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The aim of the study was to evaluate whether the static stabilometric parameters among elite fencers, were affected by prolonged, asymmetric training regimen. A sample of 26 elite fencers of both genders, aged 19.15 ± 2.24 years, practising one of the three disciplines foil, épée, or sabre, was recruited for the study. Anthropometric measurements including thigh and calf circumferences and postural assessment based on the weight distribution on a stabilimeter platform were performed. Postural tone, as indicated by measures such as sway length and sway area ratio was calculated.. No notable anthropometric asymmetries were detected within the examined group The weight distribution patterns on the support quadrants in static stabilometric measurements did not suggest clinically significant issues. There were no significant differences among subgroups based on gender and lower limb dominance for both anthropometric and stabilimeter variables. However, 30.8% of participants showed anomalies in postural tone (hypertonic and hypotonic condition). Five out of eight athletes found with abnormal postural tone were foil fencers, suggesting a potential discipline-specific effect. Individual adjustments were found in foil fencers. These findings provide insights into the potential effects of fencing training on postural parameters among elite athletes.

The rapid evolution of technologies is a key innovation in the organisation and management of physical activities (PA) and sports. The increase in benefits and opportunities related to the adoption of technologies for both the promotion of a healthy lifestyle and the management of chronic diseases is evident. In the field of telehealth, these devices provide personalised recommendations, workout monitoring and injury prevention. The study aimed to provide an overview of the landscape of technology application to PA organised to promote active lifestyles and improve chronic disease management. This review identified specific areas of focus for the selection of articles: the utilisation of mobile APPs and technological devices for enhancing weight loss, improving cardiovascular health, managing diabetes and cancer and preventing osteoporosis and cognitive decline. A multifactorial intervention delivered via mobile APPs, which integrates PA while managing diet or promoting social interaction, is unquestionably more effective than a singular intervention. The main finding related to promoting PA and a healthy lifestyle through app usage is associated with "behaviour change techniques". Even when individuals stop using the APP, they often maintain the structured or suggested lifestyle habits initially provided by the APP. Various concerns regarding the excessive use of APPs need to be addressed.

Strength training elicits benefits both in performance and on a psychological level in women, such as increased muscle strength and improved self-esteem. Whole-body electromyostimulation (WB-EMS) could be a training strategy for enhancing muscular strength. The aim of this study was to assess the acute effects of a single session of WB-EMS superimposed over classic resistance training on isometric strength, endurance strength and flexibility. Furthermore, the safety of the protocol was assessed by monitoring the levels of creatine kinase (CK) 48 h after the training protocol was completed. Sixteen active women (aged 22.06 ± 1.88) were randomly assigned to an experimental group (EG) ( n = 8) and a control group (CG) ( n = 8). The EG performed four sets of 12 repetitions of three strength exercises with superimposed WB-EMS, while the CG performed the same protocol without WB-EMS. RM-ANOVA showed a significant time*group interaction on posterior kinetic chain extensors' mean and peak strength in the EG (F (1,14) = 10.036; p = 0.007; and F (1,14) = 20.719; p < 0.001; respectively). A significant time*group interaction was found in the sit and reach test for the EG (F (1,14) = 10.362; p = 0.006). Finally, ANOVA performed on the CK levels showed no significant difference between the groups (F (1,14) = 0.715; p = 0.412). WB-EMS training led to an immediate improvement in strength performance and flexibility, and this protocol was shown to be safe in terms of CK levels, 48 h after completing the training protocol.

Background: Although physical activity (PA) has been shown to enhance hypertension control, the impact of exercise on the potential decrease of the use of antihypertensive medications remains inadequately researched., Aim: The aim was to assess the impact of a two-year PA on the medication requirements of individuals with hypertension., Methods: A clinical trial was conducted, involving 130 participants with essential hypertension who took at least one antihypertensive medication. Participants were randomly assigned to either a control group (CG n = 65) or an experimental group (EG n = 65) that underwent a 24-month supervised PA program based on a combination of aerobic and resistance training. The antihypertensive drug load for each participant was determined by adding the ratios of the prescribed daily dose (PDD) to the defined daily dose (DDD) for all antihypertensive medications taken by the participants. The outcome measures were evaluated at 0, 6, 12, 18, and 24 months., Results: A total of 76 participants completed the 24-month assessment, and RM-ANOVA revealed a significantly lower antihypertensive drug load in the EG compared to the CG at 18 ( p < 0.017) and 24 months ( p < 0.003)., Conclusion: A long-term PA program can decrease the antihypertensive drug load in older adults with essential hypertension. The trend of improvement regarding the EG drug load intake and the trend of CG drug load increase, although not significant over time, results in a significant difference between the groups at 18 months and an even greater difference at 24 months. This trend certifies the protective value of PA against the aging process and its related health risk factors.

The objective of this systematic review was to examine the effectiveness of flywheel training, which allows for the replication of specific sports movements, overloading both the concentric and eccentric phases. Inclusion criteria were injury prevention outcomes; ability in terms of strength, power, sprinting, jumping and change of direction; competitive athletes; and RCTs. Exclusion criteria were a lack of a control group and lack of baseline and/or follow-up data. The databases used were Web of Science, Scopus, PubMed, Cochrane Library, and Sage. The revised Cochrane risk-of-bias tool was used to assess the quality of the selected RCTs. The Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence was used. A PICOS (participants, intervention, comparators, study outcomes, and study design) approach was used to evaluate eligibility. A total of 21 RCTs with 8 to 54 participants in each study analyzed flywheel technology and its application in nine sports. The results showed that flywheel training is a good strategy to improve sports performance, providing variation in training methodologies and athletes' adherence. Further studies are needed to define guidelines on training modality, weekly frequency, volume, and inertia load. Only a few studies have applied the flywheel device directly to overload specific multidirectional movements at different joint angles. This method is not exempt from criticalities, such as the cost and the ability to carry out only individual training.

Background: Whole-body electromyostimulation (WB-EMS) was never previously applied to Parkinson's disease (PD) patients. This randomized controlled study aimed to find the most effective and safe WB-EMS training protocol for this population., Methods: Twenty-four subjects (age: 72.13 ± 6.20 years), were randomly assigned to three groups: a high-frequency WB-EMS strength training group (HFG) (rectangular stimulation at 85 Hz, 350 μs, 4 s stimulation/4 s rest), a low-frequency WB-EMS aerobic training group (LFG) (rectangular stimulation 7 Hz, 350 μs, with a continuous pulse duration), and an inactive control group (CG). Participants of the two experimental groups underwent 24 controlled WB-EMS training sessions, with a duration of 20 min each, during 12-week intervention. Serum growth factors (BDNF, FGF-21, NGF and proNGF), α-synuclein, physical performance and Parkinson's Disease Fatigue Scale (PFS-16) responses were analyzed to evaluate the pre-post variation and differences among groups., Results: Significant interactions of Time*Groups were detected for BDNF (Time*Groups p = 0.024; Time*CG, b = -628, IC95% = -1,082/-174, p = 0.008), FGF-21 (Time*Groups p = 0.009; Time*LFG b = 1,346, IC95% = 423/2268, p = 0.005), and α-synuclein (Time*Groups p = 0.019; Time*LFG b = -1,572, IC95% = -2,952/-192, p = 0.026). Post hoc analyses and comparisons of ΔS (post-pre), performed independently for each group, showed that LFG increased serum BDNF levels (+ 203 pg/ml) and decreased α-synuclein levels (-1,703 pg/ml), while HFG showed the opposite effects (BDNF: -500 pg/ml; α-synuclein: + 1,413 pg/ml). CG showed a significant BDNF reduction over time. Both LFG and HFG showed significant improvements in several physical performance outcomes and the LFG showed better results than HFG. Concerning PFS-16, significant differences over time ( b = -0.4, IC95% = -0.8/-0.0, p = 0.046) and among groups (among all groups p < 0.001) were found, and the LFG exhibited better results than the HFG ( b = -1.0, IC95% = -1.3/-0.7, p < 0.001), and CG ( b = -1.7, IC95% = -2.0/-1.4, p < 0.001) with this last one that worsened over time., Conclusion: LFG training was the best choice for improving or maintaining physical performance, fatigue perception and variation in serum biomarkers., Clinical Trial Registration: https://www.clinicaltrials.gov/ct2/show/NCT04878679, identifier NCT04878679., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 di Cagno, Buonsenso, Centorbi, Manni, Di Costanzo, Casazza, Parisi, Guerra, Calcagno, Iuliano, Soligo and Fiorilli.)

The COVID-19 pandemic deeply affected sports and athletes, influencing performance and psychological wellbeing. In order to provide useful guidelines for coaches, a web-based survey was conducted. Three web-based questionnaires were administered during the last phase of the Omicron wave to a total of 204 Italian athletes (age 24.96 ± 9.82): an informative questionnaire to collect sociodemographic data and infection symptoms information, the Fatigue Severity Scale (FSS) and the General Health Questionnaire-12 (GHQ-12). No differences between infection sequels of different variant typologies were found over the long term after the infection. The most frequently declared symptoms included cough (50%), muscular skeletal impairments (48%) fatigue (43%) and fever (43%). Results showed that female athletes have a higher risk of developing post-COVID-19 symptoms, GHQ-12 worse results ( p = 0.005) and greater fatigue ( p = 0.0002) than males. No significant difference in infection incidence between high- and low-level athletes was found. Endurance athletes showed greater perceived fatigue than anaerobic sports athletes ( p = 0.045). Conclusions: These results suggested the need for specific approaches and continuous updating to differentiate training programs for different athletes during the return to play. Medical controls and daily monitoring of athletes of all levels after the infection could be advisable.

The specificity of training as well as the specificity of monitoring the training process are believed to be fundamental principles to efficiently plan and carry out the preparation and performance development of athletes. The Anaerobic Intermittent Kick Test (TAIKT) is a sport-specific field test used to specifically evaluate the anaerobic profile of Taekwondo athletes. The aim of this study was to verify whether TAIKT and the 'gold standard' Wingate Anaerobic test (WAnT) were both efficient means to optimally determine the anaerobic power and anaerobic capacity of Greek Taekwondo athletes at a middle-high technical level. Fifteen athletes, 10 females and 5 males (mean age 23.4 ± 4.14 years), underwent the two anaerobic tests (TAIKT and WAnT). The peak of power, the anaerobic capacity, and the peak of blood lactate (BL) were recorded. The two tests showed a moderate correlation with the r value ranging between 0.353 and 0.428, if applied to a sample of middle-high technical level athletes. Regarding the peak of BL, data indicated 40% concordance between the two tests with a coefficient of variation of 12%. Consequently, the two tests were correlated even if not interchangeable due to the different type of exercise required in these assessments. In conclusion, to assess the anaerobic performances and physiological characteristics of Taekwondo athletes, independently of their technical level, the WAnT resulted suitable, while to better assess the functional performance and specific demands of Taekwondo, the TAIKT is more indicated.

Physical activity (PA) is a key element in the management of successful aging. The aim of this paper was to show the effects of PA on the quality of life perception, nutritional status, and daily life management of 178 older adults (aged 63.87 ± 8.17) randomly assigned to an Experimental Group (EG), which performed moderate-to-high intensity aerobic and strengthening training, and a Control Group (CG) which performed low-impact PA, assessed after 6, 12, and 24 months. The Short-Form Health Survey (SF-36), Mini Nutritional Assessment (MNA), and Physical Activity Scale for the Elderly (PASE) were used for the study. In the SF-36 assessment, EG showed a good quality of life perception maintained after 24 months, while CG showed a worsening in the same period (p = 0.018). The EG reported a significant better nutritional status as compared to pre-intervention assessment (p = 0.003) and to CG (p < 0.001). Regarding the PASE, the EG showed a higher level of weekly activities than the CG after 24 months (p = 0.011), while the CG showed a worsening after 12 months (p = 0.008). The prolonged engagement in moderate-to high-intensity PA allowed the maintenance of a good quality of life perception, a good level of nutritional status, and daily life activities.

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic illness that is impacting the cardiovascular, pulmonary, musculoskeletal, and cognitive function of a large spectrum of the worldwide population. The available pharmacological countermeasures of these long-term effects of COVID-19 are minimal, while myriads of non-specific non-pharmacological treatments are emerging in the literature. In this complicated scenario, particular emphasis should be dedicated to specific exercise interventions tailored for subjects and athletes recovering from COVID-19. Specific guidelines on adapted physical activity in this critical population are unavailable so far, therefore, in this position statement of the Società Italiana di Scienze Motorie e Sportive (SISMeS) the members of the steering committee of the research group Attività Motoria Adattata, Alimentazione, Salute e Fitness have indicated the adapted physical activity approaches to counteract the long-term effects of the COVID-19, both in good health people and athletes., (© The Author(s) 2022, corrected publication 2022.)

Background: The increasing need to face the problem of sedentarism, especially in the COVID-19 era, induced teachers and researchers to find new intervention methodologies in school context. Active breaks (ABs) include brief periods of physical activity as a part of the curriculum. This study aimed to investigate the AB acute responses on attentive skills and mathematical performance and attention in a primary school., Methods: A total of 141 children (aged 9.61 ± 0.82), divided into six classes, participated in this study. Each class was randomly assigned to three groups on the basis of the type of protocol performed during the three ABs scheduled in a school day: fitness (FIT), creativity (CREAT), and control group (CON). At baseline and at the end of interventions, all participants underwent the Stroop Color and Word test (SCWT) and the math test (MATH) to assess the level of attention and mathematical performance, respectively. The degree of enjoyment was evaluated through the modified Physical Activity Enjoyment Scale., Results: The factorial ANOVA showed significant differences between the FIT and CON in MATH test ( p = 0.023) and SCWT ( p = 0.034). CREAT and FIT groups showed higher degree of enjoyment than the CON (both p s < 0.001)., Conclusions: This study showed a positive acute impact of AB interventions. FIT positively influenced attentive and math performances more than the CREAT, probably due to the correct work/rest ratio and executive rhythm that allowed children to reach a good level of exertion. This report showed that ABs can be a useful and productive activity to be performed between curricular lessons.

The stress impact of COVID-19 restrictions has put the adapted sports community at an unprecedented level of emergency. The self-report Event Scale-Revised (IES-R) questionnaire was administered to assess the level of psychological distress and emotive reactions such as intrusion (INT), avoidance (AV) and hyperarousal (HYP) following training and competitions suspension within a sample of Italian disabled athletes. A total of 146 self-selected volunteers were included in this study: 73 disabled athletes (aged 42.11 ± 13.70) and 73 athletes (aged 40.23 ± 13.73) who served as the control group. Only 8.22% of the disabled participants vs. 30.14% of athletes were affected by subjective distress. MANOVA showed significant differences in IES-R subjective distress for age, where the emerging adults had a higher level of stress than adults ( p = 0.031), and for the type of sport, where the individual sports group showed higher scores than the team sports group ( p = 0.049). Regarding the IES-R subscales, significant differences were found in INT and AV for age, where the emerging adults showed higher scores than adults ( p = 0.018 and p = 0.046, respectively). Significant differences were found in HYP for type of sport, where the individual sports group showed higher scores than the team sports group ( p = 0.014). The results confirmed a lower distress level of disabled athletes to adverse events than that expressed by athletes. Both sports engagement and the experience of living with impairment, overcoming structural barriers, could act as a buffer effect against stress due to COVID-19 restrictions.

Intergenerational physical activity could be a pleasant method to prevent elderly sedentary behaviors. The aim of this study is to provide a basis to develop an intergenerational physical activity between preschool children and elderly people. An assessing enjoyment three questionnaire survey was administered to 140 participants (aged 67.8 ± 9.1): the global physical activity questionnaire (GPAQ) assessing the sedentariness degree; the physical activity enjoyment scale (PACES-Q) assessing enjoyment for the physical activity usually practiced; the physical activity enjoyment scale (PACES-INT) assessing the enjoyment for a hypothetical intergenerational program. Successively, the sample was divided into subgroups based on age, gender, marital status, education, employment, sports background, sedentariness level and residential location. Four multichoice questions, aiming to have guidelines in organizing an intergenerational program, were used. A total of 44.3% of the sample found the physical activity practiced pleasant, whereas 81.5% enjoyed the intergenerational program (only 7.1% expressed a negative judgment). A separated one-way ANOVA showed significant differences in PACES-INT for gender, ( p = 0.009), residential location, ( p < 0.001) and employment ( p = 0.004). About 80% of the sample would adhere to the intergenerational programs, despite the fatigue fear and logistic or family relationship problems.

The study aim was to investigate the age, gender and technical level on motor coordination abilities of Taekwondo children. One hundred and fifteen children (83 male, 32 female), aged 7.76 ± 1.71 years, divided in three different groups, under 8 (5-7 years), under 10 (8-9 years) and under 12 (10-11 years), underwent three coordination skills tests: the ruler drop test (RDT), assessing visual reaction time, the hexagonal test (HT), assessing agility, and the target kick test (TKT), assessing kicking ability. MANOVA showed significant gender differences for TKT, in which females showed higher scores than males ( p = 0.033). Significant differences were found in HT and TKT, where the under 12 group showed higher scores than younger athletes ( p < 0.001). No differences amongst different age groups were found in RDT, showing that this could be a good predictor of Taekwondo performance, assessed at an early stage. High-level athletes showed better scores in all the tests than the low levels, as it was expected. Coordinative performance improves with age and is positively influenced by practicing a sports activity. The predisposition to a particular sport with a well-planned training may lead to a motor proficiency comparable to that reached by older athletes and better than same-age athletes.

Parkinson's disease (PD) patients lead a sedentary lifestyle, being unable or unwilling to exercise conventionally, due to physical and mental limitations. The aim of this study was to assess the acute effects of a single session of whole-body electromyostimulation (WB-EMS) on the physical performances and serum levels of the neurotrophic factors in PD patients. Ten subjects (aged 72.60 ± 6.82) underwent 20 min of physical activity with superimposed WB-EMS and, after four weeks, the same protocol with no WB-EMS. WB-EMS was conducted with intermittent stimulation, with 4 s WB-EMS/4 s rest, at 85 Hz, 350 μs. A physical fitness assessment and blood samples collection, to evaluate neurotrophic factors' levels (BDNF, FGF21, proNGF, mNGF), were collected before and after the intervention. The RM-ANOVA showed significant improvements in sit-to-stand ( p < 0.01), arm curl ( p < 0.01), handgrip ( p < 0.01) and soda pop test ( p < 0.01) after the WB-EMS intervention. Higher proNFG serum levels were observed in the WB-EMS condition compared to the no WB-EMS after 60 min post-intervention ( p = 0.0163). The effect of WB-EMS confirmed the electrostimulation ability to modulate the proNGF quantity. The positive impact of the WB-EMS protocol on physical functioning, and eye-hand coordination, makes this intervention a promising strategy to improve motor and non-motor symptoms in PD patients.

The outbreak of the 2019 coronavirus disease (COVID-19) created an international public health emergency, challenging the psychological resilience of the general population. Regarding this matter, a web-based survey was performed. Data were collected from the following 1,668 self-selected volunteers: 800 athletes (28.30 ± 10.93 years old); 558 coaches (36.91 ± 11.93 years old); and 310 sports managers (42.07 ± 13.38 years old). To assess the level of psychological stress, an Impact of the Event Scale-Revised (IES-R) questionnaire was used. The results indicated that 34.4% of the participants who were interviewed were affected by subjective distress while 26.4% rated their psychological impact from the sports activity interruption as severe. Separated one-way analysis of variance (ANOVA) tests showed significant differences in the IES-R total score (TS), indicating that the level of stress in terms of gender revealed that women were more stressed than men (p = 0.000), for "sports roles" in which the manager and coaches were more stressed than the athletes (p < 0.05), and "type of sport" in which fitness and individual athletes were more stressed than team athletes (p < 0.01). The middle-level athletes showed significantly more hyperarousal levels than high-level athletes (p = 0.012). The results of this survey may raise awareness of this problem and help athletic associations to have appropriate guidelines in order to better sustain their memberships and organize an optimal resumption of their sports activities. Along these lines, social interactions, which are typical of team sports, are crucial to warrant resilience and psychological health. The athletes by managing independently the new rules and measures, thanks to a clear communication, could improve their adaptive stress reaction., Competing Interests: The authors have declared that no competing interests exist.

The 2019 Coronavirus (COVID-19) outbreak caused home confinement, as well as training and sport competitions withdrawals. The prolonged inactivity impact, and lack of in-person interactions among teammates-coaches, could negatively affect athletes. Total of 1508 self-selected Italian athletes, 338 children (aged 10.52 ± 1.31), 499 adolescents (aged 14.17 ± 1.13), and 671 adults (aged 27.59 ± 10.73), completed the Impact of Event Scale (IES-8, IES-15, and IES-R, respectively). Differences by gender, type of sport (individual vs. team), and competitive level (elite vs. amateur) were examined. One-way ANOVAs showed, in adults, significant differences between genders for perceived stress impact total score (TS; p = 0.017) and avoidance behavior, with higher scores in women ( p = 0.045). Between individual and team sport, significant differences were found in TS ( p = 0.038) and hyperarousal ( p = 0.030), with higher results in individual. Adult elite athletes showed significantly higher scores in hyperarousal ( p = 0.020) than amateurs. Significant differences were found between gender in adolescents for avoidance ( p = 0.011), and between competitive levels in children, for intrusion ( p = 0.020). These evidences may raise awareness on distress effects of COVID-19 lockdown among athletes and suggested applying specific well-being protocols during the activity resumption, considering gender, type of sport, and competitive level.

The aim of the study was to evaluate the effects of 6-weeks accentuated eccentric training, using a rotary inertial device, on range of motion, assessed with Inter Malleolar Distance test, anthropometry, lower limb explosive and reactive strength, assessed with Squat Jump, Countermovement Jump and 7-Repeated Hop tests, in young elite fencers. Moreover, the effects on hamstring eccentric strength and two technical fencing movements, lunge and advance-advance lunge, were evaluated with motion analysis. The second aim was to evaluate the duration of the accentuated eccentric training residual effects, 6 weeks after the end of the training. Fifty-four male fencers were randomly assigned either to the Inertial Group (IG; n = 26; aged 17.3 ± 1.9 years) such as experimental group, or to the Plyometric Group (PG; n = 28; aged 17.6 ± 2.7 years) such as control group. IG carried out four exercises using the rotary inertial device attached to their waist by a rope. PG carried out several plyometric exercises at the same time in which the IG performed the accentuated eccentric training. MANOVA showed significant improvements in the vertical jumps height post training, with no differences between IG and PG. Significant improvements for technical movements, lunge distance (p = 0.006) and advance-advance lunge distance (p = 0.00005), were found within-group and between-groups (p = 0.00001), with higher improvements in IG than in PG. The univariate analysis showed a significant improvement in lower limb range of motion with higher increase in IG than in PG. The main findings were the significant improvement in lunge and advance-advance lunge distance, maintaining with the same execution time. These results suggested that it is important to apply accentuated eccentric load on specific sport movements., (© Journal of Sports Science and Medicine.)

Functional inertial training, a popular high-intensity training mode, provides high neuromuscular activation, developing proprioception, postural control, power, and sprint time. Aim of the study was to assess the acute effects of two types of warm-up (WU), inertial warm-up (IWU) vs. traditional warm-up (TWU), on explosive and reactive strength, sprint, and Change of Directions (COD) in young soccer players. In a randomized cross-over design study, twelve soccer players (aged 13.3 ± 0.7) performed 16 min of IWU and 16 min of TWU. IWU and TWU were spaced two weeks apart. Pre and post intervention tests, aimed at assessing explosive and reactive strength, sprint, and COD ability included: Squat Jump test (SJ), Countermovement Jump test (CMJ), Drop Jump test (DJ), Seven Repetition Hopping test (7R-HOP), 40 m-sprint test (40 m), and Illinois Agility Test (IAT). RM-ANOVA, used to compare differences between IWU and TWU effects (the level of significance set at ρ ≤ 0.05), showed enhanced performance after the IWU compared to the TWU. In addition, the effects of the IWU on performance lasted longer after the IWU than after the TWU. For IAT, the enhanced effects of IWU on performance lasted up to ten minutes after the administration of the IWU. Our results suggest that IWU affects functional changes displaying earlier adaptation in explosive and reactive strength with longer lasting effects compared to TWU and it could be recommended in young soccer athletes as a WU procedure., Competing Interests: The authors declare no conflicts of interest.

The isoinertial training method owes its efficacy to an accommodated resistance and optimal individualized eccentric overload. The aim of this study was to assess the effects of a 6-week isoinertial eccentric-overload training program - using a flywheel inertial device during the execution of specific soccer exercises - on explosive and reactive strength, sprint ability, change of direction (COD) performance and soccer shooting precision. Thirty-four junior soccer players were randomly assigned to a plyometric training group (PT) (n = 16, aged 13.36 ± 0.80), which underwent a six-week traditional soccer training program, and a flywheel eccentric overload group (FEO) (n = 18, aged 13.21 ± 1.21), which received additional training consisting of two inertial eccentric-overload training sessions per week. Pre and post intervention tests were carried out to assess explosive and reactive strength, sprint ability, COD ability, agility using the Y-agility test (YT) and soccer shooting precision. The FEO showed significantly higher values than the PT in squat jump height (SJh) (p = 0.01), drop jump height (DJh) (p = 0.003), 7 repeated hop test heights (p = 0.001), the Illinois test (ILL) (p = 0.001), and the Loughborough Soccer Shooting Test (SHOT) (p = 0.02). Finally, the FEO showed significant between-group differences in DJh (p = 0.007), ILL (p = 0.0002), YT (p = 0.002), a linear sprint test (SPRINT) (p = 0.001), and SHOT (p = 0.003). These results confirmed the positive effect of isoinertial training. The use of an isoinertial device to overload multidirectional movements in specific sport conditions leads to greater performance improvements than conventional soccer training. The absence of knowledge of the eccentric overload applied by the isoinertial device, which is different in any exercise repetition, may stimulate the athlete's neural adaptations, improving their soccer skills and in particular their soccer shooting precision., (© Journal of Sports Science and Medicine.)

In Latin America, few studies have been done in mupirocin resistance and biofilm formation in methicillin-resistant Staphylococcus aureus (MRSA). This study investigated mupirocin-resistance in MRSA isolates from pediatric patients with bacteremia and their ability to form biofilm. Antibiotic resistance was analyzed with the Kirby-Bauer test and the broth microdilution method. Bacterial biofilm formation was measured using the crystal violet assay. Among MRSA isolates, 2.3 % (5/217) exhibited a high level of mupirocin-resistance with a minimum inhibitory concentration of >512 μg/mL, in addition to cross-resistance with clindamycin, erythromycin, gentamicin, and ciprofloxacin. Remarkably, biofilm formation in such isolates was moderate to high. This is the first report published in Argentina on clinical isolates of mupirocin-resistant MRSA and it is critical for following its evolution over time at a local level and in the Latin American region., (Sociedad Argentina de Pediatría.)

Purpose: The purpose of this study was to investigate the acute effects of whole body vibration at optimal frequency, on postural control in blind subjects., Method: Twenty-four participants, 12 congenital blind males (Experimental Group), and 12 non-disabled males with no visual impairment (Control Groups) were recruited. The area of the ellipse and the total distance of the center of pressure displacements, as postural control parameters, were evaluated at baseline (T0), immediately after the vibration (T1), after 10 min (T10) and after 20 min (T20). Whole body vibration protocol consisted into 5 sets of 1 min for each vibration, with 1 min rest between each set on a vibrating platform., Results: The total distance of center of pressure showed a significant difference (p < 0.05) amongst groups, while the area remained constant. No significant differences were detected among times of assessments, or in the interaction group × time., Conclusion: No impairments in static balance were found after an acute bout of whole body vibration at optimal frequency in blind subjects and, consequently, whole body vibration may be considered as a safe application in individuals who are blind.

Background: The goal of this study was to compare the changes of direction speed (CODS) and reactive agility (RA) in soccer players of different ages, in order to optimize the best training of these skills., Methods: One hundred eighty-seven players, divided into bi-annual age-groups, U12, U14, U16 and U18, performed two tests: Y-Agility Test, carried out in planned and reactive mode (Y-PLAN and Y-REAC) and Illinois for Change of Direction Test (ICODT). Difference between Y-REAC minus Y-PLAN represents the index of reactivity (REAC-INDEX)., Results: MANOVA showed significant differences among groups (F3,182=14.591; P<0.01; η2p=0.244). Y-PLAN showed significant differences only between U12 and the other groups (P<0.01). ICODT results were significantly different between the groups U12 and U14 and the other groups (P<0.01). Significant Pearson's correlations between Y-TEST and ICODT, for the three categories of young players (0.398 P<0.05; 0.615 P<0.01; 0.608 P<0.01 respectively), were found, whereas no significant correlation was found in U18 group., Conclusions: The best performance of Y-PLAN and ICODT, through age, depends on physical skill level, whereas the best RA results depend on technique and experience that help the players to use anticipatory skill. The high correlations between CODS and RA performances, differently than adult athletes, suggest that an effective work program for young players may include RA and CODS training at the same time.

This study aimed to evaluate the effects of different types of exercise on memory performance and memory complaint after a 12-week intervention. Eighty community-dwelling volunteers, aged 66.96 ± 11.73 years, were randomly divided into four groups: resistance, cardiovascular, postural, and control groups (20 participants for each group). All participants were tested for their cognitive functions before and after their respective 12-week intervention using Rey memory words test, Prose memory test, and Memory Complaint Questionnaire (MAC-Q). Statistical analysis showed that the three experimental groups significantly improved MAC-Q scores in comparison with the control group (p < .05). The variation of MAC-Q scores and the variations of Rey and Prose memory tests scores were not correlated. These results indicate that the 12-week interventions exclusively influenced memory complaint but not memory performance. Further investigations are needed to understand the relation between memory complaint and memory performance, and the factors that can influence this relationship.

Background: The aim of this intervention study was to determine the effects of a new experimental cervical pillow, on symptomatic adults affected by chronic mechanical neck pain., Methods: Twelve recreational athletes of both sexes (mean age 40.5 years; range 35-55), affected by grade II chronic mechanical neck pain, were evaluated with a daily diary type of self-report questionnaire, which incorporated an 11-point Numerical Rating Pain Scale, to collect the primary outcome measures of pre- and post-sleep neck pain and with the Neck Pain Disability Scale. Tympanic temperature, heart rate (HR) variability continuous monitoring during sleep, overnight pillow comfort and sleep quality were assessed., Results: Average weekly scores in overall questionnaires, tympanic temperature and the HR low frequency (LF) / high frequency (HF) ratio were significantly lower (P<0.05) after the use of the DM2 pillow than the own pillow. The 80% of participants considered the DM2 "perfectly comfortable" and reported a "good" quality of sleep lying over it., Conclusions: The use of an appropriate pillow is a determinant factor in relieving neck pain, improving LF/HF ratio and enhancing-vagal activity, promoting deeper stages during the sleep. The shape of this pillow maintains an appropriate cervical curvature, reduces intra-disc pressure allowing a better distribution of loads between cervical discs. The round shaped portion of the pillow, facilitates breathing and avoids the narrowing of the airway due to the incorrect position during the sleep. The peculiar material of the DM2 pillow, contributed to lower brain temperature promoting dry heat loss from the head to the pillow, reducing sweating.

Change Of Direction Speed (CODS) and Reactive Agility (RA) are two determining factors in the ability of young soccer players. We aimed to verify if CODS and RA could be useful in order to establish the best young soccer player field position. Ninety-two elite soccer players (15.18 ± 1.21 years, weight 59.18 ± 9.93, height 1.72 ± 0.08, BMI 19.76 ± 2.22), belonging to two youth categories from the Italian First and Second Divisions, volunteered in this study. The participants included 32 defenders (15.06 ± 0.80 years), 37 midfielders (15.11 ± 0.84 years) and 23 forwards (15.48 ± 1.16 years), and they underwent two tests, each one performed in two different ways: the Y-Agility Test, carried out in a planned and reactive mode (Y-PLAN and Y-REAC), and the Illinois for Change of Direction Test (ICODT) performed with and without the ball. REAC-INDEX, which represents the index of reactivity, was calculated as Y-REAC minus Y-PLAN. The difference between the two scores of ICODT (ICODT with the ball minus ICODT without the ball) represents the TECHN-INDEX. Multivariate Analysis of Variances (MANOVA) was used to evaluate significant differences among all position groups, for all the test scores. MANOVA showed no significant differences in test scores or in TECHN-INDEX among the groups, except for the forwards, who were significantly more reactive than the defenders (p < 0.05). The strong and significant Pearson's Correlation between ICODT with and without the ball (p < 0.01) demonstrated that physical and technical preparations have the same relevance in all positions. No significant differences were found among players in different field positions for CODS and RA performances, both with and without the ball. This study does not recommend to use RA and CODS as indicators to assign the players roles in youth soccer.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to different commonly used antibiotics, stressing the need for further strategies to treat this human pathogen with worldwide prevalence. The use of phytochemicals within the current pharmacology is a promising approach to enhance the antimicrobial activity of common antibiotics in the battle against these bacteria., Purpose: The purpose of this study was to determine the antimicrobial effectiveness of carnosic acid, the major constituent of Rosmarinus officinalis L. leaves, in combination with gentamicin against multi-drug resistant MRSA clinical isolates obtained from pediatric patients with bacteremia., Materials and Methods: Anti-MRSA activity was studied using the broth microdilution assay and time-kill method. Combinations of subinhibitory concentrations of carnosic acid and gentamicin were examined using the checkerboard method., Results: Carnosic acid exhibited a good antibacterial activity against all multidrug-resistant MRSA clinical isolates tested, which are resistant to four up to nine antibiotics. In addition, the combination of carnosic acid with gentamicin not only decreased the minimal inhibitory concentration (MIC) of both by 4- to 5-fold, but also improved the bactericidal potency of the common antibiotic by 32- to 40-fold against both gentamicin-susceptible and gentamicin-resistant MRSA clinical isolates. A clear bactericidal synergistic activity between carnosic acid and gentamicin in killing multidrug-resistant MRSA clinical isolates with a fractional bactericidal concentration index (FBCI) of 0.28-0.35 was demonstrated., Conclusions: Our findings show the potential use of carnosic acid in combination with gentamicin as a promising alternative for the control of healthcare-associated infections caused by multidrug-resistant MRSA., (Copyright © 2016 Elsevier GmbH. All rights reserved.)

Backgorund: The aim of this study was to evaluate the effects of rhythmical and extra-rhythmical qualities of music on the heart rate (HR) and rates of perceived exertion (RPE), during sub-maximal stationary bike activity., Methods: HR of 28 female adult participants was monitored during 3 session of physical activity, performed under 3 different conditions: Hi-BPM (music with 150-170 BPM), RHYTHM (rhythmical qualities only of Hi-BPM condition) and control condition without music (CONTROL). Four parameters were analyzed: the highest HR value (High-HR), High-HR minus starting HR (∆HR), time to reach the 75% of Maximal HR (MHR) (TimeTo75%) and time over 75% MHR (TimeOver75%). HR trend analysis was performed to evaluate differences among the three conditions. OMNI-Cycle Scale was administered to evaluate RPE., Results: MANOVA showed significant differences between the three conditions in TimeTo75%, ∆HR (P<0.01) and TimeOver75% (P<0.05). In RHYTHM and CONTROL conditions after reaching 75% MHR, the HR increase were significantly lower than Hi-BPM (P<0.01). No significant differences were found in OMNI-Cycle Scale scores of Hi-BPM and RHYTHM whereas RPE was significantly higher in CONTROL condition (P<0.05)., Conclusions: Hi-BPM and RHYTHM music allowed a faster reaching of the aerobic training zone compared to CONTROL conditions. Nevertheless, after 75% MHR, extra-rhythmical qualities are necessary to maintain or to increase the working HR levels.

A total of 925 Acinetobacter spp. isolates were collected from routine clinical samples of patients admitted to the university hospital of Buenos Aires city during the period 2004-2012. From this collection, 129 isolates identified as Acinetobacter baumannii were selected for molecular studies. Minimal inhibitory concentrations (MICs) of antimicrobials were determined by agar dilution method. Colistin (COL) heteroresistance was investigated by means of population analysis studies. PCR-based methods were used for epidemiological analysis and for the screening of carbapenemases and the bla(tetB) gene. We have observed a steady rise in the MIC50 of imipenem (IMI)-resistant isolates and an increment in the presence of bla(OXA-23)-like gene (74-100%) as well. A rapid increasing rate of minocycline (MIN) resistance and a rise of the MIC50 of the resistant isolates have been detected since the year 2008. All isolates harboured the tet (B) gene. An increase in the value of the tigecycline (TIG) MIC was seen from the year 2007 onwards. This loss of activity was observed among different clones. A rise of COL heteroresistance from 46.4% in 2004 to 95% in 2012 was detected. During this period, COL consumption also increased (11.1-fold). However, COL resistance remained sporadic.

Background: There is general population evidence that physical exercise is effective in reducing the risk of depression and has positive effects on mood. Some prisons encourage exercise, but there is no evidence specific to this group on its benefits or the relative merits of different programmes., Aims: To test the effect of physical exercise on the psychological well-being of prisoners and to determine which mental disorders are most affected by physical activity., Methods: Sixty-four participants were randomly assigned across three groups: cardiovascular plus resistance training (CRT), high-intensity strength training (HIST) and no exercise. Before and after the 9-month experimental period, all participants completed the Symptom Checklist-90-Revised., Results: Each form of exercise significantly reduced depression scale scores compared with those in the control group, in which average depression scale scores actually increased. The CRT group also showed a significant decrease in GSI scores on the Symptom Checklist-90 and on its interpersonal sensitivity scale, whereas the HIST group also significantly improved on the anxiety, phobic anxiety and hostility scale scores., Conclusions: Our evidence, taken together with general population studies, supports introduction of supervised, moderately intense exercise for at least 1 h per week for men in prison. They form a high risk group for mental disorders, and such exercise reduces depression and anxiety. Minimal special equipment is needed for CRT. Further research should replicate the study in a larger, multi-centre trial, and examine impact on shorter-term and longer-term prisoners, female prisoners and effects on recidivism., (Copyright © 2014 John Wiley & Sons, Ltd.)

This study aimed to evaluate the effects of different types of exercise on cognition. Eighty participants, 32 males and 48 females, aged 66.96 ± 11.73, volunteered for this study. The participants were randomly divided into the four following groups: Resistance Group (RG; n=20), involved in high intensity strength training; Cardiovascular Group (CVG; n=20), involved in high intensity cardiovascular training; Postural Group (PG; n=20) involved in low intensity training, based on postural and balance exercises; and Control Group (CG; n=20). Exercises were performed over the course of 12 weeks. All participants were tested for their cognitive functions pre- and post-intervention using the following neurocognitive tests: the Attentive Matrices Test, Raven's Progressive Matrices, Stroop Color and Word Interference Test, Trail Making Test and Drawing Copy Test. Statistical analysis showed that the CVG group improved significantly in the Attentive Matrices Test and Raven's Progressive Matrices (both p=<0.05), whereas the RG group improved in Drawing Copy Test time (p=<0.05). These results confirm that different types of exercise interventions have unique effects on cognition. Cardiovascular training is effective in improving performance attentive and analytic tasks, whereas resistance training is effective in improving praxis. Further investigation is necessary to evaluate the combination of the two exercise types in order to ascertain if their respective effects can be summated when performed together., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Multidrug-resistant Acinetobacter baumannii (MAB) is an important nosocomial pathogen., Objectives: To analyze the risk factors for acquiring MAB, and the clinical and microbiological characteristics of MAB bacteremia (MABB) in children., Materials and Methods: Control-case study 2005-2008. Demographic and clinical data from all MABB and from non-multiresistant gram-negative bacteremias were recorded. Identification at species level, antimicrobial susceptibility tests, time-kill studies and clonally relationships were performed. Stata 8.0 was used for data analysis., Results: A total of 50 MABB and 100 controls were included. Ninety four percent of patients acquired MAB in ICU and the 88% had underlying diseases. All patients had invasive procedures previous to MABB. The median of hospitalization stay previous to MABB was different in cases than in controls (16 vs 7 days, p < 0.001). Five clones were detected among the MABB. Time-killing curves showed bactericidal activity of ampicillin/sulbactam plus gentamicin and polymixin B. Three patients with MAB died. In a multivariate analysis final predictors of MABB were: previous use of broad-spectrum antibiotics [OR: 7,0; IC 95% 1,93-25,0; p: 0,003] and mechanical ventilation [OR: 4,19; IC 95% 1,66-10,0; p: 0,002]., Conclusions: MABB were detected in patients with underlying conditions, invasive procedures and prolonged hospitalization. Predictors of MABB were mechanical previous use of broad-spectrum antibiotics and mechanical ventilation.

Talent identification plans are designed to select young athletes with the ability to achieve future success in sports. The aim of the study was to verify the predictive value of coordination and precision in skill acquisition during motor learning, as indicators of talent. One hundred gymnasts, both cadets (aged 11.5 ± 0.5 yr.) and juniors (aged 13.3 ± 0.5 years), competing at the national level, were enrolled in the study. The assessment of motor coordination involved three tests of the validated Hirtz's battery (1985), and motor skill learning involved four technical tests, specific of rhythmic gymnastics. All the tests were correlated with ranking and performance scores reached by each gymnast in the 2011, 2012, and 2013 National Championships. Coordination tests were significantly correlated to 2013 Championships scores (p < 0.01) and ranking (p < 0.05) of elite cadet athletes. Precision, in skill acquisition test results, was positively and significantly associated with scores in 2013 (adj. R(2) = 0.26, p < 0.01). Gymnasts with the best results in coordination and motor learning tests went on to achieve better competition results in three- year time. Key pointsIn talent identification and selection procedures it is better to include the evaluation of coordination and motor learning ability.Motor learning assessment concerns performance improvement and the ability to develop it, rather than evaluating the athlete's current performance.In this manner talent identification processes should be focused on the future performance capabilities of athletes.

The aim of this study was to evaluate whether a mental training protocol could improve gymnastic jumping performance. Seventy-two rhythmic gymnasts were randomly divided into an experimental and control group. At baseline, experimental group completed the Movement Imagery Questionnaire Revised (MIQ-R) to assess the gymnast ability to generate movement imagery. A repeated measures design was used to compare two different types of training aimed at improving jumping performance: (a) video observation and PETTLEP mental training associated with physical practice, for the experimental group, and (b) physical practice alone for the control group. Before and after six weeks of training, their jumping performance was measured using the Hopping Test (HT), Drop Jump (DJ), and Counter Movement Jump (CMJ). Results revealed differences between jumping parameters F(1,71)=11.957; p<.01, and between groups F(1,71)=10.620; p<.01. In the experimental group there were significant correlations between imagery ability and the post-training Flight Time of the HT, r(34)=-.295, p<.05 and the DJ, r(34)=-.297, p<.05. The application of the protocol described herein was shown to improve jumping performance, thereby preserving the elite athlete's energy for other tasks., (Copyright © 2014 Elsevier B.V. All rights reserved.)

The aim of this study was to assess differences in psychological well-being, symptomatic psychological disorders and social participation, between competitive wheelchair basketball participants and those non-participants. Forty-six wheelchair participants, 24 Basketball players (aged 35.60 ± 7.56) and 22 non-players (aged 36.20 ± 6.23), completed three validated self-report questionnaires: Participation Scale (PS), Psychological Well-Being Scale [PWBS] and Symptom Checklist 90 R [SCL-90-R]. ANOVA showed significant overall differences between the two groups. The social restriction score, evaluated by PS, was significantly higher in the non-basketball participants (p=0.00001) than the basketball participants. The PWB Scale showed significant differences in all 6 dimensions: positive relations with others, environmental mastery, personal growth, purpose in life and self-acceptance (p<0.01), and autonomy (p<0.05), with better scores in the basketball participants. The SCL-90-R scores were significantly lower for the basketball group in the following 6 symptomatic dimensions: depression, phobic anxiety, and sleep disorder (p<0.01), somatization, interpersonal sensitivity and psychoticism (with p<0.05). It was concluded that competitive wheelchair basketball participants showed better psychological well-being and social skills than those non-participants., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The aim of the study was to determine which kind of physical activity could be useful to inmate populations to improve their health status and fitness levels. A repeated measure design was used to evaluate the effects of two different training protocols on subjects in a state of detention, tested pre- and post-experimental protocol.Seventy-five male subjects were enrolled in the studyand randomly allocated to three groups: the cardiovascular plus resistance training protocol group (CRT) (n = 25; mean age 30.9 ± 8.9 years),the high-intensity strength training protocol group (HIST) (n = 25; mean age 33.9 ± 6.8 years), and a control group (C) (n = 25; mean age 32.9 ± 8.9 years) receiving no treatment. All subjects underwent a clinical assessmentandfitness tests. MANOVA revealed significant multivariate effects on group (p < 0.01) and group-training interaction (p < 0.05). CRT protocol resulted the most effective protocol to reach the best outcome in fitness tests. Both CRT and HIST protocols produced significant gains in the functional capacity (cardio-respiratory capacity and cardiovascular disease risk decrease) of incarcerated males. The significant gains obtained in functional capacity reflect the great potential of supervised exercise interventions for improving the health status of incarcerated people.

Objectives: the issue of time-of-day effects on performance is crucial when considering the goal of reaching peak results in sport disciplines. The present study was designed to examine time-of-day effects in adolescents on motor coordination, assessed with Hirtz's battery and neuromuscular components of strength, evaluated with reactive strength tests., Methods: forty-two elite female gymnasts, aged 13.3 ± 0.5 years (Mean ± SD), were recruited for the study. Fifty healthy female students (aged 12.8 ± 1.7 years) served as the control group. All participants underwent the testing sessions over two days at two different times of day in a randomized order., Results: Oral temperature was measured at the two times of the day and a significant diurnal variation (p < 0.01) in both groups was found. MANOVA revealed significant group differences in the overall tests (p < 0.01). The gymnast group showed no significant differences in the coordination tests with respect to the time of day, but significant differences were observed for reactive strength as assessed with the vertical jump tests (p < 0.01). Gyamnasts attained better results in the evening in the reactive strength tests [flight time (F1.90 = 17.322 p < 0.01) and ground contact time (F1.90 = 8.372; p < 0.01) of the hopping test]., Conclusion: the temperature effect was more evident in the reactive strength tests and orientation test, especially in the gymnast group in which this effect added to their usual training time effect. The time-since-awakening influenced coordination performances in complex tasks more than reaction strength tests in simple tasks. The main outcome of the study was that we did not observe time-of-day effects on coordination skills in elite gymnasts and in untrained adolescents. The time of day in which athletes usually trained these skills could influence these results. Key pointsThe results obtained in this study suggested that the best time to perform a particular task depends specifically on the nature of the task, the precise size of the cognitive load and the level of practice of the participants.In the field of practice, it is incumbent for coaches to organise sports selection based on reactive strength, using the morning hours for untrained adolescents, when alertness and the benefits of sleeping could improve performance. Evening hours, conversely, should be used for elite gymnasts who specifically train at that time (specific "temporal training effect").These study results cannot give indications about the best time of the day to organize selection tests based on coordination skills.

Aim: The aim of this study was to identify the influence of training workloads and dietary habits on the menstrual status of elite rhythmic gymnasts. In many sports disciplines, it has long been assumed that menstrual disorders among elite female athletes are related to intense physical effort and insufficient energy intake. Potential consequences of this condition include reduced fertility and decreased bone density., Methods: Eighty-one female gymnasts (age 15.9±3.1) completed two self-administered questionnaires: the Menstrual History Questionnaire (MHQ), and the Semiquantitative Food Frequency Questionnaire (FFQ). Eighty female athletes (age 16.3±3.7), who participated in basketball, volleyball, tae kwon do and fitness activity served as a control group. Physical characteristics, menstrual cycles, training workloads and dietary habits were compared and the relationship between physical training and menstrual cycle characteristics was assessed for the two groups., Results: Fifty percent of the gymnasts declared themselves amenorrheic. Age was significantly and positively correlated (P<0.01) with menarche and menstrual irregularities, and negatively correlated with amenorrhea. The percentage of variance for age at menarche, explained by training hours/week and body mass, was 43%, (P<0.01)., Conclusion: The present study, which examined and compared different age groups of gymnasts, showed that young rhythmic gymnasts who trained intensively, had a delayed onset of menarche of more than two years, thus favouring secondary amenorrhea. Nonetheless, almost all athletes, even though with significant delay, reached cycle regularity, thus minimizing the effect of menstrual disorders on fertility and bone density.

Background: In August, 1997, a woman with no history of travel to malarious regions developed Plasmodium vivax malaria. She lived in a rural area of Italy where indigenous Anophyles labranchiae mosquitoes were present., Methods and Findings: An environmental investigation was done within a 3 km radius of the patient's house. Adult mosquitoes and larvae were collected and examined by PCR with the gene for plasmodium circumsporozoite protein as target. About 200 people living in the area were interviewed to detect possible carriers of P. vivax., Findings: None of the mosquitoes captured were carrying any malarial organisms. The house-to-house investigation identified a 7-year-old girl who had had a feverish illness a few days after her arrival in Italy from India, and who, 3 months later, still had P. vivax in her blood; she and her mother had antimalarial antibodies., Interpretation: These investigations suggest that the index case of malaria was caused by local anopheline mosquitoes infected with exogenous P. vivax.