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Julia Elisabeth Lenz,1 Dominik Szymski,1 Jonas Krueckel,1 Johannes Weber,1 Felix Krieger,2 Thomas Karius,3 Rainer Meffert,4 Volker Alt,1 Kai Fehske3,4 1Department of Trauma Surgery, University Hospital Regensburg, Regensburg, Germany; 2Department of Diagnostic and Interventional Radiology, Passau Hospital, Passau, Germany; 3Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus, Bonn, Germany; 4Department of Trauma-, Hand-, Plastic- and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, GermanyCorrespondence: Julia Elisabeth Lenz, Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg, 93053, Germany, Tel +0049 941 944 6805, Email julia1.lenz@ukr.dePurpose: This study aims to conduct an epidemiological investigation into the types and causes of injuries during CrossFit® training in Germany.Patients and Methods: Voluntary athletes from various German CrossFit® gyms participated, providing personal information, training habits, and details on injuries through a standardized questionnaire.Results: The study involved 308 participants, with an equal sex split, a peak age of 20– 40, and a BMI of 24.3 ± 3.3 kg/m2. Most participants trained for over two years (49.4%), primarily in supervised groups. Motivations for engaging in CrossFit® included health prevention (33.1%), athletic training (32.8%), and work-life balance support (17%). Injuries were reported by 28.6% of participants, with 61.4% experiencing single injuries. The majority of injuries (55.3%) occurred during the middle of workouts. Injury types included wounds (23.3%), contusions, sprains, or strains (cumulative 30.8%), and fractures (2.9%). Almost all injured individuals (96.5%) had a time-loss injury, with a return to sport ranging from a day to over three months. Treatments varied, with 50.6% not requiring medical intervention, 34.1% undergoing physiotherapy, 21.2% receiving medication and 8.2% needing surgery. Barbell exercises, notably Snatch and Clean, were main exercises with association to injuries, accounting for 36.3%. The Box Jump stood out as the exercise with the highest isolated injury prevalence (14.3%). Notable injury causes included falls during Pull-Ups and lumbar disc herniation linked to Deadlifts. Following injuries, 45.8% of participants made training adjustments.Conclusion: This study provides an epidemiological investigation into the types and causes of injuries during CrossFit® training in Germany. The shoulder and knee joint exhibited the highest injury prevalence. Barbell exercises, box jumps, and bar pull-ups were identified as major exercises with association to injuries. Prevention through technical training and the incorporation of soft boxes could reduce the risk of injuries in CrossFit®.Plain language summary: This study looks at the types and causes of injuries during CrossFit® training in Germany. A total of 308 CrossFit® athletes took part, with an equal number of men and women, mostly aged 20-40, and an average BMI of 24.3 ± 3.3 kg/m². Most had trained for over two years, often in supervised groups, and were motivated by health, fitness, and balancing work and life.About 28.6% of participants reported injuries, mostly single injuries happening in the middle of workouts. The types of injuries included cuts, bruises, sprains, strains, and fractures, with the shoulder and knee being the most commonly affected areas. Notably, exercises involving barbells like the Snatch and Clean caused a significant number (36.3%) of injuries, followed by Box Jumps (14.3%) and bar pull-ups. Causes of injuries included falls during pull-ups and back injuries from Deadlifts.After getting injured, nearly half of the participants changed their training routines. Treatments varied, with some not needing medical help and others undergoing physiotherapy, taking medication, or having surgery.The findings suggest that focusing on proper technique and using softer equipment, like softer landing surfaces for Box Jumps, could help reduce the risk of injuries in CrossFit® training.Keywords: fitness, weightlifting, bodyweight, barbell, sport injury, gymnastics

Jonas Krueckel,1 Dominik Szymski,1 Julia Lenz,1 Julian Fluegel,2 Johannes Weber,1 Leonard Achenbach,3 Rainer Meffert,4 Volker Alt,1 Kai Fehske4,5 1Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany; 2Department of Orthopaedic Surgery, Arcus Clinics Pforzheim, Pforzheim, Germany; 3Department of Orthopaedic Surgery, Koenig Ludwig Haus Wuerzburg, Wuerzburg, Germany; 4Department of Trauma Surgery, University Hosptial Wuerzburg, Wuerzburg, Germany; 5Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus Bonn, Bonn, GermanyCorrespondence: Kai Fehske, Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus Bonn, Waldstraße 73, Bonn, 53177, Germany, Email Fehske_k@ukw.de Jonas Krueckel, Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany, Email jonas.krueckel@ukr.dePurpose: While injuries among elite tennis athletes are extensively documented, a notable research gap exists regarding tennis injuries among club-level players. This study examines tennis injuries in German league players, with a particular emphasis on the impact of racquet properties and court surfaces, distinguishing between chronic and acute injuries.Patients and Methods: Retrospectively analyzing data from 600 tennis players over a 1.5-year period, a standardized questionnaire covered anthropometrics, injury characteristics, equipment usage, and court surface conditions.Results: The study identified 1012 tennis-related injuries, averaging 1.7 per player. Acute injuries predominantly affected the lower extremity (56%), with ankle injuries being the most prevalent, and ligaments were the most commonly affected structures (36.4%). Chronic complaints (reported by 364 athletes) focused on the upper extremity (63.2%), primarily tendon injuries (56.8%). Racket properties exhibited no significant impact on chronic upper extremity injuries.Conclusion: This study highlights a high incidence of acute lower extremity injuries, especially ankle ligament injuries, among German league tennis players. It offers crucial insights for devising targeted injury prevention strategies applicable to amateur, semi-professional, and professional tennis players, despite finding no significant link between racquet material and chronic upper extremity injuries.Keywords: tennis, injury, epidemiology, court surface, racquet material, ankle, ligament

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

Volker Krutsch,1 Stephan Grechenig,2 Oliver Loose,3 Leonard Achenbach,4 Johannes Zellner,2 Heiko Striegel,5 Volker Alt,2 Johannes Weber,2 Markus Braun,6 Stephan Gerling,7 Werner Krutsch2 1Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany; 2Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany; 3Clinic of Pediatric Surgery, Olga Hospital, Clinic Stuttgart, Stuttgart, Germany; 4Department of Trauma Surgery, University Hospital Würzburg, Würzburg, Germany; 5Department of Sports Medicine, University Hospital Tuebingen, Tuebingen, Germany; 6Department of Sports Medicine, Clinic Westfalen, Dortmund, Germany; 7Department of Paediatric and Young Adult Medicine, Clinic St. Hedwig, Barmherzige Brüder Regensburg, Regensburg, GermanyCorrespondence: Werner KrutschDepartment of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauß-Allee 11, Regensburg 93053, GermanyTel +49 941 9446805Email werner.krutsch@ukr.dePurpose: Injury data of professional soccer players obtained from media reports are frequently used in scientific research, but the accuracy of such data is still unclear.Patients and Methods: Injuries of professional soccer players of the German first and second league were documented by continuously screening media reports over one season (2015– 2016). After the season, the validity of media-reported injuries was anonymously analyzed by the team physicians of 8 different soccer clubs.Results: A total of 255 injuries of 240 players of 8 professional soccer teams had been published online, of which 146 were confirmed by the team doctors as correct, yielding a rate of 57.3% of confirmed media-reported injuries. In addition, 92 injuries without media registration were detected and added to the online statistics, resulting in 347 injuries and an overall weak validity of media-based data of 42.1%. Statistical analysis showed that the validity of media-reported injury data depended on both the individual soccer club and the body site affected by injury: publications on knee injuries (78.2%) had a higher validity than those on foot injuries (46.2%), and publications on severe injuries had a higher validity (joint dislocation: 100%; ligament rupture: 82.9%; fracture: 73.3%) than those on minor injuries. Publications on specific severe soccer injuries, such as anterior cruciate ligament (ACL) injuries, had a validity of 100%.Conclusion: Media-based injury data were only valid for a few severe injury types such as ACL injuries. In daily soccer routine and scientific research, media-based data should thus only be used in combination with specific criteria or verification processes.Keywords: professional football, injury, evidence, media-based, severe injury, ACL

Alan G Kabat,1 Christopher W Lievens,2 Christina M Newman,2 Jacob Weber2 1Pennsylvania College of Optometry, Salus University, Elkins Park, PA, USA; 2Southern College of Optometry, Memphis, TN, USACorrespondence: Alan G KabatPennsylvania College of Optometry, Salus University, 8360 Old York Road, Elkins Park, PA 19027, USATel +1 954 553 1061Fax +1 856 433 8439Email alan.kabat@alankabat.comPurpose: To compare the accuracy, speed and repeatability of the voice assisted subjective refractor (VASR) to traditional refractive methods.Methods: Fifty healthy adult subjects were examined by autorefractor, followed by subjective phoropter refinement. Subjects were then evaluated using the VASR (Vmax Vision) to obtain an objective and subjective result. Three total assessments were performed for each subject using each of the methods described. Corrected visual acuity was recorded for each eye after each procedure. The total time was measured for both the traditional and VASR refraction.Results: A comparison of the results obtained by traditional refraction and VASR revealed no statistically significant difference from the mean in equivalent sphere measurements (P=0.1383), and the datasets were highly correlated (r=0.993). The data comparisons for cylinder power and axis were similar (cylinder: P=0.6377, r=0.864) (axis: P=0.6991, r=0.738). VASR, on average, required 71 additional seconds to complete when compared to traditional phoropter refraction. In terms of repeatability, the average difference noted upon repeat of equivalent sphere power was 0.01 D for the phoropter (P=0.98) and 0.10 D for the VASR (P=0.23). For sphere power, the average difference was 0.02 D for the phoropter (P=0.55) and 0.07 D for the VASR (P=0.58). For cylinder power, the average difference was 0.02 D for the phoropter (P=0.11) and 0.03 D for the VASR (P=0.39). For all refractive methods, the differences between measurements amounted to ≤0.10 diopters, which is neither clinically nor statistically significant.Conclusion: Refractive error results obtained with the VASR were not statistically different from those achieved using traditional phoropter methods. Time elapsed for the VASR was slightly longer than a more traditional refractive sequence. The VASR demonstrated clinically and statistically significant repeatability of measurement, consistent with traditional refraction.Keywords: autorefractor, subjective refraction, wavefront aberrometry, point-spread function, VASR

Biological soil crusts (biocrusts) release the reactive nitrogen gases (Nr) nitrous acid (HONO) and nitric oxide (NO) into the atmosphere, but the underlying microbial process controls have not yet been resolved. In this study, we analyzed the activity of microbial consortia relevant in Nr emissions during desiccation using transcriptome and proteome profiling and fluorescence in situ hybridization. We observed that < 30 min after wetting, genes encoding for all relevant nitrogen (N) cycling processes were expressed. The most abundant transcriptionally active N-transforming microorganisms in the investigated biocrusts were affiliated with Rhodobacteraceae, Enterobacteriaceae, and Pseudomonadaceae within the Alpha- and Gammaproteobacteria. Upon desiccation, the nitrite (NO2-) content of the biocrusts increased significantly, which was not the case when microbial activity was inhibited. Our results confirm that NO2- is the key precursor for biocrust emissions of HONO and NO. This NO2- accumulation likely involves two processes related to the transition from oxygen-limited to oxic conditions in the course of desiccation: (i) a differential regulation of the expression of denitrification genes; and (ii) a physiological response of ammonia-oxidizing organisms to changing oxygen conditions. Thus, our findings suggest that the activity of N-cycling microorganisms determines the process rates and overall quantity of Nr emissions.

We present a systematic study of the electronic properties of dangling bonds (DBs) in a variety of semiconductors and examine the relationship between DBs and the charge neutrality level (CNL) in the context of band alignments of semiconductors. We use first-principles calculations based on density functional theory to assess the energetics of DBs in a set of diamond-structure group-IV and III–V or II–VI zinc-blende-structure semiconductors, considering both cation and anion-derived states. We examine the charge-state transition levels of DBs to assess whether they can serve as a CNL to align band structures, by comparing with offsets calculated from interface calculations. Our results show that this approach for evaluating the CNL yields quantitative results for band offsets and provides useful insights. We discuss the relation with alternative approaches for determination of CNLs based on branch-point energies or transition levels of interstitial hydrogen. [ABSTRACT FROM AUTHOR]

Daylight photoluminescence imaging of crystalline silicon photovoltaic modules is demonstrated for modules embedded in rooftop and utility‐scale systems, using inverters to electrically switch the operating point of the array. The method enables rapid and high‐quality luminescence image acquisition during the day, unlocking efficient performance and quality monitoring without the need to connect specific electrical hardware or to make any modifications to the system wiring. The principle of the measurement approach is discussed, and experimental results from a 12‐kWDC residential rooftop system and from a 149 MWDC utility‐scale photovoltaic power plant are presented. Measurements were performed using commercial inverters without modifications to the inverter hardware or firmware. In the case of the utility‐scale power plant, the daylight photoluminescence image acquisition of modules connected to a central inverter was obtained from a remote piloted aircraft. Data analysis includes the conversion of photoluminescence image data into implied voltage differences. [ABSTRACT FROM AUTHOR]