The Effect of Acute Breath-Holding Exercise in Different Conditions on Cognitive Performance in Free Divers / El efecto del ejercicio agudo de contener la respiración en diferentes condiciones sobre el rendimiento cognitivo en buceadores libres

There is a growing trend towards studying human cognition in aquatic environments. At present, there exists a dearth of scholarly investigations pertaining to the immediate effects on executive functions subsequent to a solitary breath-holding training session within the cohort of professional free divers who engage in highly strenuous activities that test their physiological boundaries. The objective of this study was to investigate the immediate impact of breath-holding exercises conducted in varying environments (water and land) on the executive functions of professional diving athletes. The research comprised a sample of 18 male individuals engaged in competitive free diving. The experimental design encompassed four distinct sessions: i) an initial phase dedicated to familiarising participants with the N-back test; ii) a subsequent phase involving the collection of baseline and control measurements for the N-back test; iii) a session focused on obtaining anthropometric measurements; and iv) a final session dedicated to measuring lung capacity. The cognitive assessments were conducted subsequent to the breath-holding exercise protocol, which occurred subsequent to both the land and water sessions. The results indicated a significant difference in reaction times between breath-holding exercises conducted on land and in water (p =.021). The computation of delta values was employed to ascertain alterations in cognitive test outcomes under distinct conditions (water and land) in comparison to the control condition. The findings revealed a statistically significant decline in cognitive performance in the water condition relative to the land condition (z:-2.025, p= 0.043, r= -0.544). This study claims that the implementation of breath-holding exercise training in surface water conditions among divers could potentially result in adverse effects on executive functions. Moreover, it has been observed that the identical breath-holding exercises, when executed in terrestrial environments, exhibit a moderate enhancement of executive functions. The present study posits that the aforementioned findings will make a valuable contribution to the development of training methodologies for athletes and coaches involved in the discipline of freediving. Additionally, these findings are anticipated to offer valuable insights into the physiological well-being of divers.(AU)

The Influence of Acute Sprint Interval Training on the Cognitive Performance of Male Basketball Players: An Investigation of Expertise-Related Differences.

Highly developed cognitive abilities are an important prerequisite for reaching elite athletic levels. This study aimed to investigate the effect of an acute sprint interval training (SIT) session on the cognitive performance of amateur and elite players. Eighteen amateur and ten elite male basketball players were included in this study. They were asked to perform an acute SIT consisting of the Wingate Test (i.e., four bouts of 30 s all-out sprints) on a cycle ergometer, interspersed with 4 min of active recovery. Before and after the acute SIT, three cognitive tests (i.e., Change Detection Test, Timewall Test, Mackworth Clock Test) were performed. Exercise-induced changes in cognitive performance and between-group differences were analyzed. We did not observe significant between-group differences in the performance of any cognitive test at the pretest, but elite basketball players outperformed the amateur players in specific measures of the Change Detection Test and Timewall Test after the acute SIT (p < 0.05). In addition, for the Clock Test, only the elite basketball players' performance improved from pre- to posttest. The current study's findings suggest that male elite basketball players, compared to amateur basketball players, can preserve their cognitive performance after an acute bout of SIT.

Adverse health correlates of intimate partner violence against older women: Mining electronic health records.

Intimate partner violence (IPV) is often studied as a problem that predominantly affects younger women. However, studies show that older women are also frequently victims of abuse even though the physical effects of abuse are harder to detect. In this study, we mined the electronic health records (EHR) available through IBM Explorys to identify health correlates of IPV that are specific to older women. Our analyses suggested that diagnostic terms that are co-morbid with IPV in older women are dominated by substance abuse and associated toxicities. When we considered differential co-morbidity, i.e., terms that are significantly more associated with IPV in older women compared to younger women, we identified terms spanning mental health issues, musculoskeletal issues, neoplasms, and disorders of various organ systems including skin, ears, nose and throat. Our findings provide pointers for further investigation in understanding the health effects of IPV among older women, as well as potential markers that can be used for screening IPV.

Hemodynamic changes in athletes' brains: is there any adaptation?

This study compared the hemodynamic changes in the prefrontal cortex during sprint interval training (SIT) and recovery periods in sedentary and athletes. SIT was performed on a cycling ergometer on 12 male athletes and 9 sedentary participants. A functional near-infrared spectroscopy (fNIRS) device was used to record the hemodynamic changes of the prefrontal cortex throughout the protocol. The oxyhemoglobin (Oxy-Hb) levels in the prefrontal cortex were increased significantly, and the power outputs were decreased in repetitive Wingate anaerobic tests (WAnTs) in Sedentary and Athletes group (p < 0.001). In addition, the Sedentary group had higher Oxy-Hb values (p < 0.001). However, the recovery times decreased significantly after all WAnTs (p < 0.05). Despite the increased fatigue, athletes performed better with less Oxy-Hb than the sedentary participants. Also, the recovery of the Oxy-Hb values in the prefrontal region was faster in athletes. These results may highlight a possible brain adaptation in athletes.

Disaster Training Needs and Expectations Among Turkish Emergency Medicine Physicians - A National Survey.

OBJECTIVES: Earthquakes, landslides, and floods are the most frequent natural disasters in Turkey. The country has also recently experienced an increased number of terrorist attacks. The purpose of this study is to understand the expectations and training of Turkish emergency medicine attending physicians in disaster medicine. METHODS: An online questionnaire was administered to the 937 members of the Emergency Medicine Association of Turkey, of which 191 completed the survey (20%). RESULTS: Most participants (68%) worked at a Training and Research Hospital (TRH) or a University Hospital (UH), and 69% had practiced as an attending for 5 years or less. Mass immigration, refugee problems, and war/terror attacks were considered to be the highest perceived risk topics. Most (95%) agreed that disaster medicine trainings should occur during residency training. Regular disaster drills and exercises and weekly or monthly trainings were the most preferred educational modalities. Most respondents (85%) were interested in advanced training in disaster medicine, and this was highest for those working less than 5 years as an attending. UH and TRH residency training programs were not considered in themselves to be sufficient for learning disaster medicine. CONCLUSIONS: Turkish emergency medicine residency training should include more disaster medicine education and training.

Setting Targets for Emergency Preparedness for a Jurisdiction's Whole Health Care System: The Approach Taken by New York City's Department of Health and Mental Hygiene.

There is little existing in the literature that provides a definition of readiness for a jurisdiction's whole health care system. As defining readiness at the system level has proven to be challenging, an approach that provides a framework for planning and measuring health care readiness with broad utility is needed. The New York City Department of Health and Mental Hygiene (DOHMH) devised the Readiness Target Project. Nine areas or dimensions of readiness emerged from this work. Through focus groups and feedback from hospital stakeholders DOHMH developed a matrix of readiness areas outlining current state, target state, gaps, and recommendations to achieve readiness. The matrix is in use as a systematic approach to discover and close gaps in the readiness of the whole health care system and to provide that system a locally valid framework to drive continuous improvement. This paper describes a framework for planning and determining the status of health care readiness at the system level for the jurisdiction. (Disaster Med Public Health Preparedness. 2018;12:759-764)).

Acute Supramaximal Exercise Increases the Brain Oxygenation in Relation to Cognitive Workload.

Single bout of exercise can improve the performance on cognitive tasks. However, cognitive responses may be controversial due to different type, intensity, and duration of exercise. In addition, the mechanism of the effect of acute exercise on brain is still unclear. This study was aimed to investigate the effects of supramaximal exercise on cognitive tasks by means of brain oxygenation monitoring. The brain oxygenation of Prefrontal cortex (PFC) was measured on 35 healthy male volunteers via functional near infrared spectroscopy (fNIRS) system. Subjects performed 2-Back test before and after the supramaximal exercise wingate anerobic test (WAnT) lasting 30-s on cycle ergometer. The PFC oxygenation change evaluation revealed that PFC oxygenation rise during post-exercise 2-Back task was considerably higher than those in pre-exercise 2-Back task. In order to describe the relationship between oxygenation change and exercise performance, subjects were divided into two groups as high performers (HP) and low performers (LP) according to their peak power values (PP) obtained from the supramaximal test. The oxy-hemoglobin (oxy-Hb) values were compared between pre- and post-exercise conditions within subjects and also between subjects according to peak power. When performers were compared, in the HP group, the oxy-Hb values in post-exercise 2-Back test were significantly higher than those in pre-exercise 2-Back test. HP had significantly higher post-exercise oxy-Hb change (Δ) than those of LP. In addition, PP of the total group were significantly correlated with Δoxy-Hb.The key findings of the present study revealed that acute supramaximal exercise has an impact on the brain oxygenation during a cognitive task. Also, the higher the anerobic PP describes the larger the oxy-Hb response in post-exercise cognitive task. The current study also demonstrated a significant correlation between peak power (exercise load) and post-exercise hemodynamic responses (oxy-, deoxy- and total-Hb). The magnitude of this impact might be related with the physical performance capacities of the individuals. This can become a valuable parameter for future studies on human factor.

Utility of Computed Tomography in Elbow Trauma Patients with Normal X-Ray Study and Positive Elbow Extension Test.

BACKGROUND: Elbow fractures are a common injury seen among emergency department trauma patients. Despite its high frequency, there is no standardized method of diagnosis using conventional x-ray imaging for trauma patients presenting with elbow pain and restricted elbow movement. OBJECTIVE: We aimed to assess trauma patients, using computed tomography (CT), who present with a positive elbow extension test and have no evident fracture on x-ray study. METHODS: Patients presented to our emergency department with elbow trauma and were evaluated between April 2010 and March 2011. A CT scan of the injured elbow was ordered for patients with pain on elbow extension (a positive elbow extension test) and no evidence of fracture on x-ray study. All CT and x-ray images were evaluated by a designated radiologist. RESULTS: One hundred and forty-eight patients presented to our emergency department with elbow trauma. Two patients were excluded from the study, one with former motion disability and another with an open fracture. In the remaining patients, there were 32 fractures in total. Forty-three of 114 patients without fracture signs had a positive elbow extension test and 4 of these patients refused CT imaging. Fractures were found in 5 (12.8%) of the 39 patients assessed with CT. CT imaging found that two of these patients had a radial head fracture, two others had an olecranon fracture, and one patient had a coronoid fracture. CONCLUSIONS: We recommend CT as an additional evaluation imaging study for trauma patients who have a positive elbow extension test and who present with no apparent fracture on x-ray imaging.

Assessment of prehospital medical care for the patients transported to emergency department by ambulance.

OBJECTIVES: In our study we aimed to investigate the quality and quantity of medical management inside ambulances for 14 and over 14 years old patients transported to a level three emergency department (ED). MATERIAL AND METHODS: Our study was conducted prospectively at a level three ED. 14 and over 14 years old patients who were transported to the ED by ambulance were included in the study consecutively. "Lack of vital rate" was described as missing of one or more of five vital rates during ambulance transportation. Both of two attending emergency physicians evaluated the medical procedures and management of patients at the ambulance simultaneously and this was recorded on the study forms. RESULTS: Four hundred and fifty six patients were included in the study. Missing vital signs were identified for 90.1% (n = 322) of the patients that were transported by physicians and 92.4% (n = 73) of the patients that were transported by paramedics. For five patients with cardiac arrest two (33.3%) had cardiopulmonary resuscitation (CPR), one (20%) was intubated, one (20%) received adrenaline. Out of 120 patients, needed spinal immobilization, 69 (57.5%) had spinal board. Cervical collar usage was 65.1% (n = 69) We have revealed that 316 (69.3%) patients did not receive at least one of the necessary medical intervention or treatment. CONCLUSION: During ambulance transportation, life-saving procedures like cardiopulmonary resuscitation, vital sign measurement, crucial treatment administration, endotracheal intubation, defibrillation, fracture immobilization were not performed adequately. Increasing the training on the deficient interventions and performing administrative inspections may improve quality of patient care.