Determination of change of direction deficit thresholds across a spectrum of angles in basketball players.

Change of direction deficit (CODD) offers valuable insights into a player's balance between linear and multidirectional speed. However, there are still no established reference values for CODD. The objectives of this study were to determine CODD thresholds for various change of direction angles in basketball players according to gender and analyse the relationships between CODD and execution time in speed tests. One hundred and thirty basketball players (46% female; age: 23.7 ± 5.29 years; height: 189.1 ± 11.1 cm; body mass: 84.3 ± 15.7 kg) undertook 10-m linear and change of direction speed test at 45º, 90º and 180º. A k-means cluster analysis was conducted to standardise CODD thresholds and a one-way analysis of variance to identify the differences between clusters. The results revealed angulation-specific CODD thresholds, ranging from 3% to 8%, 17% to 25% and 43% to 51% for 45º, 90º and 180º cutting angles, respectively for the pooled sample. Furthermore, differences inter-clusters (p < 0.05) were observed for execution time at all cutting angles for both genders. Therefore, strength and conditioning coaches are encouraged to assess CODD as a highly valid variable for evaluating change of direction performance and to use current CODD thresholds to tailor training programmes according to each athlete's needs.

Differences in Biomechanical Determinants of ACL Injury Risk in Change of Direction Tasks Between Males and Females: A Systematic Review and Meta-Analysis.

BACKGROUND: Change of direction (COD) movements are associated with non-contact anterior cruciate ligament (ACL) injuries in multidirectional sports. Females appear at increased risk compared to males, which could be attributable to whole body kinematic strategies and greater multiplanar knee joint loads (KJLs) during COD which can increase ACL loading. OBJECTIVE: The aim of this systematic review and meta-analysis was to examine and quantitatively synthesise the evidence for differences between males and females regarding KJLs and their biomechanical determinants (whole body kinematic strategies determining KJLs) during COD tasks. METHODS: Databases including SPORTDiscus, Web of Science, and PubMed were systematically searched (July 2021-June 2023) for studies that compared differences in knee joint loads and biomechanical determinants of KJLs during COD between males and females. Inclusion criteria were: (1) females and males with no prior history of ACL injury (18-40 years); (2) examined biomechanical determinants of KJLs and/ or KJLs during COD tasks > 20°; (3) compared ≥ 1 outcome measure between males and females. Studies published between 2000 and 2023 examining a cutting task > 20° with a preceding approach run that compared KJLs or the whole body multiplanar kinematics associated with them, between sexes, using three-dimensional motion analysis. RESULTS: This meta-analysis included 17 studies with a pooled sample size of 451 participants (227 males, 224 females). Meta-analysis revealed females displayed significantly less peak knee flexion during stance (SMD: 0.374, 95% CI 0.098-0.649, p = 0.008, I2: 0%); greater knee abduction at initial contact (IC) (SMD: 0.687, 95% CI 0.299-1.076, p = 0.001, I2: 55%); less hip internal rotation (SMD: 0.437, 95% CI 0.134-0.741, p = 0.005, I2: 34%) and hip abduction at IC (SMD: -0.454, 95% CI 0.151-0.758, p = 0.003, I2: 33%). No significant differences were observed between males and females for any internal or externally applied KJLs. All retrieved studies failed to control for strength, resistance training or skill history status. CONCLUSION: No differences were observed in KJLs between males and females despite females displaying greater knee abduction at IC and less peak knee flexion during the stance phase of CODs, which are visual characteristics of non-contact ACL injury. Further research is required to examine if this translates to a similar injury risk, considering morphological differences in strain characteristics of the ACL between males and females. This observation may in part explain the disproportionate ACL injury incidence in female multidirectional athletes. Further higher quality controlled research is required whereby participants are matched by skill training history, resistance training history and strength status to ensure an appropriate comparison between males and females.

Early detection of malignant and pre-malignant peripheral nerve tumors using cell-free DNA fragmentomics.

Early detection of neurofibromatosis type 1 (NF1) associated peripheral nerve sheath tumors (PNST) informs clinical decision-making, potentially averting deadly outcomes. Here, we describe a cell-free DNA (cfDNA) fragmentomic approach which distinguishes non-malignant, pre-malignant and malignant forms of NF1 PNST. Using plasma samples from a novel cohort of 101 NF1 patients and 21 healthy controls, we validated that our previous cfDNA copy number alteration (CNA)-based approach identifies malignant peripheral nerve sheath tumor (MPNST) but cannot distinguish among benign and premalignant states. We therefore investigated the ability of fragment-based cfDNA features to differentiate NF1-associated tumors including binned genome-wide fragment length ratios, end motif analysis, and non-negative matrix factorization deconvolution of fragment lengths. Fragmentomic methods were able to differentiate pre-malignant states including atypical neurofibromas (AN). Fragmentomics also adjudicated AN cases suspicious for MPNST, correctly diagnosing samples noninvasively, which could have informed clinical management. Overall, this study pioneers the early detection of malignant and premalignant peripheral nerve sheath tumors in NF1 patients using plasma cfDNA fragmentomics. In addition to screening applications, this novel approach distinguishes atypical neurofibromas from benign plexiform neurofibromas and malignant peripheral nerve sheath tumors, enabling more precise clinical diagnosis and management.

Manipulation of task constraints is the most effective motor learning method for reducing risk factors for ACL injury during side-step cutting in both male and female athletes.

This study compared the efficacy of linear, non-linear and differential methods on variables related to ACL injury risk of a side-step cutting task in male and female basketball players. Thirty males and thirty females practiced basketball skills in sixty 90-minute sessions across 5 months. Ten players trained in each of the LP, NLP and DL female/male groups separately. Before and after the intervention, each player was tested on a side-step cutting task. A repeated 3 × 2 × 2 factorial ANOVA with repeated measures was performed for each biomechanical variable. Variables (trunk, hip, and knee flexion angle, knee valgus angle, ankle dorsiflexion angle, hip, knee, and ankle ROM, peak VGRF and knee extension/flexion, knee moment and ankle dorsiflexion moment) all revealed significant test by group interactions (P < 0.05) but no significant group by sex interactions (P > 0.05). In both sex, biomechanical changes were better in the NLP, followed by the DL and LP. It is argued that the advantage of the NLP method results from increased exploration of movement solutions induced by the manipulation of task constraints. Therefore, according to the NLP, it is possible to manipulate the constraints without feedback and the model/pattern can keep the athlete away from possible risks.

Effects of 6 weeks in-season flywheel squat resistance training on strength, vertical jump, change of direction and sprint performance in professional female soccer players.

Flywheel resistance training devices (FRTD) is shown effective in improving strength, sprinting, jumping and changes of direction (COD) performance in male soccer players, however, this is not elucidated in female soccer players. We aimed to assess the effect of FRTD on these physical abilities in females soccer players. 24 professional female soccer players (age: 20.4 ± 2.6 years) were randomly assigned to a flywheel training group (FWTG) that trained twice a week for 6 weeks on a rotary inertia device with an initial volume of 3 sets of 6 repetitions and an inertia of 0,025 kg · m-2, increasing intensity and volume or a control group (CG) that did not performed any additional resistance training program. Concentric peak torque of the knee extensors (CONEXT) and flexors (CONFLEX), eccentric peak torque of the knee extensors (ECCEXT) and flexors (ECCFLEX) at 60° · s-1 on an isokinetic dynamometer, countermovement jump (CMJ) height, COD and 30-metres sprint were assessed. Significant time by group interactions were found in CONEXT (p = 0.002; η²p = 0.425), CONFLEX (p = 0.037; η²p = 0.22), ECCEXT (p = 0.002; η²p = 0.43) and ECCFLEX (p = 0.008; η²p = 0.334). No time by group effect was found in CMJ (p = 0.061; η²p = 0.182), COD (p = 0.067; η²p = 0.184) or sprint (p = 0.926; η²p = 4.979 · e-4). In conclusion, 6 weeks of flywheel squat training improved strength (especially eccentric strength) but not soccer-specific abilities such as jumping, changing of direction or sprinting in professional soccer players.

'They don't want them to have capacity': Multi-agency operationalisation of the Mental Capacity Act 2005 in England with adults who self-neglect.

The number of adults who self-neglect and thus fall under the aegis of local authority adult safeguarding procedures in England has increased substantially since the introduction of the Care Act 2014. The requirement for collaborative working between agencies dealing with these adults in a safeguarding context is explicit in government policy and legislation. Decisions made by the multiplicity of agencies that may work with people who self-neglect are largely guided by the Mental Capacity Act 2005 (MCA). The overall objective of this research was to develop a clearer understanding of how the range of agencies that might typically be involved in the life of a self-neglecting person work together. This article examines how agencies put the MCA into practice in their work with people who self-neglect, and how they understand their own and others' roles and responsibilities in so doing. This qualitative study took place in two local authorities in England from 2016 to 2017 and informed a wider action research study which was completed in 2019. Non-probability purposive sampling was used to recruit participants from the professional groups who might typically be involved with self-neglect cases. À total of 245 participants from across 17 different professional groups took part in semi-structured interviews, in a group, paired or individual format, decided by their customary working configuration. Data from the interview transcripts was analysed using thematic analysis. Three key themes in relation to how participants understood the MCA and multi-agency working emerged from the analysis of this data set. These were; a lack of understanding of the MCA by participants and other agencies; a reluctance to engage with MCA assessments; and a perception of manipulation of the MCA by other professionals. This study underlines the importance of the informed application of the MCA in working with people who self-neglect, and an urgent need to consider how this could be enhanced if the service user is not to experience intrusive interventions resulting from professional misinterpretation.

Countermovement Jump Standards in Rugby League: What is a "Good" Performance?

ABSTRACT: McMahon, JJ, Lake, JP, Dos'Santos, T, Jones, PA, Thomasson, ML, and Comfort, P. Countermovement jump standards in rugby league: what is a "good" performance? J Strength Cond Res 36(6): 1691-1698, 2022-The countermovement jump (CMJ) is considered an important test in rugby league, and the force platform is the recommended tool for assessing CMJ performance in this cohort. Because of inconsistent methods applied across previous studies, there is currently a lack of understanding of what constitutes a "good" CMJ performance, with respect to the typical CMJ metrics that are reported for rugby league players. The purpose of this study was, therefore, to produce a scale of reference values for the jump height (JH), reactive strength index modified (RSImod), and mean (PPmean) and peak (PPpeak) propulsion power (relative to body mass) for top-level senior rugby league players competing in the global "forward" and "back" positional groups. One hundred four players (55 forwards and 49 backs) from the top 2 tiers of English rugby league performed 3 CMJs on a force platform at the beginning of pre-season training. The JH, RSImod, PPmean, and PPpeak were calculated using criterion methods, and a scale of norm-referenced values (percentiles) was produced for each positional group. The backs outperformed the forwards for each CMJ metric reported, thus supporting the production of position-specific norm-referenced values. When each positional group was separated into quartile subgroups, the respective JH, RSImod, PPmean, and PPpeak values were mostly largely and significantly different both within and between positions. The presented scale of reference values can, therefore, be used to determine the performance standards of rugby league forwards and backs with respect to the most commonly reported CMJ-derived variables for this cohort.

Countermovement Jump Force-Time Curve Analysis between Strength-Matched Male and Female Soccer Players.

The purpose of this study was to compare countermovement jump force-time measures between strength-matched male and female soccer players. Males (n = 11) and females (n = 11) were strength-matched via isometric mid-thigh pull testing, whereby peak force values were normalised to body mass. Subjects performed three maximal-effort countermovement jumps (CMJs) on a force platform from which a range of kinetic and kinematic variables were calculated via forward dynamics. Thereafter, differences in gross measures were examined via independent t-tests, while differences in force-, power-, velocity-, and displacement-time curves throughout the entire CMJ were analysed using statistical parametric mapping (SPM). Jump height, reactive strength index modified, propulsion mean force, propulsion impulse, and propulsion mean velocity were all greater for males (d = 1.50 to 3.07). Relative force- and velocity-time curves were greater for males at 86-93% (latter half of the concentric phase) and 85-100% (latter half of the concentric phase) of normalized movement time, respectively. Time to take-off, braking phase time, braking mean velocity and impulse, propulsion phase time and centre of mass displacement were similar between males and females (d = -0.23 to 0.97). This research demonstrates the strength of SPM to identify changes between entire force-time curves. Continued development and the use of SPM analysis could present the opportunity for a refined comparison of strength-matched male and female CMJ performance with the analysis of entire force-time curves.

Changes in Early and Maximal Isometric Force Production in Response to Moderate- and High-Load Strength and Power Training.

ABSTRACT: Comfort, P, Jones, PA, Thomas, C, Dos'Santos, T, McMahon, JJ, and Suchomel, TJ. Changes in early and maximal isometric force production in response to moderate- and high-load strength and power training. J Strength Cond Res 36(3): 593-599, 2022-The aims of this study were to determine the changes in early (50-, 100-, 150-, 200-, 250 ms) and maximal isometric force production, in response to a 4-week period of moderate-load resistance training (60-82.5% 1 repetition maximum [1RM]), followed by a 4-week period of high-load (80-90% 1RM) resistance training. Thirty-four subjects (age 19.5 ± 2.8 years; height 1.72 ± 0.08 m; body mass 69.9 ± 11.4 kg; maximal power clean 0.92 ± 0.03 kg·kg-1) participated in this study. Only trivial-to-moderate (0.2-2.7%, d = 0.00-0.88) and nonsignificant (p > 0.05) changes in early isometric force production were observed in response to the moderate-load training period, whereas very large (9.2-14.6%, d = 2.71-4.16), significant (p ≤ 0.001) increases in early isometric force production were observed in response to high-load training. In contrast, there was a very large, significant increase in peak force (PF) across the moderate-load phase (7.7 ± 11.8%, d = 2.02, p = 0.003), but only a moderate significant increase in PF (3.8 ± 10.6%, d = 1.16, p = 0.001) across the high-load phase. The results of this study indicate that high-load multijoint resistance training, that follows moderate-load training, results in superior increases in early multi-joint force production, compared with the changes observed after moderate-load resistance training.

Comparison of Countermovement Jump-Derived Reactive Strength Index Modified and Underpinning Force-Time Variables Between Super League and Championship Rugby League Players.

ABSTRACT: McMahon, JJ, Jones, PA, and Comfort, P. Comparison of countermovement jump-derived reactive strength index modified and underpinning force-time variables between super league and championship rugby league players. J Strength Cond Res 36(1): 226-231, 2022-The countermovement jump (CMJ) is regularly tested in rugby league (RL), with recent work reporting reactive strength index modified (RSImod) to distinguish between levels of play. Differences in CMJ-derived RSImod and underpinning force-time variables between English Super League (SL) and RL Championship (RLC) players are, however, unknown. As SL and RLC teams compete against each other, this study addressed this knowledge gap. Sixty RL players from the English SL (n = 30) and RLC (n = 30) performed 3 CMJs on a force platform at the start of the preseason training. The RSImod was calculated by dividing jump height (JH) by time to take-off (TTT), and several other variables were also extracted from the force-time record. The SL players achieved a significantly higher (large effect) RSImod by performing the CMJ with a significantly shorter (large effect) TTT but a similar (small effect) JH. The SL players achieved the shorter TTT through a significantly reduced (large effects) relative displacement during both the countermovement (combined unweighting and braking displacement) and propulsion phases but a significantly higher (moderate effects) propulsion peak force and power. The relationships between TTT and relative countermovement (r = 0.719, p < 0.001) and propulsion (r = 0.771, p < 0.001) displacement for combined group data were very large. Practitioners working in RL should, therefore, consider reporting RSImod and TTT, alongside JH, after CMJ force-time testing. We also suggest that RL players who produce lower RSImod scores would benefit from being trained to produce larger CMJ propulsion forces over a shallower range of hip, knee, and ankle extension.

Contribution of Eccentric Strength to Cutting Performance in Female Soccer Players.

ABSTRACT: Jones, PA, Dos'Santos, T, McMahon, JJ, and Graham-Smith, P. Contribution of eccentric strength to cutting performance in female soccer players. J Strength Cond Res 36(2): 525-533, 2022-The aim of this study was to examine the contribution of eccentric strength to performance of a 70-90° cutting task (CUT) (time to complete: 5 m approach, 70-90° cut, 3 m exit). Nineteen female soccer players (mean ± SD age, height, and mass; 21.7 ± 4.3 years, 1.67 ± 0.07 m, and 60.5 ± 6.1 kg) from the top 2 tiers of English women's soccer participated in the study. Each player performed 6 trials of the CUT task whereby three-dimensional motion data from 10 Qualisys proreflex cameras (240 Hz) and ground reaction forces from 2 Advanced Mechanical Technology, Inc. force platforms (1,200 Hz) were collected. Relative eccentric knee extensor (ECC-KE) and flexor peak moments (ECC-KF) were collected from both limbs at 60°·s-1 using a Kin-Com isokinetic dynamometer. Hierarchical multiple regression revealed that minimum center of mass (CM) and approach velocities (CM velocity at touchdown of penultimate foot contact) could explain 82% (79% adjusted) of the variation in CUT completion time (F(1,16) = 36.086, p < 0.0001). ECC-KE was significantly (p < 0.05) moderately associated (R ≥ 0.610) with velocities at key instances during the CUT. High (upper 50th percentile) ECC-KE individuals (n = 9) had significantly (p ≤ 0.01; d ≥ 1.34) greater velocities at key instances during the CUT. The findings suggest that individuals with higher ECC-KE produce faster CUT performance, by approaching with greater velocity and maintaining a higher velocity during penultimate and final contact, as they are better able to tolerate the larger loads associated with a faster approach.

Relationship Between Physical Fitness and the Physical Demands of 50-Over Cricket in Fast Bowlers.

ABSTRACT: Webster, TM, Comfort, P, and Jones, PA. Relationship between physical fitness and the physical demands of 50-over cricket in fast bowlers. J Strength Cond Res 36(3): e66-e72, 2022-Professional cricket is constantly evolving and resulting in increased physiological demand placed on players. Fast bowlers experience the greatest physical demand during match-play; despite this, research has overlooked the importance of specific physical attributes to optimizing physical match performance. The aim of this study was to investigate the relationships between 50-Over physical match performance and tests of physical qualities in fast bowlers. Fifteen professional male fast bowlers (age = 23.8 ± 4.0 years; height = 183.4 ± 6.7 cm; body mass = 82.9 ± 9.2 kg) participated in the study. Subjects completed the following physical fitness tests; sum of skinfolds, countermovement jump (CMJ), 20-m sprint, and the Yo-Yo intermittent recovery test level 1. Global positioning system data were collected during 6 professional 50-Over fixtures. Moderate correlations were established between CMJ height to total distance covered (r = 0.585; p = 0.022), sprinting distance (ρ = 0.554; p = 0.032), and maximal velocity (r = 0.567; p = 0.027); 20-m sprint time to total distance covered (ρ = -0.519; p = 0.047) and PlayerLoad (ρ = -0.561; p = 0.03); and Yo-Yo distance to total match distance (r = 0.520; p = 0.047) and sprinting distance (ρ = 0.524; p = 0.045). These findings demonstrate the predictive importance of prolonged intermittent running ability, jump, and sprint performance to match running performance of elite fast bowlers in 1-day cricket. Strength and conditioning coaches should use such information to design training to ensure fast bowlers are adequately conditioned to meet the demands of match running performance.

Biomechanical Effects of a 6-Week Change of Direction Speed and Technique Modification Intervention: Implications for Change of Direction Side step Performance.

ABSTRACT: Dos'Santos, T, Thomas, C, Comfort, P, and Jones, PA. Biomechanical effects of a 6-week change of direction speed and technique modification intervention: implications for change of direction side step performance. J Strength Cond Res 36(10): 2780-2791, 2022-The aim of this study was to evaluate the biomechanical effects of change of direction (COD) speed and technique modification training on COD performance (completion time, ground contact time [GCT], and exit velocity) during 45° (CUT45) and 90° (CUT90) side step cutting. A nonrandomized, controlled 6-week intervention study was administrated. Fifteen male, multidirectional, sport athletes (age, 23.5 ± 5.2 years; height, 1.80 ± 0.05 m; mass, 81.6 ± 11.4 kg) formed the intervention group (IG) who participated in two 30-minute COD speed and technique modification sessions per week, whereas 12 male, multidirectional, sport athletes (age, 22.2 ± 5.0 years; height, 1.76 ± 0.08 m; mass, 72.7 ± 12.4 kg) formed the control group (CG) and continued their normal training. All subjects performed 6 trials of the CUT45 and CUT90 task whereby pre-to-post intervention changes in lower-limb and trunk kinetics and kinematics were evaluated using 3-dimensional motion and ground reaction force analyses. Two-way mixed analysis of variances revealed significant main effects for time (pre-to-post changes) for CUT45 completion time, exit velocity, and CUT90 completion time ( p ≤ 0.045; η 2 = 0.152-0.539), and significant interaction effects of time and group were observed for CUT45 completion time, GCT, exit velocity, and CUT90 completion time ( p ≤ 0.010; η 2 = 0.239-0.483), with the IG displaying superior performance postintervention compared with the CG ( p ≤ 0.109; g = 0.83-1.35). Improvements in cutting performance were moderately to very largely associated ( p ≤ 0.078; r or ρ = 0.469-0.846) with increased velocity profiles, increased propulsive forces over shorter GCTs, and decreased knee flexion. Change of direction speed and technique modification is a simple, effective training method requiring minimal equipment that can enhance COD performance, which practitioners should consider incorporating into their pitch- or court-based training programs.

Deceleration Training in Team Sports: Another Potential 'Vaccine' for Sports-Related Injury?

High-intensity horizontal decelerations occur frequently in team sports and are typically performed to facilitate a reduction in momentum preceding a change of direction manoeuvre or following a sprinting action. The mechanical underpinnings of horizontal deceleration are unique compared to other high-intensity locomotive patterns (e.g., acceleration, maximal sprinting speed), and are characterised by a ground reaction force profile of high impact peaks and loading rates. The high mechanical loading conditions observed when performing rapid horizontal decelerations can lead to tissue damage and neuromuscular fatigue, which may diminish co-ordinative proficiency and an individual's ability to skilfully dissipate braking loads. Furthermore, repetitive long-term deceleration loading cycles if not managed appropriately may propagate damage accumulation and offer an explanation for chronic aetiological consequences of the 'mechanical fatigue failure' phenomenon. Training strategies should look to enhance an athlete's ability to skilfully dissipate braking loads, develop mechanically robust musculoskeletal structures, and ensure frequent high-intensity horizontal deceleration exposure in order to accustom individuals to the potentially damaging effects of intense decelerations that athletes will frequently perform in competition. Given the apparent importance of horizontal decelerations, in this Current Opinion article we provide considerations for sport science and medicine practitioners around the assessment, training and monitoring of horizontal deceleration. We feel these considerations could lead to new developments in injury-mitigation and physical development strategies in team sports.

Long-Term Sex- and Genotype-Specific Effects of 56Fe Irradiation on Wild-Type and APPswe/PS1dE9 Transgenic Mice.

Space radiation presents a substantial threat to travel beyond Earth. Relatively low doses of high-energy particle radiation cause physiological and behavioral impairments in rodents and may pose risks to human spaceflight. There is evidence that 56Fe irradiation, a significant component of space radiation, may be more harmful to males than to females and worsen Alzheimer's disease pathology in genetically vulnerable models. Yet, research on the long-term, sex- and genotype-specific effects of 56Fe irradiation is lacking. Here, we irradiated 4-month-old male and female, wild-type and Alzheimer's-like APP/PS1 mice with 0, 0.10, or 0.50 Gy of 56Fe ions (1GeV/u). Mice underwent microPET scans before and 7.5 months after irradiation, a battery of behavioral tests at 11 months of age and were sacrificed for pathological and biochemical analyses at 12 months of age. 56Fe irradiation worsened amyloid-beta (Aß) pathology, gliosis, neuroinflammation and spatial memory, but improved motor coordination, in male transgenic mice and worsened fear memory in wild-type males. Although sham-irradiated female APP/PS1 mice had more cerebral Aß and gliosis than sham-irradiated male transgenics, female mice of both genotypes were relatively spared from radiation effects 8 months later. These results provide evidence for sex-specific, long-term CNS effects of space radiation.

Cell-free DNA ultra-low-pass whole genome sequencing to distinguish malignant peripheral nerve sheath tumor (MPNST) from its benign precursor lesion: A cross-sectional study.

BACKGROUND: The leading cause of mortality for patients with the neurofibromatosis type 1 (NF1) cancer predisposition syndrome is the development of malignant peripheral nerve sheath tumor (MPNST), an aggressive soft tissue sarcoma. In the setting of NF1, this cancer type frequently arises from within its common and benign precursor, plexiform neurofibroma (PN). Transformation from PN to MPNST is challenging to diagnose due to difficulties in distinguishing cross-sectional imaging results and intralesional heterogeneity resulting in biopsy sampling errors. METHODS AND FINDINGS: This multi-institutional study from the National Cancer Institute and Washington University in St. Louis used fragment size analysis and ultra-low-pass whole genome sequencing (ULP-WGS) of plasma cell-free DNA (cfDNA) to distinguish between MPNST and PN in patients with NF1. Following in silico enrichment for short cfDNA fragments and copy number analysis to estimate the fraction of plasma cfDNA originating from tumor (tumor fraction), we developed a noninvasive classifier that differentiates MPNST from PN with 86% pretreatment accuracy (91% specificity, 75% sensitivity) and 89% accuracy on serial analysis (91% specificity, 83% sensitivity). Healthy controls without NF1 (participants = 16, plasma samples = 16), PN (participants = 23, plasma samples = 23), and MPNST (participants = 14, plasma samples = 46) cohorts showed significant differences in tumor fraction in plasma (P = 0.001) as well as cfDNA fragment length (P < 0.001) with MPNST samples harboring shorter fragments and being enriched for tumor-derived cfDNA relative to PN and healthy controls. No other covariates were significant on multivariate logistic regression. Mutational analysis demonstrated focal NF1 copy number loss in PN and MPNST patient plasma but not in healthy controls. Greater genomic instability including alterations associated with malignant transformation (focal copy number gains in chromosome arms 1q, 7p, 8q, 9q, and 17q; focal copy number losses in SUZ12, SMARCA2, CDKN2A/B, and chromosome arms 6p and 9p) was more prominently observed in MPNST plasma. Furthermore, the sum of longest tumor diameters (SLD) visualized by cross-sectional imaging correlated significantly with paired tumor fractions in plasma from MPNST patients (r = 0.39, P = 0.024). On serial analysis, tumor fraction levels in plasma dynamically correlated with treatment response to therapy and minimal residual disease (MRD) detection before relapse. Study limitations include a modest MPNST sample size despite accrual from 2 major referral centers for this rare malignancy, and lack of uniform treatment and imaging protocols representing a real-world cohort. CONCLUSIONS: Tumor fraction levels derived from cfDNA fragment size and copy number alteration analysis of plasma cfDNA using ULP-WGS significantly correlated with MPNST tumor burden, accurately distinguished MPNST from its benign PN precursor, and dynamically correlated with treatment response. In the future, our findings could form the basis for improved early cancer detection and monitoring in high-risk cancer-predisposed populations.

The effect of angle on change of direction biomechanics: Comparison and inter-task relationships.

The aim of this was study to examine the inter-task relationships and compare change of direction (COD) biomechanics between different angles (45°, 90°, and 180°). Twenty-seven men performed three COD tasks, whereby lower-limb and trunk kinematics and kinetics were assessed via 3D motion and ground reaction force (GRF) analysis. Key mechanical differences (p ≤ 0.025, η2 = 0.024-0.940) in velocity profiles, GRF, sagittal joint angles and moments, multiplanar knee joint moments, and technical parameters existed between CODs. The primary findings were that as COD angle increased, velocity profiles decreased (p < 0.001, d = 1.56-8.96), ground contact times increased (p < 0.001, d = 3.00-5.04), vertical GRF decreased (p < 0.001, d = 0.87-3.48), and sagittal peak knee joint moments decreased (p ≤ 0.040, d = 0.62-2.73). Notably, the greatest peak knee internal rotation (KIRMs) and abduction moments (KAMs) and angles were observed during the 90° COD (p < 0.001, d = 0.88-1.81), indicating that this may be the riskiest COD angle. Small to very large (r = 0.260-0.702) associations in KAMs and KIRMs were observed between tasks, indicating that evaluations at different angles are needed to develop an athlete's biomechanical injury risk profile. The results support the concept that COD biomechanics and potential surrogates of non-contact anterior cruciate ligament injury risk are "angle-dependent"; which have important implications for COD coaching, screening, and physical preparation.

Change of Direction Speed and Technique Modification Training Improves 180° Turning Performance, Kinetics, and Kinematics.

This study aimed to examine the effects of change of direction (COD) speed and technique modification training on 180° turning performance (completion time, ground contact time [GCT], and exit velocity), kinetics, and kinematics. A non-randomised 6 week intervention study was administered. Thirteen male multidirectional sport athletes formed the intervention group (IG), participating in two COD speed and technique modification sessions per week. A total of 12 male multidirectional sport athletes formed the control group (CG). All subjects performed six modified 505 trials, whereby pre-to-post-intervention biomechanical changes were evaluated using three-dimensional motion analysis. Two-way mixed analysis of variances revealed significant interaction effects (group × time) for completion time, mean horizontal propulsive force (HPF), horizontal to vertical mean braking and propulsive force ratios for the penultimate (PFC) and final foot contact (FFC), FFC peak knee flexion and PFC hip flexion angle (p ≤ 0.040, η2 = 0.170-0.417). The IG displayed small to large improvements post-intervention in these aforementioned variables (p ≤ 0.058, g = 0.49-1.21). Turning performance improvements were largely to very largely (p ≤ 0.062, r or ρ = 0.527-0.851) associated with increased mean HPF, more horizontally orientated FFC propulsive force and PFC braking force, and greater pelvic rotation, PFC hip flexion, and PFC velocity reductions. COD speed and technique modification is a simple, effective training strategy that enhances turning performance.

Biomechanical Effects of a 6-Week Change-of-Direction Technique Modification Intervention on Anterior Cruciate Ligament Injury Risk.

ABSTRACT: Dos'Santos, T, Thomas, C, Comfort, P, and Jones, PA. Biomechanical effects of a 6-week change-of-direction technique modification intervention on anterior cruciate ligament injury risk. J Strength Cond Res 35(8): 2133-2144, 2021-The aim of this study was to evaluate the biomechanical effects of a 6-week change-of-direction (COD) technique modification intervention on anterior cruciate ligament (ACL) injury risk (i.e., multiplanar knee joint loads) during 45° (CUT45) and 90° (CUT90) side-step cutting. A nonrandomized, controlled 6-week intervention study was administrated. Fifteen male multidirectional sport athletes formed the intervention group (IG) who participated in two 30-minute COD technique modification sessions per week, whereas 12 male multidirectional sport athletes formed the control group and continued their normal training. Subjects performed 6 trials of the CUT45 and CUT90 task whereby pre-to-post intervention changes in lower-limb and trunk kinetics and kinematics were evaluated using three-dimensional motion and ground reaction force analysis. Two-way mixed analyses of variance revealed no significant interaction effects of group for CUT45 and CUT90 multiplanar knee joint loads (p ≥ 0.116, η2 ≤ 0.096); however, considerable individual variation was observed (positive (n = 5-8) and negative responders (n = 7-8)). Based on IG group means, COD technique modification resulted in no meaningful reductions in multiplanar knee joint loads. However, individually, considerable variation was observed, with "higher-risk" subjects generally responding positively, and subjects initially considered "low-risk" tending to increase their multiplanar knee joint loads, albeit to magnitudes not considered hazardous or "high-risk." Change-of-direction technique modification training is a simple, effective training method, requiring minimal equipment that can reduce knee joint loads and potential ACL injury risk in "higher-risk" subjects without compromising performance.

Effects of Spaceflight on Musculoskeletal Health: A Systematic Review and Meta-analysis, Considerations for Interplanetary Travel.

BACKGROUND: If interplanetary travel is to be successful over the coming decades, it is essential that countermeasures to minimize deterioration of the musculoskeletal system are as effective as possible, given the increased duration of spaceflight associated with such missions. The aim of this review, therefore, is to determine the magnitude of deconditioning of the musculoskeletal system during prolonged spaceflight and recommend possible methods to enhance the existing countermeasures. METHODS: A literature search was conducted using PubMed, Ovid and Scopus databases. 5541 studies were identified prior to the removal of duplicates and the application of the following inclusion criteria: (1) group means and standard deviations for pre- and post-spaceflight for measures of strength, muscle mass or bone density were reported (or provided by the corresponding author when requested via e-mail), (2) exercise-based countermeasures were included, (3) the population of the studies were human, (4) muscle function was assessed and (5) spaceflight rather than simulated spaceflight was used. The methodological quality of the included studies was evaluated using a modified Physiotherapy Evidence Database (PEDro) scale for quality, with publication bias assessed using a failsafe N (Rosenthal method), and consistency of studies analysed using I2 as a test of heterogeneity. Secondary analysis of studies included Hedges' g effect sizes, and between-study differences were estimated using a random-effects model. RESULTS: A total of 11 studies were included in the meta-analyses. Heterogeneity of the completed meta-analyses was conducted revealing homogeneity for bone mineral density (BMD) and spinal muscle size (Tau2 < 0.001; I2 = 0.00%, p > 0.05), although a high level of heterogeneity was noted for lower body force production (Tau2 = 1.546; I2 = 76.03%, p < 0.001) and lower body muscle mass (Tau2 = 1.386; I2 = 74.38%, p < 0.001). The estimated variance (≤ -0.306) for each of the meta-analyses was significant (p ≤ 0.033), for BMD (- 0.48 to - 0.53, p < 0.001), lower body force production (- 1.75, p < 0.001) and lower body muscle size (- 1.98, p < 0.001). Spaceflight results in small reductions in BMD of the femur (Hedges g = - 0.49 [- 0.69 to - 0.28]), trochanter (Hedges g = - 0.53 [- 0.77 to - 0.29]), and lumbo-pelvic region (Hedges g = - 0.48 [- 0.73 to - 0.23]), but large decreases in lower limb force production (Hedges g = - 1.75 [- 2.50 to - 0.99]) and lower limb muscle size (Hedges g = - 1.98 [- 2.72 to - 1.23]). CONCLUSIONS: Current exercise countermeasures result in small reductions in BMD during long-duration spaceflight. In contrast, such exercise protocols do not alleviate the reductions in muscle function or muscle size, which may be attributable to the low to moderate loads reported by crewmembers and the interference effect associated with concurrent training. It is recommended that higher-load resistance exercise and the use of high-intensity interval training should be investigated, to determine if such modifications to the reported training practices result in more effective countermeasures to the deleterious effect of long-duration spaceflight on the muscular system.