The epidemiology of eye illness in Para athletes in the Winter and Summer settings- a systematic review.

ABSTRACT: The aim of this systematic review was to evaluate eye illnesses in Para athletes in the Winter and Summer settings. A search was conducted using PubMed-Medline, EbscoHost, and Web of Science for full-text original research articles published anytime until November 2022. Studies that reported quantitative data on eye illness in highly active individuals and Para athletes, at any level of performance (elite/non-elite/recreational), aged 15-75 years were included. Of the eight studies included, two reported eye pathologies in athletes with visual impairment (VI) only, and six studies reported specific factors associated with eye illnesses in various impairments. Illnesses in the eye and adnexa were more prevalent in Winter (incidence: 1.6-2.2/1000 athlete days) compared to Summer (incidence: 0.3-0.5/1000 athlete days) settings. Eye illnesses were reported in athletes with limb deficiency (33.5%), spinal cord injury (29.4%), VI (10.6%), and central neurologic impairment (15.2%). The findings of this review indicate that: 1) Eye illness in Para athletes is an understudied area; and 2) Eye illnesses are present in athletes with impairments other than VI. There is a need for further research on eye illness, particularly in Winter sports settings to understand the types and nature of eye illness affecting Para athletes during competition and training settings.

Self-Directed Home-Based Dim-Light Melatonin Onset Collection: The Circadia Pilot Study.

Study Objectives: To test the feasibility of a novel at-home salivary Dim Light Melatonin Onset (DLMO) assessment protocol to measure the endogenous circadian phase of 10 individuals ( 1 Advanced Sleep-Wake Phase Disorder patient (ASWPD), 4 Delayed Sleep-Wake Phase Disorder patients (DSWPD), and 5 controls). Methods: The study involved 10 participants (sex at birth: females = 9; male= 1), who ranged between 27 to 63 years old, with an average age of 38 years old. Our study population consisted of 7 individuals who identified as white and 3 who identified as Asian. Our participants were diverse in gender identity (woman = 7, male = 1, transgender = 1, nonbinary = 1, none = 1).The study tracked the sleep and activity patterns of 10 individuals over a 5-6 week period using self-reported online sleep diaries and objective actigraphy data. Participants completed two self-directed DLMO assessments, approximately one week apart, adhering to objective compliance measures. Participants completed the study entirely remotely: they completed all sleep diaries and other evaluations online and were mailed a kit with all materials needed to perform the actigraphy and at-home sample collections. Results: Salivary DLMO times were calculated for 8/10 participants using the Hockeystick method. DLMO times were on average 3 hours and 18 minutes earlier than self-reported sleep onset times (DSPD: 12:04 AM, controls: 9:55 PM.) Among the 6 participants for whom we calculated two separate DLMO times, DLMOs 1 and 2 were 96% correlated (p<0.0005.). Conclusions: Our results indicate that self-directed, at-home DLMO assessments are feasible and accurate. The current protocol may serve as a framework to reliably assess circadian phase in both clinical and general populations.

Prevalence of health risk behaviours related to non-communicable diseases amongst South African university students: a systematic review.

BACKGROUND: Engagement in risk behaviours adopted during university continues after graduation, increasing the risk of non-communicable diseases (NCDs). This systematic review aimed to investigate the prevalence of NCD risk behaviours amongst South African university students. METHODS: PubMed and Scopus databases were searched (January 1990-April 2022) for studies investigating alcohol consumption, cigarette smoking, inadequate consumption of fruits and vegetables and physical inactivity. Study qualities were assessed with the Joanna Briggs Institute critical appraisal and levels of evidence checklists. An overall prevalence percentage was obtained for each risk behaviour. RESULTS: A total of 50 studies (n = 26 624 students) were included. A range of 44.8-75.0% of students consumed inadequate servings of fruits and vegetables. Just over 54% consumed alcohol (95% confidence intervals [95%CI]:54.0-55.5%). A significantly higher percentage of males (44.2%) than females (25.8%) drank heavily (P < 0.001). Approximately one-third (34.8%, 95%CI:33.4-36.3%) were sedentary and 39.0% (95%CI:37.5-40.4%) were insufficiently active. Almost one-fifth (17.9%, 95%CI:17.3-18.5%) smoked cigarettes, being significantly more prevalent amongst males (21.8%) than females (13.5%) (P < 0.001). A total of 10% smoked 1-10 cigarettes/day and 1.2% smoked >10 cigarettes/day. CONCLUSION: High percentages of South African students eat inadequate servings of fruits and vegetables, consume alcohol are physically inactive and smoke cigarettes. South African universities should implement screening measures and health campaigns.

"It gives me a wake up call"-It is time to implement athlete health monitoring within the Para sport context.

OBJECTIVES: The aim of this study was to explore elite Para athletes' and coaches' perceptions of experiences of athlete health monitoring. MATERIALS AND METHODS: This study used a qualitative design, applying a phenomenographical approach. Thirteen athletes and six coaches from two different socioeconomic contexts (the Swedish and South African Paralympic programs) participated. Data were collected through individual interviews focusing on athletes' and coaches' perceptions of experiences of athlete health monitoring within Para sport. RESULTS: Three main themes were revealed: (i) the benefits of athlete health monitoring, (ii) the importance of implementation and adaptation of athlete health monitoring in the real-world sports context, and (iii) barriers of athlete health monitoring. The perceptions were that regular monitoring can detect injuries early and thereby prevent them from progressing. Several participants highlighted the importance of monitoring factors beyond injury and illness, such as Para sport-specific health issues. Athletes' experiences were that they started to reflect on their own health, which was interpreted as improvement in health literacy. Another perception was that athlete health monitoring only is conducted within the research context and that athletes are not followed up. The perception was that it is the sports federations' responsibility to monitor and provide support when needed. Lastly, data revealed differences in the possibilities of conducting monitoring, which was related to both socioeconomic factors and Para sport. CONCLUSION: Coaches and athletes see health monitoring as valuable and important in enhancing athlete health. However, to maximize the impact, the monitoring structure should be specific to the context and provide multidisciplinary support when needed.

Dim light melatonin onset following simulated eastward travel is earlier in young males genotyped as PER35/5 than PER34/4.

Inter-individual variability exists in recovery from jetlag following travel across time zones. Part of this variation may be due to genetic differences at the variable number tandem repeat (VNTR) polymorphism of the PERIOD3 (PER3) gene as this polymorphism has been associated with chronotype and sleep, as well as sensitivity to blue light on melatonin suppression. To test this hypothesis we conducted a laboratory-based study to compare re-entrainment in males genotyped as PER34/4 (n = 8) and PER35/5 (n = 8) following simulated eastward travel across six time zones. The recovery strategy included morning blue-enriched light exposure and appropriately-timed meals during the first 24 h after simulated travel. Dim light melatonin onset (DLMO), sleep characteristics, perceived sleepiness levels (Stanford Sleepiness Scale), and resting metabolic parameters were measured during constant routine periods before and after simulated travel. While DLMO time was similar between the two groups prior to simulated eastward travel (p = .223), it was earlier in the PER35/5 group (17h23 (17h15; 17h37)) than the PER34/4 group (18h05 (17h53; 18h12)) afterwards (p = .046). During resynchronisation, perceived sleepiness and metabolic parameters were similar to pre-travel in both groups but sleep was more disturbed in the PER35/5 group (total sleep time: p = .008, sleep efficiency: p = .008, wake after sleep onset: p = .023). The PER3 VNTR genotype may influence the efficacy of re-entrainment following trans-meridian travel when blue-enriched light exposure is incorporated into the recovery strategy on the first day following travel.

Safe and Healthy Para sport project (SHAPE): a study protocol of a complex intervention within Para sport.

Elite Para athletes report a high incidence of sports injuries, illnesses and other health issues. Despite this, there are few prevention programmes in Para sport, and many of the existing prevention programmes are not adapted to Para athletes. To improve the success of preventive measures, it has been suggested that sports safety work should facilitate health promotion, including athlete health education. Therefore, the overarching aim of this project is to evaluate an accessible health promotion web platform as part of a complex intervention that aims to improve knowledge of athlete health in Para sport. In this protocol, the development, future implementation and evaluation of the intervention are described. To inform the implementation and use of such interventions, it is recommended to involve end users in the development and implementation process. Therefore, a participatory design process, including athletes and the sports organisation, was used to develop an accessible health promotion web platform. To evaluate this complex intervention, a process evaluation combining quantitative evaluation assessing causal pathways with qualitative methods assessing multifaceted pathways will be used. The primary outcomes are injury/illness incidence, athlete health parameters, health literacy and user behaviour. A cohort of elite Para athletes (n=150) from Sweden and South Africa will be invited to participate. This project will be the first that aims to improve athlete health in Para sport through pragmatic and accessible health promotion. It is a boundary-crossing project that will be conducted in a real-world sport setting, including athletes with different socioeconomic backgrounds.

Risk factors associated with acute respiratory illnesses in athletes: a systematic review by a subgroup of the IOC consensus on 'acute respiratory illness in the athlete'.

OBJECTIVE: To review risk factors associated with acute respiratory illness (ARill) in athletes, including non-infectious ARill and suspected or confirmed acute respiratory infections (ARinf). DESIGN: Systematic review. DATA SOURCES: Electronic databases: PubMed-Medline, EbscoHost and Web of Science. ELIGIBILITY CRITERIA: Original research articles published between January 1990 and July 2020 in English were searched for prospective and retrospective full text studies that reported quantitative data on risk factors associated with ARill/ARinf in athletes, at any level of performance (elite/non-elite), aged 15-65 years. RESULTS: 48 studies (n=19 390 athletes) were included in the study. Risk factors associated with ARill/ARinf were: increased training monotony, endurance training programmes, lack of tapering, training during winter or at altitude, international travel and vitamin D deficits. Low tear-(SIgA) and salivary-(IgA) were immune biomarkers associated with ARill/ARinf. CONCLUSIONS: Modifiable training and environmental risk factors could be considered by sports coaches and athletes to reduce the risk of ARill/ARinf. Clinicians working with athletes can consider assessing and treating specific nutritional deficiencies such as vitamin D. More research regarding the role and clinical application of measuring immune biomarkers in athletes at high risk of ARill/ARinf is warranted. PROSPERO REGISTRATION NUMBER: CRD42020160928.

Incidence of acute respiratory illnesses in athletes: a systematic review and meta-analysis by a subgroup of the IOC consensus on 'acute respiratory illness in the athlete'.

OBJECTIVE: To determine the incidence of acute respiratory illness (ARill) in athletes and by method of diagnosis, anatomical classification, ages, levels of performance and seasons. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Electronic databases: PubMed-Medline, EbscoHost and Web of Science. ELIGIBILITY CRITERIA: Original research articles published between January 1990 and July 2020 in English reporting the incidence of ARill in athletes, at any level of performance (elite/non-elite), aged 15-65 years. RESULTS: Across all 124 studies (n=1 28 360 athletes), the incidence of ARill, estimated by dividing the number of cases by the total number of athlete days, was 4.7 (95% CI 3.9 to 5.7) per 1000 athlete days. In studies reporting acute respiratory infections (ARinf; suspected and confirmed) the incidence was 4.9 (95% CI 4.0 to 6.0), which was similar in studies reporting undiagnosed ARill (3.7; 95% CI 2.1 to 6.7). Incidences of 5.9 (95% CI 4.8 to 7.2) and 2.8 (95% CI 1.8 to 4.5) were found for studies reporting upper ARinf and general ARinf (upper or lower), respectively. The incidence of ARinf was similar across the different methods to diagnose ARinf. A higher incidence of ARinf was found in non-elite (8.7; 95% CI 6.1 to 12.5) vs elite athletes (4.2; 95% CI 3.3 to 5.3). SUMMARY/CONCLUSIONS: These findings suggest: (1) the incidence of ARill equates to approximately 4.7 per athlete per year; (2) the incidence of upper ARinf was significantly higher than general (upper/lower) ARinf; (3) elite athletes have a lower incidence of ARinf than non-elite athletes; (4) if pathogen identification is not available, physicians can confidently use validated questionnaires and checklists to screen athletes for suspected ARinf. For future studies, we recommend that a clear diagnosis of ARill is reported. PROSPERO REGISTRATION NUMBER: CRD42020160472.

Correction to: Novel metagenome-derived ornithine lipids identified by functional screening for biosurfactants.

The published online version contains mistake in the author list.

Novel metagenome-derived ornithine lipids identified by functional screening for biosurfactants.

Biosurfactants are amphiphilic molecules that interact with the surfaces of liquids leading to many useful applications. Most biosurfactants have been identified from cultured microbial sources, leaving a largely untapped resource of uncultured bacteria with potentially novel biosurfactant structures. To access the uncultured bacteria, a metagenomic library was constructed in Escherichia coli from environmental DNA within an E. coli, Pseudomonas putida and Streptomyces lividans shuttle vector. Phenotypic screening of the library in E. coli and P. putida by the paraffin spray assay identified a P. putida clone with biosurfactant activity. Sequence analysis and transposon mutagenesis confirmed that an ornithine acyl-ACP N-acyltransferase was responsible for the activity. Although the fosmid was not active in E. coli, overexpression of the olsB gene could be achieved under the control of the inducible T7 promoter, resulting in lyso-ornithine lipid production and biosurfactant activity in the culture supernatants. Screening for activity in more than one host increases the range of sequences that can be identified through metagenomic, since olsB would not have been identified if only E. coli had been used as a host. The potential of lyso-ornithine lipids as a biosurfactant has not been fully explored. Here, we present several biosurfactant parameters of lyso-ornithine lipid to assess its suitability for industrial application.

Chronotype distribution in professional rugby players: Evidence for the environment hypothesis?

Individual sport athletes have been shown to comprise unusually high proportions of morning-types (MTs) coupled with a higher prevalence of the morningness-associated PERIOD3 variable number tandem repeat (VNTR) allele, PER35. The degree to which type of sport selected is influenced by either chronotype or genotype, or the extent to which sporting environment contributes to chronotype is unclear. The aim of this study was to assess chronotype and PER3 VNTR polymorphism frequencies in team sport players and non-athletic controls. South African male Super Rugby players (RUG, n = 120) and a control population of males with habitually low levels of physical activity (defined as exercise no more than twice a week; CON, n = 117) took part in this study. Participants completed the Horne-Östberg morningness-eveningness questionnaire to determine chronotype and donated buccal cell or blood samples from which PER3 VNTR genotype was established. There were more MTs in the RUG (47%) than CON group (23%, p < 0.001), more evening-types in the CON group (18%) compared to the RUG group (3%, p < 0.001), but no differences in PER3 VNTR genotype (p = 0.619) or allele (p = 0.758) frequencies. In both groups, more people carried the PER34 allele (RUG: 63%, CON: 62%). Chronotype was associated with genotype in the CON (p = 0.004) but not the RUG group (p = 0.895). Unlike the individual sport endurance athletes previously studied in whom the PER35 allele predominated, the PER3 VNTR genotype distribution in these team sport players was similar to that of the general population. We hypothesise that the absence of any chronotype-genotype relationship in these rugby players is because their diurnal preference is shifted towards morningness through habitual athletic behaviour.

Perception of effort in morning-type cyclists is lower when exercising in the morning.

A recent study found that South African endurance athletes are likely to be morning-types and carry the PER3(5) allele, which has been associated with a preference for mornings. The aim of this study was to measure the response of morning-type cyclists to a standardised bout of exercise performed at different times of the day. Participants ncluded 20 trained male cyclists (age: 39.8 ± 7.7 years, VO2max: 51.0 ± 7.0 ml · kg(-1) · min(-1), training: 166 ± 98 km · wk(-1)), categorised as morning-types (mean Horne-Östberg score: 68.3 ± 5.5) and carrying the PER3(5) allele. They completed a 17-min sub-maximal cycling test at 60%, 80% and 90% of maximum heart rate (HRmax) at 06h00, 10h00, 14h00, 18h00 and 22h00. These morning-type cyclists reported higher ratings of perceived exertion when cycling at 60% (P = 0.044), 80% (P < 0.001) and 90% (P < 0.001) of HRmax during the evening (18h00 and 22h00) compared to the other sessions (0600, 10h00 and 14h00). This was despite absolute power output, speed and cadence displaying no time-of-day differences. Thus, morning-type cyclists perceive the same relative intensity workload to be harder in the evening compared to the morning. This may have implications for both training and competition scheduling, and highlights the importance of considering individual chronotype in sports in which diurnal variation may be relevant to training and competition.

Chronotype and PERIOD3 variable number tandem repeat polymorphism in individual sports athletes.

A link between diurnal preference and a variable number tandem-repeat (VNTR) polymorphism in the PERIOD3 gene (PER3) has been demonstrated: the longer PER3(5) and shorter PER3(4) alleles with preferences for mornings and evenings, respectively. As many competitive events in South Africa for individual athletes are scheduled for the early mornings, we hypothesized that this might favor those athletes with a preference for morning activities. Self-selected white, male cyclists (CYC, n = 125), runners (RUN, n = 120) and Ironman triathletes (IM, n = 287) of European descent were compared with a control population of active, non-competitive individuals (CON, n = 96). The chronotypes of all CYC, RUN and CON participants and a sub-sample of the IM group (n = 49) were assessed using the Horne-Östberg Morningness-Eveningness Questionnaire, and the PER3 VNTR genotype for each participant was determined. The athlete groups contained more morning-type individuals than the CON group (CYC: 72%, n = 90; RUN: 67%, n = 80; IM: 59%, n = 29; CON: 41%, n = 39; p < .001). The prevalence of the PER3(5) allele was greater in the athlete groups (CYC: 61%, n = 152; RUN: 58%, n = 132; IM: 56%, n = 324; CON: 38%, n = 76; p < .001), and more athletes were genotyped as PER3(5/5) than CON individuals (CYC: 41%, n = 51; RUN: 23%, n = 26; IM: 28%, n = 81, CON: 9%, n = 8; p < .001). A strong relationship between chronotype and PER3 VNTR genotype was observed (p < .001). Finally, the time of day at which the athletes preferred to train was related to their chronotype (p < .001). This is the first study of its kind in a South African sporting population, and the results have not yet been replicated. These data suggest that white males of European descent participating in individual endurance sports in South Africa are more likely to be morning types. Furthermore, the PER3 VNTR may be one of the factors contributing to this observation.