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Bats play a crucial role in the ecosystem, yet concerns have arisen regarding their potential as carriers of zoonotic bacteria, including Leptospira spp. Due to the lack of knowledge about the carrier state of bats in Brazil, this study aimed to evaluate the presence of antibodies against Leptospira spp. and its DNA in bats from four Brazilian States (São Paulo, Paraíba, Pernambuco, and Ceará). Bats were captured using mist nets and categorized by sex, age, and species. Antibodies were searched in 22 bats via the microscopic agglutination test (MAT). Additionally, 168 kidney and nine urine samples were subjected to PCR for Leptospira spp. Out of 177 samples tested, two (1.13 %) were positive in PCR, while none showed reactivity in MAT. These results suggest a low prevalence of Leptospira spp. infection in bats, indicating a limited role in transmitting leptospirosis to humans, domestic animals, and wildlife in the studied region., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: Age is an important factor weighing on revascularization decisions. We analysed long-term health outcomes of young patients with low-complexity coronary anatomy suitable for both coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), according to revascularization strategy., Methods: Patients 60 years old or less, undergoing invasive coronary angiography between January 2007 and December 2015, presenting with proximal left anterior descending artery involvement, left main or multivessel disease and a SYNTAX Score ≤22 were retrospectively selected. An inverse probability of treatment weight methodology generated a pseudopopulation with well-balanced characteristics, which was used to estimate the average treatment effect between PCI (n = 374) and CABG (n = 173)., Results: Mean age was 53 ± 7 years old, 27% had diabetes mellitus and 48% presented with an acute coronary syndrome. Mean SYNTAX score was 13.6 ± 4.9 and 68% underwent PCI as index revascularization strategy. In the weighed population, the adjusted hazard of the primary end-point of all-cause death at total follow-up (median 9.3 years; interquartile range 6.9-11.7) was 0.40 (95% confidence interval 0.19-0.7) for CABG vs PCI (incidence rate 5.8 vs 14.0 deaths/1000-person-years). Accounting for death as competing risk, the cumulative hazard of new revascularization (sub-distribution hazard ratio 0.72; 95% confidence interval 0.32-1.25) and any cause hospital readmission (sub-distribution hazard ratio 0.70; 95% confidence interval 0.41-1.07) were lower in CABG patients, as opposed to death/stroke rates at 30 days which were higher with CABG (0.3% vs 1.7%; risk ratio = 5.84)., Conclusions: In this quasi-experimental analysis of young patients with coronary artery disease and an equivalent indication for both PCI and CABG, long-term health outcomes were favourably associated with CABG, as compared to PCI. These observations support the need for dedicated randomized trials with longer follow-up in order to better inform lifetime treatment options., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

This study investigated the 5-minute most demanding passages (MDP) of kinematic (distance covered) and mechanical (acceleration and deceleration) activities in elite male football according to multifactorial criterion performance variables. Global positioning systems data were collected from 39 players across 45 matches in the Swedish first division (n = 329 observations). The multifactorial kinematic variable (MDPk) was composed of the concurrent distances covered at moderate-speed running, high-speed running, and sprinting distances, and the multifactorial mechanical (MDPm) considered the concurrent occurrences of high-intensity acceleration and deceleration activities. A moving average method was used to identify the MDP across a 5-minute period. The frequency distribution of the multifactorial variables, and differences in the time of occurrence and magnitude between multifactorial performance variables and their univariate constituent variables were investigated. Frequency distribution analysis revealed MDPk and MDPm peaked in the first 5 min of the match (MDPk: χ 2 (15, N = 329) = 135.88, p ≤ 0.001, W : 0.64, 115.99 ± 32.7 s; MDPm: χ 2 (15, N = 329) = 31.02, p ≤ 0.001, W : 0.31, 101.21 ± 25.1 s; p ≤ 0.0004). Within each half, differences in the MDP commencement time between the multifactorial variables and their respective discrete univariate constituent variables were trivial to small (MDPk effect size (ES): 0.04-0.21; MDPm ES: 0.02-0.11). Linear mixed model analysis demonstrated that the MDP magnitude of multifactorial variables were approximately 8-28% and 8-21% lower across the match and halves, respectively, compared to the MDP of their respective univariate constituent variables (p ≤ 0.001; r = 0.26-0.62). The greatest differences between the respective multifactorial and discrete constituent variables were observed for sprinting (-28%) and high-intensity acceleration (-22%). The results reveal that the MDP is distinguished based on peak kinematic and mechanical demands, which occur at discrete periods and exhibit distinct locomotor profiles across the match and within each half. Practitioners should consider the methods of identifying the MDP, as the selection of univariate and multifactorial kinematic and mechanical performance variables can impact MDP characterization, which can qualify the designing of bespoke training protocols., Competing Interests: The authors declared no conflict of interest., (Copyright © Institute of Sport – National Research Instutite.)

Background & Aims: Aging frequently causes changes in body composition, such as a loss of strength and muscular mass and an increase in fat mass. Exercise training programs have been suggested as effective strategies to mitigate or prevent age-related declines in body composition. Therefore, this study examined the effects of a sixteen-week High-Speed Resistance Training (HSRT) program on body composition parameters in community-dwelling independent older adults., Methods: The present clinical trial included 79 older adults, who were divided into two groups: intervention group (IG, N = 40, age, 68.50 ± 3.54 years; weight, 68.65 ± 11.36 kg) and control group (CG, N = 39, age, 72.08 ± 5.89 years; weight, 67.04 ± 10.69 kg). IG performed the supervised HSRT for 16 weeks, with 3 sessions per week of 60-70min, each session of 5-6 exercises, 2-3 sets, and 6-10 reps/exercise, while CG did not perform any exercise training program. Body composition parameters were assessed using a multifrequency tetrapolar bioelectrical impedance analyzer (InBody® S10). The level of physical activity and the dietary intake were evaluated by the International Physical Activity Questionnaire (IPAQ-SF) and the Food Frequency Questionnaire, respectively. Statistical analyses were performed using the analysis of covariance (ANCOVA), and effect size (Cohen's d unbiased )., Results: The analysis showed significant effects of the group factor for IG on phase angle (F (1)  = 14.39, p < 0.001, η 2 p  = 0.159). Additionally, results from Δ changes (post-minus pre-values) revealed small and medium effects in favor to IG for body cell mass (t (77)  = 1.21, p = 0.230, d unb  = 0.27 [-0.17, 0.71]) and phase angle (t (77)  = 2.82, p = 0.006, d unb  = 0.63 [0.18, 1.08]), respectively., Conclusions: The HSRT could effectively prevent the decline in cellular health and cell integrity in older adults, as evidenced by the significant improvements in the phase angle., Registration: Clinicaltrial.gov (ID: NCT05586087)., Competing Interests: Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: This study explores the interplay between age-at-death, sex and occupation and the presence, location and severity of Schmorl's nodes., Materials: Vertebral columns of 327 individuals, 180 (55.1%) males and 147 (44.9%) females, with age-at-death between 20 and 65 years old, with known occupation., Methods: Schmorl's nodes were recorded as present/absent and by location and severity., Results: In this sample, 58.7% (192/327) of individuals were affected by Schmorl's nodes, 75.6% (136/180) were males and 38.1% (56/147) were females, with statistically significant differences (p=0.000). Schmorl's nodes were most commonly found on the T7-L2 (77.1% of all Schmorl's nodes) vertebrae and at the center (73.4%) of the vertebral body surface. Age and occupational categories did not correlate with prevalence, quantity or severity., Conclusions: Males appear more prone to develop Schmorl's nodes than females. In this study, the prevalence of Schmorl's nodes does not increase with age, nor with the type of occupation held by males., Significance: This study rejects the purported associations between prevalence of Schmorl's nodes and age and physical stress., Limitations: It is unknown whether individuals had the same occupation throughout their lives or for how long they performed it. Additionally, it is impossible to access when the individual developed the Schmorl's node., Suggestions for Further Research: Evaluate the onset of Schmorl's nodes in individuals under 20 and explore possible links between vertebral morphology and the occurrence of Schmorl's nodes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The current study aimed to describe sleep habits and analyze the associations between sleep indices, changes in perceived fatigue (Δ Fatigue) and external training load measures in women soccer players during a 7-day training camp. Sixteen elite women soccer players (age: 25.4 ± 3.6 years; mean ± SD) from the Portuguese Women's National Team participated in the study. Sleep indices (sleep duration and efficiency) were measured using a wrist-worn accelerometer. External training loads measures were measured using GPS devices. Players also reported perceived fatigue using a Likert scale (1 - very, very low to 7 - very, very high) before and immediately after sleep. Players' within-subject coefficient of variation for sleep duration was 5.6%, and 4.6% for sleep efficiency. Individually, 8 players (50%) slept less than 7 h per night throughout the training camp, and the same number of athletes had a sleep efficiency lower than 85%. Similar values ( p< 0.05) were measured for sleep duration and efficiency between training and match days. A moderate negative within-subjects correlation was found between Δ Fatigue and sleep duration (adjusted for pre-sleep fatigue) [r = -0.32; 95% Confidence Interval (-0.51 - -0.08); p = 0.04]. These findings reinforce the importance of sleep in the recovery process of elite women soccer players, showing that more sleep may help to attenuate fatigue.

This study aimed to verify whether peripheral perception, tactical behaviour, and physical performance are influenced by acute physical fatigue in soccer players. The study included 24 trained soccer players (18.6 ± 1.5 years) from two Brazilian clubs. The TSAFT90 test was used to induce acute physical fatigue. The results showed that physical fatigue did not affect peripheral perception (p = 0.360). Regarding tactical behaviour, improved efficiency was observed for the principles of offensive coverage (p = 0.029), width and length with the ball (p = 0.044), and concentration (p = 0.008). On the other hand, a reduction was observed in the number of tactical actions of offensive coverage (p = 0.020) and recovery balance (p = 0.042). Also, improved accuracy in the principles of defensive balance (p = 0.009), recovery balance (p = 0.021) and defensive unity (p = 0.003) occurred under physical fatigue. A reduction in the physical performance outcomes total distance covered (p < 0.001), average speed (p < 0.001), sprints (p = 0.029), number of accelerations (p = 0.008) and decelerations (p = 0.008) were also detected. The internal (p < 0.01) and external (p < 0.01) workload was higher under physical fatigue. Overall, acute physical fatigue did not influence peripheral perception. However, physical performance was reduced under fatigue, the perceived effort increased, and tactical behaviours were affected by decreasing tactical actions performed near the ball, increasing errors in defensive movements in the lateral corridors and the last defensive line, and improving offensive tactical actions performance., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

This observational study aimed to analyze external training load in highly trained female football players, comparing starters and non-starters across various cycle lengths and training days., Method: External training load [duration, total distance [TD], high-speed running distance [HSRD], sprint distance [SpD], and acceleration- and deceleration distance [AccDecdist] from 100 female football players (22.3 ± 3.7 years of age) in the Norwegian premier division were collected over two seasons using STATSports APEX. This resulted in a final dataset totaling 10498 observations after multiple imputation of missing data. Microcycle length was categorized based on the number of days between matches (2 to 7 days apart), while training days were categorized relative to match day (MD, MD+1, MD+2, MD-5, MD-4, MD-3, MD-2, MD-1). Linear mixed modeling was used to assess differences between days, and starters vs. non-starters., Results: In longer cycle lengths (5-7 days between matches), the middle of the week (usually MD-4 or MD-3) consistently exhibited the highest external training load (~21-79% of MD TD, MD HSRD, MD SpD, and MD AccDecdist); though, with the exception of duration (~108-120% of MD duration), it remained lower than MD. External training load was lowest on MD+2 and MD-1 (~1-37% of MD TD, MD HSRD, MD SpD, MD AccDecdist, and ~73-88% of MD peak speed). Non-starters displayed higher loads (~137-400% of starter TD, HSRD, SpD, AccDecdist) on MD+2 in cycles with 3 to 7 days between matches, with non-significant differences (~76-116%) on other training days., Conclusion: Loading patterns resemble a pyramid or skewed pyramid during longer cycle lengths (5-7 days), with higher training loads towards the middle compared to the start and the end of the cycle. Non-starters displayed slightly higher loads on MD+2, with no significant load differentiation from MD-5 onwards., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 K. Winther et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: The "Super Quinas" project evaluated the effectiveness of an intervention program to improve physical activity, aerobic fitness, sleep, and motor competence on children in primary school., Methods: The experimental group ( n = 19) enrolled in a 12-week intervention program (one more extra-curricular activity class of 60 min per week) compared to the CG ( n = 19), all aged 9-10 years. Physical activity (PA) and sleep were measured by accelerometry, and aerobic fitness was measured by Children's Yo-Yo test (YYIR1C) during the 1st week (PRE), the 6th week (DUR), and the 12th week (POST) of the intervention program. Motor Competence in PRE and POST intervention was also assessed by the Motor Competence Assessment (MCA) instrument. Heart rate (HR, assessed using HR monitors), and enjoyment level were recorded during all intervention program classes. A linear mixed model analysis (i.e., within-subject analyses) was performed., Results: Comparing the EG and CG in DUR and POST, the EG spent ~18 min and ~ 34 min more time in moderate to vigorous physical activity (MVPA) per day ( p  < 0.001); had ~44 min and ~ 203 min less sedentary time per day ( p  < 0.001); performed more 44 and 128 m in the Children's Yo-Yo test compared to CG ( p  < 0.001) and slept more 17 and 114 min per night ( p  < 0.001). In POST motor competence was significantly better (27%) in the EG compared to CG ( p  < 0.001). The %HRmax during the extra-curricular classes ranged between 65 and 81% (i.e., light to moderate intensities), and the enjoyment between fun and great fun., Conclusion: Our findings suggest that adding one more extra-curricular activity class of 60 min per week for 12 weeks effectively increased the levels of physical activity, aerobic fitness, sleep duration, and motor competence in children aged 9-10 years., Competing Interests: “Super Quinas” is a registered trademark of the Portuguese Football Federation. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Costa, Vale, Cordovil, Rodrigues, Cardoso, Proença, Costa, Neto, Brito, Guilherme and Seabra.)

Introduction: In the current experiment, we aimed to evaluate whether eliciting pre-exercise non-thermal cooling sensations would alter perceptual measures, and physical and physiological responses in football referees., Methods: Nine highly trained male football referees undertook two 45-minute intermittent exercise protocols in hot and humid conditions (34.2 ± 0.6°C, 62.5 ± 1.0% relative humidity). In a randomized counterbalanced crossover design, 1 of 2 beverages were given before the warm-up: a 0.01% menthol solution or a placebo noncaloric solution. Physical performance was quantified as total distance covered in each of the three 15-minute exercise blocks. Core temperature, heart rate, thermal sensation and thermal comfort were measured at rest and after each exercise block., Results: No changes were observed between trials and over time for distance covered. No main effect of mouth rinse was observed for core temperature and heart rate, but both increased over time in all conditions ( P  < 0.001). Thermal sensation and thermal comfort were significantly improved with menthol after mouth-rinsing ( P  < 0.05), but with no differences at any other time-point., Discussion: These results indicate that non-thermal cooling oral stimuli provide immediate behavioral changes but may not influence physiological or physical responses in football referees, during intermittent exercise in hot and humid environments., Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT05632692., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Roriz, Brito, Teixeira, Spyrou and Teixeira.)

The warm-up is considered beneficial for increasing body temperature, stimulating the neuromuscular system and overall preparing the athletes for the demands of training sessions and competitions. Even when warm-up-derived benefits are slight and transient, they may still benefit preparedness for subsequent efforts. However, sports training and competition performance are highly affected by contextual factors (e.g., how is the opponent acting?), and it is not always clear what should be the preferred warm-up modalities, structure and load for each athlete and context. Further, we propose that the warm-up can also be used as a pedagogical and training moment. The warm-up may serve several different (albeit complementary) goals (e.g., rising body temperature, neuromuscular activation, attentional focus) and be performed under a plethora of different structures, modalities, and loads. The current commentary highlights the warm-up period as an opportunity to teach or improve certain skills or physical capacities, and not only as a preparation for the subsequent efforts. Moreover, the (justified) call for individualized warm-ups would benefit from educating athletes about exploring different warm-up tasks and loads, providing a broad foundation for future individualization of the warm-up and for more active, engaged, and well-informed participation of the athletes in deciding their own warm-up practices., (© 2023. The Author(s).)

Aim: Transcatheter aortic valve implantation (TAVI) is a mainstay in the management of severe aortic valve stenosis in elderly patients, but there is uncertainty on their long-term effectiveness. We aimed to assess the long-term outcome of patients undergoing TAVI with the Portico valve., Methods: We retrospectively collected the data on patients in whom TAVI with Portico was attempted from 7 high-volume centres. Only patients theoretically eligible for 3 or more years of follow-up were included. Clinical outcomes, including death, stroke, myocardial infarction, reintervention for valve degeneration and hemodynamic valve performance were systematically assessed., Results: A total of 803 patients were included, with 504 (62.8%) women, mean age of 82 years, median EuroSCORE II of 3.1%, and 386 (48.1%) subjects at low/moderate risk. The median follow-up was 3.0 years (3.0; 4.0). The composite of death, stroke, myocardial infarction, and reintervention for valve degeneration occurred in 37.5% (95% confidence interval: 34.1-40.9%), with all-cause death in 35.1% (31.8-38.4%), stroke in 3.4% (1.3-3.4%), myocardial infarction in 1.0% (0.3-1.5%), and reintervention for valve degeneration in 1.1% (0.6-2.1%). The mean aortic valve gradient at follow-up was 8.1 ± 4.6 mmHg, and at least moderate aortic regurgitation was present in 9.1% (6.7-12.3%). Independent predictors of major adverse events or death were: peripheral artery disease, chronic obstructive pulmonary disease, estimated glomerular filtration rate, atrial fibrillation, prior pacemaker implantation, EuroSCORE II, and reduced left ventricular ejection fraction (all p < 0.05)., Conclusions: Portico use is associated with favorable long-term clinical outcomes. Clinical outcomes were largely impacted by baseline risk factors and surgical risk., (© 2023. The Author(s).)

Abstract: Brito, P, Costa, J, Figueiredo, P, and Brito, J. Simulated soccer game protocols: A systematic review on validated protocols that represent the demands of the game. J Strength Cond Res 38(1): 192-205, 2024-Several laboratory and field testing protocols have been developed attempting to simulate the activity pattern and physiological demands of soccer. In the present systematic review, we aimed to analyze and discuss the appropriateness, strengths, and limitations of soccer-specific simulated tests. A systematic review of the literature was conducted based on the PRISMA guidelines. Studies conducted in soccer, simulated soccer match tests, and validated simulation protocols performed on-the-field or on a treadmill were considered. No sex restriction was applied, and age >18 years (i.e., adults) was considered. At least 1 outcome measure (e.g., neuromuscular performance, external load, internal load, or psychometric state) of post-simulated-match test or protocol had to be reported. Within the 14 studies included, the average methodological quality of the included articles was 0.61 ± 0.09 (mean ± SD) of 1. Overall, 9 validated protocols were identified. In the protocols, only amateur, university, or semiprofessional soccer players were analyzed. Only one study evaluated female soccer players. None of the studies evaluated the effect on performance over the 2-3 days after the protocol. Accelerations and decelerations, and changes in direction typically present in a game have not been clearly described in any protocol. Future research should address this issue and validate soccer-specific protocols in women., (Copyright © 2023 National Strength and Conditioning Association.)

Background and Objectives : Research on female soccer players that analyzes playing status is scarce and has previously only examined load monitoring, while other markers, such as physical (i.e., strength, power, and agility), physiological (i.e., maximal oxygen uptake), and body composition (i.e., body fat mass, fat-free mass, body water, and phase angle) markers, warrant further investigation. Thus, the study aims were to (a) compare physical, physiological, body composition, and load markers between starters and non-starters; (b) compare measurements pre- and post-training intervention (five weeks); and (c) analyze any relationships between physical, physiological, body composition, and load markers in an elite female soccer team. Materials and Methods : Fourteen first-team players participated in the study (age 23.29 ± 3.19 years, weight 59.14 ± 6.87 kg, height 1.66 ± 0.08 m). Several physical ( n = 15), physiological ( n = 1), body composition ( n = 11), and load markers ( n = 14) were collected. In addition, participants were sub-divided into starters ( n = 7) and non-starters ( n = 7). Results : No differences were revealed between starters and non-starters in any of the examined variables. Moreover, following the training intervention, a significantly lower value was found for total body water/fat-free mass ratio (p = 0.043; ES = 0.582). In addition, there were several correlations detected between load and physical/physiological markers ( n = 28); load and body composition markers ( n = 6); physical/physiological and body composition markers ( n = 34); and physical and physiological markers ( n = 42). Conclusions: In conclusion, only a slight tendency of higher load values for starters than non-starters was observed. In addition, no differences in physical, physiological, and body composition markers were found between starters and non-starters, possibly suggesting that five weeks were not enough to improve such variables. Finally, the present results provide novel information assessing the effects of the pre-season in elite female Portuguese soccer players and contribute to a better understanding of the associations between different types of measurements.

Dietary supplements are widely used among athletes, and soccer players are no exception. Nevertheless, evidence supporting the use of dietary supplements aiming to enhance performance in soccer is somewhat contradictory, scarce, or even nonexistent. Thus, the present study aimed to systematically review and synthesize the effects of dietary supplements on athletic performance (e.g. distance covered, sprinting, jump performance) in elite soccer players. Studies enrolling highly trained, elite, and world-class soccer players using dietary supplements were searched in MEDLINE/PubMed, Web of Science, Scopus, and EBSCO databases in June 2022. In total, 1043 studies were identified, and 18 met the eligibility criteria. The studies evaluated the impacts on athletic performance of several dietary supplements, including caffeine, creatine, protein, beverages with carbohydrates and electrolytes, tart cherry juice, nitrate-rich beetroot juice, sodium bicarbonate with minerals, yohimbine, and a proprietary nutraceutical blend. Caffeine supplementation in doses between 3 and 6 mg/kg of body mass may improve jump height and sprint ability, particularly in female players, but individual response to caffeine must be considered. Creatine may improve sprint, agility, and in female players, jump performance. Protein supplementation can improve sprint and jump performance between matches, especially if protein ingested from food is not up to recommendations. Beverages containing carbohydrates and electrolytes can be used as part of the strategies to achieve carbohydrate intake during training and match-days but used alone do not benefit athletic performance. Tart cherry juice might be useful for maintaining athletic performance after matches that produce higher force loss and exercise-induced muscle damage, although polyphenols from the diet might attenuate the effects of tart cherry supplementation. Nitrate-rich beetroot concentrate can attenuate performance decrease in the days following matches. Further investigation with sodium bicarbonate alone is necessary, as supplementation protocols with elite players included other substances. Finally, the available data does not support yohimbine supplementation or the use of Resurgex Plus® to improve athletic performance in elite soccer players. Still, more well-designed research with elite soccer players is needed to improve support and advice regarding the use of dietary supplements for athletic performance enhancement.

Introduction: Body composition is an important predictor of performance and a key component of health and physical fitness. Therefore, the purposes of this study were to compare soccer referees of the first and second divisions and field assistant referees from Iran and to analyze associations of a body shape index (ABSI), body adiposity index (BAI), abdominal volume index (AVI), body roundness index (BRI), conicity index (ConI), and body mass index (BMI) with body fat percentage (%BF)., Methods: A total of 270 male soccer referees from the first ( n = 124) and second ( n = 72) divisions and assistant referees ( n = 74) participated in this study. Skinfold thickness (measured at the chest, biceps, triceps, subscapular, abdominal, iliac crest, and front thigh), height, weight, hip circumference, and waist circumference were assessed to evaluate waist-to-height ratio (WHtR), %BF, and also ABSI, BRI, BAI, ConI, and AVI according to the ISAK protocol., Results: The main results indicated differences in WHR, WHtR, ABSI, BRI, AVI, ConI, and BF% with the assistant referees presenting higher values ( p < 0.05). When considering the backward selection model, there were some associations with %BF in each group, specifically BMI, BAI, and ABSI in the first division; BMI, WHR, and ABSI in the second division; and BMI in the assistant referee group (all p < 0.05)., Discussion: The present study did not confirm the hypothesis that the first-division referees presented better body composition-related variables than the second division or assistant referees. Instead, it showed that the assistant referees that participated in both divisions showed a tendency to higher values which suggests that the level of division is not a major factor when analyzing body composition., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer KI declared a shared affiliation with the author MHS to the handling editor at the time of review., (Copyright © 2023 Samarein, Samanipour, Asjodi, Shokati, Fallahi, Brownlee, Brito, Bragazzi and Oliveira.)

Background: The aims of the study were to: (i) compare accumulated load and wellness between starters and non-starters of a European professional soccer team; (ii) analyze the relationships between wellness and load measures and; (iii) compare training/match ratio (TMr) of external and internal load between starters and non-starters., Methods: Ten players were considered starters while seven were classified as non-starters over a 16-week period in which six training sessions and match day (MD) were considered in each weekly micro-cycle. The following measures were used: wellness (fatigue, quality of sleep, muscle soreness, stress, and mood); load (rated of perceived exertion (RPE), session-RPE (s-RPE), high-speed running (HSR), sprinting, accelerations (ACC) and decelerations (DEC)). Accumulated wellness/load were calculated by summing all training and match sessions, while TMr was calculated by dividing accumulated training load by match data for all load measures and each player. Mann-Whitney U test was used for wellness variables, while independent T-test was used for the remaining variables to compare groups. Moreover, relationships among variables were explored using the Spearman's Rho correlation coefficient., Results: The main results showed that non-starters presented higher significant values for fatigue (p < 0.019; g = 0.24) and lower significant values for duration (p < 0.006; ES = 1.81) and s-RPE (p < 0.001; ES = 2.69) when compared to starters. Moreover, positive and very large correlation was found between quality of sleep and RPE, while negative and very large correlation were found between stress and deceleration, and mood and deceleration (all, p < 0.05). Finally, non-starters presented higher values in all TMr than starters, namely, RPE (p = 0.001; g = 1.96), s-RPE (p = 0.002; g = 1.77), HSR (p = 0.001; g = 2.02), sprinting (p = 0.002; g = 4.23), accelerations (p = 0.001; g = 2.72), decelerations (p < 0.001; g = 3.44), and duration (p = 0.003; g = 2.27)., Conclusions: In conclusion, this study showed that non-starters produced higher TMr in all examined variables despite the lower match and training durations when compared with starters, suggesting that physical load was adjusted appropriately. Additionally, higher RPE was associated with improved sleep while higher number of decelerations were associated with decreased wellness, namely, stress and mood for non-starters., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Little is known about the influence of the urban environments on bat species 'ecology. The urbanization process potentially lead to critical ecological changes in bat communities' intra and interspecific pathogenic transmissions dynamics. To date, the monitoring of pathogens in bats in Brazil has only been done with bats found dead or alive in households, from rabies surveillance systems. The present work aimed to investigate how urbanization influenced bat richness, relative abundance and pathogen occurrence. Most captured bats were Phyllostomidae, especially Sturnira lilium, Artibeus lituratus, A. fimbriatus, Glossophaga soricina, and Platyrrhinus lineatus, among others. From preserved-rural towards urban areas the lesser the bat richness, the higher the relative abundance of the captured bats. Noise level, luminosity and relative humidity correlated with bat abundance. The proportion of genders, sexually active bats and their size (weight, right forearm length, and body condition index) were stable throughout the investigation. Still, the proportion of pregnant females was higher in Spring and the number of juveniles in Summer, evidencing the seasonality of reproduction. Several Enterobacteria were isolated, evidencing a significant role of bats in the circulation of pathogens of medical and veterinary interest. These results are crucial in the pursuit of a harmonious coexistence between humans, bats and domestic animals in areas with different levels of anthropization., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Objective: This study aimed to describe and characterize injuries sustained by elite male futsal players in Portugal., Design: Prospective cohort study., Setting: Top-tier Portuguese league in the 2019 to 2020 season., Participants: One hundred sixty-seven players from 9 elite/international-level (tier 4) futsal teams., Independent Variables: The location, type, body side, body part, mechanism of injury, severity, occurrence, days lost, training, and match exposure were collected., Main Outcome Measures: Injury incidence, prevalence, and burden., Results: The study was conducted during an 8-month season. A total of 133 injuries were recorded, and 92 (67.6%) players sustained injuries. The overall time-loss injury incidence was 4.5 injuries per 1000 hours of exposure. Injury incidence during matches was higher than during training sessions (25.9 vs 3.0 per 1000 hours of exposure, respectively). Average time loss was 9 days, and moderate injuries were the most frequent (44%), followed by mild injuries (24%). Injury burden was 73.8 days lost per 1000 hours of total player exposure. Sprains/ligament (29%) and muscle rupture/tear/strains (32%) were the most common injuries. The groin (19%), thigh (17%), knee (19%), and ankle (15%) were the most affected body areas. Noncontact injuries were the most reported mechanism (65%), and 24% were overuse injuries., Conclusions: This study showed that elite/international-level (tier 4) male futsal players are more prone to noncontact injuries, primarily affecting the lower limbs. The incidence during match play increased by 9-fold compared with training sessions., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Abade, E, Brito, J, Gonçalves, B, Saura, L, Coutinho, D, and Sampaio, J. Using deadlifts as a postactivation performance enhancement strategy in warm-ups in football. J Strength Cond Res 37(9): 1821-1827, 2023-Postactivation performance enhancement activities may be relevant warm-up strategies aiming to improve subsequent physical performance. The purpose of the current study was to investigate the effects of adding barbell deadlift or hex-bar deadlift exercises to current warm-up routines on running and jumping performances in football players. Ten highly trained male football players participated in the study during the competitive phase of the season. All players performed 3 protocols in the same week: a standard warm-up that included players' regular routines and 2 other protocols with the addition of barbell or hex-bar deadlift, after the end of the warm-up (3 sets of 3 reps, progressing set by set from 60% to 85% repetition maximum). All protocols had the same time interval between pretest (immediately after the warm-up) and posttest (15 minutes after the warm-up). Vertical jumping (countermovement jump [CMJ]; Abalakov jump [AJ]) and running performances (505 test) were impaired 15 minutes after the standard warm-up (CMJ: -6.7 ± 4.2%; AJ: -8.1 ± 8.4%; and 505 time: 1.4 ± 2.5%). For warm-up with the addition of barbell deadlift, vertical jump increased by 4.3 ± 5.6% (Cohen's dunb : 0.23 [0.02-0.47]) and 505 time decreased by -5.9 ± 3.6% (Cohen's dunb : 0.97 [-1.68 to -0.43]). The warm-up with hex-bar deadlift led to trivial changes for CMJ and AJ, but 505 time decrease by -2.7 ± 2.6% (Cohen's dunb : -0.53 [-1.01 to -0.13]). The deadlift exercise can be added to warm-up routines to maintain or even enhance acute physical performance. However, coaches and practitioners should be aware that performance enhancements resultant from deadlift may vary according to individual physical profiles., (Copyright © 2023 National Strength and Conditioning Association.)

Introduction and Objectives: Randomized controlled trials comparing stress cardiac magnetic resonance (CMR) and single-photon emission computed tomography (SPECT) suggest similar diagnostic accuracy for detecting obstructive coronary artery disease (CAD). There are few data on whether this remains true in routine clinical practice. The aim of this study was to assess clinical and angiographic characteristics of patients undergoing invasive coronary angiography (ICA) after stress CMR or SPECT, and to compare their positive predictive value with published results from the CE-MARC trial., Methods: In this retrospective tertiary-center analysis, we included 429 patients undergoing ICA after a positive stress CMR or positive SPECT performed within the previous 12 months. Obstructive CAD was defined as any coronary artery stenosis ≥50% in a vessel compatible with the ischemic territory on stress testing., Results: Of the total 429 patients, 356 (83%) were referred after a positive SPECT, and 73 (17%) after a positive stress CMR. Patients did not differ according to age, cardiovascular risk factors, previous revascularization or left ventricular dysfunction, but patients with SPECT were more frequently male (p=0.046). The prevalence of obstructive CAD was similar in patients with positive SPECT vs. positive stress CMR (76.1% vs. 80.8%, respectively, p=0.385). The positive predictive values of both techniques were similar to those reported in the CE-MARC trial., Conclusion: In this tertiary center analysis, stress CMR and SPECT showed similar positive predictive values, comparable to those reported in the CE-MARC trial. This finding supports the emerging adoption of CMR in clinical practice for the diagnosis and management of CAD., (Copyright © 2023 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Within professional European competitions, matches can be played in extreme environmental temperatures, ranging from -5 °C to +30 °C in different countries. Furthermore, the World Cups are usually played in the summer months, when temperatures can exceed 35 °C, increasing physiological stress. Practical and cost-effective cooling strategies may be implemented to help players and referees to cope with exercising in the heat. No study has evaluated the effect of non-thermal internal cooling techniques regarding performance responses on elite football referees, so far. This study aims to analyse the effects of a menthol mouth rinse regarding physical, physiological, and perceptual performance in elite male football referees, during a 90-min football protocol in the heat., Methods: At least thirteen male football referees will be recruited to perform two intermittent football protocols, separated by no less than 7 days. After passing the eligibility criteria, the participants will be randomly assigned to 1 of 2 beverages: (1) intervention - menthol solution 0.01% and (2) placebo - noncaloric berry-flavored solution, both at room temperature. The beverages will be given before warm-up (pre-cooling) and at the half-time (per-cooling). The trials will follow a randomized counterbalanced crossover design, single blinded, and will take place in indoor facilities, with Wet Bulb Globe Temperature (WBGT) > 30 °C, at the same time of the day to control for circadian variations., Impact of the Project: The results of this study are expected to determine whether mouth rinsing a menthol solution before and during a football exercise protocol performed in the heat will alter perceptual measures and help ease physiological strain and attenuate performance decrements in elite male football referees, comparing to a non-cooling strategy. Thus, we can be closer to defining nutritional strategies of internal cooling that may be an advantage for the performance of the football referees in the heat., Trial Registration: www.ClinicalTrials.gov NCT05632692 registered on 20 November 2022., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Inc.)

Introduction and Objectives: Dietary supplements are part of the nutritional strategies frequently applied in sports performance support. With growing research on this subject and high demand from athletes, nutritionists need to keep up to date with the latest evidence and utility of dietary supplements, particularly in real-world contexts. As information about the use of dietary supplements among elite soccer players is still scarce, this work aimed to know how nutritionists working with elite soccer teams perceive and use these substances in their daily practice., Methods: A questionnaire previously used to describe nutritionists' beliefs and attitudes regarding the use of dietary supplements in a clinical context was adapted for this study. The online questionnaire was addressed to nutritionists working with elite soccer teams from six European Leagues and Brazil, between November 2022 and February 2023., Results: Overall, the participants considered themselves well-trained (76.9%), knowledgeable (95.4%), and interested in dietary supplements (95.4%). The majority (70.8%) of the participants agreed or strongly agreed to recommend dietary supplements to soccer players. Personal usage of dietary supplements was associated with recommending supplements ( p  < 0.001), but no relationships were found with years of experience and academic level., Discussion: Nutritionists working with elite soccer players consider the use of dietary supplements for performance-enhancement purposes and not only to compensate for nutritional deficits, which might contribute to their higher interest, training and perceived knowledge about this topic. Participants recognize players' interest in dietary supplements, and are mindful of the safety and efficacy of these products. The present study suggests that nutritionists working with elite soccer teams are among the highest prescribers of dietary supplements, although personal usage is lower than that of nutritionists working in a clinical context., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Abreu, Oliveira, Brito and Teixeira.)

Effective playing time has been debated as a topic of major concern in football. Thus, the current experimental study aimed to investigate the effects of effective playing time on technical-tactical and physical match parameters in football. One hundred and seventy-nine male highly trained football players (aged 27.9 ± 5.1 years) from twelve teams performed two different match-play conditions: 45 min of match-play without stopping the chronometer (T45), and 30 min of match-play by stopping the chronometer every time the ball was out-of-play (T30). T30 presented a significantly higher total time (49:30 vs. 45:00 min; p  = <.001; ES = 0.76), effective playing time (28:70 vs. 26:80 min; p  = <.001; ES = 0.62), and stopped time (20:60 vs. 18:20 min; p  = 0.003; ES = 0.38) compared to T45. Total ball possession (54.4% vs. 45.6%; p =  0.002) and 1/3 ball possession (55.3% vs. 44.7%; p  = 0.018) was higher in T30 condition when compared to T45. Regarding match external load, total distance covered (4,899 vs. 4,481 m; p  = <.001; ES = 0.71), moderate-speed running (607 vs. 557 m; p  = 0.002; ES = 0.26) and high-speed running (202 vs. 170 m; p  = <.001; ES = 0.33), high-speed activities (284 vs. 245 m; p  = 0.003; ES = 0.24), accelerations (27 vs. 24; p  = <.001; ES = 0.32), and decelerations (31 vs. 28; p  = 0.005; ES = 0.26) were higher in T30 compared to T45. In conclusion, these findings suggest that higher effective playing time may affect technical-tactical and physical parameters during football games., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Tojo, Spyrou, Teixeira, Pereira and Brito.)

The aims of this study were to: (i) analyse the within-microcycle variations in professional soccer players; (ii) analyse the relationships between wellness and training and match load demands; (iii) analyse the relationships between match-day (MD) demands and wellness during the following day (MD+1); and (iv) analyse the relationships between MD and wellness during the day before match-play (MD-1). Thirteen professional soccer players (age: 24.85±3.13 years) were monitored daily over 16-weeks for wellness and training and match-play intensity. The daily wellness measures included fatigue, quality of sleep, muscle soreness, mood and stress using a 1-5 scale. Internal intensity was subjectively measured daily using the rating of perceived exertion (RPE) and the multiplication of RPE by session duration (s-RPE). While external intensity was quantified utilising high-speed running, sprinting, and acceleration and deceleration metrics. Data was analysed from each training session before (i.e., MD-5) or after the match (i.e., MD+1). Repeated measures ANOVA or Friedman ANOVA was used to analyse the aims (i) where Spearman correlation was applied to analyse the relationships between the aims (ii) and (iii) between sleep quality and training intensity. The main results for aim (i) showed that MD+1 presented the lowest values for wellness variables (p < 0.05). While MD-1 presented the lowest internal and external load values (for all variables), with MD presenting the highest values (p < 0.05). Regarding aim (ii), the main result showed significant large negative correlations between fatigue and s-RPE (r = -0.593; p = 0.033). Considering aim (iii), significant small to very large negative correlations were found for sleep quality, fatigue and muscle soreness with all internal and external variables (p < 0.05). Lastly, the main results for aim (iv) showed large negative correlations for fatigue and session duration; fatigue and s-RPE; muscle soreness and session duration; muscle soreness and s-RPE; and muscle soreness and decelerations (p < 0.05, for all). The main conclusions were that MD had an influence on wellness and internal and external training intensity, notably MD-1 and MD+1 were most affected. In this regard, a tendency of higher internal and external intensity on MD was associated with lower wellness measures of sleep quality, muscle soreness and fatigue on MD+1., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Oliveira et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Recently, esports have been argued to impact esports players' health, particularly for those competing at higher levels. Esports are a relatively new phenomenon, and an inside perspective regarding esports players' needs and experiences is essential to promote adequate health support for this population. Thus, in this qualitative study, we explored the perspectives of elite esports players and staff members regarding the effects of esports participation on health. Ten semi-structured interviews were performed with members of the Portuguese FIFA (i.e. FIFA EA Sports ® ) eFootball National team (i.e. five elite electronic football players, one world-class electronic football player, two national team coaches, and two members of the esports department). Data analysis was undertaken following the principles of thematic analysis., Results: We identified four major superordinate themes: health definition (1), factors of esports that impact mental (2) and mental health (3), and strategies to improve esports players' health (4). Esports-related factors such as gaming, competition, and performance were said to impact mental health, while equipment, facilities, and esports-related sitting time affect physical health. To minimise those risks, four main strategies were suggested: optimising and scheduling esports training, improving lifestyle habits with an emphasis on physical health, enhancing facilities and equipment, and improving health support, particularly with a mental health professional., Conclusion: Esports players and staff members are concerned and aware of esports' mental and physical demands. Understanding what esports players need and perceive about their health, complemented with the view of staff members, and their proposed strategies for health promotion might help define and prioritise healthcare needs, which could help players and the broad esports community., (© 2023. The Author(s).)

This study aims to systematize effects of cardiorespiratory training (CT) programs in individuals with intellectual disability (ID) and identifying the fundamental and structuring aspects for the prescription of CT. This systematic review was carried out through four databases (Pubmed, Web of Science, Scopus, and SPORTDiscus), considering data from the period between 2013 and 2022. From 257 studies, 12 studies were included in this systematic review. Three studies used interval CT, while seven used continuous CT. Seven were carried out in the population with Down syndrome, while only three were carried out with participants with ID. The CT programs had the following characteristics: duration of 8 to 12 weeks, weekly frequency of three sessions, for 20 to 60 min, the intensity of 50% to 80% of maximal heart rate or 70% to 80% of peak oxygen consumption, using an ergometer cycle or an outdoor walking. The studies reported improvements in cardiorespiratory function, lipid, hemodynamic and metabolic profile, body composition, and neuromuscular and cognitive capacity. This review presents characteristics and recommendations that technicians can follow when structuring, prescribing, and implementing CT programs to individuals with ID.

The aim of the present cross-sectional exploratory pilot study was to analyze the ability of the Phase Angle (PhA) to predict physical function, muscle strength and bone indicators, upon adjusting for potential confounders [age, sex, lean mass, and body mass index (BMI)]. This study included 56 physically independent older adults (age, 68.29 ± 3.01 years; BMI, 28.09 ± 4.37 kg/m 2 ). A multi-frequency segmental bioelectrical impedance analysis was used to measure PhA at 50 KHz. Additionally, physical function was assessed through four functional capacity tests [30-sec chair-stand; seated medicine ball throw (SMBT); timed up & go; and 6-min walking test (6 MWT)], muscle strength through the handgrip test (dominant side) and maximal isokinetic strength of the dominant knee flexor and extensor. Moreover, bone indicators and body composition were assessed through the dual energy X-ray absorptiometry. PhA was significantly associated with SMBT (r = 0.375, effect size (ES) = moderate); 6 MWT (r = 0.396, ES = moderate); 30-sec chair-stand (rho = 0.314, ES = moderate); knee extension (rho = 0.566, ES = large) and flexion (r = 0.459, ES = moderate); handgrip (rho = 0.432, ES = moderate); whole-body bone mineral content (BMC) (r = 0.316, ES = moderate); femoral neck BMC (r = 0.469, ES = moderate); and femoral neck bone mineral density (BMD) (rho = 0.433, ES = moderate). Additionally, the results of multiple regression analysis demonstrated that PhA is significantly associated with SMBT ( p  < 0.001; R 2  = 0.629), 6 MWT ( p  = 0.004; R 2  = 0.214), knee extension ( p  < 0.001; R 2  = 0.697), knee flexion ( p  < 0.001; R 2  = 0.355), handgrip test ( p  < 0.001; R 2  = 0.774), whole-body BMC ( p  < 0.001; R 2  = 0.524), femoral neck BMC ( p  = 0.001; R 2  = 0.249), and femoral neck BMD ( p  = 0.020; R 2  = 0.153). The results of the preliminary analysis suggested that PhA is linked to muscle strength and some factors related to physical function and bone quality in community-dwelling older adults., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Fibromyalgia is a rheumatic disease characterised by chronic widespread muscular pain and its treatment is carried out by pharmacological interventions. Physical exercise and a healthy lifestyle act as an important mechanism in reducing the symptoms of the disease. The aims of this study were to analyse and systematise the characteristics of combined training programs (i.e., type and duration of interventions, weekly frequency, duration and structure of training sessions and prescribed intensities) and to analyse their effects on people diagnosed with fibromyalgia. A systematic literature search was performed using the PRISMA method and then randomised controlled trial articles that met the eligibility criteria were selected. The Physiotherapy Evidence Database scale was used to assess the quality and risk of the studies. A total of 230 articles were selected, and in the end, 13 articles met the defined criteria. The results showed different exercise interventions such as: combined training, high-intensity interval training, Tai Chi, aerobic exercise, body balance and strength training. In general, the different interventions were beneficial for decreasing physical symptoms and improving physical fitness and functional capacity. In conclusion, a minimum duration of 14 weeks is recommended for better benefits. Moreover, combined training programs were the most effective for this population, in order to reduce the symptoms of the disease with a duration between 60 and 90 min, three times a week with a light to moderate intensity.

The Nordic hamstring exercise (NHE) is a very popular exercise used to improve eccentric strength and prevent injuries. The aim of this investigation was to assess the reliability of a portable dynamometer that measures maximal strength (MS) and rate of force development (RFD) during the NHE. Seventeen physically active participants (34.8 ± 4.1 years; n = 2 women and n = 15 men) participated. Measurements occurred on two different days separated by 48-72 h. Test-retest reliability was calculated for bilateral MS and RFD. No significant test-retest differences were observed in NHE (test-retest [95% CI, confidence interval]) for MS [-19.2 N (-67.8; 29.4); p = 0.42] and RFD [-70.4 N·s -1 (-178.4; 37.8); p = 0.19]. MS showed high reliability (intraclass correlation coefficient [ICC] [95% CI], =0.93 [0.80-0.97] and large within-subject correlation between test and retest [r = 0.88 (0.68; 0.95)]. RFD displayed good reliability [ICC = 0.76 (0.35; 0.91)] and moderate within-subject correlation between test and retest [r = 0.63 (0.22; 0.85)]. Bilateral MS and RFD displayed a coefficient of variation of 3.4% and 4.6%, respectively, between tests. The standard error of measurement and the minimal detectable change for MS was 44.6 arbitrary units (a.u.) and 123.6 a.u., and 104.6 a.u. and 290.0 a.u. for peak RFD. This study shows that MS and RFD can be measured for NHE using a portable dynamometer. However, not all exercises are suitable to apply to determine RFD, so caution must be taken when analyzing RFD during NHE.

Objectives: The current study analysed the implementation costs of a community-based walking football exercise programme for patients with type 2 diabetes., Methods: The direct costs of a community-based walking football programme for middle-aged and older male patients with type 2 diabetes, designed and tested in Porto (Portugal), were calculated from the payer's perspective. One season of this programme consists of three sessions per week (60 min per session) for nine months (October to June). Cost calculations were based on two groups of 20 patients and included the sports infrastructure and equipment, human resources, pre-exercise clinical evaluation, medical equipment, technical training and other consumable costs. An economic depreciation of 1 year using the linear method for sports and electronic materials was considered. Cost analysis dated December 2021 and is expressed in international dollars ($)., Results: This programme was estimated to have a total implementation cost of $22 923.07; $2547.01/month; $573.08/patient; $106.13/session; $63.68/patient/month and $5.31/patient/session., Conclusion: A community-based walking football programme for patients with type 2 diabetes is affordable and can be scaled up by local communities to promote physical activity and manage type 2 diabetes with the involvement of multiple stakeholders such as the football clubs, municipalities and primary healthcare units., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition, the main symptoms of which are dyspnoea and fatigue. Though exercise has been recommended for subjects with COPD, its benefits remain unclear. The aim of this study was to summarise, through a systematic review and meta-analysis, the available evidence on the effects of aerobic, resistance, stretching, and combined exercise on the main symptoms of COPD., Methods: Search was performed using the electronic databases PubMed and Web of Science. Randomised controlled trials (RCTs) with interventions based on aerobic, resistance and/or combined exercise published until July 2022 were identified. The effects were summarised based on standardised mean differences (95% confidence intervals) using random and fixed effect models., Results: Eight studies were selected, including a total of 375 subjects. The results obtained showed that resistance exercise, aerobic exercise and combined exercise seem to improve dyspnoea and fatigue symptoms in COPD subjects., Conclusions: In general, we can conclude that exercise-based interventions appear to improve the main COPD symptoms and may benefit quality of life in this population.

Purpose: The aim of the current study was to report the training program and monitoring outcomes of the Portuguese national futsal team during the preparation and competition phases of the FIFA Futsal World Cup Lithuania 2021™. For that, the variations in training load and wellness were measured, as well as their relationship., Methods: The study followed a retrospective cohort design. For all field training sessions, the volume, exercise structure, and area of play were identified. Player load, session rating of perceived exertion (sRPE), and wellness were collected. Descriptive statistics and Kruskal-Wallis tests were used for comparison purposes. A visualization method was used for load and well-being., Results: No significant differences were observed in the number of training sessions, session duration, and player load between preparation and competitive periods. sRPE showed significantly higher values in preparation than in competition periods (P < .05, d = 0.86) and significant differences between weeks (P < .05, d = 1.08). Wellness showed a general statistical difference between periods (P < .001, d = 1.28) and weeks (P < .05, d = 1.17). The correlation analysis for the overall period revealed a general linear relationship within variables of training load and wellness (P < .001). Variations occurred for preparation and competition periods. The visualization method through quadrant plots allowed us to understand the adaptation of the team and the players over the specific period under analysis., Conclusions: Through this study, it was possible to better understand the training program and monitoring strategies of a high-performance futsal team over a high-level tournament.

Objective: The present study compared the effects of two different small-sided game (SSG) training methods, interval (ISSG) and continuous (CSSG) on the bio-motor abilities of young soccer players., Methods: Sixteen young soccer players (age: 19.5 ± 0.5 years; height: 177 ± 4.72 cm) were ranked based on the result of a running-based anaerobic sprint test (RAST) and randomly divided into two groups: CSSG (n = 8) and ISSG (n = 8). The training protocols were performed for eight weeks, three sessions per week. Participants were assessed twice (pre- and post-intervention) to estimate their anaerobic capacity with the RAST, aerobic capacity with Yo-Yo intermittent recovery test, body fat percentage with a bioimpedance analysis, speed with a 30-meter run test, and agility with the Illinois agility test. During the training session, the rating of the perceived exertion (RPE) and heart rate (mean and maximum) were recorded to assess the training load., Results: In general, aerobic and anaerobic capacities improved after ISSG (p < 0.05, for all). The between-group analysis with repeated measures ANOVA revealed higher values for ISSG than CSSG groups post-intervention in anaerobic power (p = 0.042, ηp 2  = 0.264). In addition, the independent t-test results indicated that ISSG presented lower values of mean heart rate (p = 0.023, effect size [ES] = 0.85) and RPE (p < 0.05, ES = 0.88) than CSSG. Moreover, higher values for maximum heart rate were revealed for ISSG than for the CSSG group (p = 0.004, ES = 0.85)., Conclusion: In conclusion, the findings of this study suggests that ISSG can lead to better improvements in anaerobic power and aerobic capacity than CSSG. Additionally, the ISSG led to a lower mean heart rate and RPE than the CSSG. Therefore, coaches and trainers may want to consider incorporating ISSG into their training programs for young soccer players to enhance their bio-motor abilities., (© 2023. The Author(s).)

Prevention has traditionally been categorized into three main areas: primary, secondary, and tertiary. In this Current Opinion, we present and discuss the concept of quaternary prevention in sports. Quaternary prevention aims to protect individuals from interventions that likely cause more harm than good, such as overdiagnosis, overtreatment, and overmedication. It includes preventing all types of harm associated with training and clinical interventions. Therefore, any sports injury prevention model or strategy should acknowledge the risks associated with training-related (i.e., overreaching and overuse) and clinical-related (i.e., overdiagnosis, over medicalization, and overtreatment) features. We propose a conceptual framework that integrates quaternary prevention into the contemporary injury prevention models in sports, taking into account that injury prevention is just one branch of the managerial, decision-making, and active hazard control process of risk management that athletes, coaches, and health and performance staff need to deal with. Therefore, we argue that integrating the concept of quaternary prevention into any form of prevention will significantly protect athletes from excessive, inappropriate, and ethically questionable interventions that may likely cause more harm than good., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: The aim of this study was two-fold: (i) to determine the correlation between 2D:4D, maximal oxygen uptake (VO 2max ), body fat percentage (BF%), maximum heart rate (HRmax), change of direction (COD), and accumulated acute and chronic workload variables; (ii) to verify if the length of the second digit divided by fourth digit (2D:4D) can explain fitness variables and accumulated training load., Methods: Twenty elite young football players (age: 13.26 ± 0.19 years; height: 165.8 ± 11.67 cm; body mass: 50.70 ± 7.56 kg; VO 2max , 48.22 ± 2.29 ml.kg - 1 .min - 1 ) participated in the present study. Anthropometric and body composition variables (e.g., height, body mass, sitting height, age, BF%, body mass index, right and left finger 2D:4D ratios) were measured. The following fitness tests were also conducted: 30 - 15 Intermittent Fitness Test (VO 2max and HRmax), COD (5-0-5 agility test), and speed (10-30msprint test. HRmax and the training load were also measured and monitored using the Rate of Perceived Exertion during the 26 weeks., Results: There were associations between HRmax and VO 2max , between 2D and 4D lengths and Left and Right hand ratios. Also, in AW with Right and Left 4D. The CW and de ACWR with the Right 4D. There were other associations between physical test variables and workload variables., Conclusions: Under-14 soccer players with low right and left-hand 2D:4D ratios did not perform better in the selected fitness tests to assess VO 2max , COD, or sprint ability. However, it cannot be ruled out that the absence of statistically significant results may be related to the small sample size and the maturational heterogeneity of the participants., (© 2023. The Author(s).)

Aims: To analyze the feasibility and impact of a walking football (WF) program on quality of life (QoL), cardiorespiratory fitness (CRF), muscle strength, and balance program in men with prostate cancer under androgen deprivation therapy (ADT)., Methods: Fifty patients with prostate cancer (stages IIb-IVb) under ADT were randomized to a 16-week WF program plus usual care (n=25) or usual care control group (n=25). The WF program consisted of three 90-minute sessions per week. Recruitment, withdrawal, adherence, enjoyment rate, and safety of the intervention were recorded throughout the study. Cardiorespiratory fitness was assessed before and after the interventions, while handgrip strength, lower limb muscle strength, static balance, and QoL were assessed before, during (week 8), and after (week 16) the interventions. Adverse events during sessions were also recorded., Results: The WF group showed high levels of adherence (81.6 ± 15.9%) and enjoyment rate (4.5 ± 0.5 out of 5 points). In the intention-to-treat analysis, the WF group showed an improvement in chair sit-to-stand (p=0.035) compared to the control group. Within-group comparisons showed that handgrip strength in the dominant upper limb (p=0.024), maximal isometric muscle strength in the non-dominant lower limb (p=0.006), and balance in the dominant limb (p=0.009) improved over time in the WF group but not in the usual care group. The results obtained from the per-protocol analysis indicate that CRF improved significantly in the WF group as compared to the control group ( p =0.035). Within-group analysis revealed that CRF ( p =0.036), muscle strength in dominant ( p =0.006) and non-dominant ( p =0.001) lower limbs, and balance in the non-dominant lower limb ( p =0.023) improved after 16 weeks of WF, but not in the control group. One major traumatic injury (muscle tear) was reported with a complete recovery before the end of the intervention., Conclusion: This study suggests that WF is feasible, safe, and enjoyable in patients with prostate cancer under hormonal therapy. Furthermore, patients who adhere to the WF program can expect cardiorespiratory fitness, muscle strength, and balance improvements., Clinical Trials Registration: clinicaltrials.gov, identifier NCT04062162., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Capela, Antunes, Coelho, Garcia, Custódio, Amorim, Costa, Vilela, Teixeira, Amarelo, Silva, Joaquim, Viamonte, Brito and Alves.)

Background: Peripheral nerve disease may lead to physical disability because of decreased muscle strength and/or loss of sensitivity in the dermatomes of affected peripheral nerves. Both human immunodeficiency virus (HIV)- and leprosy-affected patients can develop neurological damage; therefore, the coinfection of these diseases presents new challenges to the health care of these patients., Aims and Objective: This study aimed to investigate the motor alterations of patients coinfected with HIV and leprosy and their relationship with clinical and anthropometric characteristics, compared with individuals with isolated diseases., Materials and Methods: In this cross-sectional study, 90 individuals were divided equally into three groups: HIV/acquired immunodeficiency syndrome (AIDS) group, leprosy group and HIV/leprosy group. All individuals underwent an evaluation of muscle strength and upper limb endurance adjusted for the Brazilian standards, a palm print pressure test using a digital dynamometer and anthropometric measurements (weight, height and skin folds)., Results: The HIV/leprosy group had the highest mean body mass index, followed by the leprosy group and the HIV/AIDS group. Skinfolds were similar between the groups. Multiple linear regression, adjusted for sex and age, revealed the coinfection of HIV and leprosy as possible contributor to a worse prognosis of muscle function, highlighting the bilateral reduction in the levels of palm print compression strengths compared with isolated diseases (HIV and leprosy). High CD4 count and shorter antiretroviral therapy duration were associated with worse indices of muscle strength, such as gripping and resistance, in coinfected patients., Conclusion: Patients coinfected with HIV and leprosy exhibited greater motor damage than those with isolated diseases. Thus, motor damage may be related to the sum of the neurological manifestations of the two morbidities., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Dermatology.)

Diabetes is one of the most prevalent noncommunicable diseases in the world. This disease can affect both physical and mental health in the population. This study analyzed the prevalence of Self-Perceived Health (SPH), self-reported depression, and depressive symptoms in comparison with the Physical Activity Frequency (PAF) reported by Spanish older adults with diabetes. A cross-sectional study was carried out with data from 2799 self-reported diabetic participants, all of whom were residents of Spain, aged 50-79 years, and included in the European Health Surveys carried out in Spain (EHIS) both in 2014 and 2020. The relationships between the variables were analysed with a chi-squared test. A z-test for independent proportions was performed to analyze differences in proportions between the sexes. A multiple binary logistic regression was carried out on the prevalence of depression. Linear regressions were performed on depressive symptoms and SPH. Dependent relationships were found between the SPH, self-reported depression, and depressive symptoms with PAF. Most of the very active participants reported a higher prevalence of self-reported depression. Physical inactivity increased the risk of depression, major depressive symptoms, and negative SPH.

Bats have emerged as potential carriers of zoonotic viruses and bacteria, including antimicrobial-resistant bacteria. Staphylococcaceae has been isolated from their gut and nasopharynx, but there is little information about Staphylococcaceae on bat skin. Therefore, this study aimed to decipher the Staphylococci species in bat skin and their antimicrobial susceptibility profile. One hundred and forty-seven skin swabs were collected from bats during the spring and summer of 2021 and 2022. Bats were captured in different areas of the Metropolitan Region of São Paulo, Brazil, according to the degree of anthropization: Area 1 (Forested), Area 2 (Rural), Area 3 (Residential-A), Area 4 (Slum-- up to two floors), Area 5 (Residential-B-condo buildings), and Area 6 (Industrial). Swabs were kept in peptone water broth at 37 °C for 12 h when bacterial growth was streaked in Mannitol salt agar and incubated at 37 °C for 24 h. The disc-diffusion test evaluated antimicrobial susceptibility. Staphylococcaceae were isolated from 42.8% of bats, mostly from young, from the rural area, and during summer. M. sciuri was the most frequent species; S. aureus was also isolated. About 95% of isolates were resistant to at least one drug, and most strains were penicillin resistant. Eight isolates were methicillin resistant, and the mecA gene was detected in one isolate ( S. haemolyticus ). Antimicrobial resistance is a One Health issue that is not evaluated enough in bats. The results indicate that bats are carriers of clinically meaningful S. aureus and antimicrobial-resistant bacteria. Finally, the results suggest that we should intensify action plans to control the spread of resistant bacteria.

Objectives: This study examined the peak physical and physiological (heart rate) performance intensities andassociated decrements in elite soccer referees during match play., Design: Longitudinal study., Methods: Physical performancevariables and heart rate were analyzed during 457 matches across two seasons. Differences between halves, and the rate ofdecline in peak performance intensities across moving average durations of 1-10 minutes were assessed using linear mixed models and power-law analysis, respectively., Results: Large significant differences were observed between halves for mean total distance, mean velocity, mean heart rate, and percentage of maximal heart rate (p ≤ 0.05; r = 0.51-0.64). Peak intensities (p ≤ 0.05; r = 0.15-0.17) and the rate of decline (p < 0.001; r = 0.17-0.37) were significantly higher in the 2 nd half compared to the 1 st half, for relative total distance, relative high-intensity running and mean velocity. The rate of decline was significantly greater in the 2 nd half than the 1 st half for relative distance covered by high-intensity acceleration (>2 m/s -2 /min), deceleration (<-2 m/s -2 /min), and relative mean heart rate (p < 0.001; r = 0.28-0.61). Elite soccer referees might have experienced transient fatigue during match play, as relative high-intensity running immediately following the most intense 5-minute period significantly declined by 61.2% ( p< 0.001; r = 0.94), and was 16.2% lower than the mean 5-minute period (p < 0.001; r = 0.34)., Conclusions: Increased physical and physiological demands during match play, with associated declines in the second half and transient signs of fatigue throughout the match, supports the inclusion of high-intensity interval and endurance training programs to prepare soccer referees for the intensity demands and peak performance outcomes of match play., Competing Interests: Declaration of interest statement None., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction and Objectives: Obstructive coronary artery disease (CAD) remains the most common etiology of heart failure with reduced ejection fraction (HFrEF). However, there is controversy whether invasive coronary angiography (ICA) should be used initially to exclude CAD in patients presenting with new-onset HFrEF of unknown etiology. Our study aimed to develop a clinical score to quantify the risk of obstructive CAD in these patients., Methods: We performed a cross-sectional observational study of 452 consecutive patients presenting with new-onset HFrEF of unknown etiology undergoing elective ICA in one academic center, between January 2005 and December 2019. Independent predictors for obstructive CAD were identified. A risk score was developed using multivariate logistic regression of designated variables. The accuracy and discriminative power of the predictive model were assessed., Results: A total of 109 patients (24.1%) presented obstructive CAD. Six independent predictors were identified and included in the score: male gender (2 points), diabetes (1 point), dyslipidemia (1 point), smoking (1 point), peripheral arterial disease (1 point), and regional wall motion abnormalities (3 points). Patients with a score ≤3 had less than 15% predicted probability of obstructive CAD. Our score showed good discriminative power (C-statistic 0.872; 95% CI 0.834-0.909: p<0.001) and calibration (p=0.333 from the goodness-of-fit test)., Conclusions: A simple clinical score showed the ability to predict the risk of obstructive CAD in patients presenting with new-onset HFrEF of unknown etiology and may guide the clinician in selecting the most appropriate diagnostic modality for the assessment of obstructive CAD., (Copyright © 2022 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)