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Traditional movement economy (ME) measures the energetic cost of in-line running. However, it is debatable whether such a measure is representative of movement efficiency for team sport athletes who are required to run and change direction repeatedly. This study evaluated ME during both in-line running and runs with directional changes and provided a preliminary exploration as to whether these abilities discriminate soccer players according to playing position, level, and sex. Forty-three soccer players were assessed for ME as extrapolated from oxygen uptake during in-line running (RE) and running with changes of directions (using 20 and 10 m shuttle runs [SRE 20 and SRE 10 ]) at 8.4 km/h mean speed. ME worsened with change of direction frequency ( p  < 0.001). Coefficient of determination was high between RE and SRE 20 ( r 2  =   0.601) but dropped below 0.5 for RE and SRE 10 ( r 2  = 0.280) as change of direction frequency increased. No significant differences were observed between different player positions, however, centre midfielders reported the best ME across any position and running mode, with the largest differences observed in centre backs over SRE 10 (41.9 ± 2.7 ml/kg/min [centre midfielders] vs 45 ± 1.8 ml/kg/min [centre backs]; ES = 1.19). No significant differences were observed for ME over any running condition for male players of different playing levels. Female players exhibited better ME than male players with significant differences observed for SRE 10 (41.5 ± 2.6 ml/kg/min [females] vs 44 ± 2.6 ml/kg/min [males]; p  = 0.013; ES = 0.94). RE does not adequately account for efficiency during activities that involve changes of direction. SRE 10 is a stronger discriminator of ME between soccer players of different position and sex.

Purpose: To investigate the acute effect of repeated-sprint activity (RSA) on change-of-direction economy (assessed using shuttle running economy [SRE]) in soccer players and explore neuromuscular and cardiorespiratory characteristics that may modulate this effect., Methods: Eleven young elite male soccer players (18.5 [1.4] y old) were tested on 2 different days during a 2-week period in their preseason. On day 1, lower-body stiffness, power and force were assessed via countermovement jumps, followed by an incremental treadmill test to exhaustion to measure maximal aerobic capacity. On day 2, 2 SRE tests were performed before and after a repeated-sprint protocol with heart rate, minute ventilation, and blood lactate measured., Results: Pooled group analysis indicated no significant changes for SRE following RSA due to variability in individual responses, with a potentiation or impairment effect of up to 4.5% evident across soccer players. The SRE responses to RSA were significantly and largely correlated to players' lower-body stiffness (r = .670; P = .024), and moderately (but not significantly) correlated to players' force production (r = -.455; P = .237) and blood lactate after RSA (r = .327; P = .326)., Conclusions: In summary, SRE response to RSA in elite male soccer players appears to be highly individual. Higher lower-body stiffness appears as a relevant physical contributor to preserve or improve SRE following RSA.

Aims: In this work, the survival and mortality data of 54 consecutive patients admitted to the Intensive Care Unit (ICU) and suffering from severe respiratory insufficiency imputable to viral SARS - CoV - 2 infection were analyzed and shared, after a critical review of the evidence in order to optimize the most dedicated clinical and treatment strategy, for a future 'targeted' management in the care of the possible return flu outbreak., Methods: At our Emergency Department of the Crema Hospital, from the beginning of the pandemic until the end of June 2020, 54 consecutive patients admitted to ICU suffering from severe acute respiratory infection (SARI) and severe respiratory distress (ARDS) attributable to viral SARS - CoV - 2 infection were recruited. The recruitment criterion was based on refractory hypoxia, general condition and clinical impairment, comorbidities and CT images. The incoming parameters of the blood chemistry and radiology investigations and the timing of the gold - tracheal intubation were compared. Medical therapy was based on the application of shared protocols., Results: The onset of symptoms was varyng, i.e. within the range of 1-14 days. The average time from the admission to the emergency room to the admission to intensive care was approximately 120 h. The average number of days of hospitalization in the ICU was 28 days. With a majority of male patients, the most significant age group was between 60 and 69 years. There were 21 deaths and, compared to the survivors, the deceased ones were older at an average age of about 67 years (vs an average age of the survivors of about 59 years). From the available data entering the ICU, the surviving patients presented average better values of oximetry and blood gas analysis, with a lower average dosage of D-Dimer than the deceased. Ones with a presence of bilateral pneumonia in all patients, the worsening of the ARDS occurred in 31 patients. 9 out of 25 patients early intubated died, while 12 out of 23 patients died when intubation was performed after 24 h of non-invasive ventilation. The presence of multiple comorbidities was shown in 17 of 28 patients and revealed an additional adverse prognostic factor. Also, more than one complication in the same patient were detected; after respiratory worsening, renal failure was more frequently found in 16 patients. Some particular complications such as lesions induced by ventilation with barotrauma mechanism (VILI), ischemic heart disease and the appearance of central and peripheral neurological events were detected too., Considerations: SARS - CoV - 2 disease is caused by a new coronavirus that has its main route of transmission through respiratory droplets and close contact, resulting in a sudden onset of the clinical syndrome with acute respiratory infection (SARI) and severe respiratory distress (ARDS). But it can also appear with other symptoms such as gastrointestinal or neurological events, as to be considered as a disease with multisystem phenotype. This pathology evolves towards a serious form of systemic disease from an acute lung damage to venous and arterial thromboembolic complications and multi-organ failure, mostly associated with high mortality. All patients received empirical or targeted antibiotic therapy for prevention and control of infections of potential pathogens, together with low molecular weight heparin therapy. The majority of patients was subjected to the off - label protocol with antivirals and hydroxychloroquine therapy, we used cortisone support therapy under surveillance and in 3 cases the protocol with anti - IL6 monoclonal antibody (Tolicizumab). In a simplified classification of the tomographic examination of the chest, mostly 3D and 2C lesions were found in the deceased patients with a prevalence of severe and moderate forms, whilst in the survivors the distribution appears with a prevalence of medium and moderate forms. Among the intubated patients, 21 patients, all suffering from worsening ARDS, died whilst there was no mortality in patients subjected to non-invasive ventilation it so. The heterogeneity of the respiratory syndromes and the presence of multiple comorbidities represent an unfortunate prognostic factor. Among the complications, besides the respiratory worsening, renal failure, liver failure and the state of sepsis were most frequently found; less frequent complications were lesions induced by ventilation with a barotrauma mechanism, ischemic heart disease, the appearance of central neurological events of sensory alterations, meningo - encephalitis and cerebral hemorrhage, and peripheral neurological events with polyneuro - myopathies. Mechanical ventilation can adversely affect the prognosis due to lung damage induced, protective ventilation remains the necessary treatment during severe hypoxia in patients with SARS - CoV - 2. The essential prerequisite remains the search for optimal 'customized' values since conditions can vary from patient to patient and, in the same patient, during different times of ventilation., Conclusions: In these extraordinary circumstances, our reality was among the most affected and was able to hold the impact thanks to the immediate great response set in place by the operators, although it costed us an effort especially the one to try to guarantee a high quality level of assistance and care compared to the huge wave of patients in seriously bad conditions. Further research on this heterogeneous pathology and data sharing could help identify a more dedicated clinical decision-making and treatment pathway that, together with a resource planning, would allow us to better face any new disease outbreak., Competing Interests: Declaration of Competing Interest This study does not have any financial support from manufacturer or other sources. None of the Authors has any conflict of interest to declare., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Pulmonary parenchymal and vascular damage are frequently reported in COVID-19 patients and can be assessed with unenhanced chest computed tomography (CT), widely used as a triaging exam. Integrating clinical data, chest CT features, and CT-derived vascular metrics, we aimed to build a predictive model of in-hospital mortality using univariate analysis (Mann-Whitney U test) and machine learning models (support vectors machines (SVM) and multilayer perceptrons (MLP)). Patients with RT-PCR-confirmed SARS-CoV-2 infection and unenhanced chest CT performed on emergency department admission were included after retrieving their outcome (discharge or death), with an 85/15% training/test dataset split. Out of 897 patients, the 229 (26%) patients who died during hospitalization had higher median pulmonary artery diameter (29.0 mm) than patients who survived (27.0 mm, p < 0.001) and higher median ascending aortic diameter (36.6 mm versus 34.0 mm, p < 0.001). SVM and MLP best models considered the same ten input features, yielding a 0.747 (precision 0.522, recall 0.800) and 0.844 (precision 0.680, recall 0.567) area under the curve, respectively. In this model integrating clinical and radiological data, pulmonary artery diameter was the third most important predictor after age and parenchymal involvement extent, contributing to reliable in-hospital mortality prediction, highlighting the value of vascular metrics in improving patient stratification.

This study aimed to evaluate the effect of high-intensity interval training shock microcycles (HIIT SM ) on endurance, running economy and change of direction economy in female soccer players. Nineteen sub-elite female soccer players were randomised to two groups: HIIT SM (10 HIIT sessions over 13 days) or HIIT TRAD (4 HIIT sessions over 13 days) interventions. Endurance performance was evaluated through the 30-15 intermittent fitness test (30-15 IFT ); running economy over a 5-min treadmill run; and change of direction economy over two conditions: (1) 5-min 20m shuttle run, and (2) 5-min 10m shuttle run. HIIT SM significantly improved 30-15 IFT scores compared to baseline (+4.4%, p=0.009; d =0.96) and 30-15 IFT scores relative to HIIT TRAD (p=0.002; d =2.01). There was no significant interaction (group×time) for running economy and change of direction economy. Pre- to post- intervention there was a significant main time effect for blood lactate over 20m and 10m shuttle runs (p<0.001 and p=0.037, respectively), with large ( d =0.93) an d moderate ( d =0.53) changes observed for the HIIT SM over the two distances, respectively. HIIT SM may be more effective than HIIT TRAD to improve 30-15 IFT over shorter training periods but may not affect running economy and change of direction economy., Competing Interests: The authors declare that they have no competing interests nor professional relationships with companies or manufacturers who can benefit from the results of the present study., (Thieme. All rights reserved.)

Purpose: To evaluate the reliability of new change-of-direction-economy tests (assessing energetic efficiency when performing continuous shuttle runs) compared with common running-economy tests in soccer players Methods: Sixteen subelite, male soccer players were recruited to perform a testing battery involving running economy (RE), 10-m shuttle-running economy (SRE10), and 20-m shuttle-running economy (SRE20) at 8.4 km·h-1 mean speed on 2 different days within 48 hours. SRE10 and SRE20 consisted of continuous shuttle runs interspersed with 180° directional changes. During the RE, SRE20, and SRE10 tests, respiratory exchange ratio and oxygen uptake were collected and used to calculate the movement-economy values over any running condition as oxygen cost and energetic cost. The secondary variables (carbon dioxide production, heart rate, minute ventilation, and blood lactate) were also monitored during all tests., Results: Depending on expression (oxygen cost or energetic cost), reliability was established for RE (CV: 5.5%-5.8%; ICC = .77-.88), SRE10 (CV: 3.5%-3.8%; ICC = .78-.96), and SRE20 (CV: 3.5%-3.8%; ICC = .66-.94). All secondary physiological variables reported good reliability (CV < 10%), except for blood lactate (CV < 35.8). The RE, SRE10, and SRE20 tests show good reliability in soccer players, whereas blood lactate has the highest variability among physiological variables during the economy tests., Conclusion: The assessment of change-of-direction economy through performing 20- and 10-m shuttle runs is reliable and can be applied to evaluate soccer players' energetic movement efficiency under more soccer-specific running conditions.

Dolci, F, Kilding, AE, Chivers, P, Piggott, B, and Hart, NH. High-intensity interval training shock microcycle for enhancing sport performance: A brief review. J Strength Cond Res 34(4): 1188-1196, 2020-High-intensity interval training (HIIT) is a powerful strategy to develop athletes' fitness and enhance endurance performance. Traditional HIIT interventions involve multiple microcycles (7-10 days long) of 2-3 HIIT sessions each, which have been commonly supported to improve athletic performance after a minimum period of 6 weeks training. Regardless of the efficacy of such an approach, in recent years, a higher frequency of HIIT sessions within a unique microcycle, commonly referred to as an HIIT shock microcycle, has been proposed as an alternative HIIT periodization strategy to induce greater and more efficient endurance adaptation in athletes. This review article provides an insight into this new HIIT periodization strategy by discussing (1) HIIT shock microcycle format and design; (2) the sustainability of this training strategy; (3) effects on performance and physiological parameters of endurance; and (4) potential mechanisms for improvements. Evidence advocates the sustainability and effectiveness of HIIT shock microcycle in different athletes to improve intermittent and continuous running/cycling performance and suggests mitochondria biogenesis as the main acute physiological adaptation following this intervention.

Spiteri, T, Binetti, M, Scanlan, AT, Dalbo, VJ, Dolci, F, and Specos, C. Physical determinants of Division 1 Collegiate basketball, Women's National Basketball League, and Women's National Basketball Association athletes: with reference to lower-body sidedness. J Strength Cond Res 33(1): 159-166, 2019-In female basketball, the assumed components of success include power, agility, and the proficiency at executing movements using each limb. However, the importance of these attributes in discriminating between playing levels in female basketball has yet to be determined. The purpose of this study was to compare lower-body power, change of direction (COD) speed, agility, and lower-body sidedness between basketball athletes participating in Division 1 Collegiate basketball (United States), Women's National Basketball League (WNBL) (Australia), and Women's National Basketball Association (WNBA) (United States). Fifteen female athletes from each league (N = 45) completed a double- and single-leg countermovement jump (CMJ), static jump, drop jump, 5-0-5 COD test, and an offensive and a defensive agility test. One-way analysis of variance with post hoc comparisons were conducted to compare differences in physical characteristics (height, body mass, age) and performance outcomes (jump, COD, agility assessments) between playing levels. Separate dependent t-tests were performed to compare lower-body sidedness (left vs. right lower limbs) during the single-leg CMJ jumps (vertical jump height) and 5-0-5 COD test for each limb within each playing level. WNBA athletes displayed significantly greater lower-body power (p = 0.01-0.03) compared with WNBL athletes, significantly faster COD speed (p = 0.02-0.03), and offensive and defensive agility performances (p = 0.02-0.03) compared with WNBL and Collegiate athletes. The WNBL athletes also produced a faster defensive agility performance compared with Collegiate athletes (p = 0.02). Furthermore, WNBA and WNBL athletes exhibited reduced lower-body sidedness compared with Collegiate athletes. These findings indicate the importance of lower-body power, agility, and reduced lower-body imbalances to execute more proficient on-court movements required to compete at higher playing levels.

Soccer is an intermittent team-sport, where performance is determined by a myriad of psychological, technical, tactical, and physical factors. Among the physical factors, endurance appears to play a key role into counteracting the fatigue-related reduction in running performance observed during soccer matches. One physiological determinant of endurance is movement economy, which represents the aerobic energy cost to exercise at a given submaximal velocity. While the role of movement economy has been extensively examined in endurance athletes, it has received little attention in soccer players, but may be an important factor, given the prolonged demands of match play. For this reason, the current review discusses the nature, impact, and trainability of movement economy specific to soccer players. A summary of current knowledge and limitations of movement economy in soccer is provided, with an insight into future research directions, to make this important parameter more valuable when assessing and training soccer players' running performance., Competing Interests: The authors declare they have no competing interests.

The first examples of polymeric homoleptic iron chalcogenolato complexes (1)(∞)[Fe(SePh)(2)] and (1)(∞)[Fe(SeMes)(2)] (Ph = phenyl = C(6)H(5), Mes = mesityl = C(6)H(2)-2,4,6-(CH(3))(3)) have been both prepared by reaction of [Fe(N(SiMe(3))(2))(2)] with two equivalents of HSeR (R = Ph, Mes) while (1)(∞)[Fe(SePh)(2)] was found to be also easily accessible through reactions of either FeCl(2), Fe(OOCCH(3))(2) or FeCl(3) with PhSeSiMe(3) in THF. In the crystal, the two compounds form one-dimensional chains with bridging selenolate ligands comprising distinctly different Fe-Se-Fe bridging angles, namely 71.15-72.57° in (1)(∞)[Fe(SePh)(2)] and 91.80° in (1)(∞)[Fe(SeMes)(2)]. Magnetic measurements supported by DFT calculations reveal that this geometrical change has a pronounced influence on the antiferromagnetic exchange interactions of the unpaired electrons along the chains in the two different compounds with a calculated magnetic exchange coupling constant of J = -137 cm(-1) in (1)(∞)[Fe(SePh)(2)] and J = -20 cm(-1) in (1)(∞)[Fe(SeMes)(2)]. In addition we were able to show that the ring molecule [Fe(SePh)(2)](12) which is a structural isomer of (1)(∞)[Fe(SePh)(2)] behaves magnetically similar to the latter one. Investigations by powder XRD reveal that the ring molecule is only a metastable intermediate which converts in THF completely to form (1)(∞)[Fe(SePh)(2)]. Thermal gravimetric analysis of (1)(∞)[Fe(SePh)(2)] under vacuum conditions shows that the compound is thermally labile and already starts to decompose above 30 °C in a two step process under cleavage of SePh(2) to finally form at 250 °C tetragonal PbO-type FeSe. The reaction of (1)(∞)[Fe(SePh)(2)] with the Lewis base 1,10-phenanthroline yielded, depending on the conditions, the octahedral monomeric complexes [Fe(SePh)(2)(1,10-phen)(2)] and [Fe(1,10-phen)(3)][Fe(SePh)(4)]., (This journal is © The Royal Society of Chemistry 2011)

Magnesium imide (MgNH) was produced by monitoring the decomposition process of magnesium amide with in situ neutron diffraction. Significant changes in the structure of magnesium amide are detected during heat treatment and eventually result in the formation of crystalline MgNH. A model for the crystal structure of magnesium imide (MgNH) is presented for the first time. Remarkably, magnesium imide offers unique structural features similar to the cyclosilicate class and can be described as a porous solid formed by a sequence of linked chains of face sharing Mg(6)N(6) hexagonal prism clusters.

Orthodontic treatment is mainly dependent on the loads developed by metal wires. The load developed by a buckled orthodontic wire is of great concern for molar distalization and cannot be simply derived from mechanical properties measured through classical tests (i.e. tensile, torsion, and bending). A novel testing method, based on the Eulerian approach of a simple supported beam, has been developed in order to measure the load due to buckling of orthodontic wires. Elastic titanium molybdenum alloy (TMA; SDS Ormco) and superelastic Nitinol (3M Unitek) and copper nickel-titanium (NiTi; SDS Ormco) wires, each having a rectangular cross section of 0.016 x 0.022 square inches (0.41 x 0.56 mm(2)), were used. The wires were activated and deactivated by loading and unloading. In order to analyse thermo-mechanical properties in buckling, mechanical tests were assisted by calorimetric measurements through differential scanning calorimetry (DSC). Statistical analysis to determine differences between the samples was undertaken using two-way analysis of variance (ANOVA) and Tukey's post hoc test, and one-way ANOVA to assess differences between the tested wires under similar conditions and different materials. The results suggest that the load due to buckling depends on material composition, wire length, the amount of activation, temperature, and deformation rate. The results can be considered as the lower bound for the loads experienced by teeth as far as a buckled wire is concerned. At a temperature higher than the austenite finish transition temperature, superelastic wires were strongly dependent on temperature and deformation rate. The effect due to an increase of deformation rate was similar to that of a decrease of temperature. Load variations due to temperature of a superelastic wire with a length of 20 mm were estimated to be approximately 4 g/degrees C. The high performance of an applied superelastic wire may be related to the high dynamics of the load in relation to temperature.

High surface area polycrystalline calcium oxide forms ozonide O3- ions upon O2 adsorption and NO3(2-) anions under low pressures of NO. Both radical anions, detected by electron paramagnetic resonance (EPR), are not observed in the case of the homologous magnesium oxide. This behavior reveals the presence, in CaO, of anomalies with respect to the ideal composition of an ionic oxide which are identified in terms of two main types of defects. The first type consists of positive holes dispersed in the bulk and originated by the unavoidable presence of Na+ ions in the composition of the solid. The decomposition of the surface ozonide shows the formation of a transient surface stabilized O- (the chemical notation of a positive hole associated to an oxide ion) which is for the first time reported at the surface of CaO. The second type of defect consists of surface peroxide groups (present at particular surface sites where they are formed by pairing of two distinct O-) which react with nitric oxide (NO) yielding NO3(2-) radical anions. The presence of peroxide is not related to the presence of impurities but, rather, to a certain propensity of the solid to form such ions at the surface along the dehydration process.

Objective: To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy., Methods: Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient's clinics in Italy. A total of 66,501 (mean age 54.4 years) women are considered in the present paper., Results: The odds ratios of moderate and severe hot flashes/night sweats were lower in more educated women and (for severe symptoms only) in women reporting regular physical activity. Depression, difficulty to sleep, forgetfulness and irritability tended to be less frequent in more educated women and (depression only) in women reporting regular physical activity. Parous women reported more frequently these symptoms., Conclusions: This large study confirms in Southern European population that low education, body mass index and low physical activity are associated with climacteric symptoms. Parous women are at greater risk of psychological symptoms.

Objective: To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause., Subjects: Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms., Methods: Cross-sectional study with no exclusion criteria. Type 2 diabetes was defined according to National Diabetes Data Groups Indications and the fasting blood glucose at an oral glucose tolerance test within the previous year., Results: Out of the 44 694 considered in this analysis, 808 had a diagnosis of diabetes type 2 (1.8%). In comparison with women aged < 50 years, the multivariate odds ratios (OR) of type 2 diabetes were 1.31 (95% confidence interval (CI), 0.99-1.74) for women aged 50-52 years, 1.66 (95% CI, 1.27-2.17) at 53-56 years and 2.84 (95% CI, 2.20-3.67) in women aged > or = 57 years. Type 2 diabetes was less frequently reported in more educated women (OR high school/university vs. primary school = 0.44 (95% CI, 0.36-0.55)). Being overweight was associated with an increased risk of type 2 diabetes. In comparison with women reporting a low level of physical activity, the multivariate OR of type 2 diabetes was 0.67 (95% CI, 0.54-0.84) for women reporting regular physical activity. In comparison with premenopausal women, the multivariate OR of type 2 diabetes was 1.38 (95% CI, 1.03-1.84) in women with natural menopause. This finding was present also after allowing for the potential confounding effect of age. The multivariate OR of diabetes for users of hormonal replacement therapy was 0.58 (95% CI, 0.46-0.73)., Conclusions: This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy.

The authors report a case of mucinous-papilliferous adenocarcinoma of the cervical canal in a pregnant woman. After performing three Pap tests which demonstrated the presence of normoconformate endometrial cells partly with a normal conformation and partly with nuclear atypia, the patient was monitored with periodical obstetric examinations. A neoformation of the portio was observed at week 28: differential diagnosis was made between a hypertrophic benign tumour and a well differentiated adenocarcinoma. The patient was monitored until birth and colposcopy was then performed with biopsy about one month later. Histological tests were positive for mucinous papilliferous adenocarcinoma. The patient underwent conisation with rotating loop and subsequently Piver 2 surgery owing to the suspected spread of the neoplasm beyond the margin of resection. The operative finding was negative and the patient is now free of disease.

Dentine hypersensitivity still represent a major clinical problem only partially solved. The presence of exposed opened dentinal tubules has been demonstrated increase the dentine permeability and it is the responsible for pain and sensitivity. Stannous fluoride solution has been recently proposed to reduce dentine hypersensitivity. The aim of the present study was to evaluate the dentinal permeability of a new stannous fluoride gel proposed for the therapy of dentine hypersensitivity. Human extracted teeth have been used and mounted and connected with a hydraulic pressure apparatus working at 1 psi (70 cm of water pressure). It was calculated the permeability of untreated smear layer, treated smear layer (after gel application) and after acidic treatment. It was observed that gel treatment was able to reduce dentine permeability. Scanning electron microscopy demonstrated the presence of a homogeneous smear layer after treatment with gel. This in vitro study confirms that stannous fluoride treatment has the capacity to modify dentine permeability of sensitive dentine.