The effects of large-sided soccer training games and pitch size manipulation on time-motion profile, spatial exploration and surfaxe área: Tactical opportunities

Analysis of the physical, technical and physiological variations induced through the use of different soccer game formats have been widely discussed. However, the coaching justification for the specific use of certain game formats based on individual and collective spatial awareness is unclear. As a result, the purpose of this study was to analyze 11 versus 11 game formats conducted across two pitch sizes (half-size: 54 m × 68 m vs full-size: 108 m × 68 m) to identify effects of time–motion profiles, individual exploration behavior and collective organization. A total of 10 amateur soccer players from the same team (23.39 ± 3.91 years old) participated in this study. Data position of the players was used to calculate the spatial exploration index and the surface area. Distances covered in different speeds were used to observe the time–motion profile. The full-size pitch dimensions significantly contributed to greater distances covered via running (3.86–5.52 m s−1) and sprinting (>5.52 m s−1). Total distance and number of sprints were also significantly greater in the full-size pitch as compared to the half-size pitch. The surface area covered by the team (half-size pitch: 431.83 m2 vs full-size pitch: 589.14 m2) was significantly larger in the full-size pitch condition. However, the reduced half-size pitch significantly contributed to a greater individual spatial exploration. Results of this study suggest that running and sprinting activities increase when large, full-size pitch dimensions are utilized. Smaller surface area half-size pitch contributes to a better exploration of the pitch measured by spatial exploration index while maintaining adequate surface area coverage by the team. In conclusion, the authors suggest that the small half-size pitch is more appropriate for low-intensity training sessions and field exploration for players in different positions. Alternatively, the large full-size pitch is more appropriate for greater physically demanding training sessions with players focused on positional tactical behavio

How accurate and precise are limited sampling strategies in estimating exposure to mycophenolic acid in people with autoimmune disease?

Mycophenolic acid (MPA) is a potent immunosuppressant agent, which is increasingly being used in the treatment of patients with various autoimmune diseases. Dosing to achieve a specific target MPA area under the concentration-time curve from 0 to 12 h post-dose (AUC(12)) is likely to lead to better treatment outcomes in patients with autoimmune disease than a standard fixed-dose strategy. This review summarizes the available published data around concentration monitoring strategies for MPA in patients with autoimmune disease and examines the accuracy and precision of methods reported to date using limited concentration-time points to estimate MPA AUC(12). A total of 13 studies were identified that assessed the correlation between single time points and MPA AUC(12) and/or examined the predictive performance of limited sampling strategies in estimating MPA AUC(12). The majority of studies investigated mycophenolate mofetil (MMF) rather than the enteric-coated mycophenolate sodium (EC-MPS) formulation of MPA. Correlations between MPA trough concentrations and MPA AUC(12) estimated by full concentration-time profiling ranged from 0.13 to 0.94 across ten studies, with the highest associations (r (2) = 0.90-0.94) observed in lupus nephritis patients. Correlations were generally higher in autoimmune disease patients compared with renal allograft recipients and higher after MMF compared with EC-MPS intake. Four studies investigated use of a limited sampling strategy to predict MPA AUC(12) determined by full concentration-time profiling. Three studies used a limited sampling strategy consisting of a maximum combination of three sampling time points with the latest sample drawn 3-6 h after MMF intake, whereas the remaining study tested all combinations of sampling times. MPA AUC(12) was best predicted when three samples were taken at pre-dose and at 1 and 3 h post-dose with a mean bias and imprecision of 0.8 and 22.6 % for multiple linear regression analysis and of -5.5 and 23.0 % for maximum a posteriori (MAP) Bayesian analysis. Although mean bias was less when data were analysed using multiple linear regression, MAP Bayesian analysis is preferable because of its flexibility with respect to sample timing. Estimation of MPA AUC(12) following EC-MPS administration using a limited sampling strategy with samples drawn within 3 h post-dose resulted in biased and imprecise results, likely due to a longer time to reach a peak MPA concentration (t (max)) with this formulation and more variable pharmacokinetic profiles. Inclusion of later sampling time points that capture enterohepatic recirculation and t (max) improved the predictive performance of strategies to predict EC-MPS exposure. Given the considerable pharmacokinetic variability associated with mycophenolate therapy, limited sampling strategies may potentially help in individualizing patient dosing. However, a compromise needs to be made between the predictive performance of the strategy and its clinical feasibility. An opportunity exists to combine research efforts globally to create an open-source database for MPA (AUC, concentrations and outcomes) that can be used and prospectively evaluated for AUC target-controlled dosing of MPA in autoimmune diseases