Proteomic Profiling of Muscular Adaptations to Short-Term Concentric Versus Eccentric Exercise Training in Humans.

The molecular mechanisms underlying muscular adaptations to concentric (CON) and eccentric (ECC) exercise training have been extensively explored. However, most previous studies have focused on specifically selected proteins, thus, unable to provide a comprehensive protein profile and potentially missing the crucial mechanisms underlying muscular adaptation to exercise training. We herein aimed to investigate proteomic profiles of human skeletal muscle in response to short-term resistance training. Twenty young males were randomly and evenly assigned to two groups to complete a 4-week either ECC or CON training program. Measurements of body composition and physiological function of the quadriceps femoris were conducted both before and after the training. Muscle biopsies from the vastus lateralis of randomly selected participants (five in ECC and four in CON) of both before and after the training were analyzed using the liquid-chromatography tandem mass spectrometry in combination with bioinformatics analysis. Neither group presented a significant difference in body composition or leg muscle mass; however, muscle peak torque, total work, and maximal voluntary contraction were significantly increased after the training in both groups. Proteomics analysis revealed 122 differentially abundant proteins (DAPs; p value < 0.05 & fold change >1.5 or <0.67) in ECC, of which the increased DAPs were mainly related to skeletal muscle contraction and cytoskeleton and enriched specifically in the pentose phosphate pathway, extracellular matrix-receptor interaction, and PI3K-Akt signaling pathway, whereas the decreased DAPs were associated with the mitochondrial respiratory chain. One hundred one DAPs were identified in CON, of which the increased DAPs were primarily involved in translation/protein synthesis and the mitochondria respiratory, whereas the decreased DAPs were related to metabolic processes, cytoskeleton, and de-ubiquitination. In conclusion, the 4-week CON and ECC training resulted in distinctly different proteomic profiles, especially in proteins related to muscular structure and metabolism.

The neural control of movement: a century of in vivo motor unit recordings is the legacy of Adrian and Bronk.

In two papers dated 1928 to 1929 in The Journal of Physiology, Edgar Adrian and Detlev Bronk described recordings from motor nerve and muscle fibres. The recordings from motor nerve fibres required progressive dissection of the nerve until a few fibres remained, from which isolated single fibre activity could be detected. The muscle fibre recordings were performed in humans during voluntary contractions with an intramuscular electrode - the concentric needle electrode - that they describe for the first time in the second paper. They recognised that muscle fibres would respond to each impulse sent by the innervating motor neurone and that therefore muscle fibre recordings provided information on the times of activation of the motor nerve fibres which were as accurate as a direct record from the nerve. These observations and the description of the concentric needle electrode opened the era of motor unit recordings in humans, which have continued for almost a century and have provided a comprehensive view of the neural control of movement at the motor unit level. Despite important advances in technology, many of the principles of motor unit behaviour that would be investigated in the subsequent decades were canvassed in the two papers by Adrian and Bronk. For example, they described the concomitant motor neurones' recruitment and rate coding for force modulation, synchronisation of motor unit discharges, and the dependence of discharge rate on motor unit recruitment threshold. Here, we summarise their observations and discuss the impact of their work. We highlight the advent of the concentric needle, and its subsequent influence on motor control research.

Well-Dispersed CsPbBr3@TiO2 Heterostructure Nanocrystals from Asymmetric to Symmetric.

Metal halide perovskites (MHPs) have undergone rapid development in the fields of solar cells, light diodes, lasing, photodetectors, etc. However, the MHPs still face significant challenges, such as poor stability and heterocompositing with other functional materials at the single nanoparticle level. Herein, the successful synthesis of well-dispersed CsPbBr3@TiO2 heterostructure nanocrystals (NCs) is reported, in which each heterostructure NC has only one CsPbBr3 with a precise anatase TiO2 coating ranging from asymmetric to symmetric. Due to the protection of anatase TiO2, CsPbBr3 shows dramatically improved chemical stability and photostability. More significantly, the synthesized CsPbBr3@TiO2 heterostructure NCs form a type II heterojunction, which strongly promoted efficient photogenerated carrier separation between anatase TiO2 and CsPbBr3, hence leading to improved optoelectronic activity. This study provides a robust avenue for synthesizing stable and highly efficient MHPs@metal oxide heterostructure NCs, paving the way for the practical application of all inorganic perovskites.

Prevalence and phenotypes associated with ALPK3 null variants in a large French multicentric cohort: Confirming its involvement in hypertrophic cardiomyopathy.

Biallelic disease-causing variants in the ALPK3 gene were first identified in children presenting with a severe cardiomyopathy. More recently, it was shown that carriers of heterozygous ALPK3 null variants are at risk of developing hypertrophic cardiomyopathy (HCM) with an adult onset. Since the number of reported ALPK3 patients is small, the mutational spectrum and clinical data are not fully described. In this multi-centric study, we described the molecular and clinical spectrum of a large cohort of ALPK3 patients. Genetic testing using targeted next generation sequencing was performed in 16 183 cardiomyopathy index cases. Thirty-six patients carried at least one null ALPK3 variant. The five paediatric patients carried two ALPK3 variants, all presented an HCM phenotype with severe outcomes (one transplantation, one heart failure and one cardiac arrest). The 31 adult patients carried heterozygous variants and the main phenotype was HCM (n = 26/31); including 15% (n = 4) presented with an apical or a concentric form of hypertrophy. Reporting a large cohort of ALPK3 patients, this collaborative work confirmed a strong association with HCM and suggesting his screening in the context of idiopathic HCM.

The decanoate esters of nandrolone, testosterone, and trenbolone induce steroid specific memory impairment and somatic effects in the male rat.

Long-term use of anabolic androgenic steroids (AAS) in supratherapeutic doses is associated with severe adverse effects, including physical, mental, and behavioral alterations. When used for recreational purposes several AAS are often combined, and in scientific studies of the physiological impact of AAS either a single compound or a cocktail of several steroids is often used. Because of this, steroid-specific effects have been difficult to define and are not fully elucidated. The present study used male Wistar rats to evaluate potential somatic and behavioral effects of three different AAS; the decanoate esters of nandrolone, testosterone, and trenbolone. The rats were exposed to 15 mg/kg of nandrolone decanoate, testosterone decanoate, or trenbolone decanoate every third day for 24 days. Body weight gain and organ weights (thymus, liver, kidney, testis, and heart) were measured together with the corticosterone plasma levels. Behavioral effects were studied in the novel object recognition-test (NOR-test) and the multivariate concentric square field-test (MCSF-test). The results conclude that nandrolone decanoate, but neither testosterone decanoate nor trenbolone decanoate, caused impaired recognition memory in the NOR-test, indicating an altered cognitive function. The behavioral profile and stress hormone level of the rats were not affected by the AAS treatments. Furthermore, the study revealed diverse AAS-induced somatic effects i.e., reduced body weight development and changes in organ weights. Of the three AAS included in the study, nandrolone decanoate was identified to cause the most prominent impact on the male rat, as it affected body weight development, the weights of multiple organs, and caused an impaired memory function.

Utility of the Clustering Index method for diagnosing neuromuscular disorders as compared with needle electromyography.

INTRODUCTION/AIMS: Concentric needle electromyography (CNEMG) is an essential examination for evaluating neuromuscular disorders, although pain is a drawback. Clustering Index (CI) method is a non-invasive quantitative analysis for surface electromyography (SEMG) that evaluates whether the signal area is clustered into the few large motor unit potentials (MUPs) or is evenly distributed. However, the diagnostic yield of the CI method in comparison with CNEMG is not known. In this study, we aimed to compare the sensitivity of the CI method with MUP parameters in CNEMG for diagnosing neurogenic or myogenic disorders. METHODS: We retrospectively identified patients for whom both SEMG and CNEMG were performed on the same tibialis anterior (TA) muscle. In CNEMG, seven MUP parameters were evaluated, including size index (SI) and revised size indices for neurogenic (rSIn) and myogenic (rSIm) disorders. RESULTS: Identified were 21 patients with neurogenic and 21 patients with myogenic disorders. Control data were constructed from 30 control subjects. The sensitivities of the CI method for the neurogenic and myogenic groups were 76% and 62%, respectively, which were not significantly different from MUP parameters, except for being significantly higher than those of amplitude and duration for myopathy (24%). Among MUP parameters, the sensitivities of rSIn (62%) and rSIm (57%) for myopathy were significantly higher than those of amplitude and duration. The CI method significantly correlated with the strength of the TA muscle in myopathy. DISCUSSION: The CI method, having comparable diagnostic yields to MUP parameters, is promising as a non-invasive diagnostic measure.

Joint synergy and muscle activity in the motion of the ankle-foot complex.

The movement of the ankle-foot complex joints is coupled as a result of various physiological and physical constraints. This study introduces a novel approach to the analysis of joint synergies and their physiological basis by focusing on joint rotational directions and the types of muscle contractions. We developed a biomimetic model of the ankle-foot complex with seven degrees of freedom, considering the skeletal configuration and physiological axis directions. Motion capture experiments were conducted with eight participants performing dorsiflexion and plantarflexion in open-chain states, as well as various walking tasks in closed-chain states, across different ground inclinations (±10, ±5, 0 deg) and walking speeds (3 and 4 km h-1). Hierarchical cluster analysis identified joint synergy clusters and motion primitives, revealing that in open-chain movements, plantarflexion of the ankle, tarsometatarsal and metatarsophalangeal joints exhibited synergy with the inversion of the remaining joints in the complex; meanwhile, dorsiflexion was aligned with eversion. During closed-chain movements, the synergies grouping was exchanged in the subtalar, talonavicular and metatarsophalangeal joints. Further analysis showed that in open-chain movements, synergy patterns influenced by multi-joint muscles crossing oblique joint axes contribute to foot motion. In closed-chain movements, these changes in synergistic patterns enhance the propulsion of the center of mass towards the contralateral leg and improve foot arch compliance, facilitating human motion. Our work enhances the understanding of the physiological mechanisms underlying synergistic motion within the ankle-foot complex.

Tripolar concentric ring electrodes for capturing localised electroencephalography signals during sleep.

By design, tripolar concentric ring electrodes (TCRE) provide more focal brain activity signals than conventional electroencephalography (EEG) electrodes placed further apart. This study compared spectral characteristics and rates of data loss to noisy epochs with TCRE versus conventional EEG signals recorded during sleep. A total of 20 healthy sleepers (12 females; mean [standard deviation] age 27.8 [9.6] years) underwent a 9-h sleep study. Participants were set up for polysomnography recording with TCRE to assess brain activity from 18 sites and conventional electrodes for EEG, eyes, and muscle movement. A fast Fourier transform using multitaper-based estimation was applied in 5-s epochs to scored sleep. Odds ratios with Bonferroni-adjusted 95% confidence intervals were calculated to determine the proportional differences in the number of noisy epochs between electrode types. Relative power was compared in frequency bands throughout sleep. Linear mixed models showed significant main effects of signal type (p < 0.001) and sleep stage (p < 0.001) on relative spectral power in each power band, with lower relative spectral power across all stages in TCRE versus EEG in alpha, beta, sigma, and theta activity, and greater delta power in all stages. Scalp topography plots showed distinct beta activation in the right parietal lobe with TCRE versus EEG. EEG showed higher rates of noisy epochs compared to TCRE (1.3% versus 0.8%, p < 0.001). TCRE signals showed marked differences in brain activity compared to EEG, consistent with more focal measurements and region-specific differences during sleep. TCRE may be useful for evaluating regional differences in brain activity with reduced muscle artefact compared to conventional EEG.

Broadband light absorption by a hemispherical concentric nanoshell array.

Achieving highly efficient broadband absorption is an important research area in nanophotonics. In this paper, a novel method is proposed to design broadband near-perfect absorbers, consisting of a four-layer hemispherical concentric nanoshell array. The proposed nanostructure supports absorptivity exceeding 95% in the entire visible region, and the absorption bandwidth is determined by the interaction or 'hybridization' of the plasmons of the inner and outer metal-based nanoshells. Moreover, the designed absorber has wide-angle capability and is insensitive to polarization. The simple structure, as well as the stable absorption properties, suggests that such core-shell nanostructures can serve as a potential candidate for many applications such as solar energy harvesting, photo-detection, and emissivity control.

Left Ventricular Geometric Pattern Impacts QT Dispersion in Males Athletes and Sedentary Men.

AIM: To (1) compare QT dispersion (QTd) and echocardiographic features between athletes with concentric left ventricular (LV) hypertrophy, athletes with eccentric LV hypertrophy, and sedentary controls with a normal LV geometric pattern and (2) quantify associations between QTd and echocardiographic features within these groups. METHODS: Male athletes competing in different sports and sedentary men were stratified into groups according to their LV geometric pattern. These groups included eccentric LV hypertrophy (LV index > 115 g/m2, relative wall thickness [RWT] < 0.42) consisting of 38 athletes, concentric LV hypertrophy (LV index > 115 g/m2, RWT > 0.42) consisting of 40 athletes, and normal LV geometric pattern (LV index < 115 g/m2, RWT < 0.42) consisting of 40 sedentary controls. Following a cross-sectional design, participants underwent electrocardiographic (ECG) and echocardiographic screening. Data were compared between groups using one-way analyses of variance with Bonferroni post hoc tests. Associations between corrected QTd and echocardiographic variables were quantified using Pearson correlations. RESULTS: Alongside structural disparities between groups, corrected QTd was significantly (p < 0.001) lower in athletes with eccentric LV hypertrophy compared to athletes with concentric LV hypertrophy and sedentary controls. Significant, moderate-to-very-large correlations were found between corrected QTd and interventricular septal wall thickness in athletes with concentric (r = 0.416, p = 0.008) or eccentric LV hypertrophy (r = 0.734, p < 0.001), and sedentary controls (r = 0.464, p = 0.003). CONCLUSION: The provided comparative and relationship data may inform the development of more precise approaches for ECG and echocardiographic screening in athletes, particularly in those with concentric LV hypertrophy who may be at greater risk for developing prolonged QTd.

Approach to adult Moyamoya disease presenting as bilateral anterior circulation infarcts: a case report.

Moyamoya disease (MMD) is a rare progressive condition of unknown etiology that affects the blood vessels in the brain and is characterized by narrowing or stenosis of the distal parts of the internal carotid and major intracranial arteries, leading to the development of fragile collateral supplies. This makes it a significant causative factor for both ischemic strokes as well as intracerebral hemorrhages. As per the recommendations by the Research Committee on Moyamoya disease in 2021, the diagnostic criteria for MMD are essentially based on indicative radiological findings on cerebral angiography or MRI Brain and MRA, after excluding possible differentials. In this case report, we present the case of a 45-year-old Asian lady who presented with sudden-onset headaches and right-sided weakness. Her admission non-contrast CT brain scan was undiagnostic. MRI brain and MRA scans revealed bilateral anterior circulation watershed infarcts of variable age along with supra-clinoid stenosis. She was initially treated with steroids for vasculitis after discussions with a multidisciplinary team involving neurologists, stroke physicians and neuro-radiologists; however, further imaging revealed a diagnosis of MMD, and she was subsequently referred for revascularization surgery. Given the limited number of similarly documented cases, we hope this report will contribute to the knowledge base.

Left ventricle hypertrophy and re-modeling in children with essential hypertension: does the race matter?

BACKGROUND: This is the first study to report on the impact of race on differences in the prevalence of echocardiographic left ventricular hypertrophy and left ventricular adaptation at the time of diagnosis of essential hypertension in children. METHODS: This cross-sectional, single-centre study included patients aged 3-18 years who had newly diagnosed essential hypertension. Echocardiography was used to assess left ventricular mass index and left ventricular relative wall thickness. An left ventricular mass index > the 95th percentile for age and gender, and an left ventricular relative wall thickness > 0.42, were used to diagnose left ventricular hypertrophy and concentric adaptation. Various echocardiographic parameters were compared between African Americans and Caucasians. RESULTS: The study included 422 patients (289 African Americans and 133 Caucasians) diagnosed with essential hypertension at a median age of 14.6 (interquartile range; 12.1-16.3) years. Eighty-eight patients (20.9%) had left ventricular hypertrophy. There was no statistically significant difference in the prevalence of left ventricular hypertrophy between African Americans and Caucasians (22.5% versus 17.3%, p=0.22). The median left ventricular relative wall thickness was 0.35 (0.29-0.43), and 114 patients (27.0%) had an left ventricular relative wall thickness > 0.42. The presence of an left ventricular relative wall thickness > 0.42 was significantly higher among African Americans compared to Caucasians (30.1% versus 20.3%, p = 0.04). The African American race was a strong predictor for an left ventricular relative wall thickness > 0.42 (odds ratio 1.7, p = 0.04), but not for left ventricular mass index > the 95th percentile (p = 0.22). Overweight/obesity was a strong predictor for an left ventricular mass index > the 95th percentile. CONCLUSIONS: There was no difference in the prevalence of left ventricular hypertrophy in children with essential hypertension of different races. Obesity, rather than being African American, is associated with left ventricular hypertrophy.

Evaluation of Scatterer Parameters From Ultrasound Scattering Models Taking Into Account Scattering From Nuclei and Cells of Cell-Pellet Biophantoms and Ex Vivo Tumors.

The Quantitative Ultrasound backscatter coefficient provides the capability to evaluate tissue microstructure parameters. Tissue-based scatterer parameters are extracted using ultrasound scattering models. It is challenging to correlate ultrasound scatterer parameters of tissue structures from optical-measured histology, possibly because of inappropriate scattering models or the presence of multiple scatterers. The objective of this study is to pursue the quantification of pertinent scatterer parameters with scattering models that consider ultrasound scattering from nuclei and cells. The concentric sphere model (CSM) and the structure factor model adapted for two types of scatterers (SFM2) are evaluated for cell-pellet biophantoms and ex vivo tumors of four cell lines: 4T1, JC, LMTK, and MAT. The structure factor model (SFM) was used for comparison. CSM and SFM2 provided scatterer parameters closer to histology (lower relative errors) for nucleus and cell radii and volume fractions than SFM but were not always accompanied by lower dispersion of the scatterer distribution (lower coefficient of variation). CSM and SFM2 quantified cell and nucleus radius and volume fraction parameters with lower relative error compared to SFM. For tumors, CSM provided better results than SFM2.

B2 and B3 glenoid osteoarthirtis: outcomes of corrective and concentric (C2) reaming of the glenoid combined with pyrocarbon hemiarthroplasty.

BACKGROUND: Posterior humeral subluxation (PHS) in B2 and B3 glenoid is a cause of asymmetric long-term stress on the glenoid and the potential reason for glenoid loosening in anatomic total shoulder arthroplasty and painful glenoid erosion in hemiarthroplasty with metallic heads. We hypothesized that corrective and concentric (C2) reaming of the glenoid associated with pyrocarbon hemiarthroplasty (HA-PYC) could improve the centering of the humeral head and decrease the risk of persistent painful glenoid erosion in young and active patients with B2 and B3 glenoid. METHODS: Between 2014 and 2020, 41shoulders (in 35 patients, mean age of 57.9 years) underwent HA-PYC combined with C2 reaming for B2 (n = 30) or B3 (n = 11) osteoarthritis. Patients were prospectively followed with computed tomography (CT) scans performed preoperatively, immediate postoperatively, and at last follow-up (>2 years). The primary outcomes were 3D-corrected CT scan measurements of glenoid version, PHS, and progression of glenoid erosion. Secondary outcomes included functional outcome scores, return to activities, and revision rate and complications. RESULTS: At a mean follow-up of 4.5 years (2-9.5 years), the prosthesis survival was 95% (39 of 41). No patient has been reoperated for painful glenoid erosion. The mean glenoid retroversion decreased from 17.1° ± 7.5° preoperatively to 8.3° ± 8.2° at last follow-up (P = .001), and the mean PHS from 74% to 56.5% (P = .001) based on the scapular plane and from 59.9% to 50.3% based on the glenoid plane. The humeral head was recentered in 97% according to the glenoid surface and 71% according to the scapular plane. Correction of PHS in the scapular plane was highly correlated to correction of glenoid retroversion (P < .001). CT scan measurements showed that the average total medialization was 3.7 ± 3.2 mm (2.0 ± 1.8 mm due to reaming and only 1.7 ± 2.4 mm due to erosion). The adjusted Constant Score increased from 43% ± 13% to 97% ± 16% and the Subjective Shoulder Value from 38% ± 14% to 84% ± 12% (P < .001). Overall, 84% of active patients returned to work, and all patients returned to sports. CONCLUSION: In B2 and B3 glenoid arthritis, corrective, concentric glenoid reaming combined with HA-PYC improves centering of the humeral head and shows a low risk of painful glenoid erosion at midterm follow-up. The combined procedure results in excellent functional outcomes and high prosthesis survivorship at midterm follow-up. HA-PYC and C2 reaming of the glenoid is an alternative shoulder arthroplasty for young/active patients with type B glenoid osteoarthritis who want to return to work or sports practice.

3D Shape Measurement of Aeroengine Blade Based on Fringe Projection Profilometer Improved by Multi-Layer Concentric Ring Calibration.

The precision requirements for aeroengine blade machining are exceedingly stringent. This study aims to improve the accuracy of existing aeroengine blade measurement methods while achieving comprehensive measurement. Therefore, this study proposes a new concentric ring calibration method and designs a multi-layer concentric ring calibration plate. The effectiveness of this calibration method was verified through actual testing of standard ball gauges. Compared with the checkerboard-grid calibration method, the average deviation of the multilayer concentric ring calibration method for measuring the center distance of the standard sphere is 0.02352, which improves the measurement accuracy by 3-4 times. On the basis of multi-layer concentric ring calibration, this study builds a fringe projection profiler based on the three-frequency twelve-step phase shift method. Compared with the CMM, the average deviation of the blade chord length measured by this solution is 0.064, which meets the measurement index requirements of aeroengine fan blades.

Conductive Hydrogel Tapes for Tripolar EEG: A Promising Solution to Paste-Related Challenges.

Electroencephalography (EEG) remains pivotal in neuroscience for its non-invasive exploration of brain activity, yet traditional electrodes are plagued with artifacts and the application of conductive paste poses practical challenges. Tripolar concentric ring electrode (TCRE) sensors used for EEG (tEEG) attenuate artifacts automatically, improving the signal quality. Hydrogel tapes offer a promising alternative to conductive paste, providing mess-free application and reliable electrode-skin contact in locations without hair. Since the electrodes of the TCRE sensors are only 1.0 mm apart, the impedance of the skin-to-electrode impedance-matching medium is critical. This study evaluates four hydrogel tapes' efficacies in EEG electrode application, comparing impedance and alpha wave characteristics. Healthy adult participants underwent tEEG recordings using different tapes. The results highlight varying impedances and successful alpha wave detection despite increased tape-induced impedance. MATLAB's EEGLab facilitated signal processing. This study underscores hydrogel tapes' potential as a convenient and effective alternative to traditional paste, enriching tEEG research methodologies. Two of the conductive hydrogel tapes had significantly higher alpha wave power than the other tapes, but were never significantly lower.

Tumefactive Demyelination Lesions: Report on three cases.

PURPOSE: Tumefactive demyelination (TD) lesion and its subtype Balo's concentric sclerosis (BCS), are rare manifestations of central nervous system demyelinating disease. Because of its rarity, physicians might hesitate in reaching a diagnosis or initiating steroid pulse therapy. This study aims at pinpointing the key neuroimaging features to distinguish TD lesions from surgical conditions, and illustrating the clinical outcomes of patients with TD lesions. CASE REPORT: Two of the three patients had solitary TD lesions, one 47-year-old man presenting with newly onset seizure and another 54-year-old women suffering from progressive hemiparesis. The male patient underwent craniotomy for mass excision without further steroid therapy, while the female patient received methylprednisolone pulse therapy only. Both patients remained free of clinical and radiological relapses over the past 6-7 years, leading to the diagnosis of clinically isolated syndrome. The third case is a 30-year-old woman with subacute onset of dysarthria and hemiparesis. She had two BCS lesions along with other demyelinating lesions in the juxtacortical and periventricular regions, cerebellar peduncles, and spinal cord, fulfilling dissemination in time and space. Her neurological deficits resolved after pulse therapy, and she received long-term disease modifying therapy for multiple sclerosis. CONCLUSION: This study underscores the diverse neuroimaging and clinical presentations of patients with TD lesions, and emphasizes the importance of clinical vigilance regarding this rare condition.

Left Ventricular Geometry and Inferior Vena Cava Diameter Co-Modify the Risk of Cardiovascular Outcomes in Chronic Hemodialysis Patients.

Background and Objectives: Left ventricular hypertrophy (LVH) represents a significant cardiovascular risk in patients undergoing chronic hemodialysis (CHD). A large inferior vena cava diameter (IVCD), potentially indicative of fluid overload and a contributing factor to elevated cardiovascular risk, has not been sufficiently explored. Therefore, our study aims to gain further insights into this aspect. Materials and Methods: A retrospective cohort study enrolled patients receiving CHD in a single medical center with available echocardiography from October to December 2018. They were categorized into four groups based on LVH geometry and IVCD. Cox proportional hazard models assessed the risk of major adverse cardiovascular effects (MACEs) and cardiovascular and overall mortality after multivariate adjustments. Kaplan-Meier analysis depicted MACE-free events and survival during the follow-up time. Results: Of the 175 CHD patients, 38, 42, 45, and 50 exhibited small IVCD with eccentric and concentric LVH and large IVCD with eccentric and concentric LVH, respectively. Compared to small IVCD and eccentric LVH, large IVCD and eccentric LVH had the highest risk of MACEs, followed by large IVCD and concentric LVH (aHR: 4.40, 3.60; 95% CI: 1.58-12.23, 1.28-10.12, respectively). As for cardiovascular mortality, large IVCD and concentric LVH had the highest risk, followed by large IVCD and eccentric LVH, and small IVCD and concentric LVH. (aHR: 14.34, 10.23, 8.87; 95% CI: 1.99-103.35, 1.41-74.33; 1.01-77.87). The trend in overall mortality risk among the groups was similar to that of cardiovascular mortality. Conclusions: LVH geometry and IVCD co-modify the risk of MACEs and cardiovascular and overall mortality in CHD patients. The highest risk of MACEs is associated with large IVCD and eccentric LVH, while the highest risk of cardiovascular and overall mortality is linked with large IVCD and concentric LVH.

Normative Standards for Isokinetic and Anthropometric Classifications of University-Level Netball Players.

CONTEXT: The purpose of the study was to develop normative ranges and standards for knee and shoulder isokinetic and anthropometric values. These standards can be qualitatively interpreted and allow practitioners to classify isokinetic and anthropometric values more objectively for university-level netball players. DESIGN: Posttest only observational study design. All players were only evaluated once during the in-season to generate normative ranges. METHODS: A total of 51 female players volunteered. Participants were evaluated on an isokinetic dynamometer at 60° per second to obtain knee-extensor and knee-flexor values as well as shoulder-flexor and shoulder-extensor values. A total of 16 anthropometric variables were collected including stature, body mass, 8 skinfolds, and 6 circumferences. Between-group differences were calculated to determine whether playing level was a differentiating factor in data. RESULTS: Normative standards were developed for isokinetic parameters associated with the knee and shoulder joints as well as skinfolds and circumference measures. No statistically significant between-group differences were evident (χ2Kruskal-Wallis[2] = 3.96, P = .140). CONCLUSION: These standards can be used by coaches and practitioners to set attainable goals for individual players or those from secondary leagues, classify individual and team-based performances, and facilitate decision-making processes.

The Role of Social Support in Concussion Rehabilitation: A Prospective Mixed Methods Study of Canadian University Athletes' Return to Sport.

CONTEXT: Social support is an important consideration during athletes' rehabilitation following a concussion. Yet, its influence during the return-to-sport (RTS) strategy has been underexplored. DESIGN: Concussed athletes' experiences with social support during RTS were explored prospectively using an explanatory sequential mixed methods design. METHODS: University rugby, basketball, and track and field athletes (N = 8) from a single Canadian institution, 19-23 years of age (mean = 20.63, SD = 1.51), completed concentric circles maps, the Perceived Available Support in Sport Questionnaire, and 2 semistructured interviews during their RTS. We analyzed concentric circles maps and questionnaire data descriptively and interview data using codebook thematic analysis. RESULTS: Athletes identified 16 different social support agents. The 5 most important agents during RTS were athletic therapists, student therapists, head coaches, significant others, and teammates/friends. Significant others provided the most emotional (mean = 2.82, SD = 1.85) and esteem (mean = 2.63, SD = 1.85) support, and the athletic therapist (mean = 1.82, SD = 1.35) and head coaches (mean = 0.93, SD = 1.19) provided the most informational and tangible support. We generated 4 themes from athletes' interviews: social support behaviors, contextual factors, concussion and RTS factors, and psychological readiness factors. CONCLUSIONS: The number of social support agents present, frequency of support types, and demonstration of support behaviors decreased across the concussion RTS strategy. Contextual (ie, toughness), concussion (ie, visibility), and RTS (ie, prognosis uncertainty) factors influenced athletes' perceptions of social support agents' support behaviors. Results add to our limited understanding of athletes' social support during RTS following a concussion and suggest exploring the integration of behavior-specific (eg, checking in, providing reassurance, and demonstrating compassion) social support strategies to promote concussion rehabilitation and readiness to RTS.