Goalkeepers benefit from using deceptive actions in the soccer penalty kick.

Most studies on deception in soccer penalty kicks have focused on the deceptive actions used by penalty takers. However, it is worth noting that deception can also be played out by goalkeepers. To examine the effectiveness of goalkeepers' deceptive actions in professional competition, we analysed 714 penalty kicks taken during matches in the English Premier League and German Bundesliga, spanning the seasons from 2016-2017 to 2019-2020. We scored whether goalkeepers used deception, and if so, what type of deception, the outcome of the penalty and the kicking strategy of the penalty taker. The results showed that goalkeepers used deception in half of the penalty kicks, resulting in significantly less goals compared to penalties without deception. This advantage was similar for the different types of deception, but larger when penalty takers paid attention to goalkeepers. We propose that the deceptive actions by goalkeepers are effective, mainly because it leads the penalty taker to lose focus. The practical implications of these findings are discussed for both goalkeepers and penalty takers.

The Complex Dysregulations of CD4 T Cell Subtypes in HIV Infection.

Human immunodeficiency virus (HIV) infection remains an important global public health problem. About 40 million people are infected with HIV, and this infection caused about 630,000 deaths in 2022. The hallmark of HIV infection is the depletion of CD4+ T helper lymphocytes (Th cells). There are at least seven different Th subtypes, and not all are the main targets of HIV. Moreover, the effect of the virus in a specific subtype can be completely different from that of the others. Although the most compromised Th subtype in HIV infection is Th17, HIV can induce important dysregulations in other subtypes, such as follicular Th (Tfh) cells and regulatory Th cells (Treg cells or Tregs). Several studies have shown that HIV can induce an increase in the immunosuppressive activity of Tregs without causing a significant reduction in their numbers, at least in the early phase of infection. The increased activity of this Th subtype seems to play an important role in determining the immunodeficiency status of HIV-infected patients, and Tregs may represent a new target for innovative anti-HIV therapies, including the so-called "Kick and Kill" therapeutic method whose goal is the complete elimination of the virus and the healing of HIV infection. In this review, we report the most important findings on the effects of HIV on different CD4+ T cell subtypes, the molecular mechanisms by which the virus impairs the functions of these cells, and the implications for new anti-HIV therapeutic strategies.

What do we know about beach soccer injuries? Systematic video analysis of four consecutive years with 580 match injuries.

The aim of the present study was to evaluate the characteristics of match injury in male beach soccer players. Video recordings of all official beach soccer tournaments in which the European national male beach soccer teams participated from 2018 to 2021 were analysed by two sports medicine specialists retrospectively. Regarding each injury, data including the mechanism, location of the injury, whether the injury led to time-loss, and the relationship of the injury to the bicycle kick (BK), etc. were documented. A total of 632 injuries were documented, corresponding to 234.9 injuries/1000 player hours. Video footage was available for 580 injuries. Whilst 79.8% of medical attention injuries occurred due to opponent contact, 19.5% of time-loss injuries occurred due to non-contact, and 12.2% of indirect opponent contact (p < 0.01). The most common location of the BK related injury was the head/neck (68.7%), whereas most common location of the BK unrelated injury was the lower extremity (54.1%) (p < 0.01). The findings demonstrated that beach soccer injury incidence was quite high; the most common injury location was head/neck and head/neck injuries were associated with BK. In light of these results, some rule regulations, particularly those associated with BK, and the use of protective equipment should be considered to prevent these injuries.

Sustainable Antiviral Efficacy of Rejuvenated HIV-Specific Cytotoxic T Lymphocytes Generated from Induced Pluripotent Stem Cells.

Persistence of HIV latently infected cells is a barrier to HIV cure. The "kick and kill" strategy for a cure includes clearance of the viral reservoir by HIV-specific cytotoxic T lymphocytes (CTLs). However, exhaustion and senescence of T cells accelerates during HIV infection, and does not fully recover, despite complete viral suppression under antiretroviral therapy. We previously established an induced pluripotent stem cell (iPSC) from a parental HIV-specific CTL clone and generated an iPSC-derived rejuvenated HIV-specific CTL clone (iPSC-CTL), which exhibited an early memory phenotype, high proliferation capacity and effector functions in vitro. Here, we assessed the antiviral efficacy of the HIV-specific iPSC-CTL by single- and multiple-round viral suppression assays (VSAs). The HIV-specific iPSC-CTL suppressed viral replication in an HLA-dependent manner with equivalent efficacy to the parental CTL clone in single-round VSA. In multiple-round VSA, however, the ability of the iPSC-CTL to suppress viral replication was longer than that of the parental CTL clone. These results indicate that HIV-specific iPSC-CTL can sustainably exert suppressive pressure on viral replication, suggesting a novel approach to facilitate clearance of the HIV reservoir via adoptive transfer of rejuvenated CTLs. IMPORTANCE Elimination of latently HIV-infected cells is required for HIV cure. In the "kick and kill" strategy proposed for a cure to HIV, the host immune system, including HIV-specific cytotoxic T lymphocytes (CTLs), play a central role in eliminating HIV antigen-expressing cells following reactivation by latency-reversing agents (LRAs). However, CTL dysfunction due to exhaustion and senescence in chronic HIV infection can be an obstacle to this strategy. Adoptive transfer with effective HIV-specific CTLs may be a solution of this problem. We previously generated an induced pluripotent stem cell (iPSC)-derived rejuvenated HIV-specific CTL clone (iPSC-CTL) with high functional and proliferative capacity. The present study demonstrates that iPSC-CTL can survive and suppress HIV replication in vitro longer than the parental CTL clone, indicating the potential of iPSC-CTL to sustainably exert suppressive pressure on viral replication. Adoptive transfer with rejuvenated HIV-specific CTLs in combination with LRAs may be a new intervention strategy for HIV cure/remission.

Comparison of characteristics of kick- and electric-scooter-related dental and maxillofacial injuries: A retrospective study.

BACKGROUND/AIM: Owing to the nearly three-year-long COVID-19 pandemic, small personal transportation devices that allow for greater freedom of movement within the cities have gained attention. Therefore, the number of people using kick or electric scooters has increased. This study aimed to compare the characteristics of kick and electric scooter-related dental and maxillofacial trauma and provide helpful information for preventing scooter accidents, appropriate treatment of patients with scooter-related trauma, and policy establishment. MATERIALS AND METHODS: This retrospective observational study analysed the medical records of 310 patients who visited the emergency room of Ajou University Dental Hospital for kick and electric scooter-related oral and maxillofacial injuries between 1 January 2017 and 31 December 2022. Sex, age, scooter type, time, and mechanism of the accident, helmet use, alcohol consumption, dental and maxillofacial injury types, and treatment were analysed. RESULTS: The average age in the kick-scooter group (5.71 ± 4.25) was lower than that in the electric-scooter group (28.24 ± 10.02) (p < .0001). There were more males in both groups. The helmet usage rates of the two groups were 2.80% and 7.88%, respectively. In the kick-scooter group, periodontal damage was more common than pulp injury, while in the electric-scooter group, pulp injury was more common than periodontal injury. There was no significant difference in soft-tissue damage between the two groups; however, bone fractures occurred significantly more frequently in the electric-scooter group (p < .0001). CONCLUSIONS: Electric scooters cause more crown and bone fractures than kick scooters and require more active treatment of dental and maxillofacial injuries. Riders should use protective equipment to prevent dental and maxillofacial injury. Although there are regulations related to scooters, the effectiveness of both kick- and electric-scooter related laws needs to be evaluated.

General Model for Defect Dynamics in Ionizing-Irradiated SiO2 -Si Structures.

Irradiation damage is a key issue for the reliability of semiconductor devices under extreme environments. For decades, the ionizing-irradiation-induced damage in transistors with silica-silicon (SiO2 -Si) structures at room temperature has been modeled by a uniform generation of E'γ centers in the bulk silica region through the capture of irradiation-induced holes, and an irreversible conversion from E'γ to Pb centers at the SiO2 /Si interface through reactions with hydrogen molecules (H2 ). However, the traditional model fails to explain experimentally-observed dose dependence of the defect concentrations, especially at low dose rate. Here, it is proposed that the generation of E'γ centers is decelerated because the holes migrate dispersively in disordered silica and the diffusion coefficient decays as the irradiation goes on. It is also proposed that the conversion between E'γ and Pb centers is reversible because the huge activation energy of the reverse reaction can be reduced by a "phonon-kick" effect of the vibrational energy of H2 and Pb centers transferred from nearby nonradiative recombination centers. Experimental studies are carried out to demonstrate that the derived analytic model based on these two new concepts can consistently explain the fundamental but puzzling dose dependence of the defect concentrations for an extremely wide dose rate range.

Selective BCL-XL Antagonists Eliminate Infected Cells from a Primary-Cell Model of HIV Latency but Not from Ex Vivo Reservoirs.

HIV persists, despite immune responses and antiretroviral therapy, in viral reservoirs that seed rebound viremia if therapy is interrupted. Previously, we showed that the BCL-2 protein contributes to HIV persistence by conferring a survival advantage to reservoir-harboring cells. Here, we demonstrate that many of the BCL-2 family members are overexpressed in HIV-infected CD4+ T cells, indicating increased tension between proapoptotic and prosurvival family members-and suggesting that inhibition of prosurvival members may disproportionately affect the survival of HIV-infected cells. Based on these results, we chose to study BCL-XL due to its consistent overexpression and the availability of selective antagonists. Infection of primary CD4+ T cells with HIV resulted in increased BCL-XL protein expression, and treatment with two selective BCL-XL antagonists, A-1155463 and A-1551852, led to selective death of productively infected CD4+ T cells. In a primary cell model of latency, both BCL-XL antagonists drove reductions in HIV DNA and in infectious cell frequencies both alone and in combination with the latency reversing agent bryostatin-1, with little off-target cytotoxicity. However, these antagonists, with or without bryostatin-1 or in combination with the highly potent latency reversing agent combination phorbol myristate acetate (PMA) + ionomycin, failed to reduce total HIV DNA and infectious reservoirs in ex vivo CD4+ T cells from antiretroviral therapy (ART)-suppressed donors. Our results add to growing evidence that bona fide reservoir-harboring cells are resistant to multiple "kick and kill" modalities-relative to latency models. We also interpret our results as encouraging further exploration of BCL-XL antagonists for cure, where combination approaches, including with immune effectors, may unlock the ability to eliminate ex vivo reservoirs. IMPORTANCE Although antiretroviral therapy (ART) has transformed HIV infection into a manageable chronic condition, there is no safe or scalable cure. HIV persists in "reservoirs" of infected cells that reinitiate disease progression if ART is interrupted. Whereas most efforts to eliminate this reservoir have focused on exposing these cells to immune-mediated clearance by reversing viral latency, recent work shows that these cells also resist being killed. Here, we identify a "prosurvival" factor, BCL-XL, that is overexpressed in HIV-infected cells, and demonstrate selective toxicity to these cells by BCL-XL antagonists. These antagonists also reduced reservoirs in a primary-cell latency model but were insufficient to reduce "natural" reservoirs in ex vivo CD4+ T cells-adding to growing evidence that the latter are resilient in a way that is not reflected in models. We nonetheless suggest that the selective toxicity of BCL-XL antagonists to HIV-infected cells supports their prioritization for testing in combinations aimed at reducing ex vivo reservoirs.

Injuries from nonmotorized scooters treated in emergency departments in the United States, 2005-2020.

BACKGROUND: In the past decade scholarly attention has shifted away from examining injuries from nonmotorized scooters to injuries from electric scooters. This has resulted in a knowledge gap concerning current levels of injury due to the use of nonmotorized scooters. This study presents recent trend data and demographics of patients treated for injuries from nonmotorized scooters in US Emergency Departments (EDs) from 2005 to 2020. METHODS: The study examines data from a probability sample of hospitals with an ED under the auspices of the National Electronic Injury Surveillance System (NEISS). NEISS generates annual national estimates of the incidence of injuries related to nonmotorized scooters. The NEISS data set includes demographic and diagnostic information about each patient as well as a narrative surrounding the circumstances surrounding the injury. RESULTS: Injuries from unpowered scooters in the United States have undergone a decline in the past decade. However, as data from this study reveals, injuries from nonmotorized scooters still constitute a substantial source of morbidity in the United States, totaling approximately 40,000 annually. Males and children in the age group 5 to 9 were found to be most likely to be injured. The most frequent type of diagnosis was "fracture" (26.4%), followed by "contusions/abrasions" (21.7%) and "laceration" (21.4%). The most common site of injury was the head, neck, or face (32%), followed in descending order by the forearm (28%), the leg (17.3%), the arm (9.8%), and the thigh (7.7%). The gender disparity in injuries to the head region was particularly pronounced. Among those who sustained a head or facial injury, more than two-thirds (68.6%) were male and this disparity persists even when controlling for age. Over time, the geographic location of injuries has shifted downwards from the home and increased in "places or recreation or sport" or "other public places." CONCLUSIONS: Injuries from nonmotorized in the United States are still sizeable in number and can be prevented by greater use of protective equipment. Injuries predominate among males and children in the age category of 5 to 9.

Incidence and factors related to nonmotorized scooter injuries in New York State and New York City, 2005-2020.

BACKGROUND: This study provides an analysis of contemporary trends and demographics of patients treated for injuries from nonmotorized scooters in emergency departments in New York state excluding New York City (NYS) and New York City (NYC). METHODS: The study tracks the incidence of nonmotorized scooter injuries in NYS and NYC from 2005 to 2020 and furnishes a detailed profile of the injured patients using patient-level records from the Statewide Planning and Research Cooperative System (SPARCS). A negative binomial regression analysis is performed on the SPARCS data to measure the simultaneous effects of demographic variables on scooter injuries for NYS and NYC. The study also examines the demographic correlates of the rate of injuries at the neighborhood level in NYC. A thematically shaded map of the injury rates in New York City neighborhoods is created to locate neighborhoods with greater concentrations of injuries and to identify the reasons which might account for their higher rate of injuries, such as street infrastructure. RESULTS: In NYS and NYC injuries from unpowered scooters underwent an overall decline in the past decade. However, both NYS and NYC are now evidencing an increase in their rates. The upswing in the rate in NYC in 2020 is particularly noticeable. Males and children in the age group 5 to 9 were found to be most susceptible to injury. Injuries were more prevalent in more affluent New York City neighborhoods. A map of the injury rates in the City's neighborhoods revealed a clustering of neighborhoods with higher than average injury rates. CONCLUSIONS: Injuries from nonmotorized scooters number approximately 40,000 annually in the US and can be prevented by greater use of protective equipment. Street infrastructure is a critical factor contributing to injuries from the use of nonmotorized scooters. Thematically shaded maps can be used to identify and target areas for purposes of intervention.

Electric Scooter-Related Trauma in Korea.

BACKGROUND: The number of users of electric scooters, which provide swift and convenient mobility options, has increased sharply over recent years as their distribution as a shared service has expanded. Although the number of accidents and related damage has increased accordingly, limited research has analyzed data on the new types of accidents arising from electric scooters. This study aimed to analyze data on trauma characteristics due to accidents that occurred during electric scooter use. METHODS: A retrospective chart review was conducted for patients who visited the regional trauma center of our institute due to electric scooter accidents from April 2018 to October 2021. Information was extracted on helmet-wearing status, sex, age, drinking status, accident timeframe, accident mechanism, electric scooter proficiency (period of use), injury severity, severe trauma, lethality, admission to the intensive care unit, surgery under general anesthesia, and the trauma region. RESULTS: Among the 108 patients involved in electric scooter accidents, 92 patients were not wearing a helmet. Eighty-nine patients (85.2%) were male. The average age of the patients without a helmet was 31.3 years, while that of patients with a helmet was 34.1 years. The most frequent causes of accidents were lack of electric scooter operation experience and falling off the scooter due to obstacles (90 cases). Whether surgery was performed under general anesthesia was not associated with helmet use or non-use, although all patients who underwent facial fracture surgery were not wearing a helmet. CONCLUSION: The craniofacial region was most frequently affected in electric scooter accidents and wearing a helmet was the best way to prevent craniofacial trauma. Although helmet-wearing is mandatory, the majority of treated patients were not wearing a helmet at the time of injury. Thus, there is an urgent need to introduce a helmet rental system, as well as strict legal requirements, to improve this situation.

The determinant factors of undulatory underwater swimming performance: A systematic review.

The prominence of undulatory underwater swimming (UUS) has been clearly observed during recent international events. Improvement of this phase is important for overall performance. The aim of this systematic review was to identify the key factors that modulate UUS performance and provide coaches and sports science practitioners with valuable and practical information to optimise it. PubMed, Web of Science, Scopus, and SPORTDiscus databases were searched up to 14 October 2021. Studies involving competitive swimmers and which included UUS performance assessment were considered. Methodological quality assessment was conducted for the included articles. From the 193 articles screened, 15 articles were included. There was a substantial body of research conducted on kicking frequency, vertical toe and body wave velocity, angular velocity of the joints, distance per kick, joint amplitudes and mobility, and body position in UUS performance. However, further investigation is required for muscle activation and muscle strength influence. The results from this review contribute to understanding of how to optimise UUS performance, identifying the key aspects that must be addressed during training. Specifically, the caudal momentum transfer should be maximised, the upbeat duration reduced, and the frequency that best suits swimmers' characteristics should be identified individually.

The effect of a high-pressure protocol on penalty shooting performance, psychological, and psychophysiological response in professional football: A mixed methods study.

The penalty kick in soccer is arguably one of the most highly visible and high-pressured sporting situations in the world. This study examined the effect of a high-pressure protocol on penalty shooting performance, and the associated psychological and psychophysiological responses to, and perceptions of that protocol. A sequential mixed-method research design was employed wherein  the experimental condition consisted of a repeated-measures design with pressure as the within-participants factor (low-pressure, high-pressure). Quantitative data collection was complemented with a semi-structured interview. Twenty professional footballers took part. The Immediate Anxiety Measurement Scale (IAMS) and Pressure Likert-type scale were administered prior to both conditions. The NeXus-10 biofeedback system recorded players' heart rate and respiration rate. Outfield players took five penalty kicks to four targets to the goal, under low and high-pressure. Pressure, cognitive anxiety, and respiration rate significantly increased in the high-pressure condition. After controlling for the level of pressure experienced in the high-pressure condition, bivariate variable error performance significantly increased (i.e., players were more variable in their grouping of shots under stress). Qualitative data indicated the 6-step high-pressure protocol predominantly evoked the distraction mechanism. This research provided first insight into the experiences of professional footballers to a simulated high-pressure penalty protocol.

Development of an Inertial Sensor Module for Categorizing Anomalous Kicks in Taekwondo and Monitoring the Level of Impact.

In this study, an inertial measurement unit (IMU) sensor module and software algorithm were developed to identify anomalous kicks that should not be given scores in Taekwondo competitions. The IMU sensor module was manufactured with dimensions of 3 cm × 3 cm × 1.5 cm and consists of a high-g sensor for high acceleration measurement, a 9-DOF sensor, and a Wi-Fi module for wireless communication. In the experiment, anomalous kicks and normal kicks were collected by the IMU sensor module, and an AI model was trained. The anomalous kick determination accuracy of the trained AI model was found to be 97.5%. In addition, in order to check whether the strength of a blow can be distinguished using the IMU sensor module, an impact test was performed with a pendulum under the same test conditions as the impact sensor installed in the impact test setup, and the correlation coefficient was 0.99. This study is expected to contribute to improving scoring reliability by suggesting the possibility of discriminating anomalous kicks, which were difficult to judge in Taekwondo competitions, through the analysis of Taekwondo kicks using inertial data and impulses.

Adjusted Landing Technique Reduces the Load on the Achilles Tendon in Badminton Players.

Achilles tendon (AT) rupture is common among recreational male badminton players. We hypothesize that a landing technique following forehand jump strokes with the landing foot in a neutral position often performed by recreational players and occasionally by elite players may expose the AT to higher loads than a scissor kick jump (SKJ) technique with the leg/foot externally rotated. The study aimed to investigate if recreational players could reduce the load in the AT when adopting the SKJ technique compared to their habitual landing technique with the foot in a neutral position and secondarily to compare the AT force between recreational players and elite players. Ten recreational male players performed simulated jump strokes in a biomechanical laboratory using both their original technique and the SKJ technique traditionally used by elite players. For comparison reasons ten elite players performed SKJs. Landing kinematics and AT forces were captured and calculated using 3D movement analysis. The landing leg was more externally rotated in the recreational players' adjusted technique (78 ± 10 degrees, p < 0.001) compared to 22 ± 21 degrees in recreational players' original technique. The peak AT force of the recreational players was significantly higher for the original technique compared to the adjusted technique (68 ± 19 N/kg vs. 50 ± 14 N/kg, p = 0.005). Additionally, the peak AT forces observed during the recreational players' original technique was higher, though not significantly, than those observed for elite players (55 ± 11 N/kg, p = 0.017). / = 0.016 due to a Bonferroni correction. These findings indicate that recreational badminton players that normally land with the foot in a neutral position, may reduce their AT load by 25% when adopting the SKJ technique of elite players and land with the leg/foot in an externally rotated position.

Latency Reversing Agents: Kick and Kill of HTLV-1?

Human T-cell leukemia virus type 1 (HTLV-1), the cause of adult T-cell leukemia/lymphoma (ATLL), is a retrovirus, which integrates into the host genome and persistently infects CD4+ T-cells. Virus propagation is stimulated by (1) clonal expansion of infected cells and (2) de novo infection. Viral gene expression is induced by the transactivator protein Tax, which recruits host factors like positive transcription elongation factor b (P-TEFb) to the viral promoter. Since HTLV-1 gene expression is repressed in vivo by viral, cellular, and epigenetic mechanisms in late phases of infection, HTLV-1 avoids an efficient CD8+ cytotoxic T-cell (CTL) response directed against the immunodominant viral Tax antigen. Hence, therapeutic strategies using latency reversing agents (LRAs) sought to transiently activate viral gene expression and antigen presentation of Tax to enhance CTL responses towards HTLV-1, and thus, to expose the latent HTLV-1 reservoir to immune destruction. Here, we review strategies that aimed at enhancing Tax expression and Tax-specific CTL responses to interfere with HTLV-1 latency. Further, we provide an overview of LRAs including (1) histone deacetylase inhibitors (HDACi) and (2) activators of P-TEFb, that have mainly been studied in context of human immunodeficiency virus (HIV), but which may also be powerful in the context of HTLV-1.

Persistent Intracranial Hypertension in a Cranial Vault Remodeling Patient With Open Skull Fractures From Horse Kick.

A 4-year-old female with prior cranial vault remodeling for nonsyndromic bilateral coronal craniosynostosis sustained a severe traumatic brain injury with open skull fractures from a horse kick. Her post-traumatic course was complicated by persistently elevated intracranial pressure despite neurosurgical decompressions, maximum medical therapy, and trial of multiple pressure monitoring devices. She eventually had improvement in her intracranial pressures and made a full neurologic recovery. This case highlights the potential severity of horse kick injuries, the possible etiology of persistent intracranial hypertension in cranial vault remodeling patients following traumatic brain injury, the importance of a multi-team approach in the initial evaluation and postoperative follow-up of all craniosynostosis patients, and the necessity of helmet utilization.

Visual Strategies Underpinning the Spatiotemporal Demands During Visuomotor Tasks in Predicting Ball Direction.

We investigated gaze behavior of expert goalkeepers during the prediction of penalty kicks in different spatiotemporal constraints: penalties taken from 11 and 6 m. From 11 m, goalkeepers were more successful in predicting ball direction, with longer movement time initiation and a visual strategy with more fixations and greater saccade rates than penalties from 6 m, where they exhibited fewer fixations with higher microsaccade rates. As long as the opponent's distance is large and time pressure low, gaze can be frequently shifted between the kicker's body and the ball, due to the low cost of saccades. Conversely, when the objects are close, there is increased reliance on foveal and parafoveal information. In conclusion, when the spatiotemporal constraint is less severe, goalkeepers adopt a visual strategy with more fixations and small saccades. When the spatiotemporal constraint is more severe, they rely on peripheral vision to monitor kickers' movements through the use of microsaccades.

[Support for innovation at the BfArM-experiences from the consultations on digital health applications (DiGA)]. / Innovationsunterstützung im BfArM ­ Erfahrungen aus den Beratungen zu digitalen Gesundheitsanwendungen (DiGA).

Since May 2020, manufacturers have been able to submit an application to the Federal Institute for Drugs and Medical Devices (BfArM) for the inclusion of a digital health application (DiGA) in the directory pursuant to section 139e of the German Social Code Book V. This new application procedure is based on specific requirements and assessment parameters for which a large number of procedural and scientific questions arise on the side of the manufacturers.In order to meet this need, the BfArM has specifically expanded its established information and advisory services for these new questions. This article describes in detail what these are in relation to DiGA, where the corresponding information and documents can be found and what distinguishes them in each case. Furthermore, with a view to the counselling interviews conducted between May 2020 and April 2021, their influence on the outcome of the respective application procedure for inclusion in the DiGA directory is analysed. This confirms that the early discussion of parameters relevant to the evaluation and the consideration of the advisory recommendations correlate with a positive evaluation result. For the DiGA listed in the directory, 80% of the manufacturers had previously received advice from the BfArM. The rate of withdrawn or rejected applications, on the other hand, was significantly higher if manufacturers had not previously sought advice from the BfArM in advance compared to manufacturers who discussed key aspects (63% vs. 35%). Overall, all sides benefit from the early, intensive exchange - in the end especially the patients through introduction of DiGA into standard healthcare due to higher application quality without delay.

Interjoint Coordination in Kicking a Moving Target: A Comparison Between Elite and Nonelite Taekwondo Players.

Patterns of interjoint coordination in the kicking legs of taekwondo players were investigated to understand movement pattern variability as a functional property of skill level. Elite and nonelite players performed roundhouse kicks against a custom-built moving target fitted with an accelerometer, and movements were recorded by motion capture. Average foot segment velocities of 13.6 and 11.4 m/s were recorded for elite and nonelite players, respectively (P < .05), corresponding to target accelerations of 87.5 and 70.8g (P < .05). Gradient values derived from piecewise linear regression of continuous relative phase curves established the comparative incoordination of nonelite taekwondo players in the form of an overshoot behavior during the crucial period leading to target impact (P < .05). This overshoot was apparent in both knee-hip and ankle-knee continuous relative phase curves. Elite players generated greater limb speed and impact force through more effective limb segment coordination. The combination of continuous relative phase and piecewise linear regression techniques allowed identification of alternate joint control approaches in the 2 groups.

Effects of Knee Injury Length on Jump Inside Kick Performances of Wushu Player.

Background and Objectives: When performing the jump inside kick in Wushu, it is important to understand the rotation technique while in mid-air. This is because the score varies according to the mid-air rotation, and when landing after the mid-air rotation, it causes considerable injury to the knee. This study aimed to compare the differences in kinematic and kinetic variables between experienced and less experienced knee injuries in the Wushu players who perform 360°, 540°, and 720° jump inside kicks in self-taolu. Materials and Methods: The participants' mean (SD) age was 26.12 (2.84) years old. All of them had suffered knee injuries and were all recovering and returning to training. The group was classified into a group with less than 20 months of injury experience (LESS IG, n = 6) and a group with more than 20 months of injury experience (MORE IG, n = 6). For kinematic measurements, jump inside kicks at three rotations were assessed by using high-speed cameras. For kinetic measurements, the contraction time and maximal displacement of tensiomyography were assessed in the vastus lateralis, vastus medialis, rectus femoris, biceps femoris, gastrocnemius lateralis, gastrocnemius medialis, and tibialis anterior. The peak torque, work per repetition, fatigue index, and total work of isokinetic moments were assessed using knee extension/flexion, ankle inversion/eversion, and ankle plantarflexion/dorsiflexion tests. Results: Although there was no difference at the low difficulty level (360°), there were significant differences at the higher difficulty levels (540° and 720°) between the LESS IG and the MORE IG. For distance and time, the LESS IG had a shorter jump distance, but a faster rotation time compared to those in the MORE IG. Due to the characteristics of the jump inside kick's rotation to the left, the static and dynamic muscle contractility properties were mainly found to be higher in the left lower extremity than in the right lower extremity, and higher in the LESS IG than in the MORE IG. In addition, this study observed that the ankle plantarflexor in the LESS IG was significantly higher than that in the MORE IG. Conclusion: To become a world-class self-taolu athlete while avoiding knee injuries, it is necessary to develop the static and dynamic myofunctions of the lower extremities required for jumping. Moreover, it is considered desirable to train by focusing on the vertical height and the amount of rotation during jumping.