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Trace element deposition from desert dust has important impacts on ocean primary productivity, the quantification of which could be useful in determining the magnitude and sign of the biogeochemical feedback on radiative forcing. However, the impact of elemental deposition to remote ocean regions is not well understood and is not currently included in global climate models. In this study, emission inventories for eight elements primarily of soil origin, Mg, P, Ca, Mn, Fe, K, Al, and Si are determined based on a global mineral data set and a soil data set. The resulting elemental fractions are used to drive the desert dust model in the Community Earth System Model (CESM) in order to simulate the elemental concentrations of atmospheric dust. Spatial variability of mineral dust elemental fractions is evident on a global scale, particularly for Ca. Simulations of global variations in the Ca / Al ratio, which typically range from around 0.1 to 5.0 in soils, are consistent with observations, suggesting that this ratio is a good signature for dust source regions. The simulated variable fractions of chemical elements are sufficiently different; estimates of deposition should include elemental variations, especially for Ca, Al and Fe. The model results have been evaluated with observations of elemental aerosol concentrations from desert regions and dust events in non-dust regions, providing insights into uncertainties in the modeling approach. The ratios between modeled and observed elemental fractions range from 0.7 to 1.6, except for Mg and Mn (3.4 and 3.5, respectively). Using the soil database improves the correspondence of the spatial heterogeneity in the modeling of several elements (Ca, Al and Fe) compared to observations. Total and soluble dust element fluxes to different ocean basins and ice sheet regions have been estimated, based on the model results. The annual inputs of soluble Mg, P, Ca, Mn, Fe and K associated with dust using the mineral data set are 0.30 Tg, 16.89 Gg, 1.32 Tg, 22.84 Gg, 0.068 Tg, and 0.15 Tg to global oceans and ice sheets.

Background & Aims: Organized colorectal cancer (CRC) screening is not widely practiced in Latin America and the results of regional studies may help overcome barriers for implementation of national screening programs. We aimed to describe the implementation and findings of a fecal immunochemical test (FIT)-based program in Brazil., Methods: In a prospective population-based study, asymptomatic individuals (50-75 years old) from Sao Paulo city were invited to undergo FIT for CRC screening. Participants with positive FIT (≥10 μg Hb/g feces) were referred for colonoscopy. Subjects were classified into groups according to the presence of CRC, precursor lesions, and other benign findings, possibly related to bleeding., Results: Of a total of 9881 subjects, 7.8% had positive FIT and colonoscopy compliance was 68.9% (n = 535). Boston scale was considered adequate in 99% and cecal intubation rate was 99.4%. CRC was diagnosed in 5.9% of the cases, adenoma in 63.2%, advanced adenoma in 31.4%, and advanced neoplasia in 33.0%. Age was positively associated with CRC (P = .03). Higher FIT concentrations were associated with increased detection of CRC (P < .008), advanced adenoma (P < .001), and advanced neoplasia (P < .001)., Conclusions: Implementation of a FIT-based CRC screening program was feasible in a low-resource setting, and there was a high yield for neoplasia in individuals with a positive FIT. This approach could be used as a model to plan and disseminate organized CRC screening more broadly in Brazil and Latin America., (Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.)

This study aimed to investigate the effect foot position on ankle joint mechanics and vertical ground reaction forces (vGRF) across jump landings in professional ballet dancers. Twenty-seven professional ballet dancers (men: 14; women: 13) attended one data collection session, completing five maximal countermovement jumps in parallel, first, second, fourth, and fifth positions. Three-dimensional ankle mechanics, landing vGRF variables, and jump height were recorded via a seven-camera motion capture system and one force platform. A repeated measures multivariate analysis of variance was used to assess the main effects foot position across all target variables. A linear discriminate analysis was conducted to investigate target variables across foot positions. Frontal and transverse plane ankle mechanics had the largest impact when discriminating between foot positions. Ankle power in the transverse plane during jump landing in fourth was double that of all other positions. Our findings suggest that ankle range of motion should be restored before returning to jumps in fourth and fifth positions following distal lower extremity injury. The multiplanar energy transfer observed indicates a need for specific exercises to develop multiplanar force and rate of force development of local structures around the ankle.

This study aimed to investigate the associations between peak plantarflexion ankle joint moments and vertical ground reaction forces (vGRF) during jump landings, and static ankle dorsiflexion range of motion (ROM), three-dimensional ankle excursions, and lower extremity strength in professional ballet dancers. Twenty-seven professional ballet dancers volunteered to participate (men = 14, women = 13). Participants attended one data collection session to measure dorsiflexion ROM and isometric lower extremity strength. Two further sessions were used to establish ankle mechanics and vGRFs during countermovement jump landings in seven foot positions, via a seven-camera motion capture system and piezoelectric force platform. Two linear mixed-effects models were used to investigate associations between the target variables and strength, dorsiflexion ROM, and ankle excursions. Dancer identification, sex, and foot position were entered as random effects. Model fit, when considered independent of random effects, was generally poor with the predictor variables explaining little of the variance of peak plantarflexion ankle joint moments (R 2  = 0.02) or vGRF (R 2  = 0.01). Model fit improved when random effects were considered (R 2  = 0.65 & 0.34). Frontal plane ankle excursion was the only predictor variable with a significant negative association with peak plantarflexion ankle joint moments (p = .016), although coefficient estimates were small. Strength, static ankle dorsiflexion ROM, and three-dimensional ankle excursions are poor predictors of load experienced at a joint and system level in professional ballet dancers. Differences between individuals, sex, and foot position may be better indicators of the load experienced during jump landings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Preprofessional ballet dancers are exposed to the risk of injuries, primarily in the lower extremities, with most injuries occurring during jumping and landing activities. Interlimb asymmetry during jumping and landing activities has been associated with the injury risk in adolescent athletes, but this has not been examined in dancers., Purpose: To investigate associations between interlimb asymmetry during a double-leg countermovement jump (DL-CMJ) and single-leg jump (SLJ) and the injury risk in adolescent preprofessional ballet dancers., Study Design: Cohort study; Level of evidence, 2., Methods: Adolescent preprofessional ballet dancers (N = 255) performed 3 DL-CMJs and 3 SLJs on force plates during annual screening. Absolute and directional (separate values for left and right limb dominance) asymmetries in a set of kinetic variables during a DL-CMJ and in jump height during an SLJ were calculated. Each variable was characterized as having "high" or "normal" asymmetry according to the percentage of asymmetry (greater than or less than or equal to, respectively, the mean ± 0.5 SD) based on the present sample. Risk ratios (RRs) and 95% CIs were calculated based on the injury incidence in the subsequent academic year., Results: Of the 242 dancers that satisfied the inclusion criteria, 128 injuries were observed in the subsequent academic year. In the whole sample, 3 absolute, 7 left limb-dominant, and 1 right limb-dominant kinetic asymmetry in the eccentric, concentric, and landing phases of the DL-CMJ as well as left limb-dominant jump height asymmetry in the SLJ were associated with a significant ( P < .001) increase in the injury risk (RR, 1.28-1.69 [95% CI, 1.02-2.37]). Separating by sex, asymmetries in the eccentric and landing phase of the DL-CMJ were not significant in boys, while in girls, RRs for asymmetries in the eccentric and landing phase of the DL-CMJ increased, and SLJ jump height asymmetry was not significant., Conclusion: Higher asymmetries in certain kinetic variables during the DL-CMJ and in jump height during the SLJ were associated with an elevated risk of injuries in elite preprofessional ballet dancers with some sex-specific differences. Associations were mainly identified for high left limb-dominant asymmetry in the takeoff phase, suggesting that the injury risk may be specific to a relative right limb deficit., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: N.D.H.M.’s PhD studies on the relationship between adolescent maturation, physical characteristics, and injuries are funded equally by VALD Performance and The Royal Ballet School, and this work is part of his employment at The Royal Ballet School; he has not consulted them on any part of this article, and they have not taken any role in the preparation of this article or the research strategy. G.P.S., as part of his employment at Amazon, is involved in a data-sharing agreement with St Mary's University and The Royal Ballet School from 2019 to 2026 to allow for the analysis of this study's data and the submission of this work. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Competing Interests: Competing interests: None declared.

Background: Abdominal obesity (AO) indirectly represents visceral adiposity and can be assessed by waist circumference (WC) measurement. In Latin America, cut-off points for the diagnosis of AO are based on Asian population data. We aim to establish the WC cut-off points to predict major cardiovascular events (MACE) and incident diabetes., Methods: We analyzed data from the cohort PURE study in Colombia. WC cut-off points were defined according to the maximum Youden index. Multivariate logistic regression was used to obtain associations between WC and MACE, diabetes, and cumulative incidence of outcomes visualized using Kaplan-Meier curves., Results: After a mean follow-up of 12 years, 6,580 individuals with a mean age of 50.7 ± 9.7 years were included; 64.2% were women, and 53.5% were from rural areas. The mean WC was 85.2 ± 11.6 cm and 88.3 ± 11.1 cm in women and men, respectively. There were 635 cases of the MACE composite plus incident diabetes (5.25 events per 1,000 person-years). Using a cut-off value of 88.85 cm in men (sensitivity = 0.565) and 85.65 cm in women (sensitivity = 0.558) resulted in the highest value for the prediction of the main outcome. These values were associated with a 1.76 and 1.41-fold increased risk of presenting the composite outcome in men and women, respectively., Conclusions: We defined WC cut-off points of 89 cm in men and 86 cm in women to identify the elevated risk of MACE and incident diabetes. Therefore, we suggest using these values in cardiovascular risk assessment in Latin America., 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., (© 2023 Lopez-Lopez, Gonzalez, Lanza, Martinez-Bello, Gomez-Arbelaez, Otero, Cohen, Perez-Mayorga, Garcia-Peña, Rangarajan, Yusuf and Lopez-Jaramillo.)

BACKGROUND: Sport-specific training is an integral component of returning to sport following injury. Frameworks designed to guide sport-specific rehabilitation need to integrate and adapt to the specific context of elite sport. The control-chaos continuum (CCC) is a flexible framework originally designed for on-pitch rehabilitation in elite football (soccer). The concepts underpinning the CCC transfer to other elite sport rehabilitation environments. CLINICAL QUESTION: How can practitioners and clinicians transfer the CCC to elite basketball, to support planning and return to sport? On-court rehabilitation is a critical sport-specific rehabilitation component of return to sport, yet there are no frameworks to guide practitioners when planning and delivering on-court rehabilitation. KEY RESULTS: Based on our experience working in the National Basketball Association, we report how the CCC framework can apply to elite basketball. We focus on the design and delivery of progressive training in the presence of injury in this basketball-specific edition of the CCC. Given the challenges when quantifying "load" in basketball, we encourage practitioners and clinicians to consider the qualitative aspects of performance such as skill, sport-specific movement, contact, and decision making. CLINICAL APPLICATION: The 5-phase framework describes training progression from high control, a return to on-court running, to high chaos, a return to "live" unrestricted basketball. The model can be adapted to both short- and long-term injuries based on injury and progression criteria. Strength and power "diagnostics" can be strategically implemented to enhance decision making throughout the return to sport continuum. J Orthop Sports Phys Ther 2023;53(9):1-12. Epub: 9 August 2023. doi:10.2519/jospt.2023.11981 .

Background: Metabolic syndrome (MetS) is a disorder associated with an increased risk for the development of diabetes mellitus and its complications. Lower isometric handgrip strength (HGS) is associated with an increased risk of cardiometabolic diseases. However, the association between HGS and arterial stiffness parameters, which are considered the predictors of morbidity and mortality in individuals with MetS, is not well defined., Objective: To determine the association between HGS and HGS asymmetry on components of vascular function in adults with MetS., Methods: We measured handgrip strength normalized to bodyweight (HGS/kg), HGS asymmetry, body composition, blood glucose, lipid profile, blood pressure, pulse wave velocity (PWV), reflection coefficient (RC), augmentation index @75 bpm (AIx@75) and peripheral vascular resistance (PVR) in 55 adults with a diagnosis of MetS between 25 and 54 years old., Results: Mean age was 43.1 ± 7.0 years, 56.3% were females. HGS/kg was negatively correlated with AIx@75 (r = -0.440), p < 0.05, but these associations were not significant after adjusting for age and sex. However, when interaction effects between sex, HGS/kg and age were examined, we observed an inverse relationship between HGS/kg and AIx@75 in the older adults in the sample, whereas in the younger adults, a weak direct association was found. We also found a significant association between HGS asymmetry and PVR (beta = 30, 95% CI = 7.02; 54.2; p <0.012)., Conclusions: Our findings suggest that in people with MetS, maintaining muscle strength may have an increasingly important role in older age in the attenuation of age-related increases in AIx@75-a marker of vascular stiffness-and that a higher HGS asymmetry could be associated with a greater vascular resistance.

This study aimed to determine the within- and between-session reliability of ankle mechanics and vertical ground reaction forces (vGRF) during jump landings in turned-out and parallel foot positions in professional ballet dancers. Twenty-four professional ballet dancers (men = 13, women = 11) attended two data collection sessions where they completed five maximal countermovement jumps in each foot position. The ankle joint mechanics and vGRF of the right limb were recorded via a seven-camera motion capture system and one force platform. Within- and between-session intraclass correlation coefficients (ICC), coefficients of variation (CV), standard error of measurement, and minimal detectable change were calculated for three-dimensional ankle excursion, peak ankle angle, ankle joint velocity, moment, and power, as well as peak landing vGRF, time to peak landing vGRF, loading rate, and jump height. Across both foot positions, within- (ICC: 0.17-0.96; CV: 1.4-82.3%) and between-session (ICC: 0.02-0.98; CV:1.3-57.1%) reliability ranged from poor to excellent, with ankle excursion, peak ankle angle, and jump height demonstrating the greatest ICC values (ICC: 0.65-0.96; CV: 1.4-57%). Jump landings in a turned-out foot position demonstrated better within-session reliability compared to a parallel position, however, no difference in between-session reliability across the foot positions was observed. Most ankle mechanics provide adequate between-session, but not within-session, reliability during jump landings in professional ballet dancers., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Abstract: Howarth, DJ, McLean, BD, Cohen, DD, and Coutts, AJ. Sensitivity of countermovement jump variables in professional rugby union players within a playing season. J Strength Cond Res 37(7): 1463-1469, 2023-The aim of this study was to explore the measurement sensitivity of a wide range of countermovement jump (CMJ) variables to a full European professional rugby union season. A secondary purpose was to compare 3 different data treatment methods for the calculation of CMJ variables. Twenty-nine professional rugby union players (mean ± SD; age 24 ± 4 years, height 183.7 ± 8.0 cm, body mass 101.6 ± 10.7 kg) completed a minimum of 12 CMJ testing sessions on Thursdays-a day preceded by a rest day and a minimum of 96 hours after a match-throughout a season. Measurement sensitivity, quantified by signal-to-noise ratio (SNR), was determined for 74 CMJ variables and was calculated by dividing the signal, (week-to-week variation expressed as a coefficient of variation [CV%]) by the noise (interday test/retest reliability expressed as CV%). We also identified variables which had no overlap between the 95% confidence intervals (CIs) for the signal and the noise. The 3 data treatment methods for comparison were (a) mean output across 3 jump trials (Mean3), (b) single output from the trial with the highest jump (BestJH), and (c) the trial with the highest flight time to contraction time ratio (BestFTCT). Most variables had an SNR >1.0 (Mean3 = 60/74; BestFTCT = 59/74; BestJH = 48/74). Fewer variables displayed a nonoverlap of 95% CIs (Mean3 = 23/60; BestFTCT = 22/59; BestJH = 16/48). Most CMJ variables during a professional rugby season demonstrated a signal that exceeded measured noise (SNR > 1.0) and that using the Mean3 or BestFTCT data treatment methods yields a greater number of variables considered sensitive within a season (i.e., SNR > 1.0) than when using BestJH. We also recommend the calculation of the 95% CIs for both signal and noise, with nonoverlap indicative of a greater probability that the responsiveness of the variable at team level (i.e., SNR) also applies at the individual level. As sensitivity analysis is cohort and environment specific, practitioners should conduct a sensitivity analysis using internal signal and noise data to inform their own monitoring protocols., (Copyright © 2022 National Strength and Conditioning Association.)

Cardiovascular diseases (CVDs) remain the leading cause of worldwide death, accounting for significant morbidity, mortality, disability, and reduced quality of life. The global prevalence of cardiovascular (CV) risk factors, such as type 2 diabetes mellitus, hypertension, dyslipidemia, and obesity, has grown exponentially in the last decades, particularly in low-medium income countries, and it's projected to increase rapidly in the coming years as the population progressively ages, leading to increased cardiovascular disease (CVD) and associated mortality. In fact, data from the global burden of disease study shows that CV mortality, associated disability-adjusted life years (DALYs), and years of life lost (YLL) have increased steadily, nearly doubling from 1990 to 2019. Recent evidence proves the existence of an inverse association between hand grip strength (HGS), as a proxy for global muscle strength, with all-cause mortality, CV mortality, and the development of several chronic diseases. These associations have been demonstrated recurringly across the entire lifespan, beginning in childhood, and carrying on throughout adult life. Mounting evidence strongly indicates that HGS is an early predictor of chronic disease in premorbid populations and a therapeutic target for CVD prevention. Recent clinical trials have consistently shown that resistance exercise, which increases strength and potentially muscle mass, significantly improves the control of known CVD risk factors, reduces the risk of all-cause death and cardiovascular mortality. In this review, we explore the latest evidence regarding the association between low muscle strength and diverse metabolic alterations, along with the interventions that could improve cardiometabolic risk factors, while simultaneously increasing muscle fitness., (Copyright © 2022 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.)

Abstract: Spyrou, K, Alcaraz, PE, Marín-Cascales, E, Herrero-Carrasco, R, Cohen, DD, and Freitas, TT. Neuromuscular performance changes in elite futsal players over a competitive season. J Strength Cond Res 37(5): 1111-1116, 2023-A professional futsal season imposes a great amount of physiological and mechanical stress on players. The main aim of this study was to examine the changes in neuromuscular performance qualities across the season. Ten professional male players performed a 10-m sprint, standing long jumps (SLJs), and countermovement jumps (CMJs) during the competitive season (i.e., every ∼5 weeks from September to January). A one-way repeated measures ANOVA with post hoc pairwise comparisons and effect sizes (ESs) were used to analyze potential differences among these assessments. A significant and large decline was found in concentric peak power ( p = 0.040; ES = 1.24). A nonsignificant and moderate decrease was observed in sprint ability ( p = 0.155; ES = 1.03), CMJ height ( p = 0.175; ES = 1.00), and SLJ distance ( p = 0.164; ES = 1.03). Regarding other CMJ kinetic variables, nonsignificant and moderate changes were found. In summary, considering the neuromuscular performance tests and variables assessed, only concentric peak power in CMJ decreased significantly across the season; however, nonsignificant decrements were observed in sprinting time, SLJ, CMJ height, and other kinetic metrics. CMJ variables during the jump-land cycle should be incorporated alongside more traditional measures (e.g., jump height) to monitor performance during the season., (Copyright © 2023 National Strength and Conditioning Association.)

Isometric handgrip or (wall) squat exercise performed three times per week produces reductions in systolic blood pressure (SBP) in adults with hypertension. We aimed to compare these interventions and the potential to retain benefits with one exercise session per week. We compared blood pressure changes following handgrip and squat isometric training interventions with controls in a randomized controlled multicentre trial in 77 unmedicated hypertensive (SBP ≥ 130 mmHg) adults. Exercise sessions were performed in the workplace and consisted of four repetitions-three sessions per week for the first 12 weeks (phase 1), and one session per week for the subsequent 12 weeks (phase 2). Office blood pressure (BP) was measured at baseline, post-phase 1 and post-phase 2. Post-phase 1, mean reductions in SBP were significantly greater in handgrip (-11.2 mmHg, n = 28) and squat (-12.9 mmHg, n = 27) groups than in controls (-.4 mmHg; n = 22) but changes in DBP were not. There were no significant within-group changes during phase 2 but SBP was 3.8 mmHg lower in the wall squat than the handgrip group-a small magnitude but clinically important difference. While both interventions produced significant SBP reductions, the wall squat appears to be more effective in maintaining benefits with a minimal training dose. The low time investment to achieve and retain clinically significant SBP reductions-42 and 12 min, respectively-and minimal cost, particularly of the wall squat, make it a promising intervention for delivery in public health settings., (© 2023 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.)

Abstract: Howarth, DJ, Cohen, DD, McLean, BD, and Coutts, AJ. Establishing the noise: interday ecological reliability of countermovement jump variables in professional rugby union players. J Strength Cond Res 36(11): 3159-3166, 2022-The purpose of this study was to examine the interday "ecological" reliability of a wide range of ground reaction force-derived countermovement jump (CMJ) variables. Thirty-six male, professional rugby union players performed 3 CMJs on 4 separate days over an 8-day period during the first week of preseason. We calculated reliability for 86 CMJ variables across 5 interday combinations using 2 criteria: mean output across 3 jump trials (Mean 3 ) and single output from the highest jump (Best JH ). Interday coefficient of variation (CV) of the 86 variables in each CMJ phase, for Mean 3 and Best JH , respectively, ranged between concentric = 2-11% and 2-13%; eccentric = 1-45% and 1-107%; and landing = 4-32% and 6-45%. Mean 3 interday CV was lower in all 86 variables across every interday combination, compared with Best JH . CVs were lower in our cohort than previous studies, particularly for eccentric phase variables. There was no meaningful difference between interday conditions, suggesting any 2-day combination conducted within the first 8 days of preseason, represents a measure of "noise." We did not apply arbitrary reliability "cut-offs" used in previous work (e.g., CV <10%); therefore, our analysis provides reference reliability for a wide range of CMJ variables. However, we recommend that practitioners assess reliability in their athletes, as it is likely to be environment, protocol, and cohort specific., (Copyright © 2021 National Strength and Conditioning Association.)

Rapid horizontal accelerations and decelerations are crucial events enabling the changes of velocity and direction integral to sports involving random intermittent multi-directional movements. However, relative to horizontal acceleration, there have been considerably fewer scientific investigations into the biomechanical and neuromuscular demands of horizontal deceleration and the qualities underpinning horizontal deceleration performance. Accordingly, the aims of this review article are to: (1) conduct an evidence-based review of the biomechanical demands of horizontal deceleration and (2) identify biomechanical and neuromuscular performance determinants of horizontal deceleration, with the aim of outlining relevant performance implications for random intermittent multi-directional sports. We highlight that horizontal decelerations have a unique ground reaction force profile, characterised by high-impact peak forces and loading rates. The highest magnitude of these forces occurs during the early stance phase (&lt; 50 ms) and is shown to be up to 2.7 times greater than those seen during the first steps of a maximal horizontal acceleration. As such, inability for either limb to tolerate these forces may result in a diminished ability to brake, subsequently reducing deceleration capacity, and increasing vulnerability to excessive forces that could heighten injury risk and severity of muscle damage. Two factors are highlighted as especially important for enhancing horizontal deceleration ability: (1) braking force control and (2) braking force attenuation. Whilst various eccentric strength qualities have been reported to be important for achieving these purposes, the potential importance of concentric, isometric and reactive strength, in addition to an enhanced technical ability to apply braking force is also highlighted. Last, the review provides recommended research directions to enhance future understanding of horizontal deceleration ability., (© 2022. The Author(s).)

Background: Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease and is closely associated with cardiometabolic disorders, being insulin resistance (IR) the common pathogenic mechanism. The triglycerides/glucose (TyG) index and triglycerides/HDL-c (TG/HDL) ratio are markers correlated with IR. We compared the capacity of these two indexes, alongside IR, to detect NAFLD., Methods: In a cross-sectional cohort study, we examined 263 active military personnel from the Colombian Air Force, aged between 29 and 54 years. Anthropometric measurements and biochemical determinations (glycemia, lipid profile, and insulin) were obtained, and ultrasound studies were performed to evaluate the presence of NAFLD. HOMA-IR index was calculated as (fasting insulin ( µ IU/mL) × fasting glucose (mmol/L)/22.5), the TyG index as Ln (triglycerides (mg/dL) × fasting glucose (mg/dL)/2), and the TG/HDL ratio as (triglycerides (mg/dL)/HDL-c (mg/dL))., Results: NAFLD ultrasound criteria were met in 70 individuals (26.6%). Subjects with NAFLD had significantly higher values of HOMA-IR (2.55 ± 1.36 vs. 1.51 ± 0.91), TyG (9.17 ± 0.53 vs. 8.7 ± 0.51), and TG/HDL (6.6 ± 4.54 vs. 3.52 ± 2.32) compared to those without NAFLD ( p < 0.001). A TyG cutoff point of 8.92 showed an AUC of 0.731, while cutoff points of 3.83 for TG/HDL and 1.68 for HOMA-IR showed an AUC of 0.766 and 0.781, respectively., Conclusion: Our study shows that novel and lower-cost markers of IR are useful for detecting NALFD, with a performance comparable to the HOMA-IR index. These markers should be used as the first step when screening patients for NAFLD., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2022 Maritza Pérez-Mayorga et al.)

Cardiovascular disease is the leading cause of death globally, accounting for approximately 32% of all deaths in 2019. There has been increasing interest in understanding the role of low muscular strength as a risk factor for cardiovascular disease, given its association with other cardiovascular risk factors such as hypertension, diabetes mellitus, and metabolic syndrome. An inverse association between muscle strength, chronic disease, all-cause mortality, and cardiovascular-related death has been reported. Recent clinical trials have consistently shown that resistance exercise, which increases strength, and potentially muscle mass, significantly improves the control of known cardiovascular disease risk factors and reduces the risk of all-cause death and cardiovascular mortality. In the present article, we review the growing body of evidence that supports the need for future research to evaluate the potential of handgrip strength as a screening tool for cardiovascular disease and its risk factors in the clinical medical setting, as part of routine care using an affordable handgrip strength device. Moreover, it is crucial to devise largescale interventions driven by governmental health policies to educate the general population and healthcare professionals about the importance of muscular strengthening activities and to promote access to these activities to improve cardiometabolic health and reduce incidence of cardiovascular disease and mortality.

The purpose of this study was to investigate associations between, and within, drop jump (DJ) neuromuscular performance (NMP) qualities and maximal horizontal deceleration ability. We also compared DJ NMP qualities in "high" versus "low" horizontal deceleration ability athletes. Twenty-nine university athletes performed: (1) DJs on force plates from 20 (DJ20) and 40 cm (DJ40) heights and (2) maximal horizontal deceleration, measured using radar, following a 20 m acceleration. Maximal horizontal deceleration was evaluated using deceleration (HDEC; m·s -2 ), across the entire deceleration phase and during early and late deceleration sub-phases. Of the DJ variables assessed, DJ20 and DJ40 reactive strength index (RSI) and concentric mean force had the largest correlations with HDEC ( r  = -0.54 to -0.61) and the largest differences between high and low HDEC groups ( d  = 1.20 to 1.40). These correlations were stronger with the early than late HDEC sub-phase ( r  = -0.54 to -0.66 vs. r  = -0.24 to -0.40). Notably, eccentric mean force in DJ40 had large correlations with both DJ20 and DJ40 concentric mean force ( r  = 0.67 to 0.77), whereas at DJ20 these correlations were small ( r  = 0.22 to 0.40). Similarly, DJ40 eccentric mean force had a much larger difference between the high and low HDEC groups than DJ20 ( d  = 1.11 vs. 0.51). These findings suggest DJ RSI from either height may be used as a proxy for HDEC ability, while DJ kinetic analyses should use a higher height to distinguish those with a better capacity to generate eccentric braking forces under increased eccentric loading demands. HIGHLIGHTSPlayers with greater drop jump reactive strength index (RSI) demonstrated superior horizontal deceleration ability.Drop jump RSI had a greater association with the early compared to the late horizontal deceleration sub-phase.Of the drop jump kinetic variables examined, concentric mean force had the largest associations with horizontal deceleration ability.

Background: Hamstring strain injuries are the most common type of injury in elite football and are associated with a high risk of reinjury, particularly those involving the intramuscular tendon (IMT). Limited information is available regarding the rehabilitation and return to sport (RTS) processes following such injuries. This case study describes the clinical presentation of an elite football player following IMT hamstring injury, their on- and off-pitch rehabilitation alongside performance monitoring throughout RTS and beyond., Case Scenario: An elite football player suffered a grade 2c hamstring injury during an English Premier League (EPL) match. The player underwent early post-injury management, alongside progressive off-pitch physical preparation. The 'control-chaos continuum' was used as a framework for on-pitch rehabilitation to prepare the player for a return to full team training and competition. Objective and subjective markers of the player's response to progressive on- and off-pitch loading were monitored throughout RTS and beyond., Outcomes: The player returned to on-pitch rehabilitation after 11 days, to full team training having achieved weekly pre-injury chronic running load outputs after 35 days and played in the EPL 40 days post-injury. The player did not suffer reinjury for the rest of the EPL season., Conclusion: An understanding the unique structural and mechanical properties of the IMT, alongside expected RTS timeframes are important to inform rehabilitation and decision-making processes post-injury. Performance and frequent load-response monitoring throughout RTS and beyond, in conjunction with practitioner experience and effective communication are critical in facilitating effective RTS and reduce risk of reinjury following IMT injury., Competing Interests: Declaration of competing interest None declared., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: A higher prevalence of hypertension is reported among Afro-descendants compared with other ethnic groups in high-income countries; however, there is a paucity of information in low- and medium-income countries., Methods: We evaluated 3,745 adults from 3 ethnic groups (552 White, 2,746 Mestizos, 447 Afro-descendants) enrolled in the prospective population-based cohort study (PURE)-Colombia. We assessed associations between anthropometric, socioeconomic, behavioral factors, and hypertension., Results: The overall prevalence of hypertension was 39.2% and was higher in Afro-descendants (46.3%) than in Mestizos (37.6%) and Whites (41.5%), differences that were due to the higher prevalence in Afro-descendant women. Hypertension was associated with older age, increased body mass index, waist circumference and waist-to-hip ratio, independent of ethnicity. Low education was associated with hypertension in all ethnic groups, and particularly in Afro-descendants, for whom it was the factor with the strongest association with prevalence. Notably, 70% of Afro-descendants had a low level of education, compared with 52% of Whites-26% of Whites were university graduates while only 7% of Afro-descendants were. We did not find that education level alone had a mediator effect, suggesting that it is not a causal risk factor for hypertension but is an indicator of socioeconomic status, itself an important determinant of hypertension prevalence., Conclusions: We found that a higher prevalence of hypertension in Colombian Afro-descendants than other ethnic groups. This was principally associated with their lower mean educational level, an indicator of lower socioeconomic status., (© The Author(s) 2022. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The current UK physical activity guidelines recommend that adults aged 19 to 65 years perform activity to strengthen muscle and bone a minimum of twice weekly. The number of adults meeting strengthening activity guidelines is lower than for aerobic activity, but estimates vary between studies partly due to differences in how muscle-strengthening activity is defined. We aimed to provide estimates for strengthening activity prevalence in English adults based on a nationally representative sample of n = 253,423 18-65-year-olds. We attempted to quantify the variation in estimates attributable to differences in the way strengthening activity is defined. Finally, we aim to provide a brief descriptive epidemiology of the factors associated with strengthening activity. Adults met guidelines for aerobic activity if they reported the activity equivalent to >150 min/week moderate-intensity exercise. Respondents met strengthening guidelines if they reported at least two bouts per week of strengthening activity. We defined strengthening activity, first, according to criteria used in the Health Survey for England (HSE). Second, we counted bouts of strengthening activities for which we could find evidence of health-related benefits (Evidence). Third, we included bouts of strengthening activity as defined in current UK physical activity guidelines (Guideline). Two-thirds (67%) of adults met guidelines for aerobic activity (69% of men, 65% of women). Less than one-third (29% of men and 24% of women) met guidelines for the HSE definition of strengthening activity. Under the Evidence definition, 16% of men and 9% of women met strengthening guidelines. Using the most-stringent definition (Guideline) just 7.3% of men and 4.1% of women achieved the recommendations for strengthening activity. We found females and older adults (50-65 years) were less likely to meet guidelines for aerobic, strengthening, and combined aerobic plus strengthening activity. The prevalence of meeting activity guidelines was lower in adults from more deprived areas (compared with the least deprived); Adults with lower academic qualifications (Level 1) were less likely to meet activity guidelines than those educated to Level 4 (Degree Level) or higher. Having a limiting disability was associated with a lower prevalence of meeting activity guidelines. Associations between socio-demographic measures and the prevalence of adults meeting activity guidelines were stronger for strengthening activity than for aerobic 51(or combined aerobic plus strengthening) activity Compared with aerobic activity, fewer adults engage in strengthening activity regardless of how it is defined. The range in estimates for how many adults meet strengthening activity guidelines can be explained by variations in the definition of 'strengthening' that are used and the specific sports or activities identified as strengthening exercise. When strengthening activity is included, the proportion of English adults meeting current physical activity guidelines could be as high as 1 in 3 but possibly as low as just 1 in 20. A harmonized definition of strengthening activity, that is aligned with physical activity guidelines, is required to provide realistic and comparable prevalence estimates., Competing Interests: The authors have declared that no competing interests exist.

Purpose: To assess the efficacy of a supervised in-school combined resistance and aerobic training program in adolescent girls and investigate whether responses differ according to birthweight., Methods: Participants (girls aged 13-17 y) were randomized either to an intervention replacing physical education (PE) classes with 2 × 60-minute training sessions per week (n = 58) or to a control group that continued to attend 2 × 60 minutes per week of curriculum PE (n = 41). We measured muscular fitness (handgrip, standing long jump, and sit-ups), cardiorespiratory fitness (20-m shuttle run), skinfolds, and lean body mass preintervention and postintervention and determined effect size (Hedge's g) differences between changes in these measures. We also compared changes within lower (<3000 g) and normal birthweight intervention and PE control subgroups., Results: The intervention group showed greater improvements in all the fitness measures and lean body mass (g = 0.22-0.48) and lower skinfold increases (g = 0.41) than PE controls. Within the intervention group, improvements in all fitness measures were larger in lower birthweight (g = 0.53-0.94) than in normal birthweight girls (g = 0.02-0.39)., Conclusion: Replacing curriculum PE with supervised training improved muscular and cardiorespiratory fitness and body composition outcomes in adolescent females. Our findings suggest an enhanced adaptive response to training in participants with lower birthweight which warrants further investigation.

The 'control-chaos continnum' is an adaptable framework developed to guide the on-pitch rehabilitation process in elite football. One of the key objectives of the continuum is to progressively return players to their preinjury chronic running load, while incorporating the qualitative aspects of movement and cognitive stresses integral to competitive match-play. Whilst injury and player-specific considerations are key to an individualised rehabilitation approach, a host of contextual factors also play an important role in return to sport (RTS) planning. In this article, we highlight some key intrinsic and extrinsic contextual factors for the practitioner to consider in the RTS planning process to help mitigate reinjury risk upon a return to team training. While a return to chronic running load is generally a critical component of the framework, we highlight circumstances in elite football where it is a less relevant factor in RTS decision-making., Competing Interests: Declaration of competing interest None declared., (Copyright © 2021 Elsevier Ltd. All rights reserved.)