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Kuenstler EM, Leggit JC, Raiciulescu S, Zhang H, Boden BP. Facial injuries in the National Basketball Association: 2013-14 through 2017-18. PHYSICIAN SPORTSMED 2024; 52:160-166. [PMID: 36990061 DOI: 10.1080/00913847.2023.2196932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE To describe the epidemiology, mechanisms, treatment, and disability for facial injuries in National Basketball Association (NBA) athletes. METHODS This was a retrospective descriptive epidemiological chart review using NBA Electronic Medical Record (EMR) system. Responses to injuries reported in games, practices, and other activities were used for all data analysis, except for game incidence rates. Incidence rates were calculated by the game-related facial injury incidence per total athlete exposure (player-games). RESULTS There were 440 facial injuries among 263 athletes during the 5 NBA seasons with an overall single-season risk of 12.6% and a game incidence of 2.4 per 1000 athlete-exposures (95% CI: 2.18-2.68). The majority of injuries were lacerations (n = 159, 36.1%), contusions (n = 99, 22.5%), or fractures (n = 67, 15.2%), with ocular (n = 163, 37.0%) being the most commonly injured location. Sixty (13.6%) injuries resulted in at least one NBA game missed (224 cumulative player-games) with ocular injuries resulting in the most cumulative games missed (n = 167, 74.6%). Nasal fractures (n = 39, 58.2%) were the most common fracture location followed by ocular fractures (n = 12, 17.9%) but were less likely to lead to games missed (median = 1, IRQ: 1-3) than ocular (median = 7, IQR: 2-10) fractures. CONCLUSIONS An average of one in eight NBA players sustained a facial injury each season with ocular injuries being the most common location. While most facial injuries are minor, serious injuries, especially ocular fractures, can result in games missed.
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Affiliation(s)
- Ens Molly Kuenstler
- School of Medicine, The Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jeffrey C Leggit
- School of Medicine, The Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Sorana Raiciulescu
- School of Medicine, The Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Helen Zhang
- IQVIA, Injury Surveillance and Analytics, Real World Solutions, Durham, NC, USA
| | - Barry P Boden
- The Orthopaedic Center, a Division of CAO, Rockville, MD, USA
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Inclan PM, Kuhn AW, Troyer SC, Solomon GS, Matava MJ. Use of Publicly Obtained Data in Sports Medicine Research: A Systematic Review and Bibliometric Analysis. Am J Sports Med 2024; 52:1367-1373. [PMID: 37306057 DOI: 10.1177/03635465231177054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Publicly obtained data (POD) have recently been utilized frequently by sports medicine researchers to describe injury patterns, risk factors, and outcomes in elite athletes. The relative ease of this type of research that is based solely on internet and media sources has resulted in a near exponential increase in the number of these POD studies. PURPOSE To systematically review the sports medicine literature for studies based solely on POD. STUDY DESIGN Systematic review and bibliometric analysis; Level of evidence, 4. METHODS A systematic review of POD studies published since 2000 was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies of interest were those relying on publicly available injury reports or online media for data acquisition in collegiate, semiprofessional, and professional athletes. RESULTS There were 209 POD studies published between 2000 and 2022, with 173 (82.8%) of these studies published after 2016. Studies were published most frequently on athletes participating in North American professional leagues: National Football League (n = 69 [28.4%]), Major League Baseball (n = 56 [23.0%]), National Basketball Association (n = 37 [15.2%]), and National Hockey League (n = 33 [13.6%]). The most common injuries assessed were head injuries/concussions (n = 43 [21.1%]), anterior cruciate ligament injuries (n = 33 [16.2%]), and ulnar collateral ligament injuries (n = 23 [11.3%]). One-quarter of the studies (n = 53 [25.4%]) reported only 1 POD source, and 1 study (0.5%) reported no source. Additionally, 65 studies (31.1%) listed nonspecific POD resources or solely cited previous literature to describe the POD search methodology and data acquisition. CONCLUSION POD studies are exponentially increasing in number, particularly across major North American professional sports leagues, with significant variability in the injury of interest, search methodology, and number of data sources. The accuracy of the conclusions reached based on the POD methodology appears highly variable. Given the potential impact of these publications as both contributors to current knowledge and drivers of future research, the sports medicine community should be aware of the inherent biases and limitations of POD injury studies.
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Affiliation(s)
- Paul M Inclan
- Department of Orthopaedic Surgery, Washington University in St Louis, St Louis, Missouri, USA
| | - Andrew W Kuhn
- Department of Orthopaedic Surgery, Washington University in St Louis, St Louis, Missouri, USA
| | - Stockton C Troyer
- Department of Orthopaedic Surgery, Washington University in St Louis, St Louis, Missouri, USA
| | | | - Matthew J Matava
- Department of Orthopaedic Surgery, Washington University in St Louis, St Louis, Missouri, USA
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Stojanović E, Faude O, Scanlan AT, Jakovljević V, Ćosić M, Kocić M, Radovanović D. Injury incidence among adolescent and senior basketball players: a prospective study in 19 teams across an entire season. PHYSICIAN SPORTSMED 2023:1-9. [PMID: 37965758 DOI: 10.1080/00913847.2023.2284133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/13/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVE To quantify and compare injury incidence between national-level, adolescent and regional-level, senior, male basketball players competing in Serbia overall and according to injury mechanism (contact, non-contact, or overuse), exposure setting (training or games), and history (new or recurrent). METHODS A total of 218 male basketball players from 19 teams (106 senior and 112 adolescent players) volunteered to participate in the study. Descriptive data regarding game and training injury incidence were gathered across all players and reported per 10,000 athlete-exposures (AE) with 95% confidence intervals. RESULTS Overall, 26 injuries were reported across 52,509 AE. Ankle (n = 10, incidence rate [IR] = 1.90 [0.97, 3.40]) and knee injuries (n = 8, IR = 1.52 [0.71, 2.89]) accounted for 69% of all reported injuries, with only 1-2 injuries documented for other body regions. Ankle injuries were attributed to contact (60%, IR = 1.14 [0.46, 2.38]) or non-contact mechanisms (40%, IR = 0.76 [0.24, 1.84]). Most knee injuries occurred due to overuse (50%, IR = 0.76 [0.24, 1.84]) or non-contact mechanisms (38%, IR = 0.57 [0.15, 1.56]). Comparisons according to exposure setting revealed significantly higher knee (incidence rate ratio [IRR] = 9.95 [1.85, 53.41], p = 0.004) and ankle (IRR = 39.79 [7.94, 384.67], p < 0.001) injuries per 10,000 AE during games compared to training. Recurrent injuries were most prominent in the ankle (30% of all ankle injuries, p = 0.11). Total contact (p = 0.04), non-contact (p = 0.04), and recurrent IR (p = 0.005) were significantly higher in senior than adolescent players. CONCLUSION The players examined were most susceptible to ankle and knee injuries, particularly during games compared to training. Ankle injuries were mostly attributed to player contact, while knee injuries were mostly attributed to overuse and non-contact mechanisms. Senior players were at a greater risk of sustaining contact, non-contact and recurrent injuries than adolescent players.
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Affiliation(s)
- Emilija Stojanović
- Faculty of Medical Sciences, Department of Physiology, University of Kragujevac, Kragujevac, Serbia
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Aaron T Scanlan
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Vladimir Jakovljević
- Faculty of Medical Sciences, Department of Physiology, University of Kragujevac, Kragujevac, Serbia
- Department of Human Pathology, State Medical University IM Sechenov, Moscow, Russian Federation
| | - Marko Ćosić
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade, Serbia
| | - Miodrag Kocić
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
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Dreyer NA, Mack CD. Tactical Considerations for Designing Real-World Studies: Fit-for-Purpose Designs That Bridge Research and Practice. Pragmat Obs Res 2023; 14:101-110. [PMID: 37786592 PMCID: PMC10541678 DOI: 10.2147/por.s396024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023] Open
Abstract
Real-world evidence (RWE) is being used to provide information on diverse groups of patients who may be highly impacted by disease but are not typically studied in traditional randomized clinical trials (RCT) and to obtain insights from everyday care settings and real-world adherence to inform clinical practice. RWE is derived from so-called real-world data (RWD), ie, information generated by clinicians in the course of everyday patient care, and is sometimes coupled with systematic input from patients in the form of patient-reported outcomes or from wearable biosensors. Studies using RWD are conducted to evaluate how well medical interventions, services, and diagnostics perform under conditions of real-world use, and may include long-term follow-up. Here, we describe the main types of studies used to generate RWE and offer pointers for clinicians interested in study design and execution. Our tactical guidance addresses (1) opportunistic study designs, (2) considerations about representativeness of study participants, (3) expectations for transparency about data provenance, handling and quality assessments, and (4) considerations for strengthening studies using record linkage and/or randomization in pragmatic clinical trials. We also discuss likely sources of bias and suggest mitigation strategies. We see a future where clinical records - patient-generated data and other RWD - are brought together and harnessed by robust study design with efficient data capture and strong data curation. Traditional RCT will remain the mainstay of drug development, but RWE will play a growing role in clinical, regulatory, and payer decision-making. The most meaningful RWE will come from collaboration with astute clinicians with deep practice experience and questioning minds working closely with patients and researchers experienced in the development of RWE.
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Robell KC, Norcross MF, Bohr AD, Harmon KG. Pac-12 Health Analytics Program: An Innovative Approach to Health Care Operations, Data Analytics, and Clinical Research in Intercollegiate Athletics. J Athl Train 2023; 58:655-663. [PMID: 36521171 PMCID: PMC10569253 DOI: 10.4085/1062-6050-0063.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
The objective of this study was to describe the purpose, methods, and effects of the Pac-12 Health Analytics Program (HAP) approach on sports medicine informatics, research, analytics, and health care operations. Sports injury-surveillance initiatives have been supporting the clinical research community in sports medicine for nearly 4 decades. Whereas the initial systems tracked only a few sports, current surveillance programs have expanded to include entire professional and elite athlete organizations, providing important statistics on sports injury risk management. The HAP is a conference-wide data-sharing and-analytics program. It collects authorized, deidentified clinical data, encompassing multiple domains of sports medicine injury management, including sports injuries and illnesses, concussions, risk exposure, and COVID-19 testing elements. The HAP provides clinicians with access to curated data to inform evidence-based practice and support local health care operations with respect to emerging sports injury trends. The HAP supplies approved research groups with access to a data repository that describes a homogeneous, elite intercollegiate athlete sample, thereby supporting nonresearch clinical initiatives as well as contributions to peer-reviewed research that can improve the health and well-being of Pac-12 student-athletes. The HAP is a novel approach to sports injury epidemiology and surveillance that has allowed the Pac-12 Conference to meet larger objectives regarding improving the student-athlete experience and clinical research among its member schools. Data quality control has improved the accuracy of the data and value to clinical athletic trainers within the conference. Curated dashboards displaying aggregated project data offer clinicians data-driven decision-making tools that help inform sports injury risk management. As of 2021, the HAP had supported more than 3 dozen data requests. These investigations have resulted in numerous peer-reviewed research contributions to the sports medicine community with findings that have great potential to improve the health and well-being of Pac-12 student-athletes.
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Affiliation(s)
| | - Marc F. Norcross
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - Adam D. Bohr
- Department of Integrative Physiology, University of Colorado Boulder
| | - Kimberly G. Harmon
- Department of Family Medicine, University of Washington School of Medicine, Seattle
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Inclan PM, Kuhn AW, Chang PS, Mack C, Solomon GS, Sills AK, Matava MJ. Validity of Research Based on Publicly Obtained Data in Sports Medicine: A Quantitative Assessment of Concussions in the National Football League. Sports Health 2023; 15:527-536. [PMID: 37029663 PMCID: PMC10293571 DOI: 10.1177/19417381231167333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
CONTEXT Numerous researchers have leveraged publicly available internet sources to publish clinical research concerning incidence and recovery from injuries in National Football League (NFL) players. OBJECTIVE This study aims to (1) provide a comprehensive systematic review of all publicly obtained data studies (PODS) regarding concussions in NFL athletes and (2) quantify the percentage of injuries identified by these studies in comparison with published concussion data from the NFL injury database. STUDY SELECTION A systematic review was conducted in accordance with PRISMA guidelines to identify all published studies utilizing publicly obtained data regarding concussions in NFL athletes. STUDY DESIGN Systematic review. LEVEL OF EVIDENCE Level 4. DATA EXTRACTION Manuscript details, factors related to the athletes of interest (eg, study period, positions included), and results (eg, concussion rate, number of total concussions, return-to-play data) were extracted independently by 2 authors. Results were compared with incident concussions reported from 2015 to 2019 by each medical staff member to the NFL database linked to the League's electronic health record (EHR). RESULTS A total of 20 concussion-focused manuscripts based on PODS were identified from 2014 to 2020. PODS captured between 20% and 90% of concussions (mean, 70%) reported by medical staff to the injury database. PODS reported that 55% of concussions occurred on offensive plays, 45% on defensive plays and <1% occurred during special teams plays, compared with 44%, 37%, and 18%, respectively, as indicated by published data from the NFL injury database. When analyzed by position groups, running backs and quarterbacks comprised the most over-represented positions concussed in PODS, while offensive linemen, defensive backs, and linebackers comprised the most under-represented positions. CONCLUSION PODS captured approximately 70% of concussions reported by NFL medical staff to the NFL injury database. There is heterogeneity in the degree to which PODS were able to identify concussions, with a bias toward concussions among players at higher profile positions.
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Affiliation(s)
- Paul M Inclan
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri
| | - Andrew W Kuhn
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri
| | - Peter S Chang
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri
- Department of Orthopaedic Surgery, The Steadman Clinic, Vail, Colorado
| | | | - Gary S Solomon
- National Football League, New York, New York
- Department of Neurological Surgery, Vanderbilt University, Nashville, Tennessee
| | - Allen K Sills
- National Football League, New York, New York
- Department of Neurological Surgery, Vanderbilt University, Nashville, Tennessee
| | - Matthew J Matava
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri
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7
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Stojanović E, Faude O, Nikić M, Scanlan AT, Radovanović D, Jakovljević V. The incidence rate of ACL injuries and ankle sprains in basketball players: A systematic review and meta-analysis. Scand J Med Sci Sports 2023; 33:790-813. [PMID: 36752659 DOI: 10.1111/sms.14328] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/21/2022] [Accepted: 02/02/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To quantify the incidence rate of anterior cruciate ligament (ACL) injuries and ankle sprains according to player sex, playing level, and exposure setting (training vs. games) in basketball players. METHODS PubMed, MEDLINE, Google Scholar, and ScienceDirect were searched. Only studies reporting the number of ACL injuries and/or ankle sprains alongside the number of athlete-exposures (training sessions and/or games) in basketball players were included. RESULTS Thirty studies (17 reporting ACL injuries and 16 reporting ankle sprains) were included in the meta-analysis. Higher (p < 0.05) ACL injury incidence rates per 1000 athlete-exposures were recorded in females (female: 0.20 95% confidence intervals [0.16-0.25]; male: 0.07 [0.05-0.08]; female-to-male ratio: 3.33 [3.10-3.57]), in players competing at higher playing levels (amateur: 0.06 [0.04-0.09]; intermediate: 0.16 [0.13-0.20]; elite: 0.25 [0.14-0.64]), and in games (games: female, 0.27 [0.21-0.32]; male, 0.06 [0.03-0.08]; training: female, 0.03 [0.02-0.05]; male: 0.01 [0.00-0.02]; game-to-training ratio: 7.90 [4.88-12.91]). Higher (p < 0.05) ankle sprain incidence rates per 1000 athlete-exposures were observed in males (female: 0.82 [0.61-1.03]; male: 0.90 [0.61-1.19]; female-to-male ratio: 0.91 [0.83-0.99]), in players competing at higher playing levels (amateur: 0.54 [0.51-0.57]; intermediate: 1.12 [1.00-1.24]; elite: 1.87 [1.29-2.46]), and in games (games: 2.51 [1.85-3.16]; training: 0.80 [0.52-0.80]; game-to-training ratio: 2.77 [2.35-3.26]). CONCLUSION According to player sex, ACL injury incidence rate is higher in females, while ankle sprain incidence rate is greater in males. ACL injury and ankle sprain incidence rates are greater in players competing at higher playing levels and during games compared to training.
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Affiliation(s)
- Emilija Stojanović
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Miloš Nikić
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Aaron T Scanlan
- Human Exercise and Training Laboratory, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | | | - Vladimir Jakovljević
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Department of Human Pathology, Moscow State Medical University IM Sechenov, Moscow, Russia
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Chimera NJ, Merasty D, Lininger MR. Injuries and Illnesses Across 10 Years of Canada Games Competitions: 2009 - 2019. Int J Sports Phys Ther 2022; 17:1372-1382. [PMID: 36518838 PMCID: PMC9718729 DOI: 10.26603/001c.39743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/11/2022] [Indexed: 10/08/2023] Open
Abstract
Background The Canada Games are a national level competition held every two years alternating between Summer and Winter Games. Participation in elite level athletics, like the Canada Games, have an inherent risk of injury and illness. Purpose To analyze the incidence and characteristics of injuries and illnesses during Canada Games competitions from 2009-2019 (primarily) and to understand sex differences in odds of musculoskeletal injury for Summer and Winter Canada Games athletes (secondarily). Study Design Descriptive Epidemiology Study. Methods Using a retrospective cohort, data were abstracted from medical incident reports generated during Canada Games from 2009 - 2019. Data were coded for body part injured and injury type or illness system; injuries were also categorized as acute or chronic. Results Across all 10 years of competition, 3160 injuries reported in 8710 male athletes and 3272 injuries reported in 8391 female athletes. Injury incidence was 362.8 and 389.9 and illness incidence was 47.8 and 64.5 per 1000 male and female athletes, respectively. Female athletes had a 1.12 (95% CI: 1.06; 1.19) greater odds of injury and 1.37 (95% CI: 1.20; 1.57) greater odds of illness compared to male athletes. Overall, injury (399.31 vs. 360.31; p < 0.001) and illness (68.67 vs. 47.30; p < 0.001) incidences were higher in Winter Games, compared to Summer Games, per 1000 athletes. When comparing male and female athletes participating in similar sports, sex specific differences exist in odds of both injury and illness. Conclusions Male and female athletes competing in Canada Games competitions demonstrate differences in injury and illness incidence and odds of injury. This suggests a need to examine if additional modifiable risk factors may exist, which could contribute to prevention strategies to reduce injury and illness during Canada Games competition. Level of Evidence 3.
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Affiliation(s)
| | | | - Monica R Lininger
- Department of Physical Therapy and Athletic Training Northern Arizona University
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9
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Rizzi AM, Baker HP, Lee CS, Athiviraham A. Lower Extremity Stress Fractures in the National Basketball Association, 2013-2014 Through 2018-2019. Orthop J Sports Med 2022; 10:23259671221126485. [PMID: 36225389 PMCID: PMC9549108 DOI: 10.1177/23259671221126485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/27/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Players in the National Basketball Association (NBA) are at risk for lower extremity stress fractures, partly because of the sport's high-intensity demand on the lower body. PURPOSE To provide insight on the identification and management of potential risk factors associated with lower extremity stress fractures in NBA athletes. STUDY DESIGN Case series; Level of evidence, 4. METHODS A retrospective study was conducted using the NBA electronic medical record database for all players who were on an NBA roster for ≥1 game from the 2013-2014 through 2018-2019 seasons. Player characteristics, games missed, and treatment methodology were independently analyzed. Results were presented as incidence per 1000 player-games. RESULTS There were 22 stress fractures identified in 20 NBA players over the course of 6 years, with an average of 3.67 stress fractures per year and an incidence of 0.12 stress fractures per 1000 player-games. Most stress fractures occurred in the foot (17/22), and 45% (10/22) of stress fractures were treated surgically, with the most common site of operation being the navicular. On average, approximately 37 games and 243 days were missed per stress fracture injury. There was no significant difference in time to return to play between high-risk stress fractures treated operatively versus nonoperatively (269.2 vs 243.8 days; P = .82). CONCLUSION The overall incidence of stress fractures in NBA players was 0.12 per 1000 player-games, and a high percentage of players returned to NBA activity after the injury. There was a relatively even distribution between high-risk stress fractures treated operatively and nonoperatively. When comparing high-risk stress fractures treated operatively to ones treated nonoperatively, no significant difference in average time to return to play in the NBA was found.
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Affiliation(s)
- Andrew M. Rizzi
- Department of Orthopaedic Surgery, University of Chicago Medicine,
Chicago, Illinois, USA.,Andrew M. Rizzi, MD, Department of Orthopaedic Surgery,
University of Chicago Medicine, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
()
| | - Hayden P. Baker
- Department of Orthopaedic Surgery, University of Chicago Medicine,
Chicago, Illinois, USA
| | - Cody S. Lee
- Department of Orthopaedic Surgery, University of Chicago Medicine,
Chicago, Illinois, USA
| | - Aravind Athiviraham
- Department of Orthopaedic Surgery, University of Chicago Medicine,
Chicago, Illinois, USA
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10
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Egger AC, Minkara A, Parker R, Rosneck J. Intra-articular Hip Injuries in National Basketball Association Players: A Descriptive Epidemiological Study. Orthop J Sports Med 2022; 10:23259671221122744. [PMID: 36157088 PMCID: PMC9490462 DOI: 10.1177/23259671221122744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 07/06/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Since the most recent epidemiologic study of injuries in National Basketball Association (NBA) players was completed in 2012, the understanding and diagnosis of intra-articular hip injury has advanced. Purpose: To report the epidemiology of intra- versus extra-articular hip injuries in NBA players with regard to missed games, risk factors for injury, and treatment types. Study Design: Cohort study; Level of evidence, 3. Methods: The NBA injury database was queried for all reported hip and groin injuries from 2013 to 2017. The injuries were then divided into intra-articular and extra-articular types. Variables compared between injury types included player age, NBA tenure, season schedule (preseason or offseason), onset type, injury mechanism, roster position, games missed, time to return to play, and need for surgery. Results: A total of 224 athletes sustaining 353 total hip pathologies were identified. Of these injuries, 216 (61.2%) were sustained during game competition and affected 156 (69.6%) of the athletes. Intra-articular injuries represented 39 (11.0%) cases and involved 36 (16.1%) players. The time to return to play was significantly longer after intra-articular versus extra-articular injury (44.6 ± 96.0 vs 11.8 ± 32.0 days; P = .03), and the number of games missed was significantly greater after intra-articular versus extra-articular injury (8.0 ± 18.7 vs 1.54 ± 4.9 games; P = .03). Patients with intra-articular hip injuries were more likely to undergo surgery (odds ratio, 5.5 [95% CI, 1.8-16.7]; P = .005). There was no statistically significant difference in the number of games missed due to surgery (35.2 ± 8.3 [intra-articular] vs 35.4 ± 11.6 [extra-articular]; P = .42) or nonoperative treatment (4.2 ± 3.4 [intra-articular] vs 1.3 ± 0.5 [extra-articular]; P = .11). Years of NBA tenure were not significantly different between intra-articular and extra-articular injuries (7.1 ± 3.7 vs 6.3 ± 4.0 years). For both types of hip injury, there was no correlation between player age and either days to return to play or number of games missed (R2 = 0.014). Conclusion: NBA players with intra-articular hip injuries underwent surgery more frequently and had a longer return-to-play time compared with those with extra-articular hip injuries. NBA tenure and player age were not correlated with the risk of developing hip injury or the need for surgery.
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Affiliation(s)
| | - Anas Minkara
- Cleveland Clinic Foundation, Garfield Heights, Ohio, USA
| | - Richard Parker
- Cleveland Clinic Foundation, Garfield Heights, Ohio, USA
| | - James Rosneck
- Cleveland Clinic Foundation, Garfield Heights, Ohio, USA
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11
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Inclan PM, Chang PS, Mack CD, Solomon GS, Brophy RH, Hinton RY, Spindler KP, Sills AK, Matava MJ. Validity of Research Based on Public Data in Sports Medicine: A Quantitative Assessment of Anterior Cruciate Ligament Injuries in the National Football League. Am J Sports Med 2022; 50:1717-1726. [PMID: 34166138 DOI: 10.1177/03635465211015435] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Numerous researchers have leveraged publicly available Internet sources to publish publicly obtained data (POD) studies concerning various orthopaedic injuries in National Football League (NFL) players. PURPOSE To provide a comprehensive systematic review of all POD studies regarding musculoskeletal injuries in NFL athletes and to use anterior cruciate ligament (ACL) injuries in NFL players to quantify the percentage of injuries identified by these studies. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS A systematic review was conducted to identify all published studies utilizing POD regarding ACL injury in NFL athletes from 2000 to 2019. Data regarding player demographics were extracted from each publication. These results were compared with prospectively collected data reported by the teams' medical staff to the NFL Injury Surveillance System database linked to the League's electronic health record. An ACL "capture rate" for each article was calculated by dividing the number of ACL injuries in the POD study by the total number of ACL injuries in the NFL injury database occurring in the study period of interest. RESULTS A total of 42 studies were extracted that met the definition of a POD study: 28 evaluated a variety of injuries and 14 dealt specifically with ACL injuries, with 35 (83%) of the 42 studies published during or since 2015. POD studies captured a mean of 66% (range, 31%-90%) of ACL injuries reported by the teams' medical staff. This inability to capture all injury rates varied by position, with 86% capture of ACL injuries in skill athletes, 72% in midskill athletes, and 61% in linemen. POD studies captured 35% of injuries occurring during special teams play. CONCLUSION The frequency of studies leveraging publicly obtained injury data in NFL players has rapidly increased since 2000. There is significant heterogeneity in the degree to which POD studies correctly identify ACL injuries from public reports. Sports medicine research relying solely on publicly obtained sources should be interpreted with an understanding of their inherent limitations and biases. These studies underreport the true incidence of injuries, with a bias toward capturing injuries in more popular players.
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Affiliation(s)
- Paul M Inclan
- Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Peter S Chang
- Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA
| | | | - Gary S Solomon
- National Football League, New York, New York, USA.,Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Robert H Brophy
- Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA
| | | | | | - Allen K Sills
- National Football League, New York, New York, USA.,Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Matthew J Matava
- Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA
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12
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Sarlis V, Chatziilias V, Tjortjis C, Mandalidis D. A Data Science approach analysing the Impact of Injuries on Basketball Player and Team Performance. INFORM SYST 2021. [DOI: 10.1016/j.is.2021.101750] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Hak DJ, Mackowiak JI, Irwin DE, Aldridge ML, Mack CD. Real-World Evidence: A Review of Real-World Data Sources Used in Orthopaedic Research. J Orthop Trauma 2021; 35:S6-S12. [PMID: 33587540 DOI: 10.1097/bot.0000000000002038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 02/02/2023]
Abstract
SUMMARY Real-world data (RWD) play an increasingly important role in orthopaedics as demonstrated by the rapidly growing number of publications using registry, administrative, and other databases. Each type of RWD source has its strengths and weaknesses, as does each specific database. Linkages between real-world data sets provide even greater utility and value for research than single data sources. The unique qualities of an RWD data source and all data linkages should be considered before use. Close attention to data quality and use of appropriate analysis methods can help alleviate concerns about validity of orthopaedic studies using RWD. This article describes the main types of RWD used in orthopaedics and provides brief descriptions and a sample listing of publications from selected, key data sources.
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Affiliation(s)
- David J Hak
- Hughston Orthopaedic Trauma Surgeons, Central Florida Regional Hospital, Sanford, FL
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14
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Maak TG, Mack CD, Cole BJ, Herzog MM, Difiori J, Meisel P. Sports Performance and Injury Research: Methodologic Limitations and Recommendations for Future Improvements. Arthroscopy 2020; 36:2938-2941. [PMID: 33045333 DOI: 10.1016/j.arthro.2020.08.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/03/2020] [Accepted: 08/11/2020] [Indexed: 02/02/2023]
Abstract
Evidence-based research has resulted in incredible advances in sports medicine and is an important component of minimizing injury risk. Such research is similarly important when applied to care delivery to athletes after injury. For research into injury reduction and treatment outcomes to be most impactful, however, the methods must be of sufficient rigor to generate high-quality evidence. Two recent trends in sports injury research have led to specific concerns about evidence quality: 1) use of athletic performance metrics as an injury or treatment outcome and 2) use of publicly available data for injury or treatment research.
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Affiliation(s)
- Travis G Maak
- National Basketball Association, Research Committee, U.S.A.; Department of Orthopaedics, University of Utah, Salt Lake City, Utah, U.S.A..
| | - Christina D Mack
- National Basketball Association, Research Committee, U.S.A.; IQVIA Real-World Solutions, Research Triangle Park, Durham, North Carolina, U.S.A
| | - Brian J Cole
- National Basketball Association, Research Committee, U.S.A.; Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Mackenzie M Herzog
- National Basketball Association, Research Committee, U.S.A.; IQVIA Real-World Solutions, Research Triangle Park, Durham, North Carolina, U.S.A
| | - John Difiori
- National Basketball Association, Research Committee, U.S.A
| | - Peter Meisel
- National Basketball Association, Research Committee, U.S.A
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15
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Patel BH, Okoroha KR, Jildeh TR, Lu Y, Baker JD, Nwachukwu BU, Foster MG, Allen AA, Forsythe B. Adductor injuries in the National Basketball Association: an analysis of return to play and player performance from 2010 to 2019. PHYSICIAN SPORTSMED 2020; 48:450-457. [PMID: 32202444 DOI: 10.1080/00913847.2020.1746978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objectives: 1) To evaluate return to play (RTP) timing in National Basketball Association (NBA) athletes following adductor injuries, and 2) to evaluate the effect of adductor injuries on player performance, game availability, and career longevity following RTP. Methods: Adductor injuries in NBA athletes from the 2009-2010 to 2018-2019 seasons were identified utilizing publicly available records via previously validated methodology. RTP time was calculated, and player performance and game availability were compared pre- vs. post-injury. Additionally, an injury-free control group matched for age, BMI, position, and experience was assembled to allow for comparisons in performance, availability, and career length. Results: In total, 79 adductor injuries across 65 NBA athletes were identified. The average injured player was 28.3 ± 4.0 years of age, and had 6.5 ± 4.2 seasons of NBA experience. Guards were injured more frequently than forwards or centers (49% vs 25% vs 25%, respectively). All players were able to RTP following first-time adductor injury after missing an average of 7.7 ± 9.8 games (median [IQR]: 4 [1-9]) and 16.9 ± 20.4 days (median [IQR]: 9 [3.5-20]). Twelve players (18.5%) suffered an adductor re-injury at a mean latency of 509.5 ± 503.9 days. Adductor injuries did not result in significant changes in any major statistical category (points, assists, rebounds, steals, blocks, turnovers, field goal percentage), player efficiency rating (PER), minutes/game, games/season, or a number of all-star selections (all P > 0.05) following RTP. Additionally, when compared to matched controls, no difference was found in pre- to post-injury change of PER, games/season, or minutes/game (all P > 0.05). Career longevity was not significantly different between groups (P = 0.44). Conclusion: Following adductor injury, NBA players returned to gameplay after missing an average of 16 to 17 days, or 7 to 8 games. Adductor injury did not affect player performance, nor game availability or career longevity.
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Affiliation(s)
- Bhavik H Patel
- Midwest Orthopaedics at RUSH, Rush University Medical Center , Chicago, IL, USA
| | - Kelechi R Okoroha
- Department of Orthopaedic Surgery, Henry Ford Health System , Detroit, MI, USA
| | - Toufic R Jildeh
- Department of Orthopaedic Surgery, Henry Ford Health System , Detroit, MI, USA
| | - Yining Lu
- Midwest Orthopaedics at RUSH, Rush University Medical Center , Chicago, IL, USA
| | - James D Baker
- Midwest Orthopaedics at RUSH, Rush University Medical Center , Chicago, IL, USA
| | - Benedict U Nwachukwu
- Department of Orthopaedic Surgery, Hospital for Special Surgery , New York, NY, USA
| | - Mitchell G Foster
- School of Medicine, University of California, San Diego , La Jolla, CA, USA
| | - Answorth A Allen
- Department of Orthopaedic Surgery, Hospital for Special Surgery , New York, NY, USA
| | - Brian Forsythe
- Midwest Orthopaedics at RUSH, Rush University Medical Center , Chicago, IL, USA
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16
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Salehi PP, Heiser A, Torabi SJ, Azizzadeh B, Lee J, Lee YH. Facial Fractures and the National Basketball Association: Epidemiology and Outcomes. Laryngoscope 2020; 130:E824-E832. [DOI: 10.1002/lary.28690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/09/2020] [Accepted: 03/25/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Parsa P. Salehi
- Department of Surgery, Otolaryngology–Head and Neck Surgery Yale University School of Medicine New Haven Connecticut U.S.A
| | - Alyssa Heiser
- Department of Otolaryngology–Head and Neck Surgery The University of Vermont Medical Center Burlington Vermont U.S.A
| | - Sina J. Torabi
- Department of Surgery, Otolaryngology–Head and Neck Surgery Yale University School of Medicine New Haven Connecticut U.S.A
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery Beverly Hills California U.S.A
- Division of Head and Neck Surgery, Department of Otolaryngology–Head and Neck Surgery David Geffen School of Medicine at the University of California Los Angeles California Los Angeles U.S.A
| | - Jonathan Lee
- Department of Surgery, Division of Plastic Surgery Baystate Medical Center Springfield Massachusetts U.S.A
| | - Yan H. Lee
- Department of Surgery, Otolaryngology–Head and Neck Surgery Yale University School of Medicine New Haven Connecticut U.S.A
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17
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Herzog MM, Mack CD, Dreyer NA, Wikstrom EA, Padua DA, Kocher MS, DiFiori JP, Marshall SW. Ankle Sprains in the National Basketball Association, 2013-2014 Through 2016-2017. Am J Sports Med 2019; 47:2651-2658. [PMID: 31389712 DOI: 10.1177/0363546519864678] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Ankle sprains are one of the most common injuries in basketball. Despite this, the incidence and setting of ankle sprains among elite basketball players are not well described. PURPOSE To describe the epidemiology of ankle sprains among National Basketball Association (NBA) players. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS All players on an NBA roster for ≥1 NBA game (preseason, regular season, or playoffs) during the 2013-14 through 2016-17 seasons were included. Data were collected with the NBA electronic medical record system. All NBA teams used the electronic medical record continuously throughout the study period to record comprehensive injury data, including onset, mechanism, setting, type, and time lost. Game incidence rates were calculated per 1000 player-games and per 10,000 player-minutes of participation, stratified by demographic and playing characteristics. RESULTS There were 796 ankle sprains among 389 players and 2341 unique NBA player-seasons reported in the league from 2013-14 through 2016-17. The overall single-season risk of ankle sprain was 25.8% (95% CI, 23.9%-28.0%). The majority of ankle sprains occurred in games (n = 565, 71.0%) and involved a contact mechanism of injury (n = 567, 71.2%). Most ankle sprains were lateral (n = 638, 80.2%). The incidence of ankle sprain among players with a history of prior ankle sprain in the past year was 1.41 times (95% CI, 1.13-1.74) the incidence of those without a history of ankle sprain in the past year (P = .002). Fifty-six percent of ankle sprains did not result in any NBA games missed (n = 443); among those that did, players missed a median of 2 games (interquartile range, 1-4) resulting in a cumulative total of 1467 missed player-games over the 4-season study period. CONCLUSION Ankle sprains affect approximately 26% of NBA players on average each season and account for a large number of missed NBA games in aggregate. Younger players and players with a history of ankle sprain have elevated rates of incident ankle sprains in games, highlighting the potential benefit for integrating injury prevention programs into the management of initial sprains. Research on basketball- and ankle-specific injury prevention strategies could provide benefits.
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Affiliation(s)
- Mackenzie M Herzog
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,University of North Carolina Injury Prevention Research Center, Chapel Hill, North Carolina, USA.,Injury Surveillance and Analytics, Real-World Analytics Solutions, IQVIA Durham, North Carolina, USA
| | - Christina DeFilippo Mack
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Injury Surveillance and Analytics, Real-World Analytics Solutions, IQVIA Durham, North Carolina, USA
| | - Nancy A Dreyer
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Injury Surveillance and Analytics, Real-World Analytics Solutions, IQVIA Durham, North Carolina, USA
| | - Erik A Wikstrom
- Department of Exercise and Sport Science, College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Darin A Padua
- Department of Exercise and Sport Science, College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mininder S Kocher
- The Micheli Center for Sports Injury Prevention, Boston Children's Hospital Boston, Massachusetts, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital Boston, Massachusetts, USA.,Department of Orthopaedic Surgery, Harvard Medical School Boston, Massachusetts, USA
| | - John P DiFiori
- National Basketball Association New York, New York, USA.,Primary Care Sports Medicine, Hospital for Special Surgery New York, New York, USA
| | - Stephen W Marshall
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,University of North Carolina Injury Prevention Research Center, Chapel Hill, North Carolina, USA.,Department of Exercise and Sport Science, College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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