correlations in the gene expression of focal adhesion kinase and proline-rich tyrosine kinase (PTK2 and PTK2B) with NGFR (nerve growth factor receptor), PDGFRB (platelet-derived growth factor receptor B), EGFR (epithelial growth factor receptor), and CXCR1 (C-X-C motif chemokine receptor 1). This study further explores these correlations found in gene expression while accounting for sex and ethnicity. Statistically significant (p < 0.05) correlations with an r value > ±0.7 were subsequently contrasted with mRNA expression data acquired from cBioPortal for 323 GBM specimens. Significant correlations in Puerto Rican male patients were found between PTK2 and PTK2B, NGFR, PDGFRB, EGFR, and CXCR1, which did not arise in non-Hispanic male patient data. The data for Puerto Rican female patients showed correlations in PTK2 with PTK2B, NGFR, PDGFRB, and EGFR, all of which did not appear in the data for non-Hispanic female patients. The data acquired from cBioPortal for non-Puerto Rican Hispanic patients supported the correlations found in the Puerto Rican population for both sexes. Our findings reveal distinct correlations in gene expression patterns, particularly involving PTK2, PTK2B, NGFR, PDGFRB, and EGFR among Puerto Rican Hispanic patients when compared to non-Hispanic counterparts.

Epidemiology of injuries in elite female rink hockey players: A two season observational study.

OBJECTIVES: To record the time-loss injuries of female rink hockey players and describe the affected region, tissue, and onset of injury. DESIGN: Cross-sectional survey study. SETTING: First (Ok Liga) and Second (Plata) division clubs. PARTICIPANTS: 280 player-seasons. MAIN OUTCOME MEASURES: Incidence of overall, training, and match injuries (number of injuries per 1000 h) from two seasons. RESULTS: A total of 229 injuries occurred in 56,438 h of exposure. The overall incidence was 4 injuries per 1000 h (4/1000 h), with a significantly higher rate of injuries during matches (15.2/1000 h) compared to training sessions (2.6/1000 h) (p < 0.001). Injuries affecting the lower limb were the most common (2.3/1000 h), followed by upper limb (1.2/1000 h), and head/trunk (0.6/1000 h). The tissue with the highest incidence of injury was the muscle/tendon (1.3/1000 h), followed by the ligament (0.8/1000 h). Around one in every three injuries (31%) affected either the thigh or hip/groin (73 injuries). CONCLUSIONS: The injury incidence in elite female rink hockey is moderate and occurs mainly during match sessions. Preventative measurements should be implemented in rink hockey with a special concern for injuries affecting the thigh, and hip/groin.

Intramedullary Spinal Cord Tumors: Whole-Genome Sequencing to Assist Management and Prognosis.

Intramedullary spinal cord tumors (IMSCTs) harbor unique genetic mutations which may play a role in prognostication and management. To this end, we present the largest cohort of IMSCTs with genetic characterization in the literature from our multi-site institutional registry. A total of 93 IMSCT patient records were reviewed from the years 1999 to 2020. Out of these, 61 complied with all inclusion criteria, 14 of these patients had undergone genetic studies with 8 undergoing whole-genomic sequencing. Univariate analyses were used to assess any factors associated with progression-free survival (PFS) using the Cox proportional hazards model. Firth's penalized likelihood approach was used to account for the low event rates. Fisher's exact test was performed to compare whole-genome analyses and specific gene mutations with progression. PFS (months) was given as a hazard ratio. Only the absence of copy neutral loss of heterozygosity (LOH) was shown to be significant (0.05, p = 0.008). Additionally, higher risk of recurrence/progression was associated with LOH (p = 0.0179). Our results suggest LOH as a genetic predictor of shorter progression-free survival, particularly within ependymoma and glioblastoma tumor types. Further genomic research with larger multi-institutional datasets should focus on these mutations as possible prognostic factors.

Injury characteristics of young elite inline speed skaters: A one season retrospective study.

OBJECTIVES: Determining the rate of injuries related to a certain sport is accepted as the primary step toward designing, implementing and evaluating injury prevention programs. This observational and retrospective study was to examine the injuries sustained by elite young Spanish inline speed skaters during a season. METHODS: Athletes participating in the national championship (n = 80) were surveyed via an anonymous online questionnaire to screen for injury characteristics: incidence, location, and tissue affected; plus training information and demographics. RESULTS: A total of 52 injuries were recorded across 33,351 hours of exposure, which gives a rate of 1.65/1,000 h. The lower body comprised 79% of the total amount of injuries (1.3/1000 h), and the main areas affected were the thigh and foot, accounting for 25% and 19.2% of the recorded injuries, respectively. Musculotendinous injuries were the most frequent, with an incidence of 0.92/1000 h. No significant gender differences were observed for any of the variables studied. CONCLUSION: Speed skating can be considered a low injury rate sport based on our findings. The risk of sustaining an injury was independent of gender, age, and BMI.

Epidemiology of Rink Hockey-Related Injuries.

CONTEXT: Determining the rate of injuries related to a certain sport is accepted as the primary step toward designing, implementing, and evaluating injury prevention programs. The aim of this study was to examine the injuries sustained by semiprofessional Spanish rink hockey players and to compare data per playing position. DESIGN: Observational and retrospective. METHODS: Athletes from 21 teams were surveyed via a self-reported questionnaire to screen for incidence, injury burden, location, tissue, and onset of injuries. RESULTS: Overall, 101 time loss injuries were reported across 22,241 hours of exposure, giving rise to an incidence rate of 4.5/1000 hours. The main body regions injured were the hip/groin, shoulder, thigh, and head, accounting altogether for 47.5% of all injuries. Musculotendinous injuries were the most frequent, comprising 27.7% of all injuries. Incidence accounted for 3.1/1000 hours during training and 23/1000 hours during games (P < .001). A high number of injuries were caused by contact (46.5%). No differences were found for any of the variables analyzed between outfield players and goalkeepers. CONCLUSION: The injury incidence in rink hockey is moderate, occurring mainly due to a contact mechanism. Preventative measurements should be implemented in rink hockey with a special concern for injuries affecting the hip/groin and head.

Characterising groin pain in rink hockey: Function and five-second squeeze in Spanish players.

OBJECTIVES: To assess the relationship between history of past season groin pain and current pain during the five-second squeeze test (5SST) with groin function and adductor strength in rink hockey players. DESIGN: Cross-sectional. SETTING: First (Ok Liga), Second (Plata) and third division (Bronce) clubs. PARTICIPANTS: Sixty-eight female and 183 male hockey players. MAIN OUTCOME MEASURES: Seasonal prevalence of groin pain (time/non-time-loss). Adductor strength and pain during the 5SST. Function was evaluated with the Hip and Groin Outcome Score (HAGOS). RESULTS: Seasonal time-loss groin pain prevalence was 21%. Male players had 3.5 higher odds of having had an episode of time-loss groin pain during the previous season compared to female players. The adductor relative strength was no different between players with and without previous season groin injury (p = 0.53-0.55), while the HAGOS results differed between groups, with past season groin injury players obtaining lower values in all subscales. HAGOS scores differed between the 5SST pain intensity groups (p < 0.01). CONCLUSIONS: Male players had higher odds of having had a groin injury in the previous season compared to female players. Players with pain during 5SST and previous season groin injury reported functional deficits, while strength remains identical to their healthy counterparts.

Development of a Neurosurgical Cadaver Laboratory despite Limited Resources.

OBJECTIVE: Our neurosurgical program did not have a cadaver laboratory. The need to create one arose following a decrease in elective cranial cases at our institution after Hurricane Maria. Many neurosurgical programs are in countries where financial support for projects such as developing a cadaver research laboratory cannot be expected from their parent institutions. This article describes how, despite limited resources, a neurosurgical cadaver dissection laboratory can be created and maintained to promote resident education and stimulate future research. MATERIALS AND METHODS: The University of Puerto Rico Institutional Review Board evaluated and approved the proposal for creating a neurosurgical cadaver laboratory. The process to establish the laboratory was broken into steps. After obtaining the basic materials, the laboratory was created. RESULTS: The creation of our neurosurgical cadaver laboratory was divided into discrete steps that can be undertaken by any institution with a similar goal. First, a suitable workspace was identified. Second, the surgical instruments and equipment required to perform dissections were obtained. Third, cadaveric specimens for dissection and for practicing surgical approaches were acquired. Last, documentation regarding the laboratory's development was maintained, and an expansion plan was created. We created a dissection laboratory by gathering decommissioned or donated operating room equipment, seeking out contributions from other institutions, and, sometimes, by monetary contribution from the faculty or residents. CONCLUSION: Clear goals, interdepartmental collaboration, and a high degree of motivation were essential in creating, despite limited resources, a working neurosurgical cadaver laboratory to improve resident education.

Injury Characteristics among Young Adults during and Immediately after the COVID-19 Lockdown.

The lockdown due to the COVID-19 pandemic inherently changed people's lifestyles. Forty-eight days of isolation led to worsening physical fitness in addition to the development of other unhealthy habits. The aim of this study was to describe sport-related injuries in the active general population. Physical therapy centres and sports medicine clinics were contacted via e-mail, seeking patients who had sustained an injury during or immediately (up to two weeks) after the lockdown. Patients who agreed to participate completed an online survey that followed the International Olympic Committee Statement. The questionnaire focused on physical exercise habits, type of injury, location and tissue affected. A total of 51 females and 67 males (30.5, SD = 8.8 years) participated in the study. Eighty percent of the participants performed aerobic training sessions, while the rest dedicated their workouts to strength training. Two in every three injuries were located in the lower limbs, and 80% affected the musculoskeletal tissue. Of all the injuries recorded, 67% occurred during the first week after lockdown. The number of aerobic exercise sessions was positively correlated with lower limb injuries (χ2 = 17.12, p < 0.05). Exercise habits should be considered when planning to return to a sport after a period of confinement to avoid injury.

A coarse-grained approach to model the dynamics of the actomyosin cortex.

BACKGROUND: The dynamics of the actomyosin machinery is at the core of many important biological processes. Several relevant cellular responses such as the rhythmic compression of the cell cortex are governed, at a mesoscopic level, by the nonlinear interaction between actin monomers, actin crosslinkers, and myosin motors. Coarse-grained models are an optimal tool to study actomyosin systems, since they can include processes that occur at long time and space scales, while maintaining the most relevant features of the molecular interactions. RESULTS: Here, we present a coarse-grained model of a two-dimensional actomyosin cortex, adjacent to a three-dimensional cytoplasm. Our simplified model incorporates only well-characterized interactions between actin monomers, actin crosslinkers and myosin, and it is able to reproduce many of the most important aspects of actin filament and actomyosin network formation, such as dynamics of polymerization and depolymerization, treadmilling, network formation, and the autonomous oscillatory dynamics of actomyosin. CONCLUSIONS: We believe that the present model can be used to study the in vivo response of actomyosin networks to changes in key parameters of the system, such as alterations in the attachment of actin filaments to the cell cortex.

Injury in CrossFit®: A Systematic Review of Epidemiology and Risk Factors.

OBJECTIVE: To review the characteristics of the injuries among CrossFit® practitioners, including prevalence and incidence, nature, location, and risk factors. METHODS: PubMed/MEDLINE, EMBASE, Web of Science, Scopus, and SPORTDiscus databases were searched from inception through August 2020, and English-language articles reporting on CrossFit®-related injuries were included. Data including sample (sex, age, and demographics) and injuries' characteristics (prevalence, incidence rate, nature, location, percentage of injuries requiring surgery and risk factors) were extracted. RESULTS: Overall, twenty-five studies involving a total of 12,079 CrossFit® practitioners met the inclusion criteria. The mean prevalence of injuries among the included studies was 35.3%, with an incidence rate varying between 0.2 and 18.9 per 1000 hours of training. The most injured areas were shoulder (26%), spine (24%), and knee (18%). Among the studies that reported the injuries requiring surgery, the mean percentage was 8.7%. Regarding the risk factors associated with injuries, older age, male sex, a greater body mass index, the existence of previous injuries, the lack of coach supervision, the experience on CrossFit® and the participation in competitions were reported by the studies. CONCLUSIONS: CrossFit® training has an injury incidence rate similar to weightlifting and powerlifting. Findings from the studies suggest that the most affected areas are shoulder, spine, and knee. The limited quality of the studies prevents us from drawing solid conclusions about injury risk factors.

Transdermal Drug Delivery in the Pig Skin.

Transdermal delivery can be accomplished through various mechanisms including formulation optimization, epidermal stratum corneum barrier disruption, or directly by removing the stratum corneum layer. Microneedling, electroporation, a combination of both and also the intradermal injection known as mesotherapy have proved efficacy in epidermal-barrier disruption. Here we analyzed the effects of these methods of epidermal-barrier disruption in the structure of the skin and the absorption of four compounds with different characteristics and properties (ketoprofen, biotin, caffein, and procaine). Swine skin (Pietrain x Durox) was used as a human analogue, both having similar structure and pharmacological release. They were biopsied at different intervals, up to 2 weeks after application. High-pressure liquid chromatography and brightfield microscopy were performed, conducting a biometric analysis and measuring histological structure and vascular status. The performed experiments led to different results in the function of the studied molecules: ketoprofen and biotin had the best concentrations with intradermal injections, while delivery methods for obtaining procaine and caffein maximum concentrations changed on the basis of the lapsed time. The studied techniques did not produce significant histological alterations after their application, except for an observed increase in Langerhans cells and melanocytes after applying electroporation, and an epidermal thinning after using microneedles, with variable results regarding dermal thickness. Although all the studied barrier disruptors can accomplish transdermal delivery, the best disruptor is dependent on the particular molecule.

Microglial Cytokines Induce Invasiveness and Proliferation of Human Glioblastoma through Pyk2 and FAK Activation.

Glioblastoma is the most aggressive brain tumor in adults. Multiple lines of evidence suggest that microglia create a microenvironment favoring glioma invasion and proliferation. Our previous studies and literature reports indicated the involvement of focal adhesion kinase (FAK) and proline-rich tyrosine kinase 2 (Pyk2) in glioma cell proliferation and invasion, stimulated by tumor-infiltrating microglia. However, the specific microglia-released factors that modulate Pyk2 and FAK signaling in glioma cells are unknown. In this study, 20 human glioblastoma specimens were evaluated with the use of RT-PCR and western blotting. A Pierson correlation test demonstrated a correlation (0.6-1.0) between the gene expression levels for platelet-derived growth factor ß(PDGFß), stromal-derived factor 1α (SDF-1α), IL-6, IL-8, and epidermal growth factor (EGF) in tumor-purified microglia and levels of p-Pyk2 (Y579/Y580) and p-FAK(Y925) in glioma cells. siRNA knockdown against Pyk2 or FAK in three primary glioblastoma cell lines, developed from the investigated specimens, in combination with the cytokine receptor inhibitors gefitinib (1 µM), DMPQ (200 nM), and burixafor (1 µM) identified EGF, PDGFß, and SDF-1α as key extracellular factors in the Pyk2- and FAK-dependent activation of invadopodia formation and the migration of glioma cells. EGF and IL-6 were identified as regulators of the Pyk2- and FAK-dependent activation of cell viability and mitosis.

Post-exercise Recovery Methods Focus on Young Soccer Players: A Systematic Review.

Background: Prescription of post-match or post-training recovery strategies in young soccer players is a key point to optimize soccer performance. Considering that the effectiveness of recovery strategies may present interindividual variability, scientific evidence-based recovery methods and protocols used in adults are possibly not applicable to young soccer players. Therefore, the current systematic review primarily aimed to present a critical appraisal and summary of the original research articles that have evaluated the effectiveness of recovery strategies in young male soccer players and to provide sufficient knowledge regarding the effectiveness of the recovery methods and strategies. Methodology: A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines until November 31, 2020, using the next data bases: WOS, PubMed, Cochrane Library, Evidence Database (PEDro), Evidence Based Medicine (EBM) Search review, EMBASE, and Scopus. There were no filters applied. Results: A total of 638 articles were obtained in the initial search. After the inclusion and exclusion criteria, the final sample was 10 articles focusing on recovery in young male players. Conclusions: Neuromuscular performance can be recovered using WVB but not with SS, and water immersion protocols may also be useful, but their positive effects are not significant, and it is unable to distinguish the best water immersion method; match running performance maintenance may be achieved using water immersion protocols but no other recovery methods have been investigated; EIMD and inflammatory responses could be positively affected when water immersion and AR are applied, although SS seems to be ineffective; perceptual responses also seem to be better with CWI and WVB, but contradictory results have been found when AR is applied, and SS had no positive impact. Finally, it is important to consider that AR strategies may modify HR response and soccer-specific performance.

Vigorous Aerobic Exercise in the Management of Parkinson Disease: A Systematic Review.

OBJECTIVE: To summarize the findings from studies examining the effects of vigorous-intensity aerobic exercise in the management of Parkinson disease. TYPE: Systematic review. LITERATURE SURVEY: PubMed/MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, SPORTDiscus, and ScienceDirect databases were searched up to May 2020. Reference lists of the included articles were also searched for additional studies. Searches were restricted to English language. METHODOLOGY: Seven papers, including six studies, five randomized controlled trials and one controlled trial, were identified. The studies examined the effects of vigorous-intensity aerobic exercise in participants with Parkinson disease. Studies in which the minimal intensity required was ≥77% of maximum heart rate, 60% of heart rate reserve or 64% of maximal oxygen uptake met the inclusion criteria. Method appraisal showed a mean score of 5.3 in the Physiotherapy Evidence Database (PEDro) scale. SYNTHESIS: No statistically significant differences were found between vigorous-intensity aerobic exercise and moderate/low-intensity aerobic exercise for the main outcomes (disease severity and motor function). Only one study concluded a significant higher aerobic fitness in favor of the group that exercised at vigorous intensity compared to the moderate intensity group. CONCLUSIONS: Vigorous-intensity aerobic exercise has not shown statistically significant improvements in motor and nonmotor impairments in individuals with Parkinson disease as compared to moderate/low-intensity aerobic exercise. Hence, the current evidence is too limited to allow recommendations for clinical practice.

Kinematic Gait Analysis After Primary Total Hip Replacement: A Systematic Review: Gait After Total Hip Replacement: A Systematic Review.

Total hip replacement (THR) is a surgical procedure indicated for patients affected by severe hip osteoarthritis. Although this technique has proved to be effective in relieving pain and restoring function, gait limitations may persist following this procedure. The objective of this systematic review was to evaluate gait kinematics after THR and compare the results with those of the pre-operative state and with healthy control individuals. PubMed/MEDLINE, Embase, Web of Science, CENTRAL and Scopus databases were searched until December 2019. Methodological quality and internal validity score of each study were assessed using the PEDro and the Newcastle-Ottawa scales. In all, ten studies met our inclusion criteria. Following THR, statistically significant improvements were seen in dynamic hip and knee range of motion of both the affected and the contralateral limb, single-limb support time symmetry, step length, stride length, walking speed and gait pattern. However, deficits were observed in all the previous parameters, as well as in hip adduction angle in comparison with healthy subjects. In conclusion, gait patterns improve after THR in comparison with the pre-operative state, although there are deficits relative to healthy individuals.

Exercise dose affects the circulating microRNA profile in response to acute endurance exercise in male amateur runners.

The systemic response to exercise is dose-dependent and involves a complex gene expression regulation and cross-talk between tissues. This context ARISES the need for analyzing the influence of exercise dose on the profile of circulating microRNAs (c-miRNAs), as emerging posttranscriptional regulators and intercellular communicators. Thus, we hypothesized that different exercise doses will determine specific c-miRNA signatures that will highlight its potential as exercise dose biomarker. Nine active middle-aged males completed a 10-km race (10K), a half-marathon (HM), and a marathon (M). Blood samples were collected immediately before and after races. Plasma RNA was extracted, and a global screening of 752 microRNAs was analyzed using RT-qPCR. Three different c-miRNA profiles were defined according to the three doses. In 10K, 14 c-miRNAs were found to be differentially expressed between pre- and post-exercise, 13 upregulated and 1 downregulated. Regarding HM, 13 c-miRNAs were found to be differentially modulated, in all the cases upregulated. A total of 28 c-miRNAs were found to be differentially expressed in M, 21 overexpressed and 7 repressed after this race. We had also found 3 common c-miRNAs between 10K and M and 2 common c-miRNAs between 10K and HM. In silico analysis supported a close association between exercise dose c-miRNA profiles and cellular pathways linked to energy metabolism and cell cycle. In conclusion, we have observed that different exercise doses induced specific c-miRNA profiles. So, our results point to c-miRNAs as emerging exercise dose biomarkers and as one of regulatory mechanisms modulating the response to endurance exercise.