Prognostic Validity of Professional Soccer Status by Anthropometrics and Repeated Jump Testing

ABSTRACT Soccer is characterized by intermittent high-intensity actions interspersed with lower intensity ones. Soccer clubs invest time and money to early identify and nurture potential professional players in the premise to maximize the return of their investment. Multidimensional talent identification models are proposed as best practice but are difficult to be implemented in the field. Explosive lower limbs strength assessment by vertical jumping (VJ) is used as a single predictor for future player status. Alternative to VJ, the repeated vertical jump test (RVJ) has been proposed, but its prognostic ability is still unexplored. PURPOSE: To analyze the prognostic validity of the RVJ obtained variables within professional (PRO) and under 19 years old (U19) male soccer players. It was hypothesized that anthropometric and performance related variables modeled on U19 will fail to predict the PRO status. METHODS: Forty-four participants (PRO=24, U19=20), after the end of the preseason, performed 15 RVJ aiming for highest jump (hJUMP) with the minimum possible ground contact time. Group differences examined by t-test, binomial logistic regression (BLR) calculated the likelihood of each individual to be categorized as PRO or U19 and receiver operating characteristic (ROC) for prognostic validity of anthropometric and performance derivative values in predicting PRO status were used at p \u3c0.05. Statistical analyses were performed using the R-based software Jamovi version 2.3.3.0. RESULTS: PRO and U19 significantly differed in body height, mass, body mass index (BMI), hJUMP, average jump height, and relative jump power. The prediction model was significant (x2(2) = 17.12, p \u3c0.001). From the examined variables, only height and BMI were positive predictors of the PRO status (b = 21.66, SE = 8.20, p = 0.008 and b = 0.94, SE = 0.38, p = 0.014, respectively). The model was 73% accurate, 75% specific, and 71% sensitive, with acceptable area under the curve (AUC = 0.82). CONCLUSION: The RVJ test demonstrated acceptable discriminating prognostic validity between PRO and U19 soccer players. Until the applicability of the multidimensional models in predicting future player status is further established, field practitioners may use the simplistic and single dimensional RVJ testing to predict future status among male soccer players

Fulminant Aeromonas hydrophila infection during acute lymphoblastic leukemia treatment

Aeromonas hydrophila septicemia has a fulminant course and it has been usually reported in immunocompromised hosts and rarely among children with leukemia. High morbidity and mortality is associated with A hydrophila infections. We describe the case of a child with acute lymphoblastic leukemia who presented with septicemia due to A hydrophila. The patient presented with fever and skin discoloration during a febrile neutropenia episode, which rapidly evolved into bacteremia and extensive thigh suppuration, fasciitis, and myonecrosis. Apart from antibiotic treatment, surgical debridement to relieve compartment pressure and prevent further lower extremity compromise was promptly performed. Despite long delays in chemotherapy and an extensive tissue gap, primary closure of the involved area was possible with full cosmetic and functional limb recovery, and the patient has remained in clinical remission for more than 7 years

Immunomodulatory intervention in sepsis by multidrug-resistant Pseudomonas aeruginosa with thalidomide: an experimental study

BACKGROUND: Thalidomide is an inhibitor of tumour necrosis factor-alpha (TNFα) that has been proven effective for the treatment of experimental sepsis by Escherichia coli. It was tested whether it might behave as an effective immunomodulator in experimental sepsis by multidrug-resistant (MDR) Pseudomonas aeruginosa. METHODS: Sepsis was induced by the intraperitoneal injection of 1 × 10(8 )cfu/kg inoculum of the test isolate in a total of 109 Wistar rats divided in three groups as follows: group A controls; group B administered seed oil 30 minutes before bacterial challenge; and group C administered 50 mg/kg of thalidomide diluted in seed oil 30 minutes before bacterial challenge. Blood was sampled for estimation of endotoxins (LPS), TNFα, interferon-gamma (IFNγ), nitric oxide (NO) and malondialdehyde (MDA). LPS was measured by the QCL-1000 LAL assay, TNFα and IFNγ by ELISA, NO by a colorimetric assay and MDA by the thiobarbiturate assay. RESULTS: Mean (± SE) survival of groups A, B and C were 18.60 ± 1.84, 12.60 ± 0.60 and 30.50 ± 6.62 hours (p of comparisons A to C equal to 0.043 and B to C equal to 0.002). Decreased TNFα and NO levels were found in sera of animals of group C compared to group A. Plasma levels of LPS, MDA and IFNγ did not differ between groups. CONCLUSION: Intake of thalidomide considerably prolonged survival in experimental sepsis by MDR P.aeruginosa an effect probably attributed to decrease of serum TNFα

Επιπτώσεις της θεραπείας στο τελικό ανάστημα και τη λειτουργία των γονάδων σε παιδιά που έχουν ιαθεί από τη νόσο του Hodgkin

The impact of contemporary treatment for children with Hodgkin's disease upon the pattern of growth, final height and gonadal function was evaluated on patients treated according to the MDP protocol with either chemotherapy (CT, consisting of six cycles of doxorubicin, procarbazine, prednisone, vincristine and cyclophosphamide), radiation (RT), or both (CT+RT). For analyzing growth and final height, the study population included 80 patients (54 males), age less than 14 years at diagnosis, with histologically confirmed Hodgkin's disease. Median age at diagnosis was 9.7 years (range, 2.4 to 14.0 years). Patients received RT (n=11), CT (n=23) or CT+RT (n=46). Heights were obtained at diagnosis, at the end of treatment, one, two and three years following the end of treatment and at attainment of final height. Heights were converted to age and sex adjusted standard deviation scores (SDS). Gonadal function was evaluated in 65 patients (36 males) with Hodgkin's disease in complete remission after treatment with RT (n=13), CT (n=9) or CT+RT (n=43). Median age at diagnosis was 13.1 years (range, 2.4 to 22.6) and median age at evaluation was 22.6 years (range, 15.1 to 33.7) which was 6.7 years (range, 2.0 to 19.8) after the completion of all treatments. For the purpose of gonadal outcome analysis, patients were divided into three groups: Group A: patients who received only RT that did not include the pelvis (8 females, 5 males); Group B : patients who received CT but no pelvic RT (15 females, 25 males); Group C: patients who received CT plus pelvic RT (6 females, 6 males). There was a significant change in height SDS at the end of treatment compared with the height SDS at diagnosis for all three groups (CT: -0.24, p=0.012; RT: +0.09, p=0.027; CT+RT: -0.33, p<0.001). Beyond the three years following treatment, the rate of change of height SDS was not statistically different between the three treatment groups. Final height SDS was found to be decreased for patients receiving RT+CT (-0.41 SDS, p=0.02; n=31). The change in final height SDS for patients receiving RT or CT only was -0.36 (p=0.28; n=14) and +0.42 (n=4), respectively. Loss of final height SDS correlated with younger age at diagnosis (p=0.005). Patients receiving higher RT doses tended to fair worse (p=0.08). The height SDS observed at the end of treatment correlated with the final adult height SDS (r=0.35, p<0.001). All patients in the gonadal cohort progressed spontaneously through puberty and evaluable patients were found to be sexually mature (Tanner stage IV and V). Serum follicle stimulating hormone (FSH) was increased in 0/5, 13/25 and 5/6 and testicular volume was decreased in 1/3, 4/11 and 2/3 Group A, B, and C male patients, respectively. Leydig cell dysfunction was uncommon; 89% of males had normal serum concentrations of luteinizing hormone (LH) and testosterone. FSH and LH were increased in 0/8, 3/15 and 2/6 Group A, B and C female patients, respectively, at last follow up, indicating a 17% prevalence of ovarian dysfunction. Serial data in seven females whose initial levels of FSH/LH were elevated revealed normalization in four. A total of six females delivered eight normal children. In summary, pediatric patients treated for Hodgkin's disease with the combination of RT and CT suffer a small but significant decrease in their final height SDS. Younger patients and those treated with higher RT doses appear to experience the greatest loss of their height potential. Additionally, the majority of male patients who received CT ±RT show evidence of germ cell dysfunction, while Leydig cell function is unaffected in most of them. In females, although abnormal function early following the end of treatment was observed, ovarian function remained or returned to normal in most young women. Thus, in females the results of hormone testing performed early after treatment may not be predictive of their eventual reproductive potential and those tests should be repeated and followed accordingly.Οι επιπτώσεις της σύγχρονης θεραπείας της νόσου Hodgkin στα παιδιά όσον αφορά την ανάπτυξη, το τελικό ανάστημα και τη λειτουργία των γονάδων ερευνήθηκαν σε παιδιατρικούς ασθενείς που έλαβαν θεραπεία κατά το πρωτόκολλο MDP (χημειοθεραπεία αποτελούμενη από έξι κύκλους δοξορουβικίνης, προκαρβαζίδης, πρεδνιζόνης, βινκριστίνης και κυκλοφωσφαμίδης, ακτινοθεραπεία ή συνδυασμό και των δύο (ΧΘ+ΑΘ). Για την ανάλυση της σε μήκος αύξησης και του τελικού αναστήματος, εξετάστηκε ένας πληθυσμός 80 ασθενών (54 αγόρια), ηλικίας μικρότερης των 14 χρόνων κατά τη διάγνωση, με ιστολογικά επιβεβαιωμένη νόσο Hodgkin. Η διάμεση ηλικία κατά τη διάγνωση ήταν 9.7 χρόνια (εύρος, 2.4 έως 14.0 χρόνια). Οι ασθενείς έλαβαν θεραπεία με ΑΘ (11), ΧΘ (23) ή ΧΘ+ΑΘ (46). Το ύψος μετρήθηκε στη διάγνωση, στο τέλος της θεραπείας, ένα, δύο και τρία χρόνια μετά το τέλος της θεραπείας και με την ολοκλήρωση της ανάπτυξης. Για την ανάλυση των αποτελεσμάτων, οι μετρήσεις μετατράπηκαν σε εκατοστιαίες θέσεις και πηλίκο σταθερών αποκλίσεων (SDS) του ύψους. Η λειτουργία των γονάδων μελετήθηκε σε 65 ασθενείς (36 αγόρια) με λέμφωμα Hodgkin σε πλήρη ύφεση μετά από θεραπεία με ΑΘ (13), ΧΘ (9) ή ΧΘ+ΑΘ (43). Η διάμεση ηλικία κατά τη διάγνωση ήταν 13.1 χρόνια (εύρος, 2.4 έως 22.6 χρόνια) και η διάμεση ηλικία κατά τον επανέλεγχο ήταν 22.6 χρόνια (εύρος, 15.1 έως 33.7 χρόνια), που ήταν 6.7 χρόνια (εύρος, 2.0 έως 19.8 χρόνια) μετά το τέλος της θεραπείας. Για την ανάλυση της λειτουργίας των γονάδων, οι ασθενείς χωρίστηκαν σε τρεις ομάδες: Ομάδα Α: ασθενείς που έλαβαν μόνο ΑΘ η οποία δεν περιελάμβανε την πύελο (8 κορίτσια, 5 αγόρια); Ομάδα Β : ασθενείς που έλαβαν ΧΘ και όχι ΑΘ στην πύελο (15 κορίτσια, 25 αγόρια); Ομάδα Γ: ασθενείς που έλαβαν ΧΘ και επίσης ΑΘ στην πύελο (6 κορίτσια, 6 αγόρια). Υπήρξε μία σημαντική μεταβολή του SDS αναστήματος στο τέλος της θεραπείας σε σχέση με τη μέτρηση στη διάγνωση της νόσου και για τις τρεις ομάδες θεραπείας (ΧΘ: -0.24, p=0.012; ΧΘ: +0.09, p=0.027; ΧΘ+ΑΘ: -0.33, p<0.001) Κατά τα τρία χρόνια μετά το τέλος της θεραπείας ο ρυθμός αύξησης και η μεταβολή του SDS αναστήματος δεν διέφερε μεταξύ των τριών ομάδων. Το τελικό ανάστημα ενήλικα βρέθηκε σαφώς μειωμένο στους ασθενείς που θεραπεύτηκαν με ΧΘ+ΑΘ (-0.41 SDS, p=0.02; n=31). Η μεταβολή στη SDS τελικού αναστήματος ενήλικα που μετρήθηκε στους ασθενείς που έλαβαν ΑΘ ή ΧΘ ήταν -0.36 (p=0.28; n=14) και +0.42 (n=4), αντίστοιχα. Η απώλεια περισσότερων εκατοστιαίων θέσεων τελικού αναστήματος συσχετίστηκε με διάγνωση της νόσου σε μικρότερη ηλικία (p=0.005). Ασθενείς που έλαβαν υψηλότερες δόσεις ΑΘ φαίνεται να έχουν επίσης μεγαλύτερες απώλειες (p=0.08). Το SDS αναστήματος που μετρήθηκε στο τέλος της θεραπείας συσχετίστηκε με το SDS του τελικού αναστήματος (r=0.35, p<0.001). Όλοι οι ασθενείς που μελετήθηκαν για τη λειτουργία των γονάδων προχώρησαν αυτόματα σε εφηβεία χωρίς ορμονική υποκατάσταση και οι ασθενείς βρέθηκαν να έχουν αναπτύξει τα δευτερογενή χαρακτηριστικά του φύλου (στάδιο κατά Tanner IV ή V). Η θυλακιοτρόπος ορμόνη (FSH) του αίματος βρέθηκε παθολογικά αυξημένη σε 0/5, 13/25 και 5/6 και επίσης ο όγκος των όρχεων βρέθηκε μειωμένος σε 1/3, 4/11 και 2/3 άρρενες ασθενείς των Ομάδων Α, Β και Γ, αντίστοιχα. Δυσλειτουργία των κυττάρων Leydig ήταν σπάνια; 89% των ανδρών είχαν φυσιολογικές τιμές ωχρινοτρόπου ορμόνης (LH) και τεστοστερόνης. Τα επίπεδα των ορμονών FSH και LH ήταν αυξημένα σε 0/8, 3/15 και 2/6 θήλεις των Ομάδων Α, Β και Γ, αντίστοιχα, στην τελευταία τους μέτρηση, υποδηλώνοντας 17% επιπολασμό ωοθηκικής δυσλειτουργίας. Διαδοχικές μετρήσεις σε επτά γυναίκες με αρχικά αυξημένες τιμές FSH/LH έδειξαν ότι σε τέσσερις από αυτές οι τιμές επανήλθαν σε φυσιολογικά όρια. Συνολικά, έξι γυναίκες γέννησαν οκτώ φυσιολογικά μωρά. Συνοψίζοντας, τα παιδιά που λαμβάνουν θεραπεία και έχουν ιαθεί από λέμφωμα Hodgkin με το συνδυασμό ΧΘ+ΑΘ υφίστανται μικρή αλλά σημαντική μείωση της εκατοστιαίας θέσης του τελικού τους αναστήματος. Οι μεγαλύτερες απώλειες παρατηρήθηκαν σε πολύ μικρές ηλικίες και σε παιδιά που έλαβαν υψηλότερες δόσεις ακτινοβολίας. Όσον αφορά τη λειτουργία των γονάδων, η πλειοψηφία των αγοριών που θεραπεύονται με ΧΘ ±ΑΘ παρουσιάζουν δυσλειτουργία των γαμετικών κυττάρων, ενώ η λειτουργία των κυττάρων Leydig παραμένει αναλλοίωτη στους περισσότερους. Στα κορίτσια, αν και παρατηρείται δυσλειτουργία αμέσως μετά το τέλος της θεραπείας, η ωοθηκική λειτουργία παραμένει ή επανέρχεται σε φυσιολογικά επίπεδα στα περισσότερα από αυτά. Συνεπώς, στις γυναίκες τα αποτελέσματα των ορμονικών ελέγχων άμεσα μετά το τέλος της θεραπείας πιθανόν να μην αντιπροσωπεύουν την απώτερη λειτουργία των ωοθηκών και έτσι δεν πρέπει να κρίνεται η αναπαραγωγική τους ικανότητα από αυτές και μόνο τις μετρήσεις

Omitting or reducing radiotherapy in childhood or adolescence Hodgkin Lymphoma.

Despite high cure rates, treatment of childhood Hodgkin Lymphoma (HL) is associated with late effects caused mainly by radiotherapy (RT). In the GPOH-HD95 trial of the German Society of Pediatric Oncology and Hematology that was recently published in the Journal of Clinical Oncology, RT was spared in patients achieving a stringently defined complete remission (CR) with chemotherapy and reduced in patients with a good partial remission (PR). Overall, RT-treated patients had superior PFS, but overall survival (OS) was almost identical within each risk-stratified treatment group irrespectively of the use of RT. In the low-risk group, RT could be safely omitted in 20% of patients. In contrast, failure rates were considered unacceptable, when RT was omitted in intermediate or high risk patients achieving a CR. However, salvage therapy was successful, equalizing overall survival between irradiated and non-irradiated patients. Although GPOH-HD95 points out to the omission of RT in selected patients achieving a CR after chemotherapy, especially those in the low-risk group, more than 80% of the patients are still irradiated. Notably, the GPOH-HD95 was not a randomized trial. In conclusion, according to the GPOH-HD95 trial, RT can be safely omitted in pediatric and adolescent patients with low-risk, early stage HL achieving a stringently defined CR after 2 cycles of OPPA or OEPA chemotherapy. RT dose could also be reduced in case of good PR by conventional imaging. However, conventional response assessment is not the optimal means to decide whether RT is needed or not. It is now increasingly recognized that RT can be omitted in many patients with HL without compromising the final outcome and it appears wise to try to stringently limit RT in those patients who really need it. This might be achieved through the use of modern functional imaging (PET/CT). Such efforts are already in progress and results regarding efficacy are awaited relatively soon

Design and Evaluation of Low-Power Co₃O₄ Gas Sensing Element as a Part of Cyber Physical Systems

Physical processes working in parallel with digital ones have transformed the way we view systems and have led to the creation of applications that boost the quality of people’s lives, increase security as well as decrease production costs of goods. Critical to this evolution is the cost decrease in the components of such systems, among which are gas sensors. In this work, a custom-made Co3O4 gas sensing element is presented, which can potentially be used as part of a cyber-physical system (CPS) for O3 monitoring. To investigate its performance, a CPS is developed using low-cost, low-power micro-controller units (MCUs) and comparisons both with the laboratory equipment and commercial off-the-shelf (COTS) ozone sensors are provided. The experiments show that the Co3O4 sensor works at room temperature with low input voltage and low power consumption when used with the proposed MCUs. Moreover, an enhanced gas sensing performance against ozone is observed under low-pressure conditions due to the detection of low ozone concentrations (85.90 ppb) and good sensor response (113.1%) towards 1100 ppb O3. However, the drawbacks that need improvement relate to the kinetics of the charge carriers, which affect the response time and recovery behavior. The effect of humidity needs to be clarified in further works