Rauma Group (Norway)

Power-force-velocity ( P F v ) measurements have traditionally been employed to characterize the limits of an athlete’s neuromuscular system. However, in more recent years, there has been growing interest in whether P F v metrics can also be used to define and assess training outcomes, e.g., as an indicator of performance and/or neuromuscular fatigue. Here we assess performance in a repeated sprint ability ( RSA ) test using traditional P F v measurements, alongside two novel metrics: ballistic power ( P B ) and the F v -offset, with the changes observed attributed to neuromuscular fatigue. Twenty-four physically active males (age = 26.08 ± 6.84 years) undertook the RSA test, consisting of 3 sets of 5 × 50 m maximal sprints, with each participant wearing a STATSports Apex Pro series unit to track their motion. Mixed-effect models show how power-related metrics have the largest reduction due to fatigue compared to their force and velocity counterparts, with P B showing the largest decrease of ∼ 31.8% ( − 40.2 ≤ P B ( % change ) ≤ − 23.4 , 95% CI, Cohen’s d = 1.60 ) across the RSA test performed. We demonstrate that ballistic power, P B , is the most reactive metric to athlete fatigue amongst the considered values. The described methods provide a promising, feasible tool for field-based monitoring of fatigue using routine GPS data.

Abstract Ship structures feature complex fatigue critical details. Directed energy deposition (DED) could be used to manufacture the details. When DED components are connected to the surrounding structure, the cost could be significantly reduced in comparison to dedicated additive manufacturing. This study presents the case using DED component as part of a load-bearing structure, designing and performing DED manufacturing and joining the component to the structure for I-beam, pillar, and deck connection. Design work for the structural load-bearing capacity was conducted, and based on the obtained geometry, DED manufacturing was designed. Finally, a fatigue test for the structure was performed and followed by quality and performance analysis including SEM fractography comparison to camera-based deposition monitoring. A local imperfection between the deposition layers was found as an initiation point for the fatigue cracking. After considering wall thickness reduction due to imperfection, the fatigue strength of DED component in the full-scale test was found to exceed design curve FAT 100 MPa m = 5, extracted using the previously defined small-scale coupon test data. From the fatigue strength perspective, DED hybrid components could be recommended for fatigue-critical applications.

Treatment of pelvic fractures requires extensive human and material resources. The weekend is characterized by a reduced availability of these resources. In addition, weekend leisure activities lead to different injury patterns. The ‘weekend effect’, which describes these conditions, is controversially discussed in medicine. However, there is still a paucity of data, especially in traumatology and particularly in relation to pelvic injuries. The aim of this work is to assess the weekend effect on demographics, injury patterns and outcome in relation to the day of the accident. Demographic, clinical and operative parameters from the data of the German Pelvic Trauma Registry were retrospectively evaluated (n = 16,359). Differences between weekend and weekday accidents were statistically evaluated. Weekend accidents affect younger, more severely injured and less often female patients with fewer displaced fractures and a lower proportion of acetabular fractures. This results in less frequent operative treatment, but more emergency and early definitive surgery. In contrast to the numerous and significant differences in baseline conditions, the outcome in terms of quality of surgical treatment, morbidity and mortality showed only marginal and non-significant differences between weekend and weekday accidents. Weekend accidents differ from weekday accidents in their initial conditions. This does not lead to more frequent—yet more emergency and more early definitive surgeries. However, there are no differences in the quality of care or outcome according to the day of the accident.

The Department of Defense has continually refined body armor to mitigate battlefield injuries over the last 20 years. Penetrating axilla injuries remain challenging despite adoption of a four-plate ceramic armor system. This study investigates the efficacy of current armor configurations in reducing mortality and morbidity associated with axilla injuries. This was a retrospective case series using afteraction reports from a single Special Operations unit. Records (786) from 2001-2018 were screened, yielding 11 meeting inclusion criteria. Data included injuries, body armor type, clinical interventions, and outcomes. Analysis revealed significant mortality (45%) among casualties sustaining axilla injuries, with 100% mortality for those struck in uncovered side-plate regions under a two-plate system. In contrast, no fatalities occurred when injuries were within protected side-plate regions of a four-plate system. Injury patterns showed consistent thoracic cavity violations, emphasizing the need for robust protection strategies. This study underscores the efficacy of four-plate systems in reducing mortality compared to older configurations, particularly in protecting vital structures like great vessels and the heart. However, limitations in current side-plate coverage suggest potential gaps in protection, especially superiorly. Balancing protection with mobility remains crucial, as highlighted by operational challenges and weight concerns. Findings support the role of side plates in mitigating axilla injuries but highlight the need for expanded coverage using improved material technologies. Fu-ture research should focus on enhancing ballistic protection without compromising operational agility and refining trauma management protocols for optimal casualty outcomes.

摘要： 【摘要】 银屑病是一种免疫介导的、慢性、炎症性、系统性疾病，可发生于任何年龄，严重影响生活质量。白细胞介素17A是银屑病发病的重要炎症因子，司库奇尤单抗是全球首个白细胞介素17A的单克隆抗体， 在中国获批治疗中重度斑块状银屑病的6岁及以上患者、活动性银屑病关节炎成人患者和强直性脊柱炎成人患者。上市以来，我国积累了大量真实世界疗效和安全性数据。本文对司库奇尤单抗的长期疗效与安全性、长期使用策略、特殊患者的使用等进行系统综述并形成了专家共识，目的是促进司库奇尤单抗的规范化应用。

Aims and ObjectivesIncreasing injury severity generally results in poorer clinical outcomes for trauma patients, however determining the ‘severity’ of an injury is complex. Better understanding of how anatomical and physiological drivers relate to patient outcomes would support Emergency Department (ED) clinicians in providing optimal care. This study aimed to investigate the relationship between injury severity and mortality/multiple organ dysfunction, the immediate underlying biological response to injury, and how this varies between direct tissue trauma (related to anatomical injury severity) and tissue ischaemia/cell death (related to shock).Method and DesignProspectively collected data and samples from 413 patients recruited to the ACIT-II study (REC approval: 07/Q0603/29) at the Royal London Hospital were used. Patients were eligible if they arrived in the ED within two hours of injury and met local criteria for trauma team activation. ISS was used to assess anatomical injury severity and base deficit (BD) as a marker of shock. Proteomics analysis for 4979 proteins was performed on blood samples taken at presentation to the ED. Multivariable logistic regression models used bidirectional stepwise search by AIC. Non-parametric tests were used to assess correlation and significance adjusted to control for false discovery rate. All statistical analysis was performed using R.Results and ConclusionIncreasing ISS was associated with worse 24hr mortality (adj OR=1.03, CI=1.02-1.05, p=<0.001), 28 day mortality (adj OR=1.05, CI=1.04-1.07, p=<0.001), and development of Multiple Organ Dysfunction Syndrome (adj OR=1.07, CI=1.06-1.08, p=<0.001). ISS and BD were significantly correlated (⍴ = 0.33, p = <0.01). Most proteins showed significant correlation (p = <0.01) with ISS (87%) and/or BD (83%). 673 proteins showed the strongest correlation with ISS (absolute ⍴ ≥0.5), all also correlating with BD. 292 proteins correlated with ISS but not BD and 82 proteins correlated with BD but not ISS. Building understanding of the biological functions of these proteins will support development of personalised trauma care. 2998 Figure 1Protien correlations with ISS and Bas Deficit

Proximal femur fractures are common in older patients and typically require surgical treatment, with cephalomedullary nails being the gold standard device for this approach. This study aimed to identify the factors associated with the failure of cephalomedullary nailing. We retrospectively evaluated 380 patients treated with a cephalomedullary nail between August 2021 and August 2022 in a trauma referral center in Brazil. A total of 221 (58.1%) patients were included in the study after applying specific eligibility criteria. Data were collected and rates were determined by reviewing patients' medical records and radiographs. Of 221 patients, 14 (6.3%) had nail failures A significant association was found between post-fixation cervico-diaphyseal angle and the occurrence of nail failure (p<0.001). Furthermore, calcar-referenced tip-apex distance (CalTAD) and tip-apex distance (TAD) values were higher in cases with nail failure than in those without nail failure. Cutoff points were established for TAD and CalTAD to measure the correspondence with nail failures. The present study supports previous evidence that varus reduction potentially causes collapse and nail failure in pertrochanteric fractures treated with cephalomedullary nailing and that high TAD and CalTAD values contribute to the incidence of cut-out.

IntroductionFemur fracture is one of the most frequent reasons for admission to paediatric trauma units and has a bimodal incidence. The trauma mechanism varies according to the patient's age. Non-operative treatment continues to be performed, although surgical treatment has gained popularity in recent years. Paediatric orthopaedic traumatologists should always bear in mind the already known general principles of treatment. In this study, we aimed to provide a general characterization of femoral fractures, risk factors, and current definitive treatment methods in a developing Latin American country. Materials and methodsThis is an observational, analytical, retrospective study with a non-probabilistic sample of consecutive cases of skeletally immature patients with femoral fractures treated at a trauma hospital in Asunción, Paraguay, from January to December 2022. Patients with diseases fragile bones and femoral fractures were excluded. Demographic and clinical characteristics of the study population were analysed. ResultsTraffic accidents were the most frequent cause of femoral fractures in our population. Femur fractures were more common in males. The femoral shaft was the most frequent fracture site. Age was one of the most important criteria for defining the treatment approach, considering non-operative management in children younger than 4 years. ConclusionsFracture of the femoral shaft in male patients is the most frequent presentation at our Institution. Summer vacations and traffic accidents are the main risk factors identified in Paraguayan children who suffer a femoral fracture. Non-operative treatment is preferred in children under 4 years of age, while surgical treatment is preferred in children aged 5 years and above. Paediatric orthopaedic traumatologists should be involved in parent education to promote children's safety, especially by increasing care and vigilance during school vacations and dangers related to traffic accidents.

Objetivos: Apresentar a atuação da equipe de enfermagem em primeiros socorros no cuidado ao paciente vítima de trauma, com ênfase nos desafios e atualizações que podem ser vistas na saúde pública e nas importantes maneiras de se prestar esse tipo de serviço de forma qualificada. Metodologia: Trata-se de uma revisão de literatura que tem por finalidade reunir e sintetizar informações sobre equipe de enfermagem em primeiros socorros. Foram utilizados artigos publicados no período entre os anos de 2011 à 2022, excluídos artigos que não atendiam aos objetivos do estudo e não responderam à pergunta norteadora. Resultados: Após a leitura e análise dos artigos, foram selecionados 17 artigos para construção do projeto, dentre os quais foram eleitos os que melhor atenderam a proposta da temática. Para a apuração dos dados, elaborou-se um instrumento com as seguintes variáveis: número do artigo, título do artigo e ano de publicação. Conclusão: Observando o cenário complexo no qual à saúde pública enfrenta contendo grandes desafios, como o aumento da violência urbana, acidentes de trânsito e desastres naturais, que resultam em um número significativo de vítimas de trauma a atuação da equipe de enfermagem em primeiros socorros exerce um papel crucial no cuidado ao paciente vítima decorrentes dessas problemática. Em suma, a atuação da equipe de enfermagem em primeiros socorros no cuidado ao paciente vítima de trauma enfrenta desafios em constante evolução.

IntroductionAn ipsilateral fracture of the femur and tibia (also known as floating knee) is a rare injury in pediatric patients. Recent advances rapidly made the use of intramedullary elastic nails the standard of care in the management of long bone fractures, including floating knee injuries, in patients with immature skeletons. Currently, we have observed a trend of fixing both fractured bones, thus improving functional outcomes, and reducing sequelae. The aim of this study was to report our experience in the management and functional outcomes of floating knee injuries in a single trauma-I level center.Materials and methodsThis is a retrospective study of consecutive cases from June 1, 2018, to March 31, 2022, from a single trauma center. Preoperative and postoperative records and radiographs were assessed, including the epidemiological data and characteristics of the fractures type of treatment, mechanism of injury, complications, and functional evaluation at the last follow-up, which was performed according to the criteria described by Karlstrom and Olerud.ResultsTwenty-five patients were included during the four years of study, of which 18 were male (72%), and the mean age was 9.6 years. Overall, 96% of the cases were related to traffic accidents. An analysis of the provided treatment showed that 19 cases (76%) were resolved with surgery on at least of the bones, and six cases were managed with simultaneous orthopedic treatments in both injuries. Excellent outcomes were achieved in 15 cases (60%), good outcomes in three, fair outcomes in five, and poor outcomes in one. Concerning the classification of injuries according to the criteria developed by Letts and Vincent,it was observed that type D was the most frequent one. With regard to exposed bone injuries, 15 cases presented with open fractures. Complications were found in eight (32%) cases, of which five were related to limb discrepancy and three with functional limitations of the knee, with changes in its range of motion. There was also one case of nonunion of the distal tibia.ConclusionTraffic accidents are the main cause of floating knees. Surgical management of the fractures brought satisfactory outcomes and reduced complications. Thus, fixation of injuries is recommended for early return to daily activities and for a reduction in residual complications.