The validity of automatic methods for estimating skeletal age in young athletes: a comparison of the BAUSport ultrasound system and BoneXpert with the radiographic method of Fels.

This study examined the validity of two automated methods (BAUSport, BoneXpert software using Fels, Greulich-Pyle, Tanner-Whithouse III protocols) for estimating skeletal age (SA) in young athletes in comparison to a reference standard (Fels). 85 male and female athletes, nine to seventeen years of age, from multiple sports were assessed for SA as part of an annual medical and health screening programme. Intra-class correlations demonstrated high degrees of association between the automatic methods for estimating SA (BAUSport r = .98; BoneXpert r = .96-.99) and the discrepancy between SA and chronological age (SA-CA) (BAUSport r = .93; BoneXpert r = .88-.97), with the reference standard. Concordance analyses for the categorisation of participants as early, on-time and late maturing also demonstrated substantial levels of agreement for both methods (BAUSport Kappa = .71; BoneXpert Fels Kappa = .63) with the reference standard. Bland-Altman plots comparing the automatic methods with the reference standard identified statistically significant fixed biases, ranging in magnitude from small to large. Collectively, these results suggest that BoneXpert and BAUSport can provide comparable estimates of SA and SA-CA in young athletes relative to the Fels method. Biases in the estimation of SA should, however, be considered and the automatic methods should be implemented as part of a comprehensive growth and maturity screening protocol. The non-invasive nature of the BAUSport method affords particular advantages (no radiation exposure, portability) in contexts where the regular estimation of SA is recommended.

Femur 3D-DXA Assessment in Female Football Players, Swimmers, and Sedentary Controls.

Cortical and trabecular volumetric bone mineral density (vBMD), cortical thickness and surface BMD (sBMD, density-to-thickness ratio) were analyzed in the proximal femur of elite female football players and artistic swimmers using three-dimensional dual-energy X-ray absorptiometry (3D-DXA) software and compared to sedentary controls. Football players had significantly higher (p<0.05) vBMD (mg/cm3) in the trabecular (263±44) and cortical femur (886±69) than artistic swimmers (224±43 and 844±89) and sedentary controls (215±51 and 841±85). Football players had also higher (p<0.05) cortical thickness (2.12±0.19 mm) and sBMD (188±22 mg/cm2) compared to artistic swimmers (1.85±0.15 and 156±21) and sedentary controls (1.87±0.16 and 158±23). Artistic swimmers did not show significant differences in any parameter analyzed for 3D-DXA when compared to sedentary controls. The 3D-DXA modeling revealed statistical differences in cortical thickness and vBMD between female athletes engaged in weight-bearing (football) and non-weight bearing (swimming) sports and did not show differences between the non-weight bearing sport and the sedentary controls. 3D-DXA modeling could provide insight into bone remodeling in the sports field, allowing evaluation of femoral trabecular and cortical strength from standard DXA scans.

Health effects of exposure to chlorination by-products in swimming pools.

Concerns have been raised regarding the potential negative effects on human health of water disinfectants used in swimming pools. Among the disinfection options, the approaches using chlorine-based products have been typically preferred. Chlorine readily reacts with natural organic matter that are introduced in the water mainly through the bathers, leading to the formation of potentially harmful chlorination by-products (CBPs). The formation of CBPs is of particular concern since some have been epidemiologically associated with the development of various clinical manifestations. The higher the concentration of volatile CBPs in the water, the higher their concentration in the air above the pool, and different routes of exposure to chemicals in swimming pools (water ingestion, skin absorption, and inhalation) contribute to the individual exposome. Some CBPs may affect the respiratory and skin health of those who stay indoor for long periods, such as swimming instructors, pool staff, and competitive swimmers. Whether those who use chlorinated pools as customers, particularly children, may also be affected has been a matter of debate. In this article, we discuss the current evidence regarding the health effects of both acute and chronic exposures in different populations (work-related exposures, intensive sports, and recreational attendance) and identify the main recommendations and unmet needs for research in this area.

Jumping rope and whole-body vibration program effects on bone values in Olympic artistic swimmers.

INTRODUCTION: Artistic swimming seems not to benefit bone development like other out-of-water physical activities. To increase bone acquisition, artistic swimming should combine water training with weight-bearing impact or strength activities. Artistic swimmers can be a population at risk of developing osteopenia and osteoporosis in later life. The aim of the present study was to evaluate the effects of a training program on bone mineral density (BMD), bone mineral content (BMC) and body composition in an Olympic artistic swimming team. METHODS: Sixteen women aged 17-21 years, who train 30 h/week, at the Olympic Training Centre (Barcelona, Spain), were followed up over two seasons. The 1st season involved regular artistic swimming training without specific training to reduce the risk of osteopenia. The exercise intervention, jumping rope and whole-body vibration, was added in the 2nd season. The protocol included 20 min of training 2 days per week, over a 22-week period. Dual energy x-ray absorptiometry measured the bone variables and body composition. The daily diet, medical history and bone turnover markers were evaluated. RESULTS: The intervention program increased BMD on lumbar spine (2.10%, p = 0.002), total hip (2.07%, p = 0.001), and femoral neck (2.39%, p = 0.02). Lower limb's fat mass decreased (10.17%, p = 0.038). No significant differences were found for any of the measured anthropometric characteristics between both time points in the 1st season. In conclusions, combined jump rope and vibration should be considered to reduce the risk of bone damage in artistic swimmers.

Changes in Lung Diffusing Capacity of Elite Artistic Swimmers During Training.

Artistic swimmers (AS) are exposed to repeated apnoeas in the aquatic environment during high intensity exercise provoking specific physiological responses to training, apnoea, and immersion. This study aimed to evaluate the changes in lung diffusing capacity in AS pre-, mid- and post-training in a combined session of apnoeic swimming, figures and choreography. Eleven elite female AS from the Spanish national team were the study's participants. The single-breath method was used to measure lung diffusing capacity for carbon monoxide (DLCO) and one-way repeated measures ANOVA was utilized to evaluate the statistical analysis. Basal values of DLCO were higher than normal for their age and height (33.6±4.9 mL·min-1·mmHg-1; 139±19%) and there were a significant interaction between DLCO and AS training (ŋ2 p=0.547). After the apnoeic swimming (mid-training) there was an increase in DLCO from basal to 36.7±7.3 mL·min-1·mmHg-1 (p=0.021), and after the figures and choreography (post-training) there was a decrease compared to mid-training (32.3±4.6 mL·min-1·mmHg-1, p=0.013). Lung diffusing capacity changes occur during AS training, including a large increase after apnoeic swimming. There were no differences in lung diffusing capacity from pre- to post-training, although large inter-individual variability was observed.

Erythrocytes and Skeletal Muscle Unsaturated and Omega-6 Fatty Acids Are Positively Correlated after Caloric Restriction and Exercise.

BACKGROUND: Nutritional intervention studies with fatty acid (FA) supplements assess the efficacy of the intervention by measuring the changes in erythrocyte membrane lipid profiles reflected in tissue composition changes. The aim was to determine the effects of caloric restriction (CR) on erythrocytes lipid composition and to compare and correlate these changes with skeletal muscle acid profiles after CR. METHODS: Erythrocytes were obtained from 11 healthy men before and after 4 weeks of 33% CR in post-exercise conditions; muscle biopsies were obtained from the same athletes after 4 weeks of 33% CR in post-exercise conditions. Samples were used for FA determination by chromatography. RESULTS: CR significantly modified erythrocyte FAs composition. Skeletal muscle FA profile was significantly different from that for the erythrocytes. The erythrocyte FA profile was more saturated (52.1 ± 1.5% and 32.8 ± 0.9%, respectively) and less monounsaturated (21.0 ± 0.8% and 39.0 ± 2.0%, respectively) than the skeletal muscle FA profile and similarly polyunsaturated. CONCLUSIONS: CR modifies erythrocyte lipid composition, mainly omega-6 FAs. Erythrocyte monounsaturated, polyunsaturated and omega-6 FAs, but not the saturated and omega-3 FAs, were significantly positively correlated with skeletal muscle FAs. There is a discordance between saturated and omega-3 FAs from erythrocyte and from muscle, but monounsaturated, polyunsaturated and omega-6 fatty acids are positively correlated.

Exercise in a hot environment influences plasma anti-inflammatory and antioxidant status in well-trained athletes.

Exercise in thermally stressful environmental conditions can enhance oxidative stress. We sought to measure the plasma antioxidant defenses and cytokine response together with oxidative damage post-exercise in a temperate versus a hot environment. The plasma concentrations of vasoactive endothelin-1 and vascular angiogenic growth factor were also evaluated. Male athletes (n=9) volunteered to participate. The athletes randomly performed two bouts of treadmill exercise of 45min at 75-80% of maximal oxygen uptake in a climatic-controlled chamber under two different conditions: temperate environment (10-12°C, 40-55% humidity) and hot, humid environment (30-32°C, 75-78% humidity). Venous blood samples were obtained immediately pre- and post-bout and on recovery after 2h. Serum glucose, malondialdehyde and lactate concentrations were significantly increased post-exercise in hot but maintained in the temperate environment; these post-exercise values were significantly higher after exercise in hot than in temperate. Urinary 8-hydroxy-2'-deoxyguanosine concentration, plasma phosphocreatine kinase and catalase activities, creatinine and monocyte chemoattractant protein-1, and interleukin-6 significantly increased post-exercise in hot but maintained in temperate environment. The post-exercise circulating values of antioxidant enzyme paraoxonase-1 and endothelin were significantly higher in the hot than in temperate environment. Exercise in a hot and humid environment resulted in mild hyperthermia with elevated perceived exertion and thermal stress. Hyperthermic environment induced hyperglycemia, lactatecidemia and more cellular and oxidative damage than exercise in a temperate environment but also induced a post-exercise antioxidant and anti-inflammatory response in plasma. These results suggest that environmental temperature needs to be taken into account when evaluating exercise-related oxidative stress and inflammation.

Influence of Stress and Emotions in the Learning Process: The Example of COVID-19 on University Students: A Narrative Review.

Emotional instability and stress are the main disturbances that condition the learning process, affecting both teachers and students. The main objective of this review is to analyze the influence of stress and emotions (as part of stress) on the learning environment. Stress is a physiological mechanism that the organism develops to adapt and survive external and internal challenges. In this context, stress tends to be seen as a negative condition in the learning process when it is chronic. Extreme stress situations, such as the COVID-19 pandemic, can generate anxiety and frustration in students. However, other studies indicate that controlled stress can positively enhance the learning process. On the other hand, the quality and intensity of emotions resulting from stress can influence as well the learning process. Positive emotions are healthy and can promote optimal learning. Emotions lead to sentimental, cognitive, behavioral, and physiological changes, which will have a strong influence on intellectual performance. The activation of coping strategies constitutes a key mechanism for dealing positively with problems and challenges, generating positive emotions essential for the self-regulation of learning. In conclusion, correct management of emotions in stressful situations could promote effective learning through enhanced attention and capacity to solve problems.

Is Curcumine Useful in the Treatment and Prevention of the Tendinopathy and Myotendinous Junction Injury? A Scoping Review.

Physical activity in general and sports in particular, is a mechanism that produces stress and generates great force in the tendon and in the muscle-tendon unit, which increases the risk of injury (tendinopathies). Eccentric and repetitive contraction of the muscle precipitates persistent microtraumatism in the tendon unit. In the development of tendinopathies, the cellular process includes inflammation, apoptosis, vascular, and neuronal changes. Currently, treatments with oral supplements are frequently used. Curcumin seems to preserve, and even repair, damaged tendons. In this systematic review, we focus more especially on the benefits of curcumin. The biological actions of curcumin are diverse, but act around three systems: (a) inflammatory, (b) nuclear factor B (NF-κB) related apoptosis pathways, and (c) oxidative stress systems. A bibliographic search is conducted under the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) as a basis for reporting reliable systematic reviews to perform a Scoping review. After analysing the manuscripts, we can conclude that curcumin is a product that demonstrates a significant biological antialgic, anti-inflammatory, and antioxidant power. Therefore, supplementation has a positive effect on the inflammatory and regenerative response in tendinopathies. In addition, curcumin decreases and modulates the cell infiltration, activation, and maturation of leukocytes, as well as the production of pro-inflammatory mediators at the site of inflammation.

Effects of L-Carnitine Intake on Exercise-Induced Muscle Damage and Oxidative Stress: A Narrative Scoping Review.

Exercise-induced muscle damage results in decreased physical performance that is accompanied by an inflammatory response in muscle tissue. The inflammation process occurs with the infiltration of phagocytes (neutrophils and macrophages) that play a key role in the repair and regeneration of muscle tissue. In this context, high intensity or long-lasting exercise results in the breakdown of cell structures. The removal of cellular debris is performed by infiltrated phagocytes, but with the release of free radicals as collateral products. L-carnitine is a key metabolite in cellular energy metabolism, but at the same time, it exerts antioxidant actions in the neuromuscular system. L-carnitine eliminates reactive oxygen and nitrogen species that, in excess, alter DNA, lipids and proteins, disturbing cell function. Supplementation using L-carnitine results in an increase in serum L-carnitine levels that correlates positively with the decrease in cell alterations induced by oxidative stress situations, such as hypoxia. The present narrative scoping review focuses on the critical evaluation of the efficacy of L-carnitine supplementation on exercise-induced muscle damage, particularly in postexercise inflammatory and oxidative damage. Although both concepts appear associated, only in two studies were evaluated together. In addition, other studies explored the effect of L-carnitine in perception of fatigue and delayed onset of muscle soreness. In view of the studies analyzed and considering the role of L-carnitine in muscle bioenergetics and its antioxidant potential, this supplement could help in postexercise recovery. However, further studies are needed to conclusively clarify the mechanisms underlying these protective effects.

Coenzyme Q10 Supplementation and Its Impact on Exercise and Sport Performance in Humans: A Recovery or a Performance-Enhancing Molecule?

Evidence exists to suggest that ROS induce muscular injury with a subsequent decrease in physical performance. Supplementation with certain antioxidants is important for physically active individuals to hasten recovery from fatigue and to prevent exercise damage. The use of nutritional supplements associated with exercise, with the aim of improving health, optimizing training or improving sports performance, is a scientific concern that not only drives many research projects but also generates great expectations in the field of their application in pathology. Since its discovery in the 1970s, coenzyme Q10 (CoQ10) has been one of the most controversial molecules. The interest in determining its true value as a bioenergetic supplement in muscle contraction, antioxidant or in the inflammatory process as a muscle protector in relation to exercise has been studied at different population levels of age, level of physical fitness or sporting aptitude, using different methodologies of effort and with the contribution of data corresponding to very diverse variables. Overall, in the papers reviewed, although the data are inconclusive, they suggest that CoQ10 supplementation may be an interesting molecule in health or disease in individuals without a pathological deficiency and when used for optimising exercise performance. Considering the results observed in the literature, and as a conclusion of this systematic review, we could say that it is an interesting molecule in sports performance. However, clear approaches should be considered when conducting future research.

Effect of Vitamin C on Tendinopathy Recovery: A Scoping Review.

Tendinopathies represent 30-50% of all sports injuries. The tendon response is influenced by the load (volume, intensity, and frequency) that the tendon support, resulting in irritability and pain, among others. The main molecular component of tendons is collagen I (60-85%). The rest consist of glycosaminoglycans-proteoglycans, glycoproteins, and other collagen subtypes. This study's aim was to critically evaluate the efficacy of vitamin C supplementation in the treatment of tendinopathies. At the same time, the study aims to determine the optimal conditions (dose and time) for vitamin C supplementation. A structured search was carried out in the SCOPUS, Medline (PubMed), and Web of Science (WOS) databases. The inclusion criteria took into account studies describing optimal tendon recovery when using vitamin C alone or in combination with other compounds. The study design was considered, including randomized, double-blind controlled, and parallel designs in animal models or humans. The main outcome is that vitamin C supplementation is potentially useful as a therapeutic approach for tendinopathy recovery. Vitamin C supplementation, alone or in combination with other products, increases collagen synthesis with a consequent improvement in the patient's condition. On the other hand, vitamin C deficiency is mainly associated with a decrease in procollagen synthesis and reduced hydroxylation of proline and lysine residues, hindering the tendon repair process.

Efficacy of artichoke and ginger extracts with simethicone to treat gastrointestinal symptoms in endurance athletes: a pilot study.

BACKGROUND: Exercise-induced gastrointestinal (GI) symptoms are frequently reported by athletes during training and competitions. A standardized combination of artichoke leaves and ginger root extracts has shown beneficial effects in managing GI discomfort in otherwise healthy subjects. METHODS: In this pilot study, we assessed the effectiveness of artichoke leaves and ginger root extracts combination associated with simethicone in reducing exercise-related GI symptoms in endurance athletes. The effects of the combination on upper/lower GI and systemic symptoms were assessed at baseline and after 4 weeks through a questionnaire. RESULTS: Fifty endurance athletes took the extracts' combination 320 mg + simethicone 40 mg chewable pills. The extracts combination and simethicone were effective in reducing the mean intensity of upper GI (86.6%) lower GI (85.9%) and systemic symptoms (81.9%), with superior results compared to placebo. The most remarkable effects were reported in the lower GI tract, with a significant decrease in flatulence, intestinal cramps, loose stools and diarrhea. Athletes also benefited from a reduction in belching and bloating and in dizziness, headache and muscle cramps, although the decrease in systemic symptoms was not significant. CONCLUSIONS: The supplementation of standardized artichoke and ginger extracts, combined with simethicone, may be effective in decreasing digestive discomfort and alteration of gastric motility not only in healthy subjects but also in endurance athletes.

Effect of lemon verbena supplementation on muscular damage markers, proinflammatory cytokines release and neutrophils' oxidative stress in chronic exercise.

Intense exercise is directly related to muscular damage and oxidative stress due to excessive reactive oxygen species (ROS) in both, plasma and white blood cells. Nevertheless, exercise-derived ROS are essential to regulate cellular adaptation to exercise. Studies on antioxidant supplements have provided controversial results. The purpose of this study was to determine the effect of moderate antioxidant supplementation (lemon verbena extract) in healthy male volunteers that followed a 90-min running eccentric exercise protocol for 21 days. Antioxidant enzymes activities and oxidative stress markers were measured in neutrophils. Besides, inflammatory cytokines and muscular damage were determined in whole blood and serum samples, respectively. Intense running exercise for 21 days induced antioxidant response in neutrophils of trained male through the increase of the antioxidant enzymes catalase, glutathione peroxidase and glutathione reductase. Supplementation with moderate levels of an antioxidant lemon verbena extract did not block this cellular adaptive response and also reduced exercise-induced oxidative damage of proteins and lipids in neutrophils and decreased myeloperoxidase activity. Moreover, lemon verbena supplementation maintained or decreased the level of serum transaminases activity indicating a protection of muscular tissue. Exercise induced a decrease of interleukin-6 and interleukin-1ß levels after 21 days measured in basal conditions, which was not inhibited by antioxidant supplementation. Therefore, moderate antioxidant supplementation with lemon verbena extract protects neutrophils against oxidative damage, decreases the signs of muscular damage in chronic running exercise without blocking the cellular adaptation to exercise.

Vertical jump assessment on volleyball: a follow-up of three seasons of a high-level volleyball team.

This is a longitudinal descriptive study whose purpose is to assess the physical state of male volleyball players competing at the international level, comparing their jump heights during 3 different seasons. National team sample relies upon trainer decisions, and it was different every season. There were 23, 15, and 13 players in the first, second, and third years, respectively. Subjects underwent a vertical test protocol consisting of rocket jump, squat jump (SJ), countermovement jump (CMJ), CMJ with arms (CMJa), and spike jump (DJb) at the preparation period of the national team season. In 2007, an extra evaluation was performed during the competitive period. A contact mat was used for the assessment. An increase of jump height was observed over the years, with SJ and DJb increasing significantly (FSJ = 5.4; FDJb = 4.7; p < 0.05). The elasticity index decreased significantly between 2007 and 2008 (FEI = 8.5; p < 0.05), whereas arm utilization index and approach index increased, but this increase was not statistically significant. A significant increase in SJ and DJb was also observed between the 2 tests performed in 2007, whereas a nonsignificant increase was observed for CMJ and CMJa. The results indicate a better performance of explosive strength, elastic-explosive strength, and reflex-elastic-explosive strength and a better use of arms during jumps.

Swimming exercise transiently decrease lung diffusing capacity in elite swimmers.

BACKGROUND: Swimmers have larger lungs and a higher diffusion capacity than other athletes, but it remains unknown whether swimming exercise changes lung diffusing properties. This study aimed to evaluate modifications in pulmonary alveolar-capillary diffusion after swimming exercise. METHODS: The participants were 21 elite level swimmers, including 7 females and 14 males, with a training volume of 45-70 kilometers of swimming per week. The single-breath method was used to measure the lung diffusing capacity for carbon monoxide (DLCO and the transfer coefficient of the lungs for carbon monoxide (KCO) before and after 10 training sessions over 4 weeks along 207 pre- to postevaluations. RESULTS: Swimming training consistently decreased lung diffusion capacity during the follow-up period, both DLCO (44.4±8.1 to 43.3±8.9 mL·min-1·mmHg-1, P=0.047, ŋ2p=0.55) and KCO (5.92±0.79 to 5.70±0.81 mL·min-1·mmHg-1·L-1, P=0.003, ŋ2p=0.75). CONCLUSIONS: Elite swimmers experience a subclinical impairment in lung diffusing capacity after swimming exercise, but the stress caused by swimming on the lungs and the acute reduction in DLCO does not lead to physiological dysfunction.

Severe Hypoxic Exercise Does Not Impair Lung Diffusion in Elite Swimmers.

García, Iker, Franchek Drobnic, Casimiro Javierre, Victoria Pons, and Ginés Viscor. Severe hypoxic exercise does not impair lung diffusion in elite swimmers. High Alt Med Biol. 22:90-95, 2021. Background: Exercise performed at high altitude may cause a subclinical pulmonary interstitial edema that can worsen gas exchange function. This study aimed to evaluate whether there are changes in alveolar-capillary diffusion after exercise during a short-term exposure to hypobaric hypoxia in elite swimmers. Materials and Methods: Seven elite swimmers (age: 20.4 ± 1.4 years, height: 1.78 ± 10.8 m, body mass: 69.7 ± 11.1 kg) participated in the study. Diffusing capacity of the lungs for carbon monoxide (DLCO), transfer coefficient of carbon monoxide, pulse oximeter oxygen saturation (SpO2), and heart rate (HR) were measured at sea level at rest (SL-R), and after a short-term hypobaric hypoxia exposure (4,000 m), both at rest (HA-R) and at the end of moderate interval exercise (HA-E). Results: The combined exposure to high altitude and exercise did not change DLCO from SL-R to HA-R, or HA-E (43.8 ± 9.8 to 41.3 ± 10.5 to 42.4 ± 8.6 ml minutes-1 mmHg-1, p = 0.391). As expected, elite swimmers showed large decrease in SpO2 (72 ± 5; p < 0.001) and increase in HR (139 ± 9 beats minutes-1; p < 0.003) after HA-E. Conclusions: An acute high-altitude exposure combined with submaximal exercise does not change alveolar-capillary diffusion in elite swimmers.

Krill-Oil-Dependent Increases in HS-Omega-3 Index, Plasma Choline and Antioxidant Capacity in Well-Conditioned Power Training Athletes.

There is evidence that both omega-3 polyunsaturated fatty acids (n-3 PUFAs) and choline can influence sports performance, but information establishing their combined effects when given in the form of krill oil during power training protocols is missing. The purpose of this study was therefore to characterize n-3 PUFA and choline profiles after a one-hour period of high-intensity physical workout after 12 weeks of supplementation. Thirty-five healthy power training athletes received either 2.5 g/day of Neptune krill oilTM (550 mg EPA/DHA and 150 mg choline) or olive oil (placebo) in a randomized double-blind design. After 12 weeks, only the krill oil group showed a significant HS-Omega-3 Index increase from 4.82 to 6.77% and a reduction in the ARA/EPA ratio (from 50.72 to 13.61%) (p < 0.001). The krill oil group showed significantly higher recovery of choline concentrations relative to the placebo group from the end of the first to the beginning of the second exercise test (p = 0.04) and an 8% decrease in total antioxidant capacity post-exercise versus 21% in the placebo group (p = 0.35). In conclusion, krill oil can be used as a nutritional strategy for increasing the HS-Omega-3 Index, recover choline concentrations and address oxidative stress after intense power trainings.