High Protein Diets and Glomerular Hyperfiltration in Athletes and Bodybuilders: Is Chronic Kidney Disease the Real Finish Line?

Several observational and experimental studies in humans have suggested that high protein intake (PI) causes intraglomerular hypertension leading to hyperfiltration. This phenomenon results in progressive loss of renal function with long-term exposure to high-protein diets (HPDs), even in healthy people. The recommended daily allowance for PI is 0.83 g/kg per day, which meets the protein requirement for approximately 98% of the population. A HPD is defined as a protein consumption > 1.5 g/kg per day. Athletes and bodybuilders are encouraged to follow HPDs to optimize muscle protein balance, increase lean body mass, and enhance performance. A series of studies in resistance-trained athletes looking at HPD has been published concluding that there are no harmful effects of HPD on renal health. However, the aim of these studies was to evaluate body composition changes and they were not designed to assess safety or kidney outcomes. Here we review the effects of HPD on kidney health in athletes and healthy individuals with normal kidney function.

Do Elite Basketball Players Maintain Peak External Demands throughout the Entire Game?

Consideration of workload intensity and peak demands across different periods of basketball games contributes to understanding the external physical requirements of elite basketball players. Therefore, the aim of this study was to investigate the average intensity and peak demands encountered by players throughout game quarters. PlayerLoad per minute and PlayerLoad at three different time samples (30 s, 1 min, and 3 min) were used as workload metrics. A total of 14 professional elite male basketball players were monitored during 30 official games to investigate this. A linear mixed model and Cohen's d were employed to identify significant differences and quantify the effect sizes among game quarters. The results showed a significant, moderate effect in PlayerLoad per minute between Q1 vs. Q4, and a small effect between Q2 and Q3 vs. Q4. Furthermore, a small to moderate decline was observed in external peak values for PlayerLoad across game quarters. Specifically,, a significant decrease was found for the 3 min time window between Q1 and other quarters. The findings from the present study suggest that professional basketball players tend to experience fatigue or reduced physical output as the game progresses.

Home-Court Advantage is Greater for Teams Competing at Higher Playing Levels: An Exploratory Analysis of Spanish Male Basketball Leagues.

This study aimed to (i) compare the extent of home-court advantage (HA) and home win percentage (HW) between Spanish basketball leagues across different playing levels (i.e., leagues) and (ii) analyze the influence of team ability on HA and HW within each playing level. We gathered data for game locations and results from open online sources for all games in the First Division (ACB), Second Division (LEB Gold), and Third Division (LEB Silver) Spanish male basketball leagues between 2010-2023. The dataset included 12 seasons, 635 teams (215 First Division, 203, Second Division, and 217 Third Division), and 19,539 games (7075 First Division, 6344 Second Division, and 5520 Third Division). We calculated HA [(total home wins/total wins) * 100] and HW [(total home wins/total home games) * 100] for each team across each season. We performed Kruskal Wallis tests, calculated partial eta squared (ηp2), and performed Mann-Whitney U tests with rank biserial correlation (rb) effect sizes and Dwass-Steel-Critchlow-Fligner pairwise comparisons to compare HA and HW between leagues and between team abilities (low, medium, and/or high) within each league. There was a significant effect for HA between leagues (p = .01) with post hoc comparisons revealing a higher HA for the First Division than for the Third Division (p = .01), but HW was not significantly different between leagues. In turn, variations in HA and HW between team abilities were consistent across playing levels, with HW significantly increasing in a progressive manner with higher team abilities (p < .001) and with HA significantly lower among high-level teams compared to lower-ability team clusters (p < .01). These findings emphasize the importance of considering playing level and team ability and interpreting HA and HW together to contextualize an apparent home advantage in Spanish basketball.

Longitudinal Feasibility of the Montreal Cognitive Assessment (MoCA) in Non-Demented ALS Patients.

INTRODUCTION: The present study aimed at testing the longitudinal feasibility of the Montreal Cognitive Assessment (MoCA) in an Italian cohort of non-demented amyotrophic lateral sclerosis (ALS) patients. METHODS: N = 39 non-demented ALS patients were followed-up at a 5-to-10-month interval (M = 6.8; SD = 1.4) with the MoCA and the Edinburgh Cognitive and Behavioral ALS Screen (ECAS). Practice effects, test-retest reliability, and predictive validity (against follow-up ECAS scores) were assessed. Reliable change indices (RCIs) were derived via a regression-based approach by accounting for retest interval and baseline confounders (i.e., demographics, disease duration, and severity and progression rate). RESULTS: At retest, 100% and 69.2% of patients completed the ECAS and the MoCA, respectively. Patients who could not complete the MoCA showed a slightly more severe and fast-progressing disease. The MoCA was not subject to practice effects (t[32] = -0.80; p = 0.429) and was reliable at retest (intra-class correlation = 0.82). Moreover, baseline MoCA scores predicted the ECAS at retest. RCIs were successfully derived - with baseline MoCA scores being the only significant predictor of retest performances (ps < 0.001). CONCLUSIONS: As long as motor disabilities do not undermine its applicability, the MoCA appears to be longitudinally feasible at a 5-to-10-month interval in non-demented ALS patients. However, ALS-specific screeners - such as the ECAS - should be preferred whenever possible.

Cytokines and chemokines in patients with chronic inflammatory demyelinating polyradiculoneuropathy and multifocal motor neuropathy: A systematic review.

Advances in the understanding of cytokines have revolutionized mechanistic treatments for chronic inflammatory and autoimmune diseases, as exemplified by rheumatoid arthritis. We conducted a systematic literature review on the role of cytokines and chemokines in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN). Ovid Medline, EMBASE and Web of Science were searched until August 31, 2022 for human studies investigating cytokines levels in CIDP or MMN. Fifty-five articles on 1061 CIDP patients and 86 MMN patients were included, with a median of 18 patients per study (range 3-71). Studies differed in the inclusion criteria, type of assay, manufacturer, control subjects, and tested biological material. Only a minority of studies reported data on disease activity. Interleukin (IL)-6, IL-17, CXCL10, and tumor necrosis factor alpha (TNF-α), were elevated in CIDP compared to controls in most of the studies. IL-6 and TNF-α levels are also correlated with disability. In MMN patients, IL-1Ra was elevated in the majority of the reports. While acknowledging the challenges in comparing studies and the various limitations of the studies, including small patient numbers, particularly in MMN, our review suggests that IL-6, IL-17, CXCL10, and TNF-α might play a role in CIDP pathogenesis. Larger studies are needed in MMN.

Detection of harmful algal blooms from satellite-based inherent optical properties of the ocean in Paracas Bay - Peru.

Harmful algal bloom (HAB) events in front of Pisco River, inside Paracas Bay and Lagunillas inlet on the southern coast of Peru was identified from a satellite index (IOPifa) generated with daily high-resolution satellite data of phytoplankton absorption (aphy,GIOP) and non-algal detrital material plus CDOM (adCDOM,GIOP) from the Generalized Inherent Optical Properties (GIOP) model of Modis-Aqua, Viirs-Snpp and Viirs-Jpss1 satellites were used. Phytoplankton density field data sampling from HAB's monitoring programs of IMARPE of 2018 and 2019 were used to validate and identify the extent and spatio-temporal variability of these events. The satellite index (IOPifa) identified for Modis-Aqua 9 active HABs, 8 events in final conditions and 6 events that do not represent HAB conditions, while for Viirs-Snpp found 14 active HABs, 7 events in decaying bloom conditions and 13 events that do not represent HABs; and for Viirs-Jpss1 the index identified 7 active events, 14 in final bloom conditions and 6 that do not represent HABs conditions. The one-factor anova model was applied (p-value = 0.32 > 0.05), indicating that there is no evidence of a difference in the population means of the indices for each sensor. Subsequently, the pairwise multiple comparisons analysis with a 95 % confidence level of Tukey's test confirmed that there are no significant differences in the satellite index value, the differences could be associated with the spectral characteristics of the cell density of the species community and the oceanographic and environmental conditions. The spatial overlap between the in situ harmful algal blooms areas and the calculated satellite index, shows the capacity of the IOP satellite data for the HABs detection. However, it was also evidenced that some HAB events with high phytoplankton cell density had low IOPifa values, while other events with lower cell density were easily identified by the satellite index. This would indicate the ability of the ocean inherent optical properties to differentiate the phytoplankton types that cause algal blooms.

Impact of 2021 European Academy of Neurology/Peripheral Nerve Society diagnostic criteria on diagnosis and therapy of chronic inflammatory demyelinating polyradiculoneuropathy variants.

BACKGROUND AND PURPOSE: There are different criteria for the diagnosis of different variants of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) guidelines provide specific clinical criteria for each CIDP variant even if their therapeutical impact has not been investigated. METHODS: We applied the clinical criteria for CIDP variants of the 2021 EAN/PNS guidelines to 369 patients included in the Italian CIDP database who fulfilled the 2021 EAN/PNS electrodiagnostic criteria for CIDP. RESULTS: According to the 2021 EAN/PNS clinical criteria, 245 patients achieved a clinical diagnosis of typical CIDP or CIDP variant (66%). We identified 106 patients with typical CIDP (29%), 62 distal CIDP (17%), 28 multifocal or focal CIDP (7%), four sensory CIDP (1%), 27 sensory-predominant CIDP (7%), 10 motor CIDP (3%), and eight motor-predominant CIDP (2%). Patients with multifocal, distal, and sensory CIDP had milder impairment and symptoms. Patients with multifocal CIDP had less frequently reduced conduction velocity and prolonged F-wave latency and had lower levels of cerebrospinal fluid protein. Patients with distal CIDP more frequently had reduced distal compound muscle action potentials. Patients with motor CIDP did not improve after steroid therapy, whereas those with motor-predominant CIDP did. None of the patients with sensory CIDP responded to steroids, whereas most of those with sensory-predominant CIDP did. CONCLUSIONS: The 2021 EAN/PNS criteria for CIDP allow a better characterization of CIDP variants, permitting their distinction from typical CIDP and more appropriate treatment for patients.

Regular assessment of serum vascular endothelial growth factor levels to monitor POEMS syndrome.

BACKGROUND: To investigate the utility of regular serum VEGF (sVEGF) levels assessment in the monitoring of POEMS syndrome. METHODS: We retrospectively reviewed data of 30 patients with POEMS syndrome whose sVEGF was tested regularly every 6 months. sVEGF levels after treatment were measured and correlated with disability (Overall Neuropathy Limitations Scale, ONLS), clinical impairment (measured with the modified Clinical Response Evaluation Scale, mCRES), and relapse-free survival. The ability of sVEGF to predict disease flares during remission and refractory disease was also analysed. RESULTS: Patients with normalised serum VEGF levels (< 1000 pg/ml) at 6 months showed prolonged relapse-free survival (at 3-year 94% for complete VEGF response, 57% partial, 0% none, p < 0.001) and greater later clinical improvement (median ΔmCRES complete VEGF response -5 vs partial -4, p = 0.019, and vs no VEGF response -2, p = 0.006). After remission, the sensitivity of 6-month sVEGF monitoring in predicting clinical relapse was 58% with a specificity of 100%. In patients refractory to treatment, the sensitivity in predicting further clinical worsening was 15%. In addition, in 25% of the patients in remission and 16% of those refractory to therapy, sVEGF levels only increased at the time of relapse. CONCLUSIONS: Regular sVEGF assessment is a valid biomarker in the prediction of disease reactivation in POEMS syndrome and was particularly useful during the phase of remission.

Impact of Spectators, League and Team Ability on Home Advantage in Professional European Basketball.

Our aim in this study was to examine the impact of fans (vs. no fans), geographical location of league, and team ability on home winning percentage (HW%) or home advantage (HA) in professional European basketball. Data were collected from five prestigious professional, national basketball leagues within Europe (Spain, Germany, Italy, Greece and Israel) across 16 regular seasons (2005-2006 to 2020-2021). We conducted comparisons between matches with and without fans, location of leagues, team ability (High, Medium, Low), and combinations of these factors via non-parametric tests (e.g., Mann-Whitney tests, Kruskal-Wallis). We found significantly greater HA during matches with fans for leagues in Germany (p = .001), Italy (p = .012) and Spain (p = .002). For matches with fans, HA and HW% were significantly different between several, but not all, leagues for high (p < .05), medium (p < .05) and low (p < .02) team abilities. In conclusion, HA and HW% were enhanced by spectator attendance, with this phenomenon varying by location/region and team ability. Consideration of these multiple contextual factors may assist coaches and sport organizations to develop key strategies for enhanced team success.

A Narrative Review of the Most Demanding Scenarios in Basketball: Current Trends and Future Directions.

Since the analysis of most demanding scenarios (MDS) in basketball has improved the practical knowledge about match demands and possible impacts for the training process, it seems important to summarize the scientific evidence providing useful information and future directions related to MDS. This review assesses the results reflected in the available literature about the MDS in basketball, synthesizing and discussing data from scientific papers, and then providing relevant insights about terminology, sex and sample size, competition category, workload variables recorded, technology used, method of calculation, time windows analyzed, and activities evaluated related to MDS. Therefore, the present narrative review would be of practical use for coaches, scientists, athletes as well as strength and conditioning trainers exploring the current trends and future directions related to MDS in basketball.

Genetic testing in focal segmental glomerulosclerosis: in whom and when?

Background: Genetic causes are increasingly recognized in patients with focal segmental glomerulosclerosis (FSGS), but it remains unclear which patients should undergo genetic study. Our objective was to determine the frequency and distribution of genetic variants in steroid-resistant nephrotic syndrome FSGS (SRNS-FSGS) and in FSGS of undetermined cause (FSGS-UC). Methods: We performed targeted exome sequencing of 84 genes associated with glomerulopathy in patients with adult-onset SRNS-FSGS or FSGS-UC after ruling out secondary causes. Results: Seventy-six patients met the study criteria; 24 presented with SRNS-FSGS and 52 with FSGS-UC. We detected FSGS-related disease-causing variants in 27/76 patients (35.5%). There were no differences between genetic and non-genetic causes in age, proteinuria, glomerular filtration rate, serum albumin, body mass index, hypertension, diabetes or family history. Hematuria was more prevalent among patients with genetic causes. We found 19 pathogenic variants in COL4A3-5 genes in 16 (29.3%) patients. NPHS2 mutations were identified in 6 (16.2%) patients. The remaining cases had variants affecting INF2, OCRL, ACTN4 genes or APOL1 high-risk alleles. FSGS-related genetic variants were more common in SRNS-FSGS than in FSGS-UC (41.7% vs 32.7%). Four SRNS-FSGS patients presented with NPHS2 disease-causing variants. COL4A variants were the most prevalent finding in FSGS-UC patients, with 12 patients carrying disease-causing variants in these genes. Conclusions: FSGS-related variants were detected in a substantial number of patients with SRNS-FSGS or FSGS-UC, regardless of age of onset of disease or the patient's family history. In our experience, genetic testing should be performed in routine clinical practice for the diagnosis of this group of patients.

Carotid free-floating thrombus stemming from carotid web: co-occurrence of two rare causes of ischemic stroke.

BACKGROUND: Carotid web (CaW) and carotid free-floating thrombus (CFFT) are rare yet critical causes of ischemic stroke in young adults. CASE PRESENTATION: A 54-year-old woman presented with a fluctuating right sensory-motor faciobrachial syndrome. A brain MRI scan revealed multiple small recent asynchronous cortico-subcortical ischemic foci in the vascular territory of the left internal carotid artery. A CT angiography identified a CFFT in the left internal carotid artery arising from an underlying CaW. The patient was treated with excellent clinical outcomes with carotid artery stenting and dual antiplatelet therapy. CONCLUSIONS: We provide a structured pathophysiological rationale connecting CaW and CFFT and highlight pivotal therapeutic implications. Further studies are needed to investigate this relationship and guide assessment and treatment.

Do You Want to Increase Physical Activity in Adolescents? A School-Based Physical Activity Program Could Be an Efficient Way.

The aim of this study was to assess the effects of a classroom-based physical activity program, using bike desks, on academic and physical performance in adolescents. The Program to Enhance and Develop Active Lessons (PEDAL) was designed for this purpose, expecting an increase in students' physical activity without any decrease in academic performance. This intervention based on pedal or bike desks-stationary bikes that integrate with a desk workspace-was conducted with 55 high- school students who were randomly assigned to two groups: a PEDAL group (n = 28, 14.86 ± 0.65 years old, 46.4% girls) and a control group (n = 27, 15 ± 0.68 years old, 51.9% girls). Throughout the intervention, the PEDAL students pedaled 4 days a week for 10 weeks during their Spanish-language arts lessons. The comparisons between the PEDAL group and the control group, as well as the pre- and post-test results, were statistically analyzed to verify the students' physical activity (i.e., IPAQ-SF, heart rate monitors, polar OH1+), cardiorespiratory capacity (20 m shuttle run test), and academic performance (d2 test of attention and language proficiency test). Regarding the physical aspect, only the PEDAL group showed significant growth in their physical activity levels as compared to the pre-test data (p = 0.001), and they achieved higher results compared with the control group (p = 0.022) and less sedentary time than control students (p = 0.012). Concerning cardiorespiratory fitness, there were no post-test differences between the two groups (p = 0.697), probably because the physical activity performed with the bike desks was light-moderate. As far as academic performance is concerned, no significant post-test effects were discovered in either group on the levels of language competence (p = 0.48), attention (TOT, p = 0.432), and concentration (CON, p = 0.216). In conclusion, adolescents who move while learning, using bike desks, increase their light and moderate physical activity without any detriment to academic performance.

Bulbar involvement and cognitive features in amyotrophic lateral sclerosis: a retrospective study on 347 patients.

Background: This study aimed at clarifying the role of bulbar involvement (BI) as a risk factor for cognitive impairment (CI) in non-demented amyotrophic lateral sclerosis (ALS) patients. Methods: Data on N = 347 patients were retrospectively collected. Cognition was assessed via the Edinburgh Cognitive and Behavioral ALS Screen (ECAS). On the basis of clinical records and ALS Functional Rating Scale-Revised (ALSFRS-R) scores, BI was characterized as follows: (1) BI at onset-from medical history; (2) BI at testing (an ALSFRS-R-Bulbar score ≤11); (3) dysarthria (a score ≤3 on item 1 of the ALSFRS-R); (4) severity of BI (the total score on the ALSFRS-R-Bulbar); and (5) progression rate of BI (computed as 12-ALSFRS-R-Bulbar/disease duration in months). Logistic regressions were run to predict a below- vs. above-cutoff performance on each ECAS measure based on BI-related features while accounting for sex, disease duration, severity and progression rate of respiratory and spinal involvement and ECAS response modality. Results: No predictors yielded significance either on the ECAS-Total and -ALS-non-specific or on ECAS-Language/-Fluency or -Visuospatial subscales. BI at testing predicted a higher probability of an abnormal performance on the ECAS-ALS-specific (p = 0.035) and ECAS-Executive Functioning (p = 0.018). Lower ALSFRS-R-Bulbar scores were associated with a defective performance on the ECAS-Memory (p = 0.025). No other BI-related features affected other ECAS performances. Discussion: In ALS, the occurrence of BI itself, while neither its specific features nor its presence at onset, might selectively represent a risk factor for executive impairment, whilst its severity might be associated with memory deficits.

Influence of game and quarter results on external peak demands during games in under-18 years, male basketball players.

To quantify and compare the external peak demands (PD) encountered according to game result (win vs. loss), quarter result (win vs. tie vs. loss), and quarter point difference (± difference in score) in under-18 years (U18), male basketball players. Thirteen basketball players had external load variables monitored across 9 games using local positioning system technology, including distance covered, distance covered in different intensity zones, accelerations, decelerations, and PlayerLoad™. PD were calculated across 30-s, 1-min, and 5-min time windows for each variable. Linear mixed models were used to compare PD for each variable according to game result (win vs. loss), quarter result (win vs tie vs loss), and quarter point difference (high vs. low). External PD were comparable between games that were won and lost for all variables and between quarters that were won and lost for most variables (p > 0.05, trivial-small effects). In contrast, players produced higher (p < 0.05, small effects) 1-min high-speed running distance and 5-min PlayerLoadTM in quarters that were won compared to quarters that were lost. Additionally, high quarter point differences (7.51 ± 3.75 points) elicited greater (p < 0.05, small effects) external PD (30-s PlayerLoadTM, 30-s and 5-min decelerations, and 1-min and 5-min high-speed running distance) than low quarter point differences (-2.47 ± 2.67 points). External PD remain consistent (trivial-small effects) regardless of game result, quarter result, and quarter point difference in U18, male basketball players. Accordingly, external PD attained during games may not be a key indicator of team success.

Comparison of the diagnostic accuracy of the 2021 EAN/PNS and 2010 EFNS/PNS diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy.

OBJECTIVES: To compare the sensitivity and specificity of the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with those of the 2010 European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS). METHODS: Sensitivity and specificity of the two sets of criteria were evaluated in 330 patients with CIDP and 166 axonal peripheral neuropathy controls. Comparison of the utility of nerve conduction studies with different number of nerves examined and of the sensitivity and specificity of the two criteria in typical CIDP and its variants were assessed. RESULTS: EFNS/PNS criteria had a sensitivity of 92% for possible CIDP and 85% for probable/definite CIDP, while the EAN/PNS criteria had a sensitivity of 83% for possible CIDP and 74% for CIDP. Using supportive criteria, the sensitivity of the EAN/PNS criteria for possible CIDP increased to 85% and that of CIDP to 77%, remaining lower than that of the EFNS/PNS criteria. Specificity of the EFNS/PNS criteria was 68% for possible CIDP and 84% for probable/definite CIDP, while the EAN/PNS criteria had a specificity of 88% for possible CIDP and 98% for CIDP. More extended studies increased the sensitivity of both sets of criteria by 4%-7% but reduced their specificity by 2%-3%. The EFNS/PNS criteria were more sensitive for the diagnosis of typical CIDP while the EAN/PNS criteria were more specific for the diagnosis of distal and sensory CIDP. CONCLUSIONS: In our population, the EAN/PNS criteria were more specific but less sensitive than the EFNS/PNS criteria. With the EAN/PNS criteria, more extended nerve conduction studies are recommended to obtain an acceptable sensitivity while maintaining a high specificity.

Development and validation of a nomogram to predict kidney survival at baseline in patients with C3 glomerulopathy.

Background: C3 glomerulopathy is a rare and heterogeneous complement-driven disease. It is often challenging to accurately predict in clinical practice the individual kidney prognosis at baseline. We herein sought to develop and validate a prognostic nomogram to predict long-term kidney survival. Methods: We conducted a retrospective, multicenter observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases. The dataset was randomly divided into a training group (n = 87) and a validation group (n = 28). The least absolute shrinkage and selection operator (LASSO) regression was used to screen the main predictors of kidney outcome and to build the nomogram. The accuracy of the nomogram was assessed by discrimination and risk calibration in the training and validation sets. Results: The study group comprised 115 patients, of whom 46 (40%) reached kidney failure in a median follow-up of 49 months (range 24-112). No significant differences were observed in baseline estimated glomerular filtration rate (eGFR), proteinuria or total chronicity score of kidney biopsies, between patients in the training versus those in the validation set. The selected variables by LASSO were eGFR, proteinuria and total chronicity score. Based on a Cox model, a nomogram was developed for the prediction of kidney survival at 1, 2, 5 and 10 years from diagnosis. The C-index of the nomogram was 0.860 (95% confidence interval 0.834-0.887) and calibration plots showed optimal agreement between predicted and observed outcomes. Conclusions: We constructed and validated a practical nomogram with good discrimination and calibration to predict the risk of kidney failure in C3 glomerulopathy patients at 1, 2, 5 and 10 years.

Fluctuations in External Peak Demands Across Quarters During Basketball Games.

The purpose of this study was to compare external peak demands (PDs) across quarters (Q) in basketball. Thirteen elite, junior, male basketball players were monitored using electronic performance tracking systems. There were studied intervals for different time windows to determine the external PD for distance (m); player load; distance covered in four different zones; accelerations; and decelerations. A mixed linear model was run to identify differences among quarters, and the auto-correlation function was carried out to determine fluctuations across the whole game. The results showed significant differences between Q1 vs. Q2 for distance, player load, and standing-walking distance; between Q1 vs. Q3 for distance, player load, and HSR; between Q1 vs. Q4 for distance, player load, standing-walking, and HSR; and between Q3 vs. Q4 for distance and player load. These findings suggest that external PD for running-based demands (distance, player load, and high-speed running) decrease across basketball games with the most notable declines occurring between the first and fourth quarters. Nevertheless, it is important to note that non-significant differences were found between quarters for several external PD variables (jogging, running, acceleration, and deceleration) across different time windows. Findings from the present study reinforce the importance of considering specific PD variables for different functions due to the specific insight each provides.