Search

This study aimed to investigate the association between training load indices and Upper Respiratory Tract Infection (URTI) across different lag periods in elite soccer players. Internal training load was collected from 15 elite soccer players over one full season (40 weeks). Acute, chronic, Acute:Chronic Workload Ratio (ACWR), Exponentially Weighted Moving Averages (EWMA) ACWR, 2, 3 and 4-week cumulative load, training strain and training monotony were calculated on a rolling weekly basis. Players completed a daily illness log, documenting any signs and symptoms, to help determine an URTI. Multilevel logistic regression was used to analyze the associations between training load indices and URTIs across different lag periods (1 to 7-days). The results found a significant association between 2-week cumulative load and an increased likelihood of a player contracting an URTI 3 days later (Odds Ratio, 95% Confidence Interval: OR = 2.07, 95% CI = 0.026-1.431). Additionally, a significant association was found between 3-week cumulative load and a players’ increased risk of contracting an URTI 4 days later (OR = 1.66, 95% CI = 0.013–1.006). These results indicate that accumulated periods of high training load (2- and 3-week) associated with an increased risk of a player contracting an URTI, which may lead to performance decrements, missed training sessions or even competitions.

Speed agility is considered as the whole assessment of speed of movement, agility and coordination. The 10x4m test has been broadly used to evaluate physical fitness and overall health in children ...

The purpose of the current article was to use allometric models to identify the best body size descriptors and other anthropometric variables, body composition, and offset maturity that might be associated with the youngsters' 50m personal-best (PB) swim speeds (m·s

PURPOSE Recently, doubts have been raised concerning the validity of the 20-m shuttle run test (20mSRT) to predict cardiorespiratory fitness (CRF) in youth. Despite these doubts, authors continue to provide powerful evidence that CRF can be predicted reliably using the 20mSRT albeit using contrasting models. Therefore, we aimed to compare a new linear model with an alternative allometric model to predict CRF (peak oxygen uptake, V˙O2peak) using the 20mSRT. METHODS The study included 148 adolescents (43% girls) age 13.37 ± 1.84 yr. Adolescents were randomly assigned to validation (n = 91) and cross-validation (n = 57) groups. V˙O2peak was measured using a gas analyzer in both maximal exercise tests in the laboratory and the 20mSRT. Multiple linear regression methods were applied to develop the linear models using the 20mSRT (laps), body mass index, and body fat percentage. Alternative allometric models were also proposed/fitted using the 20mSRT (laps), height, and body mass. RESULTS The criterion validity values of both the linear and the allomeric models were found to be acceptable, with R2 = 82.5% and 82.7% respectively, providing reassuring evidence that the 20mSRT can be used with confidence to predict CRF. However, the allometric model identified a height-to-mass ratio, not dissimilar to the inverse body mass index (known to be a measure of leanness), to be associated with CRF. The allometric model also revealed that the rise in energy cost (V˙O2peak) with increasing laps was exponential. This will more accurately reflect the nonlinear rise in energy demand of shuttle running as the test progresses to exhaustion. CONCLUSIONS These observations provided powerful evidence that allometric models are more than satisfactory in terms of both criterion and construct validity when predicting CRF (V˙O2peak) using the 20mSRT.

Purpose: Overweight individuals are at risk of intermediate hyperglycemia (IHG) [1]. Increasing physical activity (PA) in IHG is one method to reduce the risk of glucometabolic and cardiovascular (CV) complications [2]. This study investigates walking to music as a modality to increase moderate intensity PA and regulate glucometabolic disturbances. Patients and Methods: Participants were randomized to usual care (UC) or intervention group (IG) who completed a 6 month walking to music program. Physiological assessments for a range of variables (DEXA, flow mediated dilatation (FMD) and glucometabolic biomarkers) were completed at baseline, 4, 6 and 9 months (follow-up). Results: For IG group, walking compliance decreased with time however 71.4%, 79.5% and 73% of walking completed was moderate intensity at 4, 6 and 9 months. At 6 months IG FMD was significantly lower than UC and HbA1Cwas 5% lower. Other physiological markers were not altered. Conclusion: Walking to music may be a novel method to encourage moderate intensity PA. However, the majority of results demonstrate that this intervention was not more effective than UC in managing glucometabolic and CV biomarkers in IHG. Future interventions should include additional support for the entire study duration however this has cost implications.

OBJECTIVES Our goal was to investigate the efficacy of balanced forced diuresis in reducing the rate of acute kidney injury (AKI) in cardiac surgical patients requiring cardiopulmonary bypass (CPB), using the RenalGuard® (RG) system. METHODS Patients at risk of developing AKI (history of diabetes and/or anaemia; estimated glomerular filtration rate 20–60 ml/min/1.73 m2; anticipated CPB time >120 min; log EuroSCORE > 5) were randomized to the RG system group (n = 110) or managed according to current practice (control = 110). The primary end point was the development of AKI within the first 3 postoperative days as defined by the RIFLE (Risk, Injury, Failure, Loss of kidney function, End-stage renal disease) criteria. RESULTS There were no significant differences in preoperative and intraoperative characteristics between the 2 groups. Postoperative AKI rates were significantly lower in the RG system group compared to the control group [10% (11/110) vs 20.9% (23/110); P = 0.025]. This effect persisted even after controlling for a number of potential confounders (odds ratio 2.82, 95% confidence interval 1.20–6.60; P = 0.017) when assessed by binary logistic regression analysis. The mean volumes of urine produced during surgery and within the first 24 h postoperatively were significantly higher in the RG system group (P, Acute kidney injury (AKI) after cardiac surgery is well documented [1].

Previous research into the association between aerobic fitness and physical activity in children is equivocal. However, previous research has always assumed that such an association was linear. Thi...

This study identified key somatic and demographic characteristics that benefit all swimmers and, at the same time, identified further characteristics that benefit only specific swimming strokes. Three hundred sixty-three competitive-level swimmers (male [n = 202]; female [n = 161]) participated in the study. We adopted a multiplicative, allometric regression model to identify the key characteristics associated with 100 m swimming speeds (controlling for age). The model was refined using backward elimination. Characteristics that benefited some but not all strokes were identified by introducing stroke-by-predictor variable interactions. The regression analysis revealed 7 "common" characteristics that benefited all swimmers suggesting that all swimmers benefit from having less body fat, broad shoulders and hips, a greater arm span (but shorter lower arms) and greater forearm girths with smaller relaxed arm girths. The 4 stroke-specific characteristics reveal that backstroke swimmers benefit from longer backs, a finding that can be likened to boats with longer hulls also travel faster through the water. Other stroke-by-predictor variable interactions (taken together) identified that butterfly swimmers are characterized by greater muscularity in the lower legs. These results highlight the importance of considering somatic and demographic characteristics of young swimmers for talent identification purposes (i.e., to ensure that swimmers realize their most appropriate strokes).

Tiernan, C, Lyons, M, Comyns, T, Nevill, AM, and Warrington, G. Salivary IgA as a predictor of upper respiratory tract infections and relationship to training load in elite rugby union players. J Strength Cond Res 34(3): 782-790, 2020-Upper Respiratory Tract Infections (URTI) are among the most common illnesses reported in athletes. An URTI can result in missed training days, which in turn may lead to performance decrements. The purpose of this study was to investigate the use of salivary immunoglobulin A (sIgA) as a predictor of URTI, while also exploring the relationship to weekly training load in elite rugby union players. Nineteen male elite rugby union players provided morning saliva swabs, biweekly (Monday and Friday), over a 10-week training period. Participants completed an illness log documenting symptoms of URTI. Session Rate of Perceived Exertion (sRPE) was collected to determine training load (sRPE × session duration). Weekly training load was also calculated. Logistic regression was used to analyze the relationship between incidences of URTI with sIgA and training load. Multilevel regression was conducted to compare associations between sIgA and training load. The results found that the likelihood of suffering from an URTI increased when sIgA significantly decreased (p = 0.046). Where sIgA decreased by 65% or more, a player was at a greater risk of contracting an URTI within the following 2 weeks. No association was found between sIgA and training load. In conclusion, sIgA may be a useful predictor for determining the likelihood of players contracting an URTI. This will allow the coach to make informed decisions on training status, helping reduce the risk of players missing training, which may have performance decrements. Coaches will benefit from the fast, easy, and instant results available, to analyze a player's immune function.

Understanding the factors that influence player retention within elite youth football can be used to enhance current practices. This study investigated an English Category 1 academy to determine if...

Background This study sought to explore the dose–response rate/association between aerobic fitness (VO2max) and self-reported physical activity (PA) and to assess whether this association varies by sex, age, and weight status. Methods VO2max was assessed using the 20-m shuttle-run test. PA was assessed using the Physical Activity Questionnaire (PAQ) for Adolescents (aged >11 years, PAQ-A) or for Children (aged ≤11 years, PAQ-C). The associations between VO2max and PAQ were analyzed using analysis of covariance (ANCOVA), adopting PAQ and PAQ2 as covariates but allowing the intercepts and slope parameters of PAQ and PAQ2 to vary with the categorical variables sex, age group, and weight status. Results ANCOVA identified a curvilinear association between VO2max and PAQ, with positive linear PAQ terms that varied for both sex and weight status but with a negative PAQ2 term of −0.39 (95% confidence interval (CI): –0.57 to –0.21) that was common for all groups in regard to age, sex, and weight status. These curvilinear (inverted U) associations suggest that the benefits of increasing PA (same dose) on VO2max is greater when children report lower levels of PA compared to children who report higher levels of PA. These dose–response rates were also steeper for boys and were steeper for lean children compared to overweight/obese children. Conclusion Health practitioners should be aware that encouraging greater PA (same dose) in inactive and underweight children will result in greater gains in VO2max (response) compared with their active and overweight/obese counterparts.

Literature lacks evidence about the physiological recovery of tennis players between points. This study aimed to: (i) verify the heart rate (HR) and oxygen uptake (V̇O2) recovery variance in young tennis players from the end of a tennis drill until the 25-s mark and onwards (65-s limit), performed at several intensities, and (ii) test the curve fitting that better characterizes the players’ HR and V̇O2 recovery, from the end of the drill until the 65-s mark. The sample was composed of 13 male tennis players (age: 16.80 ± 1.61 years) recruited from a National Tennis Association. Players were instructed to perform a drill test (“two-line drill wide mode”) based on an intensity increment protocol. Three levels of intensity were used based on the reserve HR and V̇O2. A significance level effect was observed on the HRreserve and V̇O2reserve (P

Tiernan, C, Lyons, M, Comyns, T, Nevill, AM, and Warrington, G. The relationship between adductor squeeze strength, subjective markers of recovery and training load in elite Rugby players. J Strength Cond Res 33(11): 2926-2931, 2019-The adductor squeeze strength test has become a popular training monitoring marker, particularly in team sports. The aim of this study was to investigate the relationship between adductor squeeze strength scores, subjective markers of recovery and training load in elite Rugby Union players, because of limited research in this area. Nineteen elite male Rugby Union players completed daily monitoring markers (adductor squeeze strength and 5 selected subjective markers of recovery), over a 10-week preseason training period. Rate of perceived exertion (RPE) was collected to determine training load (session RPE; RPE × session duration) and to calculate weekly training load. Spearman's correlation was used to analyze the relationship between adductor squeeze strength scores, subjective markers of recovery, and weekly training load. The results found that where adductor squeeze scores decreased, both perceived fatigue levels (r = -0.335; R = 11.2%; p < 0.001) and muscle soreness (r = -0.277; R = 7.7%; p < 0.001) increased. A weak correlation was found between Monday adductor squeeze strength scores and the previous week's training load (r = -0.235; R = 5.5%; p < 0.001) and Friday adductor squeeze strength scores and the same week's training load (r = -0.211; R = 4.5%; p < 0.05). These results show that adductor squeeze strength may provide coaches with a time-efficient, low-cost objective, player monitoring marker. Additionally, the combination of adductor strength squeeze, with subjective markers, perceived fatigue, and muscle soreness, and appropriately planned training load may help coaches to optimize training adaptations by determining a player's training status.

Handgrip strength (HGS) is an important indicator of health. Because HGS is strongly associated with body size, most investigators normalize HGS for some measure of body size as a more sensitive indicator of strength within a population. We aimed to 1) identify the optimal body size dimension to remove (normalize) HGS for differences in body size among adults and 2) generate norm-referenced centiles for HGS using the identified body size dimension.Data were from the National Health and Nutrition Examination Survey, a representative sample of the US noninstitutionalized civilian population. Exclusions resulted in a final sample of 8690 adults 20 yr and older. HGS was measured using handheld dynamometry. Body size dimensions included body mass, height, and waist circumference. The most appropriate dimension(s) associated with HGS is identified using allometry. We fitted centile curves for normalized HGS using the generalized additive model for location, scale, and shape.Findings suggest that neither body mass nor body mass index is appropriate to normalize HGS. Incorporating all three body size dimensions of body mass, height, and waist circumference, or the reduced subsets of body mass and height, or height alone, suggests that the most appropriate normalizing (body size) dimension associated with HGS should be a cross-sectional or surface area measure of an individual's body size (i.e., L2, where L is a linear dimension of body size). Given that height was also identified as the signally best body size dimension associated with HGS, we recommend HGS be normalized by height2 (i.e., HGS/HT2). Centile curves for HGS/HT2 by age group and gender were therefore provided.Scaling adult HGS by height2 may help normalize strength for population-based research.

We read the article by Menezes-Junior et al. (2020) entitled “Validation of equations to estimate the peak oxygen uptake in adolescents from 20 metres shuttle run test” by Menezes-Junior et al. (20...

This study investigated if music tempo can prompt a desired walking cadence, and if music can provide a stimulus to regulate physical activity intensity in a longitudinal physical activity intervention with free-living adults. Overweight adults (n = 37, 94.26 ± 17.11 kg, 49.63 ± 12.37 years) were randomly assigned to an intervention (IG, n = 17) or usual care group (UC, n = 20) as part of a novel nine-month walking intervention. IG participants walked to self-selected music with a predetermined tempo and received a behavioural change support programme. At baseline, four-, six- and nine-months participants were asked to walk around an elliptical track at their habitual pace (0–2 min) and then in time to a predetermined tempo (2–8 min) designed to elicit moderate intensity. Cadence response (steps/min) was assessed and intensity (heart rate (bpm) recorded using wireless telemetry. A repeated measures general linear model (GLM) examined differences between groups over time (p &lt, 0.05). All data is presented as means ± SD. At each assessment point both groups displayed an immediate cadence adjustment in response to music tempo (p &lt, 0.01) i.e., habitual cadence vs. 3 METs target cadence (p &lt, 0.05) and 3 METs target cadence vs. 5 METs target cadence (p &lt, 0.05). Additionally, IG participants displayed an increased habitual cadence (0–2 min) at each assessment point (p &lt, 0.05, 110 ± 9, 121.80 ± 7.5, 121.46 ± 10, 121.93 ± 7 steps/min respectively). UC participant’s habitual cadence was unchanged from 0–9 months (p &gt, 120 ± 10, 116 ± 13, 119 ± 12 and 119 ± 9 steps/min respectively). Music tempo may be a useful regulatory tool to prompt the free-living individual to reach an appropriate stride rate to achieve a walking pace that is at least moderate intensity. It also appears that results may be trainable as throughout the study an increased habitual walking cadence was observed, in the absence of music.

Body mass index (BMI) is thought to reflect excess adiposity in both youth and adults alike. However, the association between BMI and fatness varies, especially as children grow into adults. Thus, the present study sought to address this issue by characterizing how BMI reflects age and sex differences in body fatness in 7–16-year-old children. Methods: This cross-sectional study was conducted with 2150 children and adolescents, aged 7 to 16 years from the city of Santa Cruz do Sul, Brazil. BMI (kg/m2), and percentage body fat, using tricipital and subscapular folds, were assessed. For statistical analysis, ANOVA and ANCOVA were used. Results: When considered in isolation, there was no significant interaction in the age-by-sex differences in BMI (p = 0.69). However, when we controlled for percent body fatness, the analysis revealed considerable age-by-sex differences in BMI (p < 0.001). Conclusion: For the same body fat (%), there are no differences in BMI in children

Dance injury research has mainly focused on ballet and modern dance with little data on musical theatre dancers. The purpose was to assess the incidence and severity of injuries in a musical theatre dance college over a 5-year period; 198 pre-professional musical theatre dancers (3 cohorts on a 3-year training course) volunteered for the study; 21 students left the course over the study period. Injury aetiology data were collected by an in-house physiotherapy team. Differences between academic year and sex were analysed using a Poisson distribution model; significant difference was set at p≤0.05. In total, 913 injuries were recorded, and more injuries occurred in academic year 1 than year 2 and 3. Overall injury incidence was 1.46 injuries per 1000 hours (95% CI 1.34, 1.56); incidence significantly decreased between year 1, 2 and 3 (p0.05). There was no significant sex difference for incidence or severity. Most injuries were classified as overuse (71% female, 67% male). Pre-professional musical theatre dancers report a high proportion of lower limb and overuse injuries comparable to other dance genres. Unlike other studies on pre-professional dancers, injury incidence and severity decreased with academic year, even though workload increased across the course.Dance injury research has mainly focused on ballet and modern dance with little data on musical theatre dancers. The purpose was to assess the incidence and severity of injuries in a musical theatre dance college over a 5-year period; 198 pre-professional musical theatre dancers (3 cohorts on a 3-year training course) volunteered for the study; 21 students left the course over the study period. Injury aetiology data were collected by an in-house physiotherapy team. Differences between academic year and sex were analysed using a Poisson distribution model; significant difference was set at p≤0.05. In total, 913 injuries were recorded, and more injuries occurred in academic year 1 than year 2 and 3. Overall injury incidence was 1.46 injuries per 1000 hours (95% CI 1.34, 1.56); incidence significantly decreased between year 1, 2 and 3 (p0.05). There was no significant sex difference for incidence or severity. Most injuries were classified as overuse (71% female, 67% male). Pre-professional musical theatre dancers report a high proportion of lower limb and overuse injuries comparable to other dance genres. Unlike other studies on pre-professional dancers, injury incidence and severity decreased with academic year, even though workload increased across the course.

Forced-diuresis during cardiopulmonary bypass (CPB) can be associated with significant electrolyte shifts. This study reports on the serum electrolyte changes during balanced forced-diuresis with the RenalGuard® system (RG) during CPB.Patients at risk of acute kidney injury (AKI)-(history of diabetes/or anaemia, e-GFR 20-60 ml/min/1.73 mThe use of RG reduced AKI rate (10% for RG and 20.9% in control, p = .03). Mean urine output was significantly higher in the RG group during surgery (2366 ± 877 ml vs. 765 ± 549 ml, p .001). The serum potassium levels were maintained between 3.96 and 4.97 mmol/L for the RG group and 4.02 and 5.23 mmol/L for the controls. Median potassium supplemental dose was 60 (0-220) mmol (RG group) as compared to 30 (0-190) mmol for control group over first 24 h (p .001). On Day 1 post-op, there were no significant differences in the serum sodium, potassium, calcium, magnesium, phosphate, and chloride levels between the two groups. Otherwise, postoperative clinical recovery was also similar.Balanced forced-diuresis with the RG reduced AKI rates after on-pump cardiac surgery compared to controls. Although the RG group required higher doses of IV potassium replacement in the postoperative period, normal serum levels of potassium were maintained by appropriate intravenous potassium supplementation and the clinical outcomes between groups were similar.

The majority of papers submitted to the Journal of Sports Sciences are experimental. The data are collected from a sample of the population and then used to test hypotheses and/or make inferences a...

A professional English football club with Category 1 academy status was investigated to determine the magnitude of relative age effects (RAE) within the club and explore between-quartile differences for somatic maturity, anthropometry and physical performances. Birth dates of 426 players from Under 9 to First Team were categorised into four birth quartiles (Q) and examined for relative age effects. Additionally, data on 382 players (Under 11 to First Team) were obtained for somatic maturity, anthropometry, countermovement jump, sprint (10 and 30 m), agility T-test and Yo-Yo Intermittent Recovery Level 1 or 2 performance to determine between-quartile differences. Odds ratios revealed Q1 players were 6.0 times more likely to be represented than Q4 players. Multilevel modelling demonstrated between birth quartile similarities for each variable across all age groups, though there was a tendency for Q4 players to outperform Q1 players between Under 11 and Under 18 groups. Strong relative age effects exist within this club as well as a tendency to select players demonstrating advanced growth and/or maturity, with some indication that higher categorised academies in England may be at risk of amplified selection biases. Talent identification strategies in elite youth football should actively seek to adopt novel approaches to reduce selection biases and avoid wasted potential.

Unlike most neighbouring countries in the world, teachers in the occupied territories of Palestine face extraordinary conditions and challenges. These are due to the continued Israeli occupation. This article reports on a large-scale survey of Palestinian teachers. It explores the impact of the occupation on the professional lives of the teachers around Nablus, and indirectly on their students and communities, and on their digital responses. Follow-up focus groups explore their feelings, experiences and reactions, providing greater insights into this complex and troubling situation. The article underpins further work on appropriate digital literacy. It does however also provide an insight into the challenges to rigorous fieldwork outside the mainstream of the developed North and specifically in a region of conflict and occupation.

Intermittent exercise might be an efficient means of exercise for improving bone strength and quality. The aim of our study was to examine the effect of intermittent running on bone turnover markers using altered exercise-to-rest intervals. Twelve males completed one control (no exercise), and three, 45-min intermittent protocols (5, 20, and 80 s intervals) matched for distance and speed. Fasted venous blood samples were collected at baseline, 1, 2 and 24 h post-exercise. Carboxyterminal crosslinked telopeptide (CTX-I) and procollagen type 1 amino-terminal propeptide (P1NP) were used as markers of bone resorption and formation. After adjustment for baseline, CTX-I concentration at 1 h was higher (very likely to most likely small) for 5 s (30.2%; ±90% confidence limits: 10%), 20 s (2.9.0%; ±10%) and 80 s (32.0%; ±10%) compared to control. The very likely small effect remained for 5 s at 2 h (30.2%; ±15%). The effect for 20 and 80 s was possibly trivial and possibly small/possibly trivial (∼14.5%; ±∼15%). Differences in P1NP concentrations were likely to very likely trivial (∼7.4%; ±∼7.6%). Circulating CTX-I concentration is affected acutely by intermittent running with short-interval (5 s) intermittent loading resulting in a prolonged attenuation in circadian rhythm of CTX-I up to 2 h that was not demonstrated as clearly by longer intervals despite matched internal and external training load.

The identification and development of talent is an essential component of modern professional football. The recognition of key physical characteristics of such footballers who successfully progress through talent development programs is of considerable interest to academics and those working in professional football. Using Football Yearbooks, we obtained the height, body mass and ages of all players from the English top-division over the seasons 1973–4, 1983–4, 1993–4, 2003–4 and 2013–4, calculating body-mass index (BMI) (kg/m2) and reciprocal ponderal index (RPI) (cm/kg0.333). The mean squad size increased over these decades from n = 22.4 (1973–4) to n = 27.8 (2013–4). Height also increased linearly by approximately 1.2 cm per decade. Body mass increased in the first four decades, but declined in the final season (2013–4). Regression analysis confirmed inverted “u” shape trends in both body mass and BMI, but a “J” shape trend in RPI, indicating that English top-division professional footballers are getting more angular and ectomorphic. We speculate that this recent decline in BMI and rise in RPI is due to improved quality of pitches and increased work-load required by modern-day players. Defenders were also found to be significantly taller, heavier, older and, assuming BMI is positively associated with lean mass, more muscular than other midfielders or attackers. The only characteristic that consistently differentiated successful with less successful players/teams was age (being younger). Therefore, English professional clubs might be advised to attract young, less muscular, more angular/ectomorphic players as part of their talent identification and development programs to improve their chances of success.

Introduction Socioeconomic and ethnic status have in the past been implicated as possible causes of dental caries. Aims To assess the role that relative social depravation and ethnicity has on dental caries in two- and three-year-olds undergoing DGA in Wolverhampton. Design and methods Retrospective analysis of hospital records of 213 patients over a six-year period (2011-2016). A three-way analysis of variance (ANOVA) and chi-square tests were used to test statistical significance. Results The most significant factor between ethnicity, year and sex, was ethnicity (P = 0.026), with the greatest difference between mean number of teeth extracted per treatment visit for Other Whites (mean = 6.3) compared with White British (mean = 4.0) (difference P = 0.012). The association between the difference in extracted quadrant and year of treatment was significant (P = 0.011), with the greatest frequency of extractions involving three and four quadrants in the later years of 2015 and 2016. Seventy percent of children treated were living in the 20% most deprived areas (deciles one and two) compared with children living in more affluent areas (deciles three to ten) (P

The purpose of the study was to identify the optimal body shape and composition associated with physical fitness levels of children living in urban and rural areas of Italy. A total of 7102 children (11–14 years) were assessed for weight, height, percentage body fat (FM%), sit-and-reach flexibility (SAR), standing broad jump (SBJ) and sit-ups (SUP). A multiplicative allometric model, Y = a · massk1 · heightk2 ·e, was used to predict the physical outcome variables Y = SBJ and SUP. The model was expanded to incorporate FM% and SAR as follows Y = a · massk1 · heightk2 · FM%k3 · exp(b· FM% + c· SAR) ·e. Note that FM% was incorporated as a “gamma function” that allows an initial growth, and subsequent decline in Y as FM% increases in size. Although having an ectomorph body shape appears advantageous, being too thin appears detrimental to the strength outcomes. Being flexible would also benefit physical fitness levels. Finally, our results indicate that ursban children aged 11–14 have superior strength ...

Background: Athletes maintain a balance between stress and recovery and adopt recovery modalities that manage fatigue and enhance recovery and performance. Optimal TST is subject to individual variance. However, 7–9 h sleep is recommended for adults, while elite athletes may require more quality sleep than non-athletes. Methods: A total of 338 (elite n = 115, 74 males and 41 females, aged 23.44 ± 4.91 years, and sub-elite n = 223, 129 males and 94 females aged 25.71 ± 6.27) athletes were recruited from a variety of team and individual sports to complete a battery of previously validated and reliable widely used questionnaires assessing sleep, recovery and nutritional practices. Results: Poor sleep was reported by both the elite and sub-elite athlete groups (i.e., global PSQI score ≥5—elite 64% [n = 74], sub-elite 65% [n = 146]) and there was a significant difference in sport-specific recovery practices (3.22 ± 0.90 vs. 2.91 ± 0.90, p &lt, 0.001). Relatively high levels of fatigue (2.52 ± 1.32), stress (1.7 ± 1.31) and pain (50%, n = 169) were reported in both groups. A range of supplements were used regularly by athletes in both groups, indeed, whey (elite n = 22 and sub-elite n = 48) was the most commonly used recovery supplement in both groups. Higher alcohol consumption was observed in the sub-elite athletes (12%, n = 26) and they tended to consume more units of alcohol per drinking bout. Conclusion: There is a need for athletes to receive individualised support and education regarding their sleep and recovery practices.

Background Neutrophil gelatinase-associated lipocalin (NGAL) is a recognised biomarker for acute kidney injury (AKI).This study investigated the impact of balanced forced-diuresis using RenalGuard® system (RG), in reducing acute kidney injury (AKI) rates and the associated NGAL levels (6-h post-CPB plasma level) post adult cardiac surgery with cardiopulmonary bypass (CPB). Methods Patients included in the study were at high-risk for AKI post cardiac surgery, namely history of diabetes and/or anaemia, e-GFR 20–60 ml/min/1.73 m2, Logistic EuroScore > 5, anticipated CPB time > 120 min. Patients were randomized to either RG (n = 110) or managed as per current practice (control = 110). RIFLE-defined AKI rate (based on serum creatinine level increase) within first 3 days of surgery and 6-h post CPB NGAL levels were the primary and secondary end-points. Results Pre and intra-operative characteristics between the two groups were similar (p > 0.05) including the pre-op NGAL levels, the oxygen delivery (ecDO2i) and the carbon dioxide production (ecVCO2i) during CPB. Patients in the RG group had a significantly lower post-operative RIFLE-defined AKI rate compared to control (10% (11/110) v/s 20.9% (23/110), p = 0.03). Overall, median 6-h post CPB NGAL levels in patients with AKI were significantly higher than those who did not develop AKI (211 vs 150 ng/ml, p Conclusions Overall, the 6-h post-CPB plasma NGAL levels were significantly higher in patients who developed AKI. Patients managed with the novel approach of balanced forced-diuresis, provided by the RenalGuard® system, had a lower AKI rate and lower NGAL levels indicating a lesser degree of renal tissue injury. Trial registration ClinicalTrials.gov website, NCT02974946, https://clinicaltrials.gov/ct2/show/NCT02974946.

Identifying vulnerable groups and/or individuals’ cardiorespiratory fitness (CRF) is an important challenge for clinicians/researchers alike. To quantify CRF accurately, the assessment of several variables is now standard practice including maximal oxygen uptake (VʹCO2) and ventilatory efficiency, the latter assessed using the minute ventilation/carbon dioxide production (VʹE/VʹCO2) slope. Recently, reference values (centiles) for VʹE/VʹCO2 slopes for males and females aged 20 to 80 have been published, using cardiopulmonary exercise testing (CPX) data (treadmill protocol) from the Fitness Registry and the Importance of Exercise National Database (FRIEND Registry). In the current observational study we provide centile curves for the FRIEND Registry VʹE/VʹCO2 slopes, fitted using the generalised additive model for location, scale and shape (GAMLSS), to provide individuals with a more precise estimate of where their VʹE/VʹCO2 slopes fall within the population. We also confirm that by adopting allometric models (incorporating a log transformation), the resulting ANCOVAs provided more normal and homoscedastic residuals, with superior goodness-of-fit using the Akaike information criterion (AIC)=14 671 (compared with traditional ANCOVA's AIC=15 008) that confirms allometric models are vastly superior to traditional ANCOVA models. In conclusion, providing sex-by-age centile curves rather than referring to reference tables for ventilatory efficiency (VʹE/VʹCO2 slopes) will provide more accurate estimates of where an individual's particular VʹE/VʹCO2 slope falls within the population. Also, by adopting allometric models researchers are more likely to identify real and valid inferences when analysing population/group differences in VʹE/VʹCO2 slopes., This article provides centile curves of VʹE/VʹCO2 slopes and demonstrates that by adopting log-linear models, more trustworthy inferences with group differences will also be found https://bit.ly/3uitACS

ObjectivesThe objective of this study was to describe variations in COVID-19 outcomes in relation to local risks within a well-defined but diverse single-city area.DesignObservational study of COVID-19 outcomes using quality-assured integrated data from a single UK hospital contextualised to its feeder population and associated factors (comorbidities, ethnicity, age, deprivation).Setting/participantsSingle-city hospital with a feeder population of 228 632 adults in Wolverhampton.Main outcome measuresHospital admissions (defined as COVID-19 admissions (CA) or non-COVID-19 admissions (NCA)) and mortality (defined as COVID-19 deaths or non-COVID-19 deaths).ResultsOf the 5558 patients admitted, 686 died (556 in hospital); 930 were CA, of which 270 were hospital COVID-19 deaths, 47 non-COVID-19 deaths and 36 deaths after discharge; of the 4628 NCA, there were 239 in-hospital deaths (2 COVID-19) and 94 deaths after discharge. Of the 223 074 adults not admitted, 407 died. Age, gender, multimorbidity and black ethnicity (OR 2.1 (95% CI 1.5 to 3.2), pConclusionsWolverhampton’s results, reflecting high ethnic diversity and deprivation, are similar to other studies of black ethnicity, age and comorbidity risk in COVID-19 but strikingly different in South Asians and for deprivation. Sequentially considering population and then hospital-based NCA and CA outcomes, we present a complete single health economy picture. Risk factors may differ within ethnic groups; our data may be more representative of communities with high Black, Asian and minority ethnic populations, highlighting the need for locally focused public health strategies. We emphasise the need for a more comprehensible and nuanced conveyance of risk.

This is an accepted manuscript of an article published by Springer in Sports Medicine on 20/05/2021, available online: https://doi.org/10.1007/s40279-021-01464-3 The accepted version of the publication may differ from the final published version.

Information regarding urban-rural differences in health indicators are scarce in Brazil. This study sought to identify rural-urban differences in cardiorespiratory fitness (CRF) and cardiometabolic risk (CMR) in Brazilian children and adolescents whilst controlling for the important confounding variables including social economic status (SES). This is a cross-sectional study developed with children and adolescents (n = 2250, age 11.54 ± 2.76) selected from a city in the south of Brazil. CRF was estimated using a 6-minute run/walk test. CMR scores were calculated by summing different cardiometabolic risk indicators. CRF was analysed assuming a multiplicative model with allometric body-size components. CMR differences in residential locations was assessed using Analysis of caovariance (ANCOVA) adopting SES, Body Mass Index (BMI), waist circumference (WC), age and fitness as covariates. Results indicated a main effect of location (p &lt, 0.001) with children living a rural environment having the highest CRF, and children living in the periphery of towns having the lowest. Analysis also revealed significant main effects of location (p &lt, 0.001) with children living a rural environment having the lowest CMR and children living in the centre of towns having the highest. Therefore, Brazilian children living in a rural environment appear to have superior health benefits.

Tiernan, C, Comyns, T, Lyons, M, Nevill, AM, and Warrington, G. The association between training load indices and injuries in elite soccer players. J Strength Cond Res 36(11): 3143-3150, 2022-To investigate the association between contact injuries, noncontact injuries, and training load indices, across different lag periods in elite soccer players. Internal load (session rate of perceived exertion) was collected from 15 elite soccer players over 1 season (40-weeks). Acute (7 days), chronic (28 days), acute:chronic workload ratio (ACWR) (uncoupled), exponentially weighted moving averages (EWMA) ACWR, and 2-, 3-, and 4-week cumulative load were calculated on a rolling weekly basis. Multilevel logistic regression was used to analyze the associations between contact, noncontact injuries, and training load indices, across different lag periods (5 and 7 days). A player was at a significantly higher risk of a noncontact injury 5 days later, if week-to-week acute load changes increased (odds ratio [OR] = 1.97). An increase in EWMA ACWR was associated with an increased risk of both a contact (OR = 1.30) and noncontact injury (OR = 1.35), 5 days later. An increase in 2-week cumulative load (OR = 1.77) was associated with an increased risk of a contact injury 7 days later and 3-week cumulative load (OR = 1.55) 5 days later. These findings suggest that to reduce the potential risk of a noncontact injury, training load should be gradually increased, avoiding an increase in week-to-week acute load change (≥9%) or EWMA ACWR (1.20). Findings indicated that EWMA ACWR may be a more sensitive measure for detecting a player at a higher risk of an injury than ACWR. Furthermore, a high 2- and 3-week cumulative load was associated with an increased risk of a contact injury, which may indicate accumulated fatigue. Practitioners must note that this study investigated associations with injury risk and not injury prediction.

ObjectivesTo address the generalisability of COVID-19’s outcomes to the well-defined but diverse communities of a single City area.DesignAn observational study of COVID-19 outcomes using quality-assured and integrated data from a single UK hospital contextualised to its feeder population and its associated factors (comorbidities, ethnicity, age, deprivation).Setting/ParticipantsSingle city hospital with a feeder population of 228,632 adults in Wolverhampton’s city area.Main Outcome MeasuresHospital admissions and mortality.Results5558 patients admitted, 686 died (556 in hospital); 930 were COVID-19 admissions (CA),of which 270 were hospital COVID deaths, 47 non-COVID deaths, 36 deaths post-discharge; 4628 non-COVID-19 admissions (NCA), 239 in-hospital deaths (2 COVID), 94 deaths post-discharge. 223,074 adults not admitted, 407 died. Age, gender, multi-morbidity and Black ethnicity (OR 2.1 [95% CI 1.5-3.2] pConclusionsWolverhampton’s results, reflecting high ethnic diversity and deprivation, are similar to other studies for Black ethnicity, age and comorbidity risk in COVID-19 but strikingly different in South Asians and for deprivation. Sequentially considering population and then hospital based NCA and CA outcomes, we present a complete single health-economy picture. Risk factors may differ within ethnic groups; our data may be more representative of communities with high BAME populations, highlighting the need for locally focussed public health strategies. We emphasise the need for a more comprehensible and nuanced conveyance of risk.Strengths and limitations of this studyThe rapidly developing COVID-19 pandemic has led to numerous studies (published, preprints and national public health reports) of its health impacts in relation to ethnicity, co-morbidities and other factors; few studies, however, have attempted to evaluate infection patient data in terms of morbidity and mortality in context of the feeder population and most are limited by incompleteness of data and inability to account for regional variations in factors such as ethnicity and deprivationOur observational study used a high quality and complete dataset from the local population and the hospital serving it to examine the association of purported risk factors with severity and mortality and the results reveal the importance of evaluating such risks in the local, and not just national, population setting taking into account the local variations in patient backgroundsWe found an increased risk of COVID-19 mortality for Black ethnicity (OR 2.1) but a decreased risk (OR 0.5) for South Asians, compared with white ethnicity; Our analysis reveals that a nuanced approach to studying risk factors associated with COVID-19 severity and mortality is important – factoring in regional variation in ethnicity, deprivation etc. specifically linked to the source populationWe suggest, based on our findings, that understandably rapid analysis and dissemination of studies of COVID-19 risk needs to be tempered by careful consideration of the real implications; we further urge caution in conveying risk messages to the wider community because of an ethical imperative to ensure such messages do not lead to unnecessary fear and deter individuals, particularly from specific ethnic backgrounds, from seeking needed medical assistance.

The present study aims to identify the optimal body-size/shape and maturity characteristics associated with superior fitness test performances having controlled for body-size, sex, and chronological-age differences. The sample consisted of 597 Tunisian children (396 boys and 201 girls) aged 8 to 15 years. Three sprint speeds recorded at 10, 20 and 30 m; two vertical and two horizontal jump tests; a change-of-direction and a handgrip-strength tests, were assessed during physical-education classes. Allometric modelling was used to identify the benefit of being an early or late maturer. Findings showed that being tall and light is the ideal shape to be successful at most physical fitness tests, but the height-to-weight “shape” ratio seems to be test-dependent. Having controlled for body-size/shape, sex, and chronological age, the model identified maturity-offset as an additional predictor. Boys who go earlier/younger through peak-height-velocity (PHV) outperform those who go at a later/older age. However, most of the girls’ physical-fitness tests peaked at the age at PHV and decline thereafter. Girls whose age at PHV was near the middle of the age range would appear to have an advantage compared to early or late maturers. These findings have important implications for talent scouts and coaches wishing to recruit children into their sports/athletic clubs.

Background The aims of this study were to compare anthropometric and fitness variables of high-level beach handball players across Under-19 (U-19), Under-21 (U-21) and senior male categories, and between male and female senior players; and to test the correlations among those measures. Methods A total of 70 high-level players (53 male of different ages) were evaluated for 5-m acceleration, 15-m sprint, horizontal jump, handgrip strength, specific beach handball throwing velocities, and anthropometric variables. Differences between age groups were tested using ANOVA. Independent t-test was used to compare fitness variables between male and female elite athletes, and Pearson partial correlation coefficients were calculated between each of the fitness variables using BMI and age as covariates. SPSS Software was used, and the level of significance was set at 95%. Results The U-21 athletes better performed on horizontal jump and 6-m throw than the U-19 athletes. Senior athletes showed better performance on horizontal jump than U-19 athletes (P≤0.05). Positive correlation was seen for handgrip on dominant and non-dominant hands and 6-m throwing speed, and for handgrip on dominant hand and inflight velocity (P≤0.05). Negative correlations were observed between horizontal jump and 5-m acceleration, and 15-m sprint (P≤0.01 and P≤0.05, respectively). Conclusions Male athletes better performed than women in all the fitness tests. The study, for the first time, showed physical fitness comparisons between beach handball elite male athletes of different ages and between genders. These are key steps for coaches and athletes and may support future beach handball studies and practice.

Background The IBD Benchmarking Tool, comprising an online Service Self-Assessment and Patient Survey, has provided a unique and comprehensive picture of Inflammatory Bowel Disease (IBD) care across the UK. The aim was to evaluate current local service performance to facilitate future quality improvement. Methods The IBD Patient Survey (PS) ran from July to November 2019 and the Service Self-Assessment (SSA) from October 2019 to January 2020. Detailed views were collected of the quality of IBD care from patient and clinician perspectives, measured against the UK IBD Standards 2019.1 The IBD UK National Report will be published in April 2021. Results 10,222 patients completed the PS. 89% (9,100/10,222) had found it hard to cope with having Crohn’s or Colitis over the previous year. 72% (6,954/9,640) rated the quality of their care as excellent, very good or good and 28% (2,686/9,640) rated the quality of their care as fair or poor. The top three factors that predicted how highly people with IBD rated their quality of care were: feeling supported by a team of specialists; having regular reviews; and discussing wider life goals and priorities, as part of planning their care. 26% (535/2,089) had waited more than a year for their diagnosis. 41% (849/2,087) had visited Accident & Emergency at least once before being diagnosed. 32% (656/2,057) were not offered any information about their condition when diagnosed. 91% (8,284/9,099) did not have a personalised care plan. Over the previous 12 months, 70% (6,732/9,574) had one or more flares and 72% (1,622/2,250) of inpatient admissions were unplanned. A key finding from the SSA (166 centres: 134 adult, 32 paediatric) was that no adult IBD services reported meeting the IBD Standards’ recommendation for whole time equivalent (WTE) staffing across the IBD team. Where services reported meeting the WTE for IBD nurse specialists, patients were more likely to rate the quality of their care highly and to have regular clinical review of their Crohn’s or Colitis. Conclusion The results highlight four key areas for change: improvements in diagnosis and information provision; personalised care and support for self-management; faster access to specialist advice and treatment; and effective multidisciplinary team (MDT) working. The Report sets out recommendations for action in each of these areas. To our knowledge, this is the first time that healthcare professionals and patients have assessed care against a common set of standards. The IBD Benchmarking Tool provides location-matched service performance and patient experience as an exemplar for others to follow. Reference

Doubts have been raised concerning the validity of the 20-m shuttle-run test (20 mSRT) as a predictor of cardiorespiratory fitness (CRF) in youth based on Leger’s equation/model. An alternative allometric model has been published recently that is thought to provide, not only a superior fit (criterion validity) but also a more biologically and physiologically interpretable model (construct validity). The purposes of this study were to explore whether allometry can provide a more valid predictor of CRF using 20 mSRT compared with Leger’s equation/model. We fitted and compared Leger’s original model and an alternative allometric model using two cross-sectional datasets (youth, n = 306; adult n = 105) that contained measurements of CRF ( $$\dot{V}{\text{O}}_{{2{\text{peak}}}}$$ / $$\dot{V}{\text{O}}_{{{\text{2max}}}}$$ ) and 20 mSRT performance. Quality-of-fit was assessed using explained variance (R2) and Bland and Altman’s limits of agreement. The allometric models provided superior fits for the youth (explained variance R2 = 71.9%) and adult (R2 = 77.7%) datasets compared with Leger’s equation using their original fixed (R2 = 35.2%) or re-estimated parameter models (R2 = 65.9%), confirming that the allometric models demonstrate acceptable criterion validity. However, the allometric models also identified a non-linear “J-shaped” increase in energy cost ( $$\dot{V}{\text{O}}_{{2{\text{peak}}}}$$ / $$\dot{V}{\text{O}}_{{{\text{2max}}}}$$ ) with faster final shuttle-run speeds (fitted speed exponent = 1.52; 95% CI 1.38–1.65). Not only do allometric models provide more accurate predictions of CRF ( $$\dot{V}{\text{O}}_{{2{\text{peak}}}}$$ / $$\dot{V}{\text{O}}_{{{\text{2max}}}}$$ ; ml kg−1 min−1) for both youth and adults (evidence of criterion validity), the “J-shaped” rise in energy demand with increasing final shuttle-run speed also provides the evidence of construct validity, resulting in a more plausible, physiologically sound, and interpretable model.