Clinical teaching self-efficacy positively predicts professional fulfillment and negatively predicts burnout amongst Thai physicians: a cross-sectional survey.

BACKGROUND: Clinician teachers (physicians who teach in clinical settings) experience considerable psychological challenges in providing both educational training and patient care. This study aimed to determine the prevalence of physician burnout and professional fulfillment, and to identify internal and external factors associated with mental health outcomes among Thai clinician teachers working in non-university teaching hospitals. METHOD: A one-time online questionnaire was completed by physicians at 37 governmental, non-university teaching hospitals in Thailand, with 227 respondents being assessed in the main analyses. Four outcomes were evaluated including burnout, professional fulfillment, quality of life, and intentions to quit. RESULTS: The observed prevalence of professional fulfillment was 20%, and burnout was 30.7%. Hierarchical regression analysis showed a significant internal, psychological predictor (clinical teaching self-efficacy) and external, structural predictors (multiple roles at work, teaching support), controlling for the background variables of gender, years of teaching experience, family roles, and active chronic disease, with clinical teaching self-efficacy positively predicting professional fulfillment (b = 0.29, p ≤.001) and negatively predicting burnout (b = - 0.21, p =.003). CONCLUSIONS: Results highlight the importance of faculty development initiatives to enhance clinical teaching self-efficacy and promote mental health among Thai physicians.

Relationships Between Strength and Power With the 74.84-kg (165-lb) and 90.72-kg (200-lb) Body Drags.

ABSTRACT: Moreno, MR, Dawes, JJ, Orr, RM, Dulla, JM, and Lockie, RG. Relationships between strength and power with the 74.84-kg (165-lb) and 90.72-kg (200-lb) body drags. J Strength Cond Res 38(7): 1305-1313, 2024-A body drag is an essential job task in law enforcement. It is purported that strength and power should contribute to this task, but there has been limited analysis. This study examined strength (1-repetition maximum hexagonal bar deadlift [1RM HBD]) and power (vertical jump [VJ], standing broad jump [SBJ]) relationships with the 74.84-kg and 90.72-kg body drags. Forty-three civilians (24 men and 19 women) completed the SBJ, VJ, and 1RM HBD in 1 session. Peak anaerobic power measured in watts (PAPw) was derived from the VJ. Relative measures were calculated from the SBJ, PAPw, and HBD. In another 2 sessions, subjects completed 74.84-kg and 90.72-kg drags in a counterbalanced order using 2 techniques: standard and adapted (time taken to pick dummy up from ground included in time). Independent samples t-tests compared the sexes and subjects who could or could not complete all drags. Partial correlations and stepwise regression, both controlling for sex, examined relationships between strength and power and the drags. In general, men outperformed women in almost all tests (p ≤ 0.024). Thirty-five subjects completed all drags and were stronger and more powerful than subjects who could not (p ≤ 0.011). The SBJ correlated with the 74.84-kg standard (r = -0.355) and 90.72-kg adapted (r = -0.373) drags; the VJ correlated with the 74.84-kg standard drag (r = -0.356). Peak anaerobic power measured in watts and 1RM HBD correlated with all drags (r = -0.382 to -0.668); PAPw was involved in all significant predictive relationships (explained variance = 34-62%). Absolute strength and power training should be a focus for recruits to enhance their ability to perform dragging tasks, especially with heavier masses.

Relationship Between the 20-m Multistage Fitness Test and 2.4-km Run in Law Enforcement Recruits.

ABSTRACT: Lockie, RG, Dawes, JJ, Moreno, MR, Cesario, KA, Balfany, K, Stierli, M, Dulla, JM, and Orr, RM. Relationship between the 20-m multistage fitness test and 2.4-km run in law enforcement recruits. J Strength Cond Res 35(10): 2756-2761, 2021-In the United States, the 2.4-km run is arguably the most common law enforcement aerobic assessment. Potential limitations are that recruits use an internal pacing strategy, the test requires fewer direction changes, and less-fit recruits run for longer. The 20-m multistage fitness test (20MSFT) is commonly used internationally to assess aerobic fitness in law enforcement recruits and provides an external pacing strategy. This study documented sex differences between the 2.4-km run and 20MSFT in law enforcement recruits, and between-test relationships. Retrospective analysis on 8 academy classes (463 men and 87 women) from 1 agency was conducted. The 20MSFT was completed before academy and the 2.4-km run in the first week. Between-sex comparisons in the 2.4-km run and 20MSFT were conducted with independent-samples t-tests and effect sizes. Estimated V̇o2max from the tests was compared with paired-samples t-tests. Correlations and linear regression calculated 2.4-km run and 20MSFT relationships. There were significant between-sex differences for the 2.4-km run and 20MSFT (p < 0.01), with moderate (d = 0.9) and small (d = 0.4) effects, respectively. Estimated 2.4-km run V̇o2max was greater than that from the 20MSFT (p < 0.01). The 2.4-km run had significant relationships with the 20MSFT (r = -0.6), although the regression equations were low (r2 = 0.30-0.37). Between-sex differences in the 20MSFT seemed less than for those in the 2.4-km run. Nonetheless, even with significant relationships between the tests, the 20MSFT induces a higher running intensity and direction changes. This may limit transferability with the 2.4-km run in law enforcement recruits.

Effects of Sex and Age on Physical Testing Performance for Law Enforcement Agency Candidates: Implications for Academy Training.

ABSTRACT: Bloodgood, AM, Dawes, JJ, Orr, RM, Stierli, M, Cesario, KA, Moreno, MR, Dulla, JM, and Lockie, RG. Effects of sex and age on physical testing performance for law enforcement agency candidates: implications for academy training. J Strength Cond Res 35(9): 2629-2635, 2021-Law enforcement candidates are often required to complete fitness tests to assess their preparedness for training. This study investigated the influence of sex and age on candidate performance before academy training. Retrospective analysis of 516 candidates was performed. Data were stratified into men (n = 432) and women (n = 84), and the pooled (men and women combined) data were stratified into age groups (20-24; 24-29; 30-34; 35-39; and 40+ years). The tests included the following: maximal push-ups and sit-ups in 60 seconds; a 75-yard pursuit run (75PR); arm ergometer revolutions completed in 60 seconds; and a 2.4-km run. To compare the sex and age groups, a 2 × 5 analysis of variance (with Bonferroni post hoc for multiple between-age group comparisons) was used. Men performed significantly (p < 0.001) more push-ups, sit-ups, and arm ergometer revolutions and were faster in the 75PR and 2.4-km run. The 20-24, 25-29, and 35-39 year groups were faster in the 75PR compared with the 40+ year group; the 20-24 and 25-29 year groups were faster than the 35-39 year group; and the 20-24 year group was faster than the 30-34 year group (p ≤ 0.023). The 20-24 year group was faster than the 40+ year group in the 2.4-km run (p = 0.005). Women and older candidates may have a lower physical capacity than men and younger candidates, respectively, in certain physical assessments. Women and older candidates, in particular, may benefit from dedicated training before academy to better prepare for the demands of this period.

2.4-km Run and 20-m Multistage Fitness Test Relationships in Law Enforcement Recruits After Academy Training.

Lockie, RG, Hernandez, JA, Moreno, MR, Dulla, JM, Dawes, JJ, and Orr, RM. 2.4-km run and 20-m multistage fitness test relationships in law enforcement recruits after academy training. J Strength Cond Res 34(4): 942-945, 2020-The 2.4-km run and 20-m multistage fitness test (20MSFT) are common aerobic fitness tests in law enforcement. Previous research analyzed relationships between these tests in recruits, and indicated limited transferability due to disparate demands (direction changes and running intensity). However, the correlations between 2.4-km run and 20MSFT in recruits after academy training may be different, where recruits should be fitter and able to complete high-intensity running efforts. This study documented changes in and relationships between the 2.4-km run and 20MSFT in law enforcement recruits after academy training. Retrospective analysis on 6 academy classes (276 males and 50 females) from one agency was conducted. The 20MSFT and 2.4-km run were completed before and after academy training. Estimated V[Combining Dot Above]O2max was derived from 2.4-km run time and the 20MSFT shuttle number. Paired-samples t-tests ascertained whether the 2.4-km run and 20MSFT improved after academy. Correlations and linear regression derived relationships between the 2.4-km run and 20MSFT. Recruits improved in the 2.4-km run and 20MSFT (p < 0.01). There were significant correlations between the 2.4-km run and 20MSFT for all recruits (r = -0.49), males (r = -0.48), and females (r = -0.29). However, the regression equations for all recruits (r = 0.24), males (r = 0.23), and females (r = 0.08) were low. The results suggested that there were disparate aspects to the 2.4-km run and 20MSFT in law enforcement recruits after academy training. Although aerobic fitness improved, there are likely other aspects important to the 20MSFT not developed during academy (change-of-direction ability and high-intensity running). This could impact the between-test relationship.

Assessing Repeated-Sprint Ability in Division I Collegiate Women Soccer Players.

Lockie, RG, Liu, TM, Stage, AA, Lazar, A, Giuliano, DV, Hurley, JM, Torne, IA, Beiley, MD, Birmingham-Babauta, SA, Stokes, JJ, Risso, FG, Davis, DL, Moreno, MR, and Orjalo, AJ. Assessing repeated-sprint ability in Division I collegiate women soccer players. J Strength Cond Res 34(7): 2015-2023, 2020-Repeated-sprint ability (RSA) is a key component of soccer, and is the capacity to repeatedly produce near-maximal to maximal sprints with short recovery periods. Repeated-sprint ability has received little analysis in collegiate women soccer players. The purpose of this study was to investigate relationships between RSA and tests of soccer-specific performance. Nineteen players from the same Division I collegiate women's soccer team were recruited. The RSA test consisted of six 20-m sprints completed on 15-second cycles. The measurements taken were total time (TT) and percent decrement (PD; percent change from first to last sprint). Subjects also completed tests of: lower-body strength (1 repetition maximum [1RM] back squat); jump performance (vertical and standing long jumps); linear (0-5, 0-10, and 0-30 m sprint intervals) and change-of-direction (505 from each leg) speed; and soccer-specific fitness (Yo-Yo intermittent recovery test level 1 [YYIRT1]). Pearson's correlations (p ≤ 0.05) were used to calculate relationships between RSA TT and PD with the performance tests. Total time exhibited significant relationships with the 0-10 (r = 0.50) and 0-30 m (r = 0.71) sprint intervals, and the left-leg 505 (r = 0.57). However, lower-body strength measured by the 1RM back squat and jump performance did not relate to TT. Percent decrement correlated only with the left-leg 505 (r = 0.53) and no other performance test. This included the YYIRT1, although both PD and YYIRT1 performance are limited by fatigue. The results from this study indicated that faster linear sprinting speed could positively influence RSA in Division I collegiate women soccer players.

Toward Open-Ended Fraternal Transitions in Individuality.

The emergence of new replicating entities from the union of simpler entities characterizes some of the most profound events in natural evolutionary history. Such transitions in individuality are essential to the evolution of the most complex forms of life. Thus, understanding these transitions is critical to building artificial systems capable of open-ended evolution. Alas, these transitions are challenging to induce or detect, even with computational organisms. Here, we introduce the DISHTINY (Distributed Hierarchical Transitions in Individuality) platform, which provides simple cell-like organisms with the ability and incentive to unite into new individuals in a manner that can continue to scale to subsequent transitions. The system is designed to encourage these transitions so that they can be studied: Organisms that coordinate spatiotemporally can maximize the rate of resource harvest, which is closely linked to their reproductive ability. We demonstrate the hierarchical emergence of multiple levels of individuality among simple cell-like organisms that evolve parameters for manually designed strategies. During evolution, we observe reproductive division of labor and close cooperation among cells, including resource-sharing, aggregation of resource endowments for propagules, and emergence of an apoptosis response to somatic mutation. Many replicate populations evolved to direct their resources toward low-level groups (behaving like multicellular individuals), and many others evolved to direct their resources toward high-level groups (acting as larger-scale multicellular individuals).

Physical Characteristics by Sex and Age for Custody Assistants From a Law Enforcement Agency.

Lockie, RG, Orr, RM, Stierli, M, Cesario, KA, Moreno, MR, Bloodgood, AM, Dulla, JM, and Dawes, JJ. The physical characteristics by sex and age for custody assistants from a law enforcement agency. J Strength Cond Res 33(8): 2223-2232, 2019-Custody assistants (CAs) are a position within a law enforcement agency who are responsible for assisting officers with maintaining security in correctional facilities. Unlike other positions, CAs may not be required to complete physical testing before being hired. This lack of testing could influence the characteristics of CAs who attend academy training. Therefore, retrospective analysis of performance test data for 108 officers (69 men and 39 women) was conducted. The tests included: grip strength for both hands; number of push-ups and sit-ups in 60 seconds; 201-m (220 yard) and 2.4-km runs; and maximal aerobic capacity (VO2max) estimated from the 2.4-km run. Data were stratified by sex and age (≤24 years, 25-29 years, 30-34 years, and ≥35 years). Independent samples t tests (p ≤ 0.05) calculated differences between men and women. To compare age groups, a 1-way analysis of variance with Bonferroni post hoc was used (p ≤ 0.05). Men scored significantly higher than women in hand grip, push-ups, and sit-ups, were faster over the 201-m and 2.4-km runs, and had a higher Vo2max (p ≤ 0.001-0.024). There were no significant differences in performance tests across the age groups for either men or women. To better tolerate the rigors of physical training, female CAs should attempt to improve their fitness before the start of academy training because they often need to complete the same tasks as the male CAs. Age did not seem to influence the physical characteristics of CAs, although all CAs should attempt to develop the fitness qualities needed for their occupation.

Repeated-Sprint Ability in Division I Collegiate Male Soccer Players: Positional Differences and Relationships With Performance Tests.

Lockie, RG, Moreno, MR, Orjalo, AJ, Stage, AA, Liu, TM, Birmingham-Babauta, SA, Hurley, JM, Torne, IA, Beiley, MD, Risso, FG, Davis, DL, Lazar, A, Stokes, JJ, and Giuliano, DV. Repeated-sprint ability in Division I collegiate male soccer players: positional differences and relationships with performance tests. J Strength Cond Res 33(5): 1362-1370, 2019-Repeated-sprint ability (RSA) in essential for soccer. Important considerations when assessing RSA is whether there are differences between positions (defenders, midfielders, and forwards), and what physiological characteristics may contribute to RSA. This has not been assessed in collegiate male players. Eighteen Division I male field players from one school performed several performance tests. The RSA test involved 7 × 30-m sprints completed on 20-second cycles. Measurements included total time (TT), and performance decrement (percent change in time from the first to last sprint; PD). Subjects also completed tests of lower-body power (vertical [VJ] and standing broad jump [SBJ]); linear (30-m sprint; 0-5 m, 0-10 m, 0-30 m intervals) and change-of-direction (505) speed; and soccer-specific endurance (Yo-Yo Intermittent Recovery Test Level 2; YYIRT2). A one-way analysis of variance (p < 0.05) determined between-position differences, and effect sizes were calculated. Pearson's correlations (p < 0.05) calculated relationships between RSA TT and PD with the other tests. There were no significant between-position differences for any test. There were large effects for the faster right-leg 505 and greater YYIRT2 distance for midfielders compared with defenders and forwards. Nonetheless, no between-position differences in RSA TT and PD were documented. There were relationships between RSA TT and the VJ (r = -0.59), SBJ (r = -0.61), 0-10 m (r = 0.64) and 0-30-m (r = 0.83) sprint intervals. There were no significant correlations for RSA PD. Male field players from one collegiate soccer team can demonstrate similar RSA across different positions. Greater lower-body power and sprinting speed could augment RSA.

A broadly conserved NERD genetically interacts with the exocyst to affect root growth and cell expansion.

The exocyst, a conserved, octameric protein complex, helps mediate secretion at the plasma membrane, facilitating specific developmental processes that include control of root meristem size, cell elongation, and tip growth. A genetic screen for second-site enhancers in Arabidopsis identified NEW ENHANCER of ROOT DWARFISM1 (NERD1) as an exocyst interactor. Mutations in NERD1 combined with weak exocyst mutations in SEC8 and EXO70A1 result in a synergistic reduction in root growth. Alone, nerd1 alleles modestly reduce primary root growth, both by shortening the root meristem and by reducing cell elongation, but also result in a slight increase in root hair length, bulging, and rupture. NERD1 was identified molecularly as At3g51050, which encodes a transmembrane protein of unknown function that is broadly conserved throughout the Archaeplastida. A functional NERD1-GFP fusion localizes to the Golgi, in a pattern distinct from the plasma membrane-localized exocyst, arguing against a direct NERD1-exocyst interaction. Structural modeling suggests the majority of the protein is positioned in the lumen, in a ß-propeller-like structure that has some similarity to proteins that bind polysaccharides. We suggest that NERD1 interacts with the exocyst indirectly, possibly affecting polysaccharides destined for the cell wall, and influencing cell wall characteristics in a developmentally distinct manner.

Health Disparities in Patients with Pulmonary Arterial Hypertension: A Blueprint for Action. An Official American Thoracic Society Statement.

BACKGROUND: Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension (PAH) is a rare cardiopulmonary disorder that affects children and adults and that, if untreated, results in premature death. The impact of health disparities in the diagnosis, treatment, and clinical outcome of patients with PAH has not been systematically investigated. OBJECTIVES: The specific goals of this research statement were to conduct a critical review of the literature concerning health disparities in PAH, identify major research gaps and prioritize direction for future research. METHODS: Literature searches from multiple reference databases were performed using medical subject headings and text words for pulmonary hypertension and health disparities. Members of the committee discussed the evidence and provided recommendations for future research. RESULTS: Few studies were found discussing the impact of health disparities in PAH. Using recent research statements focused on health disparities, the group identified six major study topics that would help address the contribution of health disparities to PAH. Representative studies in each topic were discussed and specific recommendations were made by the group concerning the most urgent questions to address in future research studies. CONCLUSIONS: At present, there are few studies that address health disparities in PAH. Given the potential adverse impact of health disparities, we recommend that research efforts be undertaken to address the topics discussed in the document. Awareness of health disparities will likely improve advocacy efforts, public health policy and the quality of care of vulnerable populations with PAH.

The Physical and Athletic Performance Characteristics of Division I Collegiate Female Soccer Players by Position.

Lockie, RG, Moreno, MR, Lazar, A, Orjalo, AJ, Giuliano, DV, Risso, FG, Davis, DL, Crelling, JB, Lockwood, JR, and Jalilvand, F. The physical and athletic performance characteristics of Division I collegiate female soccer players by position. J Strength Cond Res 32(2): 334-343, 2018-Playing positions in soccer can exhibit different movement demands during a match, contributing to variations in physical and performance characteristics. National Collegiate Athletic Association (NCAA) soccer features different substitution rules when compared to FIFA-sanctioned matches, which could influence each players' characteristics. Therefore, this study determined the athletic performance characteristics of Division I female soccer players. Twenty-six players (3 goalkeepers; 8 defenders; 10 midfielders; 5 forwards) from the same squad completed assessments of: lower-body power (vertical and standing broad jump); linear (0-5, 0-10, 0-30 meter [m] sprint intervals) and change-of-direction (pro-agility shuttle; arrowhead change-of-direction speed test) speed; and soccer-specific fitness (Yo-Yo Intermittent Recovery Test [YYIRT] levels 1 and 2). Players were split into position groups, and a Kruskal-Wallis H test with post hoc pairwise analyses (p ≤ 0.05) calculated significant between-group differences. There were no differences in age, height, or body mass between the positions. Midfielders had a faster 0-5 m time compared with the defenders (p = 0.017) and the goalkeepers (p = 0.030). The defenders (p = 0.011) and midfielders (p = 0.013) covered a greater YYIRT2 distance compared with the goalkeepers. There were no other significant between-position differences. Overall, Division I collegiate female players from the same squad demonstrated similar characteristics as measured by soccer-specific performance tests, which could allow for flexibility in position assignments. However, a relatively homogenous squad could also indicate commonality in training prescription, particularly regarding acceleration and high-intensity running. Strength and conditioning coaches may have to consider the specific movement demands of individual positions when training these capacities.

The 1 Repetition Maximum Mechanics of a High-Handle Hexagonal Bar Deadlift Compared With a Conventional Deadlift as Measured by a Linear Position Transducer.

Lockie, RG, Moreno, MR, Lazar, A, Risso, FG, Liu, TM, Stage, AA, Birmingham-Babauta, SA, Torne, IA, Stokes, JJ, Giuliano, DV, Davis, DL, Orjalo, AJ, and Callaghan, SJ. The 1 repetition maximum mechanics of a high-handle hexagonal bar deadlift compared with a conventional deadlift as measured by a linear position transducer. J Strength Cond Res 32(1): 150-161, 2018-The high-handle hexagonal bar deadlift (HHBD), a variation of the conventional deadlift (CD), is said to reduce the lift range of motion, which may change the mechanics of the lift. However, no research has investigated this. This study compared the mechanics between a 1 repetition maximum (1RM) CD and HHBD. Thirty-one strength-trained subjects (21 men, 10 women) completed a 1RM CD and HHBD. A linear position transducer measured lift distance, duration, and work; and peak and mean power, velocity, and force. The presence of a sticking region (SR) was determined for each lift. A repeated-measures analysis of variance (ANOVA) calculated differences between 1RM CD and HHBD mechanics. A one-way ANOVA compared the mechanics of each lift between subjects who exhibited an SR or not, and the SR between the CD and HHBD. Significance was set at p < 0.01. Subjects lifted a greater load in the HHBD (154.50 ± 45.29 kg) compared with the CD (134.72 ± 40.63 kg). Lift distance and duration were 22 and 25% shorter during the 1RM HHBD, respectively. The HHBD featured greater peak power and velocity, and peak and mean force; more work was done in the CD. Most subjects did not exhibit a CD (68%) or HHBD (77%) SR. There were no differences in CD or HHBD mechanics between subjects with or without an SR, and no differences in SR region distance or duration between the CD and HHBD. Greater force can be generated in the HHBD, which could have implications for strength-training adaptations over time.

Relationships Between Height, Arm Length, and Leg Length on the Mechanics of the Conventional and High-Handle Hexagonal Bar Deadlift.

Lockie, RG, Moreno, MR, Orjalo, AJ, Lazar, A, Liu, TM, Stage, AA, Birmingham-Babauta, SA, Stokes, JJ, Giuliano, DV, Risso, FG, Davis, DL, and Callaghan, SJ. Relationships between height, arm length, and leg length on the mechanics of the conventional and high-handle hexagonal bar deadlift. J Strength Cond Res 32(11): 3011-3019, 2018-The study investigated relationships between arm length (AL) and leg length (LL) and conventional deadlift (CD) and high-handle hexagonal bar deadlift (HHBD) mechanics. Twenty-three resistance-trained subjects (14 men and 9 women) completed a 1 repetition maximum CD and HHBD. A linear position transducer was used to measure lift distance and duration; peak and mean power, velocity, and force; time to peak power and velocity; and work. Right AL and LL were measured, and AL-to-LL ratio (AL:LL) was also calculated. Spearman's correlations (ρ; p ≤ 0.05) computed relationships between anthropometry and deadlift mechanics separately for men and women. For the HHBD, greater height and LL related to greater lift distance and work (ρ = 0.54-0.68); a higher AL:LL related to time to peak power and velocity occurring sooner (ρ = -0.67 to 0.78). For the HHBD, greater height and LL related to greater lift distance and work; a higher AL:LL related to time to peak power and velocity occurring sooner in the lift (ρ = 0.54-0.77). In women, greater height, AL, and LL related to a longer CD lift distance (ρ = 0.67-0.92). For the HHBD, greater height, AL, and LL related to a longer lift distance and greater mean velocity (ρ = 0.69-0.96). There was a negative relationship between AL and lift time (ρ = -0.83), which meant longer arms resulted in a lower HHBD lift time. Arm length may have influenced women more because of the fixed dimensions of the hexagonal bar. Coaches should be cognizant of potential differences in CD and HHBD work when performed by individuals of different body sizes.

A Methodological Report: Adapting the 505 Change-of-Direction Speed Test Specific to American Football.

Lockie, RG, Jalilvand, F, Orjalo, AJ, Giuliano, DV, Moreno, MR, and Wright, GA. A methodological report: Adapting the 505 change-of-direction speed test specific to American football. J Strength Cond Res 31(2): 539-547, 2017-The 505 involves a 10-m sprint past a timing gate, followed by a 180° change-of-direction (COD) performed over 5 m. This methodological report investigated an adapted 505 (A505) designed to be football-specific by changing the distances to 10 and 5 yd. Twenty-five high school football players (6 linemen [LM]; 8 quarterbacks, running backs, and linebackers [QB/RB/LB]; 11 receivers and defensive backs [R/DB]) completed the A505 and 40-yd sprint. The difference between A505 and 0 to 10-yd time determined the COD deficit for each leg. In a follow-up session, 10 subjects completed the A505 again and 10 subjects completed the 505. Reliability was analyzed by t-tests to determine between-session differences, typical error (TE), and coefficient of variation. Test usefulness was examined via TE and smallest worthwhile change (SWC) differences. Pearson's correlations calculated relationships between the A505 and 505, and A505 and COD deficit with the 40-yd sprint. A 1-way analysis of variance (p ≤ 0.05) derived between-position differences in the A505 and COD deficit. There were no between-session differences for the A505 (p = 0.45-0.76; intraclass correlation coefficient = 0.84-0.95; TE = 2.03-4.13%). Additionally, the A505 was capable of detecting moderate performance changes (SWC0.5 > TE). The A505 correlated with the 505 and 40-yard sprint (r = 0.58-0.92), suggesting the modified version assessed similar qualities. Receivers and defensive backs were faster than LM in the A505 for both legs, and right-leg COD deficit. Quarterbacks, running backs, and linebackers were faster than LM in the right-leg A505. The A505 is reliable, can detect moderate performance changes, and can discriminate between football position groups.

Yo-Yo Intermittent Recovery Test Level 2 and Its Relationship With Other Typical Soccer Field Tests in Female Collegiate Soccer Players.

The ability to complete high-intensity running is essential for soccer. The Yo-Yo Intermittent Recovery Test Level 2 (YYIRT2) can measure this capacity, but there is limited information regarding this assessment in collegiate female soccer players. This study investigated the YYIRT2 as a measure of high-intensity running in this population, and its relationship to other soccer field tests. Twenty-one players from a Division I team were recruited. In addition to the YYIRT2, subjects completed linear (0-5, 0-10, and 0-30 m sprint intervals) and change-of-direction (pro-agility and 60-yard shuttle) speed tests, as well as the YYIRT Level 1 (YYIRT1), to assess relationships with YYIRT2 by correlations (p ≤ 0.05). The correlation of YYIRT1 with the speed tests was also assessed. The YYIRT1 and YYIRT2 were standardized using z-scores for comparison with elite benchmarks to investigate relative performance on each test. The YYIRT2 and YYIRT1 distances did not significantly correlate with those of the speed tests (r = -0.251 to 0.274). There was a large relationship between YYIRT2 and YYIRT1 distances (r = 0.582), although the explained variance was low (33.87%). Mean YYIRT2 z-scores (-4.29 ± 1.66) indicated a performance further from elite benchmarks than those of the YYIRT1 (-1.92 ± 1.61), and 90.5% (19 of 21) subjects performed relatively better in the YYIRT1 than YYIRT2. The YYIRT2 provided a more specific measure of high-intensity running to that of the YYIRT1 in collegiate female soccer players. Coaches may consider using the YYIRT2 to gauge and track progress of high-intensity running capabilities and create training programs to improve this ability in female players.

Interplay of Oncoplastic Reconstruction and Adjuvant Radiation Therapy in Breast Cancer.

Purpose: Oncoplastic breast surgery (OBS) combines breast cancer tumor removal with the cosmetic benefits of plastic surgery at the time of breast-conserving surgery. Potential advantages of OBS include wider surgical margins around the tumor bed, while the natural shape and appearance of the breast are maintained more than standard lumpectomy procedures. However, limited information is available regarding the potential effect on adjuvant radiation treatment planning. Materials and Methods: Women with localized breast cancer undergoing lumpectomy with immediate OBS and adjuvant radiation therapy between 2014 and 2019 were reviewed. OBS was performed using volume displacement techniques and patients received whole-breast irradiation with 3-dimensional conformal radiation therapy. Results: Volume of additional ipsilateral breast tissue removed during OBS ranged from 21 to 2086 cm3 (median, 304 cm3), 29% of patients had >500 cm3 of tissue removed. Surgical margins were positive in 12.5% and were not affected by volume of breast tissue removed (445 vs 439 cm3). Patients with surgical clips more often received a lumpectomy bed boost (75.9% vs 50.0%), boost volumes were on average 157 cm3 with clips versus 205 cm3 without clips. Mean V105 was comparable in patients with >500 cm3 tissue removed and irradiated breast volume >1000 cm3, while higher absolute volumes were found in patients with >26 cm posterior separation (58.0 cm3 vs 102.7 cm3; P = .07). No meaningful difference was observed in Dmax or radiation coverage (95% of the volume receiving 95% of the prescription dose) for patients with >26 cm posterior separation, >500 cm3 of breast tissue removed, or irradiated breast volume >1000 cm3. Conclusions: Radiation dosimetry plans for patients undergoing oncoplastic surgery were acceptable and no significant radiation or surgical advantage was gained in patients with more tissue removed. Our study stresses the importance of clear communication between surgeons and radiation oncologists about sufficient marking of the lumpectomy cavity, using practices that minimize the need for re-excisions and minimize lumpectomy cavity disruption during rearrangement.

Effects of Technique and Dummy Mass on Law Enforcement-Specific Body Drags: Testing and Training Implications.

Current law enforcement body drag tests may use dummy masses that are underweight compared to current population norms. This study aimed to determine differences in 74.84-kg and 90.72-kg body drag times when performed with a standard (pick up and stand with dummy prior to dragging), adapted (incorporation of time to lift dummy to standing), and preferred (drag with any technique) technique. Forty-three (24 males, 19 females) physically-active, healthy civilians (surrogate population for police recruits) completed drags over 9.75 m with 74.84-kg and 90.72-kg dummies using the three techniques previously stated. A 2 (mass) × 3 (technique) within-factorial ANOVA (p < 0.05), with Bonferroni post hoc, derived any dummy and technique differences. Thirty-five participants completed all the standard and adapted drags; all participants completed the preferred drag. There were significant main effects for dummy mass (F (1,34) = 14.762, p < 0.001) and technique (F (2,33) = 23.272, p < 0.001). Participants dragged the 74.84-kg dummy faster than the 90.72-kg dummy. The standard drag was completed faster than the adapted and preferred drags (p < 0.001). The adapted drag was completed faster than the preferred drag (p = 0.024). Even if a recruit is assessed with a lighter dummy, they need the capacity to perform heavier drags in the field. Activity-specific strength training during academy could aid this process. Though the time was slower, the adapted technique may offer information the standard technique does not as it includes the lifting portion of the drag. The preferred technique allowed all participants to complete the task, which could influence the drag techniques allowed if agencies increase testing dummy masses.

Neoadjuvant Radiotherapy Facility Type Affects Anastomotic Complications After Esophagectomy.

BACKGROUND: Esophagectomy is a complex oncologic surgery that results in lower perioperative morbidity and mortality when performed in high-volume hospitals by experienced surgeons; however, limited data exists evaluating the importance of neoadjuvant radiotherapy delivery at high- versus low-volume centers. We sought to compare postoperative toxicity among patients treated with preoperative radiotherapy delivered at an academic medical center (AMC) versus community medical centers (CMC). METHODS: Consecutive patients undergoing esophagectomy for locally advanced esophageal or gastroesophageal junction (GEJ) cancer at an academic medical center between 2008 and 2018 were reviewed. Associations between patient factors and treatment-related toxicities were calculated in univariate (UVA) and multivariable analyses (MVA). RESULTS: One hundred forty-seven consecutive patients were identified: 89 CMC and 58 AMC. Median follow-up was 30 months (0.33-124 months). Most patients were male (86%) with adenocarcinoma (90%) located in the distal esophagus or GEJ (95%). Median radiation dose was 50.4 Gy between groups. Radiotherapy at CMCs resulted in higher rates of re-operation after esophagectomy (18% vs 7%, p = 0.055) and increased rates of anastomotic leak (38% vs 17%, p < 0.01). On MVA, radiation at a CMC remained predictive of anastomotic leak (OR 6.13, p < 0.01). CONCLUSION: Esophageal cancer patients receiving preoperative radiotherapy had higher rates of anastomotic leaks when radiotherapy was completed at a community medical center versus academic medical center. Explanations for these differences are uncertain but further exploratory analyses regarding dosimetry and radiation field size are warranted.