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ABSTRACTEpilepsy and other neurological disorders can have profound social, physical and psychological consequences, especially when they begin in childhood. Moreover, seizure episodes may cause fractures, burns, head injuries and oral injuries. This report presents a case history of an adolescent with a severe tongue injury related to epileptic seizures and outlines the proposed treat‐ment, which included use of a maxillary silicone bite guard that allowed healing of the tongue injury within a few months.

(1) Background: There is a lack of literature that examines the impact of early vs. late sport specialization on quality of life after retirement from tennis. Thus, the purpose of this study was to examine the relationship between early specialization in the sport of tennis and health outcomes after retirement from collegiate/professional sport; (2) Methods: Participants were recruited through social media posts, newsletters, and contacts with tennis organizations. Basic demographic and injury information was collected from 157 former tennis players, along with the age of tennis specialization and two questionnaires: the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC), and the CDC HRQOL-14 "Healthy Days Measure" Questionnaire (HRQOL); (3) Results: Significant differences (F1,117 = 5.160, p < 0.025) in the specialization age between the low (11.9 ± 4.5 y) and high (9.8 ± 4.1 y) OSTRC groups were found after covarying for the current age. No difference (F1,72 = 0.676, p < 0.414) was shown among the high (10.9 ± 4.4 y) and low (11.28 ± 4.6 y) HRQOL groups for the specialization age after covarying for the current age. A weak negative correlation was identified between the OSTRC score and specialization age (r = −0.233, p = 0.008), while no significant changes were shown between the specialization age and HRQOL score (r = −0.021, p = 0.857), or between the OSTRC and HRQOL scores (r = 0.146, p = 0.208); (4) Conclusions: Retired tennis players with low injury/illness severity scores specialized in tennis later than those with high injury/illness severity scores, while no differences in the specialization age were noted when the sample was separated into HRQOL groups.

ABSTRACT: Road traffic accidents are currently between the seventh and tenth leading cause of death in the world, with approximately 1.35 million people killed per year. Despite extensive efforts by governments, according to the World Health Organization, road accidents still cause far too many deaths, especially among pedestrians, cyclists and two-wheel motor vehicle riders, who together account for almost 50% of road traffic fatalities. In particular, Spain had 410,974 traffic accidents between 2016 and 2019, involving 722,516 vehicles and 61,177 pedestrians with varying degrees of injury. This study uses the Bayesian network method to understand how the pedestrians? responsibility and actions at the time of the traffic accident affect the injury suffered by said pedestrian, also considering the variables of the road infrastructure and vehicles at the accident site. The results confirm that the variables linked to the unsafe behavior of pedestrians, and their responsibility in traffic accidents, increase the risk of suffering serious or fatal injuries during an accident; for example, if a pedestrian is distracted this increases his/her probability of suffering a severe injury (27.86%) with respect to not being distracted (20.73%). Conditions related to traffic in high-speed areas, areas with no or poor lighting, and areas lacking sidewalks, also record increases in pedestrian injury, as is the case in the age group of pedestrians over 60 years of age.

"In this novel approach to understanding consent, Jill D. Weinberg features two case studies where groups engage in seemingly violent acts: competitive mixed martial arts and sexual sadomasochism. These activities are similar in that consenting to injury is central to the activity, and participants of both activities have to engage in a form of social decriminalization, leveraging the legal authority imbued in the language of consent as a way to render their activities legally and socially tolerable. Yet, these activities are treated differently under criminal battery law. Using interviews with participants and ethnographic observation, Weinberg argues that where law authorizes a person's consent to an activity, consent is not meaningfully regulated or constructed by the participants themselves. In contrast, where law prohibits a person's consent to an activity, participants actively construct and regulate consent. This difference demonstrates that law can make consent less consensual. Synthesizing criminal law and ethnography, Consensual Violence is a fascinating account of how consent gets created and carried out among participants and lays the groundwork for a sociology of consent and a more sociological understanding of processes of decriminalization."--Provided by publisher

BACKGROUND: Injury incidence for physically active populations with a high volume of physical load can exceed 79%. There is little existing research focused on timing of injury and how that timing differs based on certain risk factors. PURPOSE/HYPOTHESIS: The purpose of this study was to report both the incidence and timing of lower extremity injuries during cadet basic training. We hypothesized that women, those with a history of injury, and those in underweight and obese body mass index (BMI) categories would sustain lower extremity musculoskeletal injury earlier in the training period than men, those without injury history, and those in the normal-weight BMI category. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Cadets from the class of 2022, arriving in 2018, served as the study population. Baseline information on sex and injury history was collected via questionnaire, and BMI was calculated from height and weight taken during week 1 at the United States Military Academy. Categories were underweight (BMI <20), middleweight (20-29.99), and obese (≥30). Injury surveillance was performed over the first 60 days of training via electronic medical record review and monitoring. Kaplan-Meier survival curves were used to estimate group differences in time to the first musculoskeletal injury. Cox proportional hazard regression was used to estimate hazard ratios (HRs). RESULTS: A total of 595 cadets participated. The cohort was 76.8% male, with 29.9% reporting previous injury history and 93.3% having a BMI between 20 and 30. Overall, 16.3% of cadets (12.3% of male cadets and 29.7% of female cadets) experienced an injury during the follow-up period. Women experienced significantly greater incident injury than did men (P < .001). Separation of survival curves comparing the sexes and injury history occurred at weeks 3 and 4, respectively. Hazards for first musculoskeletal injury were significantly greater for women versus men (HR, 2.63; 95% CI, 1.76-3.94) and for those who reported a history of injury ...

It is possible to eliminate death and serious injury from Canada's roads. In other jurisdictions, the European Union, centres in the United States, and at least one automotive company aim to achieve comparable results as early as 2020. In Canada, though, citizens must turn their thinking on its head and make road safety a national priority.Since the motor vehicle first went into mass production, the driver has taken most of the blame for its failures. In a world where each person's safety is dependent on a system in which millions of drivers must drive perfectly over billions of hours behind the wheel, failure on a massive scale has been the result. When we neglect the central role of the motor vehicle as a dangerous consumer product, the result is one of the largest human-made means for physically assaulting human beings. It is time for Canadians to embrace internationally recognized ways of thinking and enter an era in which the motor vehicle by-product of human carnage is relegated to history.No Accident examines problems related to road safety and makes recommendations for the way forward. Topics include types of drivers; human-related driving errors related to fatigue, speed, alcohol, and distraction and roads; pedestrians, cyclists, and public transit; road engineering; motor vehicle regulation; auto safety design; and collision-avoidance technologies such as radar and camera-based sensors on vehicles that prevent crashes. This multi-disciplinary study demystifies the world of road safety and provides a road map for the next twenty years.

PurposeThis paper aims to focus on staff injuries arising from incidents involving physical intervention (PI) with service users in a forensic, learning disability hospital.Design/methodology/approachIncident reports and individual electronic patient records were analysed to review all incidents in which staff were injured from January‐September 2011.FindingsInjury rates for staff were consistently higher than those for service users over the nine month period. The majority of staff injuries happen as a result of an assault on staff by the service user either before PI is used (36.3 per cent) or during the PI process (47.6 per cent). The remaining 16.1 per cent of staff injuries occur as a result of accidents during PI (12.9 per cent) or re‐escalation of aggression after the incident (3.2 per cent). Very few (4.8 per cent) staff injuries are reported as "serious". Most serious injuries are caused by kicks from service users. Kicks from service users are the highest cause of all staff injury.Research limitations/implicationsThis review is a retrospective analysis of incident reports and as such does not capture the richness of data which would be available in the planned qualitative piece of research.Practical implicationsThe findings of this review can be used to inform aspects of physical intervention training which may be tailored to specifically address areas where staff are at increased risk of injury.Originality/valueThis review is unique in the available literature in highlighting the point at which the injury occurs during the PI process.

Background and Aims Few large studies have examined the relationship between spinal cord injury (SCI) and lipid profile. We studied serum lipid concentrations in subjects with traumatic SCI in relation to the degree of neurological involvement and time since injury, and compared them with values from a reference sample for the Spanish population (DRECE study). Materials and Methods A retrospective cohort was built from 177 consecutive cases with traumatic SCI admitted to the SCI unit of the Miguel Servet Hospital in Aragon (Spain). Outcome measures (cholesterol, triglycerides, HDL-c and LDL-c levels) were analyzed according to the ASIA Impairment Scale (AIS), neurological level of injury (involvement of all limbs vs. only lower limbs), and time since injury. All analyses were adjusted for age and sex. Results Cases without preserved motor function (AIS A or B) had lower total and HDL cholesterol than the others (-11.4 [-21.5, -1.4] mg/dL total cholesterol and -5.1 [-8.8, -1.4] mg/dL HDL-c), and cases with all-limb involvement had lower total, HDL, and LDL cholesterol than those with only lower-limb involvement (-14.0 [-24.6, -3.4] mg/dL total cholesterol, -4.1 [-8.0, -0.2] mg/dL HDL-c, and -10.0 [-19.7, -0.3] mg/dL LDL-c) (all p < 0.05). No association was found between lipid concentrations and time since injury. Concentrations of lipid subfractions and triglycerides in SCI subjects were lower than in sex- and age-stratified values from the reference sample. Conclusion A high degree of neurological involvement in SCI (anatomically higher lesions and AIS A or B) is associated with lower total cholesterol and HDL-c. ; Dr. Laclaustra was supported in part by grants FIS CP08/00112 and PI10/00021 from the Spanish Instituto de Salud Carlos III. Dr. Castellote was supported in part by grants TPY 1115/07, PI13/00526, TPY 1444/08 and ESVI 1338/12-1 from the Instituto de Salud Carlos III. Dr. Hurtado was supported by Fellowship N degrees 088-FINCyT-BDE-2014 from the Peruvian government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ; Sí

Few large studies have examined the relationship between spinal cord injury (SCI) and lipid profile. We studied serum lipid concentrations in subjects with traumatic SCI in relation to the degree of neurological involvement and time since injury, and compared them with values from a reference sample for the Spanish population (DRECE study). A retrospective cohort was built from 177 consecutive cases with traumatic SCI admitted to the SCI unit of the Miguel Servet Hospital in Aragon (Spain). Outcome measures (cholesterol, triglycerides, HDL-c and LDL-c levels) were analyzed according to the ASIA Impairment Scale (AIS), neurological level of injury (involvement of all limbs vs. only lower limbs), and time since injury. All analyses were adjusted for age and sex. Cases without preserved motor function (AIS A or B) had lower total and HDL cholesterol than the others (-11.4 [-21.5, -1.4] mg/dL total cholesterol and -5.1 [-8.8, -1.4] mg/dL HDL-c), and cases with all-limb involvement had lower total, HDL, and LDL cholesterol than those with only lower-limb involvement (-14.0 [-24.6, -3.4] mg/dL total cholesterol, -4.1 [-8.0, -0.2] mg/dL HDL-c, and -10.0 [-19.7, -0.3] mg/dL LDL-c) (all p<0.05). No association was found between lipid concentrations and time since injury. Concentrations of lipid subfractions and triglycerides in SCI subjects were lower than in sex- and age-stratified values from the reference sample. A high degree of neurological involvement in SCI (anatomically higher lesions and AIS A or B) is associated with lower total cholesterol and HDL-c. ; Dr. Laclaustra was supported in part by grants FIS CP08/00112 and PI10/00021 from the Spanish Instituto de Salud Carlos III. Dr. Castellote was supported in part by grants TPY 1115/07, PI13/00526, TPY 1444/08 and ESVI 1338/12-1 from the Instituto de Salud Carlos III. Dr. Hurtado was supported by Fellowship N°088-FINCyT-BDE-2014 from Peruvian government. We would like to thank the staff of the Miguel Servet Hospital and especially the medical staff of the SCI ...

Acute myocardial infarction (AMI) and the heart failure (HF) that often complicates this condition, are among the leading causes of death and disability worldwide. To reduce myocardial infarct (MI) size and prevent heart failure, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury (IRI). In this regard, targeting cardiac innervation may provide a novel therapeutic strategy for cardioprotection. A number of cardiac neural pathways mediate the beneficial effects of cardioprotective strategies such as ischaemic preconditioning and remote ischaemic conditioning, and nerve stimulation may therefore provide a novel therapeutic strategy for cardioprotection. In this article, we provide an overview of cardiac innervation and its impact on acute myocardial IRI, the role of extrinsic and intrinsic cardiac neural pathways in cardioprotection, and highlight peripheral and central nerve stimulation as a cardioprotective strategy with therapeutic potential for reducing MI size and preventing HF following AMI. This article is part of a Cardiovascular Research Spotlight Issue entitled 'Cardioprotection Beyond the Cardiomyocyte', and emerged as part of the discussions of the European Union (EU)-CARDIOPROTECTION Cooperation in Science and Technology (COST) Action, CA16225.

Background Injuries sustained by military recruits during initial training impede training progression and military readiness while increasing financial costs. This study investigated training-related injuries and injury risk factors among British Army infantry recruits. Methods Recruits starting infantry training at the British Army Infantry Training Centre between September 2008 and March 2010 were eligible to take part. Information regarding lifestyle behaviours and injury history was collected using the Military Pre-training Questionnaire. Sociodemographic, anthropometric, physical fitness and injury (lower limb and lower back) data were obtained from Army databases. Univariable and multivariable Cox regression models were used to explore the association between time to first training injury and potential risk factors. Results 58% (95% CI 55% to 60%) of 1810 recruits sustained at least 1 injury during training. Overuse injuries were more common than traumatic injuries (65% and 35%, respectively). The lower leg accounted for 81% of all injuries, and non-specific soft tissue damage was the leading diagnosis (55% of all injuries). Injuries resulted in 122 (118 to 126) training days lost per 1000 person-days. Slower 2.4 km run time, low body mass, past injury and shin pain were independently associated with higher risk of any injury. Conclusions There was a high incidence of overuse injuries in British Army recruits undertaking infantry training. Recruits with lower pretraining fitness levels, low body mass and past injuries were at higher risk. Faster 2.4 km run time performance and minimal body mass standards should be considered for physical entry criteria.

ABSTRACTAcute transverse myelitis (ATM) is an inflammatory disorder that affects the spinal cord. It is characterized by signs and symptoms of neurologic dysfunction in the motor and sensory tracts of the spinal cord bilaterally, resulting in weakness, sensory loss, and autonomic dysfunction with acute or subacute onset. We report on a child who had ATM and respiratory distress requiring ventilatory assistance who presented with severe self‐mutilation involving his lips. Other findings included bruxism that had caused mobility of the primary teeth. Comprehensive dental care was carried out under sedation. The management of the lip trauma was achieved by the use of a soft, plastic mouth guard, and corticosteroid ointment.

The definition of the ideal numbers and distribution of human resources required for control of road traffic injury (RTI) is not as advanced as for other health problems. We can nonetheless identify functions that need to be addressed across the spectrum of injury control: surveillance; road safety (including infrastructure, vehicle design, and behaviour); and trauma care. Many low-cost strategies to improve these functions in low- or middle-income countries can be identified. For all these strategies, there is need for adequate institutional capacity, including funding, legal authority, and human resources. Several categories of human resources need to be developed: epidemiologists who can handle injury data, design surveillance systems, and undertake research; engineers and planners versed in safety aspects of road design, traffic flow, urban planning, and vehicle design; police and lawyers who understand the health impact of traffic law; clinicians who can develop cost-effective improvements in the entire system of trauma treatment; media experts to undertake effective behaviour change and social marketing; and economists to assist with cost-effectiveness evaluations. RTI control can be strengthened by enhancing such training in these disciplines, as well as encouraging retention of those who have the needed skills. Mechanisms to enhance collaboration between these different fields need to be promoted. Finally, the burden of RTI is borne disproportionately by the poor; in addition to technical issues, more profound equity issues must be addressed. This mandates that people from all professional backgrounds who work for RTI control should develop skills in advocacy and politics.

Road traffic crashes are recognised to be a global public health concern. Recent developments internationally have highlighted the need for the implementation of national road safety action plans. The Government of the Republic of Namibia, through the Motor Vehicle Accident Fund and the Ministry of Health and Social Services, play a critical role in advancing the road safety agenda. Both recognise the centrality of accurate and timely data as it relates to road crashes. Consequently, this report set out to examine the feasibility of establishing a linked national dataset in Namibia, drawing together available sources of information pertaining to crashes and injury outcomes. This was achieved by the development and implementation of injury surveillance and data capture processes and applied during the period of 7 December 2009 to 15 January 2010. Using these systems, all presentations to the emergency departments of four hospitals in Windhoek were recorded, with this information forming the basis for the linked data. The analysis of the pre-hospital information indicated clear differences in transportation time of those injured in crashes in Khomas compared to the other regions of Namibia, while the findings of the Emergency Department Triage Study indicated high levels of assault as well as serious injury consequences for those involved in traffic crashes. Notwithstanding a number of barriers, the feasibility and value of establishing a linked data set, drawing together multiple data sources across the entire crash-casualty continuum was demonstrated. Among a small sample of cases, differences in crash patterns and injury outcomes between car occupants, motorcyclists and pedestrians could be observed. Analysis of both the collected data and of the process itself highlighted a range of issues in the collection of these data. A series of recommendations designed to improve the quality and level of data for the monitoring of road crashes and their injury consequences are outlined.