Time-loss injuries and illnesses at the FIFA world cup Qatar 2022.

The study aimed to analyse incidence and characteristics of time-loss injuries and illnesses during the FIFA World Cup Qatar 2022. Of 838 male football players, 705 consented to participate. Team medical staff reported 82 time-loss injuries, corresponding to an injury event incidence of 5.6 injuries/1000 h of total exposure (95%CI 4.5 to 7.0 injuries/1000 h), with a median of 2 time-loss injury events per team (IQR, 1 to 4.5, range 0-7). The total injury burden was 103 (95% CI 61 to 152) days per 1000 h. Muscle/tendon injuries had the highest incidence of tissue types (48 cases, 3.3/1000 h (95% CI 2.5 to 4.4), and hamstring muscle injuries were the most frequent diagnosis (16 cases, incidence 1.1/1000 h, 95% CI 0.6 to 1.8). Match injury event incidence was 20.6/1000 h (15.0 to 27.7) and training injury event incidence was 2.1/1000 h (1.4 to 3.1). The majority (52%) of sudden-onset injuries were non-contact injuries, 40% direct contact and 8% indirect contact. We recorded 15 time-loss illnesses, corresponding to an illness event incidence of 1.1 per 1000 competition days, (95% CI: 0.6 to 1.8), and illness burden of 2.1 (1.0 to 3.4) days lost per 1000 competition days. The most common illness was respiratory infection (12 cases, 80%). Match injury event incidence was the lowest in any FIFA World Cup since injuries have been monitored.

Experiences of Interpersonal Violence in Sport and Perceived Coaching Style Among College Athletes.

Importance: Concern about interpersonal violence (IV) in sport is increasing, yet its implications remain poorly understood, particularly among currently competing college athletes. Objective: To document the self-reported prevalence of IV in college sports; identify associated risk factors; examine potential consequences associated with athletes' psychosocial well-being, emotional connection to their sport, and willingness to seek help; and explore the associations between IV reporting and perceived variations in coaching styles. Design, Setting, and Participants: This survey study analyzes results of the 2021 to 2022 National Collegiate Athletic Association (NCAA) myPlaybook survey, which was administered from July to December 2021 to 123 colleges and universities across the US. Participants were NCAA athletes aged 18 to 25 years who were current players on an NCAA-sanctioned team. Exposures: Self-reported demographic characteristics (eg, athlete gender identity and sexual orientation) and perceived differences in supportive vs abusive coaching styles (eg, athlete autonomy, team culture, and extent of abusive supervision). Main Outcomes and Measures: The primary outcome was self-reported experiences of IV in sport during the college sports career of currently competing college athletes. Types of IV considered were physical abuse, financial abuse, sexual abuse, psychological or emotional abuse, and neglect or abandonment. Outcomes potentially affected by IV were assessed with 4 questionnaires. Results: A total of 4119 athletes (mean [SD] age, 19.3 [1.5] years; 2302 males [55.9%]) completed the survey (response rate, 21.2%). One in 10 athletes (404 of 4119 [9.8%]) reported experiencing at least 1 type of IV during their college sports career, of whom two-thirds (267 [6.5%]) experienced IV within the past 6 weeks. On multivariable analysis, female gender identity (odds ratio [OR], 2.14; 95% CI, 1.46-3.13), nonheterosexual sexual orientation (OR, 1.56; 95% CI, 1.01-2.42), increasing age beyond 18 years (OR, 1.13; 95% CI, 1.01-1.30), increasing year of NCAA eligibility beyond the first year (OR, 1.19; 95% CI, 1.02-1.39), and participation in select sports (eg, volleyball: OR, 2.77 [95% CI, 1.34-5.72]; ice hockey: OR, 2.86 [95% CI, 1.17-6.95]) were independently associated with IV. When exposed to IV, college athletes reported experiencing consistently worse psychosocial outcomes, including increased burnout (mean difference on a 5-point Likert scale, 0.75; 95% CI, 0.63-0.86; P < .001) and an expressed desire to consider quitting their sport (mean difference, 0.81; 95% CI, 0.70-0.92; P < .001). They were not, however, less willing to seek help. Differences in coaching style were associated with differences in IV reporting. In risk-adjusted linear regression models, having a more supportive coach was associated with a 7.4 (95% CI, 6.4-8.4) absolute percentage point decrease in athletes' probability of reporting experiencing IV. In contrast, having a more abusive coach was associated with up to a 15.4 (95% CI, 13.8-17.1) absolute percentage point increase in athletes' probability of reporting experiencing IV. Conclusions and Relevance: Results of this survey study suggest that IV is associated with marked changes in the psychosocial health and emotional well-being of college athletes, particularly those who identify as female and with nonheterosexual sexual orientations. Variations in coaching style have the potential to alter these associations. Ongoing efforts are needed to leverage the unique position that coaches hold to help reduce IV and create safe places where all college athletes can thrive.

Video review of the frequency and assessment of head impacts during the FIFA Arab Cup 2021TM.

We used injury spotters and video footage review to establish the frequency of head impacts, their characteristics, and the subsequent medical assessment during the FIFA Arab Cup 2021TM. Six defined video signs of potential concussion based on an international consensus were used. A total of 88 head impacts were observed, with a median of 2 (IQR 1.5-4, range 0-7) head impacts per match, of which 44 (50%) resulted in on-pitch medical assessment. The median assessment duration was 51s (IQR 34-65s, range 19-262s). The most common mechanism was head-to-head contact (27% of all impacts and 43% of impacts with medical assessment). Seven head impacts showed video signs of potential concussion: six had one sign and one had two signs. The concussion substitution was used in three incidents. Head impacts during the FIFA Arab Cup were common and a median of 1 head impact per game required an on-pitch medical assessment. Only 8% of the head impacts showed any video sign of potential concussion, and only 3% resulted in a concussion substitution. The medical on-pitch assessments appeared too short (<1 min) to allow an appropriate assessment of all head impacts, indicating a need for further evaluation. Further standardisation of the injury spotter's role in football is recommended.

'Knowing we have these rights does not always mean we feel free to use them': athletes' perceptions of their human rights in sport.

Objectives: Modern sport safeguarding strategies include published global rights declarations that enshrine athletes' entitlements at the policy level. It is unclear how these documents translate to athletes' lived experiences. The study aimed to determine athletes' knowledge, attitudes and beliefs about their human rights in sports settings. Setting: Web-based survey. Participants: 1159 athletes from 70 countries completed a validated web-based survey. Over half of participants (60.1%) were between 18 and 29 years, currently competing (67.1%), not members of players' unions (54.6%), elite (60.0%) and participating in individual (55.8%) non-contact (75.6%) Olympic (77.9%) sports. Gender distribution was equal. Primary and secondary outcome measures: Participant demographics (eg, gender, age) and athletes' knowledge, attitudes and beliefs about their human rights in sports settings. Results: Most (78.5%) were unaware of any athletes' rights declarations. Gender influenced participants' confidence in acting on their rights in sport significantly. Males were more likely to accept pressure from coaches and teammates than females, but age affected how likely males were to accept this pressure. Paralympic athletes were less likely to agree that violence is acceptable in sports, compared with Olympic. Player union membership increased confidence in freely expressing one's opinion in sports settings. Athletes' rights-related awareness, knowledge and beliefs were disconnected. Conclusions: Awareness raising is not enough to prevent human rights violations in sports. The cultural climate of the entire ecosystem must be targeted, using systems-level strategies to shift stakeholders' biases, beliefs and behaviours. This approach takes the onus of addressing abuse off athletes' shoulders and places accountability on sports organisations.

Blood gas levels, cardiovascular strain and cognitive performance during surgical mask and filtering face piece application.

Mask induced airway resistance and carbon dioxide rebreathing is discussed to impact gas exchange and to induce discomfort and impairments in cognitive performance. N = 23 healthy humans (13 females, 10 males; 23.5 ± 2.1 years) participated in this randomized crossover trial (3 arms, 48-h washout periods). During interventions participants wore either a surgical face mask (SM), a filtering face piece (FFP2) or no mask (NM). Interventions included a 20-min siting period and 20 min steady state cycling on an ergometer at 77% of the maximal heart rate (HR). Hemodynamic data (HR, blood pressure), metabolic outcomes (pulse derived oxygen saturation, capillary carbon dioxide (pCO2), and oxygen partial pressure (pO2), lactate, pH, base excess), subjective response (ability to concentrate, arousal, perceived exertion) and cognitive performance (Stroop Test) were assessed. Compared to NM, both masks increased pCO2 (NM 31.9 ± 3.3 mmHg, SM = 35.2 ± 4.0 mmHg, FFP2 = 34.5 ± 3.8 mmHg, F = 12.670, p < 0.001) and decreased pH (NM = 7.42 ± 0.03, SM = 7.39 ± 0.03, FFP2 = 7.39 ± 0.04, F = 11.4, p < 0.001) during exercise. The FFP2 increased blood pressure during exercise (NM = 158 ± 15 mmHg, SM = 159 ± 16 mmHg, FFP2 = 162 ± 17 mmHg, F = 3.21, p = 0.050), the SM increased HR during sitting (NM = 70 ± 8 bpm, SM = 74 ± 8 bpm, FFP2 = 73 ± 8 bpm, F = 4.70, p = 0.014). No mask showed any comparative effect on other hemodynamic, metabolic, subjective, or cognitive outcomes. Mask wearing leads to slightly increased cardiovascular stress and elevated carbon dioxide levels during exercise but did not affect cognitive performance or wellbeing.

Development and validation of the athletes' rights survey.

A recognised imbalance of power exists between athletes and sporting institutions. Recent cases of systemic athlete abuse demonstrate the relationship between power disparities and harassment and abuse in sport. Embedding human rights principles into sporting institutions is a critical step towards preventing harassment and abuse in sport. In 2017, the World Players Association (WPA) launched the Universal Declaration of Player Rights. A year later, the International Olympic Committee (IOC) developed their Athletes' Rights and Responsibilities Declaration. These two documents codify benchmarks 'for international sporting organisations to meet their obligations to protect, respect and guarantee the fundamental rights of players'. This paper is the first project exploring athletes' knowledge, understanding and awareness of rights in the sports context. This study presents the development and validation of a survey investigating athletes' knowledge of these declarations, associated attitudes/beliefs and understanding of how these rights can be enacted in practice. The survey includes 10 statements of athlete rights based on the WPA and IOC declarations. Face validation was assessed by distributing the survey to 10 athletes and conducting qualitative interviews with a subgroup of four athletes. The survey was reworked into 13 statements, and the tool was validated with 611 responses through confirmatory factor analysis. Key findings include a weak correlation between athletes' knowledge and their attitudes/beliefs, and challenges with the interpretation of words such as 'pressure,' 'violence,' 'harassment' and 'intimidation.' This validation puts forward the first survey instrument to directly test athletes' knowledge, attitudes and beliefs about rights in sport.

Methods for epidemiological studies in competitive cycling: an extension of the IOC consensus statement on methods for recording and reporting of epidemiological data on injury and illness in sport 2020.

In 2020, the IOC released a consensus statement that provides overall guidelines for the recording and reporting of epidemiological data on injury and illness in sport. Some aspects of this statement need to be further specified on a sport-by-sport basis. To extend the IOC consensus statement on methods for recording and reporting of epidemiological data on injury and illness in sports and to meet the sport-specific requirements of all cycling disciplines regulated by the Union Cycliste Internationale (UCI). A panel of 20 experts, all with experience in cycling or cycling medicine, participated in the drafting of this cycling-specific extension of the IOC consensus statement. In preparation, panel members were sent the IOC consensus statement, the first draft of this manuscript and a list of topics to be discussed. The expert panel met in July 2020 for a 1-day video conference to discuss the manuscript and specific topics. The final manuscript was developed in an iterative process involving all panel members. This paper extends the IOC consensus statement to provide cycling-specific recommendations on health problem definitions, mode of onset, injury mechanisms and circumstances, diagnosis classifications, exposure, study population characteristics and data collection methods. Recommendations apply to all UCI cycling disciplines, for both able-bodied cyclists and para-cyclists. The recommendations presented in this consensus statement will improve the consistency and accuracy of future epidemiological studies of injury and illness in cycling.

New insights into the association between lameness, behavior, and performance in Simmental cows.

In a herd of 100 milking Simmental cows, data of performance and behavior parameters were collected automatically with different systems such as pedometers, an automatic milking system, and automatic weighing troughs for 1 yr. Performance measures were several milking-related parameters, live weight, as well as feed intake. Behavior-associated measures were feeding behavior (e.g. feeding duration, number of visits to the trough, and feeding pace) as well as activity such as lying duration, number of lying bouts, and overall activity. In the same time, lameness status of every cow was assessed with weekly locomotion scoring. According to the score animals were then classified lame (score 4 or 5) or nonlame (score 1, 2, or 3). From these data in total, 25 parameters summarized to daily values were evaluated for their ability to determine the lameness status of a cow. Data were analyzed with a regularized regression method called elastic net with the outcome lame or nonlame. The final model had a high prediction accuracy with an area under the curve of 0.91 [95% confidence interval (CI) = 0.88-0.94]. Specificity was 0.81 (95% CI = 0.73-0.85) and sensitivity was 0.94 (95% CI = 0.88-1.00). The most important factors associated with a cow being lame were number of meals, average feed intake per meal, and average duration of a meal. Lame cows fed in fewer and shorter meals with a decreased intake per meal. Milk yield and lying-behavior-associated parameters were relevant in the model, too, but only as parts of interaction terms demonstrating their strong dependence on other factors. A higher milk yield only resulted in higher risk of being lame if feed intake was decreased. The same accounts for lying duration: only if lying time was below the 50% quantile did an increased milk yield result in a higher risk of being lame. The association of lameness and daily lying duration was influenced by daily feeding duration and feeding duration at daytime. The results of the study give deeper insights on how the association between behavior and performance parameters and lameness is influenced by intrinsic factors in particular and that many of these have to be considered when trying to predict lameness based on such data. The findings lead to a better understanding why, for instance, lying duration or milk yield seem to be highly correlated with lameness in cows but still have not been overly useful as parameters in other lameness detection models.

Analysis of viral and cellular factors influencing herpesvirus-induced nuclear envelope breakdown.

Herpesvirus nucleocapsids are translocated from their assembly site in the nucleus to the cytosol by acquisition of a primary envelope at the inner nuclear membrane which subsequently fuses with the outer nuclear membrane. This transport through the nuclear envelope requires homologs of the conserved herpesviral pUL31 and pUL34 proteins which form the nuclear egress complex (NEC). In its absence, 1,000-fold less virus progeny is produced. We isolated a UL34-negative mutant of the alphaherpesvirus pseudorabies virus (PrV), PrV-ΔUL34Pass, which regained replication competence after serial passages in cell culture by inducing nuclear envelope breakdown (NEBD) (B. G. Klupp, H. Granzow, and T. C. Mettenleiter, J. Virol. 85:8285-8292, 2011). To test whether this phenotype is unique, passaging experiments were repeated with a UL31 deletion mutant. After 60 passages, the resulting PrV-ΔUL31Pass replicated similarly to wild-type PrV. Ultrastructural analyses confirmed escape from the nucleus via NEBD, indicating an inherent genetic disposition in herpesviruses. To identify the mutated viral genes responsible for this phenotype, the genome of PrV-ΔUL34Pass was sequenced and compared to the genomes of parental PrV-Ka and PrV-ΔUL34. Targeted sequencing of PrV-ΔUL31Pass disclosed congruent mutations comprising genes encoding tegument proteins (pUL49, pUL46, pUL21, pUS2), envelope proteins (gI, pUS9), and protease pUL26. To investigate involvement of cellular pathways, different inhibitors of cellular kinases were tested. While induction of apoptosis or inhibition of caspases had no specific effect on the passaged mutants, roscovitine, a cyclin-dependent kinase inhibitor, and U0126, an inhibitor of MEK1/2, specifically impaired replication of the passaged mutants, indicating involvement of mitosis-related processes in herpesvirus-induced NEBD.

Feasibility of precompetition medical assessment at FIFA World Cups for female youth players.

BACKGROUND: Although most experts agree that preparticipation screening is important to prevent sudden cardiac death in sport, only a few reports have been published on the feasibility of its practical implementation. METHODS: The football associations participating in the U-17 and U-20 Women's World Cups 2010 were asked to perform a standardised precompetition medical assessment (PCMA) of their players (in total 672). RESULTS: Compliance with the requirement for performing the PCMA was high among all teams, particularly from African, Asian and Central/South American countries. No relevant abnormal findings in personal history and clinical cardiological examination were reported. Athletic ECG patterns were frequent, but very few findings were considered to require further investigation. All players were declared as eligible to play. CONCLUSIONS: Based on the demonstrated feasibility of performing a comprehensive PCMA in elite female youth players, the Fédération Internationale de Football Association (FIFA) Executive Committee decided to make the PCMA a compulsory requirement for all FIFA competitions.

Development and implementation of a standardized precompetition medical assessment of international elite football players--2006 FIFA World Cup Germany.

OBJECTIVE: To create a model for the precompetition medical assessment (PCMA) of international elite football players aimed at identifying risk factors and to assess the feasibility of standardized requirements for teams from countries with variable medical standards. DESIGN: Descriptive feasibility study. SETTING: Medical assessment of professional football players before a major international competition. PARTICIPANTS: Thirty-two national football teams comprising 736 players participating in the 2006 FIFA World Cup. INTERVENTION: A standardized football-specific PCMA was developed, and all team physicians were asked to perform the PCMA before the 2006 FIFA World Cup. MAIN OUTCOME MEASURES: Response rate, completeness of documentation forms, and quality of data. RESULTS: Of all 32 teams participating in the 2006 FIFA World Cup, the precompetition assessment forms of 26 teams (response rate 81%) were returned. Of the initial target population of 736 players, the data of 582 players (79%) were analyzed. The average completeness of the forms ranged from 34% to 94% among teams and average completeness of the different sections of the forms from 78% to 98%. Quality of data provided varied considerably. CONCLUSION: The response rate of 81% demonstrated that a standardized approach is possible, whereas results and quality of data required adaptations of the form and review of the implementation procedure.

Precompetition cardiac assessment of football players participating in the 2006 FIFA World Cup Germany.

OBJECTIVES: To develop a precompetition medical assessment (PCMA) of elite football players aimed at identifying risk factors for sudden cardiac death. DESIGN: Retrospective analysis of the PCMA forms. PARTICIPANTS: Of the 32 national teams (with 23 players), PCMA forms from 605 players were submitted after the final match (82%). Data of 582 players were analyzed (79%). MAIN OUTCOME MEASURES: Recorded results of a standardized PCMA in all players before the 2006 FIFA World Cup including medical history, physical examination, resting/exercise electrocardiogram, and echocardiography were analyzed by 2 independent cardiologic reviewers. RESULTS: Apart from general deficits in data quality, at least 6 players (1.0%) could be identified as demanding further investigations to rule out a serious cardiovascular disease. CONCLUSIONS: Comprehensive cardiac testing is feasible in international elite football. To improve future results, the PCMA was revised. It is questionable if exercise stress testing should be included in future PCMA. To ensure correct results, sports cardiologic expertise is essential. In the face of organizational challenges and variable medical standards, alternative approaches to the practical implementation of the PCMA need to be investigated.

Precompetition orthopedic assessment of international elite football players.

OBJECTIVE: To assess the feasibility of the orthopedic part of a standardized precompetition medical assessment (PCMA) in teams from countries with variable medical background and to collect data on medical history and musculoskeletal findings of the players participating in the 2006 FIFA World Cup. DESIGN: Retrospective analysis of the PCMA forms. PARTICIPANTS: Five hundred fifty-three players (75.1%) participating in the 2006 FIFA World Cup. METHODS: The team physicians of participating teams were instructed to perform a specific standardized PCMA in all players before the 2006 FIFA World Cup. The orthopedic section included medical history and orthopedic examination of the lower extremity. RESULTS: The completeness of the orthopedic section was in general very high, but the quality of recordings and examination technique differed among teams. About half of the players (51%) were reported to have sustained at least 1 severe football injury, with ligament/meniscus lesions of the knee and ligament injuries of the ankle being the most frequent diagnoses. Pathological findings on examination were rare. CONCLUSIONS: A standardized PCMA including comprehensive orthopedic examination is principally feasible in international elite football. The challenge is to ensure the quality of the physical examinations and to verify their predictive value.

Medical report from the 2006 FIFA World Cup Germany.

OBJECTIVE: To continue the injury surveillance of FIFA-sponsored football tournaments and report on other medical aspects of the 2006 FIFA World Cup. DESIGN: Prospective epidemiological injury surveillance and descriptive summary of additional medical aspects. SETTING: Major international football tournament. PARTICIPANTS: National team players, doctors and referees at the 2006 FIFA World Cup Germany. MAIN OUTCOME MEASURES: Injury type, location and rate. RESULTS: 145 injuries were reported for the 64 matches of the 2006 FIFA World Cup Germany-an overall injury rate of 68.7 per 1000 match hours (95% CI 57.5 to 79.9) or 2.3 injuries per match, in comparison with 2.7 injuries per match in the 2002 FIFA World Cup (p = NS). Physical examinations before participation uncovered no hidden cardiovascular problems. Once the tournament started, no referees were unable to complete their duties. There were no positive doping tests. CONCLUSIONS: The injury rate for this World Cup was below that of 2002, but consistent with the overall injury rate per match since data collection began in 1998. There continues to be no evidence of systematic doping in international football.