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Objective: To examine the abrupt effects of Ramadan onset on actigraphy-based time asleep in male youth Muslim football players., Methods: We adopted a quasi-experimental, interrupted time-series research design and tracked objective time asleep over a minimum of 12 consecutive nights in the two weeks prior to and immediately after Ramadan onset, respectively. Twenty-two, male academy student-athletes (chronological age range: 12.6 to 16.2 years) participated in the study (464 individual observations). Segmented generalized mixed-effects modelling estimated the effects of Ramadan onset on time asleep during the first period of night sleep only., Results: Ramadan onset led to an immediate mean reduction of 89 min (95% confidence interval [CI], 54 to 123 min) in time asleep during the first period of night sleep compared to pre-Ramadan sleep patterns. Model-adjusted estimated marginal means for time asleep were ~ 5.7 h (95%CI, 5.1 to 6.2 h) before and ~ 4.2 h (95%CI, 3.6 to 4.7 h) after Ramadan onset. Night sleep interruptions resulting in two or more fragmented periods accounted for 8% (95%CI, 2 to 21%) to 19% (95%, 11 to 29%) of sleep observations before and after Ramadan onset, respectively., Conclusions: The onset of Ramadan determined an abrupt reduction in time asleep of ~ 1 h 30 min in the first period of a night cycle and contributed to additional problems of heterogeneous sleep fragmentation that can impact optimal school learning and youth athlete performance development processes.

The use of data and analytics in professional football organisations has grown steadily over the last decade. Nevertheless, how and whether these advances in sports analytics address the needs of professional football remain unexplored. Practitioners from national federations qualified for the FIFA World Cup Qatar 2022™ and professional football clubs from an international community of practitioners took part in a survey exploring the characteristics of their data analytics infrastructure, their role, and their value for elaborating player monitoring and positional data. Respondents from 29 national federations and 32 professional clubs completed the survey, with response rates of 90.6% and 77.1%, respectively. Summary information highlighted the underemployment of staff with expertise in applied data analytics across organisations. Perceptions regarding analytical capabilities and data governance framework were heterogenous, particularly in the case of national federations. Only a third of national federation respondents (~30%) perceived information on positional data from international sports data analytics providers to be sufficiently clear. The general resourcing limitations, the overall lack of expertise in data analytics methods, and the absence of operational taxonomies for reference performance metrics pose constraints to meaningful knowledge translations from raw data in professional football organisations.

Objective: To describe components of night-to-night variation in objective measures of sleep., Methods: We conducted a secondary data analysis of consecutive and chronologically ordered actigraphy-based measurements for time in bed (min), time asleep (min), and wake-after-sleep onset (min). This investigation examined 575 individual night-based measures available for a sub-sample of fifty-two, male youth Middle Eastern football players tracked over a 14-day surveillance period (chronological age range: 12.1 to 16 years). Distinct multivariable-adjusted generalized additive models included each objective sleep outcome measure as dependent variable and disaggregated components of variation for night measurement-by-sleep period interaction, week part (weekday or weekend), and study participant random effects from within-subject night-to-night sleep variation., Results: The within-subject standard deviation (SD) of ±98 min (95% confidence interval [CI], 92 to 104 min) for time in bed, ±87 min (95%CI, 82 to 93 min) for time asleep, and ±23 min (95%CI, 22 to 25 min) for wake-after-sleep-onset overwhelmed other sources of variability and accounted for ∼44% to 53% of the overall night-to-night variation. The night measurement-by-fragmented sleep period interaction SD was ±83 min (95%CI, 44 to 156 min) for time in bed, ±67 min (95%CI, 34 to 131 min) for time asleep, and ±15 min (95%CI, 7 to 32 min) for wake-after-sleep-onset that accounted for ∼22% to 32% of each sleep outcome measure overall variability., Conclusions: Substantial random night-to-night within-subject variability poses additional challenges for strategies aiming to mitigate problems of insufficient and inconsistent sleep that are detrimental to school learning and youth athlete development processes., 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 The Authors. Published by Elsevier B.V. All rights reserved.)

Rapid somatic growth and biological maturity status may affect injury patterns in youth football, yet firm conclusions cannot be drawn from the existing research. We aimed to explore growth velocity, maturity, and age as injury risk factors in 95 academy players (11.9-15.0 years), using anthropometric (height and body mass), maturity (skeletal age), injury, and football exposure data collected prospectively over three seasons (2016/17-2018/19). We compared the relative quality of mixed-effects logistic regression models with growth velocity for 223 growth intervals (average 113 days) included as fixed effects and adjusted for age (chronological or skeletal) plus load (hours/week). Associations were considered practically relevant based on the confidence interval for odds ratios, using thresholds of 0.90 and 1.11 to define small beneficial and harmful effects, respectively. We observed harmful effects of older age on overall (OR: 2.61, 95% CI: 1.15-5.91) and sudden onset (1.98, 1.17-3.37) injury risk. Significant associations (p<0.05) were observed for higher body mass change and greater maturity on sudden onset injuries, and for higher hours/week on gradual onset, bone tissue, and physis injuries. Future studies should include larger samples, monitoring athletes from pre-adolescence through maturation, to enable within-subject analyses and better understand the relationship between growth, maturation, and injuries., Competing Interests: Conflict of Interest The authors declare that they have no conflict of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Objectives: To assess measurement agreement between FELS and Tanner-Whitehouse (TW) II skeletal ages in male youth soccer players from the Middle East., Methods: We examined agreement between FELS and TW-II skeletal ages using data collected between- and within-subjects (n = 1057 observations) for 409 male, full-time, academy student-athletes recruited as part of the Qatar Football Association national soccer development programme (chronological age range, 9.8 to 18 years; annual screening range, one to seven visits). The Bland-Altman method for repeated measurements estimated the limits of agreement describing the expected range of differences for 95% of pairs of future FELS and TW-II skeletal ages determined on similar individuals from the reference population., Results: The mean difference for TW-II versus FELS protocols was 0.02 years (95% confidence interval, -0.04 to 0.08 years) with lower and upper limits of agreement ranging from -1.39 years (95% confidence interval, -1.48 to -1.30 years) to 1.43 years (95% confidence interval, 1.34 to 1.52 years)., Conclusion: Differences for 95% of pairs of future skeletal ages determined with FELS and TW-II methods in this population could be as high as ~3 years for some people that suggested protocols may not be interchangeable in youth Middle Eastern athletes. Justification of skeletal age protocol selection rests on knowledge of measurement bias and variability of expected growth estimations for rationalized application to a population of interest., (© 2023 Wiley Periodicals LLC.)

The feral dog population from Tierra del Fuego (Argentina) has affected provincial sheep production, and is responsible for the decrease of 43% of the sheep stock. In addition, feral dogs preys on the native fauna, especially the guanaco (Lama guanicoe), a species protected by law. Except for some data on the aforementioned impact, very little is known about feral dogs features in this region, such as distribution, abundance, diet, reproduction, health status, among others. Therefore, a descriptive observational study was carried out in the period 2018-2021 in Tierra del Fuego, with the aim to recognize the endoparasitic fauna of these dogs, with emphasis on Echinococcus granulosus sensu lato (s.l.). Feces samples were collected from 83 feral dogs captured in 15 farms, which were evaluated using flotation and sedimentation coproparasitological techniques, and optical microscope observation. These qualitative methods showed that 66.3% of the samples were positive. Nine parasitic forms were found, including eggs of taenids, Toxocara canis and Toxascaris leonina, and Sarcocystis spp. oocysts and Giardia spp. cysts. Samples with more than one parasitic form were also observed, among which the Taenia/Sarcocystis spp. association was the most frequent. For the diagnosis of canine echinococcosis, the detection of Echinococcus spp. antigens by Copro-ELISA and the molecular confirmation by Copro-PCR were performed. The Copro-ELISA test was positive in 10/80 (12.5%) of the samples processed, while 11 samples (13.8%) were positive by Copro-PCR. Their distribution showed that 9 (81.8%) corresponded to farms with sheep farming, and 2 (18.2%) with cattle farming. The presence of E. granulosus s.l. in feral dogs from Tierra del Fuego is the most relevant finding in this study. These results confirm that feral dogs have access to viscera infected with hydatid cysts. However, the intermediate hosts involved (sheep, cattle or guanacos) should be investigated. Its impact on the transmission of cystic echinococcosis in this region should be evaluated, as well as the adequacy of the disease prevention and control actions implemented in Tierra del Fuego should be considered. Finally, the existence of a wild cycle of the disease should be evaluated, in which feral dogs would act as a source of infection for other animals and humans., Competing Interests: Declaration of Competing Interest The authors have read the journal's policy and have no conflict of interests to declare., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: To develop age-specific reference intervals for physical performance test outcomes relevant to male youth Middle Eastern football players., Methods: We analyzed mixed-longitudinal data (observations range: 1751-1943 assessments) from a sample of 441 male youth outfield football players (chronological age range: 11.7-18.4 y) as part of the Qatar Football Association and Aspire Academy development program over 14 competitive seasons. Semiparametric generalized additive models for location, scale, and shape estimated age-specific reference centiles for 10-m sprinting, 40-m sprinting, countermovement jump height, and maximal aerobic speed variables., Results: The estimated reference intervals indicated that the distribution of the physical performance test scores increased monotonically and nonlinearly with advancing chronological age for sprinting and countermovement jump outcome measures, reaching a plateau after 16 years common to each of these performance variables. The maximal aerobic speed median score increased substantially until ∼14.5 years, with the nonlinear trend flattening off toward relatively older chronological ages., Conclusions: We developed age-related reference intervals for physical performance test outcomes relevant to youth Qatari football players. Country-wide age-specific reference intervals can assist in the longitudinal tracking of the individual players' progress over time against benchmark values derived from the reference population.

Objectives: To examine the timing and intensity of skeletal maturation of the radius-ulna-short (RUS) bones in elite youth Arab athletes., Methods: We compared SuperImposition by Translation And Rotation (SITAR) models with different spline degrees of freedom and transformation expressions to summarize 492 longitudinal measurements for individual RUS bones scores assessed from 99 male academy student-athletes (chronological age range, 11.4 to 18 years; annual screening range, four to seven visits)., Results: The SITAR model with 5 degrees of freedom and untransformed chronological age was superior to the other models. The mean growth curve increased with age and showed a mid-pubertal double-kink at a RUS score of ~600 bone score units (au). The SITAR model revealed a first peak in the skeletal maturation velocity curve of ~206 au·year -1 occurred at ~13.5 years. The mean age at the second and largest peak occurred at 15.1 years (95% confidence interval [CI], 14.9 to 15.3 years), with the respective estimated peak skeletal ossification rate of 334 au·year -1 (95% CI, 290 to 377 au·year -1 ). The mean age at peak height velocity was 13.5 years (95% CI, 13.3 to 13.7 years), with peak height velocity of 10 cm·year -1 (95% CI, 9.6 to 10.4 cm·year -1 )., Conclusion: Application of the SITAR method confirmed two peaks in the skeletal maturation velocity curve, with the second and largest rate of ossification occurring at a relatively later timing of ~1.5 years than the height growth spurt. Knowledge of the RUS bones timing and intensity can be important to advance strategies for athlete performance development purposes., (© 2023 Wiley Periodicals LLC.)

Purpose: To examine the general perspectives of elite soccer players on the time course of perceived postmatch fatigue and the influence of away matches on subjective perceptions., Methods: Adopting a cross-sectional study design, we invited 371 subjects from 14 top-division European clubs competing in the Belgian First Division A, English Premier League, French Ligue 1, Italian Serie A, Portuguese Primeira Liga, Russian Premier League, and Swiss Premier League to take part in a short survey on general issues relating to postmatch fatigue measurement and tracking in professional soccer., Results: Three hundred male professional soccer players completed the short questionnaire. For perceptions relevant to the time course of postmatch fatigue, two-thirds of respondents (67%) indicated higher postmatch fatigue perceived 2 days (48 h) after an official competition. Among these respondents, a higher proportion of answers was observed in wide midfielders (74%), attackers (74%), and central midfielders (68%). Approximately two-thirds of respondents (63%) indicated more than usual and much more than usual perceived postmatch fatigue following away matches., Conclusions: For the first time, our investigation addressed practical aspects that remained unexplored and fundamental to the definition of an optimal player management process following a competition. From a practical standpoint, perspectives of individual elite soccer players substantiated the notion of implementing processes with dedicated recovery protocols within 48 hours postmatch and highlighted the need for differential strategies addressing the additional burden of away matches and travel.

Purpose: To assess conventional assumptions that underpin the percentage of mature height index as the simple ratio of screening height (numerator) divided by actual or predicted adult height (denominator)., Methods: We examined cross-sectional data from 99 academy youth soccer players (chronological age range, 11.5 to 17.7 y) skeletally immature at the screening time and with adult height measurements available at follow-up., Results: The y-intercept value of -60 cm (95% confidence interval, -115 to -6 cm) from linear regression between screening height and adult height indicated the failure to meet the zero y-intercept assumption. The correlation coefficient between present height and adult height of .64 (95% confidence interval, .50 to .74) was not equal to the ratio of coefficient of variations between these variables (CVx/CVy = 0.46) suggesting Tanner's special circumstance was violated. The non-zero correlation between the ratio and the denominator of .21 (95% confidence interval, .01 to .39) indicated that the percentage of mature height was biased low for players with generally shorter adult height, and vice versa., Conclusion: For the first time, we have demonstrated that the percentage of mature height is an inconsistent statistic for determining the extent of completed growth, leading to potentially biased inferences for research and applied purposes.

Purpose: This study aimed to explore the influence of differences in relative skeletal maturity on performance test outcomes in elite youth soccer players from the Middle East., Methods: We integrated skeletal age and performance assessments using mixed-longitudinal data available for 199 outfield players (chronological age range, 11.7 to 17.8 yr) enrolled as academy student-athletes (annual screening range, 1 to 5 visits). Skeletal age was determined as per the Tanner-Whitehouse II protocol. Relative maturity was calculated as the difference (∆) between Tanner-Whitehouse II skeletal age minus chronological age. Performance test outcomes of interest were 10-m sprinting, 40-m sprinting, countermovement jump height, and maximal aerobic speed. Separate random-effects generalized additive models quantified differences in performance test outcomes by relative skeletal maturity. Estimated differences were deemed practically relevant based on the location of the confidence interval (95% CI) against minimal detectable change values for each performance test outcome., Results: For 40-m sprinting, differences of +0.51 s (95% CI, +0.35 to +0.67 s) and +0.62 s (95% CI, +0.45 to +0.78 s) were practically relevant for relative maturity status of ∆ = -1.5 yr versus ∆ = +0.5 and ∆ = +1 yr, respectively. For countermovement jump height, a difference of -8 cm (95% CI, -10 to -5 cm) was practically relevant for ∆ = -1.5 yr versus ∆ = +1 yr relative maturity status comparison. Effects for 10-m sprinting and maximal aerobic speed were unclear., Conclusions: Integration of skeletal age and performance assessments indicated that conventional maturity status classification criteria were inconsistent to inform player development processes in our sample. Between-player differences in test performance may depend on a substantial delay in skeletal maturation (∆ ≤ -1.5 yr) and the performance outcome measure., (Copyright © 2022 by the American College of Sports Medicine.)

Purpose: The muscle perfusion response to postexercise cold-water immersion (CWI) is not well understood. We examined the effects of graded postexercise CWI upon global and regional quadriceps femoris muscle perfusion using positron emission tomography and [15O]H2O., Methods: Using a matched-group design, 30 healthy men performed cycle ergometer exercise at 70% V̇O2peak to a core body temperature of 38°C, followed by either 10 min of CWI at 8°C, 22°C, or seated rest (control). Quadriceps muscle perfusion; thigh and calf cutaneous vascular conductance; intestinal, muscle, and local skin temperatures; thermal comfort; mean arterial pressure; and heart rate were assessed at preexercise, postexercise, and after CWI., Results: Global quadriceps perfusion was reduced beyond the predefined minimal clinically relevant threshold (0.75 mL per 100 g·min-1) in 22°C water versus control (difference (95% confidence interval (CI)), -2.5 (-3.9 to -1.1) mL per 100 g·min-1). Clinically relevant decreases in muscle perfusion were observed in the rectus femoris (-2.0 (-3.0 to -1.0) mL per 100 g·min-1) and vastus lateralis (-3.5 (-4.9 to -2.0) mL per 100 g·min-1) in 8°C water, and in the vastus lateralis (-3.3 (-4.8 to -1.9) mL per 100 g·min-1) in 22°C water versus control. The mean effects for vastus intermedius and vastus medialis perfusion were not clinically relevant. Clinically relevant decreases in thigh and calf cutaneous vascular conductance were observed in both cooling conditions., Conclusions: The present findings revealed that less noxious CWI (22°C) promoted clinically relevant postexercise decreases in global quadriceps muscle perfusion, whereas noxious cooling (8°C) elicited no effect., (Copyright © 2022 by the American College of Sports Medicine.)

The presence of inter-limb asymmetries can influence strength performance and represent an injury risk factor for team sport athletes. The present study aimed to investigate the effects of changes in resistance loads using different assessment modalities on the magnitude and the direction of inter-limb asymmetry within the same leg. Fifteen young elite soccer players from the same professional academy performed rear-foot-elevated-split-squat-test at different loading conditions (body mass with no overload, 25% of body mass, 50% of body mass 50%), isokinetic knee flexor (concentric 30°·s-1, concentric 60°·s-1, eccentric 90°·s-1) and extensor (concentric 60°·s-1, eccentric 60°·s-1). The outcomes from the agreement analyses suggested moderate level agreement between body mass vs body mass 25% (Kappa = 0.46), with no agreement or fair agreement for the other between-assessment comparison. Our results demonstrated that the magnitude and direction of within-limb strength imbalances were inconsistent when compared within the same assessment under different resistance load conditions., Competing Interests: The authors have declared that no competing interests exist.

The aim was to determine if players with a prior hamstring strain injury (HSI) exhibit bilateral deficits in knee flexor eccentric strength and hamstring muscle volume and differences in sprinting performance compared with players without a history of HSIs. Forty-six male professional soccer players participated in this study. Eccentric knee flexor strength, hamstring muscle volume (MRI), and a 20-m running sprint test (5- and 10-m split time) were assessed at the start of the preseason. Eccentric knee strength of the previously injured limbs of injured players was greater (ES: 1.18-1.36) than the uninjured limbs in uninjured players. Previously injured limbs showed possibly larger biceps femoris short heads (BFSh) and likely semitendinosus (ST) muscle volumes than the contralateral uninjured limbs among the injured players (ES: 0.36) and the limbs of the uninjured players (ES: 0.56), respectively. Players who had experienced a previous HSI were possibly slower in the 5-m (small ES: 0.46), while unclear differences were found in both the 10-m and 20-m times. Players with a prior HSI displayed greater eccentric knee flexor strength, possibly relatively hypertrophied ST and BFSh muscles, and possibly reduced 5-m sprinting performances than previously uninjured players. This can have implication for the design of secondary hamstring muscle injury prevention strategies.

Abstract: Kyprianou, E, Di Salvo, V, Lolli, L, Al Haddad, H, Villanueva, AM, Gregson, W, and Weston, M. To measure peak velocity in soccer, let the players sprint. J Strength Cond Res 36(1): 273-276, 2022-Expressing externals loads relative to a player's individual capacities has potential to enhance understanding of dose-response. Peak velocity is an important metric for the individualization process and is usually measured during a sprint test. Recently, however, peak velocity was reported to be faster during soccer matches when compared with a 40-m sprint test. With the aim of developing the practice of individualized training prescription and match evaluation, we examined whether the aforementioned finding replicates in a group of elite youth soccer players across a broader range of soccer activities. To do this, we compared the peak velocities of 12 full-time male youth soccer players (age 16.3 ± 0.8 years) recorded during a 40-m sprint test with peak velocity recorded during their routine activities (matches, sprints, and skill-based conditioning drills: small-sided games [SSG], medium-sided games [MSG], large-sided games [LSG]). All activities were monitored with 10-Hz global positioning systems (Catapult Optimeye S5, version 7.32) with the highest speed attained during each activity retained as the instantaneous peak velocity. Interpretation of clear between-activity differences in peak velocity was based on nonoverlap of the 95% confidence intervals for the mean difference between activities with sprint testing. Peak velocity was clearly faster for the sprint test (8.76 ± 0.39 m·s-1) when compared with matches (7.94 ± 0.49 m·s-1), LSG (6.94 ± 0.65 m·s-1), MSG (6.40 ± 0.75 m·s-1), and SSG (5.25 ± 0.92 m·s-1), but not sprints (8.50 ± 0.36 m·s-1). Our data show the necessity for 40-m sprint testing to determine peak velocity., (Copyright © 2019 National Strength and Conditioning Association.)

Purpose: To provide the first scrutiny of adult height prediction protocols based on automated Greulich-Pyle and Tanner-Whitehouse (TW) skeletal ages applied to elite youth soccer players from the Middle East., Methods: We examined the application of modified Bayley-Pinneau (BoneXpert®), TW-II, and TW-III protocols using mixed-longitudinal data available for 103 subjects (chronological age range, 19.4 to 27.9 yr) previously enrolled as academy student-athletes (annual screening range, one to six visits). Random-effects generalized additive models quantified the presence of systematic mean differences between actual versus predicted adult height. Effects were deemed practically equivalent based on the location of the confidence interval (95% CI) against a realistic difference value of Δ = ± 1 cm. Each model pooled residual standard deviation described the actual precision of height predictions and was used to calculate a 95% prediction interval., Results: The BoneXpert® method overpredicted adult height systematically at chronological ages in the range of approximately 13.5 to 14.5 yr (95% CI range, -1.9 to -1 cm) and Greulich-Pyle skeletal ages between 13.5 and 15 yr (95% CI range, -3.1 to -1 cm). Effects based on TW-II were practically equivalent across the chronological and skeletal age measurement ranges, with this protocol yielding adult height predictions with a precision (standard deviation) of approximately ±2.6 cm. The mean TW-III effects indicated systematic adult height overpredictions until the attainment of 14.5 and 15 yr of chronological age (95% CI range, -3.8 to -1.1 cm) and TW-III skeletal age (95% CI range: -5.2 to -2.3 cm), respectively., Conclusions: Tanner-Whitehouse-II adult height prediction method provided more consistent estimates and can be considered the method of choice for talent development purposes in youth soccer players from the Middle East., (Copyright © 2021 by the American College of Sports Medicine.)

Purpose: To investigate the optimal pretaper duration on match running performance in a professional soccer team., Methods: The training load was monitored during daily training sessions and matches during 2 seasons according to different periodization strategies. Matches' running distances were collected using match analysis system. The data were analyzed in 3 types of mesocycle blocks of 5 (M5), 4 (M4), and 3 weeks (M3), concludes all of them by 1 taper week., Results: Significant decreases in the training load during the taper weeks compared to standard weeks were observed in 3 types of mesocycle blocks (d ≥ 5; P < .01). An increase in overall match running performance was observed in matches played after the taper weeks compared to matches played after the standard weeks during M4 for all speed ranges (d ≥ 1.3; P < .05). The increase was only observed in low-intensity running (d = 1.3; P < .04) and total distance, low-intensity running, and intense running (d ≥ 1.3; P < .05) in M5 and M3, respectively. Match running performance following the taper weeks between the 3 different mesocycle durations was significantly higher in M4 for the number of high-speed running, sprinting, and high-intensity running (P < .05). The greatest enhancement of match running performance was observed at M4 when the training load was decreased by approximately 18% during the tapering period., Conclusion: This study suggests that a period of 3 standard weeks of training followed by 1 taper week is the optimal taper strategy when compared to different pretaper durations.

Objectives: To describe age group patterns for injury incidence, severity and burden in elite male youth football., Methods: Prospective cohort study capturing data on individual exposure and time-loss injuries from training and matches over four seasons (2016/2017 through 2019/2020) at a national football academy (U13-U18; age range: 11-18 years). Injury incidence was calculated as the number of injuries per 1000 hours, injury severity as the median number of days lost and injury burden as the number of days lost per 1000 hours., Results: We included 301 players (591 player-seasons) and recorded 1111 time-loss injuries. Overall incidence was 12.0 per 1000 hours (95% CI 11.3 to 12.7) and burden was 255 days lost per 1000 hours (252 to 259). The mean incidence for overall injuries was higher in the older age groups (7.8 to 18.6 injuries per 1000 hours), while the greatest burden was observed in the U16 age group (425 days; 415 to 435). In older age groups, incidence and burden were higher for muscle injuries and lower for physis injuries. Incidence of joint sprains and bone stress injuries was greatest for players in the U16, U17 and U18 age groups, with the largest burden observed for U16 players. No clear age group trend was observed for fractures., Conclusion: Injury patterns differed with age; tailoring prevention programmes may be possible., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

The aim was to investigate the preventive effect of a complex training program based on holistic hamstring health understanding in elite professional soccer players. This study involved an elite club in Europe and was conducted over 12 seasons. The last 2 seasons were the intervention period, and the others were the control seasons. During the intervention period, players performed a complex program organized into different interventions throughout the week having as a priority the player health. Hamstring injuries, absenteeism, injury rates, and injury burden between the control and intervention seasons were compared using a rate ratio (RR) with 95% CI. Players had a mean exposure of 333.5 ± 18.6 hours per season with no significant differences between the intervention and control seasons. The overall injury rate was 3 times lower during the two intervention seasons than during the previous seasons (P < .01); the match injury rate was 2.7 times lower (P < .01) and the training rate 4.3 times (P < .01). Injury burden was almost 4 times lower during the two intervention seasons than during the previous seasons (P < .01), and recurrences in the control group were 10% vs 0% in the intervention group. Hamstring injuries were reduced ~3 times during the seasons in which elite football players were exposed to multicomponent, complex prevention training with individual approaches based on player needs, management of training load, individualized physiotherapy treatment, and planned staff communication, in comparison to the control seasons without a clearly defined and structured injury prevention intervention., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background and Study Objectives: Adequate sleep is essential to support preparation and recovery processes for training and competition in athletes. A limited number of studies have examined whether adolescents from the Middle-East meet the minimum age-specific recommendations ranging from 8 to 9 h of night sleep based on objective measurements. This study aimed to provide an objective description of routine sleep habits in elite youth football players from the Middle-East., Methods: Using wrist-worn actigraphy, we examined objective measures of sleep over a 14-day surveillance period from fifty-nine, male, Middle-Eastern elite youth football players (age range: 12.1 to 16 years)., Results: The observed median sleep duration was approximately 5.5 to 6 h during weekdays and 6.5 to 7.5 h over weekend days. Sleep intermissions resulting in two or more periods of sleep accounted for 8% and 17% of the data during weekdays and weekends, respectively., Conclusions: For the first time, we reported an objective quantification of sleep measures indicating that elite youth athletes from the Middle-East do not meet the age-specific sleep recommendations. Integration of sleep tracking into the routine training monitoring process can be valuable to inform decisions relevant to the adoption of potential multidisciplinary interventions to address sleep insufficiency and disorders in youth athletes., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The primary aim of the present study was to analyze mechanical responses during inertial knee- and hip-dominant hamstring strengthening exercises (flywheel leg-curl and hip-extension in conic-pulley), and the secondary aim was to measure and compare regional muscle use using functional magnetic resonance imaging. Mean power, peak power, mean velocity, peak velocity and time in the concentric (CON) and eccentric (ECC) phases were measured. The transverse relaxation time (T2) shift from pre- to post-exercise were calculated for the biceps femoris long (BFl) and short (BFs) heads, semitendinosus (ST) and semimembranosus (SM) muscles at proximal, middle and distal areas of the muscle length. Peak and mean power in flywheel leg-curl were higher during the CON than the ECC phase (p<0.01). ECC peak power was higher than CON phase (p<0.01) in conic-pulley hip-extension exercise, while mean power was higher during the CON than ECC phase (p<0.01). Flywheel leg-curl showed a higher T2 values in ST and BFs and BFl (p<0.05), while the conic-pulley hip-extension had a higher T2 values in the proximal region of the ST and BFl (p<0.05). In conclusion, ECC overload was only observed in peak power during the conic-pulley hip-extension exercise. Flywheel leg-curl involved a greater overall use of the 4 muscle bellies, more specifically in the ST and BFs, with a selective augmented activity (compared with the conic-pulley) in the 3 regions of the BFs, while conic-pulley hip-extension exercise selectively targeted the proximal and medial regions of the BFl. Physiotherapists and strength and conditioning coaches should consider this when optimizing the training and recovery process for hamstring muscles, especially after injury., Competing Interests: The authors have declared that no competing interests exist.

The purpose of the study was to examine the differences in bilateral deficit (BLD) at different loadings during the half-squat jump (SJ) and horizontal countermovement jump (HCMJ) to determine if there is a relationship with linear sprint or change of direction (COD). The second goal was to check if fast players were more powerful in SJ and HCMJ than slow players in bilateral performance (BP). Twenty-seven male youth soccer players participated in the study. Players were divided in two groups, faster and slower, according to their sprint performance (10 and 40 m). BLD average power with body weight (BW) and 25%BW were significantly higher than 50%BW ( p < 0.01). BLD during HCMJ was significantly higher than BLD during SJ with BW, 25%BW and 50%BW ( p < 0.01). There were no statistical relationships between BLD and sprint or COD performance ( p > 0.05). Fast players showed significantly higher SJ power with all the different loads and HCMJ than slow players ( p < 0.01), and fast players lost more time executing COD-90° than slow players ( p < 0.01). There were no statistical differences between fast and slow players in BLD. BLD seems to be dependent on motor task, contraction type and load and could not be a proper measure to estimate sprint and COD performance. Faster players are confirmed to be more powerful players than slow players, and decrements in COD could be a key benchmark to identify deficit between linear and COD performance., Competing Interests: The authors declare no conflict of interest.

Talent identification (TID) and development (TDE) are large fields in professional soccer and in science. However,  TID and TDE processes in youth academies have not been assessed in detail. As such, our aim was to survey professional clubs from around the world about their youth academy TID and TDE processes, with 29 clubs responding to the survey. TID and TDE processes changed as a function of player age. TID processes involved finding the best players locally and regionally, but for older players the search widened to nationally and internationally for the needs of the first team. Clubs used a multidisciplinary approach to TID, but more so with older players. Median number of academy players was 80, 100, and 66 players at 8-11 years, 12-16 years, and 17-21 years, respectively. Annual player turnover in the most recent season (selections/de-selections) was 29% across all age groups, with competition from other clubs cited as a limitation to TID. TDE processes involved weekly matches and 3-5 training sessions per week led by experienced, well-qualified coaches, with most clubs providing players with academic education, residency and transportation services. Our findings extend previous research assessing professional soccer youth academy TID and TDE processes by quantifying worldwide practices.

We examined the influence of graded cold-water immersion (CWI) on global and regional quadriceps muscle perfusion with positron emission tomography (PET) and [ 15 O]H 2 O. In 30 healthy men [33 ± 8 yr; 81 ± 10 kg; 184 ± 5 cm; percentage body fat: 13 ± 5%; peak oxygen uptake (V̇o 2peak ): 47 ± 8 mL·kg -1 ·min -1 ] quadriceps perfusion, thigh and calf cutaneous vascular conductance (CVC), intestinal, muscle, and local skin temperatures, thermal comfort, mean arterial pressure, and heart rate were assessed before and after 10 min of CWI at 8°C, 15°C, or 22°C. Global quadriceps perfusion did not change beyond a clinically relevant threshold (0.75 mL·100 g·min -1 ) in any condition and was similar between conditions {range of differences [95% confidence interval (CI)]: 0.1 mL·100 g·min -1 (-0.9 to 1.2 mL·100 g·min -1 ) to 0.9 mL·100 g·min -1 (-0.2 to 1.9 mL·100 g·min -1 )}. Muscle perfusion was greater in vastus intermedius (VI) compared with vastus lateralis (VL) (2.2 mL·100 g·min -1 ; 95% CI 1.5 to 3.0 mL·100 g·min -1 ) and rectus femoris (RF) (2.2 mL·100 g·min -1 ; 1.4 to 2.9 mL·100 g·min -1 ). A clinically relevant increase in VI muscle perfusion after immersion at 8°C and a decrease in RF muscle perfusion at 15°C were observed. A clinically relevant increase in perfusion was observed in VI in 8°C compared with 22°C water (2.3 mL·100 g·min -1 ; 1.1 to 3.5 mL·100 g·min -1 ). There were no clinically relevant between-condition differences in thigh CVC. Our findings suggest that CWI (8-22°C) does not reduce global quadriceps muscle perfusion to a clinically relevant extent; however, colder water increases (8°C) deep muscle perfusion and reduces (15°C) superficial muscle (RF) perfusion in the quadriceps muscle. NEW & NOTEWORTHY Using positron emission tomography, we report for the first time muscle perfusion heterogeneity in the quadriceps femoris in response to different degrees of cold-water immersion (CWI). Noxious CWI temperatures (8°C) increase perfusion in the deep quadriceps muscle, whereas superficial quadriceps muscle perfusion is reduced in cooler (15°C) water. Therefore, these data have important implications for the selection of CWI approaches used in the treatment of soft tissue injury, while also increasing our understanding of the potential mechanisms underpinning CWI.

Training and competition loads have emerged as modifiable composite risk factors of non-contact injury. Hamstring strains are the most common injuries in football with substantial burden on the individual player and club. Nevertheless, robust evidence of a consistent load-hamstring injury relationship in professional football is lacking. Using available data from the Qatar Stars League over three competitive seasons, this study investigated the separate and combined effects of perceived exertion and session duration on hamstring injury occurrence in a sample of 30 outfield football players. Load variables were calculated into 7-day, 14-day, 21-day, 28-day periods of data, and week-to-week changes for average ratings of perceived exertion (RPE; au) score and session-RPE (s-RPE; session-duration  ×  score), plus the cumulative training and match minutes and s-RPE, respectively. Conditional logistic regression models estimated load-injury relationships per 2-within-subject standard deviation increments in each candidate variable. Associations were declared practically important based on the location of the confidence interval in relation to thresholds of 0.90 and 1.11 defining small beneficial and harmful effects, respectively. The uncertainty for the corrected odds ratios show that typically high within-subject increments in each candidate variable were not practically important for training- and match-related hamstring injury (95% confidence intervals range: 0.85 to 1.16). We found limited exploratory evidence regarding the value of perceived exertion and session duration as etiological factors of hamstring injury in Middle-East professional football. Monitoring remains valuable to inform player load management strategies, but our exploratory findings suggest its role for type-specific injury risk determination appears empirically unsupported., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To investigate the impact of physical efforts performed in the period preceding activity as a potential risk factor of muscle injury during match-play within a sample of professional soccer players., Design: Observational cohort study., Methods: Match load (running [>14.4-19.8km/h], high-speed running [>19.8-25.2km/h], sprinting [>25.2km/h], leading and explosive sprint type) averaged in 1-min and 5-min periods prior to an event or non event for 29 professional outfield soccer players. Conditional logistic and Poisson regression models estimated the relationship between load and injury for a 2 within-subject standard deviation in match load or 1-action increment in the number of sprinting activities, respectively. Associations were deemed beneficial or harmful based on non-overlap of the 95% confidence intervals against thresholds of 0.90 and 1.11, respectively., Results: An increment in sprinting distance [+2-SDs=11m] covered over a 1-min period (odds ratio [OR]: 1.22, 95%CI, 1.12 to 1.33) increased the odds of muscle injury., Conclusions: Our study provides novel exploratory evidence that the volume of sprinting during competitive soccer match-play has a harmful association with muscle injury occurrence., (Copyright © 2019 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

The aim of the study was to examine the effects of a detraining period (DTP) (i.e., off-season) with an individually prescribed training program, and a retraining period (RTP) (i.e., pre-season) combining soccer and flywheel-based strength training on fat-free mass (FFM) and fat-mass (FM) in 10 elite professional male soccer players. The present study used a controlled repeated-measures research design to investigate the changes in FFM and FM using dual-energy X-ray absorptiometry. Whole body %FM increased (effect size (ES) = 0.87 ± 0.46) and FFM reduced after DTP (ES = -0.30 ± 0.19), returning to values comparable to the end of the previous season after RTP. At regional levels, arms, legs, and trunk %FM increased (ES = from 0.42 to 1.29) while trunk-FFM was reduced (ES = -0.40 ± 0.26) after DTP, returning to the values observed at the end of the previous season after RTP. Legs-FFM did not change after DTP, with a substantial increase after RTP in comparison with pre-season values (ES = 0.34 ± 0.29 and 0.53 ± 0.36 for the right and left leg, respectively). Despite the small sample size of the present study, the findings indicate that elite soccer players can be allowed 2 weeks of rest during a five-week DTP, since the changes in %FM and FFM were relatively small, and FM and FFM returned to the optimal initial values for competition after the proposed RTP during the pre-season., Competing Interests: Luis Suarez-Arrones and Nacho Torreno are employees of FC Basel, Rafael Maldonado is an employee of FC Girondins de Bourdeaux. The authors declare there are no competing interests.

This study determined the most effective field method for quantifying fat-free mass (FFM) in elite youth male soccer players compared to dual X-ray absorptiometry (DXA) values and to develop prediction equations for FFM based on anthropometric variables. Forty-one male elite-standard youth soccer players, ages 16.2-18.0 years, undertook FFM assessments including bioelectrical impedance analysis, and different skinfold-based prediction equations. DXA provided a criterion measure of FFM. Correlation coefficients, bias, limits of agreement, and differences were used as validity measures, and regression analyses to develop soccer-specific prediction equations. Slaughter et al (1988), Durnin and Wormersley (1974), and Sarria et al (1998) equations showed the lowest biases, and no significant, standardized, and substantial differences against DXA. The new youth soccer-specific anthropometric equation explained 91% of the DXA-derived FFM variance using three circumferences, eight skinfolds, and one bone breadth. All field methods compared in this study may not be adequate for estimating FFM in elite youth male soccer players, except the equations of Slaughter et al (1988), Durnin and Wormersley (1974), and Sarria et al (1998). We recommend the use of the new soccer-specific equation proposed in this study as a valid alternative to DXA to quantify FFM among elite youth male players.

The present prospective cohort study investigated changes in body composition (BC) in young male football players ( n = 18, 16.1 ± 0.8 years; 181.0 ± 0.1 cm; 71.3 ± 4.9 kg) after combined football and strength training (ST) during a whole in-season period (26 weeks). BC was measured at whole-body absolute and regional levels by dual-energy X-ray absorptiometry in eighteen players at the beginning and at the end of the competitive period. The ST was organized into three different session types: ST in the gym, specific ST on the field, and individual ST (weak points). The results of the present study indicated that fat-free mass (FFM) was substantially higher following the competitive period (5.1% ± 1.2%), while percentage of fat showed no changes during the competitive period. At the regional level, arms' and legs' FFM increased at the end of the season, and bone mineral content (BMC) and density (BMD) increased in arms, legs, pelvis, thoracic spine, and lumbar spine. In conclusion, within the limitation of the potential positive impact of growth and/or maturation, present results seem to indicate that an ST program that supplements football-related training sessions could be an effective option to increase FFM, BMC, and BMD at both whole-body and regional level across the competitive season in young male professional football players., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

The aim of the present study was to evaluate the consequence of implementing a Nordic Hamstring exercise (NHE) protocol during the first 15 to 17 weeks of the season to assess the effect on sprinting and NHE strength (NHEs) in professional football players. The study examined 50 healthy male professional football players (age 18.8±0.8yr; height 176.8±6.9cm; weight 71.3±5.7kg) belonging to 3 of the reserve squads of three Spanish La-Liga clubs divided in 2 intervention teams [Nordic-Group1 (NG-1) and Nordic-Group2 (NG-2, extensive experience in NHE)] and 1 team as a control-group (CG). NHEs and linear sprint (T5, T10, T20-m) were evaluated at the beginning of the season and at the end of an intervention period of conditioning and football training, supplemented with a NHE protocol (24 sessions for NG-1 and 22 sessions for NG-2) or without using the NHE at all (CG). Sprint times were substantially improved in all groups (ES from -2.24±0.75 to -0.60±0.37). NHEs was enhanced absolute and relative to body-mass only in NG-1 after the training period (ES from 0.84±0.32 to 0.74±0.26), while in the NG-2 there were only improvements in average NHEs relative to body-mass (ES = 0.39±0.36). The improvements in T20-m were substantially greater in NG-2 vs. NG-1, and there were no differences in sprint performance changes between NG-1 and CG. Changes in sprinting performance and NHEs were unrelated. NHEs was largely correlated with the body-mass of the players. Results indicate that the improvements in sprint are not dependent on the NHEs changes, with no relationships between NHEs and sprint performance, and between sprint changes and changes in NHEs., Competing Interests: A commercial company employed MG, GR (FC Barcelona) and CFN (Cordoba Club de Fútbol). This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

The aim of this study was to describe the changes in body composition, strength and sprint performance in response to an entire competitive season of football training supplemented with 2 inertial eccentric-overload training sessions a week in young male professional soccer players. Whole body and regional composition (assessed using dual-energy X-ray absorptiometry), power output in half-squat and 40-m sprinting performance were evaluated in fourteen players. The eccentric-overload training consisted of training sessions a week of 1-2 sets of 10 exercises of upper-body and core (Day 1) and lower-body (Day 2), during the entire competitive season (27 weeks). Whole body fat mass decreased (-6.3 ± 3.6%, ES = -0.99 ± 0.54) substantially while lean mass increased (2.5 ± 0.8%, ES = 0.25 ± 0.09), with some regional differences. There was a substantial increase in half-squat power output (from 3% to 14%, ES from 0.45 to 1.73) and sprint performance (from 1.1% to 1.8%, ES from -0.33 to -0.44), however performance changes were not correlated with changes in body composition. A combined soccer and eccentric-overload training program was able to promote positive changes in body composition and physical factors relevant to both on-field performance and injury prevention in elite soccer players., Competing Interests: A commercial company employed AB, RM and NT: ACF Fiorentina. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Information is lacking on what parents in southern European countries know and how they view clinical shared-decision-making (SDM) for their children. This survey assesses general parental views on SDM and patient-physician SDM relationships in an Italian paediatric outpatients' clinic. In a 3-month cross-sectional survey, we enrolled 458 consecutive native and foreign Italian-speaking parents bringing their children to our public hospital for various reasons. Parents completed an anonymous questionnaire exploring their general views on SDM, including what doctor-patient relationship predominates today, and what approach reassures them most. Multivariate logistic regression analysed outcome data from parental questionnaire answers. Results are reported as percentages, odds ratios (OR) and 95% confidence intervals (CI). Multivariate logistic regression showed that 440 parents (96.1%) appreciated SDM, 245 (53.5%) preferred SDM for choosing children's treatment, 126 (27.5%) answered that SDM is the predominant relationship today, and most parents 275 (60.0%) felt reassured by SDM. More native than foreign Italian-speaking parents preferred SDM (97.0 vs 89.7%, OR = 3.8; 95% CI = 1.4-10.8). Highly-educated parents preferred SDM for choosing their child's therapy (57.9 vs 34.1%, OR = 2.7; 95% CI = 1.6-4.4) and this approach reassured them (64.3 vs 41.2%, OR = 2.5; 95% CI = 1.6-4.1). In conclusion, parents bringing children to an Italian outpatient clinic, especially highly-educated parents, wish to be offered SDM and find it reassuring. These findings should encourage paediatricians working in a challenging multicultural environment to change their physician-centred approach and engage parents in tailored SDM strategies.

Moalla, W, Fessi, MS, Makni, E, Dellal, A, Filetti, C, Di Salvo, V, and Chamari, K. Association of physical and technical activities with partial match status in a soccer professional team. J Strength Cond Res 32(6): 1708-1714, 2018-The purpose of this study was to examine the association between physical and technical activities and partial match status (winning, drawing, or losing) in a professional soccer team over 2 seasons. Physical and technical activities of 52 official matches were collected and analyzed at each 15-minute interval, for each half (45 minutes), and full match (90 minutes) using a multiple-camera computerized tracking system. The results indicated that according to full match outcome: winning status was characterized by players covering more total distance (p ≤ 0.05) and low-intensity running (<14.4 km·h) (p ≤ 0.05), whereas, losing status induced more sprinting (≥25.2 km·h) (p < 0.01) and high-intensity running (≥19.8 km·h) (p ≤ 0.05). However, according to partial match status (i.e., 15 minutes and half time), players covered more distance for all running intensities while winning (p < 0.01). Technical match performance scores were not influenced by match status. In conclusion, the present study showed that the physical activities including high-intensity running and total distance covered were related to the match status, whereas technical activities were not. The overall outcome shows that higher physical activity was associated with winning partial match periods. This approach highlights the importance of physical fitness in soccer and may help coaches to better modulate players' roles and team tactical organization throughout the match.

This study determined the most effective field method for quantifying body fat percentage in male elite youth soccer players and developed prediction equations based on anthropometric variables. Forty-four male elite-standard youth soccer players aged 16.3-18.0 years underwent body fat percentage assessments, including bioelectrical impedance analysis and the calculation of various skinfold-based prediction equations. Dual X-ray absorptiometry provided a criterion measure of body fat percentage. Correlation coefficients, bias, limits of agreement, and differences were used as validity measures, and regression analyses were used to develop soccer-specific prediction equations. The equations from Sarria et al. (1998) and Durnin & Rahaman (1967) reached very large correlations and the lowest biases, and they reached neither the practically worthwhile difference nor the substantial difference between methods. The new youth soccer-specific skinfold equation included a combination of triceps and supraspinale skinfolds. None of the practical methods compared in this study are adequate for estimating body fat percentage in male elite youth soccer players, except for the equations from Sarria et al. (1998) and Durnin & Rahaman (1967). The new youth soccer-specific equation calculated in this investigation is the only field method specifically developed and validated in elite male players, and it shows potentially good predictive power., Competing Interests: The authors declare no conflict of interest., (© Georg Thieme Verlag KG Stuttgart · New York.)

This study investigated the effects of successive matches on match-running in elite under-23 soccer players during an international tournament. Match-running data was collected using a semi-automated multi-camera tracking system during an international under-23 tournament from all participating outfield players. Players who played 100% of all group stage matches were included (3 matches separated by 72 h, n = 44). Differences in match-running performance between matches were identified using a generalised linear mixed model. There were no clear effects for total, walking, jogging, running, high-speed running and sprinting distance between matches 1 and 3 (effect size (ES); -0.32 to 0.05). Positional analysis found that sprint distance was largely maintained from matches 1 to 3 across all positions. Attackers had a moderate decrease in total, jogging and running distance between matches 1 and 3 (ES; -0.72 to -0.66). Classifying players as increasers or decreasers in match-running revealed that match-running changes are susceptible to individual differences. Sprint performance appears to be maintained over successive matches regardless of playing position. However, reductions in other match-running categories vary between positions. Changes in match-running over successive matches affect individuals differently; thus, players should be monitored on an individual basis.

This study aimed to examine: (i) the effect of decreasing training load (TL) during taper weeks on physical match activities in professional soccer players, and (ii) to disclose the relationship between weekly TL and physical match activities. Rating of perceived exertion was collected after each training session and match to quantify the TL in 19 professional players over 17 standard and 7 taper weeks during the season. Physical match activities were quantified by a computerised match analysis system and compared between standard training and taper weeks. Compared to standard weeks, the duration and frequency of training sessions during the taper weeks decreased (-21.7% and -18.8%, respectively; P < 0.01) with no change in intensity (-4.8%; P = 0.09). Consequently, the weekly TL decreased during the taper weeks (-25.5%; P < 0.01). Increases in distance covered by intense running (+15.1%; P < 0.05), high-intensity running (HIR) (+15.7%; P < 0.01), number of sprints (+17.8%; P < 0.05) and number of high-speed runs (+15.7%; P < 0.05) were observed during the seven matches played after the taper weeks. High relationships were observed between TL and HIR distance covered, number of HIR and number of sprints (r = -0.53; r = -0.55; r = -0.65, respectively; P < 0.01). Decreasing TL during taper weeks by reducing training duration and frequency but maintaining intensity was associated with an increase in physical activities during matches. However, it needs to be determined whether tapering or other match factors led to the changes in match activity.

The present study examined site-specific hamstring muscles use with functional magnetic resonance imaging (MRI) in elite soccer players during strength training. Thirty-six players were randomized into four groups, each performing either Nordic hamstring, flywheel leg-curl, Russian belt or the hip-extension conic-pulley exercise. The transverse relaxation time (T2) shift from pre- to post-MRI were calculated for the biceps femoris long (BFl) and short (BFs) heads, semitendinosus (ST) and semimembranosus (SM) muscles at proximal, middle and distal areas of the muscle length. T2 values increased substantially after flywheel leg-curl in all regions of the BFl (from 9±8 to 16±8%), BFs (41±6-71±11%), and ST (60±1-69±7%). Nordic hamstring induced a substantial T2 increase in all regions of the BFs (13±8-16±5%) and ST (15±7-17±5%). T2 values after the Russian belt deadlift substantially increased in all regions of the BFl (6±4-7±5%), ST (8±3-11±2%), SM (6±4-10±4%), and proximal and distal regions of BFs (6±6-8±5%). T2 values substantially increased after hip-extension conic-pulley only in proximal and middle regions of BFl (11±5-7±5%) and ST (7±3-12±4%). The relevance of such MRI-based inter- and intra-muscle use in designing more effective resistance training for improving hamstring function and preventing hamstring injuries in elite soccer players should be explored with more mechanistic studies., Competing Interests: GR was employed by a commercial company: FC Barcelona. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

A 59-year-old Italian woman came to our center for revaluation of a previous diagnosis of polycythemia vera. The patient presented with a lifelong history of polycythemia, no increase in white blood cells (WBCs) and platelets, and a negative bone marrow biopsy. Analysis of hemoglobin (Hb) fractions showed an abnormal fast moving Hb component. We aimed to determine if this variant was the cause of polycythemia in this patient. A complete blood count (CBC) was performed by an automated cell counter and Hb fractions were determined by high performance liquid chromatography (HPLC). Standard stability tests and oxygen affinity evaluation were also performed. Genomic DNA was extracted from peripheral blood leukocytes using the phenol chloroform method and the entire β-globin gene was analyzed by direct sequencing. At the hematological level, no anemia or hemolysis was observed but an abnormal Hb fraction was detected using cation exchange HPLC. Molecular analysis of the β-globin gene showed heterozygosity for an AAG > ACG substitution at codon 144, resulting in a Lys→Thr amino acid replacement. We demonstrated that this is a new Hb variant with increased oxygen affinity. Its altered physiology is caused by the reduction of 2,3-diphosphoglycerate (2,3-DPG) effects, due to an amino acid substitution in the central pocket near the C-terminal of the β chain. We called this new variant Hb San Cataldo for the native city of proband.

This study used functional magnetic resonance imaging (fMRI) to compare individual muscle use in exercises aimed at preventing hamstring injuries. Thirty-six professional soccer players were randomized into 4 groups, each performing either Nordic hamstring, flywheel leg curl, Russian belt or conic-pulley exercise. MRIs were performed before and immediately after a bout of 4 sets of 8 repetitions. Pre-post exercise differences in contrast shift (T2) were analyzed for the long (BFLh) and short head (BFSh) of biceps femoris, semitendinosus (ST), semimembranosus (SM) and gracilis (GR) muscles. Flywheel leg curl increased (P<0.001) T2 of GR (95%), ST (65%), BFSh (51%) and BFLh (14%). After the Nordic hamstring, GR (39%), ST (16%) and BFSh (14%) showed increased T2 (P<0.001). Russian belt and conic-pulley exercise produced subtle (P<0.02) T2 increases of ST (9 and 6%, respectively) and BFLh (7 and 6%, respectively). Russian belt increased T2 of SM (7%). Among exercises examined, flywheel leg curl showed the most substantial hamstring and GR muscle use. However, no single exercise executed was able to increase T2 of all hamstring and synergist muscles analyzed. It is therefore suggested that multiple exercises must be carried out to bring in, and fully activate all knee flexors and hip extensors., (© Georg Thieme Verlag KG Stuttgart · New York.)

Context and Objective: Despite convincing evidence that oral and injected amoxicillin have equal efficacy in children with severe community-acquired pneumonia (CAP), hospitalized children often receive injected antibiotics. To investigate whether shared decision-making (choosing the antibiotic route) influences parental satisfaction., Design, Setting and Participants: In a one-year questionnaire-based study, we enrolled consecutive children hospitalized for CAP. At admission, all children's parents received a leaflet on CAP. Parents arriving during the daytime were assigned to a shared group and could choose the antibiotic route, those admitted at other times were assigned to an unshared group for whom physicians chose the antibiotic route. Shared group parents answered anonymous questionnaire investigating why they chose a specific route. Parents in both groups answered another anonymous questionnaire at discharge assessing perceived satisfaction with care., Main Outcome Measure: Parents' satisfaction with perceived medical information as assessed by data from a questionnaire., Results: Of the 95 children enrolled, more children's parents were assigned to the unshared than the shared group (77 vs. 18). Of the 18 children's parents in the shared group, 14 chose the oral antibiotic route mainly to avoid painful injections. Doctors explanations were considered better in the shared than in the unshared group (P = 0.02)., Discussion and Conclusions: The larger number of children's parents assigned to the unshared group reflects paediatricians' reluctance to offer shared-decision making. Well-informed parents prefer oral antibiotic therapy for children with severe CAP. Allowing parents choose the antibiotic route respects parents' wishes, reduces children's pain and improves satisfaction., (© 2014 John Wiley & Sons Ltd.)

This study assessed the relationship between peak match speed (PMS) and maximal sprinting speed (MSS) in regard to age and playing positions. MSS and absolute PMS (PMSAbs) were collected from 180 male youth soccer players (U13-U17, 15.0 ± 1.2 y, 161.5 ± 9.2 cm, and 48.3 ± 8.7 kg). The fastest 10-m split over a 40-m sprint was used to determine MSS. PMSAbs was recorded using a global positioning system and was also expressed as a percentage of MSS (PMSRel). Sprint data were compared between age groups and between playing positions. Results showed that regardless of age and playing positions, faster players were likely to reach higher PMSAbs and possibly lower PMSRel. Despite a lower PMSAbs than in older groups (eg, 23.4 ± 1.8 vs 26.8 ± 1.9 km/h for U13 and U17, respectively, ES = 1.9 90%, confidence limits [1.6;2.1]), younger players reached a greater PMSRel (92.0% ± 6.3% vs. 87.2% ± 5.7% for U13 and U17, respectively, ES = -0.8 90% CL [-1.0;-0.5]). Playing position also affected PMSAbs and PMSRel, as strikers were likely to reach higher PMSAbs (eg, 27.0 ± 2.7 vs 23.6 ± 2.2 km/h for strikers and central midfielders, respectively, ES = 2.0 [1.7;2.2]) and PMSRel (eg, 93.6% ± 5.2% vs 85.3% ± 6.5% for strikers and central midfielders, respectively, ES = 1.0 [0.7;1.3]) than all other positions. The findings confirm that age and playing position affect the absolute and relative intensity of speed-related actions during matches.

Abstract During the past decade substantial development of computer-aided tracking technology has occurred. Therefore, we aimed to provide calibration equations to allow the interchangeability of different tracking technologies used in soccer. Eighty-two highly trained soccer players (U14-U17) were monitored during training and one match. Player activity was collected simultaneously with a semi-automatic multiple-camera (Prozone), local position measurement (LPM) technology (Inmotio) and two global positioning systems (GPSports and VX). Data were analysed with respect to three different field dimensions (small, <30 m 2 to full-pitch, match). Variables provided by the systems were compared, and calibration equations (linear regression models) between each system were calculated for each field dimension. Most metrics differed between the 4 systems with the magnitude of the differences dependant on both pitch size and the variable of interest. Trivial-to-small between-system differences in total distance were noted. However, high-intensity running distance (>14.4 km · h -1 ) was slightly-to-moderately greater when tracked with Prozone, and accelerations, small-to-very largely greater with LPM. For most of the equations, the typical error of the estimate was of a moderate magnitude. Interchangeability of the different tracking systems is possible with the provided equations, but care is required given their moderate typical error of the estimate.