The Application of Transcranial Electrical Stimulation in Sports Psychology.

The problem of sports psychological fatigue has become one of the focal points of common concern among scholars at home and abroad. Athletes will face many problems and challenges in competition or training, and if they are not handled properly, they will have negative experiences, which will affect the training benefits and develop psychological fatigue. Transcranial electrical stimulation (TES), which contains transcranial direct current stimulation, transcranial alternating current stimulation, and transcranial random noise stimulation, is a noninvasive brain stimulation method. By applying specific patterns of low-intensity electrical currents to specific brain regions through electrodes of different sizes, it modulates cortical neural activity and/or excitability and enhances the connections between the brain and nerves and muscles to achieve improved motor performance. TES technology is currently making the transition from laboratory research to applied research in sports science. In this paper, we first describe the neural mechanisms of TES action on the cerebral cortex, including five aspects of body balance, endurance performance, exercise fatigue, muscle strength, and motor learning ability; then, we review the relevant studies on the application of TES in functional connectivity of brain networks and explore the importance of this field for TES to improve athletic performance. This research provides a machine learning-based and transcranial electrical stimulation model for the locomotor psychological fatigue problem in rock climbers since rock climbing is a sport that places great demands on athletes' psychological quality. The research on the factors influencing the psychological fatigue of climbers and the intervention measures is beneficial to the early diagnosis and the prevention and intervention of it.

Challenges of transferring rural adults with chronic HCV infection for further HCV RNA confirmation and free DAAs treatment: a success story of the interdisciplinary collaboration approach.

BACKGROUND: Chronic hepatitis C virus (HCV), which is a concern in many countries, is the leading cause of liver cancer around the world. Since Taiwan launched its national health insurance system in 1995, it has managed to extend health coverage to 99% of the Taiwanese population, providing free but limited antiviral treatment each year since 2017. However, many people in rural areas are unaware that they have chronic HCV; nor do they realize that new drugs with high cure rates could drastically reduce their health burden. The aim of this study is to explore the implementation facilitators of and barriers to inviting potentially infected patients in rural areas to be transferred for HCV ribonucleic acid (RNA) confirmation and new drug treatment. METHODS: A descriptive and prospective study design with an interdisciplinary collaboration approach was implemented. After five elements of referral were developed, telephone counseling was conducted between August 2018 and May 2019 in Yunlin, Taiwan. The elements of referral developed by the research team were: (1) forming and coordinating physicians' schedules, (2) recruiting and training volunteers, (3) training the nursing staff, (4) raising funds or resources, and (5) connecting with village leaders. Thereafter, we collaborated with two district health centers, a private local hospital, and health clinics. Based on the medical records provided by these agencies, community adults that were HCV antibody (anti-HCV) positive were invited to join the program. RESULTS: Of the 1795 adults who were serum anti-HCV positive, 1149 (64%) accepted transfer to a qualified hospital; of these, 623 (54.2%) had an HCV infection. 552 (88.6%) of those infected started receiving direct-acting antivirals (DAAs) treatment. The top four barriers to accepting transfer were: (1) they perceived themselves to be healthy (n = 98, 32.3%); (2) mistrust of treatment/healthcare (n = 60, 20.2%); (3) limited transportation to the hospital (n = 52, 17.5%); and (4) work conflict (n = 30, 10.1%). CONCLUSION: An interdisciplinary collaboration approach significantly contributed to the invitation of CHC patients, as well as their acceptance of HCV RNA confirmation and free DAAs treatment. Using anti-HCV data from previous medical records for case-finding and collaborating with a hospital and health clinics proved to be an efficient strategy.

An Investigation of the Side Effects, Patient Feedback, and Physiological Changes Associated with Direct-Acting Antiviral Therapy for Hepatitis C.

Background: Hepatitis C virus (HCV) infection is one of the major causes of liver cirrhosis and hepatocellular carcinoma globally. The advent of direct-acting antivirals (DAAs) with high cure rates provides an opportunity to reduce the rising HCV disease burden. However, few studies have explored the side effects and physiological benefits of DAA therapy in rural areas. The aim of this study was to investigate the subjective reports of discomfort, patient feedback about the course of treatment, and physiological changes after DAA treatment in HCV patients. Methods: A descriptive, prospective, comparative cohort study was conducted from January to August 2019 in western coastal Yunlin County, Taiwan. Data regarding demographic characteristics, subjective discomfort levels, and physiological responses were collected through face to face interviews and from medical records by a cooperating hospital. Results: Six-hundred-and-twenty-three participants with an active HCV infection were identified; 555 (89.1%) had completed treatment, and sustained virologic response was achieved in 99.6% (n = 553). The mean age was 64.9 (standard deviation = 13.1) years, and 35% of patients experienced discomfort during DAA treatment, including fatigue, itching, and dizziness. After three months of treatment, physiological markers, including body weight (p < 0.001), waist circumference (p < 0.05), blood pressure (p < 0.001), alanine aminotransferase (p < 0.001), and aspartate aminotransferase (p < 0.001), had significantly improved. Almost all participants provided positive feedback about the treatment experience and reported manageable side effects. Conclusions: The findings showed that, in an endemic rural area, DAA treatment had a high cure rate and improved physiological markers with few discomforts. These results can be used to reduce the barriers HCV patients face in adopting new medications.

Attentional biases toward body images in males at high risk of muscle dysmorphia.

OBJECTIVE: Although research on muscle dysmorphia (MD), a body dysmorphic disorder subtype, has recently increased, the causes and mechanisms underlying this disorder remain unclear. Results from studies examining disorders associated with body image suggest the involvement of self-schema in biasing attention toward specific body information. The present study examined whether individuals at higher risk of MD also display attentional biases toward specific types of body images. METHODS: The validated Chinese version of the Muscle Appearance Satisfaction Scale was used to distinguish men at higher and lower risk of MD. Sixty-five adult Chinese men at higher (HRMD, n = 33) and lower risk of MD (LRMD, n = 32) performed a visual probe task. Initially, an image of a bodybuilder with either larger or smaller musculature was presented on one side of a central point, with a neutral image of a car exterior presented on the other side along the horizontal plane for 2,000 ms. The paired images were removed, and a visual target (a dot) was displayed in the location of one of the previously shown images. Participants were asked to indicate the location of the target, and their eye movements were recorded during the entire visual presentation. Participant reaction time and three eye movement measurements (gaze direction, first saccade latency, and first fixation duration) were recorded for use in determining attentional bias. RESULTS: The HRMD group revealed biases in orienting and maintaining their attention on images of bodybuilders with larger musculatures. Participants in this group consequently had a shorter reaction time in identifying the target that appeared at the location in which an image of a bodybuilder with a larger musculature had been previously displayed. They also directed their initial gaze more frequently, had shorter saccade latency, and had longer first fixation duration on images of bodybuilders with larger musculatures (all p < .0001). In comparison, the LRMD group had longer reaction times, slower attention orientation toward body images, and shorter fixation duration for images of bodybuilders with larger musculatures (all p < .0001), indicating weaker or mixed responses. DISCUSSION: Adult Chinese men at higher risk of MD displayed biases in orienting and maintaining their visual attention toward images of bodybuilders with larger musculatures, and these biases facilitated their information processing. These results suggest that development of MD may be due in part to attentional biases associated with established negative self-schema of specific body information. These findings provide insight into understanding and identifying the cognitive characteristics of MD in an Asian population.

Contributions of Visuo-oculomotor Abilities to Interceptive Skills in Sports.

PURPOSE: Monitoring and intercepting a fast approaching object is a critical skill for many sports. Athletes might be distinguished from nonathletes based on their ability to access various visual abilities to accomplish interceptive actions. Here, we examined whether interceptive visuomotor skills of athletes and nonathletes are differently correlated to a hierarchy of visuo-oculomotor abilities related to the perception of motion in depth. METHODS: Eighty-six athletes in interceptive sports, as well as 60 nonathletes, were recruited based on their sport performance and prior experiences. Their basic visual abilities (dominant eye acuity, contrast sensitivity, visual span, and visual memory) and complex visuo-oculomotor abilities (dynamic acuity, accommodative facility, near point of convergence, and near/far phoria) were analyzed in relation to critical visuomotor skills (manual interception, visually guided locomotion, and depth judgment). RESULTS: Discriminant analysis revealed that athletes and nonathletes can be accurately differentiated based on measured visuomotor skills (91.3% accuracy, p < 0.0001). Near point of convergence, accommodative facility, and dynamic acuity were moderately effective in identifying athletes (71.3%, p = 0.002) and in predicting the three visuomotor skills (all r(2) ≥ 0.096, all p ≤ 0.022). Dominant eye acuity and contrast sensitivity also identified athletes (61.4%, p = 0.021) and contributed to complex visuo-oculomotor abilities (all r(2) ≥ 0.046, all p ≤ 0.039). The correlations among measured abilities were more significant for athletes than nonathletes. CONCLUSIONS: Athletes in interceptive sports are superior to nonathletes in their visuomotor skills. They also have broader access to various visual and complex visuo-oculomotor abilities than nonathletes. This likely allows athletes to more effectively coordinate visual and oculomotor abilities under demanding conditions when some visual cues are degraded. The present findings are consistent with a pyramid of sports vision and suggest a top-down process for athlete screening and training.