15 research outputs found

    The relationship between VO2 max and 1200m shuttle run performance in elite academy football players

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    Purpose: To investigate the relationship between VO2 max and performance in the 1200m shuttle run test in elite Premier League academy football players. Methods: Seventeen male professional outfield football players completed a laboratory based incremental treadmill test to establish vVO2 max and a field based 1200m shuttle test to estimate velocity at MAS. During the pre-season period a linear speed phase consisting of twice weekly PS exposures were conducted and each player’s PS reached during this period was established. Body composition was measured using DEXA. Results: Examining the standardized (scaled) coefficients, ASR (7.373) had the largest effect on VO2 max followed by PS (-5.568), MAS (3.604), Body Fat (-0.285) and Lean Mass (-0.185).The results suggest that the model is a significantly better predictor than a model that constantly predicts the mean VO2max value (F = 3.422, p = 0.041). Conclusions: The MAS values obtained from the 1200m shuttle test may be an appropriate assessment to consider when monitoring and individualizing high-intensity performance rather than the generic threshold of 5.5 m/s.info:eu-repo/semantics/publishedVersio

    Study protocol for evaluating the implementation and effectiveness of an emergency department longitudinal patient monitoring system using a mixed-methods approach

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    Background: Early detection of patient deterioration is a key element of patient safety as it allows timely clinical intervention and potential rescue, thus reducing the risks of serious patient safety incidents. Longitudinal patient monitoring systems have been widely recommended for use to detect clinical deterioration. However, there is conflicting evidence on whether they improve patient outcomes. This may in part be related to variation in the rigour with which they are implemented and evaluated. This study aims to evaluate the implementation and effectiveness of a longitudinal patient monitoring system designed for adult patients in the unique environment of the Emergency Department (ED). Methods: A novel participatory action research (PAR) approach is taken where socio-technical systems (STS) theory and analysis informs the implementation through the improvement methodology of ‘Plan Do Study Act’ (PDSA) cycles. We hypothesise that conducting an STS analysis of the ED before beginning the PDSA cycles will provide for a much richer understanding of the current situation and possible challenges to implementing the ED-specific longitudinal patient monitoring system. This methodology will enable both a process and an outcome evaluation of implementing the ED-specific longitudinal patient monitoring system. Process evaluations can help distinguish between interventions that have inherent faults and those that are badly executed. Discussion: Over 1.2 million patients attend EDs annually in Ireland; the successful implementation of an ED-specific longitudinal patient monitoring system has the potential to affect the care of a significant number of such patients. To the best of our knowledge, this is the first study combining PAR, STS and multiple PDSA cycles to evaluate the implementation of an ED-specific longitudinal patient monitoring system and to determine (through process and outcome evaluation) whether this system can significantly improve patient outcomes by early detection and appropriate intervention for patients at risk of clinical deterioration

    Developing outcome, process and balancing measures for an emergency department longitudinal patient monitoring system using a modified Delphi

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    Early warning score systems have been widely recommended for use to detect clinical deterioration in patients. The Irish National Emergency Medicine Programme has developed and piloted an emergency department specific early warning score system. The objective of this study was to develop a consensus among frontline healthcare staff, quality and safety staff and health systems researchers regarding evaluation measures for an early warning score system in the Emergency Department

    An Analysis of Positional Generic and Individualized Speed Thresholds Within the Most Demanding Phases of Match Play in the English Premier League

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    Objectives: To analyze the positional distances covered above generic and individualized speed thresholds within the most demanding phases of match play. Categorized by position, 17 English Premier League players’ match data were analyzed over 2 consecutive seasons (2019–20 and 2020–21). The most demanding phases of play were determined using a rolling average across 4 periods of 1, 3, 5, and 10 minutes. Distance covered in the time above the standard speed of 5.5 m/s was analyzed, with individualized metrics based on the maximal aerobic speed (MAS) test data. Results: Central defenders displayed lower values for high-intensity periods when compared with fullbacks, midfielders, and wide midfielders for both generic and individualized metrics. MAS during 1-minute periods was significantly higher for forwards when compared with central defenders (82.9 [18.9] vs 67.5 [14.8] for maximum high-speed running [HSR] and 96.0 [15.9] vs 75.7 [13.8] HSR for maximum MAS activity). The maximum effect size differences between the central midfielders, wide midfielders, and fullbacks for HSR and MAS measures under the maximum HSR criterion was 0.28 and 0.18 for the 1-minute period, 0.36 and 0.19 for the 3-minute period, 0.46 and 0.31 for the 5-minute period, and 0.49 and 0.315 for the 10-minute period. Conclusions: Individualized speed metrics may provide a more precise and comparable measure than generic values. Data appear to be consistent across playing positions except for central defenders. This information may allow practitioners to directly compare individualized physical outputs of non–central defenders during the most demanding phases of play regardless of the players’ positional group. This may provide coaches with important information regarding session design, training load, and fatigue monitoring

    Active Notch1 confers a transformed phenotype to primary human melanocytes

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    The importance of mitogen-activated protein kinase signaling in melanoma is underscored by the prevalence of activating mutations in N-Ras and B-Raf, yet clinical development of inhibitors of this pathway has been largely ineffective, suggesting that alternative oncogenes may also promote melanoma. Notch is an interesting candidate that has only been correlated with melanoma development and progression; a thorough assessment of tumor-initiating effects of activated Notch on human melanocytes would clarify the mounting correlative evidence and perhaps identify a novel target for an otherwise untreatable disease. Analysis of a substantial panel of cell lines and patient lesions showed that Notch activity is significantly higher in melanomas than their nontransformed counterparts. The use of a constitutively active, truncated Notch transgene construct (N(IC)) was exploited to determine if Notch activation is a "driving" event in melanocytic transformation or instead a "passenger" event associated with melanoma progression. N(IC)-infected melanocytes displayed increased proliferative capacity and biological features more reminiscent of melanoma, such as dysregulated cell adhesion and migration. Gene expression analyses supported these observations and aided in the identification of MCAM, an adhesion molecule associated with acquisition of the malignant phenotype, as a direct target of Notch transactivation. N(IC)-positive melanocytes grew at clonal density, proliferated in limiting media conditions, and also exhibited anchorage-independent growth, suggesting that Notch alone is a transforming oncogene in human melanocytes, a phenomenon not previously described for any melanoma oncogene. This new information yields valuable insight into the basic epidemiology of melanoma and launches a realm of possibilities for drug intervention in this deadly disease

    Active Notch1 Confers a Transformed Phenotype to Primary Human Melanocytes

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    The importance of MAPK signaling in melanoma is underscored by the prevalence of activating mutations in N-Ras and B-Raf; yet, clinical development of inhibitors of this pathway has been largely ineffective, suggesting that alternative oncogenes may also promote melanoma. Notch is an interesting candidate that has only been correlated with melanoma development and progression; a thorough assessment of tumor-initiating effects of activated Notch on human melanocytes would clarify the mounting correlative evidence and perhaps identify a novel target for an otherwise untreatable disease. Analysis of a substantial panel of cell lines and patient lesions demonstrated that Notch activity is significantly higher in melanomas than their non-transformed counterparts. The use of a constitutively-active, truncated Notch transgene construct (N IC ) was exploited to determine if Notch activation is a ‘driving’ event in melanocytic transformation or instead a ‘passenger’ event associated with melanoma progression. N IC -infected melanocytes displayed increased proliferative capacity and biological features more reminiscent of melanoma such as dysregulated cell adhesion and migration. Gene expression analyses supported these observations and aided in the identification of MCAM, an adhesion molecule associated with acquisition of the malignant phenotype, as a direct target of Notch transactivation. N IC -positive melanocytes grew at clonal density, proliferated in limiting media conditions, and also exhibited anchorage-independent growth suggesting that Notch, alone, is a transforming oncogene in human melanocytes, a phenomenon not previously described for any melanoma oncogene; this new information yields valuable insight into the basic epidemiology of melanoma and launches a realm of possibilities for drug intervention in this deadly disease
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