The discriminant validity of standardised testing battery and its ability to differentiate anthropometric and physical characteristics between youth, academy and senior professional rugby league players

Accepted author manuscript version reprinted, by permission, from International Journal of Sports Physiology and Performance, 2019 (ahead of print). © Human Kinetics, Inc.Purpose: To assess a standardised testing battery’s ability to differentiate anthropometric and physical qualities between youth, academy and senior rugby league players, and determine the discriminant validity of the battery. Methods: A total of 729 rugby league players from multiple clubs within England categorised as youth (n = 235), academy (n = 362) and senior (n = 132) players completed a standardised testing battery that included the assessment of anthropometric and physical characteristics during preseason. Data was analysed using magnitude-based inferences and discriminant analysis. Results: Academy players were most likely taller and heavier than youth players (effect size (ES) = 0.64 to 1.21), with possibly to most likely superior CMJ, medicine ball throw and prone Yo-Yo IR1 performance (ES = 0.23 to 1.00). Senior players were likely to most likely taller and heavier (ES = 0.32 to 1.84), with possibly to most likely superior 10 and 20 m sprint times, CMJ, CoD, medicine ball throw and prone Yo-Yo IR1 compared to youth and academy (ES = -0.60 to 2.06). The magnitude of difference appeared to be influenced by playing position. For the most part, the battery possessed discriminant validity with an accuracy of 72.2%. Conclusion: The standardised testing battery differentiates anthropometric and physical qualities of youth, academy and senior players as a group and, in most instances, within positional groups. Furthermore, the battery is able to discriminate between playing standards with good accuracy and might be included in future assessments and rugby league talent identification

Pacing during a cross-country mountain bike mass-participation event according to race performance, experience, age and sex.

This is an Accepted Manuscript of an article published by Taylor & Francis in European Journal of Sport Science on 15-12-18, available online: https://doi.org/10.1080/17461391.2018.1552722This study describes pacing strategies adopted in an 86-km mass-participation cross-country marathon mountain bike race (the 'Birkebeinerrittet'). Absolute (km·h ) and relative speed (% average race speed) and speed coefficient of variation (%CV) in five race sections (15.1, 31.4, 52.3, 74.4 and 100% of total distance) were calculated for 8182 participants. Data were grouped and analysed according to race performance, age, sex and race experience. The highest average speed was observed in males (21.8 ± 3.7 km/h), 16-24 yr olds (23.0 ± 4.8 km/h) and those that had previously completed >4 Birkebeinerrittet races (22.5 ± 3.4 km/h). Independent of these factors, the fastest performers exhibited faster speeds across all race sections, whilst their relative speed was higher in early and late climbing sections (Cohen's d = 0.45-1.15) and slower in the final descending race section (d = 0.64-0.98). Similar trends were observed in the quicker age, sex and race experience groups, who tended to have a higher average speed in earlier race sections and a lower average speed during the final race section compared to slower groups. In all comparisons, faster groups also had a lower %CV for speed than slower groups (fastest %CV = 24.02%, slowest %CV = 32.03%), indicating a lower variation in speed across the race. Pacing in a cross-country mountain bike marathon is related to performance, age, sex and race experience. Better performance appears to be associated with higher relative speed during climbing sections, resulting in a more consistent overall race speed

Early Initiation of Antiretroviral Therapy Preserves the Metabolic Function of CD4+ T Cells in Subtype C Human Immunodeficiency Virus 1 Infection

Background: Immune dysfunction often persists in people living with human immunodeficiency virus (HIV) who are on antiretroviral therapy (ART), clinically manifesting as HIV-1-associated comorbid conditions. Early ART initiation may reduce incidence of HIV-1–associated immune dysfunction and comorbid conditions. Immunometabolism is a critical determinant of functional immunity. We investigated the effect of HIV-1 infection and timing of ART initiation on CD4+ T cell metabolism and function. // Methods: Longitudinal blood samples from people living with HIV who initiated ART during hyperacute HIV-1 infection (HHI; before peak viremia) or chronic HIV-1 infection (CHI) were assessed for the metabolic and immune functions of CD4+ T cells. Metabolite uptake and mitochondrial mass were measured using fluorescent analogues and MitoTracker Green accumulation, respectively, and were correlated with CD4+ T cell effector functions. // Results: Initiation of ART during HHI prevented dysregulation of glucose uptake by CD4+ T cells, but glucose uptake was reduced before and after ART initiation in CHI. Glucose uptake positively correlated with interleukin-2 and tumor necrosis factor-α production by CD4+ T cells. CHI was associated with elevated mitochondrial mass in effector memory CD4+ T cells that persisted after ART and correlated with PD-1 expression. // Conclusions: ART initiation in HHI largely prevented metabolic impairment of CD4+ T cells. ART initiation in CHI was associated with persistently dysregulated immunometabolism of CD4+ T cells, which was associated with impaired cellular functions and exhaustion

Player responses to match and training demands during an intensified fixture schedule in professional rugby league: A case study.

As accepted for publicationPlayer loads and fatigue responses are reported in 15 professional rugby league players (24.3 ± 3.8 y) during a period of intensified fixtures. Repeated measures of internal and external loads, perceived well-being, and jump flight time were recorded across 22 d, comprising 9 training sessions and matches on days 5, 12, 15, and 21 (player exposure: 3.6 ± 0.6 matches). Mean training loads (session rating of perceived exertion × duration) between matches were 1177, 1083, 103, and 650 AU. Relative distance in match 1 (82 m/min) and match 4 (79 m/min) was very likely lower in match 2 (76 m/min) and likely higher in match 3 (86 m/min). High-intensity running (≥5.5 m/s) was likely to very likely lower than match 1 (5 m/min) in matches 2–4 (2, 4, and 3 m/min, respectively). Low-intensity activity was likely to very likely lower than match 1 (78 m/min) in match 2 (74 m/min) and match 4 (73 m/min) but likely higher in match 3 (81 m/min). Accumulated accelerometer loads for matches 1–4 were 384, 473, 373, and 391 AU, respectively. Perceived well-being returned to baseline values (~21 AU) before all matches but was very likely to most likely lower the day after each match (~17 AU). Prematch jump flight times were likely to most likely lower across the period, with mean values of 0.66, 0.65, 0.62, and 0.64 s before matches 1–4, respectively. Across a 22-d cycle with fixture congestion, professional rugby league players experience cumulative neuromuscular fatigue and impaired match running performance

Learning to become an online editor: the editathon as a learning environment

This study explores Wikipedia as a site for learning. In particular it traces how people learn to become Wikipedia editors through engagement in an editathon, a training event for people who want to become a volunteer editor. The study is original in its emphasis on the various types of knowledge editors acquire as they develop expertise. Determining the knowledge needed to contribute to Wikipedia is significant in terms of understanding Wikipedia as a site for learning. Data was gathered from nine participants who took part in an ‘editathon’ event on the theme of the Edinburgh Seven. The study used a rigorous methodology, combining quantitative social network analysis, documenting the online activity of participants as they created and edited Wikipedia pages, with qualitative interviews, which recorded participants reflections on their participation in the editathon. A key finding is that conceptual and procedural knowledge are representative of the foundational knowledge needed to contribute to Wikipedia actively as an editor. However, this knowledge on its own is not sufficient. Editors also develop socio-cultural and relational knowledge forms of knowledge to enable them to operate and problem-solve effectively. The relationship between the physical and the digital is important, since socio-cultural and relational knowledge are developed through active experimentation as the editathon engage with physical objects to create the online wiki pages

Cost-effectiveness of financial incentives to promote adherence to depot antipsychotic medication: economic evaluation of a cluster-randomised controlled trial

Background: Offering a modest financial incentive to people with psychosis can promote adherence to depot antipsychotic medication, but the cost-effectiveness of this approach has not been examined. Methods: Economic evaluation within a pragmatic cluster-randomised controlled trial. 141 patients under the care of 73 teams (clusters) were randomised to intervention or control; 138 patients with diagnoses of schizophrenia, schizo-affective disorder or bipolar disorder participated. Intervention participants received £15 per depot injection over 12 months, additional to usual acute, mental and community primary health services. The control group received usual health services. Main outcome measures: incremental cost per 20% increase in adherence to depot antipsychotic medication; incremental cost of ‘good’ adherence (defined as taking at least 95% of the prescribed number of depot medications over the intervention period). Findings: Economic and outcome data for baseline and 12-month follow-up were available for 117 participants. The adjusted difference in adherence between groups was 12.2% (73.4% control vs. 85.6% intervention); the adjusted costs difference was £598 (95% CI -£4 533, £5 730). The extra cost per patient to increase adherence to depot medications by 20% was £982 (95% CI -£8 020, £14 000). The extra cost per patient of achieving 'good' adherence was £2 950 (CI -£19 400, £27 800). Probability of cost-effectiveness exceeded 97.5%at willingness-to-pay values of £14 000 for a 20% increase in adherence and £27 800 for good adherence. Interpretation: Offering a modest financial incentive to people with psychosis is cost-effective in promoting adherence to depot antipsychotic medication. Direct healthcare costs (including costs of the financial incentive) are unlikely to be increased by this intervention. Trial Registration: ISRCTN.com 7776928

Induction and Maintenance of CX3CR1-Intermediate Peripheral Memory CD8(+) T Cells by Persistent Viruses and Vaccines

The induction and maintenance of T cell memory is critical to the success of vaccines. A recently described subset of memory CD8+ T cells defined by intermediate expression of the chemokine receptor CX3CR1 was shown to have self-renewal, proliferative, and tissue-surveillance properties relevant to vaccine-induced memory. We tracked these cells when memory is sustained at high levels: memory inflation induced by cytomegalovirus (CMV) and adenovirus-vectored vaccines. In mice, both CMV and vaccine-induced inflationary T cells showed sustained high levels of CX3R1int cells exhibiting an effector-memory phenotype, characteristic of inflationary pools, in early memory. In humans, CX3CR1int CD8+ T cells were strongly induced following adenovirus-vectored vaccination for hepatitis C virus (HCV) (ChAd3-NSmut) and during natural CMV infection and were associated with a memory phenotype similar to that in mice. These data indicate that CX3CR1int cells form an important component of the memory pool in response to persistent viruses and vaccines in both mice and humans

Exercise for people living with frailty and receiving haemodialysis:a mixed-methods randomised controlled feasibility study

Objectives Frailty is highly prevalent in haemodialysis (HD) patients, leading to poor outcomes. This study aimed to determine whether a randomised controlled trial (RCT) of intradialytic exercise is feasible for frail HD patients, and explore how the intervention may be tailored to their needs.Design Mixed-methods feasibility.Setting and participants Prevalent adult HD patients of the CYCLE-HD trial with a Clinical Frailty Scale Score of 4–7 (vulnerable to severely frail) were eligible for the feasibility study.Interventions Participants in the exercise group undertook 6 months of three times per week, progressive, moderate intensity intradialytic cycling (IDC).Outcomes Primary outcomes were related to feasibility. Secondary outcomes were falls incidence measured from baseline to 1 year following intervention completion, and exercise capacity, physical function, physical activity and patient-reported outcomes measured at baseline and 6 months. Acceptability of trial procedures and the intervention were explored via diaries and interviews with n=25 frail HD patients who both participated in (n=13, 52%), and declined (n=12, 48%), the trial.Results 124 (30%) patients were eligible, and of these 64 (52%) consented with 51 (80%) subsequently completing a baseline assessment. n=24 (71% male; 59±13 years) dialysed during shifts randomly assigned to exercise and n=27 (81% male; 65±11 years) shifts assigned to usual care. n=6 (12%) were lost to follow-up. The exercise group completed 74% of sessions. 27%–89% of secondary outcome data were missing. Frail HD patients outlined several ways to enhance trial procedures. Maintaining ability to undertake activities of daily living and social participation were outcomes of primary importance. Participants desired a varied exercise programme.Conclusions A definitive RCT is feasible, however a comprehensive exercise programme may be more efficacious than IDC in this population.</div

Retroperitoneal abscess complicated with necrotizing fasciitis of the thigh in a patient with sigmoid colon cancer

<p>Abstract</p> <p>Background</p> <p>Necrotizing fasciitis of the thigh due to the colon cancer, especially during chemotherepy, has not been previously reported.</p> <p>Case presentation</p> <p>A 67-year-old man admitted to the hospital was diagnosed with sigmoid colon cancer that had spread to the left psoas muscle. Multiple hepatic metastases were also found, and combination chemotherapy with irinotecan and S-1 was administered. Four months after the initiation of chemotherapy, the patient developed gait disturbance and high fever and was therefore admitted to the emergency department of our hospital. Blood examination revealed generalized inflammation with a high C-reactive protein level. Computed tomography of the abdomen and pelvis showed gas and fluid collection in the retroperitoneum adjacent to the sigmoid colon cancer. The abscess was locally drained under computed tomographic guidance; however, the infection continued to spread and necrotizing fasciitis developed. Consequently, emergent debridement was performed. The patient recovered well, and the primary tumor was resected after remission of the local inflammation.</p> <p>Conclusion</p> <p>Necrotizing fasciitis of the thigh due to the spread of sigmoid colon cancer is unusual, but this fatal complication should be considered during chemotherapy for patients with unresectable colorectal cancer.</p

HIV positive men as fathers: Accounts of displacement, ir/responsibility and paternal emergence

It is now apparent that socio-cultural constructions of masculinity variously impact men’s experiences of their HIV positive status, yet how being a father can feature in this mix remains under-researched. This study employed in-depth semi-structured interviews and Foucauldian-informed discourse analysis to explore the accounts of six self-identifying heterosexual fathers (four black African migrants, two white European) who had been living with HIV from five to 24 years. While the HIV-related literature calls for the need to subvert ‘traditional’ expressions of masculinity as a means of promoting HIV prevention and HIV health, we argue that the lived experience for HIV positive men as fathers is more socially, discursively and thus more psychologically nuanced. We illustrate this by highlighting ways in which HIV positive men as fathers are not simply making sense of themselves as a HIV positive man for whom the modern (new) man and father positions are useful strategies for adapting to HIV and combating associated stigma. Discourses of modern and patriarchal fatherhoods, a gender-specific discourse of irresponsibility, and the neoliberal conflation of heath and self-responsibility are also at work in the sense making frames that HIV positive men, who are also fathers, can variously deploy. Our analysis shows how this discursive mix can underpin possibilities of often conflicted meaning and identity when living as a man and father with HIV in the UK, and specifically how discourses of fatherhood and HIV ‘positive’ health can complicate these men’s expressions and inhabitations of masculinity