Skinfold thickness variation and associations with cardiorespiratory fitness in male soccer players of different ages

OBJECTIVE: The aim of the present study was to examine skinfold thickness (SKF) distribution in youth and adult male soccer players regarding cardiorespiratory fitness (CRF) and the role of age. PATIENTS AND METHODS: Participants were youth [n=83, age 16.2 (1.0) years, mean (standard deviation)] and adult male soccer players [n=121, 23.2 (4.3) years], who were tested for SKF on 10 anatomical sites and Conconi test was used to assess velocity at maximal oxygen uptake (vVO2max). RESULTS: A between-within-subjects analysis of variance revealed a small interaction between the anatomical site and age group on SKF (p=0.006, η2=0.022), where adolescents had larger cheek (+0.7 mm; p=0.022; 95% confidence intervals - CI  - 0.1, 1.3), triceps (+0.9 mm; p=0.017; 95% CI 0.2, 1.6) and calf (+0.9 mm; p=0.014; 95% CI 0.2, 1.5) SKF, while adults had larger chin (+0.5 mm; p=0.007; 95% CI 0.1, 0.8) SKF, and no difference was observed for the rest of the anatomical sites. No difference between adolescent and adult age groups was observed in average SKF (SKFavg) [9.0 (2.7) vs. 9.1 (2.5) mm; difference -0.1 mm; 95% CI, -0.8, 0.6; p=0.738]. Compared to adults, adolescents had a lower SKF coefficient of variation (SKFcv) [0.34 (0.10) vs. 0.37 (0.09); difference-0.03; 95% CI, -0.06, -0.01; p=0.020] and subscapular-to-triceps ration (STR) [1.08 (0.28) vs. 1.29 (0.37); difference-0.21; 95% CI, -0.31, -0.12; p<0.001]. The largest Pearson moment correlation coefficient between vVO2max and SKF was shown in the subscapular (r=-0.411; 95% CI, -0.537, -0.284; p<0.001) and the smallest in the patellar anatomical site (r=-0.221; 95% CI, -0.356, -0.085; p=0.002). In addition, vVO2max correlated moderately with SKFavg (r=-0.390; 95% CI, -0.517, -0.262; p<0.001) and SKFcv (r=-0.334; 95% CI, -0.464, -0.203; p<0.001). CONCLUSIONS: In summary, CRF was related to the thickness of specific SKF and the magnitude of thickness variation by the anatomical site (i.e., the smaller the variation, the better the CRF). Considering the relevance of specific SKF for CRF, their further use would be recommended for monitoring physical fitness in soccer players

Sleep in marathon and ultramarathon runners: a brief narrative review

INTRODUCTION Sleep is considered a fundamental biological function in humans necessary for recovery from daily physical activities. Considering the increasing popularity of long-distance running and participation in races such as marathons and ultramarathons, the aim of the present study was to review the relationship of such strenuous physical activities with sleep. METHODS A search of Scopus was performed on 24/6/2023 using the syntax [ABS (sleep) AND ABS (marathon)] to identify relevant papers, the references of which were hand-searched to find additional sources. RESULTS Optimal sleep has been shown to affect injury prevention and susceptibility to infection positively. In turn, participation in a marathon race may influence nocturnal autonomic modulation and disturb homeostasis. Ultramarathon races may have such a long duration that results in sleep deprivation even for several days, where sleep duration is quite below the physiological range. It seems that for ultramarathons of short duration, continuous running and sleep deprivation are beneficial for performance. In contrast, for races longer than 200 miles, it is necessary to develop sleep strategies to sustain performance. CONCLUSION In summary, the longer the distance of a running race, the greater the importance of an optimal sleep for race performance as well as the impact of a race on sleep

Microstructural Parcellation of the Human Cerebral Cortex – From Brodmann's Post-Mortem Map to in vivo Mapping with High-Field Magnetic Resonance Imaging

The year 2009 marked the 100th anniversary of the publication of the famous brain map of Korbinian Brodmann. Although a “classic” guide to microanatomical parcellation of the cerebral cortex, it is – from today's state-of-the-art neuroimaging perspective – problematic to use Brodmann's map as a structural guide to functional units in the cortex. In this article we discuss some of the reasons, especially the problematic compatibility of the “post-mortem world” of microstructural brain maps with the “in vivo world” of neuroimaging. We conclude with some prospects for the future of in vivo structural brain mapping: a new approach which has the enormous potential to make direct correlations between microstructure and function in living human brains: “in vivo Brodmann mapping” with high-field magnetic resonance imaging

Physical exercise for a healthy pregnancy: the role of placentokines and exerkines

Complications such as diabetes and preeclampsia can occur during pregnancy. Moderate-intensity exercise can prevent such complications by releasing placentokines and exerkines, such as apelin, adiponectin, leptin, irisin, and chemerin. Exercise and apelin increase thermogenesis and glucose uptake in pregnancy by activating AMPK, PI3K, PGC-1α, AKT1, UCP3, and sarcolipin. Exercise increases apelin levels to reduce preeclampsia symptoms by increasing eNOS, NO, placental growth factor (PlGF), and VEGF and decreasing levels of fms-like tyrosine kinase 1 (sFlt-1), soluble endoglin (sEng), and oxidative stress. A negative relationship has been reported between plasma leptin and VO$_{2}$peak/kg and VO$_{2}$peak in women with gestational diabetes. In active women, decreases in leptin levels reduce the risk of preeclampsia by ~ 40%. Higher adiponectin levels are associated with greater physical activity and lead to increased insulin sensitivity. Increased adiponectin levels in preeclampsia and exercise counteract inflammatory and atherogenic activities while also having vascular protective effects. Exercise increases irisin levels that correlate negatively with fasting glucose, insulin concentration, and glycosylated hemoglobin levels. Irisin augments mRNA expression levels of UCP1 and cell death-inducing DNA fragmentation factor-like effector A (cidea) to cause browning of adipose tissue, increased thermogenesis, and increased energy consumption. Irisin concentrations in mothers with preeclampsia in the third trimester negatively correlate with systolic and diastolic blood pressure. Expression levels of chemerin, IL-6, and TNF-α are increased in gestational diabetes, and the increases in chemerin in late pregnancy positively correlate with the ratio of sFlt-1 to PlGF as a marker of preeclampsia. The effects of physical exercise on placentokines and exerkines in women at various stages of pregnancy remain poorly understood

Changes in the attractiveness of medical careers and career determinants during the bachelor's program at Zurich medical schools

BACKGROUND: Monitoring the career intentions of medical students during their undergraduate studies could help to address the shortage of physicians, particularly in general practice. This study aimed to investigate changes in medical students' career openness, attractiveness and determinants of medical career choice during their bachelor's studies. METHODS: The design was cross-sectional, recruiting all medical students who started a bachelor's program in one of the four different educational tracks in Zurich, Switzerland, in the fall of 2019 (first survey) and completed it in the summer of 2022 (second survey). Students' perceptions of the attractiveness and determinants of different medical career options were assessed using a structured online questionnaire. Absolute changes between the two-time points were reported in percentage points overall and by educational track. Regression analysis was used to examine the association of student characteristics and determinants of career options with the attractiveness of each option. RESULTS: We surveyed 354 medical students at the beginning and 433 at the end of the bachelor's program (participation rate: 71.1% and 86.9%, respectively). Overall, the proportion of students open to all proposed medical career options decreased (from 52.8% to 43.8%, p = 0.004). The attractiveness of outpatient gynecology or pediatrics increased (from 27.4% to 43.4%, p < 0.001), whereas the attractiveness of both general and specialized inpatient care decreased (from 47.8% to 40.3%, p = 0.05 and from 71.1% to 61.1%, p = 0.006 respectively). There was an increase in the proportion of students who perceived part-time work, autonomy and relationships with patients as important career determinants (from 47.3% to 64.7%, p < 0.001; from 63.3% to 77.8%, p < 0.001; from 80.8% to 89.3%, p = 0.002 respectively), while the importance of reputation and career opportunities decreased (from 42.6% to 26.2%, p < 0.001; from 79.2% to 63.6%, p < 0.001 respectively). The importance of part-time work and relationships with patients were positively associated with the attractiveness of general practice. CONCLUSIONS: During the bachelor's program, the attractiveness of a career in general practice tended to decrease, but the importance of part-time work, autonomy and relationships with patients as career determinants increased. Helping students understand how these determinants relate to general practice may increase their interest in the profession

Impact of a deprescribing tool on the use of sedative hypnotics among older patients: study protocol for a cluster randomised controlled trial in Swiss primary care (the HYPE trial)

INTRODUCTION Benzodiazepines and other sedative hypnotics (BSH) are potentially inappropriate and harmful medications in older people due to their higher susceptibility for adverse drug events. BSH prescription rates are constantly high among elderly patients and even increase with higher age and comorbidity. Deprescribing BSH can be challenging both for healthcare providers and for patients for various reasons. Thus, physicians and patients may benefit from a supportive tool to facilitate BSH deprescribing in primary care consultations. This study intends to explore effectiveness, safety, acceptance and feasibility of such a tool. METHODS AND ANALYSIS In this prospective, cluster randomised, controlled, two-arm, double-blinded trial in the ambulatory primary care setting, we will include general practitioners (GPs) from German-speaking Switzerland and their BSH consuming patients aged 65 years or older, living at home or in nursing homes. GPs will be randomly assigned to either intervention or control group. In the intervention group, GPs will participate in a 1-hour online training on how to use a patient support tool (decision-making guidance plus tapering schedule and non-pharmaceutical alternative treatment suggestions for insomnia). The control group GPs will participate in a 1-hour online instruction about BSH epidemiology and sleep hygiene counselling. This minimal intervention aims to prevent unblinding of control group GPs without jeopardising their 'usual care'.The primary outcome will be the percentage of patients who change their BSH use (ie, stop, reduce or switch to a non-BSH insomnia treatment) within 6 months from the initial consultation. EXPECTED BENEFIT Based on the results of the study, we will learn how GPs and their patients benefit from a supportive tool that facilitates BSH deprescribing in primary care consultations. The study will emphasise on exploring barriers and facilitators to BSH deprescribing among patients and providers. Positive results given, the study will improve medication safety and the quality of care for patients with sleeping disorders. ETHICS AND DISSEMINATION The study has been approved by the Ethics Committee of the Canton of Zurich (KEK-ZH Ref no. 2023-00054, 4 April 2023). Informed consent will be sought from all participating GPs and patients. The results of the study will be publicly disseminated

Exercise-Associated Hyponatremia in Marathon Runners

Exercise-associated hyponatremia (EAH) was first described as water intoxication by Noakes et al. in 1985 and has become an important topic linked to several pathological conditions. However, despite progressive research, neurological disorders and even deaths due to hyponatremic encephalopathy continue to occur. Therefore, and due to the growing popularity of exercise-associated hyponatremia, this topic is of great importance for marathon runners and all professionals involved in runners’ training (e.g., coaches, medical staff, nutritionists, and trainers). The present narrative review sought to evaluate the prevalence of EAH among marathon runners and to identify associated etiological and risk factors. Furthermore, the aim was to derive preventive and therapeutic action plans for marathon runners based on current evidence. The search was conducted on PubMed, Scopus and Google Scholar using a predefined search algorithm by aggregating multiple terms (marathon run; exercise; sport; EAH; electrolyte disorder; fluid balance; dehydration; sodium concentration; hyponatremia). By this criterion, 135 articles were considered for the present study. Our results revealed that a complex interaction of different factors could cause EAH, which can be differentiated into event-related (high temperatures) and person-related (female sex) risk factors. There is variation in the reported prevalence of EAH, and two major studies indicated an incidence ranging from 7 to 15% for symptomatic and asymptomatic EAH. Athletes and coaches must be aware of EAH and its related problems and take appropriate measures for both training and competition. Coaches need to educate their athletes about the early symptoms of EAH to intervene at the earliest possible stage. In addition, individual hydration strategies need to be developed for the daily training routine, ideally in regard to sweat rate and salt losses via sweat. Future studies need to investigate the correlation between the risk factors of EAH and specific subgroups of marathon runners

Cycling is the most important predictive split discipline in professional Ironman® 70.3 triathletes

Introduction: Our study examined 16,611 records of professional triathletes from 163 Ironman® 70.3 races across 97 countries (2004-2020). The aim was to identify the most predictive discipline—swim, bike, or run—for overall race time. Methods: We used correlation matrices to compare the dependent variable “finish time” with independent variables “swim time,” “bike time,” and “run time.” This analysis was conducted separately for male and female athletes. Additionally, univariate and multiple linear regression models assessed the strength of these associations. Results: The results indicated that “bike time” had the strongest correlation with finish time (0.85), followed by “run time” (0.75 for females, 0.82 for males) and “swim time” (0.46 for females, 0.63 for males). Regression models confirmed “bike time” as the strongest predictor of overall race time (R² = 0.8), with “run time” and “swim time” being less predictive. Discussion. The study concludes that in Ironman 70.3 races, “bike time” is the most significant predictor of overall race performance for both sexes, suggesting a focus on cycling in training and competition strategies. It also highlights a smaller performance gap between genders in swimming than in cycling or running

Trapping reactions with subdiffusive traps and particles characterized by different anomalous diffusion exponents

A number of results for reactions involving subdiffusive species all with the same anomalous exponent gamma have recently appeared in the literature and can often be understood in terms of a subordination principle whereby time t in ordinary diffusion is replaced by t^gamma. However, very few results are known for reactions involving different species characterized by different anomalous diffusion exponents. Here we study the reaction dynamics of a (sub)diffusive particle surrounded by a sea of (sub)diffusive traps in one dimension. We find rigorous results for the asymptotic survival probability of the particle in most cases, with the exception of the case of a particle that diffuses normally while the anomalous diffusion exponent of the traps is smaller than 2/3.Comment: To appear in Phys. Rev.