To determine the epidemiology, mechanisms, and trends of lawnmower-related eye injuries in the U.S., focusing on national estimates, injury types, and high-risk populations. A retrospective trend study. Individuals presenting to National Electronic Injury Surveillance System (NEISS) emergency departments. Lawnmower-related eye injuries from 2004 to 2023 were identified using the NEISS. The database narratives were coded to classify the mechanism of injury and other variables. Periorbital injuries were not included. Descriptive and comparative analyses (chi-square and Fisher's exact test) were performed of national estimates derived using statistical weights. Injury mechanisms, demographics, diagnoses, and trends over time. An estimated 120,613 lawnmower-related eye injuries occurred in the U.S. from 2004 to 2023 (N = 2467 NEISS cases). Those injured were 82% males, 95% adults, and 82% non-Hispanic Whites. Ninety-nine percent of injuries occurred at home. Most injuries (77%) were from projectiles (predominately grass, dirt, and rocks), 12% nonprojectile injuries during mowing, 8% maintenance/repair-related, and 2% from chemical exposures (primarily gasoline). Common diagnoses included eye abrasions/contusions (55%) and foreign bodies (27%). Severe injuries included retinal detachment, iris sphincter tear, corneal erosion, lens dislocation, and open globes. Only 2% of projectile injuries were documented in narratives as using eye protection, including eyeglasses. The average annual estimate for lawnmower-related eye injuries was 33% lower when comparing 2018-2023 to 2004-2017 (4502 vs 6686, P < .001). Injuries decreased more in males than in females (35% vs 23%, P < .001), and in adults aged 18 to 65 (35%) as compared to youth <18 yrs (26%) and adults >65 yrs (23%), P < .001. Whereas injuries decreased in non-Hispanic White individuals (41%), they increased in Black individuals (18%) and other racial/ethnic groups, including Hispanic (42%), P < .001. Youth <18 years were a higher proportion of bystander (50%) vs operator (5%) injuries, P < .001. Bystanders, as compared to operators, had higher rates of severe injuries requiring hospital admission, P = .002. Lawnmower-related eye injuries remain a serious risk, especially from projectiles. Interventions designed to increase the use of safety glasses both while operating mowers and when performing maintenance/repair, such as sharpening blades, and prevent bystander presence, especially children, are needed to significantly reduce risk of injury.
Lawn mower injuries can cause limb-threatening wounds in the lower extremities of children. Although most cases require only basic wound treatment, a minority need microsurgical and orthopedic reconstruction for limb salvage. These procedures remain complex owing to small vessel diameter, increased vasospasticity, limited postoperative compliance, and continued growth in children. This case series demonstrated successful microsurgical foot reconstructions in a selected pediatric patient cohort. Three patients younger than 5 years underwent foot reconstruction after mower injury. Injury patterns included (1) Chopart-like forefoot amputation, (2) first toe amputation, and (3) amputation of metatarsals I and II with destruction of the third toe, each with respective soft tissue defects. One patient required hindfoot reconstruction and tendon transfers before microsurgery. Two patients received latissimus dorsi flaps, and 1 was treated with a gracilis muscle flap. Functional outcomes were assessed using the Lower Extremity Functional Scale. Patients were aged 2, 3, and 5 years, with reconstruction performed 1-24 days postinjury. All 3 patients underwent successful microsurgical and orthopedic reconstruction with no major complications. All patients presented with preserved ability to walk and participate in sports, achieving Lower Extremity Functional Scale scores of 75-80 out of 80, even after a maximum follow-up of 20 years. Foot reconstructions after traumatic foot amputation in children are intricate procedures. Nonetheless, microvascular reconstruction is a feasible option for limb salvage in pediatric patients even at ages as young as 2 years. Interdisciplinary cooperation is essential to provide a comprehensive treatment concept and restore optimal functionality.
Lawn mower injuries represent a rare cause for severe limb threatening wounds of the lower extremity in children. Most patients can be treated with simple wound treatment involving debridement and VAC therapy,. Major amputation injuries requiring prolonged treatment and follow-up surgeries are relatively rare. In such cases, a multidisciplinary approach is often required. As part of the surgical management, the biomechanics of gait must be considered by the orthopedic team to ensure that a physiological gait pattern is maintained in these typically young patients. The present case reports the multidisciplinary management of a 3-year-old boy who was the victim of a lawnmower accident resulting in a traumatic forefoot amputation of the left foot at the level of the Chopart joint line. Furthermore, the talus exhibited a large bony defect in the anterior weight-bearing area. This is shown by the initial x-ray of the remaining hindfoot. Through the combined intervention of orthopedic reconstruction and plastic surgical coverage, it was possible to avoid a below-knee amputation, which was naturally a potential consideration in the presented case. Through multidisciplinary treatment we reached a functional, weight-bearing foot without an expected leg-lentgh-discrepancy. In cases of traumatic foot amputations, an individual assessment is necessary to determine the best course of treatment. The goal is to ensure a swift and clean procedure while minimizing long-term limitations as much as possible. A multidisciplinary treatment decision should always be made. Given the various amputation options, priority should be given to those that do not significantly alter the leg length. This approach ensures greater patient satisfaction and fewer limitations in daily life. IV - Case Report.
Penetrating abdominal injuries can be life-threatening and require prompt recognition and surgical intervention. We present the case of a 48-year-old male patient who presented to the emergency department with abdominal pain that began while mowing his lawn just before arrival but without any external signs of trauma. Point-of-care ultrasound revealed a possible linear hyperechoic foreign body just beneath the abdominal wall, a finding confirmed by computed tomography. The foreign body was subsequently retrieved in the operating room, and the patient had an excellent recovery. This type of abdominal injury mechanism is rarely documented in the literature. Relevant topics discussed include the incidence and burden of lawn mower injuries, their similarity to other projectile injuries, and potential challenges in diagnosing and managing such cases.
Penetrating cardiac injury is highly lethal due to the risk of exsanguination and cardiac tamponade, making timely diagnosis and treatment crucial. We present a rare case of cardiac impalement with a chain-link fence segment treated by surgical removal.
Dollar spot, caused by Clarireedia spp., is one of the most detrimental diseases of turfgrass worldwide, and control strategies usually involve frequent fungicide applications. These treatments are expensive and require special equipment and can contribute to fungicide resistance issues, underscoring the need for alternative management strategies. UV-C radiation has proven effective as a disease management tool in various cropping systems but is still largely unexplored in turfgrass. This study aimed to test the effects of UV-C radiation against dollar spot in seashore paspalum and to evaluate its impact on plant health and performance. In assessing UV-C's efficacy directly against C. monteithiana, daily radiation treatments ranging from 27.5 J m-2 to 77.0 J m-2 were shown to effectively reduce mycelial growth. Additionally, in vitro UV-C treatment administered in darkness was observed to be more effective in reducing pathogen growth than treatment administered in lighted conditions. In a growth chamber setting, daily 66.0-J m-2 UV-C treatment significantly reduced dollar spot severity in seashore paspalum without causing phytotoxic damage to plant tissues. In field trials, a novel UV-C application system was implemented by modifying a robotic mower to autonomously deliver UV-C radiation to seashore paspalum plots. UV-C treatment in the field significantly reduced dollar spot severity. Moreover, UV-C treatment led to several physiological and performance enhancements, including increased chlorophyll content, shoot density, surface firmness, and green speed. Findings from this study indicate that UV-C radiation may be used as an effective physical control to complement existing dollar spot management practices.
In grass headers of self-propelled and trailed mower-conditioners, the drive of a double-knife cutting apparatus is implemented by two wobble-plate mechanisms mounted on the sidewalls of the header platform and interconnected by long intermediate shafts and couplings. This drive configuration is structurally complex and material-intensive, as it consists of two independent mechanisms. Based on an analysis of existing designs and studies of cutting apparatus drive mechanisms, a new crank-rocker mechanism with flexible elastic links is proposed for driving two knives. A distinctive feature of the proposed mechanism is that the movable flexible elastic links form a closed-loop contour. The use of flexible links makes it possible to reduce the weight and material consumption of the mechanism. Owing to the presence of flexible links, the mechanism does not require high manufacturing and assembly accuracy and is insensitive to frame deformations, which contributes to improved operational reliability. The principal advantage of the proposed crank-rocker mechanism with flexible elastic links is that a single mechanism provides the drive for both knives of the cutting apparatus. Differential equations of knife motion were derived, taking into account the elastic and damping properties of the flexible elastic links of the mechanism. Solving these equations made it possible to determine the kinematic parameters of the cutting apparatus, including knife displacement, speed, and acceleration, while accounting for technological and inertial loads. During the reciprocating motion of the two knives in antiphase, the inertial forces of the knives are not completely balanced. The unbalanced inertial forces caused by the elastic compliance of the flexible links are insignificant. The operating mode of the mechanism lies in the subresonant region of the amplitude-frequency response.
Aiming at poor profiling effect and uneven stubble caused by complex terrain of the suspended mower and flattening machine while harvesting alfalfa in hilly and mountainous areas, a profiling mechanism for a suspended mowing and flattening machine was designed, and the profiling performance of the mechanism on undulating, sloping, potholed and raised roads was simulation analyzed by applying multi-body dynamics software RecurDyn. The results show that by coordinating the force of the suspension spring adjustment device and the profiling device, the profiling mechanism can control the ground pressure of the cutting table within 2000 N, achieving adaptive adjustment on slopes of ± 30°, undulating roads of 250 mm, and raised roads with depressions or protrusions of ± 50 mm. The key technical parameters of profiling springs and suspension springs had been precisely calculated, the maximum working load of the profiling spring is 9014 N, and that of the suspension spring is 10,290 N, meeting the allowable shear stress requirements for Class III loads. The effectiveness of the profiling mechanism was verified by field experiments, and the cutting height was 63.2 mm and the flattening rate was 95.1%. The research results can provide theoretical and technical support for the design and optimization of forage harvesting machinery.
Genetic deficiency of otoferlin, a protein critical to synaptic transmission by the sensory hair cells of the ear, causes congenital deafness. Medicines to treat the condition are lacking; children typically receive cochlear implants. DB-OTO is a dual adeno-associated virus 1 gene therapy that delivers human OTOF complementary DNA (encoding otoferlin) regulated by a hair cell-specific promoter. We conducted an open-label, single-group, first-in-human registrational study to evaluate DB-OTO. Children with OTOF variants and profound deafness (defined by an average audiometric threshold of >90 decibel hearing level [dB HL], indicating an inability to hear a gas-powered lawn mower) received an intracochlear infusion of DB-OTO (7.2×1012 vector genomes per ear) in one or both ears. The primary efficacy end point was an average threshold on behavioral pure-tone audiometry (PTA) at week 24 of 70 dB HL or less, a clinical standard that generally avoids cochlear implantation and enables natural acoustic hearing. A key secondary end point was the presence of an auditory brain-stem response to a click stimulus at a threshold at or below 90 dB normalized hearing level (db nHL) at week 24. Safety assessments included adverse events, laboratory results, and vestibular testing. A total of 12 children have been enrolled in the study. After a single infusion of DB-OTO, a PTA average threshold of 70 dB HL or less at week 24 (primary end point) and an auditory brain-stem response at or below 90 dB nHL (key secondary end point) were found in 9 of the 12 participants (75%; 95% confidence interval, 43 to 95; P = 1.1×10-13 for both end points). Six participants could hear soft speech without assistive devices, and 3 had average normal hearing sensitivity. A total of 67 adverse events occurred or worsened during or after treatment, none of which led to discontinued participation in the study. DB-OTO gene therapy improved hearing in patients with OTOF-related deafness, enabling natural acoustic hearing and normalizing hearing sensitivity in 3 of 12 treated patients. (Funded by Regeneron Pharmaceuticals; ClinicalTrials.gov number, NCT05788536.).
Epidural steroid injections (ESIs) are widely used for the treatment of chronic spinal pain, particularly in cervical and lumbar radiculopathy. Corticosteroids used in ESIs are broadly classified as particulate or non-particulate formulations, each with distinct safety and pharmacologic profiles. Comparative efficacy remains controversial. However, safety concerns regarding particulate steroid use in transforaminal injections are well established. However, physician perception of steroid effectiveness may influence clinical decision-making and practice patterns. To evaluate physician perceptions regarding the comparative efficacy of particulate versus non-particulate corticosteroids in ESIs. A survey-based study was conducted assessing physician beliefs on the duration and effectiveness of pain relief achieved with particulate and non-particulate steroids in ESIs. Responses were analyzed descriptively and compared to current literature. Most physicians perceived particulate steroids to provide either equivalent or longer-lasting pain relief compared to non-particulate steroids, with a slight majority favoring particulate formulations. Very few respondents believed particulate steroids were inferior. These findings align with existing literature demonstrating largely comparable efficacy between steroid types, with inconsistent evidence suggesting minor differences in duration of pain relief. Despite mixed evidence regarding comparative efficacy, physician perception continues to favor particulate steroids for longer duration of analgesia. Given the known safety risks associated with particulate steroids, clinical decision-making should incorporate both efficacy data and patient-specific risk profiles. These findings highlight the importance of aligning physician perception with evolving evidence and safety guidelines.
Acute compartment syndrome (ACS) is a surgical emergency that remains challenging to diagnose. Diagnosis is primarily clinical, with invasive intracompartmental pressure (ICP) monitoring recommended when available. However, clinical findings can be unreliable, and invasive ICP measurement carries procedural risks. Ultrasound has increasingly been investigated as a noninvasive diagnostic method for ACS. This review analyzed all reported uses of ultrasound in the context of ACS. Six primary ultrasound techniques were identified: conventional two-dimensional (2D) ultrasound, Doppler ultrasound, pulse phase-locked loop (PPLL) ultrasound, contrast-enhanced ultrasound (CEUS), pressure-related ultrasound (PrUS), and shear-wave elastography (SWE). Each method was described according to its mechanism and theoretical basis, then evaluated for its current clinical relevance. SWE appeared to hold the greatest promise for clinical implementation, with additional potential noted for Doppler ultrasound and tibial fascia angle (TFA) measurements. PrUS, CEUS, and PPLL showed practical limitations that currently restrict clinical application, though further research may address these concerns. Ultrasound offers a noninvasive, repeatable means of quantitatively assessing multiple compartments without the pain or infection risk associated with invasive ICP monitoring. While several methods demonstrate promise, none have yet been validated for clinical adoption. Larger, standardized clinical trials are needed to confirm their diagnostic accuracy and utility.
To determine whether periurethral estrogen application is noninferior to intravaginal estrogen application for the prevention of urinary tract infections (UTIs) in postmenopausal individuals with laboratory-proven recurrent UTI. The TAPER (Techniques of Applying Vaginal Estrogen for Prevention of Recurrent Urinary Tract Infections) trial was a single-center, nonblinded, randomized noninferiority trial that compared outcomes after a twice-weekly intravaginal estradiol applicator instillation of 1.0 g cream (intravaginal) compared with periurethral digital application of 0.5 g cream (periurethral) in postmenopausal individuals with recurrent UTIs. The primary outcome was the proportion of UTI-free participants at 6 months postintervention. Secondary outcomes included number of UTIs, the amount of time elapsed to the first UTI, vaginal pH, PGI-I (Patient Global Impression of Improvement) scores, patient experience with the study drug, study drug adverse effects, and urinary and sexual function. To achieve 80% power with a type 1 error of 5% and to account for loss to follow-up, 114 participants needed to be randomized based on a noninferiority margin of 25%. Of 270 eligible individuals, 114 consented and were randomized (57 intravaginal, 57 periurethral). Participants were predominantly White (92.1%) with a mean age of 71.1 years (range 52-93). Participants reported a median of three UTIs in the 12 months before enrollment. Individuals randomized to periurethral estrogen application had a similar proportion of UTI-free participants at 6 months as those randomized to intravaginal estrogen application (50.9% vs 52.6%; risk difference, -1.75 percentage points; 95% CI, -20.0 to 17.0 percentage points). Both groups experienced a decrease in vaginal pH at 6 months; the decreases did not differ by application method (-1.2 intravaginal vs -0.8 periurethral, P =.30). Participants assigned to intravaginal estrogen were more likely to experience vaginal itching after 3 months of use than those assigned to periurethral application (24.0% vs 2.4%, P <.01). Other outcomes did not differ by route of estrogen application. For postmenopausal individuals who are experiencing recurrent UTI, periurethral application of estradiol cream is noninferior to intravaginal application for UTI prevention. Both application methods resulted in approximately half of the participants being UTI-free at 6 months. ClinicalTrials.gov , NCT05472779.
The surgical indications for reverse shoulder arthroplasty (RSA) have continued to expand as it continues to be effective in restoring functionality in older, less active populations. The effect of RSA on return to sport (RTS) in the athletic population has been sparsely studied. To systematically review the RTS rate after primary RSA. Systematic review; Level of evidence, 4. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the PubMed, Embase, and Web of Science online databases was conducted and included articles published from database inception until December 22, 2024. Inclusion criteria consisted of studies reporting on RTS after primary RSA. Rates of RTS or activity were collected. Patient-reported outcome measures (PROMs) and range of motion (ROM) data were collected when available. Delta values, the change from preoperative to postoperative values, were calculated for each PROM and ROM when available. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Overall, 15 studies reporting on a total of 937 patients (954 shoulders) were included in this review. Mean patient age was 72.7 years (range, 68.0-76.5 years), and 58.1% were female. Mean follow-up was 40.5 months (range, 31.6-57.6 months). The RTS for the studies ranged from 48% to 100%. Swimming (n = 188 athletes) was the most reported sport, followed by golf (n = 151 athletes). Sport-specific RTS rates ranged from 50% to 100% for golf and 64% to 67% for swimming. Patients returned to a higher level of performance 11% to 74% of the time. Postoperative delta values ranged from -7 to -2.1 for the visual analog scale for pain (VAS Pain) during sport, -6.1 to -3 for VAS Pain, 24.4 to 59 for the American Shoulder and Elbow Surgeons score, and 3.8 to 8 for the Simple Shoulder Test. The mean MINORS score of the included studies was 16.8 (range, 16-19) for comparative studies and 10.0 (range, 9-11) for noncomparative studies. Our study showed that primary RSA allows for variable rates of RTS ranging from 48% to 100%, with 50% to 100% of patients returning to golf and 64% to 67% returning to swimming. Overall, patients reported improved postoperative outcomes scores and range of motion.
WhiB-like (Wbl) family proteins are a unique family of iron-sulfur ([4Fe-4S]) cluster-bound transcription factors found exclusively in Actinobacteria and actinobacteriophages, including the notoriously persistent pathogen Mycobacterium tuberculosis (Mtb). Despite their critical roles in cell development, stress response and antibiotic resistance, the mechanisms of gene regulation by the Wbl family proteins are not fully understood due to the lack of a canonical DNA-binding motif in most Wbl proteins. Here, we present structural and biochemical evidence demonstrating that all Mtb Wbl proteins bind to the same site in the conserved region 4 of the primary sigma 70 factor facilitated by a previously unrecognized structural motif, the aromatic patch, in the Wbl family. Our phylogenetic findings provide compelling evidence for a complex evolutionary relationship of Wbls between actinobacteria and the associated phages. Together, this work fills a critical gap in our understanding of the function, mechanism and evolutionary origin of Wbls.
Negative pressure wound therapy relies on suction, commonly set to -125 mmHg, to evacuate wound fluid, but dysvascular and pressure injuries often respond unpredictably. Newton's third law indicates that negative pressure applies an equal and opposite contact pressure on the wound surface, and this study quantified this contact pressure across dressing types, wound configurations and suction levels. Using a porcine explant model, central and peripheral contact pressure measurements were obtained beneath black reticulated open cell foam, white foam and a novel thermoplastic elastomer dressing across plexiglass, intact skin, shallow and deep wounds under -50, -75 and -125 mmHg. Contact pressure increased proportionally with negative pressure, and multivariable modelling demonstrated that dressing type, wound type and suction level significantly influenced pressure, with negative pressure explaining most of the variance (0.77 and 0.68). Thermoplastic elastomer at -50 mmHg in deep wounds produced the lowest contact pressure, whereas black reticulated open cell foam and white foam at -125 mmHg generated elevated contact pressures of approximately +125 to +195 mmHg. These findings show that black reticulated open cell foam at conventional -125 mmHg can create hypoperfusion conditions, whereas thermoplastic elastomer consistently produces the lowest pressures and may enhance perfusion at lower suction levels, offering a physiologic explanation for improved clinical outcomes in dysvascular and pressure injuries treated with reduced negative pressure.
Whether treatment setting impacts periurethral bulking efficacy is unknown. We hypothesized that periurethral bulking treatment failure rates would be greater for office versus operating room procedures. A retrospective cohort study including 113 patients undergoing polyacrylamide hydrogel periurethral bulking at a single academic medical center between 1 September 2022 and 30 March 2024 was carried out. Demographic and clinical variables, procedural details, patient satisfaction, and retreatment rates were abstracted. Primary outcomes included 6-month treatment failure, defined as no improvement following treatment, decision for additional therapy, or aborted procedure. Secondary outcomes included 12-month treatment failure and 6- and 12-month retreatment rates. Chi-squared, Fisher's exact, Mann-Whitney U, and t tests were applied, and logistic regression was used to identify factors associated with treatment failure. The 6- and 12-month treatment failure rates in the operating room versus office cohorts were 32.4% vs 51.3% (p = 0.05) and 48.1% vs 50.0% (p = 0.87) respectively. Retreatment rates and modality did not differ. Approximately 15% of office cases but no operating room cases were unable to be completed as planned (p < 0.01). Office setting was associated with 3.23 increased odds of 6-month treatment failure (p < 0.05). Periurethral bulking in the office may be more likely to result in early treatment failure than bulking performed in the operating room, but any benefit appears short lived, with similar 12-month treatment failure and retreatment rates. Our findings, together with consideration of individual patient characteristics and resource optimization, can guide decisions regarding the appropriate treatment setting for periurethral bulking.
In reverse total shoulder arthroplasty (RSA), surgeons predominantly use components from the same manufacturer. In certain situations, it may be advantageous to "mismatch" components. There is a lack of literature investigating outcomes following manufacturer-mismatched implants. Therefore, the purpose of this study was to evaluate the outcomes following RSA with manufacturer-mismatched implants. All primary or revision RSAs between 2013 to 2021 with manufacturer-mismatched glenoid and humeral components was performed. Data collected included demographic variables, postoperative function, and complications. Totally 85 patients underwent RSA with manufacturer-mismatched implants. Sixty-three were primary cases (74%) and 22 (26%) were revision cases. The mean age was 70.2 ± 8.8, and 20 (24%) were male. The mean follow-up was 47.8 (range: 24-114 months). In primary cases the mean ASES score was 79.1 ± 21.3, SANE score of 75 ± 25.4, and VAS pain score of 1.8 ± 2.5. For revisions, the mean ASES score was 61.2 ± 25.9, SANE score of 50 ± 31.9, and VAS pain score of 3.2 ± 2.9. These are comparable to historical controls. Fourteen (16.4%) patients sustained a postoperative complication, six (7.1%) underwent a reoperation. Our results demonstrate that manufacturer-mismatching has comparable postoperative function, complications, and reoperation rates to the reported literature. Level of evidence: III.
Deep decarbonization of the US power system would require rapid deployment of variable renewable energy (VRE) resources, which are projected to provide a substantial share of electricity generation at the time of net-zero emissions. However, the exact share of generation met by VRE and the roles of other technologies in supplying key electricity services-energy and firm capacity-remain uncertain. This study employs a detailed model of the US power sector to decompose the provision and value of electricity services, including negative emissions, by technology across a range of deep decarbonization scenarios. Results indicate that while technology deployment and the share of services provided by each technology vary significantly depending on future technological and market conditions, the value composition and future roles of individual technologies remain consistent. These findings offer guidance for research and development priorities and provide insights to inform electricity policy and planning.
This study compared the cardiometabolic response between rowing high intensity interval training (HIIT) and high intensity functional training (HIFT). Twenty two adults (age and V ˙ O 2 max ​= ​[25 ​± ​7] yr and [40 ​± ​9] mL/kg/min) underwent incremental exercise on a rowing ergometer to assess V ˙ O 2 max and peak power output (PPO). Subsequently, they underwent rowing HIIT (six 1 minutes [min] efforts at 85% PPO with 75 seconds [s] recovery) or HIFT (six 1 ​min efforts including pushups, jump squats, mountain climbers, and air squats with 75 ​s recovery). Gas exchange data, heart rate (HR), and blood lactate concentration (BLa) were acquired during exercise and post-exercise. These regimens elicited 92%-96% HRmax, with higher peak HR ([174 ​± ​14] b/min vs. [167 ​± ​15] b/min, p ​= ​0.002) and time spent ≥ 85% HRmax ([6.1 ​± ​2.2] min vs. [5.0 ​± ​2.8] min, p ​= ​0.03) for HIFT versus rowing HIIT. Results showed similar peak V ˙ O 2 between HIFT and HIIT ([81 ​± ​9] vs. [82 ​± ​8] V ˙ O 2 max , p ​= ​0.72), yet lower mean V ˙ O 2 ([1.73 ​± ​0.38] L/min vs. [1.93 ​± ​0.50] L/min, p ​< ​0.001). Mean and peak ventilation ( V ˙ E ) was significantly higher (p ​< ​0.05) with HIFT ([62 ​± ​13] L/min and [84 ​± ​18] L/min vs. [53 ​± ​15] L/min and [73 ​± ​19] L/min). BLa was significantly higher with HIFT versus rowing HIIT (p ​< ​0.001) and was elevated 15 ​min post-exercise ([7.0 ​± ​3.0] mM vs. [3.5 ​± ​1.1] mM). In healthy, active adults, HIFT elicits vigorous intensities similar to traditional HIIT.
To compare patient-reported outcomes and complications of medial collateral ligament (MCL) repair versus reconstruction in patients with grade III MCL injuries, and to report whether these were isolated or associated lesions, with minimum 2-year follow-up. A comprehensive search of PubMed, Scopus, and Embase was conducted from database inception to August 2024 according to PRISMA 2020 guidelines. Studies reporting outcomes and complications following repair or reconstruction of grade III MCL injuries with ≥2-year follow-up were included. Data on concomitant procedures were extracted to determine the frequency of isolated versus combined lesions. A total of 12 studies met the criteria, comprising 388 patients: 277 underwent MCL reconstruction and 111 underwent MCL repair. Mean follow-up was 37.6 months for reconstruction and 56.2 months for repair. The majority of injuries were COMBINED LESIONS: , with concomitant anterior cruciate ligament (ACL) reconstruction performed in 70.8% of reconstruction and 58.6% of repair cohorts. Postoperative IKDC scores ranged 54.3 to 89 for reconstruction and 79.1 to 88.8 for repair; Lysholm scores ranged 59.4 to 94.8 and 83.8 to 98.5, respectively. Complications occurred in 14.4% of reconstruction and 4.5% of repair patients, most commonly range of motion deficits. Reoperation rates were comparable (6.1% vs. 7.2%). Both reconstruction and repair for grade III MCL injuries yielded favorable outcomes at ≥2-year follow-up. MCL repair demonstrated slightly higher IKDC and Lysholm scores with fewer complications overall. Most cases involved COMBINED MCL AND ACL INJURIES: , highlighting the rarity of isolated grade III MCL lesions. LEVEL OF EVIDENCE: is level IV, systematic review of level II to IV studies.