Tactical skills and ball speed during a field simulation of penalty kick strategies in soccer.

This study investigates the efficacy of intermediate penalty kickers by comparing the effect of applying an automated WiFi system on the field of play to simulate a strategy that takes account of goalkeeper action (dependent) with another for which goalkeeper strategy is irrelevant (independent). Intermediate penalty kickers (n=12) took a pretreatment test of 32 kicks in a "real-play" situation with intermediate goalkeepers (n=3). Two groups of kickers underwent 11 treatment sessions using different strategies and then were administered a posttreatment test. The variables measured were the number of goals scored, whether the direction of the shot was the same or different from the direction of the goalkeeper's move (DDG), ball speed, and the duration of the kicking movement. Data suggested the goalkeepers had a greater capacity to identify advance cues when faced with independent strategy kickers and that dependent strategy kickers achieved lower ball speeds.

Real-time prediction of mediastinal lymph node malignancy by endobronchial ultrasound.

OBJECTIVE: To evaluate the utility of different ultrasonographic (US) features in differentiating benign and malignant lymph node (LN) by endobronchial ultrasound (EBUS) and validate a score for real-time clinical application. METHODS: 208 mediastinal LN acquired from 141 patients were analyzed. Six different US criteria were evaluated (short axis ≥10 mm, shape, margin, echogenicity, and central hilar structure [CHS], and presence of hyperechoic density) by two observers independently. A simplified score was generated where the presence of margin distinction, round shape and short axis ≥10 mm were scored as 1 and heterogeneous echogenicity and absence of CHS were scored as 1.5. The score was evaluated prospectively for real-time clinical application in 65 LN during EBUS procedure in 39 patients undertaken by two experienced operators. These criteria were correlated with the histopathological results and the sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated. RESULTS: Both heterogenicity and absence of CHS had the highest sensitivity and NPV (≥90%) for predicting LN malignancy with acceptable inter-observer agreement (92% and 87% respectively). On real-time application, the sensitivity and specificity of the score >5 were 78% and 86% respectively; only the absence of CHS, round shape and size of LN were significantly associated with malignant LN. CONCLUSIONS: Combination of different US criteria can be useful for prediction of mediastinal LN malignancy and valid for real-time clinical application.

Molecular mechanisms of inflammation during exacerbations of chronic obstructive pulmonary disease.

INTRODUCTION: Exacerbations of chronic obstructive pulmonary disease (COPD) are characterised by an inflammatory and systemic response that persists for some time after their clinical resolution. The mechanisms of this inflammatory process are not well known. OBJECTIVES: To explore the inflammatory changes and possible mechanisms during COPD exacerbation. METHODS: We determined the inflammatory cell concentrations in blood and sputum, nitric oxide in exhaled air (FeNO), C-reactive protein (CRP) in plasma, cytokines (IL-6, 8, 1ß, 10, 12, TNF-α) and SLPI (leukocyte protease inhibitor) and total antioxidant status (TAS) in blood and sputum, the activity of nuclear kappa B factor (NF-κ B) and of the histone deacetylase enzyme (HDAC) in 17 patients during COPD exacerbation and in stable phase, as well as in 17 smoker and 11 non-smoker controls. RESULTS: COPD exacerbations are characterised by high levels of FeNO (p<0.05), plasma CRP (p<0.001) and IL-8, IL-1B, IL-10 in sputum (p<0.05) greater activation of NF-κ appaB in sputum macrophages compared with stable COPD and controls. During the stable phase, there continue to be high levels of oxidative stress, SLPI, IL-8, IL-6 and TNF-alfa, with no observed changes in either HDAC activity or in the amount of neutrophils in sputum, despite presenting a significant improvement (p<0.05) in lung function. CONCLUSIONS: Changes were observed in different pulmonary and systemic inflammatory markers during COPD exacerbation, which did not completely resolve during stable phase. However, current treatment does not allow for HDAC activity to be modified, which limits its anti-inflammatory effects.