Scapular dyskinesis in young, asymptomatic elite swimmers

Background: Overhead athletes are at a greater risk of developing scapular dyskinesis (SD). Although swimming is considered an overhead sport, information regarding SD in these athletes is scarce. Purpose: To determine the prevalence of SD in young, asymptomatic elite swimmers. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 661 asymptomatic elite swimmers were enrolled in this study (344 male, 317 female; mean age, 15.83 ± 2.20 years). Anthropometric characteristics, training routine, and stroke specialty were recorded. SD was assessed using a dynamic test consisting of an examination of the shoulder blades throughout synchronous forward flexion motion in the sagittal plane and was deemed to be either present or absent. Each movement was repeated 5 times. These evaluations were performed with athletes at rest, before any training or competition. Statistical analysis was performed. Results: SD was detected in 56 (8.5%) participants. Type I SD was the most common (46.5%); male participants were 2 times as likely to have SD as female participants (39 male, 17 female; P < .01). No correlation was found between the dominant limb and side affected (P = .258); rather, a correlation was found between the breathing side and side affected, in that swimmers with a preferred breathing side were more prone to develop SD in the opposite shoulder (P < .05). Swimmers involved in long-distance races were found to have a greater risk of developing SD (P = .01). Conclusion: SD may be an asymptomatic condition in elite young swimmers and is present in 8.5% of these athletes. Early diagnosis may be useful for asymptomatic athletes with SD and to avoid its possible evolution to a symptomatic condition

Chiral nanostructuring of multivalent macrocycles in solution and on surfaces

We describe the design and synthesis of a novel functionality-rich, homochiral macrocycle, possessing the overall molecular D-2 symmetry, in which multivalency is introduced into the covalent framework by means of four suitably positioned pyridine moieties. The macrocycle synthesis is carried out with functionalized, enantiopure 1,1'-binaphthyl synthons as the source of chirality by means of a room temperature esterification reaction as the cyclization procedure. Upon addition of Pd2+, coordination of the pyridine moieties occurs both intra and intermolecularly, to afford chiral ordered mono and dimeric macrocycles or multimeric aggregates depending on the solvents and conditions used. The metal binding event takes place in combination with a significant macrocyclic conformational rearrangement detected by circular dichroism spectroscopy. When in combination with a third component (C-60), the macrocycle-Pd2+ hybrid undergoes surface-confined nanostructuring into chiral nanofibres

Do the Fastest Open-Water Swimmers have A Higher Speed in Middle- and Long-Distance Pool Swimming Events?

Background: It has been shown that the fastest open-water swimmers (OW-swimmers) increase significantly the speed in the last split of the open-water events. The aim of the present work was to determine if the fastest OW-swimmers have a higher speed in the middle- and long-distance pool swimming events, and to develop a multivariate model that can predict the medalist group in the 10-km competition. Methods: A total of 484 athletes (252-males and 232-females) were included in the analysis. Swimmers were divided into four groups based on their finishing position in the competition. For each swimmer, the absolute best performance (PB) of 200, 400, 800 and 1500-meter in long course, the seasonal best performance (SPB) obtained before the open-water events and critical velocity (CV) were analyzed. Multivariate analysis of variance (MANOVA) was used to detect significant differences between groups and discriminant analysis was used to predict a grouping variable. Results: All the variables analyzed were significantly different between groups (p < 0.001). The first discriminant function correctly classified 50% of the overall female and male swimmers. Conclusion: Fastest OW-swimmers have a higher speed in middle- and long-distance pool swimming events. Further studies should include different anthropometric and physiological variables to increase the accuracy of classification

Training methods and analysis of races of a top level Paralympic swimming athlete

Training methods for Paralympic swimmers must take into account different pathologies, competitions classes, athlete\u2019s individual circumstances and peculiar physical adaptation mechanisms, hence general guidelines cannot be found in literature. In this study we present a training program, implemented for the physical preparation of a top level Paralympic swimmer. The athlete under study, affected by infantile cerebral palsy within a clinical picture of a spastic tetraparesis, by the end of 2016 was holder of Italian, European, world and Paralympic titles in the 400-m freestyle competition, S6 class. The training macrocycle was structured in a 3-fold periodization (three mesocycles), in view of the preparation to three international competitions. The 4-month training mesocycles prior to each competition differed substantially in terms of mileage load, intensity and recovery times. The first mesocycle was characterized by a sizeable low-intensity mileage load, the second one was shifted to lower mileage load, carried out at middle-to-high intensity levels, the third one entailed increased effort intensity, counterbalanced by lower mileage load. In all cases, recovery times were balanced to obtain optimized performance through physical adaptation to training stimuli, keeping into account the physiopatological response. Tapering phases were adjusted to maximize performance at competition. As an assessment of the effectiveness of the training method, correspondence between chronometric and technical parameters in the three competitions and the respective mesocycle training programs was found. The results of the present study may support the development of training guidelines for athletes affected by upper motor neuron lesions

Individual and sex-related differences in pain and relief responsiveness are associated with differences in resting-state functional networks in healthy volunteers

Pain processing is associated with neural activity in a number of widespread brain regions. Here, we investigated whether functional connectivity at rest between these brain regions is associated with individual and sex-related differences in thermal pain and relief responsiveness. Twenty healthy volunteers (ten females) were scanned with functional magnetic resonance imaging in resting conditions. Half an hour after scanning, we administered thermal pain on the back of their right hand and collected pain and relief ratings in two separate runs of twelve stimuli each. Across the whole group, mean pain ratings were associated with decreased connectivity at rest between brain regions belonging to the default mode and the visual resting-state network. In men, pain measures correlated with increased connectivity within the visual resting-state network. In women, in contrast, decreased connectivity between this network and parietal and prefrontal brain regions implicated in affective cognitive control were associated with both pain and relief ratings. Our findings indicate that the well documented individual variability and sex differences in pain sensitivity may be explained, at least in part, by network dynamics at rest in these brain regions

The impact of a 14-day altitude training camp on olympic-level open-water swimmers' sleep

Despite the common belief that sleep quality at altitude is poor, the scientific evidence to support this notion is still modest. Therefore, the purpose of the present study was to evaluate possible changes of actigraphy-based and subjective sleep parameters in a group of elite open-water swimmers during a 14-day altitude training camp (ATC) at 1500 m. The study subjects were five Olympic-level open-water swimmers (mean age: 25.0 ± 3.2 years; 3 females and 2 males). All subjects wore a wrist activity monitor and filled a sleep diary for 18 consecutive nights, 4 nights before and 14 nights during ATC. The data were then analyzed at four different time points: before ATC (PRE), the first two days of ATC (T1), and after one (T2) and two weeks of ATC (T3). Training load, assessed as the covered distance (km), session rating of perceived exertion (sRPE), and heart rate (HR), was monitored during the week before and the first and second week of ATC. No significant differences in objective and subjective scores of sleep quality were detected, whereas the sleep onset time (p = 0.018; η2p = 0.83, large) and sleep offset time (p &lt; 0.001; η2p = 0.95, large) significantly differed among PRE, T1, T2, and T3: elite athletes started to sleep and woke up ≃ 1 h earlier the first two days of ATC compared to PRE (sleep onset time: p = 0.049; sleep offset time: p = 0.016). Further, an increase in the training volume during the two weeks of the ATC was observed, with the most time spent in a low-intensity regime and an increase in time spent in a high-intensity regime compared to PRE. Sleep quality was not negatively influenced by a 14-day altitude training camp at 1500 m in a group of Olympic-level elite swimmers despite an increase in perceived exertion during training sessions. Nonetheless, early sleep onset and sleep offset times were observed for the first two nights of ATC: elite athletes started to sleep and woke up ≃ 1 h earlier compared to the baseline nights

Diagnostic Role of Bronchoalveolar Lavage in Patients with Suspected SARS-CoV-2 Pneumonia and Negative Upper Respiratory Tract Swab: A Systematic Review and Meta-Analysis

The added role of bronchoalveolar lavage (BAL) in SARS-CoV-2 detection in hospitalized patients with suspected COVID-19 pneumonia and at least one negative nasopharyngeal swab (NPS) has yet to be definitively established. We aimed to provide a systematic review and meta-analysis to summarize data from the literature on the diagnostic yield of BAL in this context. We searched Medline and Embase for all studies reporting outcomes of interest published up to October 2021. Two authors reviewed all titles/abstracts and retrieved the selected full texts according to predefined selection criteria. The summary estimate was derived using the random-effects model. Thirteen original studies, involving 868 patients, were included. The summary estimate of proportions of SARS-CoV-2 positivity in BAL fluid in patients with at least one previous negative NPS was 20% (95% confidence interval [CI]; 11–30%). Moreover, microbiological tests of BAL fluid led to the identification of other pathogens, mainly bacteria, in up to two-thirds of cases. BAL plays a crucial role in the diagnostic work-up of patients with clinical suspicion of COVID-19 and previous negative NPS, as it allowed to detect the infection in a significant proportion of subjects, who would have been otherwise misclassified, with relevant implications in the prevention of disease spread, especially in hospital settings

Peculiarities of Functional Connectivity—including Cross-Modal Patterns—in Professional Karate Athletes: Correlations with Cognitive and Motor Performances

Professional karate is a sport activity requiring both physical and psychological skills that have been associated with a better "global neural efficacy." By means of resting state functional magnetic resonance imaging (rs-fMRI), we investigated the neural correlates of cognitive and kinematic abilities in a group of 14 professional karateka and 14 heathy matched controls. All subjects underwent an extensive cognitive test battery for the identification of individual multidimensional cognitive profile and rs-fMRI scans investigating functional connectivity (FC). Moreover, kinematic performances in athletes were quantified by the Ergo-Mak, an integrated system developed for measuring motor reactivity, strength, and power of athletic gestures. Karateka performed significantly better than controls in the visual search task, an ability linked with increased positive correlations in FC between the right superior parietal lobe and bilateral occipital poles. Kinematic performances of athletic feats were sustained by increased positive correlations between subcortical (cerebellum and left thalamus) and cortical (inferior frontal cortex, superior parietal cortex, superior temporal cortex) regions. An unexpected FC increase between auditory and motor-related areas emerged in karateka, possibly reflecting a cross-modal coupling due to the continuous exposure to either internal or external auditory cues, positing this sensory channel as a possible target for novel training strategies. Results represent a further step in defining brain correlates of "neural efficiency" in these athletes, whose brain can be considered a model of continuous plastic train-related adaptation