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Dominik Szymski,1 Leonard Achenbach,2,3 Martin Siebentritt,4 Karola Simoni,5 Norbert Kuner,5 Christian Pfeifer,1 Werner Krutsch,1,6 Volker Alt,1 Rainer Meffert,2 Kai Fehske2 1Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany; 2Department of Trauma-, Hand-, Plastic- and Reconstructive Surgery, University Wuerzburg, Wuerzburg, Germany; 3Department of Orthopaedics, Koenig-Ludwig-Haus, University Wuerzburg, Wuerzburg, Germany; 4Department for Anesthesiology and Operative Intensive Care, Bayreuth, Germany; 5General Medicine and Dermatology, Medical Center for General Medicine, Dermatology, Paediatrics and Internal Medicine, Costa Calma Fuerteventura, Costa Calma, Spain; 6Sports-Orthopedics, SportDocs Franken, Nuremberg, GermanyCorrespondence: Kai FehskeDepartment of Trauma-, Hand-, Plastic- and Reconstructive Surgery, University Wuerzburg, Wuerzburg, GermanyTel +49 931 201 37001Fax +49 931 201 37009Email kai.fehske@ukw.deIntroduction/Background: Surfing, wind surfing and kite surfing enjoy a growing popularity with a large number of athletes worldwide. The aim of this study was to identify and compare the injury profiles and compare the injury profiles of these three extreme water sports.Materials and Methods: These data for this retrospective cohort study were collected through an online standardised questionnaire during the 2017– 18 season. The questionnaire included questions about anthropometry, skill level, injury diagnosis, injury mechanism, environmental conditions and training regimes.Results: The 626 athletes included reported 2584 injuries. On average, each athlete sustained 4.12 injuries during the season. The most frequent injury location was in the lower extremity, in particular the foot, with 49 (16.4%) injuries in surfing, 344 (18.3%) in wind surfing and 79 (19.7%) in kite surfing. Surfing demonstrated a particularly high rate of head injuries (n = 37; 12.4%). Other frequent injury types were skin lesions (up to 42.1%) and contusions (up to 40.5%). The most common injury across all surfing sports was skin lesions of the foot (wind surfing: 11.7%; kite surfing: 13.2%; surfing: 12.7%). In surfing, skin lesions of the head were frequently observed (n = 24; 8.0%). In surfing, a ‘too large wave’ (n = 18; 24.7%) was main cause of the injury, while in wind surfing (n = 189; 34.5%) and kite surfing (n = 65; 36.7%) ‘own incompetence’ led to the most injuries.Conclusion: This unique study compares injury epidemiology and mechanism in the three most popular surfing sports: wind surfing, kite surfing and surfing. Overall, injuries were sustained mainly in the lower extremity, while surfing also demonstrated a high rate of head injuries.Keywords: water sports, injury, training, ankle, foot, epidemiology

Volker Krutsch,1 Annabelle Clement,2 Tobias Heising,3 Leonard Achenbach,4 Christian Pfeifer,2 Johannes Weber,2 Volker Alt,2 Werner Krutsch2,5 1Department of Otorhinolaryngology, Paracelsus Medical University Nuremberg, Nuremberg, Germany; 2Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany; 3Department of Internal Medicine, Marienhospital Osnabrueck, Osnabrueck, Germany; 4Department of Trauma Surgery, University Hospital Wuerzburg, Wuerzburg, Germany; 5SportDocsFranken, Nuremberg, GermanyCorrespondence: Werner KrutschDepartment of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauß Allee 1, Regensburg 93053, GermanyTel +49 176 24225995Email werner.krutsch@ukr.dePurpose: Small-field soccer is a popular type of amateur sports worldwide. One type of small-field soccer growing in popularity is bubble-soccer, but injury risks and injury patterns are still unclear. This study investigates the factors influencing injuries in bubble-soccer for the first time.Materials and Methods: This prospective cohort study of an outdoor tournament investigated the injury incidence and injury patterns as well as the factors influencing injuries in bubble-soccer matches. Data were collected according to the statement on data collection and injury definition. Preparation and physical outcome were assessed for both sexes.Results: Of 145 players (104 men, 41 women), 58 players sustained 94 injuries during the tournament and 64% of injuries affected the lower extremities. The most common traumatic injuries were skin lesions (37.5%), acute pain (15.6%) and contusion (7.8%). More female players (3818.2/1000 h bubble-soccer) than male players (1474.4) were affected by injury, mostly to the knees or the head. Also, women significantly more often reported neck pain than men (p< 0.042); 29.0% of players felt uncomfortable wearing the bubble, and 21.4% reported neurological symptoms such as headache or dizziness after the match.Conclusion: Bubble-soccer shows a relatively high injury incidence. Women had a higher injury incidence and were more often affected by traumatic injuries to the head and neck including feeling of discomfort and headache or neck pain after the match. Adequate preparation seems to be essential for injury prevention, and players should recognise the high injury risk of bubble-soccer.Keywords: bubble soccer, injury, soccer, risk factor, prevention

With regards to Berardo Di Matteo, second author. The author's name is incorrectly listed on Pub-Med. The first and last name have been mixed up.

One European and one Mediterranean Phragmites australis genotype (DK clone and ALG clone, respectively) showed distinct aboveground growth and physiology in response to different treatment combinations of elevated CO2 and temperature according to their genetic background. The DK clone was the most responsive clone., The aboveground growth, physiological and biochemical parameters of two clones of the cosmopolitan wetland grass Phragmites australis, grown at four treatment combinations of temperature and CO2, were investigated to elucidate whether their climate response differed due to inherent differences in their ecological adaptation. The two phylogeographically distinct P. australis clones (DK clone, European genetic background; ALG clone, Mediterranean genetic background) were grown for 151 days in phytotrons at 19/12 °C (day/night temperature) and 390 ppm CO2, and at elevated temperature (+5 °C) and CO2 (700 ppm) with treatment factors alone or in combination. The ALG clone had 2–4 times higher aboveground biomass, higher light-saturated rates of photosynthesis (Pmax), maximum electron transport rates (ETRmax) and Rubisco activity, and higher photosynthetic nitrogen-use efficiency than the DK clone. The DK clone, however, produced more shoots, leaves and side-shoots, and had 9–51 % higher specific leaf area and 15–39 % higher leaf nitrogen concentration than the ALG clone. Although elevated atmospheric CO2 alone barely affected the aboveground growth of the two P. australis clones, simultaneously elevated temperature and CO2 stimulated growth and aboveground biomass. Overall, elevated CO2 stimulated photosynthesis, but the clones responded differently to a concomitant increase in CO2 and temperature, depending on the phylogeographic background of the plant. The DK clone showed overall stronger responses, and can be considered the more plastic of the two clones with respect to CO2 and temperature. Thus, the DK clone may be better adapted to climate change than the ALG clone, at least in the short term.