The Physical Demands of Wheelchair Tennis Match Play: A Systematic Review with Meta-analysis.

BACKGROUND: Wheelchair tennis, a globally popular sport, features a professional tour spanning 40 countries and over 160 tournaments. Despite its widespread appeal, information about the physical demands of wheelchair tennis is scattered across various studies, necessitating a comprehensive systematic review to synthesise available data. OBJECTIVE: The aim was to provide a detailed synthesis of the physical demands associated with wheelchair tennis, encompassing diverse factors such as court surfaces, performance levels, sport classes, and sexes. METHODS: We conducted comprehensive searches in the PubMed, Embase, CINAHL, and SPORTDiscus databases, covering articles from inception to March 1, 2023. Forward and backward citation tracking from the included articles was carried out using Scopus, and we established eligibility criteria following the Population, Exposure, Comparison, Outcome, and Study design (PECOS) framework. Our study focused on wheelchair tennis players participating at regional, national, or international levels, including both juniors and adults, and open and quad players. We analysed singles and doubles matches and considered sex (male, female), sport class (open, quad), and court surface type (hard, clay, grass) as key comparative points. The outcomes of interest encompassed play duration, on-court movement, stroke performance, and physiological match variables. The selected study designs included observational cross-sectional, longitudinal, and intervention studies (baseline data only). We calculated pooled means or mean differences with 95% confidence intervals (CIs) and employed a random-effects meta-analysis with robust variance estimation. We assessed heterogeneity using Cochrane Q and 95% prediction intervals. RESULTS: Our literature search retrieved 643 records, with 24 articles meeting our inclusion criteria. Most available information focused on international male wheelchair tennis players in the open division, primarily competing in singles on hard courts. Key findings (mean [95% CI]) for these players on hard courts were match duration 65.9 min [55.0-78.8], set duration 35.0 min [28.2-43.5], game duration 4.6 min [0.92-23.3], rally duration 6.1 s [3.7-10.2], effective playing time 19.8% [18.9-20.7], and work-to-rest ratio 1:4.1 [1:3.7-1:4.4]. Insufficient data were available to analyse play duration for female players. However, for the available data on hard court matches, the average set duration was 34.8 min [32.5-37.2]. International male players on hard court covered an average distance per match of 3859 m [1917-7768], with mean and peak average forward speeds of 1.06 m/s [0.85-1.32] and 3.55 m/s [2.92-4.31], respectively. These players executed an average of 365.9 [317.2-422.1] strokes per match, 200.6 [134.7-299.0] per set, 25.4 [16.7-38.7] per game, and 3.4 [2.6-4.6] per rally. Insufficient data were available for a meta-analysis of female players' on-court movement and stroke performance. The average and peak heart rates of international male players on hard court were 134.3 [124.2-145.1] and 166.0 [132.7-207.6] beats per minute, and the average match heart rate expressed as a percentage of peak heart rate was 74.7% [46.4-100]. We found no studies concerning regional players or juniors, and only one study on doubles match play. CONCLUSIONS: While we present a comprehensive overview of the physical demands of wheelchair tennis, our understanding predominantly centres around international male players competing on hard courts in the open division. To attain a more comprehensive insight into the sport's physical requirements, future research should prioritise the inclusion of data on female and quad players, juniors, doubles, and matches played on clay and grass court surfaces. Such endeavours will facilitate the development of more tailored and effective training programmes for wheelchair tennis players and coaches. The protocol for this systematic review was registered a priori at the International Platform of Registered Systematic Review and Meta-analysis Protocols (Registration https://doi.org/10.37766/inplasy2023.3.0060 ).

Estimating the cost of achieving basic water, sanitation, hygiene, and waste management services in public health-care facilities in the 46 UN designated least-developed countries: a modelling study.

BACKGROUND: An alarming number of public health-care facilities in low-income and middle-income countries lack basic water, sanitation, hygiene (WASH), and waste management services. This study estimates the costs of achieving full coverage of basic WASH and waste services in existing public health facilities in the 46 UN designated least-developed countries (LDCs). METHODS: In this modelling study, in-need facilities were quantified by combining published counts of public facilities with estimated basic WASH and waste service coverage. Country-specific per-facility capital and recurrent costs to deliver basic services were collected via survey of country WASH experts and officials between Sept 24 and Dec 24, 2020. Baseline cost estimates were modelled and discounted by 5% per year. Key assumptions were adjusted to produce lower and upper estimates, including adjusting the discount rate to 8% and 3% per year, respectively. FINDINGS: An estimated US$6·5 billion to $9·6 billion from 2021 to 2030 is needed to achieve full coverage of basic WASH and waste services in public health facilities in LDCs. Capital costs are $2·9 billion to $4·8 billion and recurrent costs are $3·6 billion to $4·8 billion over this time period. A mean of $0·24-0·40 per capita in capital investment is needed each year, and annual operations and maintenance costs are expected to increase from $0·10 in 2021 to $0·39-0·60 in 2030. Waste management accounts for the greatest share of costs, requiring $3·7 billion (46·6% of the total) in the baseline estimates, followed by $1·8 billion (23·1%) for sanitation, $1·5 billion (19·5%) for water, and $845 million (10·7%) for hygiene. Needs are greatest for non-hospital facilities ($7·4 billion [94%] of $7·9 billion) and for facilities in rural areas ($5·3 billion [68%]). INTERPRETATION: Investment will need to increase to reach full coverage of basic WASH and waste services in public health facilities. Financial needs are modest compared with current overall health and WASH spending, and better service coverage will yield substantial health benefits. To sustain services and prevent degradation and early replacement, countries will need to routinely budget for operations and maintenance of WASH and waste management assets. FUNDING: WHO (including underlying grants from the governments of Japan, the Netherlands, and the UK), World Bank (including an underlying grant from the Global Water Security and Sanitation Partnership), and UNICEF. TRANSLATIONS: For the Arabic, French and Portuguese translations of the abstract see Supplementary Materials section.

A longitudinal study of theory of mind and listening comprehension: Is preschool theory of mind important?

Theory of mind has been shown to be important for listening comprehension for children at a range of ages. However, there is a lack of longitudinal evidence for a relationship between early theory of mind and later listening comprehension. The aim of this study was to examine whether preschool theory of mind has a longitudinal direct effect on later listening comprehension over and above the effects of concurrent theory of mind. A total of 147 children were tested on measures of theory of mind, working memory, vocabulary, and grammatical knowledge at Time 1 (mean age = 4;1 [years;months]) and Time 2 (mean age = 5;11). In addition, at Time 2 listening comprehension, comprehension monitoring, and inference making measures were taken. Data were fitted to concurrent and longitudinal models of listening comprehension. Concurrent findings at Time 2 showed theory of mind to have a direct effect on listening comprehension. However, longitudinal findings showed that earlier theory of mind in preschool (Time 1) did not have a direct effect on listening comprehension 22 months later; instead, there was only an indirect effect of earlier theory of mind on later listening comprehension via concurrent theory of mind (Time 2). Taken together, the results give further support for the importance of theory of mind for listening comprehension but show that there are limited additional benefits of early theory of mind acquisition. Implications for the development of children's listening comprehension are discussed.

CE: Diagnosing and Managing Migraine.

ABSTRACT: Roughly 90% of the U.S. population will develop a headache within their lifetime, and headache disorders account for more disability-adjusted life-years than all other neurologic disorders combined. Among primary headache disorders, the two most common are tension-type headache and migraine, with migraine identified as the most disabling. Here, the authors describe the importance of differentiating primary and secondary headache disorders and discuss the pathophysiology; clinical assessment; and outpatient management of the debilitating migraine headache, summarizing both acute and prophylactic treatment strategies that can substantially reduce associated disability.

Word prevalence norms for 62,000 English lemmas.

We present word prevalence data for 61,858 English words. Word prevalence refers to the number of people who know the word. The measure was obtained on the basis of an online crowdsourcing study involving over 220,000 people. Word prevalence data are useful for gauging the difficulty of words and, as such, for matching stimulus materials in experimental conditions or selecting stimulus materials for vocabulary tests. Word prevalence also predicts word processing times, over and above the effects of word frequency, word length, similarity to other words, and age of acquisition, in line with previous findings in the Dutch language.

Brain mechanisms of recovery from pure alexia: A single case study with multiple longitudinal scans.

Pure alexia is an acquired reading disorder, typically due to a left occipito-temporal lesion affecting the Visual Word Form Area (VWFA). It is unclear whether the VWFA acts as a unique bottleneck for reading, or whether alternative routes are available for recovery. Here, we address this issue through the single-case longitudinal study of a neuroscientist who experienced pure alexia and participated in 17 behavioral, 9 anatomical, and 9 fMRI assessment sessions over a period of two years. The origin of the impairment was assigned to a small left fusiform lesion, accompanied by a loss of VWFA responsivity and by the degeneracy of the associated white matter pathways. fMRI experiments allowed us to image longitudinally the visual perception of words, as compared to other classes of stimuli, as well as the mechanisms of letter-by-letter reading. The progressive improvement of reading was not associated with the re-emergence of a new area selective to words, but with increasing responses in spared occipital cortex posterior to the lesion and in contralateral right occipital cortex. Those regions showed a non-specific increase of activations over time and an increase in functional correlation with distant language areas. Those results confirm the existence of an alternative occipital route for reading, bypassing the VWFA, but they also point to its key limitation: the patient remained a slow letter-by-letter reader, thus supporting the critical importance of the VWFA for the efficient parallel recognition of written words.

A behavioral database for masked form priming.

Reading involves a process of matching an orthographic input with stored representations in lexical memory. The masked priming paradigm has become a standard tool for investigating this process. Use of existing results from this paradigm can be limited by the precision of the data and the need for cross-experiment comparisons that lack normal experimental controls. Here, we present a single, large, high-precision, multicondition experiment to address these problems. Over 1,000 participants from 14 sites responded to 840 trials involving 28 different types of orthographically related primes (e.g., castfe-CASTLE) in a lexical decision task, as well as completing measures of spelling and vocabulary. The data were indeed highly sensitive to differences between conditions: After correction for multiple comparisons, prime type condition differences of 2.90 ms and above reached significance at the 5% level. This article presents the method of data collection and preliminary findings from these data, which included replications of the most widely agreed-upon differences between prime types, further evidence for systematic individual differences in susceptibility to priming, and new evidence regarding lexical properties associated with a target word's susceptibility to priming. These analyses will form a basis for the use of these data in quantitative model fitting and evaluation and for future exploration of these data that will inform and motivate new experiments.

Letter transpositions within morphemes and across morpheme boundaries.

Recent evidence has revealed conflicting results regarding the influence of letter transpositions during the recognition of morphologically complex words. While some studies suggest that the disruption of the morpheme boundary through across-boundary transpositions (e.g., darnkess) leads to the absence of masked transposed-letter (TL) priming, other studies have found that TL priming occurs independently of whether or not letters have been transposed across the boundary. We conducted three experiments to test whether the difference between TL- within and TL-across priming is modulated by (a) the transposition of internal versus external letters of the stem (Experiment 1), (b) the overall proportion of affixed trials (Experiment 2), or (c) the relative frequency between prime and target (Experiment 3). The results revealed equal TL-within and TL-across boundary priming across all three experiments, which adds to previous findings suggesting that across-boundary transpositions do not interfere with the recognition of morphologically complex words.

Orthography influences the perception and production of speech.

One intriguing question in language research concerns the extent to which orthographic information impacts on spoken word processing. Previous research has faced a number of methodological difficulties and has not reached a definitive conclusion. Our research addresses these difficulties by capitalizing on recent developments in the area of word learning. Participants were trained to criterion on a set of associations between novel pictures and novel spoken words. Spelling-sound consistent or spelling-sound inconsistent spellings were introduced on the 2nd day, and the influence of these spellings on speech processing was assessed on the 3rd day. Results showed significant orthographic effects on speech perception and speech production in a situation in which spelling-sound consistency was manipulated with perfect experimental control. Results are discussed in terms of a highly interactive language system in which there is a rapid and automatic flow of activation in both directions between orthographic and phonological representations.

Embedded words in visual word recognition: does the left hemisphere see the rain in brain?

To examine whether interhemispheric transfer during foveal word recognition entails a discontinuity between the information presented to the left and right of fixation, we presented target words in such a way that participants fixated immediately left or right of an embedded word (as in gr*apple, bull*et) or in the middle of an embedded word (grapp*le, bu*llet). Categorization responses to target words were faster and more accurate in a congruent condition (in which the embedded word was associated with the same response; e.g., Does bullet refer to an item of clothing?) than in an incongruent condition (e.g., Does bullet refer to a type of animal?). However, the magnitude of this effect did not vary as a function of position of fixation, relative to the embedded word, as might be expected if information from the 2 visual fields was initially split over the cerebral hemispheres and integrated only late in the word identification process. Equivalent results were observed in Experiment 1 (long stimulus duration) and Experiment 2 (in which stimulus duration was 200 ms; i.e., less than the time required to initiate a refixation).

Is morphological decomposition limited to low-frequency words?

On the basis of data from masked priming experiments, it has been argued that an automatic process of decomposition is applied to all morphologically structured stimuli, irrespective of their lexical characteristics (Rastle, Davis, & New, 2004). So far, this claim has been tested only with respect to low-frequency primes and nonword primes. This is a limitation because some models of morphological processing postulate that only high-frequency complex words are recognized as whole forms. Thus, a more stringent test would be to determine whether high-frequency complex words also show evidence of masked priming. We report an experiment that compares masked-priming effects observed when the primes constitute morphologically structured nonwords (e.g., alarmer-ALARM), low-frequency words with a mean frequency of 2 per million (e.g., notional-NOTION), and high-frequency words with a mean frequency of 60 per million (e.g., national-NATION). These three conditions yielded significant and equivalent effects, lending strong support to the notion of a routine form of decomposition that is applied to all morphologically structured stimuli.