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As the global average temperature has increased due to climate change, the use of air conditioning equipment for cooling homes has become more popular. Inverter equipment is advertised as a better energy option than systems with an on/off control; however, there is a lack of sufficient studies to prove this. This work aims to analyze and compare the electricity consumption associated with cooling equipment with an on/off control and inverter equipment. A heat transfer model coupled with energy balance for a room is developed and implemented in Python 3.12. The indoor temperature is controlled by simulating an on/off control and a PID control for the inverter system. Subsequently, the electricity consumption of the two systems is compared, and a sensitivity analysis is performed to determine which variables have the greatest impact on electricity consumption. The results show that the inverter equipment has lower electricity consumption compared to the equipment with the on/off control. However, the sensitivity analysis shows that the indoor temperature set point plays a more relevant role since a 15% variation in its value impacts electricity consumption by up to 77%. [ABSTRACT FROM AUTHOR]

This article discusses the effectiveness of thoracoamniotic shunts in treating large macrocystic congenital cystic adenomatoid malformations (CCAM) in fetuses. The study, conducted at a fetal therapy center between 2013 and 2023, involved 8 fetuses with severe mediastinal shift and hydrops. Shunt insertion successfully reduced the size of CCAM, corrected mediastinal shift, and resolved hydrops in all cases. The study reported a postnatal survival rate of 87.5%, with premature delivery being the main complication. Overall, fetal thoracoamniotic shunting appears to have favorable outcomes for large macrocystic CCAM. [Extracted from the article]

Background: Hospitalization exacerbates sarcopenia and physical dysfunction in older adults. Whether tailored inpatient exercise prevents acute sarcopenia is unknown. This study aimed to examine the effect of a multicomponent exercise programme on muscle and physical function in hospitalized older adults. We hypothesized that participation in a brief tailored exercise regimen (i.e., 3-5 days) would attenuate muscle function and structure changes compared with usual hospital care alone., Methods: This randomized clinical trial with blinded outcome assessment was conducted from May 2018 to April 2021 at Hospital Universitario de Navarra, Spain. Participants were 130 patients aged 75 years and older admitted to an acute care geriatric unit. Patients were randomized to a tailored 3- to 5-day exercise programme (n = 64) or usual hospital care (control, n = 66) consisting of physical therapy if needed. The coprimary endpoints were between-group differences in changes in short physical performance battery (SPPB) score and usual gait velocity from hospital admission to discharge. Secondary endpoints included changes in rectus femoris echo intensity, cross-sectional area, thickness and subcutaneous and intramuscular fat by ultrasound., Results: Among 130 randomized patients (mean [SD] age, 87.7 [4.6] years; 57 [44%] women), the exercise group increased their mean SPPB score by 0.98 points (95% CI, 0.28-1.69 points) and gait velocity by 0.09 m/s (95% CI, 0.03-0.15 m/s) more than controls (both p < 0.01). No between-group differences were observed in any ultrasound muscle outcomes. There were no study-related adverse events., Conclusions: Three to 5 days of tailored multicomponent exercise provided functional benefits but did not alter muscle or fat architecture compared with usual hospital care alone among vulnerable older patients. Brief exercise may help prevent acute sarcopenia during hospitalization., Trial Registration: ClinicalTrials.gov identifier: NCT04600453., (© 2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.)

Background and study aims Artificial intelligence (AI) models have demonstrated high diagnostic performance identifying neoplasia during digital single-operator cholangioscopy (DSOC). To date, there are no studies directly comparing AI vs. DSOC-guided probe-base confocal laser endomicroscopy (DSOC-pCLE). Thus, we aimed to compare the diagnostic accuracy of a DSOC-based AI model with DSOC-pCLE for identifying neoplasia in patients with indeterminate biliary strictures. Patients and methods This retrospective cohort-based diagnostic accuracy study included patients ≥ 18 years old who underwent DSOC and DSOC-pCLE (June 2014 to May 2022). Four methods were used to diagnose each patient's biliary structure, including DSOC direct visualization, DSOC-pCLE, an offline DSOC-based AI model analysis performed in DSOC recordings, and DSOC/pCLE-guided biopsies. The reference standard for neoplasia was a diagnosis based on further clinical evolution, imaging, or surgical specimen findings during a 12-month follow-up period. Results A total of 90 patients were included in the study. Eighty-six of 90 (95.5%) had neoplastic lesions including cholangiocarcinoma (98.8%) and tubulopapillary adenoma (1.2%). Four cases were inflammatory including two cases with chronic inflammation and two cases of primary sclerosing cholangitis. Compared with DSOC-AI, which obtained an area under the receiver operator curve (AUC) of 0.79, DSOC direct visualization had an AUC of 0.74 ( P = 0.763), DSOC-pCLE had an AUC of 0.72 ( P = 0.634), and DSOC- and pCLE-guided biopsy had an AUC of 0.83 ( P = 0.809). Conclusions The DSOC-AI model demonstrated an offline diagnostic performance similar to that of DSOC-pCLE, DSOC alone, and DSOC/pCLE-guided biopsies. Larger multicenter, prospective, head-to-head trials with a proportional sample among neoplastic and nonneoplastic cases are advisable to confirm the obtained results., Competing Interests: Conflict of Interest Carlos Robles-Medranda is a key opinion leader and consultant for Pentax Medical, Steris, Medtronic, Motus, Micro-tech, G-Tech Medical Supply, CREO Medical, EndoSound, and mdconsgroup. The other authors declare no conflicts of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Introduction: Severe early childhood caries (S-ECC) is a common disease within marginalized pediatric populations. S-ECC is often treated under general anesthesia to facilitate extensive treatment in young children, but treatment does not address etiology of an infectious disease that is rooted in health behaviors. Without behavior changes related to toothbrushing and sugar consumption, many children experience recurrent disease and some require subsequent surgeries. To improve post-surgery oral health, we developed PROTECT (Preventing Recurrent Operations Targeting Early Childhood Caries Treatment), a community health worker (CHW)-delivered behavioral intervention for caregivers that focuses on children's oral health behaviors. The purpose of this study was to use qualitative research methods to receive feedback on the planned protocol for a pilot study of PROTECT, a six-month intervention initiated at the time of a child's surgery to treat severe early childhood caries., Methods: Study participants included caregivers of children presenting for surgery [ n  = 12], CHWs [ n  = 8] and dentists [ n  = 8] in a series of audio-video recorded semi-structured interviews. Five coders used Braun and Clarke's six-phase framework for data analysis., Results: Participant feedback on the pilot study protocol yielded the following themes: (1) right time, population, and type of support; (2) flexible intervention delivery and content; (3) inclusion of other social determinants of health; and (4) cultural considerations. Implementing a behavioral intervention for caregivers in the immediate time during a child's surgery for treating dental caries was widely deemed important and timely in order to affect post-surgical behavioral and clinical outcomes. Flexibility in content, timing, and communication were all named as facilitators to participant engagement and study retention. Caregivers and CHWs emphasized the relevance of addressing other social determinants of health. CHWs emphasized the importance of training in becoming aware of culture and practicing with understanding and humility, given the influence on health beliefs, behaviors, and family dynamics. Cultural considerations in intervention delivery were deemed an important factor for participant retention and engagement., Discussion: Participant feedback led to critical modifications of the pilot study protocol, specifically in intervention content and CHW-led delivery., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Patano, Borowski, Izquierdo, Wong, Avenetti, Lee and Buscemi.)

Background: The addition of hydrochlorothiazide (HCTZ) to furosemide in the CLOROTIC (Combining Loop with Thiazide Diuretics for Decompensated Heart Failure) trial improved the diuretic response in patients with acute heart failure (AHF)., Objectives: This work aimed to evaluate if these results differ across the spectrum of left ventricular ejection fraction (LVEF)., Methods: This post hoc analysis of the randomized, double-blind, placebo-controlled CLOROTIC trial enrolled 230 patients with AHF to receive either HCTZ or a placebo in addition to an intravenous furosemide regimen. The influence of LVEF on primary and secondary outcomes was evaluated., Results: The median LVEF was 55%: 166 (72%) patients had LVEF >40%, and 64 (28%) had LVEF ≤40%. Patients with a lower LVEF were younger, more likely to be male, had a higher prevalence of ischemic heart disease, and had higher natriuretic peptide levels. The addition of HCTZ to furosemide was associated with the greatest weight loss at 72 of 96 hours, better metrics of diuretic response, and greater 24-hour diuresis compared with placebo, with no significant differences according to the LVEF category (using 2 LVEF cutoff points: 40% and 50%) or LVEF as a continuous variable (all P values were insignificant). There were no significant differences observed with the addition of HCTZ in terms of mortality, rehospitalizations, or safety endpoints (impaired renal function, hyponatremia, and hypokalemia) among the 2 LVEF groups (all P values were insignificant)., Conclusions: Adding HCTZ to intravenous furosemide seems to be effective strategy for improving diuretic response in AHF without treatment effect modification according to baseline LVEF. (Combining Loop with Thiazide Diuretics for Decompensated Heart Failure [CLOROTIC], NCT01647932; Randomized, double blinded, multicenter study, to asses Safety and Efficacy of the Combination of Loop With Thiazide-type Diuretics vs Loop diuretics with placebo in Patients With Decompensated, EudraCT Number 2013-001852-36)., Competing Interests: Funding Support and Author Disclosures This work was supported by the Heart Failure Working Group of the Spanish Society of Internal Medicine. The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

The interaction between vitamin D and vitamin K is crucial for regulating bone metabolism and maintaining calcium homeostasis across diverse animal species due to their complementary roles in calcium metabolism and bone health. However, research on this interaction of vitamin D and K in fish, particularly Mediterranean species like gilthead seabream, is limited or not studied. This study aimed to understand the effects of different dietary combinations of vitamin D 3 and K 3 on juvenile gilthead seabream. Accordingly, seabream juveniles were fed with varying combinations of vitamin D 3 /vitamin K 3 (mg/kg diet) for 3 months: (0.07/0.01), (0.20/0.58), (0.19/1.65), (0.51/0.74), (0.56/1.00). At the end of the trial, survival, growth, body morphology, serum calcitriol, and vertebral mineral composition remained unaffected by varying vitamin levels, while gene expression patterns related to bone formation, resorption, and calcium regulation in various tissues were significantly influenced by both vitamins and their interaction. Gilthead seabream juveniles fed the 0.07/0.01 mg/kg diet upregulated calcium-regulating genes in the gills, indicating an effort to enhance calcium absorption to compensate for dietary deficiencies. Conversely, an increase in vitamin D 3 and K 3 up to 0.19 and 1.65 mg/kg, respectively, upregulated bone formation, bone remodeling, and calcium homeostasis-related gene expression in vertebra and other tissues. On the contrary, a dietary increase in these vitamins up to 0.56 mg/kg vitamin D 3 and 1.00 mg/kg vitamin K 3 downregulated calcium metabolism-related genes in tissues, suggesting an adverse interaction resulting from elevated levels of these vitamins in the diet. Hence, sustaining an equilibrium in the dietary intake of vitamin D 3 and vitamin K 3 , in an appropriately combined form, may potentially induce interactions between the vitamins, contributing to favorable effects on bone development and calcium regulation in gilthead seabream juveniles.

Introduction: Various classifications for osteoporotic vertebral fractures (OVFs) have been introduced to enhance patient care and facilitate clinical communication. However, there is limited evidence of their effectiveness in predicting vertebral collapse, and very few studies have compared this association across different classification systems. This study aims to investigate the association between OVF categories, according to the most widely used classification systems, and vertebral collapse., Patients and Methods: A retrospective single-center study was conducted involving patients diagnosed with acute OVFs at the emergency department of a tertiary-level academic hospital with a minimum follow-up of 6 months. Vertebral fractures were independently classified by two radiologists according to several classification systems, including those proposed by Genant, Sugita, the German Society for Orthopedics and Trauma (DGOU), and the AO Spine. Associations between vertebral collapse and OVF classification systems were analyzed using bivariate and logistic regression analyses., Results: This study included 208 patients (82.7% females; mean age of 72.6 ± 9.2 years). The median follow-up time was 15 months, with L1 being the most common fracture site (47.6%). The most frequent OVF types observed, according to Genant's morphological, Genant's quantitative, Sugita 's, DGOU's, and AO Spine's classifications, were biconcave (50%), grade 0.5 (47.6%), bow-shaped (61.5%), OF2 (74%), and A1 (61.5%), respectively. All classifications, except for Genant's quantitative system, were significantly associated with vertebral collapse in bivariate analyses. Logistic regression analyses showed a significant association ( p = 0.002) between the AO Spine classification and vertebral collapse, with 85.7% of A4 fractures developing collapse on follow-up., Conclusions: The AO Spine classification showed the highest predictive capacity for vertebral collapse. Specifically, A4 fracture types showed a very high risk of vertebral collapse, confirming the need for non-conservative management of these fractures. Further multicentric and prospective studies are warranted to confirm these findings.

Background: Sex-based differences in the clinical presentation and outcomes are well-established in patients hospitalized for geriatric syndromes. We aimed to investigate sex differences in response to in-hospital exercise on function, strength, cognition, and quality of life in acute care admissions., Methods: 570 patients (mean age 87 years, 298 females [52.3%]) admitted to acute care for elderly units were randomized to multicomponent exercise emphasizing progressive resistance training or usual care. Functional assessments included Short Physical Performance Battery (SPPB), grip strength, Mini-Mental State Examination (MMSE), and health-related quality of life (EQ-VAS)., Results: Exercising females showed more significant SPPB improvements than males (between-group difference 1.48 points, p = 0.027), exceeding the minimal clinically significant difference. While female participants significantly increased handgrip strength and male patients improved cognition after in-hospital exercise compared to the control group (all p < 0.001), no sex differences occurred., Conclusions: Females demonstrate more excellent physical function improvements compared to male older patients. Findings highlight the importance of tailored exercise incorporating patient factors like biological sex in geriatric medicine., Trial Registration: NCT04600453., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Background: This study aimed to determine the threshold of muscle power and strength enhancements that lead to functional gains after exercise intervention in an acute care unit., Methods: A total of 302 older patients (intervention: 169, control: 133) from two randomized clinical trials were included (mean age 86.7 years). We measured maximal strength (1RM) and muscle power via a velocity transducer during leg press exercise at 30% and 60% of 1RM. A multicomponent exercise program, including power training, balance, and gait exercises performed over 3 to 6 consecutive days, served as the intervention. We used an anchor-based method to correlate muscle function increases with the Short Physical Performance Battery (SPPB) and gait velocity (GVT) to define clinically meaningful improvements (CMI)., Results: In the intervention group, marked differences were found in maximal power at 30% of 1RM between SPPB responders and non-responders (relative 83.5% vs. 34.8%; absolute 33.0 vs. 12.8 W; P<0.05) and at 60% of 1RM (relative 61.1% vs. 22.4%; P<0.05). GVT responders demonstrated significantly greater improvements in both relative and absolute maximal power than non-responders at both 30% and 60% of 1RM (P<0.05), as well as greater absolute 1RM gains (21.2 vs. 15.2 kg, P<0.05). CMI for muscle power based on SPPB and GVT ranged from 30.2% to 48.7%, whereas for 1RM, it was 8.2% based on GVT., Conclusion: Muscle power gains were most notable in patients with improvements in the SPPB and GVT, highlighting the critical role of muscle power in functional recovery in these patients., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

The use of deep eutectic solvents (DESs) for the preparation of polymer membranes for environmental separation technologies is comprehensively reviewed. DESs have been divided into five categories based on the hydrogen bond donor (HBD) and acceptor (HBA) that are involved in the production of the DESs, and a wide range of DESs' physicochemical characteristics, such as density, surface tension, viscosity, and melting temperature, are initially gathered. Furthermore, the most popular techniques for creating membranes have been demonstrated and discussed, with a focus on the non-solvent induced phase separation (NIPS) method. Additionally, a number of studies have been reported in which DESs were employed as pore formers, solvents, additives, or co-solvents, among other applications. The addition of DESs to the manufacturing process increased the presence of finger-like structures and macrovoids in the cross-section and, on numerous occasions, had a substantial impact on the overall porosity and pore size. Performance data were also gathered for membranes made for various separation technologies, such as ultrafiltration (UF) and nanofiltration (NF). Lastly, DESs provide various options for the functionalization of membranes, such as the creation of various liquid membrane types, with special focus on supported liquid membranes (SLMs) for decarbonization technologies, discussed in terms of permeability and selectivity of several gases, including CO 2 , N 2 , and CH 4 .

Background and Aims: Patients with sigmoid-type achalasia can be challenging to treat with peroral endoscopic myotomy (POEM). A short myotomy improves technical success; however, outcomes have not previously been evaluated., Methods: This was a multicenter, international, retrospective study of patients who underwent POEM with short (≤4 cm) or standard esophageal myotomy. Outcomes included clinical and technical success, procedural adverse events, and reflux rates., Results: A total of 109 patients with sigmoid achalasia (sigmoid, n = 74; advanced sigmoid, n = 35) underwent POEM across 13 centers (short myotomy, n = 59; standard, n = 50). Technical success was 100% across both groups. Patients who underwent short myotomy had a significantly shorter mean procedure time (57.7 ± 27.8 vs 83.1 ± 44.7 minutes, P = .0005). A total of 6 adverse events were recorded in 6 patients (5.5%; 4 mild, 2 moderate); the adverse event rate was not significantly different between short and standard groups. Ninety-eight patients had follow-up data (median, 3.6 months; interquartile range, 1-14 months). Clinical success was 94% (short, 93%; standard, 95%; P = .70) and did not differ based on achalasia subtype or sigmoid achalasia severity. Twenty-one (22%) patients reported post-POEM reflux and 44% (16 of 36) had objective evidence of pathologic reflux. Rates of pathologic reflux were significantly increased in the standard versus short group (odds ratio, 18.0; 95% confidence interval, 2.0-159.0; P = .009)., Conclusions: POEM with short myotomy is effective and safe for the short-term treatment of sigmoid and advanced sigmoid achalasia. Short myotomy may lead to less reflux than standard myotomy., Competing Interests: Disclosure The following authors disclosed financial relationships: A. Schlachterman: Consultant for Olympus Medical, Fujifilm Healthcare, Boston Scientific, Lumendi, and Laborie. P. Kedia: Consultant for Boston Scientific, Olympus Medical, and Medtronic. R. Pawa: Consultant for Boston Scientific and Cook Medical. P.G. Arcidiacono: Consultant for Pentax Medical, Boston Scientific, and FujiFilm. Advisory Board for MediGlobe and AMBU. S. Nagi: Lecture fees from Falk Pharmaceuticals, Pfizer, and Sanofi. R Sharaiha: Consultant for Boston Scientific, Olympus, and Intuitive Surgical. S. Irani: Consultant for Boston Scientific, Conmed, and Gore. C.-R. Medranda: Key opinion leader for Pentax Medical, Steris, Micro-Tech, G-Tech Medical Supply, EndoSound, and Mdconsgroup. M. Khashab: Consultant for Boston Scientific and Olympus and he receives royalties from Elsevier and UpToDate. All other authors disclosed no financial relationships., (Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

Background: Long-COVID-19 syndrome (LCS) exhibits neurological problems such as peripheral neuropathy and autonomic nervous system (ANS) dysfunction. Exercise intolerance and, consequently, low cardiorespiratory fitness (CRF) are some of the most common symptoms of LCS. We describe a series of individuals exhibiting LCS symptoms compared to a control group and posit that this condition may be related to the exercise capacity-mediated disruption of the ANS resulting particularly in exercise intolerance., Methods: This study included 87 individuals with LCS and 71 control participants without COVID-19 diagnoses. Heart rate variability (HRV) in supine position is commonly measured to diagnose autonomic dysregulation and subsequently analyzed using the Kubios software (Kuopio, Finland). CRF (peak VO 2 ), post-COVID-19 patient-reported symptoms, maximal muscle strength (grip strength, bilateral leg press, leg extension, pectoral press, and back press exercises), and body composition were also measured. Analysis of covariance (ANCOVA) and mediation analysis were employed to assess the associations among LCS, peak VO 2 , and HRV indicators. Two-sided p < 0.05 was considered as significant., Results: The HRV parameters-RR interval, RMSSD, SDNN, PNS index, LF, HF, total power, SD1, and SD2-were significantly elevated (p < 0.05) in the control group when compared to the LCS patients. In contrast, the HR, stress index, and SNS index parameters were significantly higher (p < 0.05) in the LCS group. When adjusted for RR intervals, these parameters remained statistically significant (p < 0.05). A partially mediated effect was found between peak VO 2 and RMSSD (mediation effect = 24.4%) as well as peak VO 2 and SDNN (mediation effect = 25.1%) in the LCS patients., Conclusions: These findings contribute new insights on the interplay between CRF and HRV indicators as well as endorse that dysautonomia may be related to the low peak VO 2 observed in long COVID-19 patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Recent studies have suggested that sustained multidomain interventions, including physical exercise, may be beneficial in preventing cognitive decline. This review aims to assess the impact of prolonged physical exercise and multidomain strategies on overall cognitive faculties and dementia risk among community-dwelling older adults without dementia., Methods: We systematically searched PubMed, Web of Science, PsychInfo, and CINHAL databases from inception until April 1, 2024, for randomized controlled trials that investigated the effects of long-term (≥ 12 months) physical exercise or multidomain interventions on non-demented, community-dwelling older adults. The primary outcomes assessed were changes in global cognition and the risk of mild cognitive impairment (MCI) or dementia. Standardized mean differences (SMD) and risk ratios (RR) with 95 % confidence intervals were computed using a random-effects inverse-variance method with the Hartung-Knapp-Sidik-Jonkman adjustment for effect size calculation. The Cochrane Risk-of-Bias-2 tool (RoB-2) was used for bias assessment, and the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was applied to evaluate the certainty of evidence., Results: Sixteen trials, including 11,402 participants (mean age 73.2 [±5.5] years; 62.3 % female) were examined. The risk of bias was low. Moderate-certainty evidence indicated that physical exercise interventions had modest to no effect on cognitive function (k= 9, SMD: 0.05; 95 % CI: -0.04-0.13; p = 0.25), whereas multidomain interventions were significantly impactful (k=7, SMD: 0.09; 95 % CI: 0.04-0.15; p < 0.01). Physical exercise interventions did not alter MCI risk (k= 4, RR: 0.98; 95 % CI: 0.73-1.31; p = 0.79) or dementia onset (k= 4, RR: 0.61; 95 % CI: 0.25-1.52; p = 0.19), with very low-to low-certainty evidence, respectively., Conclusions: Integrative multidomain strategies incorporating physical exercise may benefit the global cognitive function of older adults. However, long-term physical exercise alone did not yield any cognitive gains. The effectiveness of such exercise interventions to mitigate the overall risk of incident MCI and dementia warrants further research., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest, (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Sports medical examinations are a tool to detect potentially life-threatening situations during physical activity, but their usefulness and protocols in young athletes remain controversial. The aim was to describe the diagnostic performance of a 2-step ECG and echocardiogram screening model in a large sample of healthy young-adolescent athletes (aged 11-16 years), evaluating its cost-effectiveness for cardiovascular disease (CVD) detection., Methods: Cross-sectional study of 2617 individuals (81 % male, mean age 15 years), over 20 federated sports (La Rioja-Spain). A cardiological examination included family and personal history, physical examination, ECG, and transthoracic echocardiogram. The previous ECG, conducted at 11-13 years old, was reviewed in 1589 individuals (60 %). ECGs were interpreted according to 2017 international criteria. The prevalence of structural cardiac disease (CD) was investigated, and the diagnostic performance of both tests and the cost of screening was evaluated., Results: CVD was diagnosed in 63 athletes (2.4 %) and 16 (0.6 %) with pathology related to sudden cardiac death (SCD). In 3 cases (0.11 %), cessation of sporting activity was indicated, and in 2 cases (0.07 %) treatment for congenital CD was indicated. ECG alterations were infrequent (2.5 %). Eighty percent of the structural CD diagnosed by echocardiogram had a normal ECG. The cost per CVD detected was €3,080, and for CVD associated with SCD, it was €12,323., Conclusions: Our study shows the diagnostic cost-effectiveness of a two-step cardiac screening protocol, including ECG, and highlights the role of echocardiography in young adolescent athletes, which could be implemented at a low and reasonable cost., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This study investigated the associations between pre-season and in-season performance with external workload in professional soccer players. Twenty-one players completed hamstring strength, countermovement jump (CMJ), 20-m sprint, and Yo-Yo intermittent recovery tests before (pre-season) and after 8 weeks (in-season). External workload (total distance, high-intensity running distance, number of sprints, and power plays) was quantified during this period, and used to divide the average above and below subgroups outcome by outcome for further analyses. Significance was accepted when P≤0.05. Hamstring strength declined from pre- to in-season [- 6%; p=0.014; effect size (ES): - 0.41], while Yo-Yo performance improved (46%; p=0.001; ES: 1.31). When divided by high-intensity running distance, only the below-average subgroup improved CMJ performance (5%; p=0.030). For minutes played, the above-average subgroup improved Yo-Yo performance (41%; p<0.001), but not the below-average subgroup. Furthermore, playing time correlated with improved Yo-Yo performance (p=0.040; r=0.534). Improved 20-m sprint performance associated with more sprints performed (p=0.045; r=- 0.453). Physical capabilities changed over a competitive season and were related to, and differentiated by, external workload. Because hamstring strength decreased and CMJ only improved in players exposed to less high-intensity external load, practitioners should individualize approaches to counteract these conditions when high external workload is performed over the season., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Purpose: To identify the physical conditioning and functional injury-screening characteristics of elite female soccer players., Methods: This review was prospectively registered (PROSPERO CRD4202346765). Searches were conducted in PubMed/MEDLINE, Cochrane Library, Scopus, and Web of Science (from inception in March 2023 to July 2023). Updated searches were conducted in October 2023 and April 2024. Included studies were quantitative studies conducted on female soccer players. Main outcomes were functional and physical profiles. Screening, data extraction, and quality assessment (Quality Assessment Tool for Quantitative Studies and the Oxford Levels of Evidence scales) were performed. Mean differences between preseason and in-season testing periods were estimated by Hedges g effect size. Methods and results were reported according to PRISMA guidelines., Results: The search yielded 1727 articles, of which 10 were included. Overall methodological quality of the studies was strong, with a moderate level of evidence. Players exhibited mean maximal oxygen uptake of 52.6 (4.5) mL·min-1·kg-1, 20-m linear-sprint performance of 3.58 (0.18) seconds, countermovement jump of 31.0 (2.9) cm, unilateral countermovement jump of 14.4 (2.1) cm, and quadriceps and hamstring peak torque at 60°·s-1 of 133 (23) and 87 (17) N·m, respectively. Mean scores recorded during in-season were 2% to 22% better than in preseason (effect size: small to very large)., Conclusions: This review provides valuable normative physical conditioning and functional injury-risk assessment data for elite female soccer players. Coaches and conditioning staff can use these insights to interpret their own records and optimize their training processes. Furthermore, this study identifies methodological limitations to address in future research.