human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective In this study , the injury incidence and association with type and volume of training in international rowers were described . Design A prospect i ve cohort design was used over a 12-month period . Patients 20 international rowers who were competing as part of the Irish Amateur Rowing Union squad system . Methods The rowers were interviewed monthly , and data were collected regarding their training and competition exposure as well as their injury experience . Results A mean injury rate of 3.67 per 1000 exposure hours was reported with a total of 44 injuries reported in a 12-month period . The mean number of injuries sustained per athlete was 2.2 ( 1.24 ) over the 12-month period . The area where the greatest number of injuries were reported was the lumbar spine ( 31.82 % of total injuries , 95 % CI 20 to 50 ) ( fig 2 ) followed by the knee ( 15.91 % of total injuries , 95 % CI 10 to 30 ) and the cervical spine ( 11.36 % of total injuries , 95 % CI 5 to 24 ) . Half of the injuries ( 22 injuries , 50 % of total reported injuries ) were to the spine ( χ2 = 30.8 , df = 9 , p = 0.0003 ) . Ergometer training load was the most significantly associated with injury risk ( r = 0.68 , p = 0.01 ) . Conclusion International rowers are at higher risk of injury than most non-contact sports and some contact sports . The high risk of lumbar spine injury and the significant association of high volume of ergometer training merit further research to reduce time and competition lost to injury OBJECTIVES This study aim ed to identify modifiable mechanisms associated with low back injury in adolescent cricket fast bowlers . DESIGN A prospect i ve study design examined the association between intrinsic risk factors , workload , bowling kinematics , lumbar load and low back injury incidence . METHODS Twenty-five injury free fast bowlers , aged 14 - 19 years , were assessed prior to the start of a  cricket season and observed during the season for low back injuries . RESULTS The twelve bowlers who suffered a low back injury displayed ; decreased hip flexion at front foot contact ( 46±6 ° vs 51±6 ° ) , increased pelvis rotation ( 287±11 ° vs 277±11 ° ) increased thorax lateral flexion ( 50±6 ° vs 40±8 ° ) at ball release , and larger peak lumbar flexion ( 10.5±4.9Nmkg(-1)m(-1 ) vs 6.9±2.5Nmkg(-1)m(-1 ) ) and lateral flexion moments ( 12.5±2.6Nmkg(-1)m(-1 ) vs 10.6±1.9Nmkg(-1)m(-1 ) ) . They also exhibited reduced muscular endurance of the back extensors ( 103±33s vs 132±33s ) and increased knee valgus angle during a single leg decline squat on the dominant ( 9±3 ° vs 5±4 ° ) and non-dominant leg ( 9±4 ° vs 6±3 ° ) in comparison to uninjured bowlers . CONCLUSIONS Bowlers who experience greater lumbar loads during bowling , have reduced back extensor muscle endurance , and demonstrate impaired control of the lumbo-pelvic-hip complex , are at increased risk of low back injury . This combination of strength , control and biomechanical factors may be key mechanical elements of low back injury causation in adolescent fast bowlers OBJECTIVES This study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries . DESIGN Prospect i ve cohort follow-up . METHODS Pupils from a public sports school ( 12 - 19 years ) were recruited over two separate school years ( 2008 - 2009 : 42 weeks , n=199 athletes ; 2009 - 2010 : 40 weeks , n=89 athletes ) .  Training and competition volume and intensity were recorded via a personal sports diary .  Sports injuries ( time-loss definition ) were registered by medical staff members using a st and ardized question naire . RESULTS Injury incidence was significantly higher in team compared with individual sports ( 6.16 versus 2.88 injuries/1000h , respectively ) , as a result of a higher incidence of both traumatic ( RR=2.17 ; CI95%=1.75 - 2.70 ; p<0.001 ) , and overuse injuries ( RR=2.06 ; CI95%=1.46 - 2.91 ; p<0.001 ) . A Cox proportional hazards regression revealed that team sports participation had a hazard ratio of 2.00 ( CI95%=1.49 - 2.68 ; p<0.001 ) compared to individual sports , with additionally previous injury being a risk and age a protective factor . The number of competitions per 100 days was significantly higher in team sports , whereas the number of intense training sessions per 100 days was significantly lower . In team sports , the number of competitions per 100 days was positively associated with injuries ( HR=1.072 ; CI95 % [ 1.033 ; 1.113 ] ; p<0.001 ) , while in individual sports the number of competitions per 100 days had a protective effect ( HR=0.940 ; CI95 % [ 0.893 ; 0.989 ] ; p=0.017 ) . CONCLUSIONS Team sports participation entailed a higher injury risk , whatever the injury category . Further research should eluci date the role of characteristics related to sport participation in injury causation AIM The aim of this study was to examine injury incidence in professional football players according to the playing positions and with a special reference to training periodization . METHODS A Spanish professional team was followed prospect ively for the 2007 - 08 and 2008 - 09 seasons and exposure times and time-loss injuries were individually recorded during all training sessions and matches .  Heart rate  was monitored in all training sessions . RESULTS total of 114 injuries were registered during the study period ( mean injury incidence : 6.6 injuries per 1000 hours ) . The frequency of injuries was not uniformly distributed by playing positions ( P<0.001 ) , as forwards and central defenders sustained the greatest number of injury episodes and the highest match absence . Ligament sprains and muscle strains accounted for 50 % of all injuries and 62 % of all match absences . The highest incidence of sprains was achieved during pre-season and the beginning of the competition period . The risk to sustain a muscular strain peaked at the beginning and in the final weeks of the competition period and was related ( r=0.72 ; P<0.05 ) to mean heart rate during the training stage . CONCLUSION The results suggest that there exists a difference of injury risk according to the period of the season and therefore , injury prevention strategies should be introduced from pre-season . Moreover , training workloads should be controlled to avoid increasing the risk of muscle strains Introduction Numerous studies have documented the incidence and nature of injuries in professional rugby union , but few have identified specific risk factors for injury in this population using appropriate statistical methods . In particular , little is known about the role of previous short-term or longer-term match exposures in current injury risk in this setting . Objectives Our objective was to investigate the influence that match exposure has upon injury risk in rugby union . Method We conducted a seven-season ( 2006/7–2012/13 ) prospect i ve cohort study of time-loss injuries in 1253 English premiership professional players . Players ’ 12-month match exposure ( number of matches a player was involved in for ≥20 min in the preceding 12 months ) and 1-month match exposure ( number of full-game equivalent [ FGE ] matches in preceding 30 days ) were assessed as risk factors for injury using a nested frailty model and magnitude-based inferences . Results The 12-month match exposure was associated with injury risk in a non-linear fashion ; players who had been involved in fewer than ≈15 or more than ≈35 matches over the preceding 12-month period were more susceptible to injury . Monthly match exposure was linearly associated with injury risk ( hazard ratio [ HR ] : 1.14 per 2 st and ard deviation [ 3.2 FGE ] increase , 90 % confidence interval [ CI ] 1.08–1.20 ; likely harmful ) , although this effect was substantially attenuated for players in the upper quartile for 12-month match exposures ( > 28 matches ) . Conclusion A player ’s accumulated ( 12-month ) and recent ( 1-month ) match exposure substantially influences their current injury risk . Careful attention should be paid to planning the workloads and monitoring the responses of players involved in : ( 1 ) a high ( > ≈35 ) number of matches in the previous year , ( 2 ) a low ( < ≈15 ) number of matches in the previous year , and ( 3 ) a low-moderate number of matches in previous year but who have played intensively in the recent past . These findings make a major contribution to evidence -based policy decisions regarding match workload limits in professional rugby union Background Data from scientific literature show that about 63 % of abstract s presented at biomedical conferences will be published in full . Some studies have indicated that full publication is associated with the direction of results ( publication bias ) . No study has looked into the occurrence of publication bias in the field of addiction . Objectives To investigate whether the significance or direction of results of abstract s presented at the major international scientific conference on addiction is associated with full publication Methods The conference proceedings of the US Annual Meeting of the College on Problems of Drug Dependence ( CPDD ) , were h and search ed for abstract s of r and omized controlled trials and controlled clinical trials that evaluated interventions for prevention , rehabilitation and treatment of drug addiction in humans ( years search ed 1993–2002 ) . Data regarding the study design s and outcomes reported were extracted . Subsequent publication in peer review ed journals was search ed in MEDLINE and EMBASE data bases , as of March 2006 . Results Out of 5919 abstract s presented , 581 met the inclusion criteria ; 359 ( 62 % ) conference abstract s had been published in a broad variety of peer review ed journals ( average time of publication 2.6 years , SD + /- 1.78 ) . The proportion of published studies was almost the same for r and omized controlled trials ( 62.4 % ) and controlled clinical trials ( 59.5 % ) while studies that reported positive results were significantly more likely to be published ( 74.5 % ) than those that did not report statistical results ( 60.9 % . ) , negative or null results ( 47.1 % ) and no results ( 38.6 % ) , Abstract s reporting positive results had a significantly higher probability of being published in full , while abstract s reporting null or negative results were half as likely to be published compared with positive ones ( HR = 0.48 ; 95%CI 0.30–0.74 ) Conclusion Clinical trials were the minority of abstract s presented at the CPDD ; we found evidence of possible publication bias in the field of addiction , with negative or null results having half the likelihood of being published than positive ones OBJECTIVES This study examined whether high match fast bowling workloads in the short to medium term were associated with increased  bowling injury rates . DESIGN Prospect i ve cohort study . METHODS Over a 15 year period ,  workload patterns for 235 individual fast bowlers during time periods from 5 to 26 days were examined to consider whether there was an increased injury rate during the month ( 28 days ) subsequent to the workload . RESULTS Fast bowlers who bowled more than 50 match overs in a 5 day period had a significant increase in injury over the next month compared to bowlers who bowled 50 overs or less RR 1.54 ( 95 % CI 1.04 - 2.29 ) . For periods ranging from 12 to 26 days , there was no statistically-significant increase in injury over the next month from exceeding thresholds of certain amounts of overs , although bowlers who bowled more than 100 overs in 17 days had a non-significant increase in injury over the next month RR 1.78 ( 95 % CI 0.90 - 3.50 ) . CONCLUSION There were no statistically-significant increases in subsequent injury risk for high workloads for periods of 12 - 26 days , although exceeding 100 overs in 17 days ( or less ) was associated with higher injury rates . Compression of cricket fixtures is likely to have only a minimal contribution to increased fast bowling injury rates being seen in the T20 era ( along with sudden workload increases due to transferring between forms of the game , which has been previously established as a major contributor ) Background / aims There is a paucity of prospect i ve cohort studies investigating the incidence of  low back pain ( LBP ) in rowing . We investigated ( 1 ) the prevalence and incidence of LBP among international-level rowers in New Zeal and , ( 2 ) the relationship between training volume and LBP and ( 3 ) the effect of LBP on rowers ’ ability to train and compete . Methods This was a prospect i ve cohort study of 76 New Zeal and representative rowers , including 46 men ( mean age 22 , SD=4 ) and 30 women ( mean age 21 , SD=4 ) . Data were collected using an online question naire repeated monthly for 12 months . Results The prevalence of LBP ranged from 6 % to 25 % throughout the year . The incidence of episodes of LBP was 1.67 per 1000 exposure-hours . A total of 72 episodes of LBP were reported by 40 rowers ( 53 % ) during 12 months . Of 
    Output:
    
agent
Conclusions Our results demonstrate that the existence of a relationship between training load and injury continues to be well supported in the literature and is strongest for subjective internal training load .
The directionality of this relationship appears to depend on the type and timeframe of load measured
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective In this study , the injury incidence and association with type and volume of training in international rowers were described . Design A prospect i ve cohort design was used over a 12-month period . Patients 20 international rowers who were competing as part of the Irish Amateur Rowing Union squad system . Methods The rowers were interviewed monthly , and data were collected regarding their training and competition exposure as well as their injury experience . Results A mean injury rate of 3.67 per 1000 exposure hours was reported with a total of 44 injuries reported in a 12-month period . The mean number of injuries sustained per athlete was 2.2 ( 1.24 ) over the 12-month period . The area where the greatest number of injuries were reported was the lumbar spine ( 31.82 % of total injuries , 95 % CI 20 to 50 ) ( fig 2 ) followed by the knee ( 15.91 % of total injuries , 95 % CI 10 to 30 ) and the cervical spine ( 11.36 % of total injuries , 95 % CI 5 to 24 ) . Half of the injuries ( 22 injuries , 50 % of total reported injuries ) were to the spine ( χ2 = 30.8 , df = 9 , p = 0.0003 ) . Ergometer training load was the most significantly associated with injury risk ( r = 0.68 , p = 0.01 ) . Conclusion International rowers are at higher risk of injury than most non-contact sports and some contact sports . The high risk of lumbar spine injury and the significant association of high volume of ergometer training merit further research to reduce time and competition lost to injury OBJECTIVES This study aim ed to identify modifiable mechanisms associated with low back injury in adolescent cricket fast bowlers . DESIGN A prospect i ve study design examined the association between intrinsic risk factors , workload , bowling kinematics , lumbar load and low back injury incidence . METHODS Twenty-five injury free fast bowlers , aged 14 - 19 years , were assessed prior to the start of a  cricket season and observed during the season for low back injuries . RESULTS The twelve bowlers who suffered a low back injury displayed ; decreased hip flexion at front foot contact ( 46±6 ° vs 51±6 ° ) , increased pelvis rotation ( 287±11 ° vs 277±11 ° ) increased thorax lateral flexion ( 50±6 ° vs 40±8 ° ) at ball release , and larger peak lumbar flexion ( 10.5±4.9Nmkg(-1)m(-1 ) vs 6.9±2.5Nmkg(-1)m(-1 ) ) and lateral flexion moments ( 12.5±2.6Nmkg(-1)m(-1 ) vs 10.6±1.9Nmkg(-1)m(-1 ) ) . They also exhibited reduced muscular endurance of the back extensors ( 103±33s vs 132±33s ) and increased knee valgus angle during a single leg decline squat on the dominant ( 9±3 ° vs 5±4 ° ) and non-dominant leg ( 9±4 ° vs 6±3 ° ) in comparison to uninjured bowlers . CONCLUSIONS Bowlers who experience greater lumbar loads during bowling , have reduced back extensor muscle endurance , and demonstrate impaired control of the lumbo-pelvic-hip complex , are at increased risk of low back injury . This combination of strength , control and biomechanical factors may be key mechanical elements of low back injury causation in adolescent fast bowlers OBJECTIVES This study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries . DESIGN Prospect i ve cohort follow-up . METHODS Pupils from a public sports school ( 12 - 19 years ) were recruited over two separate school years ( 2008 - 2009 : 42 weeks , n=199 athletes ; 2009 - 2010 : 40 weeks , n=89 athletes ) .  Training and competition volume and intensity were recorded via a personal sports diary .  Sports injuries ( time-loss definition ) were registered by medical staff members using a st and ardized question naire . RESULTS Injury incidence was significantly higher in team compared with individual sports ( 6.16 versus 2.88 injuries/1000h , respectively ) , as a result of a higher incidence of both traumatic ( RR=2.17 ; CI95%=1.75 - 2.70 ; p<0.001 ) , and overuse injuries ( RR=2.06 ; CI95%=1.46 - 2.91 ; p<0.001 ) . A Cox proportional hazards regression revealed that team sports participation had a hazard ratio of 2.00 ( CI95%=1.49 - 2.68 ; p<0.001 ) compared to individual sports , with additionally previous injury being a risk and age a protective factor . The number of competitions per 100 days was significantly higher in team sports , whereas the number of intense training sessions per 100 days was significantly lower . In team sports , the number of competitions per 100 days was positively associated with injuries ( HR=1.072 ; CI95 % [ 1.033 ; 1.113 ] ; p<0.001 ) , while in individual sports the number of competitions per 100 days had a protective effect ( HR=0.940 ; CI95 % [ 0.893 ; 0.989 ] ; p=0.017 ) . CONCLUSIONS Team sports participation entailed a higher injury risk , whatever the injury category . Further research should eluci date the role of characteristics related to sport participation in injury causation AIM The aim of this study was to examine injury incidence in professional football players according to the playing positions and with a special reference to training periodization . METHODS A Spanish professional team was followed prospect ively for the 2007 - 08 and 2008 - 09 seasons and exposure times and time-loss injuries were individually recorded during all training sessions and matches .  Heart rate  was monitored in all training sessions . RESULTS total of 114 injuries were registered during the study period ( mean injury incidence : 6.6 injuries per 1000 hours ) . The frequency of injuries was not uniformly distributed by playing positions ( P<0.001 ) , as forwards and central defenders sustained the greatest number of injury episodes and the highest match absence . Ligament sprains and muscle strains accounted for 50 % of all injuries and 62 % of all match absences . The highest incidence of sprains was achieved during pre-season and the beginning of the competition period . The risk to sustain a muscular strain peaked at the beginning and in the final weeks of the competition period and was related ( r=0.72 ; P<0.05 ) to mean heart rate during the training stage . CONCLUSION The results suggest that there exists a difference of injury risk according to the period of the season and therefore , injury prevention strategies should be introduced from pre-season . Moreover , training workloads should be controlled to avoid increasing the risk of muscle strains Introduction Numerous studies have documented the incidence and nature of injuries in professional rugby union , but few have identified specific risk factors for injury in this population using appropriate statistical methods . In particular , little is known about the role of previous short-term or longer-term match exposures in current injury risk in this setting . Objectives Our objective was to investigate the influence that match exposure has upon injury risk in rugby union . Method We conducted a seven-season ( 2006/7–2012/13 ) prospect i ve cohort study of time-loss injuries in 1253 English premiership professional players . Players ’ 12-month match exposure ( number of matches a player was involved in for ≥20 min in the preceding 12 months ) and 1-month match exposure ( number of full-game equivalent [ FGE ] matches in preceding 30 days ) were assessed as risk factors for injury using a nested frailty model and magnitude-based inferences . Results The 12-month match exposure was associated with injury risk in a non-linear fashion ; players who had been involved in fewer than ≈15 or more than ≈35 matches over the preceding 12-month period were more susceptible to injury . Monthly match exposure was linearly associated with injury risk ( hazard ratio [ HR ] : 1.14 per 2 st and ard deviation [ 3.2 FGE ] increase , 90 % confidence interval [ CI ] 1.08–1.20 ; likely harmful ) , although this effect was substantially attenuated for players in the upper quartile for 12-month match exposures ( > 28 matches ) . Conclusion A player ’s accumulated ( 12-month ) and recent ( 1-month ) match exposure substantially influences their current injury risk . Careful attention should be paid to planning the workloads and monitoring the responses of players involved in : ( 1 ) a high ( > ≈35 ) number of matches in the previous year , ( 2 ) a low ( < ≈15 ) number of matches in the previous year , and ( 3 ) a low-moderate number of matches in previous year but who have played intensively in the recent past . These findings make a major contribution to evidence -based policy decisions regarding match workload limits in professional rugby union Background Data from scientific literature show that about 63 % of abstract s presented at biomedical conferences will be published in full . Some studies have indicated that full publication is associated with the direction of results ( publication bias ) . No study has looked into the occurrence of publication bias in the field of addiction . Objectives To investigate whether the significance or direction of results of abstract s presented at the major international scientific conference on addiction is associated with full publication Methods The conference proceedings of the US Annual Meeting of the College on Problems of Drug Dependence ( CPDD ) , were h and search ed for abstract s of r and omized controlled trials and controlled clinical trials that evaluated interventions for prevention , rehabilitation and treatment of drug addiction in humans ( years search ed 1993–2002 ) . Data regarding the study design s and outcomes reported were extracted . Subsequent publication in peer review ed journals was search ed in MEDLINE and EMBASE data bases , as of March 2006 . Results Out of 5919 abstract s presented , 581 met the inclusion criteria ; 359 ( 62 % ) conference abstract s had been published in a broad variety of peer review ed journals ( average time of publication 2.6 years , SD + /- 1.78 ) . The proportion of published studies was almost the same for r and omized controlled trials ( 62.4 % ) and controlled clinical trials ( 59.5 % ) while studies that reported positive results were significantly more likely to be published ( 74.5 % ) than those that did not report statistical results ( 60.9 % . ) , negative or null results ( 47.1 % ) and no results ( 38.6 % ) , Abstract s reporting positive results had a significantly higher probability of being published in full , while abstract s reporting null or negative results were half as likely to be published compared with positive ones ( HR = 0.48 ; 95%CI 0.30–0.74 ) Conclusion Clinical trials were the minority of abstract s presented at the CPDD ; we found evidence of possible publication bias in the field of addiction , with negative or null results having half the likelihood of being published than positive ones OBJECTIVES This study examined whether high match fast bowling workloads in the short to medium term were associated with increased  bowling injury rates . DESIGN Prospect i ve cohort study . METHODS Over a 15 year period ,  workload patterns for 235 individual fast bowlers during time periods from 5 to 26 days were examined to consider whether there was an increased injury rate during the month ( 28 days ) subsequent to the workload . RESULTS Fast bowlers who bowled more than 50 match overs in a 5 day period had a significant increase in injury over the next month compared to bowlers who bowled 50 overs or less RR 1.54 ( 95 % CI 1.04 - 2.29 ) . For periods ranging from 12 to 26 days , there was no statistically-significant increase in injury over the next month from exceeding thresholds of certain amounts of overs , although bowlers who bowled more than 100 overs in 17 days had a non-significant increase in injury over the next month RR 1.78 ( 95 % CI 0.90 - 3.50 ) . CONCLUSION There were no statistically-significant increases in subsequent injury risk for high workloads for periods of 12 - 26 days , although exceeding 100 overs in 17 days ( or less ) was associated with higher injury rates . Compression of cricket fixtures is likely to have only a minimal contribution to increased fast bowling injury rates being seen in the T20 era ( along with sudden workload increases due to transferring between forms of the game , which has been previously established as a major contributor ) Background / aims There is a paucity of prospect i ve cohort studies investigating the incidence of  low back pain ( LBP ) in rowing . We investigated ( 1 ) the prevalence and incidence of LBP among international-level rowers in New Zeal and , ( 2 ) the relationship between training volume and LBP and ( 3 ) the effect of LBP on rowers ’ ability to train and compete . Methods This was a prospect i ve cohort study of 76 New Zeal and representative rowers , including 46 men ( mean age 22 , SD=4 ) and 30 women ( mean age 21 , SD=4 ) . Data were collected using an online question naire repeated monthly for 12 months . Results The prevalence of LBP ranged from 6 % to 25 % throughout the year . The incidence of episodes of LBP was 1.67 per 1000 exposure-hours . A total of 72 episodes of LBP were reported by 40 rowers ( 53 % ) during 12 months . Of 
    Output:
    