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This study aimed to determine the distributions of number of shots per point, point duration, point pace and technical actions during the match in professional men and women padel players. A total of 35,145 hits (3239 points; men = 1602 and women = 1637) were analyzed in 20 matches corresponding to quarterfinal, semifinal and final matches of the World Padel Tour 2020 season. The observations were conducted through systematic observation and involved a total of 32 players (16 men and 16 women). Men's points lasted 13.5-14.8 s, comprising 10-11 hits, resulting in a ratio of 0.80 shots per second, with no differences between sets. Women's points lasted longer than men's (14.4 to 16.2 s, p = 0.011) but included a similar number of shots per point, resulting in a lower rhythm of play (0.73-0.75 shots per second, p < 0.001), particularly in the third set ( p = 0.004). Volleys, lobs and directs were used in >60% of the points, with a frequency of one to three times per point. Bandejas were used in 50-60% of the points, with a frequency of one to two times per point. Backwalls and flat smashes were used at least once in 30-48% of the points. Selective actions had a greater frequency of use in the third set (i.e., flat smash and smash x3 in women; forehand/backhand volleys and side-wall forehand in men), suggesting occasional changes in the style of play, but likely explained by the onset of fatigue. In conclusion, game volumes, intensity and actions remained broadly similar throughout professional padel matches.

Exposome studies are advancing in high-income countries to understand how multiple environmental exposures impact health. However, there is a significant research gap in low- and middle-income and tropical countries. We aimed to describe the spatiotemporal variation of the external exposome, its correlation structure between and within exposure groups, and its dimensionality. A one-year follow-up cohort study of 506 children under 5 in two cities in Colombia was conducted to evaluate asthma, acute respiratory infections, and DNA damage. We examined 48 environmental exposures during pregnancy and 168 during childhood in eight exposure groups, including atmospheric pollutants, natural spaces, meteorology, built environment, traffic, indoor exposure, and socioeconomic capital. The exposome was estimated using geographic information systems, remote sensing, spatiotemporal modeling, and questionnaires. The median age of children at study entry was 3.7 years (interquartile range: 2.9-4.3). Air pollution and natural spaces exposure decreased from pregnancy to childhood, while socioeconomic capital increased. The highest median correlations within exposure groups were observed in meteorology (r = 0.85), traffic (r = 0.83), and atmospheric pollutants (r = 0.64). Important correlations between variables from different exposure groups were found, such as atmospheric pollutants and meteorology (r = 0.76), natural spaces (r = -0.34), and the built environment (r = 0.53). Twenty principal components explained 70%, and 57 explained 95% of the total variance in the childhood exposome. Our findings show that there is an important spatiotemporal variation in the exposome of children under 5. This is the first characterization of the external exposome in urban areas of Latin America and highlights its complexity, but also the need to better characterize and understand the exposome in order to optimize its analysis and applications in local interventions aimed at improving the health conditions and well-being of the child population and contributing to environmental health decision-making., 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.)

Importance: The effects of breast cancer incidence changes and advances in screening and treatment on outcomes of different screening strategies are not well known., Objective: To estimate outcomes of various mammography screening strategies., Design, Setting, and Population: Comparison of outcomes using 6 Cancer Intervention and Surveillance Modeling Network (CISNET) models and national data on breast cancer incidence, mammography performance, treatment effects, and other-cause mortality in US women without previous cancer diagnoses., Exposures: Thirty-six screening strategies with varying start ages (40, 45, 50 years) and stop ages (74, 79 years) with digital mammography or digital breast tomosynthesis (DBT) annually, biennially, or a combination of intervals. Strategies were evaluated for all women and for Black women, assuming 100% screening adherence and "real-world" treatment., Main Outcomes and Measures: Estimated lifetime benefits (breast cancer deaths averted, percent reduction in breast cancer mortality, life-years gained), harms (false-positive recalls, benign biopsies, overdiagnosis), and number of mammograms per 1000 women., Results: Biennial screening with DBT starting at age 40, 45, or 50 years until age 74 years averted a median of 8.2, 7.5, or 6.7 breast cancer deaths per 1000 women screened, respectively, vs no screening. Biennial DBT screening at age 40 to 74 years (vs no screening) was associated with a 30.0% breast cancer mortality reduction, 1376 false-positive recalls, and 14 overdiagnosed cases per 1000 women screened. Digital mammography screening benefits were similar to those for DBT but had more false-positive recalls. Annual screening increased benefits but resulted in more false-positive recalls and overdiagnosed cases. Benefit-to-harm ratios of continuing screening until age 79 years were similar or superior to stopping at age 74. In all strategies, women with higher-than-average breast cancer risk, higher breast density, and lower comorbidity level experienced greater screening benefits than other groups. Annual screening of Black women from age 40 to 49 years with biennial screening thereafter reduced breast cancer mortality disparities while maintaining similar benefit-to-harm trade-offs as for all women., Conclusions: This modeling analysis suggests that biennial mammography screening starting at age 40 years reduces breast cancer mortality and increases life-years gained per mammogram. More intensive screening for women with greater risk of breast cancer diagnosis or death can maintain similar benefit-to-harm trade-offs and reduce mortality disparities.

Purpose: our aim was to analyze the characteristics of the off-the-wall smash in men´s and women´s padel, and to compare gender differences in the set-dependent frequency of these shots., Study Sample: through systematic observation, we analyzed 441 off-the-wall smashes from the Final Master of the 2022 season of the World Padel Tour., Results: showed that the women performed twice as many off-the-wall smashes as the men. This shot was executed most frequently (90%) from the center and right side of the court and from the dominant side, usually providing volley continuity (73%) and sometimes resulting in point winners (21.5%). Furthermore, there were gender differences, depending on the defense zone from which the wall smashes were defended ( p = .014) and on the final match result ( p = .018). In men's padel, the losing pair performed more off-the-wall smashes, while in women's padel, the winning pair performed more of these smashes. Finally, between both genders, most off-the-wall smashes occurred in the first set and decreased in number in the third set, with the second set containing the fewest off-the wall smashes., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The main purpose of the paper is to show how a magnetoresistive (MR) element can work as a current sensor instead of using a Wheatstone bridge composed by four MR elements, defining the concept of a magnetoresistive shunt (MR-shunt). This concept is reached by considering that once the MR element is biased at a constant current, the voltage drop between its terminals offers information, by the MR effect, of the current to be measured, as happens in a conventional shunt resistor. However, an MR-shunt has the advantage of being a non-dissipative shunt since the current of interest does not circulate through the material, preventing its self-heating. Moreover, it provides galvanic isolation. First, we propose an electronic circuitry enabling the utilization of the available MR sensors integrated into a Wheatstone bridge as sensing elements (MR-shunt). This circuitry allows independent characterization of each of the four elements of the bridge. An independently implemented MR element is also analyzed. Secondly, we propose an electronic conditioning circuit for the MR-shunt, which allows both the bridge-integrated element and the single element to function as current sensors in a similar way to the sensing bridge. Third, the thermal variation in the sensitivity of the MR-shunt, and its temperature coefficient, are obtained. An electronic interface is proposed and analyzed for thermal drift compensation of the MR-shunt current sensitivity. With this hardware compensation, temperature coefficients are experimentally reduced from 0.348%/°C without compensation to -0.008%/°C with compensation for an element integrated in a sensor bridge and from 0.474%/°C to -0.0007%/°C for the single element.

Objective: The aim of the study is to investigate whether transcranial direct current stimulation is superior to control groups or other interventions for pain relief and improving functionality in knee osteoarthritis patients., Methods: PubMed, the Physiotherapy Evidence Database, the Cochrane Library, ProQuest, and Scopus databases were searched from inception to July 2022 to identify randomized clinical trials. The main outcomes were subjective perception of pain intensity measured either with the visual analog scale or with the numeric rating scale; and the functionality, assessed with the Western Ontario and McMaster Universities Osteoarthritis Index. As secondary outcomes, pressure pain threshold, conditioned pain modulation, and its safety were evaluated., Results: We identified 10 randomized clinical trials (634 participants). The results showed an important effect favoring transcranial direct current stimulation for pain relief (mean difference = -1.1 cm, 95% confident interval = -2.1 to -0.2) and for improving functionality (standardized mean difference = -0.6, 95% confident interval = -1.02 to -0.26). There was also a significant improvement in pressure pain threshold (mean difference = 0.9 Kgf/cm 2 , 95% confident interval = 0.1 to 1.6). The certainty of evidence according to Grades of Recommendation Assessment, Development and Evaluation was generally moderate., Conclusions: Our findings suggest that transcranial direct current stimulation is a safe treatment for reducing pain intensity, improving functionality, and the pressure pain thresholds in patients with knee osteoarthritis., 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.)

Background and Purpose: Trans-spinal direct current stimulation (tsDCS) is a noninvasive stimulation technique that applies direct current stimulation over spinal levels. However, the effectiveness and feasibility of this stimulation are still unclear. This systematic review summarizes the effectiveness of tsDCS in clinical and neurophysiological outcomes in neurological patients, as well as its feasibility and safety., Methods: The search was conducted using the following databases: PEDro, Scopus, Web of Science, CINAHL, SPORTDiscus, and PubMed. The inclusion criteria were: Participants : people with central nervous system diseases; Interventions : tsDCS alone or in combination with locomotion training; Comparators : sham tsDCS, transcranial direct current stimulation, or locomotion training; Outcomes : clinical and neurophysiological measures; and Studies : randomized clinical trials., Results: Eight studies with a total of 143 subjects were included. Anodal tsDCS led to a reduction in hypertonia, neuropathic pain intensity, and balance deficits in people with hereditary spastic paraplegia, multiple sclerosis, and primary orthostatic tremor, respectively. In contrast, cathodal tsDCS only had positive effects on balance and tremor in people with primary orthostatic tremor. No severe adverse effects were reported during and after anodal or cathodal tsDCS., Discussion and Conclusions: Although certain studies have found an effect of anodal tsDCS on specific clinical outcomes in people with central nervous system diseases, its effectiveness cannot be established since these findings have not been replicated and the results were heterogeneous. This stimulation was feasible and safe to apply. Further studies are needed to replicate the obtained results of tsDCS when applied in populations with neurological diseases., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Academy of Neurologic Physical Therapy, APTA.)

Purpose: This study analyzed the sequences of actions in professional men and women padel players to identify common game patterns., Methods: The sample comprised 17,557 stroke-by-stroke actions (N = 1640 rallies) of the championship World Padel Tour. Multistep Markov chains were used to calculate the conditional probabilities of occurrence of actions during the rally., Results: Results revealed that men's and women's padel is mainly defined by 36 patterns constituting 55% and 63% of all actions in the game, respectively, with the 10 most common sequences accounting for 42% to 45% of the game. There were recurrent technical-tactical actions with specific offensive and defensive functions that were constantly reiterated during the rallies. In men, the use of smash, volley, bandeja, direct, back wall, back-wall lobs, and direct lobs followed a foreseeable pattern up to 8 lags, whereas women described predictable interactions for volley, bandeja, direct, lobs, and direct lobs up to 5 lags and for smash and back wall up to 4 lags., Conclusions: The ability of padel players to recall these patterns and enhance their anticipation skills may potentially improve their performance. These findings contribute to a better knowledge of professional padel game dynamics while providing coaches and players with useful information to optimize training and decision-making strategies.

Background: The aim of this study was to analyze the efficiency of the serve in relation to different tactical parameters in men's professional padel., Methods: A total of 1089 points - from 217 games and 19 sets - from 8 World Padel Tour matches played in 2020 were analyzed by systematic observation., Results: The results showed that the ordinary number of the set influences the efficiency of the serve (P=0.015) with more points won on serve during the second one, and more points lost during the third one. Differently, no difference emerged for the serve efficiency in terms of situation (P=0.233). Similarly, the serving situation does not affect the efficiency in key points (P=0.097) and in non-key points (P=0.706), producing more equality in Australian formation in key points. The direction of the serve in Australian formation (P=0.351) and conventional (P=0.32) does not affect its effectiveness, without effects for the second shot after the return in Australian formation (P=0.472) and conventional (P=0.458), being in both cases the backhand volley the most frequent stroke, for which the pair lose more points when serving. The number of strokes per point is associated to a higher probability of winning the point, being the number of strokes from 3 to 10 where the serving partner maintains the advantage, losing it from that stroke, in addition, there are no winning points neither with the serve nor with the serve-return., Conclusions: There are no significant differences (but only small divergences) in most of the tactical parameters considered in terms of serve efficiency.

Objective: The aim of the study is to examine the effectiveness of extracorporeal shockwave therapy in reducing pain, improving functionality, joint range of motion, quality of life, fatigue, and health status self-perception in people with myofascial pain syndrome., Methods: PubMed, the Cochrane Library, CINAHL, the Physiotherapy Evidence Database, and SPORTDiscus were systematically searched for only randomized clinical trials published up to June 2, 2022. The main outcome variables were pain, as reported on the visual analog scale and pressure pain threshold, and functionality. A quantitative analysis was conducted using the inverse variance method and the random effects model., Results: Twenty-seven studies were included ( N = 595 participants in the extracorporeal shockwave therapy group). The effectiveness of extracorporeal shockwave therapy for relieving pain was superior for the extracorporeal shockwave therapy group compared with the control group on the visual analog scale (MD = -1.7 cm; 95% confidence interval = -2.2 to -1.1) and pressure pain threshold (mean difference = 1.1 kg/cm 2 ; 95% confidence interval = 0.4 to 1.7) and functionality (standardized mean difference = -0.8; 95% confidence interval = -1.6 to -0.04) with high heterogeneity. However, no differences were found between extracorporeal shockwave therapy and other interventions as dry needling, exercises, infiltrations, and lasers interventions., Conclusions: Extracorporeal shockwave therapy is effective in relieving pain and improving functionality in patients with myofascial pain syndrome compared with control and ultrasound therapy., To Claim Cme Credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME., To Claim Cme Credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME., Cme Objectives: Upon completion of this article, the reader should be able to: (1) Determine the effectiveness of radial and focal extracorporeal shockwaves on pain perception, the pressure pain threshold, and functionality in people with myofascial pain syndrome; (2) Describe the intervention protocol of extracorporeal shockwave therapy to improve pain perception in people with myofascial pain syndrome; and (3) Describe the advantages and disadvantages of extracorporeal shockwave therapy versus other intervention such as dry needling., Level: Advanced., Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity., Level: Advanced., Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity., 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.)

Introduction: Intensive care unit-acquired weakness is a frequent complication that affects the prognosis of critical illness during hospital stay and after hospital discharge., Objectives: To determine if a multicomponent protocol of early active mobility involving adequate pain control, non-sedation, non-pharmacologic delirium prevention, cognitive stimulation, and family support, reduces intensive care unit-acquired weakness at the moment of discharge., Materials and Methods: We carried out a non-randomized clinical trial in two mixed intensive care units in a high-complexity hospital, including patients over 14 years old with invasive mechanical ventilation for more than 48 hours. We compared the intervention –the multicomponent protocol– during intensive care hospitalization versus the standard care., Results: We analyzed 82 patients in the intervention group and 106 in the control group. Muscle weakness acquired in the intensive care unit at the moment of discharge was less frequent in the intervention group (41.3% versus 78.9%, p<0.00001). The mobility score at intensive unit care discharge was better in the intervention group (median = 3.5 versus 2, p < 0.0138). There were no statistically significant differences in the invasive mechanical ventilation-free days at day 28 (18 versus 15 days, p<0.49), and neither in the mortality (18.2 versus 27.3%, p<0.167)., Conclusion: A multi-component protocol of early active mobility significantly reduces intensive care unit-acquired muscle weakness at the moment of discharge.

Modern morphometric-based approaches provide valuable metrics to quantify and understand macroevolutionary and macroecological patterns and processes. Here we describe TriloMorph, an openly accessible database for morpho-geometric information of trilobites, together with a landmark acquisition protocol. In addition to morphological traits, the database contains contextual data on chronostratigraphic age, geographic location, taxonomic information and lithology of landmarked specimens. In this first version, the dataset has broad taxonomic and temporal coverage and comprises more than 55% of all trilobite genera and 85% of families recorded in the Paleobiology Database through the Devonian. We provide a release of geometric morphometric data of 277 specimens linked to published references. Additionally, we established a Github repository for constant input of morphometric data by multiple contributors and present R functions that help with data retrieval and analysis. This is the first attempt of an online, dynamic and collaborative morphometric repository. By bringing this information into a single open database we enhance the possibility of performing global palaeobiological research, providing a major complement to current occurrence-based databases., (© 2023. The Author(s).)

Background: Motor impairments are very common in neurological diseases such as multiple sclerosis. Noninvasive brain stimulation could influence the motor function of patients., Objective: The aim of this meta-analysis was to evaluate the effectiveness of transcranial direct current stimulation (tDCS) on balance and gait ability in patients with multiple sclerosis. Additionally, a secondary aim was to compare the influence of the stimulation location of tDCS on current effectiveness., Methods: A search was conducted for randomized controlled trials published up to May 2023 comparing the application of tDCS versus a sham or control group. The primary outcome variables were balance and gait ability., Results: Eleven studies were included in the qualitative analysis, and ten were included in the quantitative analysis, which included 230 patients with multiple sclerosis. The average effect of tDCS on gait functionality was superior to that of the control group (SMD = -0.71; 95% CI, -1.05 to -0.37). However, the overall results of the tDCS vs. sham effect on static balance did not show significant differences between groups (MD = 1.26, 95% CI, -1.31 to 3.82). No significant differences were found when different locations of tDCS were compared., Conclusions: These results reveal that tDCS is an effective treatment for improving gait ability with a low quality of evidence. However, the application of tDCS has no effect on static balance in patients with multiple sclerosis with very low quality of evidence. Similarly, there seems to be no difference regarding the stimulation area with tDCS., (© 2023. BioMed Central Ltd., part of Springer Nature.)

The objective of this research was to analyze the importance of maintaining the net position in men's and women's professional padel. The data sample was drawn from 2,756 padel rallies ( n = 1,434 men's and n = 1,322 women's) in matches played during the 2021 season of the World Padel Tour circuit. The results showed that there was no net exchange in 50.7% of the women's rallies, while in 65.9% of men's rallies, the servers kept the net. Due to their physical advantages, men servers had more opportunities to finish the rally at the net than women servers, giving them more opportunities to win the rally. However, when either men or women receivers finished the rally at the net, they had more opportunities to win the rally. In addition, both men and women tended to end the rallies with a winner when they were in the net zone and with an error when they were at the back of the court. These findings suggest that wins in padel are closely related to time spent at the net., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Padel is the world's fastest growing racket sport. However, the analysis of the intake of sports supplements in padel players is scarce. The aim of this research was to analyse and compare the type of diet and the use of sports supplements in padel players according to their competition level and sex. A total of 123 players (94 men and 29 women) participated in the study. Subjects were divided according to their sex and competition level. All participants completed an anonymous questionnaire on diet type and nutritional supplement intake. There were differences found in diet type between competition levels. Regarding players' sex, differences in the number of supplements consumed were reported ( p < 0.01). Relationships were found between the number of supplements ingested and the perceived effectiveness of supplements with frequency and time of training ( p < 0.05). Creatine in men (≈15%) and vitamin complexes (≈10%) in women were the most used supplements. Lower level padel players do not adapt their diet to the physical demands of padel. Male padel players use a greater number of supplements than female padel players. It is important that nutrition specialists advise players to control diets and supplement.

The aim of the study was to carry out a systematic review of the most recent research on performance analysis in padel. An electronic search was made in four sport science databases: Web of Science, Pubmed, Scopus and Google Scholar. Systematic review principles were used to identify and select studies following inclusion and exclusion criteria. From a total of 261 articles identified in the initial search, 27 articles were included in analysis, all dating from after 2018. The articles were classified according to four study variables: temporal aspects, game actions, on-court movements and match score studies, ordered in turn according to the year of publication. The results show differences in the four study variables according to the gender or the level of players, the side or the zone of play and the duration of the match. In conclusion, the results define the relevant aspects of the game with the aim of being used at a technical, tactical and physical level, as well as contributing to the development of scientific knowledge in padel, allowing future research to address less studied topics and carry out more complete and specific studies and interventions for a greater understanding of the needs of padel., Competing Interests: The authors declare no conflict of interest., (Copyright: © Academy of Physical Education in Katowice.)

Temporomandibular disorders comprise a set of conditions that include alterations of the temporomandibular joint and masticatory muscles. Although different modalities of electric currents are widely used for treating temporomandibular disorders, previous reviews have suggested these are ineffective. This systematic review and meta-analysis aimed to determine the effectiveness of different electrical stimulation modalities in patients with temporomandibular disorders for reducing musculoskeletal pain, increasing the range of movement, and improving muscle activity. An electronic search was conducted of randomized controlled trials published until March of 2022 that compared the application of an electrical stimulation therapy versus a sham or control group. The main outcome measure was pain intensity. Seven studies were included in the qualitative analysis and in the quantitative analysis (n = 184 subjects). The overall effect of electrical stimulation on pain reduction was statistically superior to sham/control (MD = -1.12 cm; CI 95%: -1.5 to -0.8), showing moderate heterogeneity of results (I 2  = 57%, P = .04). The overall effect on range of movement of the joint (MD = 0.97 mm; CI 95%: -0.3 to 2.2) and muscle activity (SMD = -2.9; CI 95%: -8.1 to 2.3) were not significant. Transcutaneous electrical nerve stimulation (TENS) and high-voltage current stimulation reduces pain intensity clinically in people with temporomandibular disorders with a moderate quality of evidence. On the other hand, there is no evidence of the effect of different electrical stimulation modalities on range of movement and muscle activity in people with temporomandibular disorders with a moderate and low quality of evidence respectively. PERSPECTIVE: TENS and high voltage currents are valid options for the control of pain intensity in patients suffering from temporomandibular disorder. Data suggest clinically relevant changes compared to sham. Healthcare professionals should take this into account as it is inexpensive therapy, has no adverse effects and can be self-administered by patients., (Copyright © 2023 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)

Iron (Fe) metabolism and concentrations change during a sports season. Fe deficiency affects a significant number of women athletes. The aims of the present study were: (i) to analyze changes in hematological parameters of Fe status and (ii) to analyze changes in Fe concentrations in different biological matrices (serum, plasma, urine, erythrocytes, and platelets) during a sports season. Twenty-four Spanish semi-professional women's soccer players (23.37 ± 3.95 years) participated in the present study. Three assessments were performed throughout the sports season (beginning, middle and end of the season). Nutritional intake was evaluated and female hormones, hematological parameters of Fe status and Fe concentrations in plasma, serum, urine, erythrocytes and platelets were determined. There were no differences in Fe intake. Hemoglobin and mean corpuscular hemoglobin concentrations increased at the end of the season compared to initial values ( p < 0.05). There were no significant changes in extracellular Fe concentrations (plasma, serum, and urine). However, erythrocyte Fe concentrations were lower at the end of the season ( p < 0.05). Hematological parameters of Fe status and intracellular Fe concentrations change throughout the sports season in women's soccer players.

Purpose: The present study aimed to analyse sex differences in cadmium and lead concentrations in plasma, urine, platelets and erythrocytes and to relate these concentrations to biomarkers of iron status., Methods: A total of 138 soccer players divided according to sex: men (n = 68) and women (n = 70) participated in the present study. All participants resided in the city of Cáceres (Spain). Erythrocyte, haemoglobin, platelet, plateletcrit, ferritin and serum iron values were determined. Cadmium and lead concentrations were quantified by inductively coupled plasma mass spectrometry., Results: The women had lower haemoglobin, erythrocyte, ferritin and serum iron values (p < 0.01). Regarding cadmium, the women showed higher concentrations in plasma, erythrocytes and platelets (p < 0.05). As for lead, they also showed higher concentrations in plasma, relative values of erythrocytes and relative values of platelets (p < 0.05). Significant correlations were observed between cadmium and lead concentrations with biomarkers of iron status., Conclusions: Cadmium and lead concentrations are different between sexes. Biological differences between sexes and iron status could influence cadmium and lead concentrations. Lower serum iron concentrations and markers of Fe status increase Cd and Pb concentrations. Ferritin and serum iron have been directly related to increased Cd and Pb excretion., 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 © 2023. Published by Elsevier B.V.)

Percutaneous electrical nerve stimulation (PENS) consists of applying an electric current of <1,000 Hz to different neuromuscular structures through acupuncture needles. Currently, there is controversy surrounding the effect of PENS on muscle strength in the scientific literature. The main objective was to assess the effect of PENS applied to the median and cubital nerves on the maximum handgrip strength (MHS) compared to sham stimulation, as well as to determine the safety of the intervention. A parallel, randomized, double-blind controlled trial in a sample of 20 healthy subjects. Participants were randomly allocated in the experimental (n = 10) and control (n = 10) groups. A blinded researcher measured MHS. Measurements of MHS of the dominant hand were taken at four time points: preintervention, immediately postintervention, 24 hr after the intervention, and at a 10-day follow-up. A 10-Hz percutaneous electrical current stimulation was employed. The control group also received the same puncture method but with no electric stimulation. Compared to baseline, the MHS decreased 10.4% (SEM = 3.2, p = .02) in the PENS group at 24 hr postintervention, with no differences observed between baseline and at 10 days postintervention. No changes in grip strength were observed at any time point in the sham group. To sum up, PENS decreased MHS at 24 hr postintervention, which does not persist 10 days after the stimulation. PENS can be considered a safe technique. Trials with larger sample sizes are required to corroborate the findings of this study. Clinical Trials Registration: NCT, NCT04662229, filed on March 12th of 2020., (© 2022 The Authors. The Anatomical Record published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

High-intensity laser therapy (HILT) is one of the therapeutic approaches used in the treatment of musculoskeletal disorders (MSD). The main objective of this study was to examine the effectiveness of HILT for reducing pain and improving functionality in people with MSD. Ten databases were systematically searched for randomized trials published up to 28 February 2022. Randomized clinical trials (RCTs) assessing the effectiveness of HILT on MSD were included. The main outcome measures were pain and functionality. In total, 48 RCTs were included in the qualitative synthesis and 44 RCTs in the quantitative analysis. HILT showed a decrease on the pain VAS (mean difference (MD) = -1.3 cm; confidence interval (CI) 95%: -1.6 to -1.0) and an improvement in functionality (standardized mean difference (SMD) = -1.0; CI95%: -1.4 to -0.7), with low and moderate quality of evidence, respectively. A greater effect was observed when compared with control than with other conservative treatments, both on pain (χ2 = 20.6; p < 0.001) and functionality (χ2 = 5.1; p = 0.02). Differences in the effectiveness of HILT were found depending on the location (χ2 = 40.1 p < 0.001), with further improved functionality in MSD of the knee and shoulder. HILT is an effective treatment for improving pain, functionality, range of motion, and quality of life in people with MSD, although these findings must be treated with caution due to the high risk of bias in the studies. Further clinical trials should be well designed to lower the risk of bias.

Background: Unmodulated high-frequency alternating currents (HFAC) are employed for producing peripheral nerves block. HFAC have been applied in humans with frequencies up to 20 kHz, whether transcutaneously, percutaneously, or via surgically-implanted electrodes. The aim of this study was to assess the effect of percutaneous HFAC, applied with ultrasound-guided needles at 30 kHz, on the sensory-motor nerve conduction of healthy volunteers., Methods: A parallel, double-blind, randomized clinical trial with a placebo control was conducted. Percutaneous HFAC at 30 kHz or sham stimulation was applied via ultrasound-guided needles in 48 healthy volunteers ( n = 24 in each group) for 20 min. The assessed outcome variables were pressure pain threshold (PPT), mechanical detection threshold (MDT), maximal finger flexion strength (MFFS), antidromic sensory nerve action potential (SNAP), hand temperature, and subjective sensations by the participants. The measurements were recorded pre-intervention, during the stimulation (at 15 min), immediately post-intervention (at 20 min), and 15 min after the end of treatment., Results: The PPT increased in the active group compared with sham stimulation, both during the intervention [14.7%; 95% confidence interval (CI): 4.4-25.0], immediately post-intervention (16.9%; 95% CI: -7.2-26.5), and 15 min after the end of the stimulation (14.3%; 95% CI: 4.4-24.3) ( p < 0.01). The proportion of participants who reported feelings of numbness and heaviness was significantly higher in the active group (46 and 50%, respectively) than in the sham group (8 and 18%, respectively) ( p < 0.05). No intergroup differences were observed in the remaining outcome variables. No unexpected adverse effects derived from the electrical stimulation were reported., Conclusion: Percutaneous stimulation with HFAC at 30 kHz applied to the median nerve increased the PPT and subjective perception of numbness and heaviness. Future research should evaluate its potential therapeutic effect in people with pain., Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04884932, identifier NCT04884932., Competing Interests: JA-C and JG-S own a patent of a device that produces electrical currents between 10 and 50 kHz. However, this device has not been used in this work. The remaining 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 Álvarez, Serrano-Muñoz, Fernández-Pérez, Gómez-Soriano and Avendaño-Coy.)

The familial occurrence of hematological malignancies has been underappreciated. Recent studies suggest that up to 15% of adults with myeloid neoplasms carry germline pathogenic variants in cancer-predisposing genes. This study aimed to identify the underlying germline predisposition variant in patients with a strong family or personal onco-hematological history using whole exome sequencing on sixteen uncharacterized individuals. It was carried out in two groups of patients, one with samples available from two affected relatives (Cohort A) and one with available samples from the index case (Cohort B). In Cohort A, six families were characterized. Two families shared variants in genes associated with DNA damage response and involved in cancer development ( CHEK2 and RAD54L ). Pathogenic or likely pathogenic germline variants were also found in novel candidate genes ( NFATC2 and TC2N ). In two families, any relevant pathogenic or likely pathogenic genomic variants were identified. In Cohort B, four additional index cases were analyzed. Three of them harbor clinically relevant variants in genes with a probable role in the development of inherited forms of hematological malignancies ( GATA1 , MSH4 and PRF1 ). Overall, whole exome sequencing is a useful approach to achieve a further characterization of these patients and their mutational spectra. Moreover, further investigations may help improve optimization for disease management of affected patients and their families.

Background: Air pollution contains a mixture of different pollutants from multiple sources. However, the interaction of these pollutants with other environmental exposures, as well as their harmful effects on children under five in tropical countries, is not well known., Objective: This study aims to characterize the external exposome (ambient and indoor exposures) and its contribution to clinical respiratory and early biological effects in children., Materials and Methods: A cohort study will be conducted on children under five (n = 500) with a one-year follow-up. Enrolled children will be followed monthly (phone call) and at months 6 and 12 (in person) post-enrolment with upper and lower Acute Respiratory Infections (ARI) examinations, asthma development, asthma control, and genotoxic damage. The asthma diagnosis will be pediatric pulmonologist-based and a standardized protocol will be used. Exposure, effect, and susceptibility biomarkers will be measured on buccal cells samples. For environmental exposures PM2.5 will be sampled, and questionnaires, geographic information, dispersion models and Land Use Regression models for PM2.5 and NO2 will be used. Different statistical methods that include Bayesian and machine learning techniques will be used for the ambient and indoor exposures-and outcomes. This study was approved by the ethics committee at Universidad Pontificia Bolivariana., Expected Study Outcomes/findings: To estimate i) The toxic effect of particulate matter transcending the approach based on pollutant concentration levels; ii) The risk of developing an upper and lower ARI, based on different exposure windows; iii) A baseline of early biological damage in children under five, and describe its progression after a one-year follow-up; and iv) How physical and chemical PM2.5 characteristics influence toxicity and children's health., Competing Interests: JCT is the owner and CEO of ATB SERVICE SAS. He does not have access to any children’s information and the Environmental information is transmitted in real time and the data will be public. JMA and SM are employed by the Healthcare Company, SURA. JJB is employed by GENES laboratory. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The other authors do not have conflicts of interest to declare, (Copyright: © 2023 Marín 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.)

Physical training produces changes in the concentrations of trace mineral elements. Sex differences in copper (Cu) concentrations in athletes are scarce. The objectives of this study were (i) to analyze changes in intracellular (erythrocytes and platelets) and extracellular (plasma and urine) Cu concentrations during a sports season in soccer players and (ii) to analyze sex differences. A total of 46 soccer players (22 men and 24 women) participated in the study. Three assessments were performed throughout the sports season. Anthropometry, body composition, nutritional intake, physical condition, female hormones (menstrual cycle) and hematology were evaluated, as well as Cu determination (plasma, urine, erythrocytes, and platelets). Regarding longitudinal differences, there were discrepancies in plasma, urine, absolute erythrocyte, and absolute platelet Cu concentrations ( p < 0.05). There were differences between sexes in Cu concentrations in urine, erythrocytes relative to cell number and in platelets relative to cell number ( p < 0.05). During a sports season, there are changes in Cu concentrations in soccer players. Likewise, there could be sex differences in urinary, erythrocyte and platelet Cu concentrations.

Chromolaena tacotana is a source of flavonoids with antiproliferative properties in human breast cancer cells, the most common neoplasm diagnosed in patients worldwide. Until now, the mechanisms of cell death related to the antiproliferative activity of its flavonoids have not been elucidated. In this study, a novel flavanone (3',4'-dihydroxy-5,7-dimethoxy-flavanone) was isolated from the plant leaves and identified by nuclear magnetic resonance (NMR) and mass spectrometry (MS). This molecule selectively inhibited cell proliferation of triple-negative human breast cancer cell lines MDA-MB-231 and MCF-7 whit IC 50 values of 25.3 μg/mL and 20.8 μg/mL, respectively, determined by MTT assays with a selectivity index greater than 3. Early and late pro-apoptotic characteristics were observed by annexin-V/7-AAD detection, accompanied by a high percentage of the Bcl-2 anti-apoptotic protein inactivated and the activation of effector Caspase-3 and/or 7 in breast cancer cells. It was verified the decreasing of XIAP more than Bcl-2 anti-apoptotic proteins expression, as well as the XIAP/Caspase-7 and Bcl-2/Bax complexes dissociation after flavanone treatment. Docking and molecular modeling analysis between the flavanone and the antiapoptotic protein XIAP suggests that the natural compound inhibits XIAP by binding to the BIR3 domain of XIAP. In this case, we demonstrate that the new flavanone isolated from leaves of Chomolaena tacotana has a promising and selective anti-breast cancer potential that includes the induction of intrinsic apoptosis by downregulation of the anti-apoptotic proteins XIAP and Bcl-2. New studies should deepen these findings to demonstrate its potential as an anticancer agent.

The objectives of this study were to analyze the injuries suffered during the previous year by amateur padel players according to the characteristics of the racket, their usual volume of practice and their experience in padel. A total of 950 amateur players ( X age: 31.68 years; X weight: 70.84 kg; X height: 170.9 cm) participated voluntarily, completing an ad-hoc questionnaire. The results indicated that the appearance of the injuries and their location was different according to the sex of the amateur padel players. Men had a higher incidence of muscle and ligament injuries in the shoulder, and tendon injuries in the elbow. On the other hand, women had a greater probability of having muscle injuries in the shoulder and arm, ligament injuries in the elbow and bone injuries in the wrist and elbow. In general, tendon injuries were the most common injury in padel and the shoulder and elbow were the most affected areas. Moreover, men tend to use heavy (CSR = 6.0), fiberglass or carbon (CSR = 2.1), diamond-shaped rackets (CSR = 3.2), with a hard core (CSR = 4.4) and with two or more over grips (CSR = 2.7). Women usually use less heavy (CSR = 6.0), round-shaped rackets (CSR = 4.9), with a soft core (CSR = 4.4) and with one or no over grips (CSR = 2.7). In addition, men tend to play padel more often and have been practicing for longer. In conclusion, although the risk of injury depends on many factors, we identified that the characteristics of the racket, the volume of weekly practice, the experience of the player and the gender of the player are fundamental aspects to take into account for the prevention of injuries in amateur padel players.

Molybdenum (Mo) and zinc (Zn) play important roles in the process of adaptation to physical training. The aims of the present study were: (i) to analyze the differences in extracellular (plasma and urine) and intracellular (erythrocytes and platelets) Mo and Zn concentrations between sexes and (ii) to relate extracellular Zn concentrations with biomarkers of muscle damage and muscle mass. The present study involved 138 semi-professional soccer players divided according to sex: male (n = 68) and female (n = 70). Mo and Zn concentrations were determined by inductively coupled plasma mass spectrometry. Erythrocytes, platelets, creatine kinase (CK), and lactate dehydrogenase (LDH) values were also determined by automatic cell counter and spectrophotometric techniques. There were no sex differences in Mo and Zn intake. Male soccer players obtained higher values of erythrocytes, CK, and LDH (p < 0.05), and showed higher plasma and urinary concentrations of Mo and Zn (p < 0.05). Female soccer players showed relatively higher Zn concentrations in erythrocytes (p < 0.05). Finally, positive correlations were observed between extracellular Zn concentrations with CK, LDH and muscle mass. Extracellular concentrations of Mo and Zn were higher in male soccer players. However, the relative concentrations of Zn in relation to the number of erythrocytes were higher in female soccer players.

Metabolic reprogramming is required to fight infections and thyroid hormones are key regulators of metabolism. We have analyzed in hospitalized COVID-19 patients: 40 euthyroid and 39 levothyroxine (LT4)-treated patients in the ward and 29 euthyroid and 9 LT4-treated patients in the intensive care unit (ICU), the baseline characteristics, laboratory data, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), the FT3/FT4 ratio, 11 antiviral cytokines and 74 metabolomic parameters. No evidence for significant differences between euthyroid and LT4-treated patients were found in the biochemical, metabolomic and cytokines parameters analyzed. Only TSH (p=0.009) and ferritin (p=0.031) showed significant differences between euthyroid and LT4-treated patients in the ward, and TSH (p=0.044) and FT4 (p=0.012) in the ICU. Accordingly, severity and mortality were similar in euthyroid and LT4-treated patients. On the other hand, FT3 was negatively related to age (p=0.012), independently of sex and body mass index in hospitalized COVID-19 patients. Patients with low FT3 and older age showed a worse prognosis and higher levels of the COVID-19 severity markers IL-6 and IL-10 than patients with high FT3. IL-6 negatively correlated with FT3 (p=0.023) independently of age, body mass index and sex, whereas IL-10 positively associated with age (p=0.035) independently of FT3, body mass index and sex. A metabolomic cluster of 6 parameters defined low FT3 ward patients. Two parameters, esterified cholesterol (p=4.1x10 -4 ) and small HDL particles (p=6.0x10 -5 ) correlated with FT3 independently of age, body mass index and sex, whereas 3-hydroxybutyrate (p=0.010), acetone (p=0.076), creatinine (p=0.017) and high-density-lipoprotein (HDL) diameter (p=8.3x10 -3 ) were associated to FT3 and also to age, with p-values of 0.030, 0.026, 0.017 and 8.3x10 -3 , respectively. In conclusion, no significant differences in FT3, cytokines, and metabolomic profile, or in severity and outcome of COVID-19, were found during hospitalization between euthyroid patients and hypothyroid patients treated with LT4. In addition, FT3 and age negatively correlate in COVID-19 patients and parameters that predict poor prognosis were associated with low FT3, and/or with age. A metabolomic cluster indicative of a high ketogenic profile defines non-critical hospitalized patients with low FT3 levels., 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 © 2022 Amich, Anguita, Escribano-Serrat, Alvarez, Rodríguez-Muñoz, García, Bello, Peña-Pedrosa, Martínez-Micaelo, Amigó, Ortiz, Torrejón, Boscá, Martín-Sánchez, Aranda and Alemany.)

The aim of this study was to evaluate the acute effect of a single dry sauna bath lasting twelve minutes on the indirect determination of the one maximum repetition (1RM) leg press among trained and untrained participants. Thirty young men participated in the study, a trained group (TG; n = 15; age: 20.97 ± 0.44 years) and an untrained group (UG; n = 15; age: 21.03 ± 0.11 years). Subjects in the TG had performed resistance training for at least two years before the beginning of the experiment. All participants performed two indirect tests of their one maximum repetition leg press on two different days, with a rest period of three weeks between tests. Additionally, anthropometric, body composition, blood pressure, body temperature, and rated perceived exertion were evaluated. On the second testing day, all of the participants took a dry sauna bath lasting 12 min immediately before performing the leg press test. In the second evaluation (pre-heating in the sauna), the UG experienced increases in absolute RM (178.48 ± 56.66 to 217.60 ± 59.18 kg; p < 0.05; R = 0.798), relative RM (2.65 ± 0.61 to 3.24 ± 0.58 kg·g body mass -1 ; p < 0.05; R = 0.798), and muscular RM (5.64 ± 1.20 to 6.77 ± 1.14 kg·kg muscle mass -1 ; p < 0.05; R = 0.797). The TG also increased their values on the second day in absolute RM (284.96 ± 62.41 to 314.92 ± 1.04 kg; p < 0.01; R = 0.886), in relative RM (3.61 ± 0.88 to 3.99 ± 1.85 kg*kg body mass -1 ; p < 0.01; R = 0.886), and muscular RM (7.83 ± 1.69 to 8.69 ± 1.85 kg·kg muscle mass -1 ; p < 0.01; R = 0.854). A passive, extreme-heat sauna bath lasting 12 min taken immediately before a relative maximum repetition test seems to provoke clear positive responses for the development of strength.

Iron (Fe) is one of the most widely studied trace mineral elements. Fe metabolism and homeostasis could be altered by physical training. The aim of this study was to analyze the influence of long-term physical training on serum, plasma, urine (extracellular), erythrocyte and platelet (intracellular) Fe concentrations. Forty men from the same geographical area divided into a training group (TG; n = 20; 18.15 ± 0.27 years) and a control group (CG; n = 20; 19.25 ± 0.39 years) participated in this study. The TG was composed of soccer players of the highest youth category. The CG consisted of young people who did not follow any training routine and had not practiced any sport for at least the previous six months. The TG showed higher plasma and serum Fe concentrations (p < 0.05), but lower concentrations in erythrocytes and platelets compared to the CG (p < 0.01). Due to the differences observed in the extracellular and intracellular compartments, it seems necessary to perform a global Fe analysis to assess Fe status.

Background: The justification for this review is the need for high-quality evidence to assist in the decision-making process when applying percutaneous electrical nerve stimulation (PENS) or transcutaneous electrical nerve stimulation (TENS) in a clinical setting. The main aim was to determine if the use of PENS is more effective and should be recommended when compared to TENS for the reduction of musculoskeletal pain intensity., Methods: A search for randomized controlled trials (RCTs) was performed. Studies published until 31/12/2020, comparing the effectiveness of PENS and TENS, were considered. The main outcome was pain assessed with a visual analog scale or numerical pain rating scale., Results: Nine RCTs were included in the qualitative analysis, with seven of them in the quantitative analysis (n = 527). The overall effect of PENS on pain was statistically but not clinically superior to TENS (mean difference [MD]=-1.0 cm; 95% confidence interval [CI]: -1.5 to -0.4) with a high level of heterogeneity (I2=76%, P > .01). When only studies with a lower risk of bias (n = 3) were analyzed, the heterogeneity decreased to I = 0% (P = .06) and no difference was observed between TENS and PENS (MD=-0.81 cm; 95% CI:-1.6 to 0.02) with a moderate recommendation level according to GRADE. There were no data concerning adverse effects., Conclusions: There is low-quality of evidence for more pain intensity reduction with PENS, but the difference was not clinically significant. However, when only studies with low risk of bias are meta-analyzed, there is a moderate quality of evidence that there is no difference when TENS or PENS is applied for pain intensity., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Oncogene-immortalized bone marrow-derived macrophages are considered to be a good model for the study of immune cell functions, but the factors required for their survival and proliferation are still unknown. Although the effect of the thyroid hormones on global metabolic and transcriptional responses in macrophages has not yet been examined, there is increasing evidence that they could modulate macrophage functions. We show here that the thyroid hormone T3 is an absolute requirement for the growth of immortal macrophages. The hormone regulates the activity of the main signaling pathways required for proliferation and anabolic processes, including the phosphorylation of ERK and p38 MAPKs, AKT, ribosomal S6 protein, AMPK and Sirtuin-1. T3 also alters the levels of metabolites controlling transcriptional and post-transcriptional actions in macrophages, and causes widespread transcriptomic changes, up-regulating genes needed for protein synthesis and cell proliferation, while down-regulating genes involved in immune responses and endocytosis, among others. This is not observed in primary bone marrow-derived macrophages, where only p38 and AMPK activation is regulated by T3 and in which the metabolic and transcriptomic effects of the hormone are much weaker. However, the response to IFN-γ is reduced by T3 similarly in immortalized macrophages and in the primary cells, confirming previous results showing that the thyroid hormones can antagonize JAK/STAT-mediated signaling. These results provide new perspectives on the relevant pathways involved in proliferation and survival of macrophage cell culture models and on the crosstalk between the thyroid hormones and the immune system., 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 © 2022 López-Mateo, Rodríguez-Muñoz, de La Rosa, Castrillo, Alemany and Aranda.)

Background: Coeliac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten in genetically predisposed individuals. Gluten restriction in CD sufferers leads to numerous limitations in various aspects of daily life and can significantly impact the quality-of-life (QoL). The specific and widely used Coeliac Disease Questionnaire (CDQ) is an excellent tool to evaluate QoL in patients with CD, assessing physical, psychological, and social domains. This questionnaire is unavailable in Spain. Therefore, our study is the first to translate, culturally adapt, validate, and apply the Spanish version of CDQ to a representative sample of Spanish teenagers and adults with CD., Methods: A total of 153 CD participants with biopsy-proven and self-reported gluten-free adherence were included in the cross-sectional study, which included four stages: (1) translation and retranslation of the French CDQ version into Spanish; (2) cultural adaptation and semantic evaluation; (3) CDQ validation through the internal consistency determination and reproducibility of the QoL; and (4) application of the questionnaire to Spanish teenagers and adults with CD and estimation of QoL using EQ-5D., Results: The internal consistency and test-retest reliability of the Spanish CDQ were satisfactory and no ceiling or floor effects were detected. Significant correlations were identified between the CDQ scales, and the instrument for validation covering similar dimensions of the QoL was identified. The mean CDQ total score was 131.03 ± 24.1, and the social domain had the highest rating. There was no correlation between the time spent on a gluten-free diet and QoL. A significantly higher QoL score was reported among males and adolescents in the 15-17 age groups., Conclusion: The newly Spanish CDQ is an appropriate tool to assess the QoL of the teenager and adult patients with CD. This study highlights the importance of identifying the affected scales to address actions to reduce the impact of the gluten-free diet burden of the coeliac patients and maintain public health regulations that support patients with chronic diseases such as CD., 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 © 2022 Moreno, Sánchez-Muñoz and Sousa.)

This study aimed to assess the physical fitness and upper body asymmetries of young padel players aged between 13 and 16 years and to determine the possible differences between genders and categories. A total of 60 padel players were divided into four groups: under-14 male (n = 15; age: 13.75 ± 0.45 years; height: 1.64 ± 0.07 m; weight: 54.7 ± 8.3 kg), under-14 female (n = 15; age: 13.75 ± 0.44 years; height: 1.60 ± 0.05 m; weight: 51.5 ± 6.0 kg), under-16 male (n = 15; age: 15.44 ± 0.51 years; height:1.71 ± 0.04 m; weight: 63.88 ± 6.2 kg) and under-16 female (n = 15; age:15.46 ± 0.52 years; height:1.63 ± 0.05 m; weight: 55.08 ± 3.6 kg). Handgrip strength, ischiosural flexibility, gestural speed of the dominant arm, vertical jump, cardiorespiratory capacity, lateral movement, lateral acceleration and reaction time were measured. Male players showed better results in manual grip strength, vertical jump power, cardiorespiratory capacity and lateral movement (p < 0.05). Moreover, males presented a higher percentage of asymmetry in upper limb strength. Female players showed better reaction time and greater flexibility (p < 0.05). Regarding the differences between categories, the under-16 players showed greater flexibility, gestural speed, vertical jump power, cardiorespiratory capacity and lateral movement compared to the under-14 players. These results can be used as reference values for coaches/physical trainers of younger categories to improve health control and physical performance planning.

The aim of this study was to evaluate the effects of Tetraselmis chuii (TC) microalgae supplementation for sixty days on hematological, anthropometric and hormonal parameters in healthy young men. Forty-six men divided into a placebo group (PG; n = 16; 20.77 ± 2.7 years; 72.14 ± 7.18 kg; 1.76 ± 0.07 m), a group supplemented with 25 mg/day of TC (SG 25; n = 15; 20.40 ± 1.40 years; 71.28 ± 8.26 kg; 1.76 ± 0.05 m) and another group supplemented with 200 mg/day of TC (SG 200; n = 15; 20.83 ± 2.45 years; 72.30 ± 11.13 kg; 1.77 ± 0.08 m) participated in this double-blind study. PG ingested 200 mg/day of lactose powder. Participants underwent 4 assessments (baseline, month 1, month 2 and desadaptation) separated in time by an interval of thirty days. At SG 25 and SG 200, significant increases in percent muscle mass, erythropoietin, insulin-like growth factor 1, free testosterone, leukocytes, neutrophils and lymphocytes were observed (p < 0.05). Decreases in the levels of percent fat mass, platelets, hematocrit and mean corpuscular hemoglobin also occurred in these groups (p < 0.05). TC supplementation induced favorable changes on anthropometric, hematological and hormonal levels. In view of the data, it seems that the most effective dose was 25 mg/day of TC.

Background: Electrical microcurrent therapy (EMT) consists of the application of low intensity (μA) currents that are similar to endogenous electric fields generated during wound healing., Aims: To examine the effectiveness and safety of EMT for improving wound healing and pain in people with acute or chronic wounds., Method: Randomized clinical trials (RCTs) assessing the effectiveness of EMT in wound healing published up to August 1st, 2020 were included. The main outcomes were wound surface area, healing time, and number of wounds healed. Secondary outcomes were pain perception and adverse events. A quantitative analysis was conducted using the inverse variance and Mantel-Haenszel methods., Results: Eight RCTs were included in the qualitative summary and seven in the quantitative analysis (n = 337 participants). EMT plus standard wound care (SWC) produced a greater decrease in wound surface [mean difference (MD) = -8.3 cm 2 ; CI 95%: -10.5 to -6.0] and healing time (MD = -7.0 days; CI 95%: -11.9 to -2.1) that SWC alone, showing moderate and low certainty in the evidence, respectively. However, no differences were observed in the number of healed wounds [risk ratio = 2.0; CI 95%: 0.5 to 9.1], with very low quality of evidence. EMT decreased perceived pain (MD = -1.4; CI 95%: -2.7 to -0.2), but no differences in adverse effects were noted between groups (risk difference = 0.05; CI 95%: -0.06 to 0.17)., Conclusions: EMT is an effective, safe treatment for improving wound area, healing time, and pain. Further clinical trials that include detailed intervention parameters and protocols should be designed to lower the risk of bias., (Copyright © 2021 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.)

Trace mineral element concentrations are under homeostatic control. Selenium (Se) is a very important micronutrient for the antioxidant and immune system. Se metabolism could be modified due to physical training. This research aimed to analyze the extracellular (plasma, urine and serum) and intracellular (platelets and erythrocytes) concentrations of Se in athletes and to compare it with subjects with low levels of physical training. Forty young men divided into a control group (CG; n = 20; 19.25 ± 0.39 years) and a training group (TG; n = 20; 18.15 ± 0.27 years) participated in this study. The TG was formed by semi-professional soccer players. The analysis of Se was determined by inductively coupled plasma mass spectrometry. The TG obtained higher values of maximum oxygen consumption and muscle percentage (p < 0.05). The TG showed reduced absolute (p < 0.01) and relative (p < 0.05) Se concentrations in erythrocytes and platelets in comparison to CG. Trace element assessments should not be limited only to extracellular compartments as there could be deficiencies at the intracellular level.

The modulation of the host's metabolism to protect tissue from damage induces tolerance to infections increasing survival. Here, we examined the role of the thyroid hormones, key metabolic regulators, in the outcome of malaria. Hypothyroidism confers protection to experimental cerebral malaria by a disease tolerance mechanism. Hypothyroid mice display increased survival after infection with Plasmodium berghei ANKA, diminishing intracranial pressure and brain damage, without altering pathogen burden, blood-brain barrier disruption, or immune cell infiltration. This protection is reversed by treatment with a Sirtuin 1 inhibitor, while treatment of euthyroid mice with a Sirtuin 1 activator induces tolerance and reduces intracranial pressure and lethality. This indicates that thyroid hormones and Sirtuin 1 are previously unknown targets for cerebral malaria treatment, a major killer of children in endemic malaria areas.

Background: Physical exercise affects zinc (Zn) homeostasis. This study aimed to analyze the influence of physical training on extracellular (serum, plasma, and urine) and intracellular (erythrocytes and platelets) concentrations of Zn., Methods: Forty young men, divided into a training group (TG; n = 20; 18.15 ± 0.27 years; 68.59 ± 4.18 kg; 1.76 ± 0.04 m) and a control group (CG; n = 20; 19.25 ± 0.39 years; 73.45 ± 9.04 kg; 1.79 ± 0.06 m), participated in this study. The TG was formed by semiprofessional soccer players from a youth category with a regular training plan of 10 h/week. The CG was formed by healthy men who did not practice physical exercise and had not followed any specific training plan. Plasma, serum, urine, erythrocyte, and platelet samples of Zn were obtained and analyzed by inductively coupled plasma mass spectrometry., Results: The TG showed elevated plasma Zn concentrations (p < 0.01) despite similar intakes. However, TG showed reduced absolute (p < 0.01) and relative (p < 0.05) Zn concentrations in erythrocytes., Conclusions: Athletes who underwent regular physical training showed elevated plasma and reduced erythrocyte Zn concentrations despite similar intakes to the CG., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Disaster victim identification (DVI) entails a protracted process of evidence collection and data matching to reconcile physical remains with victim identity. Technology is critical to DVI by enabling the linkage of physical evidence to information. However, labelling physical remains and collecting data at the scene are dominated by low-technology paper-based practices. We ask, how can technology help us tag and track the victims of disaster? Our response to this question has two parts. First, we conducted a human-computer interaction led investigation into the systematic factors impacting DVI tagging and tracking processes. Through interviews with Australian DVI practitioners, we explored how technologies to improve linkage might fit with prevailing work practices and preferences; practical and social considerations; and existing systems and processes. We focused on tagging and tracking activities throughout the DVI process. Using insights from these interviews and relevant literature, we identified four critical themes: protocols and training; stress and stressors; the plurality of information capture and management systems; and practicalities and constraints. Second, these findings were iteratively discussed by the authors, who have combined expertise across electronics, data science, cybersecurity, human-computer interaction and forensic pathology. We applied the themes identified in the first part of the investigation to critically review technologies that could support DVI practitioners by enhancing DVI processes that link physical evidence to information. This resulted in an overview of candidate technologies matched with consideration of their key attributes. This study recognises the importance of considering human factors that can affect technology adoption into existing practices. Consequently, we provide a searchable table (as Supplementary information) that relates technologies to the key considerations and attributes relevant to DVI practice, for readers to apply to their own context. While this research directly contributes to DVI, it also has applications to other domains in which a physical/digital linkage is required, and particularly within high stress environments with little room for error.Key points:Disaster victim identification (DVI) processes require us to link physical evidence and digital information. While technology could improve this linkage, experience shows that technological "solutions" are not always adopted in practice.Our study of the practices, preferences and contexts of Australian DVI practitioners suggests 10 critical considerations for these technologies.We review and evaluate 44 candidate technologies against these considerations and highlight the role of human factors in adoption., Competing Interests: No relevant financial or non-financial competing interests to declare., (© 2022 The Author(s). Published by Taylor & Francis Group on behalf of the Academy of Forensic Science.)

Former studies investigated the application of high-frequency alternating currents (HFAC) in humans for blocking the peripheral nervous system. The present trial aims to assess the effect of HFAC on the motor response, somatosensory thresholds, and peripheral nerve conduction when applied percutaneously using frequencies of 10 kHz and 20 kHz in healthy volunteers. A parallel, placebo-controlled, double-blind, randomized clinical trial was conducted. Ultrasound-guided HFAC at 10 kHz and 20 kHz and sham stimulation were delivered to the median nerve of 60 healthy volunteers for 20 min. The main assessed variables were the maximum isometric flexion strength (MFFS) of the index finger, myotonometry, pressure pain threshold (PPT), mechanical detection threshold (MDT), and sensory nerve action potential (SNAP). A decrease in the MFFS is observed immediately postintervention compared to baseline, both in the 10 kHz group (-8.5%; 95% CI -14.9 to -2.1) and the 20 kHz group (-12.0%; 95% CI -18.3 to -5.6). The between-group comparison of changes in MFFS show a greater reduction of -10.8% (95% CI -19.8 to -1.8) immediately postintervention in the 20 kHz compared to the sham stimulation group. The percutaneous stimulation applying 20 kHz HFAC to the median nerve produces a reversible postintervention reduction in strength with no adverse effects.

Padel, an increasingly popular sport, presents some associated cardiovascular risks, which can be prevented by heart rate variability (HRV) monitoring. However, there is no study worldwide that characterizes HRV during padel games. Therefore, this study aims to monitor HRV responses and characterize them using linear and non-linear metrics at three timepoints: at baseline, during a game, and during recovery. Twenty-seven amateur participants had their HRV monitored before, during, and after a 90 min padel game. We extracted time, frequency, and non-linear measures with MATLAB for baseline, rest period, and at three periods of 5 min during the game. The differences in measures were assessed through an ANOVA. The autonomic modulation was affected by the padel match in amateur players. In this regard, the root mean square of successive differences between normal heartbeats (RMSsd), Poincaré plot (perpendicular standard deviation (SD1) and horizontal standard deviation (SD2)), sample entropy (SampEn), low frequencies (LF), and very low frequencies (VLF) were significantly reduced during the game, whereas alpha-2, high frequencies (HF), and the ratio between low and high frequencies (LF/HF) increased during the game. Furthermore, an abrupt change was found in the autonomic modulation between game and recovery assessments, which suggests the need to rethink the practices of cool-down protocols. The multiple timepoints analyzed during this study allow us to investigate the evolution of different HRV measures in the time, frequency, and non-linear domains, clarifying the interpretation of the variables, especially the less-investigated ones such as the non-linear measures.

Complex diseases such as neurodegenerative disorders and cancer constitute a growing public health problem due to the rising incidence and lack in effective therapies. Since pharmacotherapy based on a single target has been insufficient for drug development in complex diseases, the emerging multi-target approach is a promising strategy for the search of new drug candidates. Plant-derived isoquinoline alkaloids comprise a vast source of multimodal agents with unique structural diversity, and variated range of pharmacological activities. This review offers an exhaustive compilation of the pharmacological relevance and multi-target potential of natural isoquinolines, emphasizing their features and promising activity in complex diseases such as Alzheimer, Parkinson, and Cancer. Selected examples were discussed in depth to illustrate the most relevant structural motifs and their possible relationship with the multimodal activity offering a comprehensive baseline in the search and optimization of isoquinoline scaffolds with polypharmacological potential for complex diseases., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

To carry out research that analyzes performance indicators through observational methodology, it is necessary to have validated tools. The purpose of this study was to design and validate a tool to ascertain the characteristics of the strokes that padel pairs use to reach the net and their consequences in the two subsequent shots of the game. Eleven experts, who had to meet four of the five inclusion criteria established by the researchers, participated in the process. Aiken's V coefficient and confidence intervals were used to analyze content validity and Cronbach's α coefficient to calculate reliability. The adequacy and wording of the sixteen variables initially designed were evaluated. Four variables were eliminated due to obtaining values <0.90 in Aiken's V coefficient in adequacy. The rest of the variables were modified in their wording, according to the qualitative evaluations of the experts, or were considered correct. The reliability of the instrument was acceptable (α = 0.89). The NAPOA instrument is novel, as it is of interest to analyze the characteristics of the strokes that padel players use to achieve the offensive position.

Objective: The aim of this study was to assess whether anodal DCS applied to the suboccipital (SO) target area could potentiate antinociception assessed primarily with conditioned pain modulation of tonic thermal test stimuli., Design: Randomized double-blinded control trial., Setting: Rehabilitation hospital., Subjects: Healthy participants., Methods: Forty healthy participants were randomized to receive either SO-DCS or M1-DCS. The 20-minute 1.5 mA anodal or sham DCS intervention were applied to each participant in randomized order during two test sessions. The primary outcome measure included heterotopic cold-pressor conditioned pain modulation (CPM) of tonic heat pain. Secondary measures included pressure pain threshold and tonic thermal pain intensity., Results: Heterotopic CPM of tonic heat pain intensity was unaffected by either SO-DCS or active M1, including the secondary measures of pressure pain threshold and tonic thermal pain intensity. Although low-power non-significant interactions were identified for DCS intervention (active versus sham) and time (before and after), a significant within-group inhibition of tonic cold pain was identified following SO-DCS (P = .011, mean [SD]: -0.76 ± 0.88 points) and M1-DCS (P < .002: -0.84 ± 0.82 points), without a significant change following sham DCS., Conclusions: Although heterotopic CPM was not facilitated with either SO-DCS or M1-DCS, a general significant inhibition of tonic cold pain intensity was demonstrated following both interventions. The general effects of active DCS compared to sham on tonic cold pain-irrespective of the M1 or SO target-need to be confirmed using standard quantitative sensory testing., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Aims: The aim of this study was to compare serum vanadium (V) concentrations between athletes of different sports modalities and people who did not practise physical exercise regularly., Methods: One hundred and twenty-one subjects divided into a control group (CG; n = 37; 1.75 ± 0.03 m; 79.45 ± 10.20 kg; 24.72 ± 6.06 years) and an athletes' group (AG; n = 84; 1.77 ± 0.05 m; 66.34 ± 6.12 kg; 19.57 ± 1.95 years) participated in this research. AG were classified by sports modality: aerobic (AE; n = 26), anaerobic (ANA; n = 22); aerobic-anaerobic (AE-ANA; n = 36). Serum V concentrations were analysed by inductively coupled plasma mass spectrometry., Results: AG showed higher V concentrations compared to CG (p < 0.01). AE obtained higher concentrations compared to ANA and AE-ANA (p < 0.05)., Conclusions: Physical training could increase serum V levels. Specifically, aerobic sports modalities could increase serum V levels to a greater extent than other sports modalities., (Copyright © 2021 Elsevier GmbH. All rights reserved.)

The aim of this study was to analyze the influence of service tactic formation on players' movements and point outcome at two different performance levels. The sample contained 2,148 points corresponding to 18 matches from two male padel indoor tournaments. Players were classified according to their game level: high-level (N = 36; age = 33.3 ± 6.9 years) and beginner (N = 36; age = 35.4 ± 6.8 years). Variables pertaining to service tactic formation (conventional or Australian), point outcome and movement patterns were analysed from the matches through systematic observation. The results showed how high-level players used a significantly higher percentage of the Australian formation than beginners. Also, high-level players won a significantly higher percentage of points than recreational players when using both service tactics. According to movement variables, servers were significantly closer to the net and the side wall using a conventional formation when the returner hit the ball. Furthermore, servers had to move quicker when they used the Australian formation. Finally, the comparison of movement patterns of servers according to game level, showed how high-level players ran faster to the offensive position, covered a greater distance and spent less time between serve and return impacts than beginners., Competing Interests: The authors have declared that no competing interests exist.