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Background and Objectives: The optimal mechanical thrombectomy technique for distal, medium vessel occlusion (DMVO) stroke remains unknown. We aimed to compare the safety and efficacy of 2 thrombectomy first-line approaches, direct aspiration (DA), and combined technique (CT) in patients with DMVOs., Methods: We conducted a retrospective review of a prospectively collected multicenter database of patients with DMVOs (at or distal to M2 and A1), who underwent mechanical thrombectomy with JET D reperfusion catheters between January 2020 and December 2021. The primary end point was the rate of first-pass complete recanalization, defined as modified treatment in cerebral infarction (mTICI) 3. The hemorrhagic complications, the 90 days functional independence rate (modified Rankin Scale 0-2), and mortality were also evaluated., Results: A total of 171 consecutive patients were enrolled (95 in DA and 76 in CT cohort). The 2 groups had comparable demographics and baseline characteristics. The DA group had a higher rate of first-pass effect (40.0% vs 10.5%, P < .001), final mTICI 2b-3 (89.5% vs 71.1%, P = .003) and final mTICI 3 (58.9% vs 28.9%, P < .001), shorter groin to reperfusion time (65 ± 43 min vs 101 ± 60 min, P < .001), and higher rate of 90-day functional independence (63.7% vs 36.1%; P = .001) compared with the CT group. There were no significant differences in hemorrhagic complications between the 2 groups. The DA group showed a lower rate of 90-day mortality (9.9% vs 27.8%; P = .004)., Conclusion: In patients with DMVOs, DA with a distal dedicated reperfusion catheter appears to demonstrate better safety and efficacy when compared with the CT using the same catheter., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

Background: Mechanical thrombectomy (MT) was found to be beneficial in acute ischemic stroke patients with anterior tandem occlusion (a-TO). Instead, little is known about the effectiveness of MT in stroke patients with posterior tandem occlusion (p-TO). We aimed to compare MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO., Methods: We conducted a cohort study on prospectively collected data of patients registered in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) who were treated with MT within 24 h from last known well time for acute ischemic stroke with p-TO (n = 275) or a-TO (n = 1853)., Results: After adjustment for unbalanced pre-procedure variables (year 2015-2021, age, sex, NIHSS score, ASPECTS, and time strata for puncture groin) and pre-stroke mRS score as pre-defined predictor, p-TO was significantly associated with lower probability of mRS score 0-2 (OR 0.415, 95% CI 0.268-0.644) and with higher risk of death (OR 2.813, 95% CI 2.080-3.805) at 3 months. After adjustment for unbalanced procedural and post-procedure variables (IVT, general anesthesia, TICI 3, and 24-h HT) and pre-stroke mRS score as pre-defined predictor, association between p-TO and lower probability of mRS score 0-2 (OR 0.444, 95% CI 0.304-0.649) and association between p-TO and with higher risk of death (OR 2.971, 95% CI 1.993-4.429) remained significant., Conclusions: MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO was associated with worse outcomes at 3 months., (© 2024. Fondazione Società Italiana di Neurologia.)

Objectives: We aimed to compare whether: (1) social media use (SMU) would induce a similar state of mental fatigue compared to the Modified Stroop task (MST); (2) the SMU and the MST would affect neuroelectric responses; and (3) sport-specific visuomotor performance in the taekwondo (TKD) athletes was impaired by mental fatigue., Methods: Fifteen TKD athletes underwent a 60-min Modified Stroop Task (MST), engaged in SMU, or watched a documentary (CON) in a randomized order. Pre and post-each conditions they responded to a Stroop task (ST) while the event-related potentials (ERP) were measured. The Visual Analogue Scale for mental tiredness (VAS-MT) was used to measure subjective feelings of mental fatigue Then, the athletes completed TKD-specific visuomotor tests., Results: The VAS-MT response increases progressively in the MST condition (p < 0.001). The response time of ST was slower in the MST than in SMU (p = 0.04). The accuracy dropped in MST comparing pre- and post-manipulation (p < 0.001) and was lower than post-CON (p = 0.005). The peak amplitude for N200 ERP was higher post-than pre for all conditions (p < 0.001) on the Fz channel. N200 amplitude was higher on CON than MST on post-manipulation (p = 0.02). The amplitude increased significantly from pre-to post in the CON condition (p = 0.009) on the Cz channel. There was no difference in visuomotor performance among conditions (all ps > 0.05)., Conclusion: Prolonged performance of the MST, but not SMU, induces a state of mental fatigue. Neuroelectric and cognitive responses were impaired by mental fatigue induced by MST, but the visuomotor performance remained unaffected by any condition., 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.)

The ATP-PCr system represents the main source of energy during high-intensity attack actions in taekwondo matches. In contrast, the glycolytic system supports the maintenance of these actions when repeated techniques are performed. Given the close relationship between anaerobic energy systems and attack activity in combat, the literature relating to the use of sport-specific test protocols for anaerobic assessment has experienced a remarkable increase. This narrative review aims to illustrate the sport-specific anaerobic tests available in taekwondo by retracing and examining development and validation process for each test. Forty-one articles published between 2014 and 2023 were selected via the MEDLINE and Google Scholar bibliographic databases. These tests are the Taekwondo Anaerobic Test and Adapted Anaerobic Kick Test (i.e., continuous mode testing); the 10 s and multiple Frequency Speed of Kick Tests; the chest and head Taekwondo Anaerobic Intermittent Kick Tests; and the Taekwondo-Specific Aerobic-Anaerobic-Agility test (i.e., intermittent mode testing). Coaches and strength and conditioning professionals can use all the tests described in taekwondo gyms as they feature short and easy-to-implement protocols for monitoring and prescribing specific anaerobic training. The guidelines in this review evaluate each test from several perspectives: basic (e.g., validity, reliability, and sensitivity), methodological (e.g., continuous or intermittent mode testing) and application (e.g., time-motion structure and performance parameters). This comprehensive approach aims to assist stakeholders in selecting the most appropriate test.

Embryonic-type neuroectodermal tumor (ENT) is a somatic-type malignancy characterized by overgrowth of embryonic-type neuroectodermal tissue (EtNT). In germ cell tumors, EtNT is frequently intermingled with other components that may exhibit significant morphologic overlap [mature neuro-glial tissue (MNGT), nephroblastomatous tissues, and primitive endodermal-type glands]. Therefore, the quantification of EtNT (crucial for the diagnosis of ENT) can be challenging. In this study, we investigated the immunohistochemical profile of ENT, EtNT, and MNGT using a broad immunohistochemical panel. We found that SOX2 was the most sensitive marker for EtNT (100%), but it also stained MNGT (28.6%). GFAP and S100 were relatively sensitive (71.4%) and highly specific (GFAP 100%, S100 85.8%) for MNGT, whereas synaptophysin stained both. Combining our results with those of previous studies, we propose that a combination of SOX11, SOX2, GFAP, S100, AFP, villin, CDX2, PAX8, and nuclear WT1 may help to identify and quantify EtNT in germ cell tumors., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Combat sports, such as judo, are weight categorized. Weight control was established to promote fair disputes among individuals. However, combat sports athletes adopt rapid weight loss (RWL) to obtain an advantage over smaller and lighter opponents. This scoping review article presents the prevalence, magnitude, and methods of RWL and its effects on physical and competitive performance, health risks, and psychological effects. Specific recommendations for attenuating the effects of RWL are also presented., Methods: Studies were retrieved from Web of Science, PubMed, and Scopus databases. Four hundred and forty-six articles were identified, of which fifty-three were considered eligible for this review., Results: The results showed that the prevalence of RWL was between 40% and 92.9% and that athletes reduced their body mass by approximately 5%. Although the literature suggests that RWL impairs the performance and psychological well-being of athletes, these results were obtained when recovery time was not provided., Conclusion: No negative effects on performance were observed when the recovery time was >4 h. However, health risks due to RWL practices should be considered, and RWL should be avoided.

Karate athletes strategically use lower-limb techniques in combat, with the roundhouse kick ( mawashi geri ) being highly effective in kumite. To quickly improve the technical performance before training or competitions, conditioning activities (CAs) are often utilized. Recently, Whole-Body Vibration (WBV) has emerged as a potential conditioning activity (CA). This study aimed to analyze the acute effects of WBV as a CA on the performance of the mawashi geri . The sample included sixteen male karate athletes. The study had a familiarization and two experimental sessions: one with WBV and the other without (NWBV), conducted randomly and counterbalanced, each preceded and followed by a mawashi geri assessment on a force platform. During the CA intervention, the participants performed four sets of isometric half-squats on a vibration platform at a frequency of 26 Hz and an amplitude of 4 mm in the WBV condition, while the platform was off in the NWBV condition. A significant reduction in the mawashi geri attack phase time was observed under the WBV condition [pre: 0.31 ± 0.03 s; post: 0.30 ± 0.03 s] compared to the NWBV condition [pre: 0.31 ± 0.04 s; post: 0.32 ± 0.03 s] ( p = 0.02). However, no differences were noted regarding the impact force or other kinetic variables between the conditions. Therefore, WBV did not increase the performance of the kinetic and kinematic variables of the mawashi geri in karate athletes, but it is possible that there is a positive effect on attack time, suggesting that further studies with different vibration protocol configurations would be beneficial.

Background: The elevated blood pressure (BP) and lower cardiac autonomic modulation (CAM) are associated with higher morbidity mortality risk among older adults. Although exercise is an important intervention for cardiovascular promotion, it is unclear whether combat sports training could benefit cardiovascular outcomes as much as autonomic in this population. This study compared the effects of 12 weeks of Muay Thai (MT) training against functional training (FT) on CAM and hemodynamic parameters in older adults., Methods: The sample consisted of 50 older adults (41 women; 66.0 ± 5.3 years old), who were equaly randomized into FT (n = 25) and MT (n = 25) intervention groups. CAM was measured by 30-min rest heart rate variability. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and resting heart rate (RHR) were measured using an automatic oscillometric device. Pulse pressure (PP) and the double product (DP) were also calculated. The interventions were carried out three times a week, with 60-min length per session, during 12 consecutive weeks. The intensity of the interventions was measured using the subjective perception of exertion scale and by accelerometer. Two-factor repeated measures analysis of covariance was used for groups comparison, considering intervention group and body mass as factors. The 95% confidence interval of the difference (95%CIdif) was also calculated and the effect size was measured using partial eta squared (η 2 p )., Results: CAM indices did not show significant changes across moments and intervention groups. In hemodynamic parameters, only in DBP was there an effect of the moment (F 1,39  = 8.206; P = 0.007; η 2 p  = 0.174, large) and interaction effect between group*moment (F 1,39  = 7.950; P = 0.008; η 2 p  = 0.169, large). Specifically, the MT group at the post-training moment showed lower DBP (P = 0.010; 95%CI dif  = -13.3; -1.89) in relation to the FT group. Furthermore, the MT group showed a decrease in DBP during training (P = 0.002; 95%CI dif  = -10.3; -2.6). Also, an increase in training intensity was also found over the 12 weeks in FT, with no difference between the groups., Conclusion: After 12 weeks of MT practice there was a reduction in DBP compared to FT in older adults., Trial Registration: NCT03919968 Registration date: 01/02/2019., (© 2024. The Author(s).)

Introduction: Piloting an aircraft is a complex multitasking activity that involves managing information in a nonautomatic way and generates a high workload (psychological, cognitive, and physical) for the pilot. The excess of these demands can result in decreased performance and may impair flight safety. Heart rate variability (HRV) has been used in recent studies as a method to investigate operator's workload in complex environments. This measure can assess the stress and recovery ability of the autonomic nervous system. However, a better understanding of flight influence on the pilot's autonomic modulation is necessary. Therefore, this scoping review aims to systematically map the studies related to changes in the autonomic modulation in military pilots during flight, in order to characterize their workload at different times and flight profiles., Materials and Methods: A literature search was conducted using MEDLINE (by PubMed), SCOPUS, and LILACS databases. Recent records (2002-2022) that analyzed HRV in military pilots during flight were included. Meanwhile, studies in which piloting activity was not performed were excluded. The study was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline extension for Scoping Reviews and the Updated Methodological Guidance for the Conduct of Scoping Reviews., Results: A total of 298 records were obtained, of which 19 were included in the scoping review. The studies analyzed flights performed in high- and low-performance aircrafts, helicopters, and flight simulators, using time domain, frequency domain, and nonlinear HRV indices. Real and simulated flights produced significant autonomic changes. Some flights elicited autonomic nervous system responses that persisted up to 5 h after landing. During real flight, the most sensitive indices for identifying variations in pilot workload were root mean square of successive differences between normal heartbeats, standard deviation of interbeat interval of normal sinus beat (SDNN), ratio of low-frequency to high-frequency power, and Poincaré plot standard deviation perpendicular to the line of identity (SD1), whereas the interbeat interval (RR), SDNN, SD1, and Poincaré plot standard deviation along the line of identity (SD2) were the most sensitive indices when comparing segments of simulated flight with different levels of difficulty., Conclusions: This scoping review provided insight into the influence of flight on autonomic modulation in military pilots. Some key themes were highlighted: Increased sympathetic activity during flight, sensibility of different domains of HRV to flight demands, and autonomic changes during recovery time. Future research efforts may allow us to enhance the understanding of pilot's workload limits and to elucidate the optimal postflight recovery time., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Ischemic preconditioning (IPC), which involves episodes of blood flow restriction followed by reperfusion, has uncertain effects on athletes. Additionally, employing sports-specific tests that are highly familiar to athletes can enhance methodological rigor in determining IPC's effects on taekwondo performance. This study aimed to investigate IPC's influence on taekwondo athletes' performance through two studies. To induce occlusion in both studies, the cuff was inflated to an individualized occlusion pressure established for each athlete's lower limb, with four cycles of occlusion lasting five minutes each, alternated with five-minute reperfusion intervals. Both traditional frequentist statistics and Bayesian analysis were employed. In the first study, eleven high-level athletes were subjected to either IPC or a placebo (SHAM) procedure on both legs, followed by performing countermovement jumps (CMJs) and a specific taekwondo endurance test. However, no significant differences were observed in taekwondo endurance performance or CMJ between the IPC and SHAM conditions. The second study involved fourteen elite athletes who underwent the same IPC or SHAM conditions, performing CMJ and three bouts of the Multiple Frequency Speed of Kick test (FSKTmult) in three blocks, each separated by approximately thirty minutes. Again, the results indicated no significant differences in FSKTmult measures or CMJ performance between the two conditions. In conclusion, IPC did not significantly affect neuromuscular (in both studies), endurance (in the first study), or anaerobic (in the second study) performance in these taekwondo athletes.

Abstract: Rufino, HVdO, Franchini, E, Forte, LDM, da Silva, TBO, Meireles, CLS, and Soares, YM. Physiological and perceptual responses of a guard passing test and a simulated Brazilian jiu-jitsu combat: a pilot study. J Strength Cond Res XX(X): 000-000, 2024-Brazilian jiu-jitsu (BJJ) is a grappling combat sport characterized by high-intensity efforts during the scoring actions interspersed by low-intensity actions or pause during the referee stoppage. Therefore, understanding of the physiological response to a BJJ match and BJJ-specific test can contribute to both athletes testing and training prescription. Thus, the present study aimed to compare the physiological and perceptual responses to a guard passing test (GPT) and to a simulated BJJ combat (simulated combat [SC]). For that, 7 male BJJ athletes performed a BJJ SC and the GPT at different days at random order. GPT was composed by 6 sets of all-out guard passing movements. Heart rate, blood lactate concentration ([La]), and rate of perceived exertion (RPE) were measured immediately after SC and after each set of GPT. RPE increased after sets 4, 5, and 6 compared with set 1, with no differences to SC (p < 0.001). In additionally, no differences were observed between [La] or heart rate after SC to GPT. Results suggests that GPT is an efficient training protocol that elicits similar physiological and perceptual responses to BJJ combat. Future studies should investigate GPT reliability and validity for performance assessment., (Copyright © 2024 National Strength and Conditioning Association.)

Antimicrobial de-escalation (ADE) is defined as the discontinuation of one or more antimicrobials in empirical therapy, or the replacement of a broad-spectrum antimicrobial with a narrower-spectrum antimicrobial. The aim of this review is to provide an overview of the available literature on the effectiveness and safety of ADE in critically ill patients, with a focus on special conditions such as anti-fungal therapy and high-risk categories. Although it is widely considered a safe strategy for antimicrobial stewardship (AMS), to date, there has been no assessment of the effect of de-escalation on the development of resistance. Conversely, some authors suggest that prolonged antibiotic treatment may be a side effect of de-escalation, especially in high-risk categories such as neutropenic critically ill patients and intra-abdominal infections (IAIs). Moreover, microbiological documentation is crucial for increasing ADE rates in critically ill patients with infections, and efforts should be focused on exploring new diagnostic tools to accelerate pathogen identification. For these reasons, ADE can be safely used in patients with infections, as confirmed by high-quality and reliable microbiological samplings, although further studies are warranted to clarify its applicability in selected populations.

Few data are available on the lung microbiota composition of patients with coronavirus disease 2019-related acute respiratory distress syndrome (C-ARDS) receiving invasive mechanical ventilation (IMV). Moreover, it has never been investigated whether there is a potential correlation between lung microbiota communities and respiratory mechanics. We performed a prospective observational study in two intensive care units of a university hospital in Italy. Lung microbiota was investigated by bacterial 16S rRNA gene sequencing, performed on bronchoalveolar lavage fluid samples withdrawn after intubation. The lung bacterial communities were analyzed after stratification by respiratory system compliance/predicted body weight (Crs) and ventilatory ratio (VR). Weaning from IMV and hospital survival were assessed as secondary outcomes. In 70 C-ARDS patients requiring IMV from 1 April through 31 December 2020, the lung microbiota composition (phylum taxonomic level, permutational multivariate analysis of variance test) significantly differed between who had low Crs vs those with high Crs ( P = 0.010), as well as in patients with low VR vs high VR ( P = 0.012). As difference-driving taxa, Proteobacteria ( P = 0.017) were more dominant and Firmicutes ( P = 0.040) were less dominant in low- vs high-Crs patients. Similarly, Proteobacteria were more dominant in low- vs high-VR patients ( P = 0.013). After multivariable regression analysis, we further observed lung microbiota diversity as a negative predictor of weaning from IMV and hospital survival (hazard ratio = 3.31; 95% confidence interval, 1.52-7.20, P = 0.048). C-ARDS patients with low Crs/low VR had a Proteobacteria-dominated lung microbiota. Whether patients with a more diverse lung bacterial community may have more chances to be weaned from IMV and discharged alive from the hospital warrants further large-scale investigations., Importance: Lung microbiota characteristics were demonstrated to predict ventilator-free days and weaning from mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). In this study, we observed that in severe coronavirus disease 2019 patients with ARDS who require invasive mechanical ventilation, lung microbiota characteristics were associated with respiratory mechanics. Specifically, the lung microbiota of patients with low respiratory system compliance and low ventilatory ratio was characterized by Proteobacteria dominance. Moreover, after multivariable regression analysis, we also found an association between patients' microbiota diversity and a higher possibility of being weaned from mechanical ventilation and discharged alive from the hospital. For these reasons, lung microbiota characterization may help to stratify patient characteristics and orient the delivery of target interventions. (This study has been registered at ClinicalTrials.gov on 17 February 2020 under identifier NCT04271345.)., Registered at ClinicalTrials.gov, 17 February 2020 (NCT0427135)., Competing Interests: The authors declare no conflict of interest.

Objective: We analyzed the retrospective performance of para powerlifters over 8 yrs considering sex, the origin of impairment, and sport classification of para powerlifting., Design: This retrospective study analyzed data from 6791 (4613 and 2178 for male and female, respectively) individual results from 1634 athletes' performances. We collected absolute load (in kilograms), relative load (in kilogram/body mass), chronological age and origin of impairment (acquired or congenital), and sport classification (leg length difference, limb deficiency, range of movement, impaired muscle power, hypertonia, ataxia, athetosis, and short stature of para powerlifters., Results: Males were stronger than females thorough the years with acquired impairment being stronger than congenital impairment. Para powerlifters with acquired impairment were older compared with congenital impairment over the years. Acquired impairment males won 60% more medals than the congenital group. There was a significant association between competition achievement and sports class classification, with a higher number of medals for limb deficiency than other sports classes., Conclusions: These results demonstrate that the sex, origin of impairment, and sports classification influence performance of athletes in para powerlifting. Thus, this information can help athletes, coaches, sport managers, and sport institutions involved in the sport of para powerlifting., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

The ALOG (Arabidopsis LIGHT-DEPENDENT SHORT HYPOCOTYLS 1 (LSH1) and Oryza G1) proteins are conserved plant-specific Transcription Factors (TFs). They play critical roles in the development of various plant organs (meristems, inflorescences, floral organs, and nodules) from bryophytes to higher flowering plants. Despite the fact that the first members of this family were originally discovered in Arabidopsis, their role in this model plant has remained poorly characterized. Moreover, how these transcriptional regulators work at the molecular level is unknown. Here, we study the redundant function of the ALOG proteins LSH1,3,4 from Arabidopsis. We uncover their role in the repression of bract development and position them within a gene regulatory network controlling this process and involving the floral regulators LEAFY, BLADE-ON-PETIOLE, and PUCHI. Next, using in vitro genome-wide studies, we identified the conserved DNA motif bound by ALOG proteins from evolutionarily distant species (the liverwort Marchantia polymorpha and the flowering plants Arabidopsis, tomato, and rice). Resolution of the crystallographic structure of the ALOG DNA-binding domain in complex with DNA revealed the domain is a four-helix bundle with a disordered NLS and a zinc ribbon insertion between helices 2 and 3. The majority of DNA interactions are mediated by specific contacts made by the third alpha helix and the NLS. Taken together, this work provides the biochemical and structural basis for DNA-binding specificity of an evolutionarily conserved TF family and reveals its role as a key player in Arabidopsis flower development., Competing Interests: Competing interests statement:The authors declare no competing interest.

Background: The aim of this study was to assess the effectiveness of a new Short Intermittent Taekwondo Test (SITT) in 17 black belt athletes., Methods: Maximal oxygen uptake (V̇O2max), carbon dioxide production (V̇CO2), respiratory exchange ratio (RER), heart rate (HR), and blood lactate concentration [La] + during treadmill cardiopulmonary exercise test (CPET) and SITT were compared. SITT started with 10 sec of all-out kicks, alternating legs, and progressively increasing 5 s on each stage until the 4 th stage. After the 4 th stage the participants performed 25 s of turning kicks (Dolleo chagi), on each stage until the last (10 th stage). The passive recovery phase after the 4 th and the 7 th stage lasted 30 s., Results: V̇O2max and maximal HRmax were not significantly different (P=0.85 vs. P=0.76) between tests, while RER and [La] + were significantly higher in SITT than in CPET (P=0.002 vs. P=0.001). No difference in RPE (P=0.84) was found. A significant positive correlation between two tests for V̇O2max and HRmax was found., Conclusions: Our findings showed that SITT induces physiological responses like CPET suggesting that it can be used to assess aerobic power in national taekwondo athletes, thus helping coaches to select correctly training intensities and monitor athletes' aerobic performance along the training phases.

Purpose : We determined whether cadet and junior Judo World Championship participation and medal achievement would predict senior performance at World Championship (WC) and Olympic Games (OG). Methods : We analyzed retrospectively a total of 7780 athletes who competed at the OG and WC in the cadet, junior, and senior between 2009 and 2021. Results : There was an increase in the probability of winning a medal in the senior category (WC and OG, and only WC) ranged from 4.3 to 4.5 for medal-winning cadets compared to non-medalists and this probability remained around 3.3-3.8 for medalists in the male and 5.3-5.4 for the female medalists in cadet WC. Moreover, the chance of winning a medal in the senior category (WC and OG) was 8.1-8.5 times greater for medalists when compared to non-medalists in the junior WC. In turn, the probability of winning a medal in the senior (WC) was 1.5-1.7 times greater for athletes who did not compete in the junior WC. In the OG, the probability of winning a medal was 3.5 greater times for medalists when compared to non-medalists at cadet and junior WC. Conclusion : Thus, being a cadet or junior WC medalist increases the probability of winning a senior WC or an Olympic medal.

Match-related performance analysis in judo Para athletes with visual impairments is important to coaches and staff to identify technical-tactical profiles of their athletes and opponents but also to identify whether there are similar characteristics in each visual class. Thus, this study explores the match-related performance in judo Para athletes and verifies the relationship between performance using the old and new classification systems. The match-derived variables were analyzed using different statistical methods considering a total of 182 matches from the Tokyo 2020 Paralympic Games. The results indicated that performance was affected by sex and degree of impairment. The new classification system seems suitable for grouping Para judo athletes, as it differentiates performance between the two proposed classes (J1 and J2), since athletes from each group compete separately. Furthermore, different variability index measures were correlated with competitive performance, demonstrating a specific performance profile for each sport class in judo.

Severe infections frequently require admission to the intensive care unit and cause life-threatening complications in critically ill patients. In this setting, severe infections are acknowledged as prerequisites for the development of sepsis, whose pathophysiology implies a dysregulated host response to pathogens, leading to disability and mortality worldwide.Vitamin D is a secosteroid hormone that plays a pivotal role to maintain immune system homeostasis, which is of paramount importance to resolve infection and modulate the burden of sepsis. Specifically, vitamin D deficiency has been widely reported in critically ill patients and represents a risk factor for the development of severe infections, sepsis and worse clinical outcomes. Several studies have demonstrated the feasibility, safety and effectiveness of vitamin D supplementation strategies to improve vitamin D body content, but conflictual results support its benefit in general populations of critically ill patients. In contrast, small randomised clinical trials reported that vitamin D supplementation may improve host-defence to pathogen invasion via the production of cathelicidin and specific cytokines. Nonetheless, no large scale investigations have been designed to specifically assess the impact of vitamin D supplementation on the outcome of critically ill septic patients admitted to the intensive care unit., (© 2024. The Author(s).)

Modified exercise prescription in judo is commonly used to activate the energy systems in different magnitudes. In order to study the physiological and rating of perceived exertion (RPE) responses according to area sizes (i.e., 4 m × 4 m, 6 m × 6 m and 8 m × 8 m) and training mode variations (i.e., groundwork, ne-waza; standing combat only, tachi-waza; and free combat, free randori), eighteen male judo athletes (age: 22.6 ± 1.8 years) were randomly assigned, on separate days, to 9 experimental conditions (3 area sizes × 3 training modes) with each condition lasting 4 min. Delta lactate [La] was calculated based on the blood lactate values measured before and after every condition. Heart rate (HR) was measured during and after each bout and RPE recorded at the end of each combat. The results showed that mean and peak HR, percentage of maximum HR (% HR max ), delta [La] values and RPE scores were lower in 4 m × 4 m compared to 6 m × 6 m and 8 m × 8 m, and in groundwork training mode compared to standing combat and free randori (all p < 0.001). Furthermore, the 6 m × 6 m condition induced lower delta [La] values than 8 m × 8 m (p < 0.001) and free randori resulted in higher RPE scores than standing combat (p = 0.001). In conclusion, different training variables can be easily manipulated in a variety of different ways to specifically activate the energetic systems. Focusing on groundwork, the 6 m × 6 m area size was found to be the most suitable condition to induce a higher cardiovascular response, while the standing combat and free randori in 6 m × 6 m resulted in increased glycolytic activation compared to the groundwork condition., Competing Interests: All authors declare having no conflict of interest., (Copyright © Biology of Sport 2024.)

Background: This study compared the arbitrary and individualized speed and metabolic power (Pmet) intensity thresholds in a small-sided game (SSG) regarding: 1) distance covered; 2) variations of the physical parameters during the SSG; and 3) associations with physical fitness., Methods: Twenty-four amateur soccer players (age: 20.0±1.7 years; height: 176.4±4.2 cm; body mass: 67.6±3.2 kg), after being tested for maximal aerobic speed (MAS) and maximal sprinting speed (MSS), participated in a SSG in a separate session and were monitored with global positioning systems (GPS). The distance covered was classified into three intensity zones for each variable (speed and Pmet) using arbitrary and individualized zones based on MAS., Results: There were differences in the distance covered between methods in zones 1 and 2 for both speed and Pmet (P<0.001), and in zone 3 only for Pmet (P<0.001). There were no variations in any variable analyzed during the SSG. MAS was positively correlated with the distance covered in zone 3 in the arbitrary speed (r=0.67; P<0.001) and Pmet (r=0.60; P<0.01). MSS was negatively correlated with the distance covered in zone 3 in the individualized speed (r=-0.49; P<0.05) and Pmet (r=-0.48; P<0.05)., Conclusions: This study showed that arbitrary and individualized provide different information. While the individualized method could be used to monitor physical demands, the arbitrary could be used to assess running physical performance.

Introduction: The aim of this study was to compare the outcomes of patients treated with intravenous thrombolysis (IVT) <4.5 h after symptom onset plus mechanical thrombectomy (MT) <6 h with those treated with IVT alone <4.5 h for minor stroke (NIHSS ≤5) with large vessel occlusion (LVO) in the anterior circulation., Patients and Methods: Patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) and in the Italian centers included in the SITS-ISTR were analyzed., Results: Among the patients with complete data on 24-h ICH type, 236 received IVT plus MT and 382 received IVT alone. IVT plus MT was significantly associated with unfavorable shift on 24-h ICH types (from no ICH to PH-2) (OR, 2.130; 95% CI, 1.173-3.868; p=0.013) and higher rate of PH (OR, 4.363; 95% CI, 1.579-12.055; p=0.005), sICH per ECASS II definition (OR, 5.527; 95% CI, 1.378-22.167; p=0.016), and sICH per NINDS definition (OR, 3.805; 95% CI, 1.310-11.046; p=0.014). Among the patients with complete data on 3-month mRS score, 226 received IVT plus MT and 262 received IVT alone. No significant difference was reported between IVT plus MT and IVT alone on mRS score 0-1 (72.1% versus 69.1%), mRS score 0-2 (79.6% versus 79%), and death (6.2% versus 6.1%)., Conclusions: Compared with IVT alone, IVT plus MT was associated with unfavorable shift on 24-h ICH types and higher rate of 24-h PH and sICH in patients with minor stroke and LVO in the anterior circulation. However, no difference was reported between the groups on 3-month functional outcome measures., (© 2023. Fondazione Società Italiana di Neurologia.)

Background: Predictors of radiological complications attributable to reperfusion injury remain unknown when baseline setting is optimal for endovascular treatment and procedural setting is the best in stroke patients with large vessel occlusion (LVO)., Aims: To identify clinical and radiological/procedural predictors for hemorrhagic transformation (HT) and cerebral edema (CED) at 24 hr in patients obtaining complete recanalization in one pass of thrombectomy for ischemic stroke ⩽ 6 h from symptom onset with intra-cranial anterior circulation LVO and ASPECTS ⩾ 6., Methods: We conducted a cohort study on prospectively collected data from 1400 patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke., Results: HT was reported in 248 (18%) patients and early CED was reported in 260 (19.2%) patients. In the logistic regression model including predictors from a first model with clinical variables and from a second model with radiological/procedural variables, diabetes mellitus (odds ratio (OR) = 1.832, 95% confidence interval (CI) = 1.201-2.795), higher National Institutes of Health Stroke Scale (NIHSS) (OR = 1.076, 95% CI = 1.044-1.110), lower Alberta Stroke Program Early CT (ASPECTS) (OR = 0.815, 95% CI = 0.694-0.957), and longer onset-to-groin time (OR = 1.005, 95% CI = 1.002-1.007) were predictors of HT, whereas general anesthesia was inversely associated with HT (OR = 0.540, 95% CI = 0.355-0.820). Higher NIHSS (OR = 1.049, 95% CI = 1.021-1.077), lower ASPECTS (OR = 0.700, 95% CI = 0.613-0.801), intravenous thrombolysis (OR = 1.464, 95% CI = 1.061-2.020), longer onset-to-groin time (OR = 1.002, 95% CI = 1.001-1.005), and longer procedure time (OR = 1.009, 95% CI = 1.004-1.015) were predictors of early CED. After repeating a fourth logistic regression model including also good collaterals, the same variables remained predictors for HT and/or early CED, except diabetes mellitus and thrombolysis, while good collaterals were inversely associated with early CED (OR = 0.385, 95% CI = 0.248-0.599)., Conclusions: Higher NIHSS, lower ASPECTS, and longer onset-to-groin time were predictors for both HT and early CED. General anesthesia and good collaterals were inversely associated with HT and early CED, respectively. Longer procedure time was predictor of early CED., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Manuel Cappellari received consultancy or advisory board fees or speaker’s honoraria from Boehringer Ingelheim, Pfizer/Bristol Meyer Squibb, and Daiichi Sankyo. Andrea Zini received consulting fees from Boehringer-Ingelheim consulting fees from Boehringer-Ingelheim, Alexion and CLS Behring. All other authors report no conflicts of interest. The other authors report no conflicts.

Objective: This study was conducted to investigate the performance difference for current World (Junior and Senior) and Paralympic (Senior) record holders according to origin of impairment (acquired or congenital), level of competition, and sex and to describe the performance progression of Paralympic Powerlifting records holders., Design: This retrospective cohort study involving 60 current world (20 Junior and 20 Senior) and Paralympic (20 Senior) Para powerlifting record holders with 15 males congenital impairment and 14 acquired impairment, while 18 females were acquired impairment and 9 congenital impairments., Results: The origin of impairment did not influence the absolute and relative load of male and female recordists. However, for males, acquired athletes were older and heavier when compared with congenital athletes, but without differences for females. The absolute load of Junior World recordists was lower in relation to Senior World and Paralympic recordists independently of the sex. Congenital athletes more often reached the world record in the Junior category, while the acquired athletes were the ones who obtained most of the records in senior categories., Conclusions: Our results show that origin of impairment did not influence the absolute and relative load of current World (Junior and Senior) and Paralympic (Senior) recordists., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

The 2022 WHO classification of urinary and male genital tumors introduced several novel kidney entities exhibiting eosinophilic/oncocytic features with specific mutational backgrounds. Thus, molecular techniques, such as next-generation sequencing (NGS), became more commonly used for their evaluation. We studied 12 low-grade oncocytic tumors (LOT) of the kidney (from 11 patients), identified in a cohort of 210 eosinophilic/oncocytic renal tumors, diagnosed in our institution between October 2019 and May 2023, which represented 5.7% (12/210) of all eosinophilic/oncocytic renal tumors during this period. We reviewed their clinicopathologic, histologic, and immunohistochemical features, as well as their mutational profiles. We also reviewed the literature on NGS-derived data of LOT, by selecting papers in which LOT diagnosis was rendered according to the criteria proposed initially. Median age was 65 years (mean: 63.5; range 43-79) and median tumor size was 2.0 cm (mean: 2.2; range: 0.9-3.1). All tumors were positive for PAX8, CK7, and GATA3, and negative or focally positive for CD117/KIT. We found the following gene mutations: MTOR ((6/11), 54.5%)), TSC1 ((2/11), 18.2%)), and 1 had both NOTCH1 and NOTCH4 ((1/11), 9.1%)). Wild-type status was found in 2/11 (18.2%) patients and one tumor was not analyzable. A review of 8 previous studies that included 79 LOTs revealed frequent mutations in the genes that regulate the mammalian target of rapamycin (mTOR) pathway: MTOR (32/79 (40.5%)), TSC1 (21/79 (26.6%)), and TSC2 (9/79 (11.4%)). Other mutated genes included PIK3CA, NF2, and PTEN, not typically known to affect the mTOR pathway, but potentially acting as upstream and downstream effectors. Our study shows that LOT is increasingly diagnosed in routine practice when applying the appropriate diagnostic criteria. We also confirm that the mTOR pathway is strongly implicated in the pathogenesis of this tumor mainly through MTOR, TCS1, and TSC2 mutations, but other genes could also be involved in the pathway activation, especially in LOTs without "canonical" mutations., (© 2023. The Author(s).)

Background: Heart failure (HF) is the second most important cardiac risk factor for stroke after atrial fibrillation (AF). Few data are available on mechanical thrombectomy (MT) in acute ischemic stroke (AIS) patients with HF., Methods: The source of data is the multicentre Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS). All AIS patients ≥ 18 years receiving MT were categorised in two groups: HF and no-HF. Baseline clinical and neuroradiological findings on admission were analysed., Results: Of 8924 patients, 642 (7.2%) had HF. Compared to the no-HF group, HF patients had higher prevalence of cardiovascular risk factors. Rate of complete recanalisation (TICI 2b-3) was 76.9% in HF vs 78.1% in no-HF group (p = 0.481). Rate of symptomatic intracerebral haemorrhage at 24-h non-contrast computed tomography (NCCT) was 7.6% in HF vs 8.3% in no-HF patients (p = 0.520). At 3 months, 36.4% of HF patients and 48.2% of no-HF patients (p < 0.001) had mRS 0-2, and mortality was, respectively, 30.7% and 18.5% (p < 0.001). In multivariate logistic regression, HF was independently associated with mortality at 3 months (OR 1.53, 1.24-1.88 95% CI, p < 0.001). In multivariate ordinal regression, HF patients had a probability of transitioning to a higher mRS level of 1.23 (1.05-1.44 95% CI, p = 0.012). The propensity score analysis of two groups matched for age, sex, and NIHSS at admission yielded the same results., Conclusion: MT is safe and effective in HF patients with AIS. Patients with HF and AIS suffered from higher 3-month mortality and unfavourable outcome regardless of acute treatments., (© 2023. Fondazione Società Italiana di Neurologia.)

Efficacy and safety of mechanical thrombectomy (MT) for stroke with posterior circulation large vessel occlusion (LVO) is still under debate. We aimed to compare the outcomes of stroke patients with posterior circulation LVO treated with intravenous thrombolysis (IVT) (< 4.5 h after symptom onset) plus MT < 6 h after symptom onset with those treated with IVT alone (< 4.5 h after symptom onset). Patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) and in the Italian centers included in the SITS-ISTR were analysed. We identified 409 IRETAS patients treated with IVT plus MT and 384 SITS-ISTR patients treated with IVT alone. IVT plus MT was significantly associated with higher rate of sICH (ECASS II) compared with IVT alone (3.1 vs 1.9%; OR 3.984, 95% CI 1.014-15.815), while the two treatments did not differ significantly in 3-month mRS score ≤ 3 (64.3 vs 74.1%; OR 0.829, 95% CI 0.524-1.311). In 389 patients with isolated basilar artery (BA) occlusion, IVT plus MT was significantly associated with higher rate of any ICH compared with IVT alone (9.4 vs 7.4%; OR 4.131, 95% CI 1.215-14.040), while two treatments did not differ significantly in 3-month mRS score ≤ 3 and sICH per ECASS II definition. IVT plus MT was significantly associated with higher rate mRS score ≤ 2 (69.1 vs 52.1%; OR 2.692, 95% CI 1.064-6.811) and lower rate of death (13.8 vs 27.1%; OR 0.299, 95% CI 0.095-0.942) in patients with distal-segment BA occlusion, while two treatments did not differ significantly in 3-month mRS score ≤ 3 and sICH per ECASS II definition. IVT plus MT was significantly associated with lower rate of mRS score ≤ 3 (37.1 vs 53.3%; OR 0.137, 0.009-0.987), mRS score ≤ 1 (22.9 vs 53.3%; OR 0.066, 95% CI 0.006-0.764), mRS score ≤ 2 (34.3 vs 53.3%; OR 0.102, 95% CI 0.011-0.935), and higher rate of death (51.4 vs 40%; OR 16.244, 1.395-89.209) in patients with proximal-segment BA occlusion. Compared with IVT alone, IVT plus MT was significantly associated with higher rate of sICH per ECASS II definition in patients with stroke and posterior circulation LVO, while two treatment groups did not differ significantly in 3-month mRS score ≤ 3. IVT plus MT was associated with lower rate of mRS score ≤ 3 compared with IVT alone in patients with proximal-segment BA occlusion, whereas no significant difference was found between the two treatments in primary endpoints in patients isolated BA occlusion and in the other subgroups based on site occlusion., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The use of strength training is important for athletes in combat sports such as judo and jiu-jitsu. Specificity is key when prescribing strength training programs for athletes, considering maximal strength, muscular power and strength-endurance. Grappling combat sports require grip control, which is necessary to execute throwing techniques and groundwork. The aim of this study was to verify the bilateral strength deficit in general and in grappling combat sport-specific action in the control group and grapplers. A sample of 73 subjects, divided into 2 groups, was used: the Student Group (15 females and 16 males) and the Grappler Group (29 males and 13 females). The male and female participants attended four laboratory sessions over a 48-hour interval, the first two to familiarize themselves with the Electromechanical Functional Dynamometer (EMFD), and the last two to collect maximal isometric strength data, using a standard grip and a judo/jiujitsu specific grip. Significant differences in mean and peak forces ( p  < 0.001) were found, with high performance combat sport athletes having greater maximal isometric strength compared to students both bilaterally and unilaterally ( p  < 0.001). All comparisons also indicated higher values for males compared to females ( p  < 0.001). The results suggest that specific training in combat sports as well as sex differences play a significant role in maximal isometric strength performance. The type of grip used affects the application of force in the upper limb isometric strength tests, finding a main effect of grip type ( p  < 0.001), with the standard grip obtaining higher levels. However, the dominance between hands remains constant. More research is needed on specific judogi/jiu-jitsu-gi grips and their impact on maximal isometric strength with the EMFD., 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 Escobar-Molina, Cuevas-Laguna, Chirosa-Ríos, Merino-Fernández, Chirosa-Ríos and Franchini.)

The prevalence of rapid weight loss (RWL) among martial arts athletes including judo is very high. Many applied RWL strategies could be dangerous to health and even lead to death. Therefore, the International Judo Federation (IJF) introduced changes in the weigh-in rules, changing the official weigh-in for the day before the competition. Thus, the purpose of this study was to examine the impact of the new IJF rules on hydration status and weight loss strategies among professional judo athletes. Seventeen elite judo athletes participated in the study. Body mass and hydration status, were analyzed before the competition. Moreover, competition result and practice of RWL survey were collected. All subjects reached their weight category limits for the competition. RWL resulted in body mass changes (p < 0.001, η p 2  = 0.79) and dehydration among participants (urine osmolality > 700 [mOsmol * kg] -1 and urine specific gravity > 1.020 [g * cm 3 ] -1 ). However, urine osmolality (p > 0.05, η p  = 0.16), at subsequent time points of measurement revealed no statistical differences. The prevalence of RWL was 100%, and only 17.6% of the athletes declared that they would compete in a different weight category if the competition would be conducted on the same day of the weigh-in. All judo athletes applied RWL procedures using traditional methods to achieve the required body mass (i.e., increased exercise, reduced fluid, and food intake). Dehydration state was not associated with competitive performance (p > 0.05).2  = 0.18), as well as urine specific gravity (p > 0.05, η p 2  = 0.16), at subsequent time points of measurement revealed no statistical differences. The prevalence of RWL was 100%, and only 17.6% of the athletes declared that they would compete in a different weight category if the competition would be conducted on the same day of the weigh-in. All judo athletes applied RWL procedures using traditional methods to achieve the required body mass (i.e., increased exercise, reduced fluid, and food intake). Dehydration state was not associated with competitive performance (p > 0.05)., (© 2023. Springer Nature Limited.)

Background: The aim of the present study was to determine the time-motion structure of high-level taekwondo matches during the Tokyo 2020 Olympic Games in relation to sex, match outcome, weight category and match round., Methods: Overall, 7007 actions were recorded during the analysis of 134 performances (67 rounds of 24 matches: four rounds of 16, eight quarterfinals, eight semifinals and four finals) in male and female flyweight (≤58 kg and ≤49 kg, respectively), and heavyweight categories (≥80 kg and ≥67 kg, respectively). The attack time (AT), number of AT (AN), skipping time (ST) and pause time (PT) were registered., Results: The AT/ST ratio was ~1:1.5. Male athletes performed significantly longer (P<0.001) sum PT than female athletes. Flyweight athletes differed significantly from their heavyweight counterparts by having longer (P<0.001) average and sum AT, greater (P<0.001) AN, higher (P<0.001) AT/ST ratio, shorter (P<0.001) average and sum ST, and lower (P<0.01) (AT+ST)/PT ratio. Rounds 2 and 3 had average PT significantly longer (P<0.01) than round 1. Round 3 had sum PT longer (P<0.001) and (AT+ST)/PT ratio lower than in round 1., Conclusions: The rule changes and the implementation of the electronic score recording system had a major impact on the time-motion structure of combat by generating a considerably higher AT/ST ratio than in the past. The comparisons indicated that the structure of the combat is modulated by weight category and phase of the combat. In practice, coaches could develop sport-specific high-intensity interval training using the time-motion indexes of the present study as guidelines.

Purpose: This study investigated the effects of time-of-day on judo athletes' performances and the associated psychological variables and perceived exertion following judo-specific tests. Methods: Twelve male judo athletes (age: 16 ± 1 years) performed in a randomized and counterbalanced order the special judo fitness test (SJFT), the judo physical fitness test (JPFT), the dynamic and isometric judogi chin-up tests in the morning (8:00 a.m), midday (12:00 p.m), and afternoon (5:00 p.m). Oral temperature and psychological variables [profile of mood state (POMS), Hooper questionnaire, total quality of recovery (TQR)] were assessed before and after the tests, and ratings of perceived exertion (RPE) and the physical activity enjoyment scale (PACES) were assessed only after the tests. Results: RPE score was higher in the morning compared to the afternoon after the JPFT (d = 0.38, p = .045). PACES after JPFT was higher in the morning compared to midday (d = 0.85, p < .001). The isometric and dynamic performances during chin-up tests were higher in the afternoon compared to the morning (d = 0.38, p = .048 and 0.047, respectively). Also, oral temperature was higher in the afternoon compared to the morning (d = 0.41, p = .050) and the midday (p = .047) for dynamic test, while TQR, well-being indices, and POMS did not differ according to time-of-day (p > .05). Conclusions: These results suggest that dynamic and isometric judo chin-up tests are time-of-day dependent with higher performance recorded in the afternoon than in the morning. However, performances in the JPFT and SJFT were not time-of-day dependent.

Purpose: This study investigated the test-retest reliability and discriminant validity of the Kickboxing Anaerobic Speed Test (KAST) and established a comparison with the maximal cycling sprint test (MCST). Methods: Forty-two male kickboxing athletes (18 elite and 24 sub-elite) participated in this study. Kickboxers performed the tests in both single and multiple forms. The KAST single was composed of kicks and punches, performed as quickly as possible until 5 reps of a 4 techniques' combination (i.e., straight left punch, right-roundhouse kick, straight right punch, and left-roundhouse kick) were completed. The MCST single was composed by a single 6-s maximal effort. The KAST multiple was performed using 5 sequential sets of the single form following a 10s rest interval between sets. The MCST multiple was performed using 5 × 6 s repeated cycling efforts with 10s rest intervals. The tests and retests were carried out on separate occasions. To establish the test's discriminatory capability, elite and sub-elite athletes were compared. Results: All tests' performance scores showed excellent relative and absolute reliability (ICC > 0.900, SEM ≤ 0.98 s for KASTs and ≤ 0.74 W•kg -1 for MCST tests). Significant correlations between the identical versions were "large" (r > 0.70). Receiving operating characteristic analyses indicated that the KASTs and cycling tests were able to effectively discriminate between elite and sub-elite kickboxers. Additionally, the findings showed that KAST single , MCST single , KAST multiple , and MCST multiple correctly classified the groups by 78.6%, 73.6%, 88.1%, and 78.6%, respectively. Conclusions: This study supported the test-retest reliability and the discriminant validity of the KAST single and KAST multiple to evaluate kickboxing athletes.

Aims: Yolk sac tumour postpubertal-type (YSTpt) shows a wide range of histological patterns and is challenging to diagnose. Recently, forkhead box transcription factor A2 (FoxA2) emerged as a driver of YSTpt formation and a promising marker for diagnosing YSTpt. However, FoxA2 has not been tested in the different patterns of YSTpt. This study aimed to assess the staining pattern of FoxA2 in te different patterns of YSTpt and other germ cell tumours of the testis (GCTT), comparing it with glypican-3 (GPC3) and α-fetoprotein (AFP)., Methods and Results: FOXA2, GPC3 and AFP immunohistochemistry was performed on 24 YSTpt (24 microcystic/reticular, 10 myxoid, two macrocystic, five glandular/alveolar, two endodermal sinus/perivascular, four solid, two polyembryoma/embryoid body and two polyvesicular vitelline) and 81 other GCTT. The percentage of positive cells (0, 1+, 2+, 3+) and the intensity (0, 1, 2, 3) were evaluated regardless of and within each YSTpt pattern. FoxA2 was positive in all YSTpt (24 of 24) and all but one (23 of 24) exhibited 2+/3+ stain, with higher intensity [median value (mv): 2.6] than AFP (1.8) and GPC3 (2.5). Both FoxA2 and GPC3 were positive in all microcystic/reticular (24 of 24), myxoid (10 of 10), macrocystic (two of two), endodermal sinus/perivascular (four of four) and polyembryoma/embryoid body (two of two) patterns. Nevertheless, only FoxA2 was positive in all glandular/alveolar (five of five), solid (four of four) and polyvesicular vitelline (two of two) patterns. The intensity of FoxA2 was higher than AFP and GPC3 in almost all YST patterns. In the other GCTT, FoxA2 was positive only in teratoma postpubertal-type (Tpt) [13 of 20 (65%)], with staining almost exclusively confined to the mature gastrointestinal/respiratory tract epithelium., Conclusions: FoxA2 is a highly sensitive and specific biomarker that supports the diagnosis of YSTpt. FoxA2 is superior to GPC3 and AFP, especially in rare and difficult-to-diagnose histological patterns of YSTpt, but mature glands of Tpt could represent a potential diagnostic pitfall., (© 2023 John Wiley & Sons Ltd.)

Introduction: The Brazilian Air Force (BAF) personnel must be prepared to perform their professional activities under the worst conditions. This preparation goes beyond habits of practicing physical activity, since it is necessary to perform specific physical tasks, referred to as "combat tasks" (CTs). This study aimed to investigate a combination of specific physical tests (SPTs) for predicting physical performance on simulated tasks (STs) that mimicked the performance of CTs., Materials and Methods: Thirty infantry cadets from the BAF took part in anthropometric assessments, 11 SPTs, and 3 STs, during 7 testing days. Bivariate Pearson's correlation was used to determine linear relationships between SPT and ST results, and multiple linear regression models were used to identify test batteries that significantly predicted performance on STs. The level of significance was set at 5%. The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of the BAF (protocol code 15796819.4.0000.5250, date of approval September 25, 2019)., Results: The greatest predictive power was obtained by the test battery that consisted of sprint-drag-carry, leg tucks, and handgrip strength (R2 = 0.56, P < .01). Conversely, the test battery comprised of push-ups, sit-ups, and 12-minute run (which represents the conventional physical test of the BAF), which presented the lowest predictive power (R2 = 0.14, P < .05)., Conclusions: In conclusion, this study identified a test battery for predicting performance on the following STs: foot march, casualty drag, and move under direct fire. This finding represents the first step to improve the reliability of the BAF physical assessments, focusing on combat readiness levels., (© The Association of Military Surgeons of the United States 2022. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The purpose of this study was to assess the effects of acute caffeine supplementation on physical performance and perceived exertion during taekwondo-specific tasks in male and female athletes with varying expertise. In a double-blinded, randomized, placebo-controlled crossover study design, 52 young athletes from elite (n = 32; 16 males and 16 females) and sub-elite competitive level (n = 20; 10 males and 10 females) participated. Athletes performed taekwondo-specific tasks including the taekwondo-specific agility test (TSAT), 10 s frequency speed of kick test (FSKT-10 s) and multi-bout FSKT (FSKT-multi) under the following conditions: (1) Caffeine (CAF; 3 mg kg -1 ), placebo (PLA), and no supplement control (CON). Session rating of perceived exertion (s-RPE) was determined after the tests. Findings show that regardless of condition, males performed better than females (p < 0.05) and elite athletes had superior performance compared to their sub-elite counterparts (p < 0.05). For the TSAT (p < 0.001), FSKT-10s (p < 0.001), and FSKT-multi (p < 0.001), CAF enhanced performance in elite female athletes compared to sub-elite females. Likewise, CAF ingestion resulted in superior performance in elite males compared to sub-elite males for FSKT-10s (p = 0.003) and FSKT-multi (p < 0.01). The ergogenic potential of CAF during taekwondo-specific tasks appears to be related to a competitive level, with greater benefits in elite than sub-elite athletes., (© 2023. Springer Nature Limited.)

In this study, we aimed to investigate the effects of warm-up music preference and loudness on physical performance, perceived exertion (RPE), and enjoyment in young taekwondo athletes. In a crossover counterbalanced design, 20 taekwondo athletes (10 male, 10 female) performed a battery of physical tasks specific to taekwondo under the following five conditions: (a) No music (NM), (b) Preferred music-Soft (60 dB; PMS), (c) Preferred music-Loud (80 dB; PML), (d) Non-preferred music-Soft (60 dB; NPMS), and (e) Non-preferred music-Loud (80 dB; NPML). On each lab visit, participants completed a taekwondo-specific agility test (TSAT), a10-second kick test (KSKT-10s) and a multiple frequency speed of kick tests (FSKT) within each music condition. Pre-exercise enjoyment was assessed using the Physical Activity Enjoyment Scale (PACES) after the warm-up, while we obtained RPE scores after each test. The PML condition resulted in significantly better agility test times on the TSAT compared to PMS ( p < .001), and NPML ( p < .001). Furthermore, PML led to a greater number of total kicks during the FSKT-10s test compared to the PMS ( p < .001), and NPML ( p < .001) conditions. The decrement index on the FSKT was lower in PML than in PMS and NPML conditions ( p < .001). For RPE, values were significantly lower with preferred than non-preferred music ( p < .001). These findings lend support to ergogenic benefits of listening to PML prior to taekwondo physical tasks, with important implications for enhancing taekwondo training and performance.

Introduction: The present study assessed the effects of conditioning activities, using different effort-to-pause ratios and rest intervals, on taekwondo physical performance. Methods: Twenty-one athletes (13 males and 8 females) (Mean ± SD; age = 20.4 ± 1.4 years) performed a control (CC) and twelve experimental conditions. Each condition contained a standard warm-up (i.e., CC: running at 9 km/h for 10 min) and conditioning activities comprising plyometrics P) or repeated high-intensity techniques (RT) using 1:6, 1:9 and self-selected rest (SSR) ratios, and two rest intervals (3 and 7 min). Athletes then performed a battery of fitness tests: countermovement jump (CMJ), taekwondo specific agility (TSAT), 10s and multiple frequency speed kick test (FSKT-10s and FSKT-mult, respectively). Results: All of the preloads provided higher performance outputs compared to the control trial (all p < 0.05). For CMJ, 1:6 ratio with 3 min induced lower values with RT compared to P ( p = 0.037) and 1:9 ratio using 3 min induced higher values with RT compared to P ( p = 0.027). Additionally, 1:6 ratio using 7 min induced higher values with RT compared to P ( p = 0.016). For FSKT-10, 3 min using 1:6 induced higher values with P compared to RT, while RT induced higher values with 7 min using 1:6 ratio compared to P (both p < 0.001). Moreover, 3 min using 1:9 ratio induced higher values with P compared to RT ( p = 0.034), while RT induced higher values with 1:9 ratio using 7 min compared to P ( p < 0.001). Finally, 3 min using SSR ratio induced higher values with RT compared to P ( p = 0.034). Conclusion: Plyometrics and RT activities improved performance with plyometrics requiring shorter rest interval to induce potentiation effects compared to RT, which required longer interval., 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 Ouergui, Delleli, Messaoudi, Bridge, Chtourou, Franchini and Ardigò.)

Background: One of the most relevant genetic alterations in cutaneous melanoma (CM) is the biallelic inactivation/loss-of-heterozygosis (LOH) of cyclin-dependent kinase inhibitor 2 A (CDKN2A), which results in the immunohistochemical loss of p16 frequently found in CM. However, we recently described a rare case of dermal/deep-seated melanoma arising in giant congenital nevus (DDM-GCN) with p16 overexpression combined with p53 loss and tumor protein 53 (TP53) mutation. Herein, we reported a case series of CM with p16 overexpression and analyzed their clinicopathologic features, immunohistochemical expression of the cell cycle regulatory molecules (CCRM: p53, p21, Cyclin D1, Rb), and mutational landscape., Methods: We retrospectively tested for p16 all cases of CM diagnosed at our institution between January 1st 2019-April 1st 2022. In CM with p16 overexpression, we reported clinicopathologic features, immunohistochemical results for melanocytic markers and CCRM, and mutational landscape investigated with a next-generation sequencing (NGS) panel. In cases with zonal p16 overexpression, the immunohistochemical assessment for melanocytic markers and CCRM, as well as the NGS analysis have been performed in both components {with and without p16 overexpression [p16(+)c and p16(-)]}., Results: Overexpression of p16 was found in 10/2879 (0.35%) CM [5/10 (50%) diffuse and 5/10 (50%) zonal]. We combined the immunohistochemical results for CCRM and molecular data to classify the cases as follows: a) Group 1 with altered expression of at least one CCRM but no TP53 mutations [3/10 (30%), all with Rb altered/lost]; b) Group 2 with altered expression of at least one CCRM and TP53 mutations [4/10 (40%), all with p53 altered]; c) Group 3 with normal expression of CCRM and no TP53 mutations [3/10 (30%), all with mutations in MAPK pathway genes (NRAS and BRAF)]. In CM with zonal p16 overexpression, the histologic appearance of p16(+)c was heterogeneous, whereas combining CCRM profiles and molecular data the cases could be categorized as follows: a) cases with the same CCRM and molecular profiles in both p16(+)c and p16(-)c; b) cases with p16(+)c showing additional genetic mutations and/or modifications of CCRM expression., Conclusions: p16 overexpression is a rare event, occurring in advanced-stage, clinically- and histologically-heterogeneous CM. These lesions may be classified into three different groups based on CCRM expression and mutational profiles (including TP53 mutation). The analysis of CM with zonal p16 overexpression suggests that, at least in a subset of cases, this phenomenon could represent a sign of "molecular progression" due to the acquisition of additional genetic mutations and/or modifications of the CCRM profile., Competing Interests: Declaration of Competing Interest All the Authors present in this article declare no conflicts of interest., (Copyright © 2023 Elsevier GmbH. All rights reserved.)

Background: In recent years, several studies focused on the process of reprogramming of seminoma (S) cells, which regulates the transition from pure S (P-S) to S component (S-C) of mixed germ cell tumors of the testis (GCTT) and finally to embryonal carcinoma (EC) and other nonseminomatous GCTT (NS-GCTT). The accepted pathogenetic model is driven and regulated by cells (macrophages, B- and T-lymphocytes) and molecules of the tumor microenvironment (TME). Herein, we tested a series of GCTT with double staining (DS) for CD68-PD-L1 to evaluate tumor-associated macrophages (TAMs) expressing programmed death-ligand 1 (PD-L1) [TAMs PD-L1(+)] and clarify if these cells may be involved in establishing the fate of GCTT., Methods: We collected 45 GCTT (comprising a total of 62 different components of GCTT). TAMs PD-L1(+) were evaluated with three different scoring systems [TAMs PD-L1(+)/mm 2 , TAMs PD-L1(+)/mm 2 H-score, TAMs PD-L1(+) %], and compared using pertinent statistic tests (Student's t-test and Mann-Whitney U test)., Results: We found that TAMs PD-L1(+) values were higher in S rather than EC (p = 0.001, p = 0.015, p = 0.022) and NS-GCTT (p < 0.001). P-S showed statistically significant differences in TAMs PD-L1(+) values compared to S-C (p < 0.001, p = 0.006, p = 0.015), but there were no differences between S-C and EC (p = 0.107, p = 0.408, p = 0.800). Finally, we found statistically significant differences also in TAMs PD-L1(+) values between EC and other NS-GCTT (p < 0.001)., Conclusions: TAMs PD-L1(+) levels gradually decrease during the reprogramming of S cells {P-S [(high values of TAMs PD-L1(+)] → S-C and EC [(intermediate values of TAMs PD-L1(+)] → other NS-GCTT [(low values of TAMs PD-L1(+)], supporting a complex pathogenetic model where the interactions between tumor cells and TME components [and specifically TAMs PD-L1(+)] play a key role in determining the fate of GCTT., Competing Interests: Declaration of Competing Interest All the authors present in his article declare no conflict of interests., (Copyright © 2023 Elsevier GmbH. All rights reserved.)

The architecture of the rice inflorescence is an important determinant of crop yield. The length of the inflorescence and the number of branches are among the key factors determining the number of spikelets, and thus grains, that a plant will develop. In particular, the timing of the identity transition from indeterminate branch meristem to determinate spikelet meristem governs the complexity of the inflorescence. In this context, the ALOG gene TAWAWA1 (TAW1) has been shown to delay the transition to determinate spikelet development in Oryza sativa (rice). Recently, by combining precise laser microdissection of inflorescence meristems with RNA-seq, we observed that two ALOG genes, OsG1-like 1 (OsG1L1) and OsG1L2, have expression profiles similar to that of TAW1. Here, we report that osg1l1 and osg1l2 loss-of-function CRISPR mutants have similar phenotypes to the phenotype of the previously published taw1 mutant, suggesting that these genes might act on related pathways during inflorescence development. Transcriptome analysis of the osg1l2 mutant suggested interactions of OsG1L2 with other known inflorescence architecture regulators and the data sets were used for the construction of a gene regulatory network (GRN), proposing interactions among genes potentially involved in controlling inflorescence development in rice. In this GRN, we selected the homeodomain-leucine zipper transcription factor encoding the gene OsHOX14 for further characterization. The spatiotemporal expression profiling and phenotypical analysis of CRISPR loss-of-function mutants of OsHOX14 suggests that the proposed GRN indeed serves as a valuable resource for the identification of new proteins involved in rice inflorescence development., (© 2023 The Authors. The Plant Journal published by Society for Experimental Biology and John Wiley & Sons Ltd.)

Introduction: The International Judo Federation introduced a ranking system in 2009 that determines top athletes for the Olympic Games and seeds them in competitions. Previous research indicated that this ranking list and past performances predicted 19%-27% of performance in the Olympic Games and World Championships. However, due to the COVID-19 pandemic, the relationship between Judo World Tour competitions and Olympic Games performance may have been affected. This study aimed to examine the relationship between athletes' performance in Judo World Tour competitions and their competitive performance at the Olympic Games., Methods: Data from 393 athletes who participated in the Tokyo Olympics were analyzed considering both long and short-term performance measures. Pearson correlation was used to determine the relationship between variables and multiple linear regressions were used to predict performance for each sex and the entire sample., Results: The results revealed a range of magnitudes in the correlation between variables, varying from small to large. In terms of regression analyses, it was observed that, for females, the percentage of matches won during the classification period and competition in the year prior to the Olympic Games predicted 37% of their performance. For males, the percentage of matches won during the classification period and competition in the six months before the Olympic Games predicted 36% of their performance., Discussion: Thus, athletes' quality and reduced exposure to competition near the Olympic Games appear to be important factors in their performance at the event., 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 Santos, Kons, Lopes-Silva, Agostinho, Detanico, Takito and Franchini.)

Purpose: This study investigated the effects of 4 weeks of repeated sprint training (RST) versus repeated high-intensity technique training (RTT) on the physiological responses (ie, blood lactate), mean and peak heart rate, rating of perceived exertion, technical-tactical performance, and time-motion variables during simulated taekwondo combats., Methods: Twenty-four taekwondo athletes (18 male and 6 female; age: 16 [1] y) were randomly and equally assigned to RST (10 × 35-m running sprints interspersed by 10-s rest) or RTT (10 × 6-s bandal-tchagui kicking executions interspersed by 10-s rest) groups in addition to their regular training. Both groups performed simulated combats before and after training., Results: Delta lactate and peak heart rate were attenuated following training (P < .001 and P = .03, respectively), with no differences identified between RTT and RST conditions. Rating of perceived exertion decreased after training only in the RTT (P = .002). Time fighting and preparatory activities increased following training (P < .001), with higher values observed following RTT than RST (P < .001). Nonpreparatory time decreased after training (P < .001), with more pronounced reductions observed following RTT when compared to RST (P < .001). The number of single attacks decreased only following RST (P < .001), whereas combined attacks increased only after RTT training (P < .001)., Conclusions: Similar adjustments in the physiological responses to combat were observed following 4 weeks of either RST or RTT, but RTT elicited more favorable perceptual responses and combat-related performance. This highlights the importance of specificity of training and its effective transfer to combat.

This study was conducted to determine whether the relative age effect (RAE) is present in different age groups, weight categories, sexes, and across different time frames in international-level judo competition. A total of 9451 judo athletes competing at the Olympic Games and/or World Championships in the Cadet, Junior and/or Senior age groups between 1993 and 2020 were considered. Athletes' birthdate distributions were grouped in four quartiles (Q1: January-March; Q2: April-June; Q3: July-September; Q4: October-December) and compared to a day-corrected theoretical distribution using Chi-squared analysis. Poisson regression was also used to evaluate the ability to explain weekly birth count. RAE was more prevalent in males than females ( p < .05), and for Cadets and Juniors compared to Seniors ( p < .05). Heavyweight and middleweight categories presented RAEs in Senior and Junior males, while for females it was present in Cadet heavyweights ( p < .05). RAE was more prevalent in recent years (2009-2021) for Senior male judo athletes ( p < .05). Poisson analysis illustrated some nuanced information, including RAE detection during an earlier time frame, not readily apparent with the traditional analysis.

The long-term impact of weight cycling on health status, eating habits, physical activity and the lifestyle of former combat sports athletes is still insufficiently explored. Therefore, a novel questionnaire in English, Portuguese, Spanish and Croatian language was constructed. To determine the reliability and the content/face validity, a total of 110 participants filled the questionnaire on two occasions. With the majority of intra-class correlation coefficient values above 0·75, the questionnaire items were shown to be very stable. Additionally, according to κ values, the questionnaire has fair test-retest reliability, with only one coefficient being labelled as poor (Q40 in ESP). All questionnaire sub-scales showed moderate to very good internal consistency when the overall sample was observed ( α ranging from 0·605 to 0·802). Poor α values were found only in Godin-Shephard Leisure-Time Physical Activity Questionnaire for CRO and ESP samples. Wilcoxon's signed rank test showed significant differences only in the Mindful Eating Questionnaire sub-scale scores (overall: P = 0·002, effect size = -0·208 [moderate]; CRO: P = 0·005, effect size = 0·303 [moderate]). It can be concluded that the newly developed questionnaire had strong test-retest reliability. Further validity research in a larger sample of former combat sports athletes should be considered.

The ergogenic effect of pre-selected warm-up music with the tempo and loudness variations on the performance of combat sports' athletes as well as the difference between sexes is not well established. The present study aimed to assess the effects of listening to music with different tempos and loudness during warm-up on perceived exertion, physical enjoyment and physical performances in young taekwondo athletes. In a randomized study design, 20 taekwondo athletes (10 males, mean ± SD: age: 17.5 ± 0.7 years, taekwondo experience: ≥ 6 year) performed the taekwondo specific agility test (TSAT) and the 10s and multiple frequency speed of kick test (FSKT-10s and FSKT-mult) after warming-up with or without music. The music was played at high (140 beats·min-1) or very high (200 beats·min-1) tempo combined with low (60 dB) or high (80 dB) loudness, resulting in four experimental and control conditions. The ratings of perceived exertion (RPE) and physical activity enjoyment scale (PACES) were assessed after each condition. After normality, homogeneity and sphericity checks, two-way (or multivariate) analysis of variance and Bonferrroni (or Friedman's and Wilcoxon's test) post-hoc test were operated when necessary. For TSAT, 140 beats·min-1+80 dB induced better performance compared with 200 beats·min-1+80 dB, 200 beats·min-1+60 dB, control and the 140 beats·min-1+60 dB conditions. For FSKT-10s, 140 beats·min-1+80 dB condition induced higher performance compared with 200 beats·min-1+60 dB, 200 beats·min-1+80 dB, 140 beats·min-1+60 dB and the control conditions. For FSKT-mult, 140 beats·min-1+80 dB induced higher number of techniques compared with 200 beats·min-1+60 dB, 140 beats·min-1+60 dB, control and the 200 beats·min-1+80 dB conditions. Moreover, 140 beats·min-1+80 dB induced lower decrement index (DI) compared with the other conditions and lower DI in 140 beats·min-1+60 dB compared with 200 beats·min-1+80 dB and control conditions. Moreover, 140 beats·min-1+80 dB resulted in greater PACES scores compared with 200 beats·min-1+80 dB and control conditions. Better performance was found for males compared with females in TSAT, FSKT-10s and FSKT-mult (i.e., techniques' number), as well as lower DI and higher RPE post-FSKT-10s. Pre-selected warm-up music played at 140 beats·min-1 and 80 dB is an efficient strategy to enhance physical activity enjoyment and specific performances in taekwondo., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ouergui 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.)

Purpose: The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT., Methods: We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. Outcomes were 3 months' mortality, functional outcome, complete and successful recanalization, any intracranial hemorrhage, parenchymal hematoma and symptomatic intracerebral hemorrhage., Results: Among 466 AIS patients with TO, CAS patients were 122 and no-CAS patients were 226 (118 excluded). After adjustment for unbalanced variables, CAS was associated with a lower rate of 3 months' mortality (OR 0.407, 95% CI 0.171-0.969, p = 0.042). After adjustment for pre-defined variables, CAS was associated with a lower rate of 3 months' mortality (aOR 0.430, 95% CI 0.187-0.989, p = 0.047) and a higher rate of complete recanalization (aOR 1.986, 95% CI 1.121-3.518, p = 0.019), successful recanalization (aOR 2.433, 95% CI 1.263-4.686, p = 0.008) and parenchymal hematoma (aOR 2.876, 95% CI 1.173-7.050, p = 0.021). CAS was associated with lower 3 months mortality (OR 0.373, 95% CI 0.141-0.982, p = 0.046) and higher rates of successful recanalization (OR 2.082, 95% CI 1.099-3.942, p = 0.024) after adjustment for variables associated with 3 months' mortality and successful recanalization, respectively., Conclusions: Among AIS patients with TO, CAS during EVT was associated with a higher rate of successful reperfusion and a lower rate of 3 months' mortality., (© 2022. The Author(s) under exclusive licence to Belgian Neurological Society.)

Purpose: To assess the variations in power performance and perceptual training responses and compare the physical performance of national boxing athletes qualified or not qualified for the Tokyo Olympic Games over a 7-month training period., Methods: Twelve amateur boxers from the Brazilian national team were tested 6 times across 7 months. In the first assessment, boxers performed squat and countermovement jumps and bench press, prone bench pull, half squat, and jump squat power tests. In the following testing sessions, only countermovement jump and bench press power were assessed. In addition, the rating of perceived exertion and total quality recovery status were assessed in 106 training sessions across the study. Independent t test and repeated-measures analysis of variance were used for data analysis purposes., Results: No significant differences (P > .05) were observed between Olympic and non-Olympic groups for any test variables (effect size [95% CI] ranging from 0.01 [-1.13 to 1.13] to 0.69 [-0.53 to 1.79]). No significant changes (P > .05) were detected throughout the study for countermovement jump height and bench press power in either group (effect size [95% CI] ranging from 0.01 [-1.13 to 1.13] to 1.03 [-0.25 to 2.14]). Overall, both groups exhibited similar variations in both rating of perceived exertion and total quality recovery over the 7-month period., Conclusions: Within the same national team, power-related performance was similar between Olympic and non-Olympic boxers. The maintenance of power abilities and optimization of technical and tactical skills seem to be key issues to consider during the final stages of preparation for international boxing competitions.

This narrative review focuses on the studies that estimate the energy systems' contributions during match simulations of striking (boxing, karate, and taekwondo), grappling (judo), and weapon-based (fencing) Olympic combat sports. The purpose is to provide insights into the metabolism of these athletes. In striking Olympic combat sports, the oxidative contribution varied from 62% (in karate and taekwondo) to 86% (in boxing), the ATP-PCr system contribution varied from 10% (in boxing) to 31% (in taekwondo), and the glycolytic contribution was between 3% (in the third round of taekwondo) and 21% (in karate). In grappling combat sports, only judo was studied, and for a 4 min match, the oxidative contribution was 79%, followed by 14% ATP-PCr system contribution and 7% contribution from the glycolytic system. In fencing, the only weapon-based Olympic combat sport, the oxidative contribution varied from 81% (in the first bout) to 90% (in the second bout), followed by 9% (bout 2) to 12% (bout 1) contribution from the ATP-PCr system, and 0.6% to 7% contribution from the glycolytic system during 3 × 3 min bouts of épée match simulation. Hence, Olympic combat sports are primarily powered by the oxidative system, but the key scoring actions are likely fueled by anaerobic pathways.

This review aimed to identify the effects of strength training programs on the physical fitness of Olympic combat sports (OCS) athletes. The systematic review included peer-reviewed articles that incorporated interventions that included pre- and post-intervention physical fitness assessment. The search was performed in the SCOPUS, PubMed, and Web of Science databases between April and September 2022. PRISMA and the TESTEX checklist were used to select and assess the methodological quality of the studies. Twenty studies with 504 participants (428 males and 76 females) were included. Significant improvements were found in athletes' maximal dynamic and isometric strength, muscle power, flexibility, and balance. In addition, improvements in favor of the training groups in specific actions of judo, karate, fencing, and boxing were observed. In conclusion, interventions aimed at the development of muscle strength in OCS, specifically in judo, boxing, karate, wrestling, and fencing, proved to be beneficial at a physical fitness level, resulting in significant increases in favor of the training groups with OCS, which could be used by trainers and coaches to improve the physical performance of athletes.

Background and Purpose: Poor clinical outcomes are still common in successfully reperfused acute ischemic stroke patients. The aim of our study was to assess the impact of sarcopenia and myosteatosis on neurological outcomes and mortality in successfully reperfused acute ischemic stroke patients., Materials and Methods: We included in our retrospective observational study 166 consecutive patients who underwent technically successful mechanical thrombectomy for anterior circulation acute ischemic stroke between Jan 2016 and Dec 2019. ASPECTS and collateral score were assessed on pre-operative CT/CTA. Masseter muscles area and attenuation were measured on CTA images. Clinical and radiological variables were tested in multivariate logistic models to predict the probability of death and, among survivors, of incurring poor outcome., Results: At admission, mean NIHSS was 19 (SD = 6.5), mean body mass index 25.5 (SD = 4.4) kg/m 2 , and mean ASPECTS 8.0 (SD = 1.9). Of all, 48.2% patients showed good collaterals, 38.5% intermediate collaterals, and 13.3% poor collaterals. Overall, 90 days mRS was ≤2 in 48.2% of the patients, 3-5 in 30.7%, and 6 in 21.1%. At multivariate logistic regression, age (OR = 1.08, p = 0.036), ASPECTS (OR = 0.59, p = 0.013), and masseter muscles attenuation (OR = 0.93, p = 0.010) were independent predictors of mortality, whereas sex (OR = 7.15, p = 0.043), age (OR = 1.05, p = 0.042), body mass index (OR = 1.35, p = 0.013), NIHSS (OR = 1.12, p = 0.012), and ASPECTS (OR = 0.64, p = 0.024) were independent predictors of poor neurological outcome (mRS 3-5)., Conclusion: Beyond other well-known variables, low masseter attenuation, indicating myosteatosis, represents an independent negative prognostic factor for 90 days mortality in patients successfully reperfused after anterior circulation stroke.