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1.
Nat Commun ; 15(1): 4517, 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38806479

RESUMEN

Networks of nanowires, nanotubes, and nanosheets are important for many applications in printed electronics. However, the network conductivity and mobility are usually limited by the resistance between the particles, often referred to as the junction resistance. Minimising the junction resistance has proven to be challenging, partly because it is difficult to measure. Here, we develop a simple model for electrical conduction in networks of 1D or 2D nanomaterials that allows us to extract junction and nanoparticle resistances from particle-size-dependent DC network resistivity data. We find junction resistances in porous networks to scale with nanoparticle resistivity and vary from 5 Ω for silver nanosheets to 24 GΩ for WS2 nanosheets. Moreover, our model allows junction and nanoparticle resistances to be obtained simultaneously from AC impedance spectra of semiconducting nanosheet networks. Through our model, we use the impedance data to directly link the high mobility of aligned networks of electrochemically exfoliated MoS2 nanosheets (≈ 7 cm2 V-1 s-1) to low junction resistances of ∼2.3 MΩ. Temperature-dependent impedance measurements also allow us to comprehensively investigate transport mechanisms within the network and quantitatively differentiate intra-nanosheet phonon-limited bandlike transport from inter-nanosheet hopping.

2.
Front Physiol ; 15: 1376047, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38567112

RESUMEN

This study provides insight into the current fitness testing practices in elite male soccer. One hundred and two practitioners from professional soccer leagues across 24 countries completed an online survey comprising 29 questions, with five sections: a) background information, b) testing selection, c) testing implementation, d) data analysis, and e) data reporting. Frequency analysis was used to evaluate the responses to fixed response questions and thematic analysis was used for open-ended questions to generate clear and distinct themes. Strength (85%) and aerobic capacity (82%) represent the most frequently assessed physical qualities. Scientific literature (80%) is the most influential factor in testing selection and practitioners conduct fitness testing less frequently than their perceived ideal frequency per season (3.6 ± 2 vs. 4.5 ± 2). Time and competitive schedule were the greatest barriers to fitness testing administration. Practitioners mostly used a 'hybrid' approach (45%) to fitness testing, blending 'traditional' (i.e., a day dedicated to testing) and 'integrated' (i.e., testing within regular training sessions) methods. Microsoft Excel is the most used software for data analysis (95%) and visualization (79%). An equal use of the combination of best and mean scores of multiple trials (44%) and the best score (42%) was reported. Comparing a player's test performance with previous scores (89%) was the most common method for interpreting test results. However, only 38% considered measurement error. Digital displays and verbal feedback are the most common data reporting methods, with different data reporting processes for coaches and players. Practitioners can use data and findings from this study to inform their current testing practices and researchers to further identify areas for investigation, with the overarching aim of developing the field of fitness testing in elite male soccer.

3.
J Funct Morphol Kinesiol ; 9(2)2024 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-38651419

RESUMEN

Relative age effects (RAEs) within sports refer to the overrepresentation of athletes born earlier in the selection year and the underrepresentation of those born later in the selection year. Research examining RAEs in women's and girls' rugby union remains limited in comparison to the male literature, whilst the impacts of RAEs on the youth-senior transition are yet to be explored in a female sport context. As such, the purpose of this study was to examine RAEs during entry into the women's and girls' premiership and international rugby union pathways in England, as well as to compare them to their respective senior cohort (n = 1367): (a) U18 England Rugby Centre of Excellence Player (n = 325) vs. Senior Premiership Player (n = 868), and (b) U18 England Player (n = 49) vs. Senior England Player (n = 125). Chi-square (χ2) analyses compared birth quarter (BQ) distributions against expected distributions. The findings revealed no significant difference in BQ distributions at either youth or senior levels, as well as no significant differences in the BQ distributions of those who were likely to transition from youth to senior levels (all p > 0.05). Importantly, though, descriptive statistics showed a skewed birthdate distribution in both U18 England Rugby Centre of Excellence Player (BQ1 = 30% vs. BQ4 = 20%) and U18 England Player cohorts (BQ1 = 33% vs. BQ4 = 18%). We highlight the gender-specific mechanisms that potentially explain the variations between male and female RAEs in rugby union, including developmental differences, sport popularity, and sociocultural norms. We also warn against a 'copy and paste' template from the male provision to ensure the recent growth of female rugby union does not fall victim to the same RAEs in the future.

4.
Sports (Basel) ; 12(4)2024 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-38668571

RESUMEN

Soccer organizations generally adopt deterministic models within their talent pathways. In this framework, early ability and results are emphasized, leading to selection biases, such as birth advantages (i.e., relative age effects and birthplace effects), which research has shown affect both early developmental experiences and continued sporting involvement. Accordingly, this study aimed to (a) provide further test of birth advantages in Italian youth soccer by exploring the birth quarter (BQ) and birthplace (BP) distribution of 1050 male Italian players born between 1999 and 2001 who competed in the national U17 championship throughout the 2015-16 season and (b) investigate how birth advantages influenced selected players' future career status. Chi-square goodness-of-fit tests revealed early born players, and players born in North Italy were overrepresented at the youth level (p-values < 0.0001). Successive prospective analysis revealed only 18% of players developed into professional-level soccer players. Chi-square tests of independence indicated that players' BP was associated with their future career status (p < 0.0001), whereas their BQ was not (p = 0.459). Odds ratios showed players born in North Italy were five times more likely to complete the youth-to-senior transition than those born in South Italy. These findings highlighted environmental factors influence Italian players' early developmental experiences and their future career status.

5.
Children (Basel) ; 11(2)2024 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-38397315

RESUMEN

In recent times, research and technological advancements have opened an unprecedented window of opportunity for sports science to play a pivotal role in the holistic well-being of children [...].

6.
Nat Commun ; 15(1): 278, 2024 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-38177181

RESUMEN

Networks of solution-processed nanomaterials are becoming increasingly important across applications in electronics, sensing and energy storage/generation. Although the physical properties of these devices are often completely dominated by network morphology, the network structure itself remains difficult to interrogate. Here, we utilise focused ion beam - scanning electron microscopy nanotomography (FIB-SEM-NT) to quantitatively characterise the morphology of printed nanostructured networks and their devices using nanometre-resolution 3D images. The influence of nanosheet/nanowire size on network structure in printed films of graphene, WS2 and silver nanosheets (AgNSs), as well as networks of silver nanowires (AgNWs), is investigated. We present a comprehensive toolkit to extract morphological characteristics including network porosity, tortuosity, specific surface area, pore dimensions and nanosheet orientation, which we link to network resistivity. By extending this technique to interrogate the structure and interfaces within printed vertical heterostacks, we demonstrate the potential of this technique for device characterisation and optimisation.

7.
J Strength Cond Res ; 38(2): 350-359, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38258831

RESUMEN

ABSTRACT: McAuley, ABT, Hughes, DC, Tsaprouni, LG, Varley, I, Suraci, B, Bradley, B, Baker, J, Herbert, AJ, and Kelly, AL. Genetic associations with acceleration, change of direction, jump height, and speed in English academy football players. J Strength Cond Res 38(2): 350-359, 2024-High-intensity movements and explosive actions are commonly assessed during athlete development in football (soccer). Although many environmental factors underpin these power-orientated traits, research suggests that there is also a sizeable genetic component. Therefore, this study examined the association of 22 single-nucleotide polymorphisms (SNPs) with acceleration, change of direction, jump height, and speed in academy football players. One hundred and forty-nine, male, under-12 to under-23 football players from 4 English academies were examined. Subjects performed 5-, 10-, 20-, and 30-m sprints, countermovement jumps (CMJs), and the 5-0-5 agility test. Simple linear regression was used to analyze individual SNP associations, whereas both unweighted and weighted total genotype scores (TGS; TWGS) were computed to measure the combined influence of all SNPs. To control for multiple testing, a Benjamini-Hochberg false discovery rate of 0.05 was applied to all genotype model comparisons. In isolation, the GALNT13 (rs10196189) G allele and IL6 (rs1800795) G/G genotype were associated with faster (∼4%) 5-, 10-, and 20-m sprints and higher (∼16%) CMJs, respectively (p < 0.001). Furthermore, the TGS and TWGS significantly correlated with all performance assessments, explaining between 6 and 33% of the variance (p < 0.001). This study demonstrates that some genetic variants are associated with power-orientated phenotypes in youth football players and may add value toward a future polygenic profile of physical performance.


Asunto(s)
Fútbol , Adolescente , Masculino , Humanos , Aceleración , Academias e Institutos , Alelos
8.
Caries Res ; 58(1): 49-58, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38043513

RESUMEN

INTRODUCTION: This in vitro study aimed to evaluate the effect of three different chemical agents on stain removal and mineral uptake of artificial dentin caries (ADC) lesions treated with silver diamine fluoride (SDF). METHODS: Baseline L*a*b* values were determined in polished human permanent dentin blocks, and ADC lesions were induced with an acid gel for 1 week. Samples were assigned to four groups; in three groups, half of each sample received SDF (30% SDF for 3 min), while the other half received SDF followed by a bleaching treatment protocol (garlic extract, bentonite, or 35% hydrogen peroxide). The fourth group had one SDF-treated half and one half without SDF. Color changes (ΔE) were measured by spectrometry, and transversal microradiography was used to quantify integrated mineral loss (ΔZ) 24 h after treatment (SDF or SDF + bleaching). A two-way mixed ANOVA was applied to thirty percent. RESULTS: SDF application increased mineral uptake by ADC (p = 0.001). The type of chemical agent evaluated (p < 0.0001), time (p = 0.01), and their interaction (p < 0.0001) bleached the ADC treated with SDF. However, 35% hydrogen peroxide was the only compound with a bleaching effect (p < 0.001), without returning to baseline color. None of the compounds altered the mineral uptake effect of SDF (p = 0.30). CONCLUSION: This in vitro study showed mineral uptake effect in ACD within 24 h after SDF application and the ability of hydrogen peroxide to partially remove (reduction of 24%) the staining caused by SDF without affecting its mineral uptake effect.


Asunto(s)
Colorantes , Susceptibilidad a Caries Dentarias , Compuestos de Amonio Cuaternario , Compuestos de Plata , Humanos , Peróxido de Hidrógeno/farmacología , Minerales , Dentina/diagnóstico por imagen , Fluoruros Tópicos
9.
Adv Mater ; 36(9): e2306954, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37812735

RESUMEN

Thin film networks of solution processed nanosheets show remarkable promise for use in a broad range of applications including strain sensors, energy storage, printed devices, textile electronics, and more. While it is known that their electronic properties rely heavily on their morphology, little is known of their mechanical nature, a glaring omission given the effect mechanical deformation has on the morphology of porous systems and the promise of mechanical post processing for tailored properties. Here, this work employs a recent advance in thin film mechanical testing called the Layer Compression Test to perform the first in situ analysis of printed nanosheet network compression. Due to the well-defined deformation geometry of this unique test, this work is able to explore the out-of-plane elastic, plastic, and creep deformation in these systems, extracting properties of elastic modulus, plastic yield, viscoelasticity, tensile failure and sheet bending vs. slippage under both out of plane uniaxial compression and tension. This work characterizes these for a range of networks of differing porosities and sheet sizes, for low and high compression, as well as the effect of chemical cross linking. This work explores graphene and MoS2 networks, from which the results can be extended to printed nanosheet networks as a whole.

10.
FEBS Open Bio ; 14(3): 515-524, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38143305

RESUMEN

Exposure to time-varying electromagnetic fields (EMF) has the capacity to influence biological systems. Our results demonstrate that exposure to time-varying EMF modeled after the physiological firing frequency of intercellular calcium waves can inhibit proliferation and induce apoptosis in malignant cells. Single exposure of B16-BL6 cells to a Ca2+ EMF for 40 min reduced the number of viable cells by 50.3%. Cell imaging with acridine orange and ethidium bromide dye revealed substantial cellular apoptosis, preapoptotic cells, nuclear fragmentation, and large spacing between cells in the Ca2+ EMF condition when compared to the control condition. The ability of Ca2+ EMF to influence the proliferation and survival of malignant cells suggests that exposure to specific EMF may function as a potential anticancer therapy.


Asunto(s)
Señalización del Calcio , Melanoma Experimental , Animales , Humanos , Campos Electromagnéticos , Apoptosis , Factores de Tiempo
11.
Front Sports Act Living ; 5: 1120033, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38022777

RESUMEN

The pathway towards senior professional status in sport is affected by a multitude of factors. An abductive examination of the talent identification and development processes at an English Premiership rugby union (RU) club was undertaken for the present study. Part one examined the perspectives on the selection and development processes of senior academy male players (n = 8), whereas part two explored the perceptions of male coaches (n = 7). A total of three focus groups were used. Three main themes were confirmed by players and coaches: (a) task constraints, (b) performer constraints, and (c) environmental constraints. Specifically, although athletes and coaches believed that performer constraints were highly impactful on players' career in RU, there were inconsistencies surrounding the task and environmental constraints. Despite an indication that three common themes impacted an players path, this preliminary study shows an imbalance in the understanding of some of the key factors perceived to be important for talent progression in the present rugby academy. More research using similar qualitative methods is recommended to better understand the differences in opinions between players and coaches. Meanwhile, practitioners should consider implementing objective and holistic strategies to improve the talent pathway in English RU academies.

12.
ACS Appl Mater Interfaces ; 15(33): 39864-39871, 2023 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-37561092

RESUMEN

Transparent conductors (TCs) represent key components in many applications from optoelectronic devices to electromagnetic shielding. While commercial applications typically use thin films of indium tin oxide, this material is brittle and increasingly scarce, meaning higher performing and cheaper alternatives are sought after. Solution-processible metals would be ideal owing to their high conductivities and printability. However, due to their opacity to visible light, such films need to be very thin to achieve transparency, thus limiting the minimum resistance achievable. One solution is to print metallic particles in a grid structure, which has the advantages of high tunable transparency and resistance at the cost of uniformity. Here, we report silver nanosheets that have been aerosol jet printed into grids as high-performance transparent conductors. We first investigate the effect of annealing on the silver nanosheets where we observe the onset of junction sintering at 160 °C after which the silver network becomes continuous. We then investigate the effect of line width and thickness on the electrical performance and the effect of varying the aperture dimensions on the optical performance. Using these data, we develop simple models, which allow us to optimize the grid and demonstrate a printed transparent conductor with a transmittance of 91% at a sheet resistance of 4.6 Ω/sq.

13.
Nutrients ; 15(15)2023 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-37571244

RESUMEN

The aim of this study was to observe the nutritional supplement practices of highly trained swimmers on a national talent pathway, since it is often reported that swimmers engage in widespread supplement use at the elite level. Thus, this study employed a validated supplement intake questionnaire with forty-four swimmers from a high-performance swimming club, which had three distinct talent stages: development (aged 11-14 years, n = 20), age-group (aged 13-17 years, n = 13), and national level (aged ≥ 16 years, n = 11). Ninety-eight percent of the interviewed swimmers reported using at least one supplement, with performance (34%) and recovery (19%) cited as the primary reasons. National swimmers used more total supplements (8.1 ± 3.4 supplements) compared to age-group (4.8 ± 2.0 supplements, p = 0.003, g = 1.17) and development (3.9 ± 1.7 supplements, p < 0.001, g = 1.69) swimmers, mostly because of a greater intake of ergogenic aids (2.4 ± 1.4 supplements vs. age-group: 0.5 ± 0.5 supplements, p < 0.001, g = 1.12; vs. development: 0.1 ± 0.2 supplements, p < 0.001, g = 1.81). Parents/guardians were the primary supplement informants of development swimmers (74%, p < 0.001, V = 0.50), whereas performance nutritionists informed ~50% of supplements used by age-group and national swimmers (p < 0.001, V = 0.51). Based on these results, supplement education and greater focus on basic sport nutrition practices may be required for parents/guardians at the development level. Moreover, further research is needed to support the high number of ergogenic aids used by national swimmers, with the efficacy of these supplements currently equivocal in the applied setting.


Asunto(s)
Atletas , Natación , Humanos , Suplementos Dietéticos , Estado Nutricional , Reino Unido
14.
Diagnostics (Basel) ; 13(15)2023 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-37568931

RESUMEN

This study proposed using enamel surface texture and thickness for the objective detection and monitoring of erosive tooth wear (ETW), comparing them to the standard subjective Basic Erosive Wear Evaluation (BEWE). Thirty-two subjects (n = 597 teeth) were enrolled in this longitudinal observational clinical study. Enamel thickness (by cross-polarization optical coherence tomography, CP-OCT) and 3D dental microwear parameters, i.e., area-scale fractal complexity (Asfc), anisotropy (Str), and roughness (Sa) (by white-light scanning confocal profilometry), were obtained from buccal surfaces. Buccal, occlusal, and lingual surfaces were scored for BEWE and the maximum score per tooth (BEWEMax) was determined at baseline and 12 months (M12). Data outcome relationships were evaluated (alpha = 0.05). Enamel thickness decreased (p < 0.001), BEWE scores, Sa, and Str increased (p < 0.001), while Asfc did not change at M12. Baseline BEWEBuccal correlated strongly with BEWEMax (r = 0.86, p < 0.001) and moderately with BEWELingual (r = 0.42, p < 0.001), but not with enamel thickness (r = 0.03, p = 0.43). Change (Δ) in surface texture outcomes correlated poorly but significantly with ΔBEWEBuccal (r = -0.15-0.16, p < 0.001) and did not correlate with Δenamel thickness (r = 0.02-0.09, p > 0.06). Teeth with BEWE progression revealed a greater increase in ΔSa and ΔStr. These findings suggest that enamel surface roughness can potentially determine ETW severity, and CP-OCT may be relevant for clinically monitoring enamel thickness.

16.
Genes (Basel) ; 14(7)2023 07 12.
Artículo en Inglés | MEDLINE | ID: mdl-37510335

RESUMEN

The purpose of this study was to examine polygenic profiles previously associated with maturity timing in male academy football players across different age phases. Thus, 159 male football players from four English academies (U12-16, n = 86, aged 13.58 ± 1.58 years; U17-23, n = 73, aged 18.07 ± 1.69 years) and 240 male European controls were examined. Polygenic profiles comprised 39 single nucleotide polymorphisms and were analysed using unweighted and weighted total genotype scores (TGSs; TWGSs). There were significant differences in polygenic profiles between groups, whereby U17-23 players had more genetic variants associated with later maturity compared to U12-16 players (TGS, p = 0.010; TWGS, p = 0.024) and controls (TGS, p = 0.038; TWGS, p = 0.020). More specifically, U17-23 players had over two-times the odds of possessing >36 later-maturing alleles than <30 compared to U12-16 players (odds ratio (OR) = 2.84) and controls (OR = 2.08). These results suggest there was a greater proportion of relatively later-maturing players as maturation plateaus towards adulthood, which may be explained by the 'underdog hypothesis'. This study provides the first known molecular evidence that supports the notion that a maturity selection bias exists within male academy football.


Asunto(s)
Fútbol Americano , Masculino , Humanos , Adulto , Adolescente , Adulto Joven , Factores de Edad , Polimorfismo de Nucleótido Simple/genética , Genotipo
17.
Int J Sports Med ; 44(12): 871-881, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37524114

RESUMEN

The purpose of this study was to evaluate young male and female handball players' perceptions of the bio-banding concept. The estimated biological maturity status was assessed in a sample of 46 male and 40 female handball players (aged 14.06±1.40 years), who competed in both an annual age-group and bio-banded tournament. To test the players' perception of bio-banding, a post-competition questionnaire was conducted. A series of ANOVA and one-sample t-tests were used in order to examine the differences in perception between the different maturity groups. An inductive thematic analysis of the qualitative data recorded in the open-ended questions was also carried out. The results showed that early-maturing boys enjoyed the bio-banding tournament more than late-maturing boys (p<0.05). Conversely, no differences were found in girls (p>0.05). Furthermore, discussions were conducted based on the qualitative analysis of the players' written comments regarding their overall experience, finding individual variance in biological maturity may be less relevant in female sports contexts due to gender-related differences. Thus, a greater influence on play and leadership in late maturing boys and early maturing girls, a greater physical challenge in early maturing boys and an opportunity to express themselves technically and tactically in late maturing boys and on-time maturing girls were observed. Therefore, stakeholders must consider the different consequences of bio-banding in order to maximize the athlete's sport development process.


Asunto(s)
Deportes , Humanos , Masculino , Femenino , Antropometría/métodos , Estatura
18.
Braz Oral Res ; 37: e068, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37436291

RESUMEN

Dental hard tissue conditions can be of pre- or post-eruptive nature, such as enamel fluorosis and erosive tooth wear (ETW), respectively. Dental enamel fluorosis is caused by the chronic and excessive intake of fluoride during enamel development, leading to increased fluoride concentration and increased porosity. ETW has become a common clinical condition and often impairs dental function and aesthetics. This in vitro study tested the hypothesis that fluorotic enamel presents different susceptibility to dental erosion-abrasion. It consisted of a 3×3×2 factorial design, considering a) fluorosis severity: sound (TF0), mild (TF1-2), moderate (TF3-4); b) abrasive challenge: low, medium, and high; and c) erosive challenge: yes or no. A total of 144 human teeth were selected according to the three fluorosis severity levels (n=48), and subdivided into six groups (n = 8) generated by the association of the different erosive and abrasive challenges. Enamel blocks (4×4 mm) were prepared from each tooth and their natural enamel surfaces subjected to an erosion-abrasion cycling model. After cycling, the depth of the lesions in enamel was assessed by profilometry. ANOVA showed that the three-way and two-way interactions among the factors were not significant (p > 0.20). Enamel fluorosis level (p=0.638) and abrasion level (p = 0.390) had no significant effect on lesion depth. Acid exposure caused significantly more enamel surface loss than water (p < 0.001). Considering the limitations of this in vitro study, fluorosis did not affect the susceptibility of enamel to dental erosion-abrasion.


Asunto(s)
Abrasión de los Dientes , Erosión de los Dientes , Humanos , Fluoruros/efectos adversos , Erosión de los Dientes/inducido químicamente , Esmalte Dental/patología , Abrasión de los Dientes/etiología , Abrasión de los Dientes/patología , Cepillado Dental
19.
BMJ Case Rep ; 16(7)2023 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-37433691

RESUMEN

We present a rare case of a man in his 40s who presented with bilateral lower extremity necrosis. After an extensive workup, he was diagnosed with type I cryoglobulinaemia (TIC) based on severe vaso-occlusive symptoms, presence of serum cryoglobins and tissue biopsy showing small-vessel vasculitis. Treatment was multimodal and targeted both his underlying lymphoproliferative disorder (monoclonal gammopathy of undetermined significance) and inflammatory state. Steroids, plasmapheresis and immunotherapy were administered with temporary remission of symptoms. After discharge, patient continued to repeatedly present with progressive bilateral lower extremity necrosis and new upper extremity digital necrosis necessitating further pharmacological treatment and surgical intervention-bilateral above the knee amputation and multiple digital hand amputations. This case illustrates a severe example of TIC where diagnosis was difficult due to atypical presentation, and disease was refractory to multimodal therapies necessitating surgical intervention to achieve temporary remission.


Asunto(s)
Crioglobulinemia , Masculino , Humanos , Crioglobulinemia/complicaciones , Crioglobulinemia/diagnóstico , Crioglobulinemia/terapia , Amputación Quirúrgica , Biopsia , Terapia Combinada , Necrosis
20.
J Stroke Cerebrovasc Dis ; 32(8): 107233, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37364401

RESUMEN

BACKGROUND: Acute stroke therapy and rehabilitation declined during the COVID-19 pandemic. We characterized changes in acute stroke disposition and readmissions during the pandemic. METHODS: We used the California State Inpatient Database in this retrospective observational study of ischemic and hemorrhagic stroke. We compared discharge disposition across a pre-pandemic period (January 2019 to February 2020) to a pandemic period (March to December 2020) using cumulative incidence functions (CIF), and re-admission rates using chi-squared. RESULTS: There were 63,120 and 40,003 stroke hospitalizations in the pre-pandemic and pandemic periods, respectively. Pre-pandemic, the most common disposition was home [46%], followed by skilled nursing facility (SNF) [23%], and acute rehabilitation [13%]. During the pandemic, there were more home discharges [51%, subdistribution hazard ratio 1.17, 95% CI 1.15-1.19], decreased SNF discharges [17%, subdistribution hazard ratio 0.70, 95% CI 0.68-0.72], and acute rehabilitation discharges were unchanged [CIF, p<0.001]. Home discharges increased with increasing age, with an increase of 8.2% for those ≥85 years. SNF discharges decreased in a similar distribution by age. Thirty-day readmission rates were 12.7 per 100 hospitalizations pre-pandemic compared to 11.6 per 100 hospitalizations during the pandemic [p<0.001]. Home discharge readmission rates were unchanged between periods. Readmission rates for discharges to SNF (18.4 vs. 16.7 per 100 hospitalizations, p=0.003) and acute rehabilitation decreased (11.3 vs. 10.1 per 100 hospitalizations, p=0.034). CONCLUSIONS: During the pandemic a greater proportion of patients were discharged home, with no change in readmission rates. Research is needed to evaluate the impact on quality and financing of post-hospital stroke care.


Asunto(s)
COVID-19 , Accidente Cerebrovascular , Humanos , Anciano de 80 o más Años , Alta del Paciente , Readmisión del Paciente , Pandemias , Pacientes Internos , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/terapia , California/epidemiología , Instituciones de Cuidados Especializados de Enfermería , Estudios Retrospectivos , Hospitales
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