BACKGROUND: Falls are the leading cause of injuries in older adults. Environmental objects (such as furniture, walls, and handrails) may act as hazards or facilitators to balance maintenance and safe landing. There is lack of objective evidence on how older adults interact with objects during falls. We addressed this gap by characterizing body part contacts with objects other than the floor during real-life falls in long-term care.
METHODS: We analyzed videos of 1759 falls experienced by 584 residents to characterize the prevalence of contacts with objects before, during, and after fall initiation. Using generalized estimating equations, we compared the prevalence of falls with versus without contact to objects after fall initiation. Using linear mixed models, we tested for differences across body parts in the probability of contacting objects after fall initiation.
RESULTS: In nearly one-third of falls, interactions with objects (e.g., trips over objects, loss of support with objects) or with other people (e.g., being pushed by another person) had a primary role in causing imbalance and initiating the fall. After fall initiation, participants contacted objects in 60% of falls, with intentional hand contacts to objects via reach-to-grasp or bracing being the most common type of interaction (Probability ± SE = 0.32 ± 0.01), followed by unintentional impacts to the torso (0.21 ± 0.01) and head (0.16 ± 0.01). Intentional hand contact to an object was more common during forward than backward falls (p < 0.001), while head and torso contacts to objects were more common during backward and sideways falls than forward falls (multiple p values ≤ 0.003). The hand most often contacted chairs, wheelchairs or couches, followed by tables or counters, walls, other people, walkers, and handrails. The head, torso, and shoulder most often contacted a wall.
CONCLUSIONS: Most falls in long-term care involved contacts with objects other than the ground, indicating that complex environments often accompany falls in long-term care. Higher probabilities of intentional hand contacts in forward falls, versus unintentional head and torso impacts in backward and sideways falls may reflect the influence of being able to visualize and adjust one\'s falling patterns to nearby objects.

OBJECTIVE: To determine whether spotters with medical training and experience in managing concussion have higher inter-rater reliability and accuracy than non-medical personnel when identifying video signs associated with concussion in Australian football.
METHODS: Retrospective cohort study.
METHODS: Video clips were collected of all impacts potentially resulting in concussion during 2012 and 2013 Australian Football League (AFL) seasons. Raters were divided into medical doctors and a non-medical group comprising allied health practitioners (physiotherapists) and non-medical/non-allied health personnel (performance analysts). Raters assessed 102 randomly selected videos for signs of concussion. The inter-rater reliability was calculated. Sensitivity, specificity, positive and negative predictive values were calculated by comparing the rater responses to the consensus opinion from two highly experienced clinicians with expertise in concussion.
RESULTS: No statistically significant difference in inter-rater reliability was observed between the medical doctors and the non-medical group. Both groups demonstrated good to excellent agreement for slow to get up, clutching at head/face and facial injury. Both groups displayed intra-class coefficient >0.55 for no protective action-floppy, loss of responsiveness, and motor incoordination, and displayed lowest agreement for no protective action-tonic posturing, impact seizure and blank/vacant look. No statistically significant difference was found between the groups for sensitivity, specificity, positive and negative predictive values for correctly classifying video signs compared to the expert consensus opinion.
CONCLUSIONS: After completing sufficient standardised training and testing, medical and non-medical personnel demonstrate comparable reliability in identifying video signs of concussion in professional Australian football and may be suitable for the role of video spotter.

UNASSIGNED: The literature on the running kinematics of youth distance runners is limited.
UNASSIGNED: We sought to describe 2-dimensional (2D) video analysis of running kinematics in healthy adolescent distance runners, which has not been previously described.
UNASSIGNED: We conducted an observational study of healthy, competitive runners between the ages of 14 and 18 years, prospectively recruited through local running clubs and our hospital\'s outreach between August 2019 and July 2023. Participants ran on a treadmill at a self-selected speed with markers attached to the thorax, pelvis, and lower extremities. A high-definition video camera recorded the runners in the sagittal and frontal planes. Kinematic measurements were completed using Dartfish software and reported as means and standard deviations.
UNASSIGNED: Of the 53 participants (51% boys, mean age: 16.0 ± 1.4 years) included in the 2D running analysis, 91% ran with a rearfoot strike pattern, with a mean foot inclination angle of 10.2° ± 6.2°. Knee flexion angle at initial contact was 13.2° ± 3.8°, tibia inclination angle was 8.5° ± 3.2°, and peak knee flexion was 44.5° ± 3.6°. Cadence was 168.7° ± 8.6°. Contralateral pelvic drop was 6.0° ± 2.2° and peak rearfoot eversion was 11.8° ± 3.6°.
UNASSIGNED: This study is the first to describe running kinematics as captured by 2D video in healthy adolescent runners and to identify kinematic variables that may differ from those of adult runners. Further research is required to determine if adult recommendations are applicable to adolescent populations.

Instrumented mouthguards (iMGs) are widely applied to measure head acceleration event (HAE) exposure in sports. Despite laboratory validation, on-field factors including potential sensor skull-decoupling and spurious recordings limit data accuracy. Video analysis can provide complementary information to verify sensor data but lacks quantitative kinematics reference information and suffers from subjectivity. The purpose of this study was to develop a rigorous multi-stage screening procedure, combining iMG and video as independent measurements, aimed at improving the quality of on-field HAE exposure measurements. We deployed iMGs and gathered video recordings in a complete university men\'s ice hockey varsity season. We developed a four-stage process that involves independent video and sensor data collection (Stage I), general screening (Stage II), cross verification (Stage III), and coupling verification (Stage IV). Stage I yielded 24,596 iMG acceleration events (AEs) and 17,098 potential video HAEs from all games. Approximately 2.5% of iMG AEs were categorized as cross-verified and coupled iMG HAEs after Stage IV, and less than 1/5 of confirmed or probable video HAEs were cross-verified with iMG data during stage III. From Stage I to IV, we observed lower peak kinematics (median peak linear acceleration from 36.0 to 10.9 g; median peak angular acceleration from 3922 to 942 rad/s2) and reduced high-frequency signals, indicative of potential reduction in kinematic noise. Our study proposes a rigorous process for on-field data screening and provides quantitative evidence of data quality improvements using this process. Ensuring data quality is critical in further investigation of potential brain injury risk using HAE exposure data.

The sensitivity of DNA analysis has progressed to the point that trace levels of DNA, originating from only a few cells, can generate informative profiles. This means that virtually any item or surface can be sampled with a reasonable chance of obtaining a DNA profile. As the presence of DNA does not suggest how it was deposited, questions are often raised as to how the DNA came to be at a particular location and the activity that led to its deposition. Therefore, understanding different modes of DNA deposition, reflective of realistic forensic casework situations, is critical for proper evaluation of DNA results in court. This study aimed to follow the movements of DNA to and from individuals and common household surfaces in a residential premises, while socially interacting. This took place over an hour and involved four participants, with known shedder status, designated as visitors (a male and a female) and hosts (a male and a female), who engaged in the activity of playing a board game while being served food. During the study, the participants were instructed to use the toilet on a single occasion to assess the transfer of DNA to new and unused underwear that was provided. All contacts made by the participants in the dining room and kitchen were video recorded to follow the movements of DNA. Samples were collected based on the history of contact, which included hands, fingernails and penile swabs. Direct contacts resulted in detectable transfer (LR > 1) in 87 % (87/100) of the non-intimate samples and clothing. For surfaces touched by multiple participants, DNA from the person who made the last contact was not always detectable. The duration and number of contacts did not significantly affect the detection of the person contacting the item. On the other hand, presence of background DNA and participant\'s shedder status appear to play an important role. Further, unknown contributors were detected in the majority of samples. Finally, indirect transfer was observed on a number of occasions including co-habiting partners of guests who were not present at the study location. The results of this study may assist with decision making for exhibit selection or targeting areas for sampling within the home environment. Our findings can also be used in conjunction with previous literature to develop activity-level evaluations in such situations where the source of the DNA is conceded, but the mode of deposition is disputed.

Purpose: This study aimed to explore the impact of different landing methods on leg movement ability and the relationship between various parameters of leg movement. Methods: This work parameters including stride, contact time, flight time, duty factor, stride angle, vertical stiffness, leg stiffness and peak vertical ground reaction force. Thirty healthy subjects voluntarily participated in this study. In this experiment, each subject was required to perform two tests on a treadmill (using a speed of 10 km/h and 160 spm) (The interval between two experiments is 7 days). In the first test, subjects used RFS. In the second test, FFS was used. A high-speed video camera was used to collect the images and the Kwon3D motion analysis suite was used to process the images in this experiment. Results: The findings of this study revealed that runners employing the forefoot strike FFS method exhibited several favorable characteristics in contrast to those using the rearfoot strike RFS method. These included shorter contact time, longer flight time, reduced duty cycle, increased stride angle and heightened leg stiffness. Additionally, peak vertical ground reaction forces were significantly elevated in females. Conclusions: While rear foot strike RFS demonstrates a notable enhancement in leg stiffness among female runners with low leg stiffness, it concurrently leads to a significant increase in peak vertical ground reaction force and imposes a greater load on the legs. However, this phenomenon is not observed among male participants.

OBJECTIVE: To undertake a systematic analysis of 17 medical attention and time-loss lateral ankle ligament sprain (LALS) events from televised Australian professional netball games during the 2020-2023 seasons.
METHODS: Case series.
METHODS: Three analysts independently assessed the video footage and then convened to review and discuss each case until a consensus was reached.
RESULTS: When in possession (7 cases) a player was commonly performing an agility-based manoeuvre to break free from an opponent and reposition themselves to be a passing option (5/7 cases). When out of possession (10 cases) a player was either attempting to intercept a pass (6 cases) or marking an opponent (4 cases). Players tended to land on the anterior one-third of the plantar surface of the foot - forefoot or shoe tip (7 cases). Players often landed on either the ground (7 cases) or the opponent\'s shoe then the ground (8 cases). In 9 cases the ankle-foot was considered to be in a neutral alignment in the frontal plane at landing. At the estimated index frame the players\' weight tended to be all on the foot on the injured side (11 cases) or favouring the foot on the injured side (5 cases). Inversion and adduction was a common injury mechanism. Plantar-flexion was rarely involved.
CONCLUSIONS: Landing on the anterior one-third of the plantar surface of the foot and subsequent weight transference onto the injured limb side was more important than ankle-foot inversion at initial ground contact. Exercises involving external perturbations that challenge the control of frontal and transverse plane ankle-foot motion and improve proprioception, neuromuscular control, and dynamic balance are warranted.

BACKGROUND: Laparoscopic pancreatoduodenectomy (LPD) is one of the most challenging operations and has a long learning curve. Artificial intelligence (AI) automated surgical phase recognition in intraoperative videos has many potential applications in surgical education, helping shorten the learning curve, but no study has made this breakthrough in LPD. Herein, we aimed to build AI models to recognize the surgical phase in LPD and explore the performance characteristics of AI models.
METHODS: Among 69 LPD videos from a single surgical team, we used 42 in the building group to establish the models and used the remaining 27 videos in the analysis group to assess the models\' performance characteristics. We annotated 13 surgical phases of LPD, including 4 key phases and 9 necessary phases. Two minimal invasive pancreatic surgeons annotated all the videos. We built two AI models for the key phase and necessary phase recognition, based on convolutional neural networks. The overall performance of the AI models was determined mainly by mean average precision (mAP).
RESULTS: Overall mAPs of the AI models in the test set of the building group were 89.7% and 84.7% for key phases and necessary phases, respectively. In the 27-video analysis group, overall mAPs were 86.8% and 71.2%, with maximum mAPs of 98.1% and 93.9%. We found commonalities between the error of model recognition and the differences of surgeon annotation, and the AI model exhibited bad performance in cases with anatomic variation or lesion involvement with adjacent organs.
CONCLUSIONS: AI automated surgical phase recognition can be achieved in LPD, with outstanding performance in selective cases. This breakthrough may be the first step toward AI- and video-based surgical education in more complex surgeries.

The tackle contest is the most common and most injurious match contact event in rugby and is an indicator of performance. Tackle Ready is World Rugby\'s tackle technique education program. Limited research has characterized the tackle contest in women\'s rugby. The purpose of this study is to: (1) identify the match situational characteristics, ball-carrier and tackler technical actions demonstrated in elite women\'s Rugby Union and (2) to determine the extent to which Tackle Ready recommended tackle techniques were exhibited. Technical characteristics for 1500 tackle events in the 2022-2023 Women\'s Six Nations Championship were visually assessed according to a predefined coding framework and the Tackle Ready program. Tackles lacked full completion (0.2%) of the 22 coded Tackle Ready techniques with 47% of the recommended techniques demonstrated in each tackle on average (range 15%-98%). A high proportion of tackles involved two defenders (48%), approaching ball-carriers from the side (38%) or oblique angles (39%), in an upright position (30%), and with initial contact made with the arm (51%). Incorrect pre-contact head positioning and head placement upon contact accounted for 50% and 15% of tackles, respectively, and there was a mean of 14 (95% CI 11-18) head and neck contacts to a tackler and 18 (95% CI 14-22) head and neck contacts to a ball-carrier per game. Targeted interventions to encourage adoption of recommended techniques are needed to reduce tackle-related injury risk in women\'s rugby. This study provides valuable context for future discussion across law enforcement, coach education and gender-specific tackle coaching in the women\'s game.

Background: The side hop test (SHT) measures the number of jumps performed over 30 s. Although this measure has demonstrated its value in clinical practice, the temporal parameters of the SHT allow for a deeper analysis of the execution strategy. The aim of this study is to assess the reliability and construct validity of contact time parameters during the SHT recorded by a video analysis system in anterior cruciate ligament reconstructed (ACLR) patients. Methods: We investigated the reliability (intra-rater, standard error of measurement (SEM), and minimum detectable change (MDC)), discriminant validity (operated (OP) versus non-operated (NOP) side), and convergent validity (relationship with strength and psychological readiness) of SHT contact time parameters, number of valid hops and limb symmetry index (LSI) in 38 ACLR patients. Contact time parameters are presented as mean, standard deviation (SD), and coefficient of variation (CV) of contact time. Results: Intra-tester reliability was good to excellent for all contact time parameters. For discriminant validity, the mean and SD contact times of the OP leg were significantly longer than those of the NOP leg, although the difference was smaller than the SEM and MDC values. The number of valid jumps and CV contact time parameters were not significantly different. Isokinetic quadriceps strength (60°/s) was strongly correlated with mean contact time for both legs. However, psychological readiness was not correlated with any of the contact time parameters. Conclusions: Temporal parameters of the SHT measured on video analysis are valid and reliable parameters to assess the performance strategy of the SHT. The results should be interpreted with caution regarding the SEM and MDC values. Further studies are needed to measure criterion validity, inter-rater reliability, and responsiveness.