Female Athlete Triad: Evaluation of the Cumulative Risk Assessment Tool for Female Collegiate Athletes

Content: As the pressure on collegiate and elite female athletes to perform at their highest possible capabilities has grown, so to have the consequences associated with their high energy expending lifestyles. The Female Athlete Triad (Triad) is a syndrome defined as having one or more of the following conditions: LEA with or without disordered eating, menstrual dysfunction, and/or low BMD. Due to potential long-term, irreversible health consequences of the Triad, the Female Athlete Triad Coalition developed a risk assessment tool known as the Triad CRA to identify at-risk athletes and subsequent return-to-play status. Objective: To determine the risk classification and return-to-play status for each female collegiate student-athlete according to the Triad CRA, and to examine the efficacy of the Triad CRA. Design: This was a retrospective study designed to investigate the efficacy of the Triad CRA. The data analyzed was part of a larger study. Setting: Research laboratory. Participants: This study re-evaluated previously collected data from local female collegiate student-athletes (n = 125). The student-athletes included were from the disciplines of equestrian (n=29), volleyball (n=13), softball (n=17), beach volleyball (n=18), soccer (n=20), and ballet (n=28). Interventions: Independent variables included sport type. Main Outcome Measures: Dependent variables included Triad CRA classifications (low, moderate, high) and corresponding return-to-play status (full clearance, provisional clearance, restricted from training). Results: Overall, significant differences were found between sport type and CRA scores (P = .035) and LEA with or without an ED risk (P ≤ 0.01). For LEA with or without ED risk, 2.4% (n=3/125) of student-athletes were classified as low risk, 34.4% (n=43/125) were moderate risk, and 63.2% (n=79/125) were high risk. Significant differences were also found between return-to-play status and sport type (P = .045). Full clearance was given to 24.0% (n=30/125) of athletes, provisional/ limited clearance was given to 74.4% (n=93/125) and restricted from training and competing was given to 1.6% (n=2/125). Conclusion: Since it was predicted that the majority of the study’s female student- athletes would be placed in the moderate risk category, the hypothesis was supported because 74.4% of student-athletes were assigned moderate risk (provisional clearance). Another important finding was that 34.4% of all athletes had moderate risk and 63.2% of athletes had high risk for LEA with or without ED risk. Since LEA with or without ED risk has been shown to have potential long-term, irreversible health consequences, an athlete could be considered high risk and suffer future medical consequences without having a clinical ED diagnosis and, therefore, it should not be used as criteria in the Triad CRA. Lastly, any athlete classified as moderate or high risk warrants greater surveillance and further investigation into their health status before healthcare providers can confidently allow them a safe, full clearance on training and competing

Breath‐by‐breath oxygen uptake during running: Effects of different calculation algorithms

New Findings What is the central question of this study? Breath‐by‐breath gas exchange analysis during treadmill exercise can be disturbed by different breathing patterns depending on cadence, and the flow sensor might be subjected to variable mechanical stress. It is still unclear whether the outcomes of the gas exchange algorithms can be affected by running at different speeds. What is the main finding and its importance? Practically, the three investigated breath‐by‐breath algorithms ('Wessel', 'expiration‐only' and 'independent breath') provided similar average gas exchange values for steady‐state conditions. The 'independent breath' algorithm showed the lowest breath‐by‐breath fluctuations in the gas exchange data compared with the other investigated algorithms, both at steady state and during incremental exercise. AbstractRecently, a new breath‐by‐breath gas exchange calculation algorithm (called 'independent breath') was proposed. In the present work, we aimed to compare the breath‐by‐breath O2 uptake () values assessed in healthy subjects undergoing a running protocol, as calculated applying the 'independent breath' algorithm or two other commonly used algorithms. The traces of respiratory flow, O2 and CO2 fractions, used by the calculation algorithms, were acquired at the mouth on 17 volunteers at rest, during running on a treadmill at 6.5 and 9.5 km h−1, and thereafter up to volitional fatigue. Within‐subject averages and standard deviations of breath‐by‐breath were calculated for steady‐state conditions; the data of the incremental phase were analysed by means of linear regression, and their root mean square was assumed to be an index of the breath‐by‐breath fluctuations. The average values obtained with the different algorithms were significantly different (P < 0.001); nevertheless, from a practical point of view the difference could be considered 'small' in all the investigated conditions (effect size <0.3). The standard deviations were significantly lower for the 'independent breath' algorithm (post hoc contrasts, P < 0.001), and the slopes of the relationships with the corresponding data yielded by the other algorithms were <0.70. The root mean squares of the linear regressions calculated for the incremental phase were also significantly lower for the 'independent breath' algorithm, and the slopes of the regression lines with the corresponding values obtained with the other algorithms were <0.84. In conclusion, the 'independent breath' algorithm yielded the least breath‐by‐breath O2 uptake fluctuation, both during steady‐state exercise and during incremental running

Integrating Design Thinking in Teacher Education to Foster Creativity

This paper discusses how design thinking was used in a one-semester education course at the University of Calgary with secondary school prospective teachers of different disciplinary backgrounds and high school subject specializations.  It presents some key characteristics of design thinking and their relationship to creativity and students’ learning.  It shares ways in which a sample of the student teachers engaged in design thinking, which stimulated their creativity and resulted in new thinking that included the development of classroom instructional strategies and products to support creativity in students’ learning of mathematics and science.

Examination of the Cumulative Risk Assessment and Nutritional Profiles among College Ballet Dancers

This study examined female collegiate ballet dancers\u27 ( = 28) Female Athlete Triad (Triad) risk via the Cumulative Risk Assessment (CRA) and nutritional profiles (macro- and micronutrients; = 26). The CRA identified Triad return to play criteria (RTP: Full Clearance, Provisional Clearance, or Restricted/Medical Disqualified) by assessing eating disorder risk, low energy availability, menstrual cycle dysfunction, and low bone mineral density. Seven-day dietary assessments identified any energy imbalances of macro- and micronutrients. Ballet dancers were identified as low, within normal, or high for each of the 19 nutrients assessed. Basic descriptive statistics assessed CRA risk classification and dietary macro- and micronutrient levels. Dancers averaged 3.5 ± 1.6 total score on the CRA. Based on these scores, the RTP outcomes revealed Full Clearance 7.1%, = 2; Provisional Clearance 82.1%, = 23; and Restricted/Medical Disqualification 10.7%, = 3. Dietary reports revealed that 96.2% ( = 25) of ballet dancers were low in carbohydrates, 92.3% ( = 24) low in protein, 19.2% ( = 5) low in fat percent, 19.2% ( = 5) exceeding saturated fats, 100% ( = 26) low in Vitamin D, and 96.2% ( = 25) low in calcium. Due to the variability in individual risks and nutrient requirements, a patient-centered approach is a critical part of early prevention, evaluation, intervention, and healthcare for the Triad and nutritional-based clinical evaluations

Altered brain morphometry in carpal tunnel syndrome is associated with median nerve pathology☆☆☆

Objective: Carpal tunnel syndrome (CTS) is a common median nerve entrapment neuropathy characterized by pain, paresthesias, diminished peripheral nerve conduction velocity (NCV) and maladaptive functional brain neuroplasticity. We evaluated structural reorganization in brain gray matter (GM) and white matter (WM) and whether such plasticity is linked to altered median nerve function in CTS. Methods: We performed NCV testing, T1-weighted structural MRI, and diffusion tensor imaging (DTI) in 28 CTS and 28 age-matched healthy controls (HC). Voxel-based morphometry (VBM) contrasted regional GM volume for CTS versus HC. Significant clusters were correlated with clinical metrics and served as seeds to define associated WM tracts using DTI data and probabilistic tractography. Within these WM tracts, fractional anisotropy (FA), axial (AD) and radial (RD) diffusivity were evaluated for group differences and correlations with clinical metrics. Results: For CTS subjects, GM volume was significantly reduced in contralesional S1 (hand-area), pulvinar and frontal pole. GM volume in contralesional S1 correlated with median NCV. NCV was also correlated with RD and was negatively correlated with FA within U-fiber cortico-cortical association tracts identified from the contralesional S1 VBM seed. Conclusions: Our study identified clear morphometric changes in the CTS brain. This central morphometric change is likely secondary to peripheral nerve pathology and altered somatosensory afference. Enhanced axonal coherence and myelination within cortico-cortical tracts connecting primary somatosensory and motor areas may accompany peripheral nerve deafferentation. As structural plasticity was correlated with NCV and not symptomatology, the former may be a better determinant of appropriate clinical intervention for CTS, including surgery

Improving nutrition with agricultural biodiversity

A manual on implementing food systems field projects to assess and improve dietary diversity, and nutrition and health outcome

Examination of the Cumulative Risk Assessment and Nutritional Profiles among College Ballet Dancers

This study examined female collegiate ballet dancers’ (n = 28) Female Athlete Triad (Triad) risk via the Cumulative Risk Assessment (CRA) and nutritional profiles (macro- and micronutrients; n = 26). The CRA identified Triad return to play criteria (RTP: Full Clearance, Provisional Clearance, or Restricted/Medical Disqualified) by assessing eating disorder risk, low energy availability, menstrual cycle dysfunction, and low bone mineral density. Seven-day dietary assessments identified any energy imbalances of macro- and micronutrients. Ballet dancers were identified as low, within normal, or high for each of the 19 nutrients assessed. Basic descriptive statistics assessed CRA risk classification and dietary macro- and micronutrient levels. Dancers averaged 3.5 ± 1.6 total score on the CRA. Based on these scores, the RTP outcomes revealed Full Clearance 7.1%, n = 2; Provisional Clearance 82.1%, n = 23; and Restricted/Medical Disqualification 10.7%, n = 3. Dietary reports revealed that 96.2% (n = 25) of ballet dancers were low in carbohydrates, 92.3% (n = 24) low in protein, 19.2% (n = 5) low in fat percent, 19.2% (n = 5) exceeding saturated fats, 100% (n = 26) low in Vitamin D, and 96.2% (n = 25) low in calcium. Due to the variability in individual risks and nutrient requirements, a patient-centered approach is a critical part of early prevention, evaluation, intervention, and healthcare for the Triad and nutritional-based clinical evaluations

Nonlinear control of transcription through enhancer-promoter interactions.

Chromosome structure in mammals is thought to regulate transcription by modulating three-dimensional interactions between enhancers and promoters, notably through CTCF-mediated loops and topologically associating domains (TADs)1-4. However, how chromosome interactions are actually translated into transcriptional outputs remains unclear. Here, to address this question, we use an assay to position an enhancer at large numbers of densely spaced chromosomal locations relative to a fixed promoter, and measure promoter output and interactions within a genomic region with minimal regulatory and structural complexity. A quantitative analysis of hundreds of cell lines reveals that the transcriptional effect of an enhancer depends on its contact probabilities with the promoter through a nonlinear relationship. Mathematical modelling suggests that nonlinearity might arise from transient enhancer-promoter interactions being translated into slower promoter bursting dynamics in individual cells, therefore uncoupling the temporal dynamics of interactions from those of transcription. This uncovers a potential mechanism of how distal enhancers act from large genomic distances, and of how topologically associating domain boundaries block distal enhancers. Finally, we show that enhancer strength also determines absolute transcription levels as well as the sensitivity of a promoter to CTCF-mediated transcriptional insulation. Our measurements establish general principles for the context-dependent role of chromosome structure in long-range transcriptional regulation