EZH2 mutations at diagnosis in follicular lymphoma: a promising biomarker to guide frontline treatment.

EZH2 is mutated in nearly 25% of follicular lymphoma (FL) cases. Little is known about how EZH2 affects patients' response to therapy. In this context, the aim of this study was to retrospectively analyze the frequency of mutations in EZH2 at diagnosis in tissue and ctDNA in patients with FL and to assess the patients' outcomes after receiving immunochemotherapy, depending on the EZH2 mutation status. Among the 154 patients included in the study, 27% had mutated EZH2 (46% with high-grade and 26% with low-grade FL). Of the mutated tissue samples, the mutation in ctDNA was identified in 44% of cases. EZH2 mutation in ctDNA was not identified in any patient unmutated in the tissue.Unmutated patients who received R-CHOP had significantly more relapses than patients who received R-Bendamustine (16/49 vs. 2/23, p = 0.040). Furthermore, our results show that patients with mutated EZH2 treated with R-CHOP vs. those treated with R-Bendamustine present a lower incidence of relapse (10% vs. 42% p = 0.09 at 4 years), a higher PFS (92% vs. 40% p = 0.039 at 4 years), and higher OS (100% vs. 78% p = 0.039 at 4 years). Based on these data, RCHOP could be a more suitable regimen for mutated patients, and R-bendamustine for unmutated patients. These findings could mean the first-time identification of a useful biomarker to guide upfront therapy in FL.

Episcleral infantile hemangioma successfully treated with topical timolol.

Episcleral hemangiomas are usually associated with neonatal hemangiomatosis. Recently, propranolol has been described for the treatment of this entity. We present for the first time a patient with an episcleral hemangioma without neonatal hemangiomatosis successfully treated with topical timolol.

Psychological Impacts of Teaching Models on Ibero-American Educators during COVID-19.

Educational systems globally, and notably in the Ibero-American context, underwent significant adaptations in response to the myriad challenges imposed by the COVID-19 pandemic. The pedagogical evolution unfolded through three discernible phases: predominantly online, hybrid, and ultimately, a return to face-to-face instruction. While these phases were universally apparent, cultural, socio-economic, and health disparities across regions subtly influenced the quality and experiential aspects of teaching and learning within these models. This study seeks to illuminate the psychological profiles and evaluative perspectives regarding teaching and learning quality among university educators during COVID-19's tri-phase educational transformation. Engaging 601 university instructors from various Ibero-American countries, a comprehensive questionnaire mapped demographic, academic, and psychological landscapes across the pandemic's distinctive epochs. The pivot to online educational methodologies, supplanting traditional modalities, permeated numerous facets of the educational endeavor, particularly impacting faculty life and wellbeing. Data underscored a prevalent sentiment of loneliness, indicative of broader mental health challenges, especially pronounced among educators in Latin American nations. Notwithstanding these hurdles, Latin American educators demonstrated a predilection towards online instruction, in stark contrast to their European peers, who exhibited a preference for in-person pedagogy. This study unveils the divergent pedagogical preferences and mental health challenges among university educators in the Ibero-American realm during COVID-19's educational shifts, underlining the need for adaptable educational frameworks and robust mental health support, attuned to the region's distinct socio-cultural and economic contexts.

Match running performance and exercise intensity in elite female Rugby Sevens.

The purpose of this study was to describe the match-play demands of professional female rugby players competing in Rugby Sevens (Rugby 7's) matches. Time-motion analyses (global position system) were performed on 12 elite female rugby players during 5 competitive matches in a 2-day international tournament. Data revealed that players covered an average distance of 1,556.2 ± 189.3 m per game (14 minutes). Over this distance, 29.7% (462.6 ± 94.6 m) was spent standing and walking, 33.2% (515.9 ± 88.6 m) jogging, 11.6% (181.0 ± 61.4 m) cruising, 16.4% (255.7 ± 88.3 m) striding, 3.7% (57.1 ± 40.8 m) high-intensity running, and 5.4% (84.0 ± 64.8 m) sprinting. The average maximal distance of sprints, number of sprints, minimum distance of sprint, and mean sprint distance over the game were as follows: 25.8 ± 16.1 m, 5.3 ± 3.2 sprints, 6.5 ± 2.0 m, and 17.2 ± 8.8 m, respectively. The players' work-to-rest ratio was 1:0.4. For over 75% of the game, the players were exposed to heart rates (HRs) >80% of their maximal HR. There were no statistical differences between the first and second halves in any of the variables analyzed. This study suggests that the physical demands of Rugby 7's are quite different from those reported in other rugby codes. For players and teams to remain competitive in female Rugby Sevens, coaching, conditioning, and physical fitness testing should reflect these current demands.

Inter-limb asymmetry in youth elite soccer players: Effect of loading conditions.

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.

The High-Pull Exercise: A Comparison Between a VersaPulley Flywheel Device and the Free Weight.

The aim of this study was to examine the kinematics and kinetics (force, velocity, and acceleration) and blood lactate concentration with the VersaPulley (VP) device in comparison with free-weight (FW) exercise at a similar external load. Fifteen rugby players randomly performed 2 training sessions of 6 sets of 6 repetitions with 20 s of recovery between sets of the high-pull exercise with the VP and the FW. The training sessions were separated by 72 h. Barbell displacement (cm), peak velocity (m/s), peak acceleration (m/s2), mean propulsive velocity (m/s), mean propulsive acceleration (m/s2), propulsive phase (%), and mean and maximal force (N) were continuously recorded during each repetition. Blood lactate concentration was measured after each training session (end) and 3 min and 5 min later. Barbell displacement (+4.8%, small ES), peak velocity (+4.5% small ES), mean propulsive acceleration (+8.8%, small ES), and eccentric force (+26.7, large ES) were substantially higher with VP than with FW. Blood lactate concentration was also greater after the VP exercise (end +32.9%, 3 min later +36%, 5 min later +33.8%; large ES). Maximal concentric force was substantially higher with FW than VP during the 6th set (+6.4%, small ES). In the cohort and exercise investigated in the current study, VP training can be considered an efficient training device to induce an accentuated eccentric overload and augmented metabolic demands (ie, blood lactate concentration).

Structural Damage of Jailed Guidewire During the Treatment of Coronary Bifurcation Lesions: A Microscopic Randomized Trial.

OBJECTIVES: The study sought to compare the safety (resistance to damage) and efficacy (ability to cross the side branch) of polymer-coated and non-polymer-coated guidewires in the jailed wire technique used during the percutaneous treatment of bifurcation lesions. BACKGROUND: The jailed wire technique is a useful strategy in the treatment of bifurcation lesions by provisional stenting. However, these wires can be damaged or even be broken during their removal. METHODS: We performed a randomized study in patients with bifurcation lesions treated by provisional stenting. The jailed wire technique was mandatory, and the types of guidewires, polymer-coated (n = 115) and non-polymer-coated (n = 120), were randomized. After the procedures, the wires were evaluated by stereoscopic microscopy. The induced damage in the wires was classified as follows: no damage, mild, moderate, or severe. RESULTS: The clinical characteristics were similar between patients treated with polymer-coated or non-polymer-coated wires. Polymer-coated wires were significantly (p < 0.001) more resistant to retrieval damage (only 2 wires showed mild damage) than were non-polymer-coated wires. However, 63 (55%) of the non-polymer-coated wires were damaged; 37 (32%), 24 (21%), and 2 (2%) had mild, moderate, and severe damage, respectively. Additionally, the jailed length of the wire was a factor contributing to the degree of wire damage. The time of side branch wiring was shorter in the polymer-coated wire group (19 ± 40 s vs. 42 ± 72 s; p < 0.05). CONCLUSIONS: Jailed wires during interventional procedures of bifurcation lesions commonly showed microscopic damage. Polymer-coated wires were more resistant to retrieval damage and were more efficient in crossing the side branch ostium than non-polymer-coated wires. (Jailed Wire Technique in the Treatment of Coronary Bifurcations Lesions With Stent: Stereoscopic Microscopy Study; NCT02516891).

Improvement of Repeated-Sprint Ability and Horizontal-Jumping Performance in Elite Young Basketball Players With Low-Volume Repeated-Maximal-Power Training.

PURPOSE: To examine the effects of a low-volume repeated-power-ability (RPA) training program on repeated-sprint and change-of- direction (COD) ability and functional jumping performance. METHODS: Twenty-two male elite young basketball players (age 16.2 ± 1.2 y, height 190.0 ± 10.0 cm, body mass 82.9 ± 10.1 kg) were randomly assigned either to an RPA-training group (n = 11) or a control group (n = 11). RPA training consisted of leg-press exercise, twice a week for 6 wk, of 1 or 2 blocks of 5 sets × 5 repetitions with 20 s of passive recovery between sets and 3 min between blocks with the load that maximized power output. Before and after training, performance was assessed by a repeated-sprint-ability (RSA) test, a repeated-COD-ability test, a hop for distance, and a drop jump followed by tests of a double unilateral hop with the right and left legs. RESULTS: Within-group and between-groups differences showed substantial improvements in slowest (RSAs) and mean time (RSAm) on RSA; best, slowest and mean time on repeated-COD ability; and unilateral right and left hop in the RPA group in comparison with control. While best time on RSA showed no improvement in any group, there was a large relationship (r = .68, 90% CI .43;.84) between the relative decrement in RSAm and RSAs, suggesting better sprint maintenance with RPA training. The relative improvements in best and mean repeated-COD ability were very largely correlated (r = .89, 90% CI .77;.94). CONCLUSIONS: Six weeks of lowvolume (4-14 min/wk) RPA training improved several physical-fitness tests in basketball players.

Líneas de Beau y enfermedad de Kawasaki / Beau’s lines and Kawasaki disease

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