Search

Identifying fast athletes is an important part of the National Football League (NFL) Combine. However, not all athletes partake in the 36.58-m sprint, and relying on this single test may miss potentially fast athletes. Therefore, the purpose of this study was to determine whether sprinting times can be predicted using simple anthropometric and jumping measures. Data from the NFL Combine between the years 1999-2020 inclusive were used (n = 4,149). Subjects had a mean (±SD) height = 1.87 ± 0.07 m and body mass = 111.96 ± 20.78 kg. The cross-validation technique was used, partitioning the data into a training set (n = 2,071) to develop regression models to predict time over the 9.14-, 9.14-to 18.29-, 18.29-to 36.58-m, and 36.58-m segments using vertical jump, broad jump, height, and mass as the independent variables. The models were then evaluated against a test set (n = 2,070) for agreement. Statistically significant (p < 0.01) models were determined for 9.14-m time (adjusted R² = 0.76, SEE = 0.05 seconds), 9.14- to 18.29-m time (adjusted R² = 0.74, SEE = 0.04 seconds), 18.29- to 36.59-m time (adjusted R² = 0.79, SEE = 0.07 seconds), and 36.58-m time (adjusted R² = 0.84, SEE = 0.12 seconds). When evaluated against the test set, the models showed biases of -0.05, -0.04, -0.02, and - 0.02 seconds and root-mean-square error of 0.07,0.05,0.07, and 0.12 seconds for the 9.14-, 9.14-to 18.29-, 18.29-to 36.58-m, and 36.58-m segments, respectively. However, 5-6% of the predictions lay outside of the limits of agreement. This study provides 4 formulae that can be used to predict sprint performance when the 36.58-m sprint test is not performed, and practitioners can use these equations to determine training areas of opportunity when working with athletes preparing for the NFL Combine. [ABSTRACT FROM AUTHOR]

BACKGROUND: LMNA (lamin A/C)-related dilated cardiomyopathy is a rare genetic cause of heart failure. In a phase 2 trial and long-term extension, the selective p38a MAPK (mitogen-activated protein kinase) inhibitor, ARRY-371797 (PF-07265803), was associated with an improved 6-minute walk test at 12 weeks, which was preserved over 144 weeks. REALM-DCM (NCT03439514) was a phase 3, randomized, double-blind, placebo-controlled trial in patients with symptomatic LMNA-related dilated cardiomyopathy. Patients with confirmed LMNA variants, New York Heart Association class II/III symptoms, left ventricular ejection fraction =50%, implanted cardioverter-defibrillator, and reduced 6-minute walk test distance were randomized to ARRY-371797 400 mg twice daily or placebo. The primary outcome was a change from baseline at week 24 in the 6-minute walk test distance using stratified Hodges-Lehmann estimation and the van Elteren test. Secondary outcomes using similar methodology included change from baseline at week 24 in the Kansas City Cardiomyopathy Questionnaire-physical limitation and total symptom scores, and NT-proBNP (N-terminal pro-B-type natriuretic peptide) concentration. Time to a composite outcome of worsening heart failure or all-cause mortality and overall survival were evaluated using Kaplan-Meier and Cox proportional hazards analyses. RESULTS: REALM-DCM was terminated after a planned interim analysis suggested futility. Between April 2018 and October 2022, 77 patients (aged 23-72 years) received ARRY-371797 (n=40) or placebo (n=37). No significant differences (P>0.05) between groups were observed in the change from baseline at week 24 for all outcomes: 6-minute walk test distance (median difference, 4.9 m [95% CI, -24.2 to 34.1]; P=0.82); Kansas City Cardiomyopathy Questionnaire-physical limitation score (2.4 [95% CI, -6.4 to 11.2]; P=0.54); Kansas City Cardiomyopathy Questionnaire-total symptom score (5.3 [95% CI, -4.3 to 14.9]; P=0.48); and NT-proBNP concentration (-339.4 pg/mL [95% CI, -1131.6 to 452.7]; P=0.17). The composite outcome of worsening heart failure or all-cause mortality (hazard ratio, 0.43 [95% CI, 0.11-1.74]; P=0.23) and overall survival (hazard ratio, 1.19 [95% CI, 0.23-6.02]; P=0.84) were similar between groups. No new safety findings were observed. CONCLUSIONS:' Findings from REALM-DCM demonstrated futility without safety concerns. An unmet treatment need remains among patients with LMNA-related dilated cardiomyopathy. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to report adverse effects from clinical studies on ultrasound-guided percutaneous cryoneurolysis for spasticity. Design: Patients were prospectively enrolled in three studies at a single institution. Cryoneurolysis was performed to primarily motor nerve branches (medial and lateral pectoral, musculocutaneous, radial, median, ulnar, tibial, obturator) and mixed motor sensory nerve trunks (median, ulnar, suprascapular, radial, and tibial). Results: Cryoneurolysis was performed for 277 nerves (99 mixed motor sensory), on 113 patients (59 F, 54 M, average age 54.4 yrs). One patient had a local skin infection and two patients had bruising or swelling; all resolved within 1 mo. Nine reported nerve pain or dysesthesia (two motor, seven mixed motor sensory nerves). Four received no treatment, four oral or topical medications, two perineural injections, one botulinum toxin. Three patients’ symptoms remained until 3 mos and one had numbness at six. One patient had botulinum toxin injections for cramping. All had at minimum 3-mo follow-up; seven withdrew (x̄= 5.4 mos), four passed away. None of these 11 reported adverse effects. Conclusions: A total of 96.75% of nerve treatments had no pain or dysesthesias beyond treatment. Few had pain or numbness beyond 3 mos. Cryoneurolysis has potential to be a safe spasticity treatment with manageable adverse effects. [ABSTRACT FROM AUTHOR]

Background: Hypertension is the leading global cause of cardiovascular disease and premature mortality in women. The effects of postmenopausal hormone therapy (HT) on blood pressure are uncertain but may be related to route of estrogen administration and formulation of estrogen. We sought to determine the association between route of administration and formulation of estrogen HT and hypertension risk in postmenopausal women. Methods: Population-based cohort study with women aged ≥45 years who filled ≥2 consecutive prescriptions for estrogen-only HT, identified from linked provincial health administrative data from Alberta, Canada, between 2008 and 2019. The primary outcome, incident hypertension, was identified using standardized International Classification of Diseases , Ninth and Tenth Revision. Cox proportional hazard models were used to calculate hazard ratios (HRs) for hypertension in women using oral HT compared with nonoral HT (transdermal, vaginal, or intramuscular). Results: In total, 112 240 women used an estrogen-only form of HT. Oral estrogen was associated with a higher risk of hypertension compared with both transdermal (HR, 1.14 [95% CI, 1.08–1.20]) and vaginal (HR, 1.19 [95% CI, 1.13–1.25]) estrogens. Conjugated equine estrogen was associated with an increased risk of hypertension compared with estradiol (HR, 1.08 [95% CI, 1.04–1.14]) but not estrone (HR, 1.00 [95% CI, 0.93–1.10]). Duration of estrogen exposure and cumulative dose of estrogen was positively associated with risk of hypertension. Conclusions: Oral estrogen-only HT use was associated with an increased risk of hypertension in women. In women using estrogen-only HT, nonoral estradiol at the lowest dose and for the shortest time-period is associated with the lowest risk of hypertension. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is available in the text Objective: The objectives of this study were to review the coaching literature to (1) characterize the criteria integral to the coaching process, specifically in surgery, and (2) describe how these criteria have been variably implemented in published studies. Background: Coaching is a distinct educational intervention, but within surgery the term is frequently used interchangeably with other more established terms such as teaching and mentoring. Methods: A systematic search was performed of the MEDLINE and Cochrane databases to identify studies that used coach/coaching as an intervention for surgeons for either technical or nontechnical skills. Study quality was evaluated using the Medical Education Research Study Quality Instrument (MERSQI). Results: A total of 2280 articles were identified and after screening by title, abstract and full text, 35 remained. Thirteen coaching criteria (a–m) were identified in 4 general categories: 1. overarching goal (a. refine performance of an existing skill set), 2. the coach (b. trusting partnership, c. avoids assessment, d. 2-way communication), the coachee (e. voluntary participation, f. self-reflection, g. goal setting, h. action plan, i. outcome evaluation), and the coach-coachee rapport (j. coaching training, k. structured coaching model, l. non-directive, m. open ended questions). Adherence to these criteria ranged from as high of 73% of studies (voluntary participation of coach and coachee) to as low as 7% (use of open-ended questions). Conclusions: Coaching is being used inconsistently within the surgical education literature. Our hope is that with establishing criteria for coaching, future studies will implement this intervention more consistently and allow for better comparison and generalization of results. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is available in the text. Background: The turnover of cardiac ion channels underlying action potential duration is regulated by ubiquitination. Genome-wide association studies of QT interval identified several single-nucleotide polymorphisms located in or near genes involved in protein ubiquitination. A genetic variant upstream of LITAF (lipopolysaccharide-induced tumor necrosis factor) gene prompted us to determine its role in modulating cardiac excitation. Methods: Optical mapping was performed in zebrafish hearts to determine Ca2+ transients. Live-cell confocal calcium imaging was performed on adult rabbit cardiomyocytes to determine intracellular Ca2+handling. L-type calcium channel (LTCC) current (I Ca,L) was measured using whole-cell recording. To study the effect of LITAF on Cav1.2 (L-type voltage-gated calcium channel 1.2) channel expression, surface biotinylation, and Westerns were performed. LITAF interactions were studied using coimmunoprecipitation and in situ proximity ligation assay. Results: LITAF knockdown in zebrafish resulted in a robust increase in calcium transients. Overexpressed LITAF in 3-week-old rabbit cardiomyocytes resulted in a decrease in I Ca,L and Cavα1c abundance, whereas LITAF knockdown increased I Ca,L and Cavα1c protein. LITAF-overexpressing decreases calcium transients in adult rabbit cardiomyocytes, which was associated with lower Cavα1c levels. In tsA201 cells, overexpressed LITAF downregulated total and surface pools of Cavα1c via increased Cavα1c ubiquitination and its subsequent lysosomal degradation. We observed colocalization between LITAF and LTCC in tsA201 and cardiomyocytes. In tsA201, NEDD (neural precursor cell expressed developmentally downregulated protein) 4-1, but not its catalytically inactive form NEDD4-1-C867A, increased Cavα1c ubiquitination. Cavα1c ubiquitination was further increased by coexpressed LITAF and NEDD4-1 but not NEDD4-1-C867A. NEDD4-1 knockdown abolished the negative effect of LITAF on I Ca,L and Cavα1c levels in 3-week-old rabbit cardiomyocytes. Computer simulations demonstrated that a decrease of I Ca,L current associated with LITAF overexpression simultaneously shortened action potential duration and decreased calcium transients in rabbit cardiomyocytes. Conclusions: LITAF acts as an adaptor protein promoting NEDD4-1–mediated ubiquitination and subsequent degradation of LTCC, thereby controlling LTCC membrane levels and function and thus cardiac excitation. [ABSTRACT FROM AUTHOR]