The first decade of web-based sports injury surveillance: Descriptive epidemiology of injuries in US high school girls' lacrosse (2008-2009 through 2013-2014) and National Collegiate Athletic Association women's lacrosse (2004-2005 through 2013-2014)

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online (HS RIO) system and the National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) has aided the acquisition of girls' and women's lacrosse injury data. Objective: To describe the epidemiology of injuries sustained in high school girls' lacrosse in the 2008-2009 through 2013-2014 academic years and collegiate women's lacrosse in the 2004-2005 through 2013-2014-academic years using Web-based sports injury surveillance. Design: Descriptive epidemiology study. Setting: Online injury surveillance from high school girls' (annual average ¼ 55) and collegiate women's (annual average ¼ 19) lacrosse teams. Patients or Other Participants: Female lacrosse players who participated in practices or competitions during the 2008-2009 through 2013-2014 academic years for high school or the 2004-2005 through 2013-2014 academic years for college. Main Outcome Measure(s): Athletic trainers collected time-loss injury (24 hours) and exposure data. We calculated injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis. Results: High school RIO documented 700 time-loss injuries during 481 687 AEs; the NCAA-ISP documented 1027 time-loss injuries during 287 856 AEs. The total injury rate during 2008-2009 through 2013-2014 was higher in college than in high school (2.55 versus 1.45/1000 AEs; IRR ¼ 1.75; 95% CI ¼ 1.54, 1.99). Most injuries occurred during competitions in high school (51.1%) and practices in college (63.8%). Rates were higher during competitions compared with practices in high school (IRR ¼ 2.32; 95% CI ¼ 2.00, 2.69) and college (IRR ¼ 2.38; 95% CI ¼ 2.09, 2.70). Concussion was the most common diagnosis among all high school and most collegiate player positions, and the main mechanism of contact was with a playing apparatus (eg, stick, ball). Ligament sprains were also common (HS RIO practices ¼ 22.2%, competitions ¼ 30.3%; NCAA-ISP practices ¼ 25.5%, competitions ¼ 30.9%). Conclusions: Rates of injury were higher in college versus high school female lacrosse players and in competitions versus practices. Injury-prevention strategies are essential to decrease the incidence and severity of concussions and ligament sprains

The first decade of web-based sports injury surveillance: Descriptive epidemiology of injuries in US high school boys' lacrosse (2008-2009 through 2013-2014) and National Collegiate Athletic Association men's lacrosse (2004-2005 through 2013-2014)

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's lacrosse injury data. Objective: To describe the epidemiology of injuries sustained in high school boys' lacrosse in the 2008-2009 through 2013-2014 academic years and collegiate men's lacrosse in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance. Design: Descriptive epidemiology study. Setting: Online injury surveillance from lacrosse teams of high school boys (annual average ¼ 55) and collegiate men (annual average ¼ 14). Patients or Other Participants: Boys' and men's lacrosse players who participated in practices and competitions during the 2008-2009 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college. Main Outcome Measure(s): Athletic trainers collected time-loss (24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated. Results: High School Reporting Information Online documented 1407 time-loss injuries during 662 960 AEs. The National Collegiate Athletic Association Injury Surveillance Program documented 1882 time-loss injuries during 390 029 AEs. The total injury rate from 2008-2009 through 2013-2014 was higher in college than in high school (3.77 versus 2.12/1000 AEs; IRR ¼ 1.78; 95% CI ¼ 1.63, 1.94). Most injuries occurred during competitions in high school (61.4%) and practices in college (61.4%). Injury rates were higher in competitions compared with practices in high school (IRR ¼ 3.59; 95% CI ¼ 3.23, 4.00) and college (IRR ¼ 3.38; 95% CI ¼ 3.08, 3.71). Lower limb injuries, muscle strains, and ligament sprains were common at both levels. Concussion was the most frequent competition diagnosis for all high school player positions. Conclusions: Rates of time-loss injury were higher in college versus high school and in competitions versus practices. Attention to preventing common lower leg injuries and concussions, especially at the high school level, is essential to decrease their incidence and severity

A Brane World Perspective on the Cosmological Constant and the Hierarchy Problems

We elaborate on the recently proposed static brane world scenario, where the effective 4-D cosmological constant is exponentially small when parallel 3-branes are far apart. We extend this result to a compactified model with two positive tension branes. Besides an exponentially small effective 4-D cosmological constant, this model incorporates a Randall-Sundrum-like solution to the hierarchy problem. Furthermore, the exponential factors for the hierarchy problem and the cosmological constant problem obey an inequality that is satisfied in nature. This inequality implies that the cosmological constant problem can be explained if the hierarchy problem is understood. The basic idea generalizes to the multibrane world scenario. We discuss models with piecewise adjustable bulk cosmological constants (to be determined by the 5-dimensional Einstein equation), a key element of the scenario. We also discuss the global structure of this scenario and clarify the physical properties of the particle (Rindler) horizons that are present. Finally, we derive a 4-D effective theory in which all observers on all branes not separated by particle horizons measure the same Newton's constant and 4-D cosmological constant.Comment: revtex, 63 pages, 8 figures, one table, revised version, more discussions on the global structure, references adde

On the Degeneracy Inherent in Observational Determination of the Dark Energy Equation of State

Using a specific model for the expansion rate of the Universe as a function of scale factor, it is demonstrated that the equation of state of the dark energy cannot be determined uniquely from observations at redshifts $z\lesssim{\rm a few}$ unless the fraction of the mass density of the Universe in nonrelativistic particles, $\Omega_M$, somehow can be found independently. A phenomenological model is employed to discuss the utility of additional constraints from the formation of large scale structure and the positions of CMB peaks in breaking the degeneracy among models for the dark energy.Comment: 12 pages, 3 figures. Several references adde

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries