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AimsTo assess the associations of exposure and modifications in exposure (i.e., discontinuation on admission, initiation during hospitalization) to eight common cardiovascular therapies with the risk of in-hospital death among inpatients with coronavirus disease 2019 (COVID-19).MethodsIn this observational study including 838 hospitalized unvaccinated adult patients with confirmed COVID-19, the use of cardiovascular therapies was assessed using logistic regression models adjusted for potential confounders.ResultsNo cardiovascular therapy used before hospitalization was associated with an increased risk of in-hospital death. During hospitalization, the use of diuretics (aOR 2.59 [1.68-3.98]) was associated with an increase, and the use of agents acting on the renin-angiotensin system (aOR 0.39 [0.23-0.64]) and lipid-lowering agents (aOR 0.41 [0.24-0.68]) was associated with a reduction in the odds of in-hospital death. Exposure modifications associated with decreased survival were the discontinuation of an agent acting on the renin-angiotensin system (aOR 4.42 [2.08-9.37]), a β-blocker (aOR 5.44 [1.16-25.46]), a lipid-modifying agent (aOR 3.26 [1.42-7.50]) or an anticoagulant (aOR 5.85 [1.25-27.27]), as well as the initiation of a diuretic (aOR 5.19 [2.98-9.03]) or an antiarrhythmic (aOR 6.62 [2.07-21.15]). Exposure modification associated with improved survival was the initiation of an agent acting on the renin-angiotensin system (aOR 0.17 [0.03-0.82]).ConclusionIn hospitalized and unvaccinated patients with COVID-19, there was no detrimental association of the prehospital use of any regular cardiovascular medication with in-hospital death, and these therapies should be continued as recommended.

This study aimed to assess the capacity for repeated maximal effort (RME) of soccer players in the thermo-natural conditions (NC) and in simulated conditions for the 2022 FIFA World Cup in Qatar (QSC). Twenty-four semi-professional soccer players participated in the study. The exercise test consisted of ten 6-second maximal efforts on a cycloergometer. A 90-second passive rest interval was used. The test was performed in a Weiss Technik WK-26 climate test chamber in two different conditions: 1) thermo-neutral conditions (NC-20.5°C; 58.7% humidity); and 2) simulated conditions for the 2022 World Cup in Qatar (QSC-28.5 ± 1.92°C; 58.7 ± 8.64% humidity). Power-related, physiological, psychomotor, blood, and electrolyte variables were recorded. Results showed that (1) players achieved higher peak power (max 1607,46 ± 192,70 [W] - 3rd rep), needed less time to peak power (min 0,95 ± 0,27 [s] - 3rd rep), and had a higher fatigue slope (max 218,67 ± 59,64 [W/sek] - 7th rep) in QSC than in NC (in each repetition of study protocol); (2) between the 1st repetition and subsequent repetitions a number of significants in among physiological, blood-related, and electrolyte variables were noted, but their direction was similar in both simulated conditions (e.g. V'O2/kg 37,59 ± 3,96 vs 37,95 ± 3,17 [ml/min/kg] - 3rd rep, LAC 13,16 ± 2,61 vs 14,18 ± 3,13 [mg/dl] - 10th rep or K 4,54 ± 0,29 vs 4,79 ± 0,36 [mmol/l] - 2nd rep when compare QCS and NC respectively); (3) an 8°C of temperature difference between the climatic conditions did not significantly affect the soccer players' physical and physiological responses in RME. The study results can be used in the design of training programs aimed to increase players' physiological adaptations by simulating soccer-specific conditions of play in terms of anaerobic capacity, in particular, repetitive maximal efforts. These findings will be useful during the upcoming 2022 World Cup in Qatar and in locations where high ambient temperatures are customary.

BackgroundDespite the fact that an educational programme for parents of youth tennis players has been launched recently, there is a need to empower parents of athletes in sustaining the combination of education and sport careers (i.e., dual career) of their talented and elite athletes across sports. The aim of this study was to explore the parents' view of their role as dual career supporters and their need for educational support in this area.MethodsIn total, 115 parents (F = 49, M = 66) of athletes (14-23 yrs) engaged in full time academic education (high school/university) and competitive (e.g., National, International) sports (individual = 12, team = 9) in five European Member States (e.g., France, Ireland, Italy, Portugal, Slovenia) took part in national workshops. The workshops involved discussing five themes and agreeing statements relevant to assist parents supporting their children as dual career athletes: 1) the athletes' needs; 2) the sports environment; 3) the academic environment; 4) dual career-related policies and services; 5) The educational methods for parenting dual career athletes.ResultsA final list of 80 agreed statements were identified: 25 statements mainly related to the sports entourage; 23 to information on dual career-related policies and services; 22 to the athletes' needs; 17 to the academic entourage, and 8 to the relevant educational resources to parenting dual career athletes, respectively.ConclusionsThis cross-national qualitative research synthesized the parents' perspectives about their needs and the most relevant content of an educational programme for parenting dual career athletes. The findings of this research will help influence the formulation of effective education strategies on parenting dual career athletes to ensure an optimal supportive environment for the successful combination of high-level sport and education careers.

This study examined the effect of a competitive season on salivary responses [cortisol (sC), testosterone (sT), Testosterone/Cortisol ratio (sT/C), Immunoglobulin A (sIgA), sIgA secretion rate (srIgA), alpha-amylase (sAA)] and upper respiratory symptoms (URS) occurrence in three teams of male soccer players (Under-15, Under-17 and Under-19 yrs.). Training and competition volumes, salivary biomarkers and URS were determined monthly. No differences were found for monthly training volume between teams. Incidence of URS was higher for the U15 (44.9% of the total cases). Higher sT and srIgA were observed for the U19, lower sC were found for the U17 and sAA showed higher values for the U15 throughout the season. In the U15, significant difference (p = .023) was found for sIgA concentration with higher concentration values in January compared to December (-42.7%; p = .008) and the sT showed seasonal variation (p < .001) with the highest value in January significantly different from October (-40.2%; p = .035), November (-38.5%; p = 0.022) and December (-51.6%; p = .008). The U19 presented an increase in sC in March compared to February (-66.1%, p = .018), sT/C were higher in February compared to March (-58.1%; p = .022) and sAA increased in March compared to September (-20.5%; p = .037). Negative correlations, controlled for age group, were found between URS occurrence and srIgA (r = -0.170, p = .001), sAA (r = -0.179, p = .001) and sT (r = -0.107, p = .047). Monitoring salivary biomarkers provides information on mucosal immunity with impact in URS occurrence. Coaches could manipulate training loads to attenuate the physical stressors imposed on athletes, especially at demanding and stressful periods.

The current study aimed to examine the reproducibility of estimated peak power and estimated pedal velocity in a multi-trial 10-s all-out cycling test among adult athletes (n = 22; aged 23.50±4.73 years). Stature, sitting height and body mass were measured. Leg length was estimated as stature minus sitting height. Body volume was obtained from air displacement plethysmography and was subsequently used to calculate body density. Fat mass and fat-free mass were derived. The short-term power outputs were assessed from the force-velocity test (FVT), using a friction-braked ergometer on two separated occasions. Differences between repeated measurements were examined with paired t-test and effect sizes calculated. No significant differences were found between session 1 (898 W, 142 rpm) and session 2 (906 W, 142 rpm). Test-retest procedure showed acceptable reliability for estimated peak power output [technical error of measurement (TEM) = 31.9 W; % coefficient of variation (CV) = 3.5; intra-class correlation coefficient (ICC) = 0.986] and pedal velocity (TEM = 5.4 rpm, %CV = 3.8, ICC = 0.924). The current study demonstrated a reasonable reproducibility of estimated peak power and pedal velocity outputs in non-elite male athletes and supports that a familiarization session including a complete FVT protocol is not required.

Agility and change of direction speed are two different abilities, but no study has investigated if this difference exists also in fatigued conditions, and whether fatigue develops in a different way in a repeated-trial scenario. Fourteen soccer players (age: 17.0 ± 0.4 yrs; height: 176.9 ± 6.5 cm; body mass: 69.2 ± 6.4 kg) competing in a national-level youth league completed in a randomized counter-balanced crossover design a repeated agility protocol (RA) and a repeated change-of-direction one (RCOD), both consisting in performing 20 consecutive repetitions (work:rest ratio 1:5). The 20 repetitions were divided into 4 blocks (each block containing 5 repetitions) for the analysis. Results show that agility and COD are two different abilities both in rest and fatigue conditions: block 1 RA vs 1 RCOD (p < 0.001; ES = 2.02 huge; r = 0.17 poor; r2 = 0.03), 2 RA vs 2 RCOD (p < 0.001; ES = 2.3 huge; r = 0.51 fair; r2 = 0.26), 3 RA vs 3 RCOD (p < 0.001; ES = 2.38 huge; r = 0.54 fair; r2 = 0.29), and 4 RA vs 4 RCOD (p < 0.001; ES = 2.7 huge; r = 0.41 fair; r2 = 0.17). However, the fatigue development in both conditions was similar, with a percentage decrement score (Sdec) of 7.5% for RA, and 7.3% for RCOD. Ratings of perceived exertions (RPE) were similar too (7.3 ± 1.7, and 6.6 ± 1.9, for RA and RCOD, respectively). However, a significant fatigue-related performance impairment arose earlier in RA (block 2) than in RCOD (block 3). Total RA and total RCOD times were significantly different (p < 0.001; ES = 2.65 huge; r = 0.41 fair; r2 = 0.17), suggesting that they are two different and independent abilities.

BackgroundThis study aimed to use a concept mapping methodology to develop a European framework of the needs of parents/guardians (P/G) for supporting athletes combining sport and education (dual career, DC).MethodsBy means of a concept mapping methodology, 337 French, Irish, Italian, Portuguese, and Slovenian parents sorted and rated 80 potential statements associated to parenting DC athletes.ResultsFive distinct clusters emerged: 1. P/G' roles, needs and awareness to support athletes, including 22 statements (mean:3.7; range: 3.2-4.2 pt); 2. Requirements for effective planning of DC pathway, including 19 statements (mean:3.7; range: 3.2-4.5 pt); 3. Educational opportunity, including 13 statements (mean:3.5; range: 3.1-4.0 pt); 4. Policy and provision for DC, including 19 statements (mean:3.7; range: 3.1-4.2 pt); and 5. Athletes' lifestyle & self-management, including 7 statements (mean:4.0; range: 3.5-4.5 pt). Estimates of effect size (Partial eta-squared) were calculated for ANOVAs to assess the degree of variability on the statement importance ranking as the dependent variable accounted for by the demographic data. The concept mapping showed good validity (stress value: 0.11) and high reliability (rSHT: 0.99, rSHM: 0.98; rRR:0.98). One-third of the statements indicated differences (pConclusionIn synthesizing the opinions, experience and needs of P/Gs of DC athletes the present framework provided sound theoretical underpinnings to inform the development of an online educational programme for empowering parenting DC athletes (https://edu.empatiasport.eu/eng/), as well as be a foundation for future Pan-European DC research on how these statements interact with each other, in different European contexts.

PURPOSE:The present study was designed to investigate the influence of two distinct small-sided game (SSG) regimes on physiological, perceptual, and technical parameters in male elite lacrosse players. METHOD:Data were collected in twelve elite male Austrian lacrosse players (25.8 ± 5.5 years; 80.1 ± 7.7 kg; 178.5 ± 6.2 cm). Players' were assigned to an intermittent (SSG-I) or a continuous (SSG-C) SSG regime, respectively. Regimes were equated for total practice time, but not active playing time. SSG data from eight sessions of 3 vs. 3 self-regulated match-play were collected along a 4-week pre-season period. Players' YoYo-Level 1 (YYL1) performance before and after the training intervention was recorded. Further, heart-rate (HR), rating of perceived exertion (RPE), physical activity enjoyment scale (PACES), and technical actions during and after SSG sessions were analyzed. RESULTS:Both SSG regimes showed improvement with medium to very large effect sizes (ES) in YYL1 total distance covered pre- to post-intervention (SSG-C mean-difference ± SD: 840 ± 299 m; p = 0.003; d = 1.08; CI = 0.60 to 1.56 and SSG-I: 607 ± 274 m; p = 0.003; d = 1.25; CI = 0.66 to 1.85 respectively). Higher %HRmax values with very large ES (92 ± 0.6%; p = 0.002; d = 5.33; CI = 2.78 to 7.88) and time spent in HR zone 4 (1248.0 ± 122.7 s; p = 0.000; d = 3.43; CI = 2.31 to 4.55) were observed for SSG-C. No differences between regimes were found for any of the assessed technical actions, global RPE, and PACES scores. CONCLUSIONS:Both SSG regimes investigated in this study were effective in improving YYL1 performance. Further, findings indicate that the regime does not influence players' subjective feelings and technical actions in SSG play. However, SSG-I in lacrosse specific training could have additional benefits such as lower signs of fatigue. Further, breaks can be used to give technical and tactical inputs by coaches.

Both motor and non-motor symptoms could contribute to significant deterioration of psychological well-being in patients with Parkinson's disease (PD). However, its assessment has been only indirectly evaluated using tools based on health-related quality of life (HRQoL), such as the PDQ-39 scale.To evaluate psychological well-being in PD using a specific tool of assessment, the Psychological Well-being Scale (PWS), and its clinical correlates.This article reports data of patients' perception of health state, as measured by means of the PWS, from an epidemiological, cross-sectional study conducted in Italian PD patients (FORTE Study). We tested possible relationship between well-being and clinical characteristics including fatigue, depression, sleep disruption and HRQoL.272 patients completed the PWS questionnaire. Significant and clinically-relevant correlations were found between PWS total score and Parkinson's Fatigue Scale, Beck Depression Inventory, UPDRS Section I, PD Sleep Scale and PDQ-39 for HRQoL scores. Only clinically negligible correlations were found between PWS and motor scores.Non-motor symptoms have a significant impact on psychological well-being in PD patients.

BackgroundThe pericardial tissue is commonly used to produce bio-prosthetic cardiac valves and patches in cardiac surgery. The procedures adopted to prepare this tissue consist in treatment with aldehydes, which do not prevent post-graft tissue calcification due to incomplete xeno-antigens removal. The adoption of fixative-free decellularization protocols has been therefore suggested to overcome this limitation. Although promising, the decellularized pericardium has not yet used in clinics, due to the absence of proofs indicating that the decellularization and cryopreservation procedures can effectively preserve the mechanical properties and the immunologic compatibility of the tissue.Principal findingsThe aim of the present work was to validate a procedure to prepare decellularized/cryopreserved human pericardium which may be implemented into cardiovascular homograft tissue Banks. The method employed to decellularize the tissue completely removed the cells without affecting ECM structure; furthermore, uniaxial tensile loading tests revealed an equivalent resistance of the decellularized tissue to strain, before and after the cryopreservation, in comparison with the fresh tissue. Finally, immunological compatibility, showed a minimized host immune cells invasion and low levels of systemic inflammation, as assessed by tissue transplantation into immune-competent mice.ConclusionsOur results indicate, for the first time, that fixative-free decellularized pericardium from cadaveric tissue donors can be banked according to Tissue Repository-approved procedures without compromising its mechanical properties and immunological tolerance. This tissue can be therefore treated as a safe homograft for cardiac surgery.