Power, Endurance, and Body Composition Changes Over a Collegiate Career in National Collegiate Athletic Association Division I Women Soccer Athletes.

ABSTRACT: McFadden, BA, Bozzini, BN, Cintineo, HP, Hills, SP, Walker, AJ, Chandler, AJ, Sanders, DJ, Russell, M, and Arent, SM. Power, endurance, and body composition changes over a collegiate career in National Collegiate Athletic Association Division I women soccer athletes. J Strength Cond Res 37(7): 1428-1433, 2023-The purpose of this study was to determine longitudinal changes in fitness and body composition throughout athletes' 4-year collegiate soccer careers. Performance testing occurred before preseason during freshman, sophomore, junior, and senior year in 17 female Division I soccer players. Body composition was assessed through air-displacement plethysmography to determine percent body fat (%BF), fat-free mass (FFM), and body mass (BM). Maximal countermovement vertical jump height was assessed through contact mat using arm swing (CMJ AS ) and hands-on-hips (CMJ HOH ) methods to calculate power (CMJ watts / HOHwatts ). Aerobic capacity (V̇ o2 max) and ventilatory threshold (VT) were assessed by indirect calorimetry during a maximal graded exercise test on a treadmill. Linear mixed models were used to assess changes across academic years ( p < 0.05). No changes occurred in %BF, BM, V̇ o2 max, VT, CMJ AS , or CMJ watts . A time main effect was seen for FFM ( p = 0.01) with increases from freshman to senior ( p = 0.02). Time main effects were observed for CMJ HOH ( p < 0.001) and CMJ HOHwatts ( p < 0.001) with increases from freshman to junior (CMJ HOH,p = 0.001; CMJ HOHwatts , p = 0.02) and senior (CMJ HOH , p < 0.001; CMJ HOHwatts , p = 0.003) as well as sophomore to senior (CMJ HOH , p < 0.001; CMJ HOHwatts , p = 0.02). Countermovement vertical jump with hands on hips also increased from sophomore to junior ( p = 0.005). The lower FFM and power capabilities as freshmen compared with upperclassman indicate a potential limited readiness. Coaches and training staff should account for these developmental differences when entering the preseason. Adequate conditioning programs before starting a collegiate program may help build a fitness foundation and prepare freshmen athletes to compete at the same level as their upperclassmen counterparts.

Safe implementation of transoral incisionless fundoplication as a new technique in a tertiary care center.

BACKGROUND/AIMS: Transoral incisionless fundoplication (TIF) is an accepted anatomic treatment for gastroesophageal reflux disease in selected patients. In this report, we analyze our institution's programmatic allocation of resources during the safe implementation of TIF as a new procedure. METHODS: A retrospective analysis of all patients who underwent TIF from January 2020 to February 2021 at our institution was performed. The process of initially allocating the operating room (OR) with overnight admission and postoperative esophagram for added safety, and subsequently transitioning TIF to the endoscopy suite (ES) as an outpatient procedure was described. Patient safety and outcomes were evaluated during transition. RESULTS: Thirty patients who underwent TIF were identified. The mean age was 51.2±16.0 years. TIF was performed in an OR in nine patients (30%) and 21 (70%) in the ES. All the OR patients were admitted overnight and had routine EG. In contrast, four (19%) from the ES group required clinically-indicated admission and three (14.2%) required esophagram. The mean procedure duration was significantly lower in the ES group (65.7 min vs. 84 min, p=0.02). CONCLUSION: A stepwise, resource-efficient process was described that allowed safe initiation of TIF as a new technique and its effective transition to a fully outpatient procedure.

Endoscopic ultrasound-guided gastroenterostomy versus surgical gastrojejunostomy in treatment of malignant gastric outlet obstruction: Systematic review and meta-analysis.

Background and study aims Palliative treatment of malignant gastric outlet obstruction (GOO) has conventionally been with surgical gastrojejunostomy (SGJ). Advent of devices like lumen apposing metal stents has made endoscopic ultrasound-guided gastroenterostomy (EUS-GE) a potential alternative to SGJ for these patients. We performed a systematic review and meta-analysis of studies that compared outcomes of EUS-GE versus SGJ. Methods We performed a comprehensive systematic search of multiple electronic databases and conference proceedings through January 2021 and identified six studies that compared outcomes of EUS-GE versus SGJ in the management of malignant GOO. The rates of technical success, clinical success, and AEs were analyzed, and pooled odds ratios were calculated using random effects model. Results Six studies were included in our analysis with a total of 484 patients, of which 291 underwent EUS-GE and 193 underwent SGJ. The technical success rate of SGJ was superior to EUS-GE (OR = 0.195; 95 %CI:0.054-0.702; P  = 0.012; I 2  = 0). The clinical success of EUS-GE was statistically similar to SGJ (OR = 1.566; 95 %CI:0.585-4.197; P  = 0.372; I 2  = 46.68 %). EUS-GE had significantly fewer AEs compared to SGJ (OR = 0.295; 95 %CI:0.172-0.506; P  < 0.005; I 2  = 0). Among studies which reported reintervention rates, EUS-GE was statistically similar to SGJ (OR = 0.587; 95 %CI:0.174-1.979; P  = 0.390, I 2  = 54.91). Minimal to moderate heterogeneity was noted in the analyses. Conclusions EUS-GE has equivalent clinical success and reintervention rates, but significantly lower adverse events compared to SGJ. When feasible, EUS-GE appears to be an effective and safe alternative to SGJ for palliative management of malignant GOO.

Spatiotemporal proteomic profiling of the pro-inflammatory response to lipopolysaccharide in the THP-1 human leukaemia cell line.

Protein localisation and translocation between intracellular compartments underlie almost all physiological processes. The hyperLOPIT proteomics platform combines mass spectrometry with state-of-the-art machine learning to map the subcellular location of thousands of proteins simultaneously. We combine global proteome analysis with hyperLOPIT in a fully Bayesian framework to elucidate spatiotemporal proteomic changes during a lipopolysaccharide (LPS)-induced inflammatory response. We report a highly dynamic proteome in terms of both protein abundance and subcellular localisation, with alterations in the interferon response, endo-lysosomal system, plasma membrane reorganisation and cell migration. Proteins not previously associated with an LPS response were found to relocalise upon stimulation, the functional consequences of which are still unclear. By quantifying proteome-wide uncertainty through Bayesian modelling, a necessary role for protein relocalisation and the importance of taking a holistic overview of the LPS-driven immune response has been revealed. The data are showcased as an interactive application freely available for the scientific community.

Endoscopic retrograde cholangiopancreatography: Current practice and future research.

Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a primarily diagnostic to therapeutic procedure in hepatobiliary and pancreatic disease. Most commonly, ERCPs are performed for choledocholithiasis with or without cholangitis, but improvements in technology and technique have allowed for management of pancreatic duct stones, benign and malignant strictures, and bile and pancreatic leaks. As an example of necessity driving innovation, the new disposable duodenoscopes have been introduced into practice. With the advantage of eliminating transmissible infections, they represent a paradigm shift in quality improvement within ERCP. With procedures becoming more complicated, the necessity for anesthesia involvement and safety of propofol use and general anesthesia has become better defined. The improvements in endoscopic ultrasound (EUS) have allowed for direct bile duct access and EUS facilitated bile duct access for ERCP. In patients with surgically altered anatomy, selective cannulation can be performed with overtube-assisted enteroscopy, laparoscopic surgery assistance, or the EUS-directed transgastric ERCP. Cholangioscopy and pancreatoscopy use has become ubiquitous with defined indications for large bile duct stones, indeterminate strictures, and hepatobiliary and pancreatic neoplasia. This review summarizes the recent advances in infection prevention, quality improvement, pancreaticobiliary access, and management of hepatobiliary and pancreatic diseases. Where appropriate, future research directions are included in each section.

Use of Smartphones and Wearables for Arrhythmia Monitoring.

Smartphones and other wearable electronic devices increasingly are used for ambulatory cardiac rhythm assessment. These consumer technologies have been evaluated in several studies for diagnosis and management of atrial fibrillation. Diverse mobile health applications, including management of other arrhythmias and medical conditions, are expanding alongside advances in technology. Electronic devices owned by millions of consumers have the potential to alter health care delivery as well as research design and implementation. This review provides an up-to-date discussion of the available mobile health technologies, specific applications and limitations for arrhythmia evaluation, their impact on health care systems, and key areas for future investigation.

The role of the microbiome in gastrointestinal inflammation.

The microbiome plays an important role in maintaining human health. Despite multiple factors being attributed to the shaping of the human microbiome, extrinsic factors such diet and use of medications including antibiotics appear to dominate. Mucosal surfaces, particularly in the gut, are highly adapted to be able to tolerate a large population of microorganisms whilst still being able to produce a rapid and effective immune response against infection. The intestinal microbiome is not functionally independent from the host mucosa and can, through presentation of microbe-associated molecular patterns (MAMPs) and generation of microbe-derived metabolites, fundamentally influence mucosal barrier integrity and modulate host immunity. In a healthy gut there is an abundance of beneficial bacteria that help to preserve intestinal homoeostasis, promote protective immune responses, and limit excessive inflammation. The importance of the microbiome is further highlighted during dysbiosis where a loss of this finely balanced microbial population can lead to mucosal barrier dysfunction, aberrant immune responses, and chronic inflammation that increases the risk of disease development. Improvements in our understanding of the microbiome are providing opportunities to harness members of a healthy microbiota to help reverse dysbiosis, reduce inflammation, and ultimately prevent disease progression.

Training Demands and Physiological Profile of Cross-Disciplined Collegiate Female Dancers.

ABSTRACT: Sanders, DJ, Walker, AJ, Prior, KE, Poyssick, AN, and Arent, SM. Training demands and physiological profile of cross-disciplined collegiate female dancers. J Strength Cond Res 35(8): 2316-2320, 2021-Little is known about the physical demands of high-level dance training. Therefore, the purpose of this study was to investigate the physiological demands of a typical ballet and modern class through training load (TL) and to assess differences in TL between the 2 class types. In addition, a physiological profile of cross-disciplined collegiate female dancers was determined. Seventeen college-aged female dancers were recruited and performed a battery of performance tests assessing body fat (%BF), lean body mass, vertical jump (VJ), peak power, maximal oxygen consumption (V̇o2max), and ventilatory threshold (VT). Two ballet and modern dance classes were monitored for TL and exercise energy expenditure (EEE) using the Polar Team2 Pro System. Performance testing results were as follows: M%BF = 24.1 ± 4.2%, MLBM = 46.8 ± 8.5 kg, MV̇o2max = 42.9 ± 4.3 ml·kg-1·min-1, MVT = 76.2 ± 6.5% of V̇o2max, MVJ = 44.1 ± 1.4 cm, and MPP = 519.1 ± 177.5 W. Training load of 41.0 ± 17.0 for ballet and 44.8 ± 27.4 for modern dance was found, with an EEE of 394.0 ± 111.9 and 421.9 ± 161.4 kcal, respectively. Time spent at or above VT was 1.2 ± 2.6 minutes in ballet and 3.4 ± 8.3 minutes in modern. Compared with other female power-endurance athletes, the dancers accumulated a much lower TL during both class types. Low TL may inhibit typical adaptations seen in other athletes, which may explain why dancers in this study had lower aerobic and anaerobic capacities and higher body fat percentage than other collegiate female athletes. Also, it suggests that supplemental conditioning could be incorporated into a dancers training paradigm to optimize performance.

Agreement between B-Mode Ultrasound and Air Displacement Plethysmography in Preprofessional Ballet Dancers.

PURPOSE: This study aimed to assess the agreement between B-mode ultrasound and air displacement plethysmography (ADP) body composition results in preprofessional ballet dancers. METHODS: Male (n = 21, Mage = 17.2 ± 1.7 yr, MBMI = 20.5 ± 2.0 kg·m-2) and female (n = 27, Mage = 16.1 ± 1.4 yr, MBMI = 18.3 ± 1.3 kg·m-2) dancers were assessed by ADP and ultrasound to determine body fat percentage (%BF), fat mass (FM), and fat-free mass (FFM). Pearson's correlations were used to assess agreement, and paired t-tests were used to determine differences between devices (α = 0.05). Ultrasound validity was assessed using SEE and total error. Bland-Altman plots were used to identify 95% limits of agreement. RESULTS: Agreement was high for %BF (females, r = 0.94; males, r = 0.77), FM (females, r = 0.94; males, r = 0.73), and FFM (females, r = 0.95; males, r = 0.99). However, ultrasound overestimated %BF and FM and underestimated FFM (P < 0.05) compared with ADP in females only. In addition, there were stronger agreement and lower error for FFM compared with both %BF and FM regardless of sex. CONCLUSION: There is strong agreement between ultrasound and ADP in this population. Although ultrasound may be a useful field tool to assess body composition, future research is needed to refine %BF equations in this population to reduce calculation errors.

Biomarkers Correlate With Body Composition and Performance Changes Throughout the Season in Women's Division I Collegiate Soccer Players.

The purpose of this study was to evaluate the effects of a competitive soccer season on biomarkers and performance metrics in order to determine the correlation between changes in biomarkers, body composition, and performance outcomes. Twenty-one Division 1 female collegiate soccer players were monitored throughout the 16-week season. Player workload was measured using heart rate and Global Position Satellite systems at all practices and games. Performance testing, including vertical jump, VO2max, and 3-repetition maximum testing for bench press, squat and deadlift, occurred prior to pre-season and immediately post-season. Blood draws occurred prior to preseason and every 4-weeks thereafter, following a game. Body composition was assessed prior to the start of season (week 0) and weeks 6, 10, 14, and 17 (post-season). Delta area under the curve was calculated for biomarkers and body composition variables to account for seasonal changes adjusted for baseline. Pearson-product moment correlations were used to assess relationships with significance set at p < 0.05. Trends were considered p ≤ 0.10. No significant time main effects were seen for anabolic biomarkers (p > 0.05). Significant time effects were seen for catabolic biomarkers throughout the season (p = 0.001). No changes in body weight, VO2max, vertical jump, and deadlift occurred. Squat and bench press improved (p = 0.01 and p = 0.02, respectively) with a decline in percent body fat (p = 0.03) and a trend for increased fat free mass (p = 0.09). Additionally, total cortisol (TCORT) negatively correlated with fat free mass (r = -0.48; p = 0.03) and positively correlated with VO2max (r = 0.47; p = 0.04). A trend was shown for a positive correlation between both TCORT and free cortisol (FCORT) and percent body fat (r = 0.39; r = 0.40; p = 0.08, respectively). IGF-1 and growth hormone positively correlated to deadlift (r = 0.57; P = 0.02 and r = 0.59; p = 0.03), whereas creatine kinase showed a trend for a positive correlation with deadlift (r = 0.49; p = 0.06). IL-6 negatively correlated with bench press (r = -0.53; p = 0.03). These findings support a relationship between biomarkers, performance outcomes, and body composition. Biomarker monitoring may be useful to detect individual player's physiological response to an athletic season and may help provide insights in efforts to optimize performance outcomes.

Endocarditis Complicated by Severe Aortic Insufficiency in a Patient with COVID-19: Diagnostic and Management Implications.

A 38-year-old man presented with cough, shortness of breath, and fatigue. He was diagnosed with Coronavirus Disease-2019 (COVID-19) as well as Enterococcus faecalis bacteremia. Imaging revealed a subaortic membrane with aortic valve endocarditis and severe aortic insufficiency. He had successful aortic valve replacement with a mechanical prosthesis and subaortic membrane resection. This case highlights some of the diagnostic and therapeutic challenges presented by COVID-19 pandemic.

Comparison of passive-dosed and solvent spiked exposures of pro-carcinogen, benzo[a]pyrene, to human lymphoblastoid cell line, MCL-5.

Genotoxicity testing methods in vitro provide a means to predict the DNA damaging effects of chemicals on human cells. This is hindered in the case of hydrophobic test compounds, however, which will partition to in vitro components such as plastic-ware and medium proteins, in preference to the aqueous phase of the exposure medium. This affects the freely available test chemical concentration, and as this freely dissolved aqueous concentration is that bioavailable to cells, it is important to define and maintain this exposure. Passive dosing promises to have an advantage over traditional 'solvent spiking' exposure methods and involves the establishment and maintenance of known chemical concentrations in the in vitro medium, and therefore aqueous phase. Passive dosing was applied in a novel format to expose the MCL-5 human lymphoblastoid cell line to the pro-carcinogen, benzo[a]pyrene (B[a]P) and was compared to solvent (dimethyl sulphoxide) spiked B[a]P exposures over 48 h. Passive dosing induced greater changes, at lower concentrations, to micronucleus frequency, p21 mRNA expression, cell cycle abnormalities, and cell and nuclear morphology. This was attributed to a maintained, definable, free chemical concentration using passive dosing and the presence or absence of solvent, and highlights the influence of exposure choice on genotoxic outcomes.