Preserving Endothelial Integrity in Human Saphenous Veins during Preparation for Coronary Bypass Surgery.

INTRODUCTION: While multiple factors influence coronary artery bypass graft (CABG) success rates, preserving saphenous vein endothelium during surgery may improve patency. Standard preparations include saphenous vein preparation in heparinized saline (saline) which can result in endothelial loss and damage. Here, we investigated the impact of preparing saphenous graft vessels in heparinized patient blood (blood) versus saline. METHODS: Saphenous vein tissues from a total of 23 patients undergoing CABG were split into 2 groups (1) saline and (2) heparinized patient blood. Excess tissue was fixed for analysis immediately following surgery. Level of endothelial coverage, oxidative stress marker 4-hydroxynonenal (4HNE), and oxidative stress protective marker nuclear factor erythroid 2-related factor 2 (NRF2) were evaluated. RESULTS: In saline patient veins, histological analysis revealed a limited luminal layer, suggesting a loss of endothelial cells (ECs). Immunofluorescent staining of EC markers vascular endothelial cadherin (VE-cadherin) and endothelial nitric oxide identified a significant improvement in EC coverage in the blood versus saline groups. Although both treatment groups expressed 4HNE to similar levels, EC blood samples expressed higher levels of NRF2. CONCLUSION: Our data indicate that use of heparinized patient blood helps preserve the endothelium and promotes vein graft health. This has the potential to improve long-term outcomes in patients.

Prenatal and childhood exposure to organophosphate pesticides and functional brain imaging in young adults.

BACKGROUND: Early life exposure to organophosphate (OP) pesticides has been linked with poorer neurodevelopment from infancy to adolescence. In our Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) birth cohort, we previously reported that residential proximity to OP use during pregnancy was associated with altered cortical activation using functional near infrared spectroscopy (fNIRS) in a small subset (n = 95) of participants at age 16 years. METHODS: We administered fNIRS to 291 CHAMACOS young adults at the 18-year visit. Using covariate-adjusted regression models, we estimated associations of prenatal and childhood urinary dialkylphosphates (DAPs), non-specific OP metabolites, with cortical activation in the frontal, temporal, and parietal regions of the brain during tasks of executive function and semantic language. RESULTS: There were some suggestive associations for prenatal DAPs with altered activation patterns in both the inferior frontal and inferior parietal lobes of the left hemisphere during a task of cognitive flexibility (ß per ten-fold increase in DAPs = 3.37; 95% CI: -0.02, 6.77 and ß = 3.43; 95% CI: 0.64, 6.22, respectively) and the inferior and superior frontal pole/dorsolateral prefrontal cortex of the right hemisphere during the letter retrieval working memory task (ß = -3.10; 95% CI: -6.43, 0.22 and ß = -3.67; 95% CI: -7.94, 0.59, respectively). We did not observe alterations in cortical activation with prenatal DAPs during a semantic language task or with childhood DAPs during any task. DISCUSSION: We observed associations of prenatal OP concentrations with mild alterations in cortical activation during tasks of executive function. Associations with childhood exposure were null. This is reasonably consistent with studies of prenatal OPs and neuropsychological measures of attention and executive function found in CHAMACOS and other birth cohorts.

An unexpected shift in constant year effects in female elite handball.

One of the most convincing studies about the importance of the cutoff date in relative age effects was when Helsen et al. (2000) showed that a shift in the date directly resulted in a change of birth month distributions in soccer. Over the past four decades, the role of the birth year has also been associated with relative age effects (as reflected in constant year effects). In this investigation, two studies attempted to replicate the shift of birth year distributions caused by a change in birth years in international female handball. In Study 1, the results from the female handball world championship 2017 showed a significant within-year effect overall and a constant year effect for players born 1988 and after. A second study was conducted with female players from world championships in 2009, 2011, 2013, and 2015. Results demonstrated small effect sizes for most tests. However, there was an unexpected trend toward a constant year effect shift at the age of 28 years. Several hypotheses are presented as an explanation for this trend.

Impact of an alpha helix and a cysteine-cysteine disulfide bond on the resistance of bacterial adhesion pili to stress.

Escherichia coli express adhesion pili that mediate attachment to host cell surfaces and are exposed to body fluids in the urinary and gastrointestinal tracts. Pilin subunits are organized into helical polymers, with a tip adhesin for specific host binding. Pili can elastically unwind when exposed to fluid flow forces, reducing the adhesin load, thereby facilitating sustained attachment. Here we investigate biophysical and structural differences of pili commonly expressed on bacteria that inhabit the urinary and intestinal tracts. Optical tweezers measurements reveal that class 1a pili of uropathogenic E. coli (UPEC), as well as class 1b of enterotoxigenic E. coli (ETEC), undergo an additional conformational change beyond pilus unwinding, providing significantly more elasticity to their structure than ETEC class 5 pili. Examining structural and steered molecular dynamics simulation data, we find that this difference in class 1 pili subunit behavior originates from an α-helical motif that can unfold when exposed to force. A disulfide bond cross-linking ß-strands in class 1 pili stabilizes subunits, allowing them to tolerate higher forces than class 5 pili that lack this covalent bond. We suggest that these extra contributions to pilus resiliency are relevant for the UPEC niche, since resident bacteria are exposed to stronger, more transient drag forces compared to those experienced by ETEC bacteria in the mucosa of the intestinal tract. Interestingly, class 1b ETEC pili include the same structural features seen in UPEC pili, while requiring lower unwinding forces that are more similar to those of class 5 ETEC pili.

Genetic Associations With Acceleration, Change of Direction, Jump Height, and Speed in English Academy Football Players.

ABSTRACT: McAuley, ABT, Hughes, DC, Tsaprouni, LG, Varley, I, Suraci, B, Bradley, B, Baker, J, Herbert, AJ, and Kelly, AL. Genetic associations with acceleration, change of direction, jump height, and speed in English academy football players. J Strength Cond Res 38(2): 350-359, 2024-High-intensity movements and explosive actions are commonly assessed during athlete development in football (soccer). Although many environmental factors underpin these power-orientated traits, research suggests that there is also a sizeable genetic component. Therefore, this study examined the association of 22 single-nucleotide polymorphisms (SNPs) with acceleration, change of direction, jump height, and speed in academy football players. One hundred and forty-nine, male, under-12 to under-23 football players from 4 English academies were examined. Subjects performed 5-, 10-, 20-, and 30-m sprints, countermovement jumps (CMJs), and the 5-0-5 agility test. Simple linear regression was used to analyze individual SNP associations, whereas both unweighted and weighted total genotype scores (TGS; TWGS) were computed to measure the combined influence of all SNPs. To control for multiple testing, a Benjamini-Hochberg false discovery rate of 0.05 was applied to all genotype model comparisons. In isolation, the GALNT13 (rs10196189) G allele and IL6 (rs1800795) G/G genotype were associated with faster (∼4%) 5-, 10-, and 20-m sprints and higher (∼16%) CMJs, respectively (p < 0.001). Furthermore, the TGS and TWGS significantly correlated with all performance assessments, explaining between 6 and 33% of the variance (p < 0.001). This study demonstrates that some genetic variants are associated with power-orientated phenotypes in youth football players and may add value toward a future polygenic profile of physical performance.

Direct inhibition of the longevity-promoting factor SKN-1 by insulin-like signaling in C. elegans.

Insulin/IGF-1-like signaling (IIS) is central to growth and metabolism and has a conserved role in aging. In C. elegans, reductions in IIS increase stress resistance and longevity, effects that require the IIS-inhibited FOXO protein DAF-16. The C. elegans transcription factor SKN-1 also defends against oxidative stress by mobilizing the conserved phase 2 detoxification response. Here we show that IIS not only opposes DAF-16 but also directly inhibits SKN-1 in parallel. The IIS kinases AKT-1, -2, and SGK-1 phosphorylate SKN-1, and reduced IIS leads to constitutive SKN-1 nuclear accumulation in the intestine and SKN-1 target gene activation. SKN-1 contributes to the increased stress tolerance and longevity resulting from reduced IIS and delays aging when expressed transgenically. Furthermore, SKN-1 that is constitutively active increases life span independently of DAF-16. Our findings indicate that the transcription network regulated by SKN-1 promotes longevity and is an important direct target of IIS.

Navigating our way through a hospital ransomware attack: ethical considerations in delivering acute orthopaedic care.

Ransomware attacks on healthcare systems are becoming more prevalent globally. In May 2021, Waikato District Health Board in New Zealand was devastated by a major attack that crippled its information technology system. The Department of Orthopaedic Surgery faced a number of challenges to the way they delivered care including, patient assessment and investigations, the deferral of elective surgery, and communication and patient confidentiality. These issues are explored through the lens of the four key principles of medical ethics in the hope that they will provide some guidance to future departments who may experience such attacks.

On the predictive validity of the National Football League combine: does it forecast future success?

The National Football League (NFL) Combine provides NFL teams the ability to assess prospective athletes' medical histories and physical and psychological abilities. Using this information, NFL personnel must then decide whether an athlete is a good fit to their team. Given the combine's 40-year history and the availability of peer reviewed articles on the function and efficacy of the combine, the purpose of this systematic review was to synthesize the literature evaluating the predictive validity of the combine according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Full-text, peer-reviewed articles containing information relevant to the NFL combine and at least one measure of future success were retained. The search yielded 1954 articles and after screening, 68 articles remained. These remaining articles focused on measures of success pertaining to (a) medical testing and future performance (n = 25), (b) combine tests (n = 12), (c) draft position (n = 10), (d) draft and future performance (n = 8), (e) medical testing (n = 7), (f) career longevity (n = 3), (g) draft and salary (n = 2), and (h) playing performance (n = 1). Due to the mixed results of combine measures on future success, this review highlights the need for more research to investigate the combine's influence on long-term performance and success.

Early CRP Trends in Childhood Osteomyelitis Predict Complicated Disease.

BACKGROUND: Acute hematogenous osteomyelitis (AHO) remains a cause of severe illness among children. Contemporary research aims to identify predictors of acute and chronic complications. Trends in C-reactive protein (CRP) after treatment initiation may predict disease course. We have sought to identify factors associated with acute and chronic complications in the New Zealand population. METHODS: A retrospective review of all patients younger than16 years with presumed AHO presenting to a tertiary referral centre between 2008 and 2018 was performed. Multivariate was analysis used to identify factors associated with an acute or chronic complication. An "acute" complication was defined as the need for 2 or more surgical procedures, a hospital stays longer than 14 days, or recurrence despite intravenous antibiotics. A "chronic" complication was defined as growth or limb length discrepancy, avascular necrosis, chronic osteomyelitis, pathologic fracture, frozen joint, or dislocation. RESULTS: One hundred fifty-one cases met the inclusion criteria. The median age was 8 years (69.5% male). Within this cohort, 53 (34%) experienced an acute complication and 18 (12%) a chronic complication. Regression analysis showed that contiguous disease, delayed presentation, and failure to reduce CRP by 50% at day 4/5 predicted an acutely complicated disease course. Chronic complication was predicted by the need for surgical management and failed CRP reduction by 50% at day 4/5. CONCLUSIONS: CRP trends over 96 hours after the commencement of treatment differentiate patients with AHO likely to experience severe disease. LEVEL OF EVIDENCE: Level II, retrospective study.

Ten-year Review of Acute Pediatric Hematogenous Osteomyelitis at a New Zealand Tertiary Referral Center.

BACKGROUND: Acute hematogenous osteomyelitis (AHO) remains a cause of severe illness among children with the possibility of long-term consequences for growth and development. Recent research has highlighted an unusually high burden of disease in the New Zealand population compared with other Western regions. We have sought to identify trends in presentation, diagnosis, and management of AHO, with added focus on ethnicity and access to health care. METHODS: A 10-year retrospective review of all patients <16 years with presumed AHO presenting to a tertiary referral center between 2008 and 2018 was performed. RESULTS: One hundred fifty-one cases met inclusion criteria. The median age was 8 years with a male predominance (69.5%). Staphylococcus aureus was the most common pathogen using traditional laboratory culture method (84%). The number of cases per year decreased from 2008 to 2018. Assessment using New Zealand deprivation scores showed Maori children were most likely to experience socioeconomic hardship ( P ≤0.01). Median distance traveled by families to first hospital consult was 26 km (range 1 to 178 km). Delayed presentation was associated with need for prolonged antibiotic therapy. Incidence of disease varied by ethnicity with 1:9000 cases per year for New Zealand European, 1:6500 for Pacific, and 1:4000 for Maori. Overall recurrence rate was 11%. CONCLUSIONS: The incidence of AHO in New Zealand is concerningly high within Maori and Pacific populations. Future health interventions should consider environmental, socioeconomic, and microbiological trends in the burden of disease. LEVEL OF EVIDENCE: Retrospective study, Level III.

What Do We Know About the Value of Sport for Older Adults? A Scoping Review.

Issues relating to older adults in sport are ongoing topics of interest among sport scientists; however, our knowledge on how older athletes have been studied is incomplete, which has implications for understanding the comprehensiveness of this evidence base. This scoping review aimed to provide an overview of how sport and older adults have been studied since the first World Masters Games. Data on research topics, research methods, sport-specific information, and demographic information on older athletes were collected and reviewed. Results suggest older athletes who are White, male, and competitive athletes have largely been the focus of research. In addition, results highlight an alarming number of unreported data related to the demographics of athlete samples. As a result, the well-documented benefits of sport may reflect a homogenous group of older adults, limiting our overall understanding of aging and sport and the value of this research for developing evidence-informed policy.

Coach and Athlete Perspectives on Talent Transfer in Paralympic Sport.

Research pertaining to the experiences and motives of Paralympic athletes who transfer between sports is scant. This study aimed to address this gap through semistructured interviews with Canadian Paralympic coaches (n = 35) and athletes (n = 12). Three higher-order themes of "alternative to retirement," "career extension," and "compatibility" were identified. The subthemes of "psychobehavioral" and "physical and physiological" (from the higher-order theme of alternative to retirement) captured reasons leading to transfer, which are similar to reasons athletes may consider retirement. The subthemes of career extension-"better opportunities" and "beneficial outcomes"-shed light on factors that contributed to the withdrawal of negative experiences and reinforcement of positive outcomes associated with transferring sports. Last, compatibility had three subthemes of "resources," "sport-specific," and "communication," which encapsulated factors athletes should consider prior to their transfer. In conclusion, the participants highlighted the importance of transparent and effective communication between athletes and sports to align and establish realistic expectations for everyone involved.

The Emergence of the Pandemic: High-Performance Coach and Athlete Experiences.

The current study explored coach and athlete reactions and challenges leading up to the Tokyo 2020 Paralympic Games, with a specific focus on the impacts of the COVID-19 pandemic and the Games' postponement. Nine Australian Paralympic coaches (n = 3) and athletes (n = 6) shared their experiences in semistructured interviews. The thematic analysis highlighted how participants experienced the emergence of the pandemic in different ways, but all were relieved when the late but eventual decision to postpone the Games was made. Regarding lockdown periods (i.e., social-distancing restrictions), some coaches and athletes thrived under the new reality (i.e., training from home, online coaching) while others had more difficulty adjusting. Furthermore, results highlight the many uncertainties still remaining, which continue to influence participants' sport and personal lives. The experiences of coaches and athletes during the COVID-19 pandemic sheds light on strategies and resources that could support Paralympic coaches and athletes during current and future crises.

Septic arthritis of the native hip joint: a multi-pattern, multi-outcome disease.

PURPOSE: Septic arthritis of the native hip joint (SANH) is an uncommon surgical and medical emergency with few reports. The aim of this study was to determine predictors of return to theatre (RTT), complications and mortality. METHODS: Patients with SANH were identified from January 2009 to June 2022; 50 patients and three subgroups were identified: Pyogenic (surgical washout without systemic inflammatory disease), Systemic (surgical washout with SIDs) and patients managed non-surgically. Patterns of these groups were assessed with a principal component analysis. The cumulative incidences for death, any complication and RTT for repeat washout were calculated. The predictive variables associated with outcomes were selected with univariable models and then incorporated in multivariable CoxPH regressions. RESULTS: The 1-year cumulative incidence was 14% for mortality and 48.5% for any complication. Amongst patients managed surgically, 1-year risk of RTT was 46% in Pyogenic subgroup and 21% in Systemic subgroup. Systemic subgroup had lower complications and RTT and higher rate of sterile aspirate, compared to Pyogenic. Charlson comorbidity index (CCI) (HR = 1.41, P value = 0.03), preoperative albumin (HR = 0.81, P value = 0.009) and preoperative haemoglobin (HR = 0.95, P value = 0.02) were significantly associated with 1-year mortality. Time between symptom onset and admission > 7 days (HR = 3.15, P value = 0.042), preoperative Hb (HR = 1.05, P value = 0.016), socioeconomic deprivation (HR = 1.18, P value = 0.04) and Systemic subgroup (HR = 0.25, P value = 0.04) were significantly associated with RTT. CONCLUSION: Mortality was well predicted by the usual parameters including CCI, albumin, but also low haemoglobin. Patients presenting in a delayed fashion were more likely to have multiple lavages.

Unveiling molecular interactions that stabilize bacterial adhesion pili.

Adhesion pili assembled by the chaperone-usher pathway are superelastic helical filaments on the surface of bacteria, optimized for attachment to target cells. Here, we investigate the biophysical function and structural interactions that stabilize P pili from uropathogenic bacteria. Using optical tweezers, we measure P pilus subunit-subunit interaction dynamics and show that pilus compliance is contour-length dependent. Atomic details of subunit-subunit interactions of pili under tension are shown using steered molecular dynamics (sMD) simulations. sMD results also indicate that the N-terminal "staple" region of P pili, which provides interactions with pilins that are four and five subunits away, significantly stabilizes the helical filament structure. These data are consistent with previous structural data, and suggest that more layer-to-layer interactions could compensate for the lack of a staple in type 1 pili. This study informs our understanding of essential structural and dynamic features of adhesion pili, supporting the hypothesis that the function of pili is critically dependent on their structure and biophysical properties.

Global epidemiology of childhood bone and joint infection: a systematic review.

PURPOSE: Childhood bone and joint infection (BJI) is a potentially severe disease that may have permanent sequelae, including growth impairment and limb deformity. It has been characterised in the literature with a focus on Western epidemiology; there are currently no reports detailing global epidemiology and bacteriology. This omits key data from determining temporal trends, appropriate antibiotic therapy, and resource allocation. This review aims to identify studies that characterise the incidence of childhood bone and joint infection or provide detailed bacteriology within their region. METHODS: A systematic review of the literature was performed from 01/01/1980 to 31/12/2020. Data has been analysed to give incidence of disease per 100,000 children, primary pathogen by country where available, and risk ratio (RR) for disease by ethnicity. This is applicable for areas that experience race-related inequitable burden of disease. RESULTS: Forty-four articles met the inclusion area; of these, seven were population-wide studies, primarily from Europe or the United States, and the remainder were cohort studies. Incidence could be derived from 26 studies compromising over 34, 000 children. Information on bacteriology was available from 39 publications (10, 957 cases). Methicillin-sensitive Staphylococcus aureus is the most common pathogen in the West. Recently, disease secondary to Kingella kingae and methicillin-resistant S. aureus has increased. Salmonella remains a dominant pathogen in African regions. Increased risk of disease is observed in Aboriginal, New Zealand Maori, Pacific, Indigenous Fijian, and Bedouin children. CONCLUSION: The current state of the literature detailing incidence of childhood BJI focuses on disease patterns from the West. There is a paucity of high-quality publications in the developing world. Despite these limitations, global trends in burden of disease show race-related inequitable risk of BJI. Temporal and regional variation in bacteriology can be demonstrated. LEVEL OF EVIDENCE: III.

Geospace Concussion: Global Reversal of Ionospheric Vertical Plasma Drift in Response to a Sudden Commencement.

An interplanetary shock can abruptly compress the magnetosphere, excite magnetospheric waves and field-aligned currents, and cause a ground magnetic response known as a sudden commencement (SC). However, the transient (<∼1 min) response of the ionosphere-thermosphere system during an SC has been little studied due to limited temporal resolution in previous investigations. Here, we report observations of a global reversal of ionospheric vertical plasma motion during an SC on 24 October 2011 using ∼6 s resolution Super Dual Auroral Radar Network ground scatter data. The dayside ionosphere suddenly moved downward during the magnetospheric compression due to the SC, lasting for only ∼1 min before moving upward. By contrast, the post-midnight ionosphere briefly moved upward then moved downward during the SC. Simulations with a coupled geospace model suggest that the reversed E ⃗ × B ⃗ vertical drift is caused by a global reversal of ionospheric zonal electric field induced by magnetospheric compression during the SC.

Long-ranged heterogeneous structure in aqueous solutions of the deep eutectic solvent choline and geranate at the liquid-vapor interface.

The deep eutectic solvent choline and geranate (CAGE) has shown promise in many therapeutic applications. CAGE facilitates drug delivery through unique modes of action making it an exciting therapeutic option. We examine the behavior of aqueous CAGE solutions at a liquid-vapor interface. We find that the liquid-vapor interface induces large oscillations in the density, which corresponds to spontaneous segregation into regions enriched with geranate and geranic acid and other regions enriched with water and choline. These heterogeneities are observed to extend nanometers into the liquid. Additionally, we find that the geranate and geranic acid orient so that their polar carboxyl or carboxylate groups are on average pointed toward the layer containing water and choline. Finally, we report surface tension and thermal expansion coefficients for various concentrations of aqueous CAGE. We find a non-monotonic trend in the surface tension with concentration. The structural and thermodynamic properties we report provide a new perspective on CAGE behavior, which helps deduce the action of CAGE in more sophisticated systems and inspire other studies and applications of CAGE and related materials.

Exposure to DDT and DDE and functional neuroimaging in adolescents from the CHAMACOS cohort.

BACKGROUND: Epidemiological studies suggest that exposure to p,p'-dichloro-diphenyl-trichloroethane (p,p'-DDT) is associated with poorer cognitive function in children and adolescents, but the neural mechanisms underlying this association remain unclear. OBJECTIVE: We investigated associations of prenatal and childhood exposure to p,p'-DDT and its metabolite p,p'-dichloro-diphenyl-dichloroethylene (p,p'-DDE) with cortical activation in adolescents using functional near-infrared spectroscopy (fNIRS). METHODS: We administered fNIRS to 95 adolescents from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) aged 15-17 years. We assessed cortical activity in the frontal, temporal, and parietal brain regions while participants completed tasks of executive function, language comprehension, and social cognition. We measured serum p,p'-DDT and -DDE concentrations at age 9 years and then estimated exposure-outcome associations using linear regression models adjusted for sociodemographic characteristics. In secondary analyses, we back-extrapolated prenatal concentrations using prediction models and examined their association with cortical activation. RESULTS: Median (P25-P75) p,p'-DDT and -DDE concentrations in childhood were 1.4 (1-2.3) and 141.5 (75.0-281.3) ng/g lipid, respectively. We found that childhood exposure to p,p'-DDT and -DDE was associated with altered patterns of brain activation during tasks of cognition and executive functions. For example, we observed increased activity in the left frontal lobe during a language comprehension task (ß per 10 ng/g lipid increase of serum p,p'-DDE at age 9 years = 3.4; 95% CI: 0.0, 6.9 in the left inferior frontal lobe; and ß = 4.2; 95% CI: 0.9, 7.5 in the left superior frontal lobe). We found no sex differences in the associations of childhood p,p'-DDT and -DDE concentrations with neural activity. Associations between prenatal p,p'-DDT and p,p'-DDE concentrations and brain activity were similar to those observed for child p,p'-DDT and -DDE concentrations. CONCLUSIONS: Childhood p,p'-DDT and -DDE exposure may impact cortical brain activation, which could be an underlying mechanism for its previously reported associations with poorer cognitive function.

To draft or not to draft? A systematic review of North American sports' entry draft.

In theory, professional sport "entry drafts" are designed to promote parity by granting poorly performing teams with early selections and winning teams with later selections. While this process has intentions to "level the playing field", mixed findings exist in the literature. The aim of this review is to identify and synthesize the literature examining the efficacy of the draft for professional, North American sport leagues. A systematic review of four databases was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Full-text articles containing relevant data on the draft system for the four major professional North American sports were identified. Further restrictions were made to include articles focusing on a specific outcome regarding future success (i.e., whether the draft related to a measure of future performance). The search returned 10 962 records and after screening, 18 articles were synthesized. Of the articles examined, the measures of future success with relation to draft order were (a) career length and/or number of games played at the majors (n = 8), (b) future performance statistics at the professional level (n = 5), (c) change in winning percentage and/or number of wins produced (n = 3), (d) financial compensation (n = 1), and (e) a combination of measures (a) to (d), (n = 1). Most commonly, the first/early rounds most accurately predicted future measures of success (ie, number of games played, signing bonuses, and playing statistics) across sports. The middle and late rounds were less accurate, with the degree of accuracy increasing slightly in the last rounds. This review highlights several opportunities to better understand the draft process (e.g., potential improvements in middle round picks) and emphasizes the need for more research on analyzing and scrutinizing the draft.