Two-dimensional perovskitoids enhance stability in perovskite solar cells.

Two-dimensional (2D) and three-dimensional (3D) perovskite heterostructures have played a key role in advancing the performance of perovskite solar cells1,2. However, the migration of cations between 2D and 3D layers results in the disruption of octahedral networks, leading to degradation in performance over time3,4. We hypothesized that perovskitoids, with robust organic-inorganic networks enabled by edge- and face-sharing, could impede ion migration. We explored a set of perovskitoids of varying dimensionality and found that cation migration within perovskitoid-perovskite heterostructures was suppressed compared with the 2D-3D perovskite case. Increasing the dimensionality of perovskitoids improves charge transport when they are interfaced with 3D perovskite surfaces-this is the result of enhanced octahedral connectivity and out-of-plane orientation. The 2D perovskitoid (A6BfP)8Pb7I22 (A6BfP: N-aminohexyl-benz[f]-phthalimide) provides efficient passivation of perovskite surfaces and enables uniform large-area perovskite films. Devices based on perovskitoid-perovskite heterostructures achieve a certified quasi-steady-state power conversion efficiency of 24.6% for centimetre-area perovskite solar cells. We removed the fragile hole transport layers and showed stable operation of the underlying perovskitoid-perovskite heterostructure at 85 °C for 1,250 h for encapsulated large-area devices in ambient air.

Implementation strategies for hospital-based probiotic administration in a stepped-wedge cluster randomized trial design for preventing hospital-acquired Clostridioides difficile infection.

BACKGROUND: Clostridioides difficile infection (CDI) is associated with considerable morbidity and mortality in hospitalized patients, especially among older adults. Probiotics have been evaluated to prevent hospital-acquired (HA) CDI in patients who are receiving systemic antibiotics, but the implementation of timely probiotic administration remains a challenge. We evaluated methods for effective probiotic implementation across a large health region as part of a study to assess the real-world effectiveness of a probiotic to prevent HA-CDI (Prevent CDI-55 +). METHODS: We used a stepped-wedge cluster-randomized controlled trial across four acute-care adult hospitals (n = 2,490 beds) to implement the use of the probiotic Bio-K + ® (Lactobacillus acidophilus CL1285®, L. casei LBC80R® and L. rhamnosus CLR2®; Laval, Quebec, Canada) in patients 55 years and older receiving systemic antimicrobials. The multifaceted probiotic implementation strategy included electronic clinical decision support, local site champions, and both health care provider and patient educational interventions. Focus groups were conducted during study implementation to identify ongoing barriers and facilitators to probiotic implementation, guiding needed adaptations of the implementation strategy. Focus groups were thematically analyzed using the Theoretical Domains Framework and the Consolidated Framework of Implementation Research. RESULTS: A total of 340 education sessions with over 1,800 key partners and participants occurred before and during implementation in each of the four hospitals. Site champions were identified for each included hospital, and both electronic clinical decision support and printed educational resources were available to health care providers and patients. A total of 15 individuals participated in 2 focus group and 7 interviews. Key barriers identified from the focus groups resulted in adaptation of the electronic clinical decision support and the addition of nursing education related to probiotic administration. As a result of modifying implementation strategies for identified behaviour change barriers, probiotic adherence rates were from 66.7 to 75.8% at 72 h of starting antibiotic therapy across the four participating acute care hospitals. CONCLUSIONS: Use of a barrier-targeted multifaceted approach, including electronic clinical decision support, education, focus groups to guide the adaptation of the implementation plan, and local site champions, resulted in a high probiotic adherence rate in the Prevent CDI-55 + study.

Is Running Power a Useful Metric? Quantifying Training Intensity and Aerobic Fitness Using Stryd Running Power Near the Maximal Lactate Steady State.

We sought to determine the utility of Stryd, a commercially available inertial measurement unit, to quantify running intensity and aerobic fitness. Fifteen (eight male, seven female) runners (age = 30.2 [4.3] years; V·O2max = 54.5 [6.5] ml·kg-1·min-1) performed moderate- and heavy-intensity step transitions, an incremental exercise test, and constant-speed running trials to establish the maximal lactate steady state (MLSS). Stryd running power stability, sensitivity, and reliability were evaluated near the MLSS. Stryd running power was also compared to running speed, V·O2, and metabolic power measures to estimate running mechanical efficiency (EFF) and to determine the efficacy of using Stryd to delineate exercise intensities, quantify aerobic fitness, and estimate running economy (RE). Stryd running power was strongly associated with V·O2 (R2 = 0.84; p < 0.001) and running speed at the MLSS (R2 = 0.91; p < 0.001). Stryd running power measures were strongly correlated with RE at the MLSS when combined with metabolic data (R2 = 0.79; p < 0.001) but not in isolation from the metabolic data (R2 = 0.08; p = 0.313). Measures of running EFF near the MLSS were not different across intensities (~21%; p > 0.05). In conclusion, although Stryd could not quantify RE in isolation, it provided a stable, sensitive, and reliable metric that can estimate aerobic fitness, delineate exercise intensities, and approximate the metabolic requirements of running near the MLSS.

Ischemic Preconditioning, But Not Priming Exercise, Improves Exercise Performance in Trained Rock Climbers.

ABSTRACT: MacDougall, KB, McClean, ZJ, MacIntosh, BR, Fletcher, JR, and Aboodarda, SJ. Ischemic preconditioning, but not priming exercise, improves exercise performance in trained rock climbers. J Strength Cond Res 37(11): 2149-2157, 2023-To assess the effects of ischemic preconditioning (IPC) and priming exercise on exercise tolerance and performance fatigability in a rock climbing-specific task, 12 rock climbers completed familiarization and baseline tests, and constant-load hangboarding tests (including 7 seconds on and 3 seconds off at an intensity estimated to be sustained for approximately 5 minutes) under 3 conditions: (a) standardized warm-up (CON), (b) IPC, or (c) a priming warm-up (PRIME). Neuromuscular responses were assessed using the interpolated twitch technique, including maximum isometric voluntary contraction (MVC) of the finger flexors and median nerve stimulation, at baseline and after the performance trial. Muscle oxygenation was measured continuously using near-infrared spectroscopy (NIRS) across exercise. Time to task failure (T lim ) for IPC (316.4 ± 83.1 seconds) was significantly greater than CON (263.6 ± 69.2 seconds) ( p = 0.028), whereas there was no difference between CON and PRIME (258.9 ± 101.8 seconds). At task failure, there were no differences in MVC, single twitch force, or voluntary activation across conditions; however, recovery of MVC and single twitch force after the performance trial was delayed for IPC and PRIME compared with CON ( p < 0.05). Despite differences in T lim , there were no differences in any of the NIRS variables assessed. Overall, despite exercise tolerance being improved by an average of 20.0% after IPC, there were no differences in neuromuscular responses at task failure, which is in line with the notion of a critical threshold of peripheral fatigue. These results indicate that IPC may be a promising precompetition strategy for rock climbers, although further research is warranted to elucidate its mechanism of action.

Age-related reductions in the number of serial sarcomeres contribute to shorter fascicle lengths but not elevated passive tension.

We investigated age-related changes to fascicle length, sarcomere length and serial sarcomere number (SSN), and how this affects passive force. Following mechanical testing to determine passive force, the medial gastrocnemius muscle of young (n=9) and old (n=8) Fisher 344BN hybrid rats was chemically fixed at the optimal muscle length for force production; individual fascicles were dissected for length measurement, and laser diffraction was used to assess sarcomere length. Old rats had ∼14% shorter fascicle lengths than young rats, which was driven by a ∼10% reduction in SSN, with no difference in sarcomere length (∼4%). Passive force was greater in the old than in the young rats at long muscle lengths. Shorter fascicle lengths and reduced SSN in the old rats could not entirely explain increased passive forces for absolute length changes, owing to a slight reduction in sarcomere length in old rats, resulting in similar sarcomere length at long muscle lengths.

The effect of torsional shoe sole stiffness on knee moment and gross efficiency in cycling.

Altering torsional stiffness of cycling shoe soles may be a novel approach to reducing knee joint moments and overuse injuries during cycling. We set out to determine if the magnitude of three-dimensional knee moments were different between cycling shoe soles with different torsional stiffnesses. Eight trained male cyclists cycled at 90% lactate threshold power output in one of two cycling shoe conditions in a randomized crossover design. The shoe sole was considered torsionally flexible (FLEX) compared to a relatively stiffer (STIFF) sole. Gross efficiency (GE) and knee joint moments were quantified. No significant effect of shoe condition was seen in GE (21.4 ± 1.1% and 20.9 ± 1.6% for FLEX and STIFF, respectively, P = 0.12), nor in three-dimensional knee moments. 4 of the 8 subjects had reduced knee moments in at least 2 of the 3 moment directions. These "responders" were significantly shorter (1.73 ± 0.02 m vs 1.81 ± 0.04 m, P = 0.017) and had a higher relative maximal aerobic power (MAP) (4.6 ± 0.3 W∙kg-1 vs 3.9 ± 0.3 W∙kg-1, P = 0.024) compared to non-responders. These results suggest that certain shoe characteristics may influence certain individuals differently because these participants belong to different "functional groups"; certain individuals may respond positively to FLEX, while others may not. Further studies should test this proposed hypothesis.

Estimates of Achilles Tendon Moment Arm Length at Different Ankle Joint Angles: Effect of Passive Moment.

The length of a muscle's moment arm can be estimated noninvasively using ultrasound and the tendon excursion method. The main assumption with the tendon excursion method is that the force acting on the tendon during passive rotation is constant. However, passive force changes through the range of motion, and thus moment arm is underestimated. The authors attempted to account for passive force on the measurement of Achilles tendon moment arm using the tendon excursion method in 8 male and female runners. Tendon excursion was measured using ultrasound while the ankle was passively rotated at 0.17 rad·s-1. Moment arm was calculated at 5° intervals as the ratio of tendon displacement to joint rotation from 70° to 115°. Passive moment (MP) was measured using a dynamometer. The displacement attributable to MP was calculated by monitoring tendon displacement during a ramp isometric maximum contraction. MP was 5.7 (2.1) N·m at 70° and decreased exponentially from 70° to 90°. This resulted in MP-corrected moment arms that were significantly larger than uncorrected moment arms at joint angles where MP was present. Furthermore, MP-corrected moment arms did not change with ankle angle, which was not the case for uncorrected moment arms.

Estimates of Achilles Tendon Moment Arm Length at Different Ankle Joint Angles: Effect of Passive Moment.

The length of a muscle's moment arm can be estimated non-invasively using ultrasound, and the tendon excursion method. The main assumption with the tendon excursion method, however, is that the force acting on the tendon during passive rotation is constant. However, passive force changes through the range of motion, and moment arm is underestimated. We attempted to account for passive force on the measurement of Achilles tendon moment arm using the tendon excursion method in 8 male and female runners. Tendon excursion was measured using ultrasound while the ankle was passively rotated at 0.17 rad•s-1. Moment arm was calculated at 5° intervals as the ratio of tendon displacement to joint rotation from 70° to 115°. Passive moment (MP) was measured by a dynamometer. The displacement attributable to MP was calculated by monitoring tendon displacement during a ramp isometric maximum contraction. MP was 5.7±2.1 Nm at 70° and decreased exponentially from 70°-90°. °. This resulted in MP-corrected moment arms that were significantly larger than uncorrected moment arms at joint angles where MP was present. Further, MP-corrected moment arms did not change with ankle angle, which was not the case for uncorrected moment arms.

Effectiveness of Bio-K+ for the prevention of Clostridioides difficile infection: Stepped-wedge cluster-randomized controlled trial.

OBJECTIVE: To evaluate the impact of administering probiotics to prevent Clostridioides difficile infection (CDI) among patients receiving therapeutic antibiotics. DESIGN: Stepped-wedge cluster-randomized trial between September 1, 2016, and August 31, 2019. SETTING: This study was conducted in 4 acute-care hospitals across an integrated health region. PATIENTS: Hospitalized patients, aged ≥55 years. METHODS: Patients were given 2 probiotic capsules daily (Bio-K+, Laval, Quebec, Canada), containing 50 billion colony-forming units of Lactobacillus acidophilus CL1285, L. casei LBC80R, and L. rhamnosus CLR2. We measured hospital-acquired CDI (HA-CDI) and the number of positive C. difficile tests per 10,000 patient days as well as adherence to administration of Bio-K+ within 48 and 72 hours of antibiotic administration. Mixed-effects generalized linear models, adjusted for influenza admissions and facility characteristics, were used to evaluate the impact of the intervention on outcomes. RESULTS: Overall adherence of Bio-K+ administration ranged from 76.9% to 84.6% when stratified by facility and periods. Rates of adherence to administration within 48 and 72 hours of antibiotic treatment were 60.2% -71.4% and 66.7%-75.8%, respectively. In the adjusted analysis, there was no change in HA-CDI (incidence rate ratio [IRR], 0.92; 95% confidence interval [CI], 0.68-1.23) or C. difficile positivity rate (IRR, 1.05; 95% CI, 0.89-1.24). Discharged patients may not have received a complete course of Bio-K+. Our hospitals had a low baseline incidence of HA-CDI. Patients who did not receive Bio-K+ may have differential risks of acquiring CDI, introducing selection bias. CONCLUSIONS: Hospitals considering probiotics as a primary prevention strategy should consider the baseline incidence of HA-CDI in their population and timing of probiotics relative to the start of antimicrobial administration.

Anomalous Behavior in Dark-Bright Splitting Impacts the Biexciton Binding Energy in (BA)2(MA)n-1PbnBr3n+1 (n = 1-3).

Two-dimensional Ruddlesden-Popper series are an excellent system for tuning physical properties of the perovskite by controlling the layer number (n). For instance, bandgap and exciton binding energies of the series gradually increase upon reducing n via enhanced quantum and dielectric confinements. Here, we present findings that challenge the anticipated trend in electron-hole exchange interaction within (BA)2MAn-1PbnBr3n+1 (n = 1-3), which causes spin-dependent exciton level splitting into bright and dark states, where the latter is partially visible near the surface of the Br-based two-dimensional Ruddlesden-Popper series. Contrary to expectations, the smallest gap between bright and dark exciton levels is observed from n = 2 at 10 K. This anomaly results in the strongest biexciton binding between two dark excitons occurring at n = 2, rather than at n = 1 as initially hypothesized. The observed anomaly arises from a phase transition induced by octahedral tilting occurring only for n = 2 near 100 K as confirmed by temperature-dependent optical and X-ray diffraction measurements. Our results show that Coulomb interaction need not vary gradually with n, which can impact the optoelectronic properties of the Ruddlesden-Popper series.

Can muscle shortening alone, explain the energy cost of muscle contraction in vivo?

PURPOSE: Decreased whole-body energy cost of running has been associated with an increased Achilles tendon stiffness. It is usually assumed that this lower energy cost can be attributed to less muscle fascicle shortening with a stiffer tendon. Increased fiber shortening is an important determinant of muscle energetics in vitro. However, other factors, like increased muscle activation may be important when considering whole muscle energetics in vivo. METHODS: To determine the effects of a small additional muscle shortening on skeletal muscle energy requirement, 19 subjects performed 30 plantarflexions on two separate occasions: isometric (ISO) and isokinetic (KIN, 6.98 rad s(-1)), each with a target of 50 % of maximum isometric torque. Medial gastrocnemius muscle fascicle length (FL) was measured by ultrasound and rate of oxyhemoglobin (HbO2) desaturation was measured during blood flow occlusion using near-infrared spectroscopy. RESULTS: KIN resulted in significantly greater muscle shortening (23.8 ± 1.3 mm) than ISO (18.3 ± 1.0 mm, p < 0.001, mean ± SEM), and greater shortening velocity (KIN = 2.5 ± 0.3 FL s(-1), ISO = 1.1 ± 0.1 FL s(-1), p < 0.001). Rate of HbO2 desaturation was 19 ± 7 %, greater in KIN than ISO (p < 0.01), despite 19 ± 2 % lower mean torque (p < 0.001) and 9.8 ± 1.6 Nm s lower mean impulse per contraction (p < 0.001) in KIN compared to ISO. Root mean square for EMG was significantly greater (p < 0.05) during KIN (73 ± 3 %) than during ISO (63 ± 2 %). CONCLUSION: These results illustrate that muscle energy requirement is greater when muscle fascicle shortening and/or velocity of shortening is increased, and suggest that greater activation contributes to that increased energy requirement.

More than energy cost: multiple benefits of the long Achilles tendon in human walking and running.

Elastic strain energy that is stored and released from long, distal tendons such as the Achilles during locomotion allows for muscle power amplification as well as for reduction of the locomotor energy cost: as distal tendons perform mechanical work during recoil, plantar flexor muscle fibres can work over smaller length ranges, at slower shortening speeds, and at lower activation levels. Scant evidence exists that long distal tendons evolved in humans (or were retained from our more distant Hominoidea ancestors) primarily to allow high muscle-tendon power outputs, and indeed we remain relatively powerless compared to many other species. Instead, the majority of evidence suggests that such tendons evolved to reduce total locomotor energy cost. However, numerous additional, often unrecognised, advantages of long tendons may speculatively be of greater evolutionary advantage, including the reduced limb inertia afforded by shorter and lighter muscles (reducing proximal muscle force requirement), reduced energy dissipation during the foot-ground collisions, capacity to store and reuse the muscle work done to dampen the vibrations triggered by foot-ground collisions, reduced muscle heat production (and thus core temperature), and attenuation of work-induced muscle damage. Cumulatively, these effects should reduce both neuromotor fatigue and sense of locomotor effort, allowing humans to choose to move at faster speeds for longer. As these benefits are greater at faster locomotor speeds, they are consistent with the hypothesis that running gaits used by our ancestors may have exerted substantial evolutionary pressure on Achilles tendon length. The long Achilles tendon may therefore be a singular adaptation that provided numerous physiological, biomechanical, and psychological benefits and thus influenced behaviour across multiple tasks, both including and additional to locomotion. While energy cost may be a variable of interest in locomotor studies, future research should consider the broader range of factors influencing our movement capacity, including our decision to move over given distances at specific speeds, in order to understand more fully the effects of Achilles tendon function as well as changes in this function in response to physical activity, inactivity, disuse and disease, on movement performance.

How do differences in Achilles' tendon moment arm lengths affect muscle-tendon dynamics and energy cost during running?

Introduction: The relationship between the Achilles tendon moment arm length (ATMA) and the energy cost of running (Erun) has been disputed. Some studies suggest a short ATMA reduces Erun while others claim a long ATMA reduces Erun. For a given ankle joint moment, a short ATMA permits a higher tendon strain energy storage, whereas a long ATMA reduces muscle fascicle force and muscle energy cost but shortening velocity is increased, elevating the metabolic cost. These are all conflicting mechanisms to reduce Erun, since AT energy storage comes at a metabolic cost. Neither of these proposed mechanisms have been examined together. Methods: We measured ATMA using the tendon travel method in 17 males and 3 females (24 ± 3 years, 75 ± 11 kg, 177 ± 7 cm). They ran on a motorized treadmill for 10 min at 2.5 m · s-1 while Erun was measured. AT strain energy storage, muscle lengths, velocities and muscle energy cost were calculated during time-normalized stance from force and ultrasound data. A short (SHORT n = 11, ATMA = 29.5 ± 2.0 mm) and long (LONG, n = 9, ATMA = 36.6 ± 2.5 mm) ATMA group was considered based on a bimodal distribution of measured ATMA. Results: Mean Erun was 4.9 ± 0.4 J · kg-1 · m-1. The relationship between ATMA and Erun was not significant (r 2 = 0.13, p = 0.12). Maximum AT force during stance was significantly lower in LONG (5,819 ± 1,202 N) compared to SHORT (6,990 ± 920 N, p = 0.028). Neither AT stretch nor AT strain energy storage was different between groups (mean difference: 0.3 ± 1 J · step-1, p = 0.84). Fascicle force was significantly higher in SHORT (508 ± 93 N) compared to LONG (468 ± 84 N. p = 0.02). Fascicle lengths and velocities were similar between groups (p > 0.72). Muscle energy cost was significantly lower in LONG (0.028 ± 0.08 J · kg · step-1) compared to SHORT (0.045 ± 0.14 J · kg · step-1 p = 0.004). There was a significant negative relationship between ATMA and total muscle energy cost relative to body mass across the stance phase (r = -0.699, p < 0.001). Discussion: Together these results suggest that a LONG ATMA serves to potentially reduce Erun by reducing the muscle energy cost of the plantarflexors during stance. The relative importance of AT energy storage and return in reducing Erun should be re-considered.

Test-Retest Reliability of a 4-Minute All-Out Critical Force Test in Rock Climbers.

The purpose of this study was to assess the test-retest reliability of a 4-minute all-out critical force test in well-trained rock climbers. Thirteen rock climbers (n=4 females) completed a familiarization session and two all-out critical force tests on different days. During each trial, participants completed 24 repetitions of 7s right-handed, maximal effort hangs from a 20mm edge interspersed with 3 s rest. The end-test force (EF; i.e., critical force), impulse above EF (IEF), and peak force achieved during the test were analyzed with paired t-tests to determine differences between trials. Intraclass correlation coefficient (ICC), coefficient of variation (CV), and Bland-Altman analysis were performed to quantify the relative and absolute reliability of the measure, respectively. The level of significance for this study was set at p<0.05. There were no significant differences between trials for any of the reported variables (P≥0.455). For EF, IEF, and peak force, ICC was 0.848, 0.820, and 0.938, respectively; and CV was 21.0%, 13.2%, and 5.6%, respectively. Bland-Altman analyses showed a mean relative bias of -2.3%, -2.8%, and -1.3%, with 95% limits of agreement (LoA) of -62.6% to 58.1%, -40.5% to 30.9%, and -17.2% to 14.6% for EF, IEF, and peak force, respectively, however linear regression revealed a significant proportional bias for EF (p = 0.026, R2 = 0.377). The reliability of this protocol was good to excellent for all parameters; however, there was larger intra-individual variability for EF and IEF. This study suggests that when using the 4-min all-out critical force test in rock climbers, coaches and athletes should be aware that there may be a trade-off between the test's practicality and the precision of its results.

Validity of the Entralpi force plate in the assessment of finger flexor performance metrics in rock climbers.

This study assessed the validity of the Entralpi force plate in the assessment of finger flexor performance in rock climbers. In addition to a static force evaluation, peak force, peak impulse, and total impulse were measured during 30 all-out performance trials by 15 participants, in which force during the trials was recorded simultaneously by the Entralpi and a Pasco force plate. Agreement between devices was assessed by a variety of statistical analyses, including intraclass correlation coefficient (ICC), coefficient of variation (CV), and Bland-Altman analyses. The static force evaluation showed a mean relative error of 0.41% and excellent day-to-day reliability (ICC = 1; CV = 0.03%). Peak force, peak impulse, and total impulse from the performance trials demonstrated strong agreement (ICC ≥ 0.991, CV ≤ 1.9%, Bland-Altman mean bias ≤ 0.5%). These results illustrate that the Entralpi force plate provides accurate and reliable data for rock climbing related tasks at an affordable cost.

Chemical activation of commodity plastics for patterned electroless deposition of robust metallic films.

A general approach to increase the adhesion of metal films to commodity plastic substrates using a metal-chelating polymer, polyethyleneimine, in conjunction with patterned electroless deposition is described. This general fabrication method is compatible with a diverse array of plastics and metals with properties applicable to flexible electronic circuits and electrochemical cells.

Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?

PURPOSE: This study aimed to investigate if changing the midsole bending stiffness of athletic footwear can affect the onset of lower limb joint work redistribution during a prolonged run. METHODS: Fifteen trained male runners (10-km time of <44 min) performed 10-km runs at 90% of their individual speed at lactate threshold (i.e., when change in lactate exceeded 1 mmol/L during an incremental running test) in a control and stiff shoe condition on 2 occasions. Lower limb joint kinematics and kinetics were measured using a motion capture system and a force-instrumented treadmill. Data were acquired every 500 m. RESULTS: Prolonged running resulted in a redistribution of positive joint work from distal to proximal joints in both shoe conditions. Compared to the beginning of the run, less positive work was performed at the ankle (approximately 9%; p ≤ 0.001) and more positive work was performed at the knee joint (approximately 17%; p ≤ 0.001) at the end of the run. When running in the stiff shoe condition, the onset of joint work redistribution at the ankle and knee joints occurred at a later point during the run. CONCLUSION: A delayed onset of joint work redistribution in the stiff condition may result in less activated muscle volume, because ankle plantar flexor muscles have shorter muscles fascicles and smaller cross-sectional areas compared to knee extensor muscles. Less active muscle volume could be related to previously reported decreases in metabolic cost when running in stiff footwear. These results contribute to the notion that footwear with increased stiffness likely results in reductions in metabolic cost by delaying joint work redistribution from distal to proximal joints.

How Can Biomechanics Improve Physical Preparation and Performance in Paralympic Athletes? A Narrative Review.

Recent research in Paralympic biomechanics has offered opportunities for coaches, athletes, and sports practitioners to optimize training and performance, and recent systematic reviews have served to summarize the state of the evidence connecting biomechanics to Paralympic performance. This narrative review serves to provide a comprehensive and critical evaluation of the evidence related to biomechanics and Paralympic performance published since 2016. The main themes within this review focus on sport-specific body posture: the standing, sitting, and horizontal positions of current summer Paralympic sports. For standing sports, sprint and jump mechanics were assessed in athletes with cerebral palsy and in lower-limb amputee athletes using running-specific prostheses. Our findings suggest that running and jumping-specific prostheses should be 'tuned' to each athlete depending on specific event demands to optimize performance. Standing sports were also inclusive to athletes with visual impairments. Sitting sports comprise of athletes performing on a bike, in a wheelchair (WC), or in a boat. WC configuration is deemed an important consideration for injury prevention, mobility, and performance. Other sitting sports like hand-cycling, rowing, and canoeing/kayaking should focus on specific sitting positions (e.g., arm-crank position, grip, or seat configuration) and ways to reduce aero/hydrodynamic drag. Para-swimming practitioners should consider athlete-specific impairments, including asymmetrical anthropometrics, on the swim-start and free-swim velocities, with special considerations for drag factors. Taken together, we provide practitioners working in Paralympic sport with specific considerations on disability and event-specific training modalities and equipment configurations to optimize performance from a biomechanical perspective.

Increasing the midsole bending stiffness of shoes alters gastrocnemius medialis muscle function during running.

In recent years, increasing the midsole bending stiffness (MBS) of running shoes by embedding carbon fibre plates in the midsole resulted in many world records set during long-distance running competitions. Although several theories were introduced to unravel the mechanisms behind these performance benefits, no definitive explanation was provided so far. This study aimed to investigate how the function of the gastrocnemius medialis (GM) muscle and Achilles tendon is altered when running in shoes with increased MBS. Here, we provide the first direct evidence that the amount and velocity of GM muscle fascicle shortening is reduced when running with increased MBS. Compared to control, running in the stiffest condition at 90% of speed at lactate threshold resulted in less muscle fascicle shortening (p = 0.006, d = 0.87), slower average shortening velocity (p = 0.002, d = 0.93) and greater estimated Achilles tendon energy return (p ≤ 0.001, d = 0.96), without a significant change in GM fascicle work (p = 0.335, d = 0.40) or GM energy cost (p = 0.569, d = 0.30). The findings of this study suggest that running in stiff shoes allows the ankle plantarflexor muscle-tendon unit to continue to operate on a more favourable position of the muscle's force-length-velocity relationship by lowering muscle shortening velocity and increasing tendon energy return.

SARS-CoV-2 Infection and Oral Health: Therapeutic Opportunities and Challenges.

The novel corona virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and the disease it causes, COVID-19 (Coronavirus Disease-2019) have had multi-faceted effects on a number of lives on a global scale both directly and indirectly. A growing body of evidence suggest that COVID-19 patients experience several oral health problems such as dry mouth, mucosal blistering, mouth rash, lip necrosis, and loss of taste and smell. Periodontal disease (PD), a severe inflammatory gum disease, may worsen the symptoms associated with COVID-19. Routine dental and periodontal treatment may help decrease the symptoms of COVID-19. PD is more prevalent among patients experiencing metabolic diseases such as obesity, diabetes mellitus and cardiovascular risk. Studies have shown that these patients are highly susceptible for SARS-CoV-2 infection. Pro-inflammatory cytokines and oxidative stress known to contribute to the development of PD and other metabolic diseases are highly elevated among COVID-19 patients. Periodontal health may help to determine the severity of COVID-19 infection. Accumulating evidence shows that African-Americans (AAs) and vulnerable populations are disproportionately susceptible to PD, metabolic diseases and COVID-19 compared to other ethnicities in the United States. Dentistry and dental healthcare professionals are particularly susceptible to this virus due to the transferability via the oral cavity and the use of aerosol creating instruments that are ubiquitous in this field. In this review, we attempt to provide a comprehensive and updated source of information about SARS-CoV-2/COVID-19 and the various effects it has had on the dental profession and patients visits to dental clinics. Finally, this review is a valuable resource for the management of oral hygiene and reduction of the severity of infection.