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LeBrun DG, Del Rosario J, Kelly JD, Wren SM, Spiegel DA, Mkandawire N, Gosselin RA, Kushner AL. An Estimation of the Burden of Sports Injuries among African Adolescents. J Epidemiol Glob Health 2019; 8:171-175. [PMID: 30864759 PMCID: PMC7377560 DOI: 10.2991/j.jegh.2017.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 10/25/2017] [Indexed: 11/06/2022] Open
Abstract
The extent to which sports injuries contribute to the burden of injury among adolescents in low- and middle-income countries (LMICs) is unknown. The goal of this study was to estimate the incidence of sports injuries among adolescents in Africa. Data from the World Health Organization Global School-Based Student Health surveys were used to estimate the annual number of African adolescents sustaining sports injuries. Gender-stratified injury rates were calculated and applied to every African country’s adolescent population to estimate country-specific and continent-wide injury totals. A total of 21,858 males and 24,691 females from 14 countries were included in the analysis. Country-specific annual sports injury rates ranged from 13.5% to 38.1% in males and 5.2% to 20.2% in females. Weighted average sports injury rates for males and females were 23.7% (95% CI 23.1%–24.2%) and 12.5% (95% CI 12.1%–12.9%), respectively. When these rates were extrapolated to the adolescent populations of the African continent, an estimated 15,477,798 (95% CI 15,085,955–15,804,333) males and 7,943,625 (95% CI 7,689,429–8,197,821) females sustained sports injuries. Our findings suggest that over 23 million African adolescents sustained sports injuries annually. Further work will help to more precisely define the burden of sports injuries in LMICs and the role that surgery can play in mitigating this burden.
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Affiliation(s)
- Drake G LeBrun
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.,Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Jordan Medical Education Center, Philadelphia, PA 19104, USA
| | - Julius Del Rosario
- School of Engineering and Applied Science, University of Pennsylvania, 220 South 33rd Street, 107 Towne Building, Philadelphia, PA 19104, USA
| | - John D Kelly
- Division of Sports Medicine, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, 235 S 33rd St, Philadelphia, PA 19104, USA
| | - Sherry M Wren
- Department of Surgery, Stanford University, School of Medicine, 300 Pasteur Dr, Stanford, CA 94305, USA
| | - David A Spiegel
- Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA
| | - Nyengo Mkandawire
- Department of Orthopaedic Surgery, University of Malawi, College of Medicine, P/B 360, Chichiri, Blantyre 3, Malawi.,Flinders University School of Medicine, Sturt Rd, Bedford Park, South Australia 5042, Australia
| | - Richard A Gosselin
- Institute of Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California San Francisco, 2550 23rd Street, Building 9, 2nd Floor, San Francisco, CA 94110, USA
| | - Adam L Kushner
- Department of Surgery, Columbia University College of Physicians and Surgeons, 177 Fort Washington Ave., New York, NY 10032, USA.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.,Surgeons OverSeas, 99 Avenue B, Suite 5E, New York, NY 10009, USA
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Qin P, Arabacilar P, Bernard RE, Bao W, Olzinski AR, Guo Y, Lal H, Eisennagel SH, Platchek MC, Xie W, Del Rosario J, Nayal M, Lu Q, Roethke T, Schnackenberg CG, Wright F, Quaile MP, Halsey WS, Hughes AM, Sathe GM, Livi GP, Kirkpatrick RB, Qu XA, Rajpal DK, Faelth Savitski M, Bantscheff M, Joberty G, Bergamini G, Force TL, Gatto GJ, Hu E, Willette RN. Activation of the Amino Acid Response Pathway Blunts the Effects of Cardiac Stress. J Am Heart Assoc 2017; 6:JAHA.116.004453. [PMID: 28487390 PMCID: PMC5524058 DOI: 10.1161/jaha.116.004453] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The amino acid response (AAR) is an evolutionarily conserved protective mechanism activated by amino acid deficiency through a key kinase, general control nonderepressible 2. In addition to mobilizing amino acids, the AAR broadly affects gene and protein expression in a variety of pathways and elicits antifibrotic, autophagic, and anti-inflammatory activities. However, little is known regarding its role in cardiac stress. Our aim was to investigate the effects of halofuginone, a prolyl-tRNA synthetase inhibitor, on the AAR pathway in cardiac fibroblasts, cardiomyocytes, and in mouse models of cardiac stress and failure. METHODS AND RESULTS Consistent with its ability to inhibit prolyl-tRNA synthetase, halofuginone elicited a general control nonderepressible 2-dependent activation of the AAR pathway in cardiac fibroblasts as evidenced by activation of known AAR target genes, broad regulation of the transcriptome and proteome, and reversal by l-proline supplementation. Halofuginone was examined in 3 mouse models of cardiac stress: angiotensin II/phenylephrine, transverse aortic constriction, and acute ischemia reperfusion injury. It activated the AAR pathway in the heart, improved survival, pulmonary congestion, left ventricle remodeling/fibrosis, and left ventricular function, and rescued ischemic myocardium. In human cardiac fibroblasts, halofuginone profoundly reduced collagen deposition in a general control nonderepressible 2-dependent manner and suppressed the extracellular matrix proteome. In human induced pluripotent stem cell-derived cardiomyocytes, halofuginone blocked gene expression associated with endothelin-1-mediated activation of pathologic hypertrophy and restored autophagy in a general control nonderepressible 2/eIF2α-dependent manner. CONCLUSIONS Halofuginone activated the AAR pathway in the heart and attenuated the structural and functional effects of cardiac stress.
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Affiliation(s)
- Pu Qin
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Pelin Arabacilar
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Roberta E Bernard
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Weike Bao
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Alan R Olzinski
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Yuanjun Guo
- Basic & Translational Research, School of Medicine, Vanderbilt University, Nashville, TN
| | - Hind Lal
- Basic & Translational Research, School of Medicine, Vanderbilt University, Nashville, TN
| | - Stephen H Eisennagel
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Michael C Platchek
- Target and Pathway Validation, Target Sciences, GlaxoSmithKline, King of Prussia, PA
| | - Wensheng Xie
- Target and Pathway Validation, Target Sciences, GlaxoSmithKline, King of Prussia, PA
| | - Julius Del Rosario
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Mohamad Nayal
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Quinn Lu
- Target and Pathway Validation, Target Sciences, GlaxoSmithKline, King of Prussia, PA
| | - Theresa Roethke
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Christine G Schnackenberg
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Fe Wright
- Preclinical and Translational Imaging, Platform Technology and Science, GlaxoSmithKline, King of Prussia, PA
| | - Michael P Quaile
- Preclinical and Translational Imaging, Platform Technology and Science, GlaxoSmithKline, King of Prussia, PA
| | - Wendy S Halsey
- Target and Pathway Validation, Target Sciences, GlaxoSmithKline, King of Prussia, PA
| | - Ashley M Hughes
- Target and Pathway Validation, Target Sciences, GlaxoSmithKline, King of Prussia, PA
| | - Ganesh M Sathe
- Target and Pathway Validation, Target Sciences, GlaxoSmithKline, King of Prussia, PA
| | - George P Livi
- Target and Pathway Validation, Target Sciences, GlaxoSmithKline, King of Prussia, PA
| | | | - Xiaoyan A Qu
- Computational Biology, Projects Clinical Platforms and Sciences, GlaxoSmithKline, King of Prussia, PA
| | - Deepak K Rajpal
- Computational Biology, Projects Clinical Platforms and Sciences, GlaxoSmithKline, King of Prussia, PA
| | | | | | - Gerard Joberty
- Cellzome GmbH, A GSK Company, GlaxoSmithKline, King of Prussia, PA
| | | | - Thomas L Force
- Basic & Translational Research, School of Medicine, Vanderbilt University, Nashville, TN
| | - Gregory J Gatto
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Erding Hu
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
| | - Robert N Willette
- Heart Failure Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapy Area GlaxoSmithKline, King of Prussia, PA
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