Integrated computational and in vivo models reveal Key Insights into Macrophage Be-havior during bone healing

Myeloid-derived monocyte and macrophages are key cells in the bone that contribute to remod-eling and injury repair. However, their temporal polarization status and control of bone-resorbing osteoclasts and bone-forming osteoblasts responses is largely unknown. In this study, we fo-cused on two aspects of monocyte/macrophage dynamics and polarization states over time: 1) the injury-triggered pro- and anti-inflammatory monocytes/macrophages temporal profiles, 2) the contributions of pro- versus anti-inflammatory monocytes/macrophages in coordinating healing response. Bone healing is a complex multicellular dynamic process. While traditional in vitro and in vivo experimentation may capture the behavior of select populations with high resolution, they cannot simultaneously track the behavior of multiple populations. To address this, we have used an integrated a coupled ordinary differential equations (ODEs)-based framework describing mul-tiple cellular species to in vivo bone injury data in order to identify and test various hypotheses regarding bone cell populations dynamics. Our approach allowed us to infer several biological insights including, but not limited to,: 1) anti-inflammatory macrophages are key for early osteo-clast inhibition and pro-inflammatory macrophage suppression, 2) pro-inflammatory macrophag-es are involved in osteoclast bone resorptive activity, whereas osteoblasts promote osteoclast differentiation, 3) Pro-inflammatory monocytes/macrophages rise during two expansion waves, which can be explained by the anti-inflammatory macrophages-mediated inhibition phase be-tween the two waves. In addition, we further tested the robustness of the mathematical model by comparing simulation results to an independent experimental dataset. Taken together, this novel comprehensive mathematical framework allowed us to identify biological mechanisms that best recapitulate bone injury data and that explain the coupled cellular population dynamics involved in the process. Furthermore, our hypothesis testing methodology could be used in other contexts to decipher mechanisms in complex multicellular processes.

Injuries in Elite Men’s Rugby Union: An Updated (2012–2020) Meta-Analysis of 11,620 Match and Training Injuries

Background The most recent meta-analytic review of injuries in elite senior men’s Rugby Union was published in 2013. The demands of the game at the elite level are continually changing alongside law amendments and developments in player preparation. As such, an updated meta-analysis of injury data in this setting is necessary. Objective To meta-analyse time-loss injury data in elite senior men’s Rugby Union between 2012 and 2020. Methods Electronic databases were searched using the keywords ‘rugby’ and ‘inj*’. Nineteen studies met the inclusion criteria. Injury incidence rate data were modelled using a mixed-effects Poisson regression model. Days missed data were modelled using a general linear mixed model. Results The included data encompassed a total of 8819 match injuries and 2801 training injuries. The overall incidence rate of injuries in matches was 91 per 1000 h (95% confidence interval (CI) 77–106). The estimated mean days missed per match injury was 27 days (95% CI 23–32). The overall incidence rate of match concussions was 12 per 1000 h (95% CI 9–15). The overall incidence rate of training injuries was 2.8 per 1000 h (95% CI 1.9–4.0). Playing level was not a significant effect modifier for any outcome. Conclusions The injury incidence rate and mean days missed per injury in the present meta-analysis were higher, but statistically equivalent to, the 2013 meta-analysis (81 per 1000 h and 20 days, respectively). The injury incidence rate for match injuries in elite senior men’s Rugby Union is high in comparison to most team sports, though the training injury incidence rate compares favourably. The tackle event and concussion injuries should continue to be the focus of future preventative efforts.

Construction and Simulation of Injury Early Warning Model for Retired Athletes Based on Improved Self-organizing Neural Network

With the progress of sci-tech, the interdisciplinary and comprehensive development, and various advanced sci-tech gradually integrated into the field of sports, it has become possible to study how to reasonably prevent sports injuries, minimize the risk of sports injuries, and maintain the best physical condition of retired athletes. Due to the long-term high-load exercise of retired athletes during their sports career, athletes’ physical functions have been damaged to varying degrees, resulting in more injuries. According to the characteristics that many factors need to be considered in the prediction of retired athletes’ injuries, this paper puts forward an improved self-organizing neural network (SOM) method to predict retired athletes’ injuries. In this paper, an early warning analysis model of retired athletes’ susceptibility to injury based on SOM is proposed, which screens the state of retired athletes’ physical function variables in each stage, considers athletes’ physical function data whose standard deviation is higher than the limit specification of susceptibility to injury as susceptible injury data, quickly judges all vulnerable injury data, and completes the high-speed early warning analysis of retired athletes’ susceptibility to injury.

The South African Rugby Injury and Illness Surveillance and Prevention Project (SARIISPP): SARU Girls’ Youth Week Injury Surveillance Report 2019

As part of the South African Rugby Injury and Illness Surveillance and Prevention Project (SARIISPP), the annual SARU Youth Week tournaments’ injury data are recorded and investigated by SA Rugby. The BokSmart National Rugby Safety Programme has been collecting and analysing these data annually since 2011 for the SARU Boy’s Youth Week tournaments. In 2015, the SARU Girls’ Youth Week data collection began; this report being the first to analyse the Girls’ Youth Week data. The analysis shows injury patterns over time between tournaments, and collectively, for the girls’ u16 and u18 SARU Youth Weeks. Additionally, the analysis compares the profiles of injured players at each individual tournament. When investigating these patterns, areas of concern are identified, changes in the game, tournament structure or medical support services are considered or contested against the evidence, and injury specific interventions can be created and implemented, where the evidence indicates such a need. Each medical facility at the SARU Youth Week tournaments has a designated researcher onsite, who together with the tournament medical doctors, records the tournament injury data daily. Three injury cases were removed from the analysis. These data were recorded but did not appear to be accurate on follow-up and were therefore removed. Unfortunately, inaccuracy can occur during data collection and measures have been implemented to ensure that this is limited. This 2019 SARU Girls’ Youth Week report focuses on the Girls’ tournaments, comprising of the Girls u16 Week (Gu16W) and Girls u18 Week (Gu18W) held in 2019. The tournaments consisted of 32 teams and 48 matches. Comparisons are made between SARU Girls’ Youth Week tournaments and over time between 2015 and 2019. It must be noted that no Gu16W tournament was held in 2017. In 2019, the Gu16W recorded a higher Time-Loss injury incidence at 22 (11 - 33) [mean (95% confidence intervals)] injuries per 1000 player hours. Gu18W recorded slightly lower Time-Loss injury incidence at 19 (10 – 28) injuries per 1000 player hours. The collective tournament average was measured at 21 (13 to 28) injuries per 1000 player hours. When combining the injury incidence data collected over the five years, Gu18W had a lower Time-Loss injury incidence. In 2019, the Tackler and Open Play, followed by the Ball Carrier, were the most frequent injury-causing events in that order. Tackling front-on (regulation), Tackling LOW side-on, and Tackling LOW front-on, were the most frequent injury causing mechanisms involved in the Tackler phases of play. While Collision in Open Play was the most frequent injury causing mechanism in Open Play. The most common injury type was Central Nervous System injuries, where Gu18W recorded a higher incidence. Head and Neck were the most common injury locations in 2019, accounting for 69% of the injuries, with most of these injuries occurring in the Gu18W. Scrumhalves and flyhalves were the player positions with the highest normalised injury incidence per player per position across all tournaments. As expected, the injury incidence of ‘New’ injuries was higher than subsequent ‘Recurrent’ injuries. The majority of ‘New’ injuries were injuries to the joint, while most ‘Recurrent’ injuries were ligament and joint injuries. Fourteen concussions occurred across the two tournaments in 2019, which has dropped since the spike recorded in 2018. The Gu18W had the higher concussion incidence of the two tournaments. Furthermore, the act of Tackling contributed to 50% of the events causing concussions. The tackle contest is clearly an event that requires additional injury prevention focus for coaches on preparing their younger female players better for rugby, and requires more time spent on teaching them safer techniques and body positions in the tackle contest.

Injury epidemiology in professional football in South America compared with Europe

ObjectiveTo describe the injury epidemiology in professional football in South America and compare it with European professional football.MethodsData about football exposures and injury occurrences were registered in Six teams participating in Copa Libertadores in 2016. These teams’ exposure and injury data were compared with teams participating in the UEFA Elite Club Injury Study during the 2015/2016 and 2016/2017 seasons.ResultsA total of 271 injuries were reported in the South American cohort representing a training injury incidence of 3.2 (95% CI=2.7 to 3.7) injuries/1000 hours of training exposure and 20.9 (95% CI=17.3 to 25.1) injuries/1000 hours of match exposure. While no differences in muscle injury incidence were observed between South American and European teams, the ligament injury incidence in training among South American teams was significantly higher than European teams (0.6 vs 0.3, RR 1.87, 95% CI 1.21 to 2.87). In addition, a significantly higher proportion of all reported injuries among South American teams than European teams occurred in training.ConclusionsA larger proportion of injuries occur in training in South American compared with European professional football. Specifically, ligament injuries in training were more frequent among South American teams.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Swimming and Diving: 2014–2015 Through 2018–2019

Context The number of women's swimming and diving teams sponsored by the National Collegiate Athletic Association has increased over the last 5 years. Background Routine examinations of women's swimming and diving injuries are important for identifying emerging temporal patterns. Methods Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014–2015 through 2018–2019 athletic seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates. Results The overall injury rate was 1.78 per 1000 athlete-exposures in swimmers and 2.49 per 1000 AEs in divers. Shoulder (33.0%) injuries accounted for the largest proportion of all swimming injuries; most injuries were classified as overuse (51.3%). Head or face (29.4%) and trunk (20.2%) injuries accounted for the largest proportions of all diving injuries. Summary Findings indicated that shoulder and trunk injuries, as well as injuries resulting from overuse mechanisms, warrant further attention in swimming. Given the low in the National Collegiate Athletic Association Injury Surveillance Program observed across the study period, the need for greater participation in sports injury surveillance is also apparent.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Swimming and Diving: 2014–2015 Through 2018–2019

Context The National Collegiate Athletic Association (NCAA) has sponsored men's swimming and diving since 1937. Background Routine examinations of men's swimming and diving injuries are important for identifying emerging injury-related patterns. Methods Exposure and injury data collected in the NCAA Injury Surveillance Program during the 2014–2015 through 2018–2019 academic years were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates. Results The overall injury rate was 1.56 per 1000 athlete-exposures (AEs) for swimmers and 1.52 per 1000 AEs for divers. Shoulder (27.0%) injuries accounted for the largest proportion of all swimming injuries, and most injuries were attributed to overuse mechanisms (42.6%). Shoulder (23.3%) and trunk (23.3%) injuries accounted for the largest proportion of all diving injuries, and most injuries resulted from surface contact (32.6%). Conclusions Findings were consistent with existing literature on swimming and diving. The need for continued surveillance, coupled with more robust participation by swimming and diving programs was also highlighted.