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The purpose of this study was to determine the relationship between acute, chronic, and acute:chronic sleep on aerobic performance in female youth soccer athletes. Fifty-nine female soccer players (13–18 years) reported prior night (acute) and average prior month (chronic) sleep duration before undergoing cycle ergometer testing to determine maximal aerobic capacity (VO2max), time to exhaustion (Tmax), and ventilatory threshold (VO2VT). Variables were grouped by prior night and prior month sleep duration (< 8 h, ≥ 8 h) as well as acute:chronic sleep (< 1, ≥ 1) and compared between groups using least squares means from age-adjusted linear models. No statistically significant differences were identified between those participants who slept ≥ 8 h the prior night and those who slept < 8 h, with respect to VO2max (50.3 ± 5.9 vs. 47.6 ± 5.9 ml/kg/min, p = 0.10, d = 0.45), Tmax (15.7 ± 2.8 vs.14.9 ± 2.2 min, p = 0.17, d = 0.37), or VO2VT (43.2 ± 5.4 vs. 40.7 ± 5.4 ml/kg/min, p = 0.09, d = 0.46). Participants who averaged ≥ 8 h of sleep in the prior month demonstrated significantly greater VO2max (50.2 ± 5.7 vs. 45.4 ± 5.7 ml/kg/min, p = 0.023, d = 0.83) and VO2VT (43.0 ± 5.2 vs. 39.0 ± 5.2 ml/kg/min, p = 0.016, d = 0.78), but not Tmax (15.6 ± 2.2 vs. 14.8 ± 2.2 min, p = 0.24, d = 0.37). On the other hand, participants with higher acute:chronic sleep demonstrated greater Tmax (16.4 ± 2.1 vs. 14.9 ± 2.1 min, p = 0.012, d = − 0.73), but not VO2max (50.1 ± 6.0 vs. 48.7 ± 6.0 ml/kg/min, p = 0.38, d = − 0.25) or VO2VT (42.7 ± 5.5 vs. 41.9 ± 5.5 ml/kg/min, p = 0.60, d = − 0.15). Greater chronic prior month sleep duration is associated with increased VO2max and VO2VT, while increased acute prior night sleep relative to the preceding month was associated with increased Tmax. [ABSTRACT FROM AUTHOR]

Streamflow monitoring networks provide information for a wide range of public interests in river and streams. A general approach to evaluate monitoring for different interests is developed to support network planning and design. The approach defines three theoretically distinct information metrics (coverage, resolution, and representation) based on the spatial distribution of a variable of interest. Coverage is the fraction of information that a network can provide about a variable when some areas are not monitored. Resolution is the information available from the network relative to the maximum information possible given the number of sites in the network. Representation is the information that a network provides about a benchmark distribution of a variable. Information is defined using Shannon entropy where the spatial discretization of a variable among spatial elements of a landscape or sites in a network indicates the uncertainty in the spatial distribution of the variable. This approach supports the design of networks for monitoring of variables with heterogeneous spatial distributions ("hot spots" and patches) that might otherwise be unmonitored because they occupy insignificant portions of the landscape. Areas where monitoring will maintain or improve the metrics serve as objective priorities for public interests in network design. The approach is demonstrated for the streamflow monitoring network operated by the United States Geological Survey during water year 2020 indicating gaps in the coverage of coastal rivers and the resolution of low flows. [ABSTRACT FROM AUTHOR]

Background: Pulse pressure is a dynamic marker of cardiovascular function and is often impaired in patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO). Pulsatile blood flow also serves as a regulator of vascular endothelium, and continuous-flow mechanical circulatory support can lead to endothelial dysfunction. We explored the impact of early low pulse pressure on occurrence of acute brain injury (ABI) in VA-ECMO. Methods: We conducted a retrospective analysis of adults with VA-ECMO at a tertiary care center between July 2016 and January 2021. Patients underwent standardized multimodal neuromonitoring throughout ECMO support. ABI included intracranial hemorrhage, ischemic stroke, hypoxic ischemic brain injury, cerebral edema, seizure, and brain death. Blood pressures were recorded every 15 min. Low pulse pressure was defined as a median pulse pressure < 20 mm Hg in the first 12 h of ECMO. Multivariable logistic regression was performed to investigate the association between pulse pressure and ABI. Results: We analyzed 5138 blood pressure measurements from 123 (median age 63; 63% male) VA-ECMO patients (54% peripheral; 46% central cannulation), of whom 41 (33%) experienced ABI. Individual ABIs were as follows: ischemic stroke (n = 18, 15%), hypoxic ischemic brain injury (n = 14, 11%), seizure (n = 8, 7%), intracranial hemorrhage (n = 7, 6%), cerebral edema (n = 7, 6%), and brain death (n = 2, 2%). Fifty-eight (47%) patients had low pulse pressure. In a multivariable model adjusting for preselected covariates, including cannulation strategy (central vs. peripheral), lactate on ECMO day 1, and left ventricle venting strategy, low pulse pressure was independently associated with ABI (adjusted odds ratio 2.57, 95% confidence interval 1.05–6.24). In a model with the same covariates, every 10-mm Hg decrease in pulse pressure was associated with 31% increased odds of ABI (95% confidence interval 1.01–1.68). In a sensitivity analysis model adjusting for systolic pressure, pulse pressure remained significantly associated with ABI. Conclusions: Early low pulse pressure (< 20 mm Hg) was associated with ABI in VA-ECMO patients. Low pulse pressure may serve as a marker of ABI risk, which necessitates close neuromonitoring for early detection. [ABSTRACT FROM AUTHOR]

Introduction and Methods: We examined the relationship between 24-h pre- and post-cannulation arterial oxygen tension (PaO2) and arterial carbon dioxide tension (PaCO2) and subsequent acute brain injury (ABI) in patients receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO) with granular arterial blood gas (ABG) data and institutional standardized neuromonitoring. Results: Eighty-nine patients underwent VV-ECMO (median age = 50, 63% male). Twenty (22%) patients experienced ABI; intracranial hemorrhage (ICH) was the most common diagnosis (n = 14, 16%). Lower post-cannulation PaO2 levels were significantly associated with ICH (66 vs. 81 mmHg, p = 0.007) and a post-cannulation PaO2 level < 70 mmHg was more frequent in these patients (71% vs. 33%, p = 0.007). PaCO2 parameters were not associated with ABI. By multivariable logistic regression, hypoxemia post-cannulation increased the odds of ICH (OR = 5.06, 95% CI:1.41–18.17; p = 0.01). Conclusion: In summary, lower oxygen tension in the 24-h post-cannulation was associated with ICH development. The precise roles of peri-cannulation ABG changes deserve further investigation, as they may influence the management of VV-ECMO patients. [ABSTRACT FROM AUTHOR]

Background: Sport-related concussions (SRCs) affect millions of adolescents and young adults annually in the USA; however, current SRC consensus statements provide limited guidance on academic support for students within higher education. Objective: To generate consensus on appropriate academic recommendations for clinicians, students, and academic stakeholders to support university students during their recovery. Methods: Panelists participated in three stages of a modified Delphi procedure: the first stage included a series of open-ended questions after reviewing a literature review on post-SRC return-to-learn (RTL) in higher education; the second stage asked panelists to anonymously rate the recommendations developed through the first Delphi stage using a 9-point scale; and the final stage offered panelists the opportunity to change their responses and/or provide feedback based on the group's overall ratings. Results: Twenty-two panelists including clinicians, concussion researchers, and academic stakeholders (54.5% female) from 15 institutions and/or healthcare systems participated in a modified Delphi procedure. A total of 42 statements were developed after round one. Following the next two rounds, 27 statements achieved consensus amongst the panel resulting in the four-stage Post-Concussion Collegiate RTL Protocol. Conclusion: There are several unique challenges when assisting university students back to the classroom after SRC. Explicit guidelines on when to seek additional medical care (e.g., if they are experiencing worsening or persistent symptoms) and how to approach their instructor(s) regarding academic support may help the student self-advocate. Findings from the present study address barriers and provide a framework for universities to facilitate a multidisciplinary approach amongst medical and academic stakeholders. [ABSTRACT FROM AUTHOR]

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Objectives: Aggressive behaviors are consistently linked to alcohol use and are over-represented among individuals in substance misuse treatment compared to the general population. Trait mindfulness (i.e., a multifaceted construct including attending to and accepting experiences) had an inverse relationship with aggression such that greater trait mindfulness may attenuate the risk alcohol use poses for aggression. Methods: We examined the moderating effect of the five facets of trait mindfulness on the relationship between alcohol use/problems and aggressive attitudes, physical aggression, and verbal aggression among 516 men in residential treatment for substance use disorders. Results: Explication of the significant interactions utilizing the Johnson-Neyman technique revealed alcohol use/problems positively related to aggressive attitudes for men with below average and average Nonreactivity and Acting mindfulness facets. The positive relationship between alcohol use/problems and verbal aggression was present among men below average in Nonreactivity and Acting. Alcohol use/problems positively related to physical aggression among men below average and average in the mindfulness facets of Describe and Acting. Furthermore, alcohol use/problems positively related to aggressive attitudes and physical aggression among men average or above average in the mindfulness facet of Observe. Conclusions: Findings suggest that among men who misuse substances, the relation between alcohol use and aggression may be conditional and influenced by deficits in trait mindfulness. [ABSTRACT FROM AUTHOR]