Machine learning techniques to predict the risk of developing diabetic nephropathy: a literature review.

Purpose: Diabetes is a major public health challenge with widespread prevalence, often leading to complications such as Diabetic Nephropathy (DN)-a chronic condition that progressively impairs kidney function. In this context, it is important to evaluate if Machine learning models can exploit the inherent temporal factor in clinical data to predict the risk of developing DN faster and more accurately than current clinical models. Methods: Three different databases were used for this literature review: Scopus, Web of Science, and PubMed. Only articles written in English and published between January 2015 and December 2022 were included. Results: We included 11 studies, from which we discuss a number of algorithms capable of extracting knowledge from clinical data, incorporating dynamic aspects in patient assessment, and exploring their evolution over time. We also present a comparison of the different approaches, their performance, advantages, disadvantages, interpretation, and the value that the time factor can bring to a more successful prediction of diabetic nephropathy. Conclusion: Our analysis showed that some studies ignored the temporal factor, while others partially exploited it. Greater use of the temporal aspect inherent in Electronic Health Records (EHR) data, together with the integration of omics data, could lead to the development of more reliable and powerful predictive models.

Analysis of Off-The-Wall Smash Shots in Men's and Women's Professional Padel.

PURPOSE: our aim was to analyze the characteristics of the off-the-wall smash in men´s and women´s padel, and to compare gender differences in the set-dependent frequency of these shots. STUDY SAMPLE: through systematic observation, we analyzed 441 off-the-wall smashes from the Final Master of the 2022 season of the World Padel Tour. RESULTS: showed that the women performed twice as many off-the-wall smashes as the men. This shot was executed most frequently (90%) from the center and right side of the court and from the dominant side, usually providing volley continuity (73%) and sometimes resulting in point winners (21.5%). Furthermore, there were gender differences, depending on the defense zone from which the wall smashes were defended (p = .014) and on the final match result (p = .018). In men's padel, the losing pair performed more off-the-wall smashes, while in women's padel, the winning pair performed more of these smashes. Finally, between both genders, most off-the-wall smashes occurred in the first set and decreased in number in the third set, with the second set containing the fewest off-the wall smashes.

Absence of association between serve and winning point in professional padel.

BACKGROUND: The aim of this study was to analyze the efficiency of the serve in relation to different tactical parameters in men's professional padel. METHODS: A total of 1089 points - from 217 games and 19 sets - from 8 World Padel Tour matches played in 2020 were analyzed by systematic observation. RESULTS: The results showed that the ordinary number of the set influences the efficiency of the serve (P=0.015) with more points won on serve during the second one, and more points lost during the third one. Differently, no difference emerged for the serve efficiency in terms of situation (P=0.233). Similarly, the serving situation does not affect the efficiency in key points (P=0.097) and in non-key points (P=0.706), producing more equality in Australian formation in key points. The direction of the serve in Australian formation (P=0.351) and conventional (P=0.32) does not affect its effectiveness, without effects for the second shot after the return in Australian formation (P=0.472) and conventional (P=0.458), being in both cases the backhand volley the most frequent stroke, for which the pair lose more points when serving. The number of strokes per point is associated to a higher probability of winning the point, being the number of strokes from 3 to 10 where the serving partner maintains the advantage, losing it from that stroke, in addition, there are no winning points neither with the serve nor with the serve-return. CONCLUSIONS: There are no significant differences (but only small divergences) in most of the tactical parameters considered in terms of serve efficiency.

Performance Analysis in Padel: A Systematic Review.

The aim of the study was to carry out a systematic review of the most recent research on performance analysis in padel. An electronic search was made in four sport science databases: Web of Science, Pubmed, Scopus and Google Scholar. Systematic review principles were used to identify and select studies following inclusion and exclusion criteria. From a total of 261 articles identified in the initial search, 27 articles were included in analysis, all dating from after 2018. The articles were classified according to four study variables: temporal aspects, game actions, on-court movements and match score studies, ordered in turn according to the year of publication. The results show differences in the four study variables according to the gender or the level of players, the side or the zone of play and the duration of the match. In conclusion, the results define the relevant aspects of the game with the aim of being used at a technical, tactical and physical level, as well as contributing to the development of scientific knowledge in padel, allowing future research to address less studied topics and carry out more complete and specific studies and interventions for a greater understanding of the needs of padel.

Type of Diet and Sports Supplements in Padel Players According to Level of Competition and Sex.

Padel is the world's fastest growing racket sport. However, the analysis of the intake of sports supplements in padel players is scarce. The aim of this research was to analyse and compare the type of diet and the use of sports supplements in padel players according to their competition level and sex. A total of 123 players (94 men and 29 women) participated in the study. Subjects were divided according to their sex and competition level. All participants completed an anonymous questionnaire on diet type and nutritional supplement intake. There were differences found in diet type between competition levels. Regarding players' sex, differences in the number of supplements consumed were reported (p < 0.01). Relationships were found between the number of supplements ingested and the perceived effectiveness of supplements with frequency and time of training (p < 0.05). Creatine in men (≈15%) and vitamin complexes (≈10%) in women were the most used supplements. Lower level padel players do not adapt their diet to the physical demands of padel. Male padel players use a greater number of supplements than female padel players. It is important that nutrition specialists advise players to control diets and supplement.

Importance of Maintaining Net Position in Men's and Women's Professional Padel.

The objective of this research was to analyze the importance of maintaining the net position in men's and women's professional padel. The data sample was drawn from 2,756 padel rallies (n = 1,434 men's and n = 1,322 women's) in matches played during the 2021 season of the World Padel Tour circuit. The results showed that there was no net exchange in 50.7% of the women's rallies, while in 65.9% of men's rallies, the servers kept the net. Due to their physical advantages, men servers had more opportunities to finish the rally at the net than women servers, giving them more opportunities to win the rally. However, when either men or women receivers finished the rally at the net, they had more opportunities to win the rally. In addition, both men and women tended to end the rallies with a winner when they were in the net zone and with an error when they were at the back of the court. These findings suggest that wins in padel are closely related to time spent at the net.

Three-year efficacy of switching to dolutegravir plus lamivudine: A real-world study.

BACKGROUND: Dolutegravir (DTG) plus lamivudine (3TC) has proven highly efficacious as a switching strategy in virologically suppressed people with HIV (PWH). As this strategy was introduced relatively recently, real-world, long-term durability studies are lacking. METHODS: We performed a retrospective review of treatment-experienced patients who started DTG + 3TC in a cohort of PWH. HIV-RNA <50 copies/mL was analysed at 144 weeks in an intention-to-treat (ITT) analysis (missing = failure) and a per-protocol (PP) analysis (patients with missing data or changes for reasons other than virological failure were excluded). RESULTS: The study population comprised 358 PWH (19% women). Median age and time with HIV infection were 51.7 and 13.4 years, respectively. The median number of previous antiretroviral combinations was three. Previous virological failure was reported in 27.1% of patients, and the M184V resistance mutation was detected in 17 patients. At 144 weeks, the percentage of individuals with HIV-RNA <50 copies/mL was 77.4% (277/358) in the ITT analysis and 95.5% (277/290) in the PP analysis. A total of 68 participants were excluded from the PP analysis (data missing, 25, discontinuation due to toxicity, 19; other, 16; death, 8). Two people with virological failure selected resistance-associated mutations (M184V and M184V + R263K). HIV-RNA remained undetectable in 17 patients with a previous history of the M184V mutation. CONCLUSION: Our results confirm the real-world, long-term efficacy, tolerability and high genetic barrier of DTG + 3TC in treatment-experienced PWH. Although scarce, mutations causing resistance to nucleosides and integrase can emerge.

Análisis De La Efectividad Del Golpeo en Pádel en Función Del Género, Duración Del Punto Y Tipo De Punto / Analysis of the Effectiveness of Hitting in Paddle Depending on Gender, Duration of the Point and Type of Point

This study aims to analyse the winners and errors shot in professional padel according to gender, type of point and the point duration, observing the differences between winners and losers. For this 1927 points of 14 matches (7 male and 7 female category) from the World Padel Tour Master Final 2021 were analyzed, where participated 32 padel players (16 men players and 16 women players), using an ad-hoc instrument obtaining an inter-observer reliability above 0.9. The results show that the effectiveness depending on the gender (p = .001), where the male padel players perform 12% more winners than females padel players. Attending to the importance of the point, winning pairs perform 10% more winner shots than lossers, both in the male category (p=.002) and female (p= .004) in no key points. No differences exist in key points. Point duration affects to the shot effectiveness, specifically in medium duration points in male category (p=.026), and short duration points in female category (p=.007), with a higher winner shot produced by winning pairs. These results have a great practical application for coaches, providing information for the design of training programs similar to competitions situations. In addition, especific strategies can be develop during the matches according to the gender and the score.(AU)

A cluster analysis of high-performance female team players' perceived motivational climate: Implications on perceived motor competence and autonomous behaviour.

High performance sport for females is an area which is gaining more and more relevance today, but which hasn't received the same research interest as sport for males. The aim of the present study was to analyse the motivational climate perceived by high performance female athletes and the implications on perceived motor competence and autonomous behaviour and check the differences according category, sport experience and training hours in performance and master climate. The participants were 615 female athletes who practice top level team sports, with ages comprised of 16 to 38 (M = 22,10; SD = 4,91). The sample consisted of two different categories: junior (n = 242) and senior (n = 373). These players participated in different team sports, specifically football, handball, basketball and volleyball, training between 6 and 24 hours a week (M = 8,34; DT = 4,33). The variables measured were: perceived motivational climate in sport, autonomous behaviour and perceived motor competence. A cluster analysis was carried out using, as a variable, the perceived motivational climate, and showing the existence of two profiles, one related to ego and the other to task. The multivariate analysis showed that the profile orientated towards the task had significant differences compared to the autonomous behaviour (M = 4.66 vs M = 3.41). At the same time an analysis was carried out looking at different social demographic variables, revealing how there were differences in the sports experience (those participants with more than ten years' experience were more orientated towards ego, compared to those with less than ten years' experience) and the category (junior athletes were more orientated towards the task, compared to senior athletes). It was concluded that a greater orientation towards the task can lead to an improvement in the perception of motor competence, with the youngest and least experienced athletes being the most prominent in this category.

Rehabilitation for post-COVID-19 condition through a supervised exercise intervention: A randomized controlled trial.

PURPOSE: The aim of the study was to compare the outcomes of patients with post-COVID-19 condition undergoing supervised therapeutic exercise intervention or following the self-management WHO (World Health Organization) rehabilitation leaflet. METHODS: A randomized controlled trial was carried out that included 39 participants with post-COVID-19 condition who had a chronic symptomatic phase lasting >12 weeks. Comprehensive medical screening, patient-reported symptoms, and cardiorespiratory fitness and muscular strength were assessed. Patients were randomly assigned to a tailored multicomponent exercise program based on concurrent training for 8 weeks (two supervised sessions per week comprised resistance training combined with aerobic training [moderate intensity variable training], plus a third day of monitored light intensity continuous training), or to a control group which followed the WHO guidelines for rehabilitation after COVID-19. RESULTS: After follow-up, there were changes in physical outcomes in both groups, however, the magnitude of the change pre-post intervention favored the exercise group in cardiovascular and strength markers: VO2 max +5.7%, sit-to-stand -22.7% and load-velocity profiles in bench press +6.3%, and half squat +16.9%, (p < 0.05). In addition, exercise intervention resulted in a significantly better quality of life, less fatigue, less depression, and improved functional status, as well as in superior cardiovascular fitness and muscle strength compared to controls (p < 0.05). No adverse events were observed during the training sessions. CONCLUSION: Compared to current WHO recommendations, a supervised, tailored concurrent training at low and moderate intensity for both resistance and endurance training is a more effective, safe, and well-tolerated intervention in post-COVID-19 conditions.

Genetic variants associated with steatohepatitis and liver fibrosis in HIV-infected patients with NAFLD.

Background and aims: Nonalcoholic fatty liver disease (NAFLD) is a common cause of liver damage in people living with HIV (PLWHIV). Several studies have investigated candidate genes for susceptibility to NAFLD and to steatohepatitis. PNPLA3, TM6SF2, and MBOAT7-TMC4 have been reported to be associated with elevated ALT levels and the histologic parameters of nonalcoholic steatohepatitis and severity of fibrosis. Our objective was to analyze the relationship between PNPLA3, TM6SF2, and MBOAT7-TMC4 and steatosis, steatohepatitis, and liver fibrosis in PLWHIV with NAFLD. Method: A cohort of PLWHIV with persistently elevated aminotransferase levels and suspected NAFLD who underwent liver biopsy and determination of genetic variants was assessed at two large centers in Spain. All participants included in the current study were genotyped for rs738409 (PNPLA3), rs58542926 (TM6SF2), and rs641738 (MBOAT7-TMC4). Results: The study population comprised PLWHIV who were on stable antiretroviral therapy [7.7% women; median age, 49.3 years (44-53.4)]. The median CD4 count was 829 (650-980), 60% had metabolic syndrome, and 18.5% were diabetic. The median BMI was 28.9 (25.5-30.8). Patients with liver steatosis (any grade) vs. nonsteatosis tended to harbor the PNPLA3 G allele variant [57.6% vs. 16.7% (p = 0.09)], but not TM6SF2 or MBOAT7-TMC4 variants. However, those with steatohepatitis vs. nonsteatohepatitis significantly more frequently had the PNPLA3 G allele variant [69.4% vs. 39.1% (p < 0.05)] and the MBOAT7-TMC4 A allele variant [75% vs. 42% (p < 0.05)]. In our cohort, the TM6SF2 gene variant was not associated with steatosis or steatohepatitis. The PNPLA3 G allele variant was associated with steatohepatitis [OR 4.9 (1.3-18); p 0.02] and liver fibrosis [OR 4.3 (1.1-17.4); p 0.04], and the MBOAT7-TMC4 A allele variant was associated with steatohepatitis [OR 6.6 (1.6-27.6); p 0.01]. Conclusion: The PNPLA3 G allele variant and MBOAT7-TMC4 A allele variant were associated with steatohepatitis and liver fibrosis in PLWHIV with persistently elevated aminotransferases and NAFLD. We recommend routine genotyping for PNPLA3 and MBOAT7-TMC4 in PLWHIV with NAFLD to identify those at higher risk of progression.

Assessment of Noninvasive Markers of Steatosis and Liver Fibrosis in Human Immunodeficiency Virus-Monoinfected Patients on Stable Antiretroviral Regimens.

Background: Nonalcoholic fatty liver disease (NAFLD) is a major nonacquired immune deficiency syndrome-defining condition for persons with human immunodeficiency virus (PWH). We aimed to validate noninvasive tests for the diagnosis of NAFLD in PWH. Methods: This is a cross-sectional study of PWH on stable antiretroviral therapy with persistently elevated transaminases and no known liver disease. The area under the receiver operating characteristic curve (AUROC) was calculated to compare the diagnostic accuracy of liver biopsy with abdominal ultrasound, transient elastography (TE) (including controlled attenuation parameter [CAP]), and noninvasive markers of steatosis (triglyceride and glucose index [TyG], hepatic steatosis index [HSI], fatty liver index [FLI]) and fibrosis ([FIB]-4, aminotransferase-to-platelet ratio index [APRI], NAFLD fibrosis score). We developed a diagnostic algorithm with serial combinations of markers. Results: Of 146 patients with increased transaminase levels, 69 underwent liver biopsy (90% steatosis, 61% steatohepatitis, and 4% F ≥3). The AUROC for steatosis was as follows: ultrasound, 0.90 (0.75-1); CAP, 0.94 (0.88-1); FLI, 0.81 (0.58-1); HSI, 0.74 (0.62-0.87); and TyG, 0.75 (0.49-1). For liver fibrosis ≥F3, the AUROC for TE, APRI, FIB-4, and NAFLD fibrosis score was 0.92 (0.82-1), 0.96 (0.90-1), 0.97 (0.93-1), and 0.85 (0.68-1). Optimal diagnostic performance for liver steatosis was for 2 noninvasive combined models of tests with TyG and FLI/HSI as the first tests and ultrasound or CAP as the second tests: AUROC = 0.99 (0.97-1, P < .001) and 0.92 (0.77-1, P < .001). Conclusions: Ultrasound and CAP performed best in diagnosing liver steatosis, and FLI, TyG, and HSI performed well. We propose an easy-to-implement algorithm with TyG or FLI as the first test and ultrasound or CAP as the second test to accurately diagnose or exclude NAFLD.

The Role of Padel in Improving Physical Fitness and Health Promotion: Progress, Limitations, and Future Perspectives-A Narrative Review.

Benefits of regular exercise for health are beyond any doubt. However, adherence to regular physical activity is an ongoing challenge. Among the options for exercise engagement, racket sports, and particularly padel, stand as emerging practices for children and adults to have fun, improve physical fitness, and potentially develop motor and cognitive skills. In the last decade, the literature on padel is increasing exponentially. However, there is a need for further experimental research. To design safe and effective sport-base physical activity promotion interventions, it is essential to have a deep understanding of the physical requirements, technical complexity, injury risks, and strength and conditioning programs. To assist researchers to conduct effective padel-based interventions for health, this review summarizes the state-of-the-art evidence about padel, identifies key topics to be addressed in the future, and discusses the potential role of padel as a physical fitness and health promotion strategy. A narrative review is presented, summarizing the results of padel articles from three different databases: Web of Science, Scopus, and Google Scholar. Studies written in Spanish and English were the inclusion criteria. The studies had to be published from 2000 onwards and be original, as well as peer-reviewed.

[Real-world efficacy of switching to bictegravir/ emtricitabine/tenofovir alafenamide in pretreated patients with triple therapy containing rilpivirine]. / Eficacia en vida real del cambio a bictegravir/ emtricitabina/tenofovir alafenamida en pacientes previamente tratados con pautas triples que contienen rilpivirina.

OBJECTIVE: To analyze the efficacy and tolerability of the strategy to change from rilpivirine (RPV) based regimens to bictegravir / emtricitabine / tenofovir alafenamide (B/F/TAF). METHODS: Single-center, observational and retrospective study. Patients who made the change to B/F/TAF before February 2020 were selected, analyzing the results after 24 and 48 weeks. The percentage that remained with an undetectable viral load was determined, as well as the changes in CD4 + lymphocytes, metabolic parameters and renal function. RESULTS: A total of 42 patients were included. Thirty-two of the 35 patients (91.4%) who completed the 48 weeks of follow-up had an undetectable viral load. The CD4 + lymphocyte count remained stable at 24 and 48 weeks. The response to B/F/TAF was not influenced by the two analogs previously received. CONCLUSIONS: Switching from triple therapy with RPV to B/F/TAF is a safe and effective strategy in real life.

Glutathione-Responsive Heterogeneous Metal-Organic Framework Hybrids for Photodynamic-Gene Synergetic Cell Apoptosis.

A core-shell heterogeneous metal-organic framework (MOF) hybrid is sequentially designed by a photosensitized porous coordination network (PCN)-typed MOF as core and Cu2+ -centered zeolitic imidazolate framework (ZIF-67) as shell encapsulating cyanine 3-labelled siRNA. The heterogeneous MOF hybrid realized stimulus-responsive photodynamic therapy (PDT) and controllable siRNA delivery through 1 O2 -assistant endosomal escape for imaging-guided photodynamic-gene synergetic theranostics.

Past and future of HIV infection. A document based on expert opinion.

HIV infection is now almost 40 years old. In this time, along with the catastrophe and tragedy that it has entailed, it has also represented the capacity of modern society to take on a challenge of this magnitude and to transform an almost uniformly lethal disease into a chronic illness, compatible with a practically normal personal and relationship life. This anniversary seemed an ideal moment to pause and reflect on the future of HIV infection, the challenges that remain to be addressed and the prospects for the immediate future. This reflection has to go beyond merely technical approaches, by specialized professionals, to also address social and ethical aspects. For this reason, the Health Sciences Foundation convened a group of experts in different aspects of this disease to discuss a series of questions that seemed pertinent to all those present. Each question was presented by one of the participants and discussed by the group. The document we offer is the result of this reflection.

Comparison of service tactic formation on players' movements and point outcome between national and beginner level padel.

The aim of this study was to analyze the influence of service tactic formation on players' movements and point outcome at two different performance levels. The sample contained 2,148 points corresponding to 18 matches from two male padel indoor tournaments. Players were classified according to their game level: high-level (N = 36; age = 33.3 ± 6.9 years) and beginner (N = 36; age = 35.4 ± 6.8 years). Variables pertaining to service tactic formation (conventional or Australian), point outcome and movement patterns were analysed from the matches through systematic observation. The results showed how high-level players used a significantly higher percentage of the Australian formation than beginners. Also, high-level players won a significantly higher percentage of points than recreational players when using both service tactics. According to movement variables, servers were significantly closer to the net and the side wall using a conventional formation when the returner hit the ball. Furthermore, servers had to move quicker when they used the Australian formation. Finally, the comparison of movement patterns of servers according to game level, showed how high-level players ran faster to the offensive position, covered a greater distance and spent less time between serve and return impacts than beginners.

Gender Differences in Physical Fitness Characteristics in Professional Padel Players.

The aims of the present study were to examine the fitness characteristics of professional padel players and to determine differences in physical performance regarding players' gender. Thirty professional padel players (men: n = 15, age = 27.4 ± 6.8 years, height = 177.9 ± 4.0 cm; women: n = 15, age = 30.0 ± 4.2 years, height = 166.6 ± 4.8 cm) completed a 4-day evaluation process, including: isometric handgrip strength, sit and reach, 10 × 5 shuttle test, countermovement jump (CMJ), squat jump (SJ), Abalakov test, one-repetition maximum test (bench press, leg extension, leg curl, lat pulldowns, overhead press, and shoulder press), anthropometry and VO2 max tests. The men players had higher values in terms of weight, height, one maximum repetition, jump tests (CMJ and ABK) and VO2 max test than the women (p < 0.005). By contrast, the women had higher values for fat mass (p = 0.005; ES: 2.49). The values from this multifaceted test battery can be a useful guide for coaches regarding players' development in future evaluations and monitoring.

Post-COVID-19 Syndrome and the Potential Benefits of Exercise.

The coronavirus disease (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, is leading to unknown and unusual health conditions that are challenging to manage. Post-COVID-19 syndrome is one of those challenges, having become increasingly common as the pandemic evolves. The latest estimates suggest that 10 to 20% of the SARS-CoV-2 patients who undergo an acute symptomatic phase are experiencing effects of the disease beyond 12 weeks after diagnosis. Although research is beginning to examine this new condition, there are still serious concerns about the diagnostic identification, which limits the best therapeutic approach. Exercise programs and physical activity levels are well-known modulators of the clinical manifestations and prognosis in many chronic diseases. This narrative review summarizes the up-to-date evidence on post-COVID-19 syndrome to contribute to a better knowledge of the disease and explains how regular exercise may improve many of these symptoms and could reduce the long-term effects of COVID-19.

Stroke Analysis in Padel According to Match Outcome and Game Side on Court.

The aim of this study was to analyze the distribution of padel strokes, their effectiveness, direction, and court zone, comparing between the winning and losing pairs in the match and the playing side of the players. The sample included 8441 strokes corresponding to 1055 points out of a total of nine padel matches in the First National Category. The variables analyzed were type of stroke, court area, effectiveness and directions of the strokes, match outcome, and game side. Matches were analyzed through systematic observation. The results showed that the winning pair made a significantly higher percentage of winners, and cross-court smashes and volleys from the offensive zone. In addition, players on the left side executed a higher percentage of cross-court and winning shots than the players on the right side. Such knowledge may constitute a useful guide in the design of appropriate game strategies and specific training sessions based on the shots that will help players to win the match according to the role of the player and depending on their game side.