Gradual vs. Maximal Acceleration: Their Influence on the Prescription of Maximal Speed Sprinting in Team Sport Athletes

The primary purpose of this study was to determine if a difference existed between peak speed attained when performing a sprint with maximal acceleration versus from a gradual build-up. Additionally, this investigation sought to compare the actual peak speed achieved when instructed to reach 75% and 90% of maximum speed. Field sport athletes (n = 21) performed sprints over 60 m under the experimental conditions, and the peak speed was assessed with a radar gun. The gradual build-up to maximum speed (8.30 ± 0.40 m∙s-1) produced the greater peak speed (effect size = 0.3, small) than the maximum acceleration run (8.18 ± 0.40 m∙s-1), and the majority of participants (62%) followed this pattern. For the sub-maximum runs, the actual mean percentage of maximum speed reached was 78 ± 6% for the 75% prescribed run and 89 ± 5% for the 90% prescription. The errors in attaining the prescribed peak speeds were large (~15%) for certain individuals, especially for the 75% trial. Sprint training for maximum speed should be performed with a gradual build-up of speed rather than a maximum acceleration. For sub-maximum interval training, the ability to attain the prescribed target peak speed can be challenging for field sport athletes, and therefore where possible, feedback on peak speeds reached should be provided after each repetition

Bypass of Primary Stroke Centers Compared With Secondary Transfer for Endovascular Thrombectomy

Background Our stroke network operates a hybrid organizational structure, with patients with potential large‐vessel occlusion taken to the local primary stroke center (PSC) during office hours, and directly bypassed to the endovascular thrombectomy–capable stroke center (EVT‐SC) after hours. We aimed to compare the 2 methods of transfer. Methods Consecutive patients with anterior large‐vessel occlusion treated with EVT between August 2017 and February 2021 were identified. Patients who had EVT puncture within 6 hours of last known normal were included for analysis. Patients were grouped into method of presentation: direct bypass to EVT‐SC (“EVT‐SC direct”) or taken to local PSC with secondary transfer to EVT‐SC (“PSC‐transfer”). The primary outcome was 3‐month functional independence (modified Rankin scale score 0–2). Secondary outcomes included mortality at 7 days and at 3 months. Results A total of 259 patients (109 women; mean±SD age, 66.8±15.2 years) were included; there were 91 (35.1%) EVT‐SC direct and 168 (64.9%) PSC‐transfer patients. The EVT‐SC direct patients had shorter median times from last known normal to thrombolysis (120 versus 147 minutes; P=0.004) and puncture (190 versus 230 minutes; P<0.001). Multivariable logistic regression analysis found that EVT‐SC direct patients had greater 3‐month functional independence (odds ratio [OR], 2.04 [95% CI, 1.12–3.73]; P=0.02) and lower 3‐month mortality (OR, 0.33 [95% CI, 0.12–0.91]; P=0.03). For every 100 patients directly bypassed to EVT‐SC, there were 14 more patients functionally independent and 9 fewer who had died, at 3 months. Conclusions In this comparison of 2 organizational paradigms in patients with a PSC as the closest stroke center, direct bypass to EVT‐SC resulted in significantly better process times and clinical outcomes compared with secondary transfers from PSCs

Peripheral Neuropathy and Tear Film Dysfunction in Type 1 Diabetes Mellitus

Purpose. To compare tear film metrics in patients with type 1 diabetes mellitus (DM) and healthy controls and investigate the association between peripheral neuropathy and ocular surface quality. Methods. Dry eye symptoms were quantified in 53 patients with type 1 DM and 40 age-matched controls. Ocular examination included tear film lipid layer thickness grading, tear film stability and quantity measurement, and retinal photography. DM individuals additionally underwent a detailed neuropathy assessment. Results. Neither mean age nor dry eye symptom scores differed significantly between the DM and control groups (P=0.12 and P=0.33, resp.). Tear lipid thickness (P=0.02), stability (P<0.0001), and quantity (P=0.01) were significantly lower in the DM group. Corneal sensitivity was also reduced in the DM group (P<0.001) and tear film stability was inversely associated with total neuropathy score (r=-0.29, P=0.03). Conclusion. The DM group exhibited significantly reduced tear film stability, secretion, and lipid layer quality relative to the age-matched control group. The negative correlation between tear film parameters and total neuropathy score suggests that ocular surface abnormalities occur in parallel with diabetic peripheral neuropathy