Análisis secuencial de golpeos finales del punto en pádel mediante árbol decisional / Analysis of Shots Patterns Finishing the Point in Padel through Decision-Tree Analysis

El objetivo de este estudio fue analizar la secuencia de los dos últimos golpeos del punto en pádel, y clasificarlos a través de árbol decisional multivariante. Se analizaron un total de 2110 acciones de juego, siendo las variables analizadas: golpeo, zona de la pista, eficacia, dirección, resultado y lado de juego. Los partidos fueron analizados mediante observación sistemática. Los resultados mostraron que mantener posiciones cercanas a la red aumenta las probabilidades de victoria, observándose que las secuencias de finalización más frecuentes son las de fondo-volea y globo-remate. Las parejas ganadoras realizan mayor número de puntos ganadores en la red y menos errores en el fondo de la pista. Además, utilizar trayectorias cruzadas en el penúltimo golpe aumentará las posibilidades de un error posterior de los rivales. Estos datos tienen aplicación práctica en el entrenamiento perceptivo y decisional del jugador de pádel, y la aplicación de feedbacks por parte del entrenador. (AU)

The main objective was to analyze the sequence of the last two shots of the point in padel and to make a classification through the multivariate decision tree approach. A total of 2110 game actions were analyzed. The variables analyzed were: shot, court zone, efficiency, direction, match outcome and side court. Matches were analyzed through systematic observation. The results determined that maintain net positions during the last two shots would increase the probabilities of victory, observing that the most frequent sequence of the last two shots were groundstroke-volley and lob-smash. In addition, winners make the highest number of winning points on the net and the least number of errors at the baseline. On the other hand, the use of cross-court shots will increase the chances of a opponents’ error. These data have an important practical application in the perceptive and decisional training and the feedback application by the coach. (AU)

El servicio en tenis profesional femenino: influencia del ranking y la lateralidad / Tennis Service Performance in Professional Women Players: Influence of Ranking Position and Opponent's Laterality

A pesar de que el saque es el golpe más determinante en el tenis moderno, existen hasta la fecha pocas investigaciones en tenis profesional femenino. El objetivo del presente estudio fue identificar las diferencias en la dirección y eficacia del saque en función del ranking; así como observar las diferencias según la lateralidad de la jugadora rival (diestra o zurda) en torneos de Grand Slam. Se analizaron un total de 108 partidos femeninos disputados en los torneos del Abierto de los Estados Unidos y Wimbledon. Los resultados mostraron una mayor variabilidad en la táctica del saque en Wimbledon frente al Abierto de Estados Unidos. Además, se identificaron diferencias en la dirección y eficacia del saque de las jugadoras diestras en función de la lateralidad del rival, en especial cuando se sacó a jugadoras zurdas. Estos resultados contribuyen al conocimiento de las dinámicas y rendimiento del saque en las jugadoras de tenis profesionales. (AU)

Serve is the most important stroke in modern tennis, but the number of studies on professional women’s tennis is scarce. The aim of the present study was to identify differences in service direction and effectiveness regarding players’ ranking position; as well as to observe the differences according to the opponent’s laterality (right-handed or left-handed). A total of 108 matches from the US Open and Wimbledon tournaments were analysed. Results showed a larger variability in service tactics in Wimbledon compared to the US Open. In addition, the direction and effectiveness of the service of right-handed players differed depending on the opponent’s laterality, especially against left-handed players. These results contribute to the knowledge of the service dynamics and performance in professional women’s tennis players. (AU)

Ethnic differences in the impact of gestational diabetes on macrosomia.

BACKGROUND: Previous studies reported an ethnic disparity in gestational diabetes mellitus-associated birth outcomes, with some suggesting that macrosomia increases to a lesser extent in groups at high risk, the opposite of the pattern observed by others. Our aim was to evaluate ethnic variation in the impact of gestational diabetes mellitus (GDM). METHODS: A case-control study evaluating pregnancy outcomes was conducted in women with and without GDM from five ethnic groups. Data on GDM were collected between January 2004 and July 2017. Women giving birth between May 2013 and July 2017 in whom pre-existing diabetes had been ruled out served as controls. A multivariate logistic regression analysis was performed to determine factors independently associated with macrosomia. RESULTS: Overall, 852 GDM women and 3,803 controls were included. In Caucasian and East-Asian women excessive gestational weight gain (OR 2.273, 95% CI 1.364-3.788 and OR 3.776, 95% CI 0.958-14.886) was an independent predictor of macrosomia. In Latin-American and Moroccan women, obesity (OR 1.774, 95% CI 1.219-2.581 and OR 1.656, 95% CI 1.054-2.601), GDM (OR 2.440; 95% CI 1.048-5.679 and OR 3.249, 95% CI 1.269-8.321) and gestational weight gain but only for Latin-American women (OR 2.365, 95% CI 1.039-5.384) were associated with macrosomia. In South-Central Asian women, only GDM was associated with macrosomia (OR 3.701, 95% CI 1.437-9.532). CONCLUSIONS: GDM is an independent predictor of macrosomia in Latin-American, South-Central Asian and Moroccan women but not in Caucasian or East-Asian women in whom other factors play a more important role.

Influencia de las pelotas de baja presión en la iniciación al pádel / Influence of Low-Compression Balls in Padel Initation Stage

El objetivo de este estudio fue analizar las demandas físicas de la competición en pádel de iniciación, y observar la influencia de diferentes tipos de pelota Dieciséis jugadores de pádel en iniciación participaron en este estudio. Cada judador portó un pulsómetro durante el partido. Se utilizaron cuestionarios al término de cada partido para evaluar el esfuerzo percibido y la satisfacción. Los resultados no mostraron diferencias significativas en la estructura temporal de los partidos. Se encontraron diferencias (p < 0,001) entre los partidos con pelota normal y pelota de baja presión tanto en la frecuencia cardiaca media (145,43 ppm vs 140,19 ppm) como en el %FCmáx (72,47 vs 69,85). Los jugadores mostraron mayor satisfacción en el uso de pelotas de baja presión. Estos datos pueden ser de utilidad para determinar el uso de un tipo de pelota u otra y mejorar la planificación del entrenamiento específico en jóvenes jugadores de pádel

The aim of this study was to analyze the physical demands in padel initiation stage and to observe the influence of playing with different type of padel balls. Sixteen padel players at initiation stage participated in this study. Players wore a heart rate (HR) monitor. Perceived exertion and satisfaction questionnaires were administrated at the end of the matches. No differences were found in the match temporal structure. Playing with official balls caused a significant increase in HR (p < 0.001) both in average and maximal values (Average HR: 145 bpm, %HRmax: 72.5%) comparing to low-compression balls (Average HR: 140 bpm, %HRmax: 69.9%). In addition, players showed higher satisfaction when using low-compression balls. This information may have implications to determine the use of normal balls or low-compression balls and the design of specific training programmes for young padel players

Diferencias en la forma de organización de las sesiones de pádel con estudiantes / Differences in forms of organization of the padel lessons with students

El objetivo del presente estudio es conocer los efectos en la cantidad y eficacia de golpeos y la percepción de satisfacción/diversión, aburrimiento y esfuerzo a través de cuatro formas de organización diferentes de sesiones de pádel. Los participantes del estudio fueron 48 estudiantes del Ciclo Formativo de Técnico en Animación y Actividades Físico Deportivas (33 chicos y 15 chicas), con edades comprendidas entre los 18 y los 26 años. Se evaluó la cantidad y eficacia de los golpeos a través de una hoja de observación directa. La percepción de diversión y aburrimiento fue evaluada a través del Sport Satisfaction Instrument y la percepción de esfuerzo a través de la Pictorial Children's Effort Rating Table. Los resultados obtenidos muestran que la forma de organización basada en el peloteo entre los alumnos se plantea como la más eficaz en la enseñanza del pádel, obteniendo un número significativamente mayor y más eficaz de golpeos, así como valores significativamente superiores de diversión/satisfacción y esfuerzo e inferiores de aburrimiento (AU)

The aim of this study was to determine the effects on the quantity and effectiveness of strokes and perceived satisfaction / fun, boredom and effort through four different organizational forms of paddle sessions. Study participants were 48 students from the Technical Training Course in Animation and Sports Physical Activities (33 boys and 15 girls) with ages between 18 and 26 years. The amount and effectiveness of beatings through direct observation of a sheet was evaluated. The perception of fun and boredom was evaluated through the Sport Satisfaction Instrument and perception of effort through the Pictorial Children's Effort Rating Table. The results show that the form of organization based on the rally among students is seen as the most effective in teaching paddle. A significantly greater and more effective number of strokes and significantly higher values ​​of amusement / satisfaction and effort and lower boredom have been proved as a result of this form of organization (AU)

Match activity and physiological load in wheelchair tennis players: a pilot study.

STUDY DESIGN: There is a lack of information about the physiological and psychological parameters in competition that shows a comprehensive profile of the demands of the game situation. OBJECTIVE: The aim of the present study was to examine the activity patterns and physiological-perceptual responses (heart rate (HR), blood lactate concentrations (LA) and the rate of perceived exertion (RPE), respectively, during singles wheelchair tennis (WT) matches. METHODS: A total of four WT players played three matches each. HR, LA and RPE were measured during each match. An activity pattern analysis was performed during all matches. Furthermore, LA and RPE were compared between service and return games. RESULTS: The results show a mean (s.d.) total match time of 69.04 (2.3) minutes, an effective playing time of 17.65% (0.03%), a work:rest (W:R) time ratio of 1:4.6 (0.48) and a rally length of 7.04 (4.44) seconds. Most of the points end in three or fewer shots. The mean (s.d.) physiological load during the matches were as follows: HR 124.25 (24.7) beats per minute, %HRmax 66.31% (4.5%), LA 1.41 (0.43) mmol l(-)(1) and RPE 12.45 (1.91). No significant differences were found in LA and RPE between service and return games (P>0.05). CONCLUSIONS: In this descriptive study, match activity and physiological load in WT are described. Match activities are similar to conventional tennis, although the physiological load is lower. Service and return situations show similar physiological and perceptual responses. These results might be used to develop specific interval training protocols for a male WT player.

Is there a role for music in reducing anxiety in plastic surgery minor operations?

INTRODUCTION: It is well documented that music plays a role in reducing anxiety levels. Its role in reducing intra-operative anxiety levels in surgical patients while awake is less well known. We report the effects of music on intra-operative patient anxiety in both the elective and trauma plastic surgical setting. METHODS: Two groups of patients undergoing local anaesthetic surgical procedures were identified: those where music was played in the operating theatre (Group 1) and those where it was not (Group 2). Ninety-six patients were included. Subjectively anxiety was evaluated by the patient with a visual analogue scale (VAS) and objectively by the respiratory rate (RR), both pre and post-operatively. The unpaired t-test was used to evaluate the statistical significance of differences between the groups. RESULTS: The mean pre-operative VAS score was similar in both groups (5.7 in Group 1 and 5.8 in Group 2). The mean pre-operative RR was 15 breaths per minute in both groups. Post-operatively, the VAS score and RR were both lower in Group 1 (VAS: 3.5 vs 4.9; p<0.01 and RR: 11 vs 13 breaths per minute; p<0.05). CONCLUSIONS: In the era of the patient centred approach to clinical care, it is crucial to minimise patient anxiety. Music appears to reduce intra-operative anxiety in awake patients in both the elective and trauma plastic surgical setting. Easy listening music and chart classics appear to be suitable genres according to patients. We believe there is a role for a large, multicentre, randomised control study to examine the benefits of music in all local anaesthetic procedures across different specialties.

The degree of matching at HLA-DPB1 predicts for acute graft-versus-host disease and disease relapse following haematopoietic stem cell transplantation.

The importance of matching for HLA-DPB1 in unrelated donor haematopoietic stem cell (HSC) transplantation is little understood. Most transplant centres do not, currently, prospectively match for DPB1, but emerging data show that DPB1 matching does play a role in determining outcome. We studied the impact of HLA-DPB1 matching on outcome in 143 recipients of T-cell depletion transplants, who matched with their respective unrelated donors (allelic level) at HLA-A, -B, -C, -DRB1 and -DQB1. Of those matched at DPB1, 47.2% (17/36) developed acute graft-versus-host disease (aGvHD) as compared to 66.3% (55/83) of those who were mismatched. This led to a 19.1% (95% CI 0.1-38.3%) increase in the chance of developing aGvHD in mismatched patients (P=0.049). Relapse of the original disease occurred in 51 recipients; 23 of 37 (62%) matched at both DPB1 alleles, 28 of 82 (34%) were mismatched at one or two DPB1 alleles. Thus, there was a significantly higher relapse rate (P=0.0011) in transplant recipients who matched at both DPB1 alleles. In conclusion, a donor/recipient DPB1 match was associated with a significantly lower incidence of aGvHD and a significantly higher incidence of disease relapse. This study provides further evidence for an immunogenic role of HLA-DPB1 in HSC transplants.

Comparison of outcomes of unrelated bone marrow and umbilical cord blood transplants in children with acute leukemia.

In order to compare the outcomes of unrelated umbilical cord blood transplants (UCBTs) or bone marrow transplants, 541 children with acute leukemia (AL) transplanted with umbilical cord blood (n = 99), T-cell-depleted unrelated bone marrow transplants (T-UBMT) (n = 180), or nonmanipulated (UBMT) (n = 262), were analyzed in a retrospective multicenter study. Comparisons were performed after adjustment for patient, disease, and transplant variables. The major difference between the 3 groups was the higher number in the UCBT group of HLA mismatches (defined by serology for class I and molecular typing for DRB1). The donor was HLA mismatched in 92% of UCBTs, in 18% of UBMTs, and in 43% of T-UBMTs (P <.001). Other significant differences were observed in pretransplant disease characteristics, preparative regimens, graft-versus-host disease (GVHD) prophylaxis, and number of cells infused. Nonadjusted estimates of 2-year survival and event-free survival rates were 49% and 43%, respectively, in the UBMT group, 41% and 37% in the T-UBMT group, and 35% and 31% in the UCBT group. After adjustment, differences in outcomes appeared in the first 100 days after the transplantation. Compared with UBMT recipients, UCBT recipients had delayed hematopoietic recovery (Hazard ratio [HR] = 0.37; 95% confidence interval [95CI]: 0.27-0.52; P <.001), increased 100 day transplant-related mortality (HR = 2.13; 95CI: 1.20-3.76; P <.01) and decreased acute graft-versus-host disease (aGVHD) (HR = 0.50; 95CI: 0.34-0.73; P <.001). T-UBMT recipients had decreased aGVHD (HR = 0.25; 95CI: 0.17-0.36; P <.0001) and increased risk of relapse (HR = 1.96; 95CI: 1.11-3.45; P =.02). After day 100 posttransplant, the 3 groups achieved similar results in terms of relapse. Chronic GVHD was decreased after T-UBMT (HR = 0.21; 95CI: 0.11-0.37; P <.0001) and UCBT (HR = 0.24; 95CI: 0.01-0.66; P =.002), and overall mortality was higher in T-UBMT recipients (HR = 1.39; 95CI: 0.97-1.99; P <.07). In conclusion, the use of UCBT, as a source of hematopoietic stem cells, is a reasonable option for children with AL lacking an acceptably matched unrelated marrow donor.

Reference strand mediated conformation analysis resolves HLA-DRB1 typing ambiguities when matching for unrelated bone marrow transplantation.

We show here the use of reference strand mediated conformation analysis (RSCA) to unambiguously resolve the HLA-DRB1 typing of two individuals which were selected as potential unrelated donors for bone marrow transplantation (BMT). In the first case, both sequence-specific primer (SSP) amplification and sequence-specific oligonucleotide probing (SSO), routinely used in different tissue typing laboratories gave, for the two unrelated donors, the same ambiguous typing of HLA-DRB1*04011+*0403 or DRB1*0407+*0413. In this case sequence-based typing (SBT) was not the method of choice to resolve the situation, due to the sequence ambiguities of these two given combinations. RSCA of both samples, using homozygous typing cells (HTCs) for DRB1*04011, *0403 and *0407 as internal controls, gave the unambiguous result that both donors were HLA-DRB1*04011+*0403. In the second case, a donor was typed as DRB1*1102+1103 by SSP, while SSO excluded the DRB1*1102 allele. The patient was unambiguously typed as DRB1*1101+1103 by both techniques. RSCA, using DNA from reference cell lines as internal controls, gave the unambiguous typing that the donor was DRB1*1103 homozygous.

[Mutation analysis of the beta-catenin gene in epithelial carcinomas of the ovaries]. / A beta-catenin génmutáció analízise epithelialis ovarium-carcinomákban.

beta-catenin is a continuously expressed cytoplasmic protein that has an important role is both E-cadherin-mediated cell-cell adhesion and in activation of Wnt/Wingless transcriptional pathway. The accumulation of stabilized beta-catenin caused by the mutation of the exon 3 of beta-catenin gene can stimulate the T-cell factor/Lymphoid enhancing factor-mediated transcriptional activation. The activation of transcriptional pathway may through oncogenes is an important step of the oncogenesis in solid tumors. In this study we analyzed mutations in exon 3 of the beta-catenin gene in 18 sporadic epithelial ovarian tumors. Three mutations were found from these 18 ovarian tumor samples which contained 8 serous, 3 mucinous, 5 endometrioid, one malignant Brenner-type tumor and one transitional cell carcinoma. Two mutations occurred in endometrioid-type (in 47 and 55 codons) and one in serous-type (in 47 codon) ovarian carcinomas, and both mutations were missense and somatic. The patients with mutated beta-catenin gene appeared from the younger patients under the age of 50. Our results suggest that the stabilization of beta-catenin protein by the mutation of CTNNB1 gene can contribute to the multistep process of the oncogenesis of epithelial ovarian tumors. Furthermore these mutations mostly occurs in the endometrioid-type of EOT, but can appear in other types such as serous-type ovarian tumor.

Cardiac compromise in a patient with Down's Syndrome: a lesson learnt.

A 49 year old burn victim with Down's Syndrome (Trisomy 21) was admitted with 15% body surface area (BSA) superficial burns. This was complicated by a large atrioseptal defect. Her course was stormy with difficulties encountered in managing her fluid status. Adequate fluid resuscitation was difficult to maintain with a fragile compromise between pulmonary insufficiency and renal impairment. She expired 12 days post-injury. Cardiac anomalies are not uncommon in the subgroup of patients with major burns who respond poorly to fluid resuscitation.

Laser transmission through membranes using the Q-switched Nd:YAG laser.

BACKGROUND AND OBJECTIVE: Many laser centres utilise various transparent membranes during treatment sessions with Q-switched lasers to prevent or reduce tissue splatter, thereby reducing the aerosolised biohazard of cellular debris to operator and laser. STUDY DESIGN/MATERIALS AND METHODS: We performed a series of experiments with the Q-Switched Nd:YAG laser, a selection of 11 varieties of membrane and a power meter in order to ascertain which of the membranes was the most effective protector concerning transmission of laser energy. Other mechanical properties such as transparency, strength, ease of application, and flexibility were taken into account. RESULTS: Tegaderm (overall average 94% transmission), Cling Film (93%), Bioclusive (89%), Opsite (91%), and Microwave Cling Film (87%) all consistently performed well in pure transmission terms, whereas other membranes tested such as Acetate (74%), Grades of Melinex (75%, 72%, 75%), 2nd Skin (74%), and Perspex (68%) were unsuitable as protection. CONCLUSION: Cling Film proved to be the best all round membrane. We recommend its use for operator and laser protection against the tissue spatter produced from the Q-Switched Nd:YAG laser.

Subcutaneous emphysema of a digit through a pre-existing puncture wound.

A case of injection of compressed air into a digit is reported. The air was injected at 50 PSI through a trivial puncture wound sustained some hours previously. The case had a benign course, in comparison to high pressure injection injuries with foreign material.