Non-athletic Individuals Research Articles

Bioelectrical Impedance Vector Analysis (BIVA) for Assessment of Hydration Status: A Comparison between Endurance and Strength University Athletes.

Athletic performance is greatly impacted by hydration status. The combination of several techniques is recommended to accurately measure water losses and gains. The aim of this study is to assess the validity of bioelectrical impedance vector analysis (BIVA) as a tool for measuring hydration status in endurance and strength athletes. A total of 148 athletes were evaluated on one experimental day, pre- and post-training. Urine samples were collected and analyzed for color and specific gravity. Body weight changes were measured, sweat rate was calculated, and BIVA was performed. Reference ellipses were plotted using data of 200 healthy non-athletic individuals. A moderate significant agreement was noted between raw bioelectrical values and urine specific gravity (USG) (p > 0.05). The sensitivity of classic BIVA in detecting minor changes in hydration status is confirmed both graphically and statistically. R/h and Z statistically significantly decreased post-training. Male athletes exhibited a specific BIA vector distribution compared to the reference population and were slightly more hydrated than female athletes. BIVA validation may be an essential step to allow its use among university students to assess dehydration in a non-invasive, practical, and inexpensive way.

Sport PRactice and its Effects on aortic size and valve function in bicuspid Aortic valve Disease: a cross-sectional report from the SPREAD study

ObjectiveConcerns exist about the possible detrimental effects of exercise training on aortic size and valve function in individuals with bicuspid aortic valve (BAV). This multicentre international study aimed to determine...

Comparison of Myofascial Release Technique and Manual Therapy for the Management of Plantar Fasciitis

Background: Plantar fasciitis (PF) is the most common cause of inferior heel pain, affecting up to 10% of the general population over a lifetime. It accounts for 8% to 15% of foot complaints in both athletic and non-athletic individuals. Objective: This study aimed to compare the effectiveness of the myofascial release technique and manual therapy in the management of plantar fasciitis. Methods: Thirty patients diagnosed with plantar fasciitis were enrolled in the study and randomly divided into two groups. Group A received myofascial release (MFR) therapy, while Group B underwent manual therapy. Each treatment was administered three times a week for four weeks, with a minimum one-day gap between sessions. Each session lasted 30 minutes and targeted the affected side. Outcome measures included the Foot Function Index (FFI) and the Numerical Pain Rating Scale (NPRS), recorded at baseline (Week 1), post-intervention (Week 4), and follow-up (Week 12). Statistical analysis was performed using SPSS version 25, with paired and independent t-tests used to evaluate within-group and between-group differences. Results: Both groups showed significant improvement in pain and function. Group A's mean NPRS score decreased from 8.00 (SD = 1.06) to 1.13 (SD = 1.06), while Group B's score decreased from 9.13 (SD = 0.63) to 4.20 (SD = 0.56), with a p-value of 0.00 for both groups. For the FFI, Group A's mean score decreased from 52.80 (SD = 4.36) to 11.46 (SD = 3.20), while Group B's score decreased from 58.53 (SD = 1.35) to 39.46 (SD = 4.61), also showing a p-value of 0.00. Conclusion: Both myofascial release and manual therapy effectively managed plantar fasciitis. However, myofascial release demonstrated superior outcomes in pain reduction and functional improvement. These findings suggest that myofascial release should be considered a primary treatment option for plantar fasciitis to enhance patient recovery and quality of life.

Shoulder pathology on advanced imaging in asymptomatic non-athlete individuals: A narrative review.

The prevalence of asymptomatic shoulder pathology has been shown to be high on both ultrasound and magnetic resonance imaging (MRI). The most common shoulder pathologies identified in asymptomatic, non-athlete individuals include rotator cuff pathology, acromioclavicular (AC) joint pathology, labral tears, subacromial bursitis, and calcific tendinitis. The data in the current literature suggest that asymptomatic rotator cuff tears are diagnosed on ultrasound and MRI at high rates, suggesting that rotator cuff tears may be considered an age-related, normal, degenerative change. However, there are data to suggest that the presence of an asymptomatic rotator cuff tear on imaging may predispose a patient to shoulder pain in the future, although the data remain inconclusive. AC joint arthritic changes are also common in older individuals on advanced imaging. Recent studies have reported that labral tears are common in asymptomatic shoulders, although at less frequent rates than in athletes, but more research is required on this topic. In addition, the presence of subacromial bursitis on imaging has not been found to accurately differentiate between symptomatic and asymptomatic shoulders. Finally, calcific tendinitis has been diagnosed asymptomatically, with most individuals remaining asymptomatic. Individuals who did develop pain developed severe pain, although the risk factors for developing symptomatic calcific tendinitis are unclear. In summary, given the high prevalence of shoulder pathology diagnosed on imaging, it is important to not over diagnose or complete an unnecessary workup for an asymptomatic person who is otherwise healthy.

A longitudinal study of quantitative late gadolinium enhancement analysis in young athletes versus non-athletic individuals with acute myocarditis

A longitudinal study of quantitative late gadolinium enhancement analysis in young athletes versus non-athletic individuals with acute myocarditis

Divergent Gut Microbiota: Archaeal and Bacterial Signatures Unveil Unique Patterns in Colombian Cyclists Compared to Weightlifters and Non-Athletes.

Engagement in physical activity, across various sports, promotes a diverse microbiota in active individuals. This study examines the gut microbiota of Colombian athletes, specifically weightlifters (n = 16) and road cyclists (n = 13), compared to non-athletes (n = 15). Using Kruskal-Wallis tests, the physical activity level of a group of non-athletic individuals and the sports experience of a group of professional athletes is analyzed. The median age of participants is 24 years, comprising 25 men and 19 women. The microbiota is collected using fecal samples. Participants provided these samples during their pre-competitive stage, specifically during the concentration phase occurring two weeks prior to national competitions. This timing is chosen to capture the microbial composition during a period of heightened physical preparation. Questionnaire responses and microbial composition assessments identify disparities among groups. Microbial composition analysis explores core microbiome, abundance, and taxonomy using Pavian, MicrobiomeAnalyst 2.0, and GraPhlAn. ANCOM-BC2 reveals differentially abundant species. Road cyclists exhibit decreased Bacteria and increased Archaea abundance. Phylum-level variations included Planctomycetes, Acidobacteria, and Proteobacteria, while Bacteroidetes prevailed. Key families influencing gut microbiota are Bacteroidaceae, Muribaculaceae, and Selenomonadaceae. Weightlifters exhibit unique viral and archaeal community connections, while cyclists showed specialized microbial interplay influenced by endurance exercise. Correlation network analysis emphasizes distinctive microbial interactions within athlete groups, shedding light on the impact of physical activities on gut microbiota and athlete health.

Acute Hemodynamic, Metabolic, and Hormonal Responses to a Boxing Exergame with and without Blood Flow Restriction in Non-Athlete Young Individuals.

This study aimed to compare acute hemodynamic, metabolic (glucose and blood lactate concentrations), hormonal (growth hormone and normetanephrine), heart rate variability (HRV), and rating of perceived exertion (RPE) responses before and after bouts of a boxing exergame with and without blood flow restriction (BFR) in non-athlete young individuals. Fourteen participants (age: 30 ± 10 y; BMI: 21 ± 3 kg.m-2) participated in two sessions of a 20 min boxing exergame. During week one, the participants were randomly divided into two groups and played against one another under normal (n = 7) and BFR (n = 7) conditions. Over the next exercise session, participants were then reallocated to the opposite condition (normal vs. BFR) for data collection. Hemodynamic, metabolic, HRV, and hormonal parameters were measured before and immediately after the exercise protocols. Playing exergame led to a significant increase in hemodynamic variables (except for diastolic blood pressure) regardless of BFR condition with no between-group differences. Regarding HRV, significant reductions in total power (TP) and low-frequency (LF) waves were identified in the non-BFR group (p < 0.0001) compared with the BFR group. Conversely, a significant increase in very LF (VLF) waves was noted for the BFR group (p = 0.050), compared with the non-BFR group. Significant increases were observed in serum concentrations of growth hormone, normetanephrine, and blood lactate concentration from pre- to post-exercise under both conditions (p ≤ 0.05), with no significant differences between the groups. Moreover, no statistically significant changes were observed in glucose levels. RPE responses were significantly greater (p ≤ 0.05) in the BFR group compared with the non-BFR group throughout the exercise session. We observed similar hemodynamic, hormonal, and metabolic responses after an acute boxing exergame session in young individuals, whether conducted with or without BFR. However, notable differences were observed in certain HRV markers and RPE. Specifically, the inclusion of BFR resulted in an elevation of VLF and a heightened perceived exertion. These findings suggest that BFR may alter cardiac autonomic and perceptual responses during exergaming. Further research is warranted to understand the long-term implications and potential benefits of incorporating BFR into exergaming routines.

Microbiome features associated with performance measures in athletic and non-athletic individuals: A case-control study.

The influence of human gut microbiota on health and disease is now commonly appreciated. Therefore, it is not surprising that microbiome research has found interest in the sports community, hoping to improve health and optimize performance. Comparative studies found new species or pathways that were more enriched in elites than sedentary controls. In addition, sport-specific and performance-level-specific microbiome features have been identified. However, the results remain inconclusive and indicate the need for further assessment. In this case-control study, we tested two athletic populations (i.e. strength athletes, endurance athletes) and a non-athletic, but physically active, control group across two acute exercise bouts, separated by a 2-week period, that measured explosive and high intensity fitness level (repeated 30-s all-out Wingate test (WT)) and cardiorespiratory fitness level (Bruce Treadmill Test). While we did not identify any group differences in alpha and beta diversity or significant differential abundance of microbiome components at baseline, one-third of the species identified were unique to each group. Longitudinal sample (pre- and post-exercise) analysis revealed an abundance of Alistipes communis in the strength group during the WT and 88 species with notable between-group differences during the Bruce Test. SparCC recognized Bifidobacterium longum and Bifidobacterium adolescentis, short-chain fatty acid producers with probiotic properties, species strongly associated with VO2max. Ultimately, we identified several taxa with different baseline abundances and longitudinal changes when comparing individuals based on their VO2max, average power, and maximal power parameters. Our results confirmed that the health status of individuals are consistent with assumptions about microbiome health. Furthermore, our findings indicate that microbiome features are associated with better performance previously identified in elite athletes.

Assessment of Lipid Profiles among Athletes and Non-Athletes in Kalar City

Regular and professional physical activity has a significant impact on general health, lipid status, and body composition., Lipid profiles and anthropometric measures are considered the main indicators for understanding body composition and cardiovascular risk factors among both athletes and non-athletes. The aim of this study was to assess the body composition and lipid profile of athletes and non-athlete college students at the University of Garmian. This study used a cross-sectional design and was conducted on 45 endurance athletes and 30 sedentary male and female individuals. It took venous blood samples from the antecubital vein. Total blood cholesterol (TC), triglycerides (TG), high-dense lipoprotein cholesterol (HDL), Low-dense lipoprotein cholesterol (LDL), and very low lipoprotein cholesterol (VLDL) were determined by standard methods. It was found a significant difference in lipid profile and body mass index (BMI) between athletic and non-athletic individuals at different ages. A significant reduction in TC, TG, LDL, and VLDL concentrations was observed in athletes as compared to the control group. However, the HDL cholesterol and BMI of athletes were not significantly different when compared to the control group. Among athletes, BMI had a significant correlation with age, TC, and VLDL, but the same correlation was not significant in non-athletes. TG had a significant correlation with VLDL in athletes but not in non-athletes. According to this study, athletes had a better lipid profile than non-athletes, despite the slight difference in BMI, and this achieves one of the sustainable development goals of the United Nations in Iraq which is (Good Health). The significant correlations of body composition (BMI) and age with body lipid profiles in athletes may be useful for assessing body health.

Lateral Ankle Sprain: Epidemiology, Prevention, Treatment, and Group-specified Guidelines

Lateral ankle sprains are a prevalent and diverse injury, but unfortunately, in previous studies, there are few clear guidelines for categorized patient groups to face it. So, this article aims to present a comprehensive guide for specific patient groups to make right the decisions when facing the problem of lateral ankle sprain by comparing and analyzing epidemiology, prevention, and treatment strategies of lateral ankle sprain. Risking factors are revealed in Epidemiological studies. The advantages and disadvantages of prevention strategies including taping &amp; bracing, shoe design, and exercise programs are discussed. And surgical and conservative treatments are compared. For suggestions, athletes should apply a balanced approach involving taping, bracing, exercise programs, and surgical options. Non-athlete individuals engaging in sports activities should make their prevention and treatment choices based on their functional demands. Those less sport-inclined can employ few preventions and choose more conservative treatments.

Exercising with a Surgical Mask is Safe but Decreases Performance in Both Athletic and Non-Athletic Individuals

Introduction: Upper respiratory tract infections (URTI) are common medical problems in athletes. Many athletes with URTI continue to train at high-levels and even compete. Using a mask as an additional measure may be beneficial to prevent the spreading of infection among teammates. However, there are many concerns about the effects of mask use on exercise safety and performance. Although some studies have investigated the effects of masks on performance in healthy individuals, studies in athletes are even more limited. Thus, we aimed to evaluate the impact of surgical masks on performance and safety during a cardiorespiratory exercise test (CPET) test applied to both athletes and non-athletes. Patients and Methods: A cross-over, non-randomized study was designed. The study was conducted in two phases. In phase 1, the CPET was performed without using a surgical mask. In phase 2, CPET was performed with a surgical mask in addition to the spiro mask 48 hours after the first test. Thirty participants aged 18-35 were included in the study. They were further divided as athletes (n= 17) and non-athletes (n= 13) subgroups. Results: Significant decreases were observed in some parameters of submaximal exercise [VEan, BFan, VE/ VO2 , VE/VCO2 (p&lt; 0.001)] and in maximal exercise [VEmax, BFmax, TVmax, VE/VO2 , VE/VCO2 (p&lt; 0.001)]. There were also significant decreases in VO2 levels (VO2 an, VO2 max) when compared with and without a surgical mask in both submaximal and maximal exercise (p&lt; 0.001). Additionally, PETO2 decreased, and PETCO2 increased in maximum exercise (p&lt; 0.001), whereas no significant changes were detected at the submaximal level. In subgroup analysis, VEan, VEmax, VO2 an, VO2 max parameters were decreased in athletes compared to non-athletes in surgical masked tests. Conclusion: Surgical masks for athletes and non-athletes decrease performance but have no detrimental effect on cardiorespiratory parameters. Athletes should be aware of this negative effect when high-level performance is demanded.

Inferior T wave inversion in young individuals: should we be worried

Abstract Introduction Cardiac screening in young individuals may identify individuals at risk of sudden cardiac death (SCD). The ECG is crucial to identify individuals who harbour pre-clinical/clinical phenotypes. T wave inversion (TWI) are often found at screening. Outcomes and clinical implications of individuals with TWI are dependent on demographic variables and territory involved. However, the implications of inferior TWI in young individuals are poorly understood. Aim This study was carried out to ascertain prevalence and outcomes of adolescent individuals with inferior TWI. Methodology Cardiac screening (questionnaire/ECG) was carried out in 2672 students (14-17 years) attending year 11 classes during the 2017/2018 scholastic year (3991 eligible citizens) as part of a national cardiac screening program (BEAT-IT). Cases with contiguous TWI in ≥2 leads in the inferior (II/III/aVF) leads were included (isolated and those extending into the lateral leads). ECGs with inferior TWI were repeated (in shallow breathing) to ensure appropriate lead placement. An athlete was defined as an individual who participated in organized sport and/or engaged in &amp;gt;4 hours of physical activity weekly. Results 2672 adolescents gave consent (mean, 50.4% were female). 1042 (39.0%) were athletes. Most were of Caucasian ethnicity (95.8%). Inferior TWI were present in 15 (0.6%), all were Caucasian and 9 of these were non-athletic individuals. 4 had symptoms (26.7%) and 1 (6.7%) had a positive family history [HCM]. Inferior TWI (n=15) was more frequent in females (n=13 [1.0%] vs n=2 [0.2%] vs 0.2%, p=0.037). The prevalence was similar in athletes and non-athletes (n=6 [0.6%] vs n=9 [0.6%], p=0.858). 11 (0.4%) had isolated inferior TWI. Only 1 (9.1%) had TWI involving all three inferior leads. Another 4 (0.1%) had inferior TWI extending into the lateral leads. Borderline/other pathological ECG patterns were as likely in both groups (p=0.770). Two participants with inferior TWI (22.2%) had other abnormal ECG patterns (P mitrale [n=1] and ST segment depression [n=2]). One participant (24.0%) from the inferolateral TWI group had ST segment depression. Two patients (13.3% of all participants with inferior TWI) were given a clinical diagnosis (one HCM [inferolateral TWI] and one MVP [inferior TWI]). Both were asymptomatic. The yield was similar for inferolateral (25.0%) and isolated inferior (11.1%) TWI [2 leads] (p=0.523). Most participants with isolated inferior TWI (n=5, 55.6%) were discharged after referral vs 0% in those with inferolateral TWI. Some (n=6) are under surveillance (mean±SD 1897±9 days). Two refused further evaluation. Conclusion Inferior TWI is an infrequent finding in young individuals and may be a marker of pathology in a small group of subjects. The number of leads with TWI (inferior [2 leads], inferior [3 leads] and inferolateral TWI) did not influence the diagnostic yield. Further evaluation is warranted in such cases.

Body composition in male lifelong trained strength, sprint and endurance athletes and healthy age-matched controls.

Aging involves many physiological processes that lead to decreases in muscle mass and increases in fat mass. While regular exercise can counteract such negative body composition outcomes, masters athletes maintain high levels of exercise throughout their lives. This provides a unique model to assess the impact of inherent aging. The present study compared lean mass and fat mass in young and masters athletes from different sports to age-matched non-athletic individuals. Participants included young (20-39 years, n = 109) and older (70-89 years, n = 147) competitive male athletes, and 147 healthy age-matched controls (young = 53, older = 94 males). Athletes were separated into strength (e.g., weightlifters, powerlifters), sprint (e.g., sprint runners, jumpers) and endurance (e.g., long-distance runners, cross-country skiers) athletic disciplines. Body composition was assessed by dual-energy x-ray absorptiometry (DXA). Upper and lower limb lean mass was combined for appendicular lean mass as well as appendicular lean mass index (ALMI; kg/m2). Individuals' scores were assessed against established cut-offs for low muscle mass, obesity, and sarcopenic obesity to determine prevalence in each group. ALMI was greater in young strength (0.81-2.36 kg/m2, ∼15% and 1.24-2.74 kg/m2, ∼19%) and sprint (95% CI = 0.51-1.61 kg/m2, ∼11% and 0.96-1.97 kg/m2, ∼15%) athletes than in endurance and controls, respectively (all P < 0.001). In masters athletes, only strength athletes had greater ALMI than endurance athletes, but both older strength and sprint athletes had greater ALMI than older controls (0.42-1.27 kg/m2, ∼9% and 0.73-1.67 kg/m2, ∼13%, respectively, both P < 0.001). Fat mass was significantly lower in sprint and endurance athletes compared to strength athletes and controls in both age-groups. Sarcopenic obesity was identified in one young (2%) and eighteen (19%) older controls, while only two older endurance athletes (3%) and one older strength athlete (2%) were identified. Lifelong competitive sport participation leads to lower prevalence of sarcopenic obesity than a recreationally active lifestyle. This is achieved in strength athletes by emphasizing muscle mass, while sprint and endurance athletes demonstrate low fat mass levels. However, all older athlete groups showed higher fat mass than the young groups, suggesting that exercise alone may not be sufficient to manage fat mass.

Reliability and validity of the Chinese version of the Athens insomnia scale for non-clinical application in Chinese athletes.

This study aimed to revise and examine the reliability and validity of the Chinese version of the Athens Insomnia Scale for Non-clinical Application (AIS-NCA) among Chinese athletes. Additionally, the study tested the scale in non-athlete individuals with similar sleep management practices to further analyze its cultural specificity among Chinese athletes and make preliminary inferences about its applicability in other Chinese populations. Four hundred twenty-six Chinese professional athletes and 779 high school students participated in this research. Both athletes and students were divided into two parallel groups for exploratory and confirmatory factor analyses. Additionally, three athlete samples and one student sample were established for reliability and validity assessments. Among athletes, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Athlete Sleep Screening Questionnaire, and the Warwick-Edinburgh Mental Well-Being Scale were employed to evaluate convergent and discriminant validity. Re-test reliability was evaluated at intervals of 1 and 2 weeks. In the case of students, convergent and discriminant validity were tested using the Pittsburgh Sleep Quality Index and the General Self-Efficacy Scale, with re-test reliability assessed at two-week intervals. The Chinese version of the AIS-NCA consists of six items, categorized into two dimensions: sleep problems and daytime functioning. This structure explained 65.08% (athletes) and 66.22% (students) of the variance. Confirmatory factor analysis revealed good model fit, with values of χ2/df = 2.217, CFI = 0.975, AGFI = 0.929, TLI = 0.953, and RMSEA = 0.076 among athletes, and χ2/df = 3.037, CFI = 0.979, AGFI = 0.947, TLI = 0.961, and RMSEA = 0.072 among students. The scale demonstrated a reasonable degree of measurement invariance. The overall scale and two subscales exhibited strong reliability and validity among athletes. Similar results in terms of reliability and validity were also observed within the student sample. The Chinese version of the AIS-NCA shows promise as an assessment tool for evaluating the sleep quality of Chinese athletes. It effectively captures both sleep-related concerns and daytime functionality within the athlete population. The scale demonstrates solid reliability and validity in professional athletes and holds potential for application across various other demographic groups in China.

Assessment of left atrial morphological and functional differences in professional male football players: a prospective, case-control study.

Intensive physical activity in athletes leads to considerable changes in the morphology and physiology of the left atrium through physiological, exercise-induced remodelling. This study aimed to assess the mechanical and electrophysiological changes in professional football players using electrocardiographic and echocardiographic assessment tools. This prospective, case-control study was performed between February and June 2022. The population consisted of elite male football players (n = 49, group F) as the study group, and healthy male non-athlete individuals of matching age (n = 50, group C) as the control group. All participants underwent electrocardiographic and echocardiographic (two-dimensional and tissue Doppler) examinations. Volumetric and functional assessment of the left atrium was identified as the study's primary outcome. There was no significant difference between the groups in terms of demographic and morphometric characteristics (p > 0.05). Maximum and minimum P waves and PR-interval duration were significantly higher in group F than in group C (p = 0.011, p = 0.005 and p < 0.001). Diameter, maximum and minimum volumes of the left atrium, and their corresponding indexes were significantly increased in group F (p < 0.0). Ejection fraction of the left atrium was significantly lower in group F than in group C (p = 0.001). Pulmonary acceleration time and tricuspid annular plane systolic excursion was significantly higher in the football players (p = 0.023 and p < 0.001). Increased diameter, maximum and minimum volumes of the left atrium, and their corresponding indexes could be demonstrated in the elite football players. The morphological and functional changes in the left atrium might be a physiological consequence of left atrial cardiac remodelling to intensive and chronic training.

Genetic Differences in Peroxisome Proliferator-Activated Receptor Alpha Gene in Endurance Athletes (Long Distance Runners) and Power/Endurance Athletes (Wrestlers, Football Players)

Introduction: Peroxisome proliferator-activated receptor alpha gene plays an important role in the expression of genes involved in fatty acid, glucose, and energy metabolism. PPARα intron 7 G/C polymorphism (rs4253778) is one of the genes associated with athletic performance. This study aimed to investigate the genotype distribution and allele frequencies of PPARα G/C of endurance-oriented athletes (long-distance runners) and power/endurance-oriented athletes (wrestlers and football players) (n=158) and non-athletic individuals (n=56). &#x0D; Material and Methods: PPARα intron 7 G/C gene polymorphism was analyzed using the polymerase chain reaction and restriction fragment length polymorphism methods. &#x0D; Results: Genotypes and allele frequencies of PPARα intron 7 G/C were compared between endurance-oriented athletes (long-distance runners) and power/endurance-oriented athletes (wrestlers, and football players) categorized according to their sport disciplines. In addition, athletes were compared to non-athletic individuals. The genotype and allele frequencies of PPARα intron 7 G/C were similar in the groups of athlete and non-athletic individuals (p˃0.05). There was no statistically significant association in genotype distribution and allele frequencies of the PPARα gene among endurance-oriented athletes, power/endurance-oriented athletes, and non-athletic individuals (p˃0.05). &#x0D; Conclusion: The PPARα gene polymorphism may not be considered as a distinctive genetic marker in endurance and mixed sport disciplines.

Outcomes of a cardiac screening program: are those referred worse off?

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): 1. Cardiovascular PHD Scholarship awarded by Research, Innovation and Development Trust Malta (supported by Beating Hearts Malta). 2. Tertiary Education Scholarship Scheme. Introduction Awareness of sudden cardiac death in young individuals is gaining momentum. The evidence supporting screening in non-athletic individuals is also growing, but outcome data in this subgroup is lacking. Objective This study assessed the short-term outcomes of a large cohort of screened Maltese adolescent individuals. Outcome analysis was also extended to a large group of age matched individuals who were not offered systematic screening. Methodology Fifth form students (born 2002) were systematically invited to undergo cardiac screening in the 2017/2018 scholastic year. Most were cleared at screening (Group 1). The rest were referred at enrolment or had an abnormal ECG with a known diagnosis (Group 2). Events since enrolment were obtained from hospital databases. Outcome analysis for adolescents born in 2001 who were alive and residing in Malta in 2017 was also conducted (Group 3). Data was collected through public registries. These individuals were not offered systematic cardiac screening. An event was defined as death, hospitalisation (cardiac symptoms with abnormal findings, arrhythmias or heart failure) or cardiac intervention. Kaplan Meier and log rank analysis (IBM SPSS Statistics vs23) were used to determine the event free proportion in both groups. Events deemed to be of an acquired nature (inflammatory disorders or trauma) were disregarded. Results The cohort consisted of 6580 adolescents. Groups 1 and 2 included 2672 adolescents (mean age 15.0±0.33 years, 50.4% female). 109 (4.1%) were referred for further evaluation. After a median follow-up of 52±2 months, 9 (0.3%) subjects experienced an event. No deaths were recorded. Events included hospitalisation (Group 1: n=2, Group 2: n=5) and interventions (Group 1: Pacemaker n=1, Group 2: EPS &amp; ILR n=6). One subject (Group 2) had 3 events. Group 2 were more likely to experience an event (p&amp;lt;0.001). 99.9% in Group 1 and 94.8% in Group 2 remained event free. Group 3 consisted of 3913 subjects. This group was also followed up for 52±1 months. Three subjects (0.1%) had an event (n=1 hospitalisation with a new diagnosis of cardiomyopathy, n=2 EPS &amp; ILR) at a similar rate as group 1 (p=0.097) and lower compared to group 2 (p&amp;lt;0.001). 99.9% remained event free. Conclusion Participants in group 2 were more likely to experience an event. Cardiac screening does not offer any outcome benefit in the short term. Studies with longer follow-up periods are required to determine the efficacy of a cardiac screening program.

Exercise in Winter: A Hypothesis from Persian Medicine to Improve Healthy Lifestyle

Dear Editor, Winter sports" refer to athletic activities that take place in cold or snowy weather, such as skiing and ice hockey, which are popular in certain regions and often require specialized equipment. Consequently, some researchers suggest that the health and performance of athletes engaged in winter sports should be evaluated (1). There have been several studies examining the effects of climate change on winter sports, such as Orr's research on organized sports (2) and Gatterer's investigation of the impact of cold environments on the body (3). Gatterer et al. note that exposure to cold temperatures can affect cardiovascular capacity, metabolic function, neuromuscular performance, and psychological factors, including cognition, motivation, and pain tolerance. Therefore, exercise recommendations for cold weather can vary depending on the type of activity, the environment, and factors such as clothing choices, skin care, and strategies for coping with the cold (3). According to the doctrine of ancient medicine, appropriate physical activity and exercise have long been recognized as significant factors for promoting a healthy lifestyle. Avicenna (980 - 1037) believed that appropriate physical activity and exercise play the most important role in maintaining and improving adult health (4). He also explained how regular exercise can prevent diseases (5). To derive maximum benefits from exercise, it is essential to choose an exercise that is suitable for one's individual needs. In Persian medicine, age, gender, temperament, body type, and health condition are all considered individual determining criteria. Additionally, environmental conditions, including the season, should be taken into account (6). According to Persian medicine, there are at least four recommendations to improve the healthy lifestyle of non-athletic individuals in relation to exercising during winter: (A) Exercising More in Winter: As a general rule, exercising in winter is more crucial than in other seasons due to the cold and damp temperament of the season, which can increase susceptibility to certain illnesses. Exercise enhances blood flow and generates pleasant warmth throughout the body, creating a warm and dry temperament that can help protect against these diseases (6). Additionally, exercise has a positive impact on mood, which is another reason why it is necessary during the winter. Jorjani (1040 - 1136) noted that the combination of short daylight hours and cold weather can lead to a depressed mood (7), but exercise can prevent this by creating a sense of exhilaration (6). (B) Increasing Exercise Volume: During winter, it is advisable to increase the volume of exercise by increasing both the duration and frequency of the workout. This is because longer and more frequent exercise sessions help to create a dry temperament, while increasing the intensity of the workout generates more warmth in the body temperament - both of which are the opposite of the winter temperament (6). For non-athletic individuals, fast walking and jogging are two of the best sports to engage in during the winter (6). (C) The appropriate time and place for exercise: In winter, the warm hours of the day are the best time for exercising because it reduces the inhibitory effects of cold air. The warm and indoor place in addition to enough and appropriate clothing are recommended as well (6). (D) Diet: As exercise volume should be increased during winter, the diet should be adjusted accordingly. Some recommended foods include chicken and mutton, along with the use of hot-tempered spices such as cinnamon and cumin. Foods containing milk, flour, honey, and oil are also suitable for this season (6). In summary, although the term "winter sports" typically refers to recreational activities that may not necessarily be linked to promoting health, the recommendations of ancient medicine regarding exercise in winter are intended to continue individuals' daily exercise routines, adjusted to suit the specific conditions of the season. Consequently, these recommendations are both public and designed to maintain and promote health. It is important to note, however, that these recommendations are theoretical hypotheses that require further qualitative and quantitative study to confirm their effectiveness.

Muscle Contraction Adaptations in Top-Level Karate Athletes Assessed by Tensiomyography.

Background: This paper aimed to compare the involuntary stimulated neuromuscular response of thigh muscles in top-level karate athletes and recreational groups. Methods: The study included 13 male karate athletes (KAs) and 14 non-athlete male individuals (NAs). Tensiomyographic (TMG) measurements were obtained from the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF) and semitendinosus (ST). Results: Statistically significant differences were observed between KAs and NAs in knee extensor/flexor delay time (Td), contraction time (Tc), total contraction time (Tct), maximal radial displacement of the muscle belly (Dm) and rate of muscle tension development (RMTD). On a group level, KA dominant-leg extensors and flexors and also non-dominant-leg knee flexors had significant differences when compared to NA. Tct is a TMG parameter in which the KAs and NAs differ the most in the case of the knee extensors, while flexor muscles differ the most in the RMTD parameter. Conclusions: The lower Tct values indicate an improved ability of top-level karateka to make fast contractions of the agonist muscles. KAs’ higher RMTD values suggest on strength characteristics needed in breaking actions of the antagonist muscles. Existence of contraction-relaxation-contraction neuromuscular pattern in the RF muscle suggests on implementation of training strategies that involves both rapid muscle contractions and relaxations.

Investigation of the Ecological Link between Recurrent Microbial Human Gut Communities and Physical Activity.

ABSTRACTEmerging evidence has shown an association between the composition of intestinal microbial communities and host physical activity, suggesting that modifications of the gut microbiota composition may support training, performance, and post-exercise recovery of the host. Nevertheless, investigation of differences in the gut microbiota between athletes and individuals with reduced physical activity is still lacking. In this study, we performed a meta-analysis of 207 publicly available shotgun metagenomics sequencing data of fecal samples from athletes and healthy non-athletes. Accordingly, analysis of species-level fecal microbial profiles revealed three recurring compositional patterns, named HPC1 to 3, that characterize the host based on their commitment to physical activity. Interestingly, the gut microbiome of athletes showed a higher abundance of anti-inflammatory, health-promoting bacteria than that of non-athletic individuals. Moreover, the bacterial species profiled in the gut of professional athletes are short-fatty acid producers, which potentially improve energy production, and therefore sports performances. Intriguingly, microbial interaction network analyses suggested that exercise-induced microbiota adaptation involves the whole microbial community structure, resulting in a complex microbe-microbe interplay driven by positive relationships among the predicted butyrate-producing community members.IMPORTANCE Through metagenomic analyses, this work revealed that athletes have a gut-associated microbial community enriched in butyrate-producing species compared with non-athletes. This evidence can support the existence of a two-way association between the host’s lifestyle and the gut microbiota composition, with potential intriguing athletic performance outcomes.