Effect of the role, playing position and the body characteristics on physical performance in female soccer players

The aims of this study were to know the physical demands according to the playing position and team role, and to assess the effect of the body characteristics on the physical performance of semi-professional female soccer players. Forty-five female semi-professional soccer players during 9 home-matches of the 2021-2022 season were analyzed and GPS devices (GPEXE ®) were used. ANCOVA tests were performed with playing time as covariate. The results showed greater physical demands in forwards and wide-midfielders and offensive role players. Total distance, metabolic power, accelerations, deaccelerations, and distance covered to medium and high speed obtained a strong effect size in these analyses according to the playing position. Furthermore, relationships between body weight and physical performance were found (p < 0.05). In conclusion, the main finding of this study showed that semi-professional female soccer players compete differently, caused by differentiated functions, evidenced in the playing positions and role in the team. Offensive role, forwards and wide-midfielder female players performed the highest physical demands in the competition. This study has shown relevant information for coaches, S&C coaches, and training staff of the semi-professional female soccer teams in order to propose new keys and ways of planning training sessions.

FAST® questionnaire for identifying glaucoma patients at risk for ocular surface disease

OBJECTIVES

To evaluate the validity and reliability of the new Fast Assessment of the Ocular Surface Trouble (FAST®) questionnaire for identifying glaucoma or ocular hypertension (OHT) patients at risk of ocular surface disease (OSD).

METHODS

A multicenter, international, cross-sectional, epidemiological survey evaluated the most accurate interview items and ocular signs on the initial 14-item version of FAST® to develop a shorter version for routine, quick clinical use. Rasch analysis and least absolute shrinkage and selection operator (LASSO) method was used to reduce the number of items on the questionnaire. Sensitivity and specificity of FAST® were assessed with receiver operating characteristic (ROC) curves for the detection of OSD with the questionnaire and ophthalmic assessment.

RESULTS

A total of 2308 eyes (1154 patients) were analyzed in this study by 92 ophthalmologists. The initial version of the FAST® indicated 60% of the subjects had OSD. Rasch analysis allowed removal of some clinical signs. The LASSO method allowed elimination of some items from the original questionnaire for a 9-item and a 6-item version of FAST®. For the 6-item questionnaire, the sensitivity and specificity were 71.9% and 74.3% respectively and the area under the curve was 0.815.

CONCLUSIONS

The FAST® questionnaire is a valid and reliable tool for use in routine clinical practice and in clinical trials. The short versions of the questionnaire allow quick detection of the majority of patients with OHT or glaucoma at risk of dry eye.

Self-perception of dual career barriers and athletic identity in student-athletes with disabilities according to disability type and level of professionalization

The objective of this study was to analyze the perceived barriers to dual career success and athletic identity of student-athletes according to disability type and level of professionalization. The final sample consisted of 203 student-athletes with disabilities from five European countries. The questionnaires used were ESTPORT, EBBS and AIMS. Depending on disability type, it was found that student-athletes with hearing and physical impairment showed the highest difficulty in reconciling sports and studies (p = 0.001); that student-athletes with a hearing impairment showed the highest score in the barrier 'the cost of education is high' (p = 0.023); that student-athletes with a physical impairment had the highest scores in the barrier 'Exercise tires me' (p = 0.013); that student-athletes with cerebral palsy showed the highest scores in the barrier 'I do not have enough university/educational institution support' (p = 0.014) and 'Exercise facilities do not have convenient timetables for me' (p = 0.001). Depending on sports professionalization level, semi-professional student-athletes showed the highest values in the barrier 'the university/educational institution is far from my training center' (p = 0.040); while professional student-athletes had the highest score in the barrier 'exercise takes too much time from family responsibilities' (p = 0.034). In most of the variables related to identity as athletes, professional student-athletes showed the highest values, followed by semi-professional athletes (p = 0.043- < 0.001). In conclusion, the self-perception of barriers is quite relevant, with differences arising from disability type and level of professionalization, whereas the identity as an athlete is only different according to the level of professionalization.

Cause-Effect: The Relationship between Role and Experience with Psychological and Physical Responses in the Competition Context in Soccer Referees

This study analyzed the effects of psychological responses (impulsivity, self-esteem, self-confidence, and anxiety) in baseline and pre-competitive contexts of national soccer referees (SRs), their control of the game (yellow and red cards), and physical performance (PP) according to the role (assistant or main referee), and experience in the category. Twenty-seven national SRs from Spain participated in this study. Baseline and pre-competitive psychological data were collected through the Competitive State Anxiety Inventory-2 (CSAI-2 test), Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency, Impulsive Behavior Scale (UPPS-P test), and Rosenberg tests. Furthermore, WIMU PRO™ inertial devices were used to monitor PP. The results indicated that a lack of perseverance and self-esteem were higher in the main SRs and somatic anxiety in assistant SRs. Experience of SRs was related to anxiety, self-confidence, self-esteem, impulsivity dimensions, and PP metrics (p < 0.05). Finally, red cards were related to positive and negative urgency (r = 0.38 and r = 0.35, p < 0.05, respectively). In conclusion, the main SRs and SRs with more experience had better psychological characteristics and PP in a competitive context. However, yellow and red cards were not associated with these factors, although red cards were related with urgency. Based on these data, specific training programs could be incorporated to enhance emotional control in SRs with less experience to achieve greater performance and professional development.

Influence of physical fitness on decision-making of soccer referees throughout the match

The purpose of this study was to analyze the relationships between physical fitness and physical performance in competition and the decision-making (successes and errors). A sample of 22 male national-level soccer referees (weight: 72.7 kg; height: 178.0 cm; age: 23.4 years) participated in this study. Physical fitness was assessed through 6 series of 40 m (velocity) and Yo-yo (aerobic) test in annual exam by Soccer Committee, physical performance was performed through the total distance covered in competition (Experiment 1), and decision-making was registered through a simulated Video Assistant Referee system (VAR) with the consensus of 2 national referees evaluating only warnings (yellow cards), expulsions (red cards), established penalties and obvious goal actions (called and no called) (Experiments 2 and 3). Results showed that physical fitness test was related with total distance (rho = 0.63, p < .01) and success rate percentage (rho = 0.74, p < .05) registered during competition. The success rate percentage, in the first half, was observed 44% successes, and in the second half, 59% successes. The number of events called was related with the physical fitness test score (R2 = 0.71, p = .035; R2 = 0.64, p = .056, respectively). As conclusion, the main finding of this study has provided insight into decision-making behavior in real competitive matches and the physical fitness was the predictor of the successful decision-making being able to determine the permanency, promotion or decrease of category.

Endocannabinoid regulation of hippocampus-dependent memory

Over the past few decades, tremendous work has been dedicated to understanding how cannabinoids, both endogenous and exogenous, impact the process of learning and memory. Here we attempt to summarize the breadth of this research investigating the role of cannabinoid signaling on episodic or hippocampus-dependent memory. This review will focus primarily on studies using pharmacological approaches, allowing us to discuss the impact of cannabinoids at different phases of the memory formation process. We will briefly provide an overview of the endocannabinoid system and the mechanisms underlying memory formation, then discuss the impact of cannabinoids on memory encoding, consolidation, retrieval, and extinction. Additionally, we examine the impact of cannabinoids on synaptic plasticity and intracellular signaling within the hippocampus related to these processes.

Starters and non-starters soccer players in competition: is physical performance increased by the substitutions?

BACKGROUND

Non-starters soccer players have a great role within the team, being indispensable to reduce fatigue, as well as to maintain and increase the team's performance during the match.

OBJECTIVE

This study aimed to analyze the physical performance of the starter and non-starters players during competitive soccer matches.

METHODS

Twenty-two soccer players participated in this study, divided into two groups according to the role in the match (starters or non-starters). WIMU Global Positioning System devices were used in order to record physical performance metrics. Independent samples t-test and one-way ANOVA tests were performed to compare starters and non-starters, and the playing position, respectively, and two-way ANOVA test was perform with these factors too.

RESULTS

There were no differences in the main physical performance metrics between starters and non-starters players during competition, although there were differences in physical performance metrics according to the playing position. Midfielders performed highest distance per minute, player load, and distance covered between 12 and 21 km·h^- 1 (p < .05). Finally, distance covered at speeds greater than 24 km·h^- 1 was predicted by the playing role (starters and non-starters) and playing position factors with 88% of explained variance (η_p² = 0.772).

CONCLUSION

The main findings of this study showed that non-starter players had a similar physical performance during competitive matches as the starter players for whom they are substituted. In addition, the playing position determined different physical performance, contributing in this manuscript that behavior and decision-making of the players could be affected by their position in the field. More studies are needed on non-starter player performance and contextual factors that could influence the physical responses of these players.

Development of an Online Multilingual Educational Programme for Parents of Dual-Career Athletes: A Participatory Design

There is a need for educational support structures to empower parents in sustaining talented athletes pursuing academic and sports careers (e. g., dual career). The present work describes the participatory design used to develop a series of educational resources and the subsequent iterations used to evaluate the content of the EMPATIA online education programme for parents of dual-career athletes. Following an ethnographic approach, the project team (18 dual-career experts) engaged in four iterations (i.e., rounds) planned to develop (rounds 1 and 2) educational material from preliminary evidence (systematic literature review) and eminence (focus groups and concept mapping) knowledge and to evaluate the educational programme (round 3 and 4) engaging end users (n = 76) and other stakeholders (9 dual-career experts). The EMPATIA programme was developed and organized in four modules labeled after macro-aspects, parents could ask about dual career: “Why” (the definition and challenges of dual career for athletes and their parents), “What” (insights, guidelines, and suggestions on the parental role in support of student-athletes), “How” (practical advice on planning dual career at sports and academic levels, and post-sports careers), and “Where” (finding legal information or counseling on dual career). Despite overall positive evaluations of the programme, parents of dual-career athletes attributed higher scores with respect to those of dual-career experts. The participatory approach presented in this work enables developers to apply a systematic and multidisciplinary approach toward the creation of educational programmes for parents. The cooperation among dual-career researchers, experts from high-performance centers, Olympic bodies, sports clubs, and parents of elite student-athletes of different sports and nationalities created an educational programme suitable for end users to support parenting athletes in combining their sports and academic careers.

Environmental Enrichment Sex-dependently Rescues Memory Impairment in FABP5 KO Mice Not Mediated by Brain-Derived Neurotrophic Factor

Fatty acid-binding proteins (FABPs) are intracellular carriers of bioactive lipids and play a role in the trafficking of endocannabinoids as well as polyunsaturated fatty acids. Mice lacking the FABP5 gene have memory impairments. Environmental enrichment is a potent manipulation known to rescue or improve memory performance. The extent to which the memory impairments in FABP5 knockout (KO) mice can be rescued or improved through environmental conditions remains to be understood. To address this, we raised wild type (WT) and FABP5 KO mice in either socially isolated or environmental enrichment conditions during adolescence. Once in adulthood, mice were tested for Novel Object Recognition (NOR), T-maze, and Morris Water Maze (MWM) to evaluate memory performance. Mice were then euthanized to assess hippocampal brain-dervied neurotrophic factor (BDNF) concentrations. MWM results showed that male FABP5 KO mice performed worse compared to WT counterparts. Male and female mice raised in an enriched environment improved performance regardless of genotype. Results on the NOR test showed that male FABP5 KO mice displayed lower object recognition compared to WT counterparts across both environments. No differences of genotype or environment were seen in female mice. T maze findings showed that impaired performance in socially isolated FABP5 KO mice. Adolescent environmental enrichment rescued this deficit in male, but not female, FABP5 KO mice. Lastly, environmental enrichment increased hippocampal BDNF levels in male WT mice only. Our results corroborate the previously observed role of the FABP5 gene on memory performance and identify an important interaction with the environment during adolescence.

Binge ethanol drinking associated with sex-dependent plasticity of neurons in the insula that project to the bed nucleus of the stria terminalis

Modifications in brain regions that govern reward-seeking are thought to contribute to persistent behaviors that are heavily associated with alcohol-use disorder (AUD) including binge ethanol drinking. The bed nucleus of the stria terminalis (BNST) is a critical node linked to both alcohol consumption and the onset, maintenance and progression of adaptive anxiety and stress-related disorders. Differences in anatomy, connectivity and receptor subpopulations, make the BNST a sexually dimorphic region. Previous work indicates that the ventral BNST (vBNST) receives input from the insular cortex (IC), a brain region involved in processing the body's internal state. This IC-vBNST projection has also been implicated in emotional and reward-seeking processes. Therefore, we examined the functional properties of vBNST-projecting, IC neurons in male and female mice that have undergone short-term ethanol exposure and abstinence using a voluntary Drinking in the Dark paradigm (DID) paired with whole-cell slice electrophysiology. First we show that IC neurons projected predominantly to the vBNST. Next, our data show that short-term ethanol exposure and abstinence enhanced excitatory synaptic strength onto vBNST-projecting, IC neurons in both sexes. However, we observed diametrically opposing modifications in excitability across sexes. In particular, short-term ethanol exposure resulted in increased intrinsic excitability of vBNST-projecting, IC neurons in females but not in males. Furthermore, in females, abstinence decreased the excitability of these same neurons. Taken together these findings show that short-term ethanol exposure, as well as the abstinence cause sex-related adaptations in BNST-projecting, IC neurons.

Photodegradation of Molecular Iodine on SiO2 Particles: Influence of Temperature and Relative Humidity

A molecular derivatization method followed by gas chromatographic separation coupled with mass spectrometric detection was used to study photodegradation of molecular I2 adsorbed on solid SiO2 particles. The heterogeneous photodegradation of I2 was studied as a function of temperature and relative humidity in synthetic air to better understand its environmental fate. Two sets of experiments were carried out. In the first set of experiments, the temperature was T = (298 ± 1) K and relative humidity was varied from ≤ 2% to 75%RH under given experimental conditions. In the second set of experiments, the relative humidity within the Pyrex bulb was 40%RH and the temperature was varied from 283 ± 1 ≤ T (K) ≤ 323 ± 1. The obtained results show a considerably enhanced atmospheric lifetime of molecular iodine adsorbed on solid media that does not depend on relative humidity of the environment. The obtained results show that the rate constant for the photolysis of molecular iodine adsorbed on model SiO2 particles depends on temperature and is reported to be J (T)=(1.24 ± 1.4)×10−2×exp[(1482±345)/T]/s over the measured temperature range. The heterogeneous atmospheric residence time () of I2 adsorbed on solid media is calculated to range from 2 to 4.1 h. The experimentally obtained heterogeneous lifetime of I2 is shown to be considerably longer than its destruction by its principal atmospheric sink, photolysis. The observed enhanced atmospheric lifetime of I2 on heterogeneous media will likely have direct consequences on the atmospheric transport of I2 that influences the toxicity or the oxidative capacity of the atmosphere.

Integrated efforts to promote mental health care during the SARS-CoV-2 pandemic: Reflecting on the experience of a university helpline

Introduction

The SARS-CoV-2 pandemic is affecting numerous dimensions of our society since the beginning of the outbreak. A significant increase in emotional distress was expected in the general population, particularly among the high-risk groups such as the oldest, chronic patients, healthcare professionals, and psychopathology vulnerable people. There was an urgent need to adapt and create solutions to promote mental health. Given the recommendations to minimize face-to-face interactions, several helplines were widely developed.

Objectives

In this work, we aim to reflect on the experience of a university helpline, that integrated efforts with the regional mental health care services.

Methods

A University helpline was created to give support to the regional community outside academia. The team was created on an online teamwork platform, to communicate through the chat, carry videoconference meetings, and store useful files. A Manchester screening decision tree was adopted, to define a set of guidelines to provide support to the callers, based mainly on the guidelines defined by the Order of Portuguese Psychologists. Liaison with the mental health care services, including other specific helplines, was established.

Results

Notwithstanding all the efforts, the number of received calls was scarce, similarly to helplines created by other national universities and by other entities.

Conclusions

A new approach to psychological intervention in crisis is needed, maintaining integrated efforts, and taking advantage of the opportunity to foster personalized mental health care in the digital era. It is important to continuously assess the value of integrated efforts in patient care and to the healthcare system.

Understanding the educational needs of parenting athletes involved in sport and education: The parents' view

BACKGROUND

Despite 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.

METHODS

In 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.

RESULTS

A 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.

CONCLUSIONS

This 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.

Interprofessional health education and its impact on integral healthcare

Background

Interprofessionality is a tool for optimizing the human resources available towards the consolidation of a resolutive healthcare. However, applying it is a challenge due to the fragmented training of health professionals.

Objective

to describe the experience of planning and executing an interprofessional health education activity.

Methods

An educational workshop was developed aiming at interprofessional health practice. A clinical case was distributed, which addressed the story of an elderly person who suffered a stroke and lived with the sequels of this episode in addition to emotional trauma from the experience. Each professional was asked to define a therapeutic proposal for the case and one of them was invited to present his proposal and complement it based on the suggestions of the other members.

Results

the workshop enabled the perception that, in isolation, no profession would be able to fully contemplate the patient's needs. Therefore, it encouraged the use of integrated action between different professionals by demonstrating that punctual and disjointed actions would not be sufficient to act effectively in the care and needs related to the individual's health.

Conclusions

the final product of this workshop resulted in a consistent activity contemplated by multiple perspectives, experiences and knowledges which would not be so successful if planned in isolation by a single professional group.

Key messages

Due to its low cost, interprofessional action responds to the new health needs of contemporary times and its implementation is of great value in combating the fragmented trend in health training. The interprofessional view is a common ground to health not only where the study took place but worldwide, consolidating itself as a valuable asset to the construction of integral healthcare.

Dendritic spine density is increased on nucleus accumbens D2 neurons after chronic social defeat

Stress alters the structure and function of brain reward circuitry and is an important risk factor for developing depression. In the nucleus accumbens (NAc), structural and physiological plasticity of medium spiny neurons (MSNs) have been linked to increased stress-related and depression-like behaviors. NAc MSNs have opposing roles in driving stress-related behaviors that is dependent on their dopamine receptor expression. After chronic social defeat stress, NAc MSNs exhibit increased dendritic spine density. However, it remains unclear if the dendritic spine plasticity is MSN subtype specific. Here we use viral labeling to characterize dendritic spine morphology specifically in dopamine D2 receptor expressing MSNs (D2-MSNs). After chronic social defeat, D2-MSNs exhibit increased spine density that is correlated with enhanced social avoidance behavior. Together, our data indicate dendritic spine plasticity is MSN subtype specific, improving our understanding of structural plasticity after chronic stress.

Photolytic degradation of molecular iodine adsorbed on model SiO2 particles

A molecular derivatization method followed by gas chromatographic separation coupled with mass spectrometric detection was used to study photolytic degradation of I₂ adsorbed on solid SiO₂ particles. This heterogeneous photodegradation of I₂ is studied at ambient temperature in synthetic air to better understand I₂ atmospheric dispersion and environmental fate. The obtained laboratory results show a considerably enhanced atmospheric lifetime of molecular iodine adsorbed on solid media. The heterogeneous atmospheric residence time (τ) of I₂ is calculated to be τ ≈ 187 min, i.e., τ ≈ 3 h. The obtained heterogeneous lifetime of I₂ is shown to be considerably longer than its destruction by its principal atmospheric sink, namely, photolysis. The observed enhanced atmospheric lifetime of I₂ on heterogeneous media will likely have direct consequences on the atmospheric transport of I₂ that influences the toxicity or the oxidative capacity of the atmosphere.

Cyclophosphamide-bortezomib-dexamethasone compared with bortezomib-dexamethasone in transplantation-eligible patients with newly diagnosed multiple myeloma

Introduction

Cyclophosphamide-bortezomib-dexamethasone (CyBorD) is considered a standard induction regimen for transplant-eligible patients with newly diagnosed multiple myeloma (mm). It has not been prospectively compared with bortezomib-dexamethasone (Bor-Dex). We aimed to compare the efficacy of CyBorD and Bor-Dex induction in transplant-eligible patients.

Methods

In a retrospective observational study at a single tertiary centre, all patients with transplant-eligible mm who received induction with CyBorD or Bor-Dex between March 2008 and April 2016 were enrolled. Progression-free survival (pfs), response, and stem-cell collection for a first autologous stem-cell transplantation (ahsct) were compared.

Results

Of 155 patients enrolled, 78 (50.3%) had received CyBorD, and 77 (49.7%), Bor-Dex. The patients in the Bor-Dex cohort were younger than those in the CyBorD cohort (median: 57 years vs. 62 years; p = 0.0002) and more likely to have had treatment held, reduced, or discontinued (26% vs. 14.5%, p = 0.11). The stem-cell mobilization regimen for both cohorts was predominantly cyclophosphamide and granulocyte colony-stimulating factor (gcsf). Plerixafor was used more often for the CyBorD cohort (p = 0.009), and more collection failures occurred in the CyBorD cohort (p = 0.08). In patients receiving Bor-Dex, more cells were collected (9.9×10⁶ cells/kg vs. 7.7×10⁶cells/kg, p = 0.007). At day +100, a very good partial response or better was achieved in 75% of the CyBorD cohort and in 73% of the Bor-Dex cohort (p = 0.77). Median pfs was 3.2 years in the Bor-Dex cohort and 3.7 years in the CyBorD cohort (p = 0.56).

Conclusions

Overall efficacy was similar in our patients receiving CyBorD and Bor-Dex. After ahsct, no difference in depth of response or pfs was observed. Cyclophosphamide-gcsf seems to increase collection failures and hospitalizations in patients receiving CyBorD. Prospective studies are required to examine that relationship.

A Rare Manifestation of Tuberculosis in a Renal Transplant Patient: A Case Report

Cutaneous lesions in the presence of fever in patients undergoing immunosuppressive therapy are a diagnostic challenge and may represent manifestations of multiple diseases, such as fungal infections, nocardiosis, lymphoproliferative diseases, zoonosis, and tuberculosis. The authors report a case of a 66-year-old white man with chronic kidney disease since 2014 (chronic pyelonephritis) who had a renal transplant in the previous 6 months. Induction therapy was performed with thymoglobulin, and his current immunosuppression scheme included tacrolimus, mycophenolate mofetil, and prednisolone. The patient had no history of pulmonary tuberculosis. The patient presented with 2 cutaneous lesions, localized on the back and abdomen, that appeared to be firm, painful, subcutaneous, erythematous nodules with an approximately 5 cm diameter overlying an infected focus and purulent material inside. The patient also had a fever and fatigue. Blood analysis showed pancytopenia with an elevation of inflammatory markers and graft dysfunction. Tissue cultures and skin biopsy with histological analysis were performed. Histopathology of the lesion showed a nonspecific inflammatory infiltrate without granulomas, and acid-fast bacillus staining was negative. Nevertheless, serum QuantiFERON testing was positive. But polymerase chain reaction finally confirmed the presence of Mycobacterium tuberculosis, which confirmed the diagnosis of cutaneous tuberculosis. A chest computed tomography scan showed a lung pattern of miliary tuberculosis. The patient was treated with multidrug tuberculosis therapy, resulting in lesion clearance after 3 weeks. Tuberculosis is a serious infection, especially in high-risk patients, such as those in an immunocompromised state. The incidence of cutaneous tuberculosis is rare, but it should be considered in patients presenting with atypical skin lesions suggestive of an underlying infectious etiology.

Pretransplant Biopsy of Marginal Kidneys: Is It Necessary?

INTRODUCTION

Pretransplant kidney biopsy from marginal donors is used to guide the decision of whether to accept or discard organs for transplantation; however, there is controversy about this procedure, and the need for a pretransplant biopsy is still a debate. We sought to determine if histologic evaluation before implantation of marginal kidneys would influence the outcome.

METHODS

A retrospective observational cohort study of marginal donor transplants at Centro Hospitalar e Universitário de Coimbra was done. From 2009 to 2016, 650 marginal kidney transplants were analyzed. We evaluated long-term graft survival in a cohort of patients who received marginal kidneys. The recipients were divided into 2 groups based on whether a pretransplant donor biopsy was performed. Continuous variables were summarized by mean and standard deviation or median and range, as applicable. Categorical variables were summarized by relative and absolute frequencies. The survival analysis was obtained and plotted using the Kaplan-Meier method and compared with the log-rank test.

RESULTS

The median age of recipients and donors were statistically different between both groups (P < .001), with the donors and the recipients being younger in the group without a pretransplant biopsy. The median cold ischemia time was higher in the biopsy group (P = .01). The survival analysis showed that graft survival didn't differ between the groups (P = .2).

CONCLUSIONS

Selection of kidneys based on histological findings may not influence the graft survival and implies a higher cold ischemia time. More data are necessary to provide insight into which clinical, histologic, and biochemical parameters are necessary for decision making on kidney acceptance.

Metronomic oral vinorelbine for the treatment of advanced non-small cell lung cancer: a multicenter international retrospective analysis

PURPOSE

Metronomic oral vinorelbine (MOV) could be a treatment option for unfit patients with advanced non-small cell lung cancer (NSCLC) based on its safety profile and high patient compliance.

METHODS

We retrospectively collected data on 270 patients [median age 76 (range 48-92) years, M/F 204/66, PS 0 (27)/1 (110)/≥ 2 (133), median of 3 serious comorbidities] with stage IIIB-IV NSCLC treated with MOV as first (T1) (67%), second (T2) (19%) or subsequent (T3) (14%) line. Schedules consisted of vinorelbine 50 mg (138), 40 mg (68) or 30 mg (64) three times a week continuously.

RESULTS

Patients received an overall median of 6 (range 1-25) cycles with a total of 1253 cycles delivered. The overall response rate was 17.8% with 46 partial and 2 complete responses and 119 patients (44.1%) experienced stable disease > 12 weeks with an overall disease control rate of 61.9%. Median overall time to progression was 5 (range 1-21) months [T1 7 (1-21), T2 5.5 (1-19) and T3 4 (1-19) months] and median overall survival 9 (range 1-36) months [T1 10 (1-31), T2 8 (1-36) and T3 6.5 (2-29) months]. Treatment was extremely well tolerated with 2% (25/1253) G3/4 toxicity (mainly G3 fatigue and anemia) and no toxic deaths. We observed the longer OS 14 (range 7-36) months in a subset of squamous NSCLC patients receiving immunotherapy after metronomic oral vinorelbine.

CONCLUSION

We confirmed MOV as an extremely safe treatment in a large real world population of advanced NSCLC with an interesting activity mainly consisting of long-term disease stabilization. We speculate the possibility of a synergistic effect with subsequent immunotherapy.

Pediatric Renal Transplantation: Evaluation of Long-Term Outcomes and Comparison to Adult Population

BACKGROUND

In Europe, pediatric transplantation accounts for only about 4% of all kidney transplantations performed. The aim of our work is to evaluate the evolution of pediatric renal transplantation in our department over time, but also to compare this special population with the adult one.

METHODS

We evaluated all pediatric renal transplantations performed in our department between January 1981 and December 2016. We performed the analysis of clinical, analytical, and surgical factors to look for predictive factors of graft loss or decrease of survival. In addition, we performed a comparative study of pediatric and adult populations and an evaluation of the evolution of pediatric renal transplantation in our department over time.

RESULTS

We evaluated 101 renal transplantations performed in patients younger than 18 years. Pediatric transplantations corresponded to 3.4% of all renal transplantations performed in our department. The rate of living donors was 12%. Donors of grafts for the pediatric population were significantly younger than in the adult population. The increase in donor age was associated with lower renal graft survival rates. Acute rejections were more frequent in the pediatric population. Eleven pediatric recipients (10.9%) died in the follow-up period. Renal graft survival in the pediatric population was 94.8%, 77.4%, and 66.5% at 1, 5, and 10 years, respectively. There was no significant difference in graft survival in the pediatric and adult population. The pediatric overall survival rate at 1, 5 and 10 years was 97.9%, 96.8%, and 91.9%, respectively.

CONCLUSION

Pediatric renal transplantation presents results identical to those identified in adults.

Athletes' perceptions of coaching competency and team conflict in sport teams: A multilevel analysis

The purpose of this study was to examine the relationship between coaching competency and team conflict, at individual and team levels, over the season. The participants were professional female and male soccer players, who participated in the First and Second Division. A longitudinal study was performed. At Time 1, the sample of participants consisted of 581 soccer players aged between 15 and 39 years. At Time 2, 549 players were recruited from the original sample aged between 15 and 37 years. Finally, at Time 3, the sample comprised 576 players aged between 15 and 37 years. All participants completed a multi-section questionnaire assessing coaching competency (motivation, game strategy, technique competency, and character-building competency) and team conflict (task conflict and relationship conflict). Results showed that both task and relationship conflict increased significantly over time. Multilevel modelling analysis showed that game strategy and character-building competencies negatively predicted both task and relationship conflicts at the individual level, whereas motivation competency was also added as a significant predictor of task conflict at the team level. Moreover, technique competency positively predicted task conflict at the team level. The current study suggests the importance of coaching competency in group dynamics in sport.

Staphylococcus Infection-Associated Glomerulonephritis in a Kidney Transplant Patient: Case Report

BACKGROUND

Staphylococcus infection-associated glomerulonephritis is a rare cause of graft dysfunction in kidney transplant. Suspicion should be high in the setting of elevation of serum creatinine, active urinary sediment, with or without hypocomplementemia, and simultaneous Staphylococcus aureus infection. A kidney biopsy is usually diagnostic.

CASE REPORT

A 56-year-old man, who received a kidney transplant in 1998, with basal serum creatinine of 1.2 mg/dL and normal urinary sediment, was admitted to our kidney transplantation unit with graft dysfunction and a urinary tract infection caused by S aureus with septicemia, treated with antibiotics, in the context of recently intensified immunosuppression for a primary immune thrombocytopenia diagnosed 3 weeks earlier. After antibiotic treatment, the patient persisted with graft dysfunction, edema, and hypertension, with a S aureus isolation in the urine culture, active urinary sediment, and low C3. A kidney biopsy was performed, showing diffuse proliferative endocapillary and mesangial glomerulonephritis, with IgA(++) and C3(++) mesangial and endocapillary deposits in immunofluorescence. The patient was treated symptomatically and maintained his regular immunosuppression. At the last follow-up, his serum creatinine value was stable at 2.5 mg/dL.

CONCLUSIONS

The onset of a nephritic syndrome with a simultaneous S aureus infection should lead to suspicion of this uncommon entity, confirmed histologically. Despite its association with poor graft survival, our patient's graft survival remained stable.

Fatty acid binding protein deletion prevents stress-induced preference for cocaine and dampens stress-induced corticosterone levels

Genetic and pharmacological manipulation of endocannabinoid (eCB) signaling has previously been shown to have an important role on the rewarding properties of drugs of abuse, including cocaine. Recently, fatty acid binding proteins (FABPs) have been proposed as intracellular transporters of the endocannabinoid anandamide (AEA) as well as other bioactive lipids to their catabolic enzyme, fatty acid amide hydrolase (FAAH). The role of these transporters in modulating the brains reward system has yet to be investigated. This study examined the effects of genetic deletion of FABP 5/7 on cocaine preference, as assessed by the Conditioned Place Preference (CPP) paradigm. Male and female wild type (WT) and FABP 5/7 KO mice showed similar acquisition of cocaine CPP, with no differences found in overall locomotor activity. In addition, while male and female WT mice showed stress-induced CPP for cocaine, male and female FABP 5/7 KO mice failed to show a stress-induced preference for the cocaine-paired chamber. Additionally, serum corticosterone levels were analyzed to explore any potential differences in stress response that may be responsible for the lack of stress-induced preference for cocaine. Serum samples were obtained in animals under basal conditions as well as following a 30-min tube restraint stress. Male and female FABP 5/7 KO mice showed reduced corticosterone levels under stress compared to their WT counterparts. The reduction in corticosterone response under stress may mediate that lack of a stress-induced preference for cocaine in the FABP 5/7 KO mice. Thus, the role of FABPs may play an important role in drug-seeking behavior under stressful conditions.

Ocular Symptoms and Signs with Preserved and Preservative-Free Glaucoma Medications

PURPOSE

To compare the prevalence of side effects between eyedrops with or without preservatives, in terms of subjective symptoms and objective signs in patients with open-angle glaucoma.

METHODS

In a multicenter cross-sectional epidemiologic survey in four European countries, ophthalmologists in private practice enrolled 9658 nonconsecutive patients using preservative (P) or preservative-free (PF) beta-blocking eyedrops between June 1997 and December 2003. Subjective symptoms, conjunctival and palpebral signs, and superficial punctate keratitis were explored before and after a change in therapy. For statistical analysis, a Chi-square test was used to calculate the differences in the prevalence of symptoms and signs with or without preservatives.

RESULTS

A total of 74% of the patients used P, 12% PF, 10% a P-PF combination, and in 4% the type of medication was unknown. Each recorded symptom and all the palpebral, conjunctival, and corneal signs were significantly more frequent (p<0.0001) in the P-group than in the PF-group, such as pain or discomfort during instillation (48 vs 19%), foreign body sensation (42 vs 15%), stinging or burning (48 vs 20%), and dry eye sensation (35 vs 16%). A total of 68% of the patients had a sec-ond visit performed, of whom 63% (6083) had been evaluated on treatment difference. A significant decrease (p<0.0001) of all ocular symptoms and signs was observed in patients in whom the preserved eyedrops were diminished in number or altered into preservative free drops.

CONCLUSIONS

Compared to preserved eyedrops, preservative free eyedrops are significantly less associated with ocular symptoms and signs of irritation.

Mediterranean Diet and Musculoskeletal-Functional Outcomes in Community-Dwelling Older People: A Systematic Review and Meta-Analysis

BACKGROUND

Population aging is increasing and this process together with its characteristics influence the prevalence and incidence of chronic conditions and musculoskeletal-functional outcomes such as frailty, functional disability and sarcopenia. Nutritional strategies focused on dietary patterns, such as a Mediterranean diet, can be protective from these outcomes.

PURPOSE

To investigate the association between adherence to a Mediterranean diet and frailty, functional disability and sarcopenia in community-dwelling older people.

METHODS

We systematically reviewed electronic databases (MEDLINE, EMBASE, and others) and grey literature for articles investigating the relationship between adherence to a Mediterranean diet and frailty, functional disability and sarcopenia in community-dwelling people aged 60 and over. Study selection, quality of study assessment and data extraction were conducted independently by two authors. Random effects meta-analyses were performed, and pooled Odds Ratios (OR) were obtained.

RESULTS

After the literature search, screening and eligibility investigation, we included 12studies, with a total of 20,518 subjects. A higher adherence to a Mediterranean diet was found to be inversely associated with frailty (OR 0.42, 95% CI: 0.28-0.65, I2=24.9%, p=0.262) and functional disability (OR 0.75, 95% CI: 0.61-0.93, I2=0.0%, p=0.78). Highly different study characteristics prevented us from performing a meta-analysis for sarcopenia. Cohort data indicated no association between adherence to a Mediterranean diet and sarcopenia; however, cross-sectional results showed a positive relationship.

CONCLUSION

A Mediterranean diet is protective of frailty and functional disability, but not of sarcopenia. More longitudinal studies are needed to understand the relationship between a Mediterranean diet and sarcopenia.

Early Rehospitalization Post-Kidney Transplant Due to Infectious Complications: Can We Predict the Patients at Risk?

INTRODUCTION

Rehospitalization early post-kidney transplant is common and has a negative impact in morbidity, graft survival, and health costs. Infection is one the most common causes, and identifying the risk factors for early readmission due to infectious complications may guide a preventive program and improve outcome. The aim of this study was to evaluate the incidence, characterize the population, and identify the risk factors associated with early readmission for infectious complications post-kidney transplantation.

METHODS

We performed a retrospective cohort study of all the kidney transplants performed during 2015. The primary outcome was readmission in the first 3 months post-transplant due to infectious causes defined by clinical and laboratory parameters.

RESULTS

We evaluated 141 kidney transplants; 71% of subjects were men, with an overall mean age of 50.8 ± 15.4 years. Prior to transplant, 98% of the patients were dialysis dependent and 2% underwent pre-emptive living donor kidney transplant. The global readmission rate was 49%, of which 65% were for infectious complications. The most frequent infection was urinary tract infection (n = 28, 62%) and the most common agent detected by blood and urine cultures was Klebsiella pneumonia (n = 18, 40%). The risk factors significantly associated with readmission were higher body mass index (P = .03), diabetes mellitus (P = .02), older donor (P = .007), and longer cold ischemia time (P = .04). There were 3 graft losses, but none due to infectious complications.

CONCLUSION

There was a high incidence of early rehospitalization due to infectious complications, especially urinary tract infections to nosocomial agents. The risk factors identified were similar to other series.

Long-Term Outcomes of Kidney Transplantation From Expanded-Criteria Deceased Donors: A Single-Center Experience

BACKGROUND

Organ shortage has prompted the use of expanded-criteria donors (ECDs). Our objective was to compare long-term outcomes of kidney transplants from ECDs with those from concurrent standard-criteria donors (SCDs). In addition, we evaluated variables associated with graft survival in both groups.

METHODS

We retrospectively reviewed all 617 deceased-donor kidney transplantations performed from 2005 to 2009 in our department. The population was divided according to donor status into ECD or SCD. Patients were followed until 5 years after transplantation, death, graft failure, or loss to follow-up.

RESULTS

We transplanted 150 deceased-donor kidneys from ECDs and 467 from SCDs. ECD were older, more frequently women, had a lower pre-retrieval glomerular filtration rate, and more frequently died due to cerebrovascular accident. ECD recipients were older, presented a lower proportion of black race, more frequently were on hemodialysis, and presented a higher rate of first kidney transplants. Mean glomerular filtration rate was consistently lower in the ECD group. Patient and graft survivals were lower in the ECD group, but statistical significance was present only in graft survival censored for death with a functioning graft at 3 years and graft survival noncensored for death with a functioning graft at 5 years. Younger recipient ages, longer time on dialysis, acute rejection episodes, and glomerular filtration rate at 1 year after transplantation were independent risk factors for lower graft survival.

CONCLUSIONS

Transplantation with the use of ECD kidneys provide quite satisfactory patient and graft survival rates despite their poorer long-term outcomes.