Personal Goods Research Articles

Self-interacting CBO: Existence, uniqueness, and long-time convergence

A self-interacting dynamics that mimics the standard Consensus-Based Optimization (CBO) model is introduced. This single-particle dynamics is shown to converge to a unique invariant measure that approximates the global minimum of a given function. As an application, its connection to CBO with Personal Best introduced by C. Totzeck and M.-T. Wolfram (Math. Biosci. Eng., 2020) has been established.

Based on Sportomics: Comparison of Physiological Status of Collegiate Sprinters in Different Pre-Competition Preparation Periods.

This study aimed to assess the impact of pre-competition training by comparing the differences of collegiate sprinters in physiological state between strengthening and tapering training period by sportomics and combining their sport performance. Fifteen collegiate sprinters were investigated or tested on their body composition, dietary habits, energy expenditure, sleep efficiency, heart rate and respiratory rate during training, blood (blood cells, biochemical and immune markers) and urine (urinalysis), gut microbiome distribution, microbiome and blood metabolites, and their functions during the strengthening (Group A) and tapering training period (Group B) prior to competing in the national competitions. We found that 26.67% of sprinters achieved personal bests (PB) after the competition. The limb skeletal muscle mass and lymphocyte ratio of male sprinters in Group B were lower than those in Group A, and the serum creatine kinase (CK) level was higher than Group A (p < 0.05). The levels of serum CK, interleukin-6 (IL-6), interleukin-1β (IL-1β), and urine-specific gravity (SG) of the two groups were higher than the upper limit of the reference value. The detection rates of urine white blood cell (WBC) and protein in Group B were higher than those in Group A. The gut microbiome health index (GMHI) of Group A was higher than that of Group B, and the microbial dysbiosis index was lower than that of Group B. The ratio of Firmicutes/Bacteroidota (F/B) in Group A was higher than that in Group B. There were 65 differential metabolites in the A/B group, and the enriched pathway was mainly the NF-kappa B signaling pathway (up); B/T cell receptor signaling pathway (up); Th1 and Th2 cell differentiation (up); phenylalanine metabolism (up); and growth hormone synthesis, secretion, and action (up). There were significant differences in blood metabolites between the A and B groups, with a total of 89 differential metabolites, and the enriched pathway was mainly the NF-kappa B signaling pathway (up), T cell receptor signaling pathway (up), Th1 and Th2 cell differentiation (up), and glycerophospholipid metabolism (down). In conclusion, the imbalance of the gut microbiome and inflammation and immune-related metabolites of collegiate sprinters during the pre-competition tapering training period may be the cause of their limited sports performance.

Fascicle Behavior and Muscle Activity of The Biceps Femoris Long Head during Running at Increasing Speeds.

Hamstring strain injuries (HSIs) are prevalent in sports involving high-speed running and most of the HSIs are biceps femoris long head (BFlh) injuries. The primary cause for HSIs during high-speed running remains controversial due to the lack of in vivo measurement of the BFlh muscle behavior during running. Therefore, the purpose of this study was to quantify the muscle-tendon unit (MTU) and fascicle behavior of BFlh during running. Seven college male sprinters (22.14 ± 1.8 years; 177.7 ± 2.5 cm; 70.57 ± 5.1 kg; personal bests in 100m: 11.1 ± 0.2 s) were tested on a motorized treadmill instrumented with two force plate for running at 4, 5, 6m/s. The ground reaction force (GRF), 3D lower limb kinematics, EMG, and ultrasound images of biceps femoris long head (BFlh) in the middle region were recorded simultaneously. BFlh fascicles undergo little length change (about 1 cm) in the late swing phase during running at three submaximal speeds. BFlh fascicle lengthening accounted for about 30% of MTU length change during the late swing phase. BFlh was most active during the late swing and early stance phases, ranging from 83%MVC at a running speed of 4 m/s to 116%MVC at 6 m/s. Muscle fascicles in the middle region of BFlh undergo relatively little lengthening relative to the MTU in the late swing phase during running in comparison to results from simulation studies. These results suggest that there is a decoupling between the fascicle in the middle region and MTU length changes during the late swing phase of running.

High-level performances following low altitude training and tapering in warm environments in elite racewalkers.

Current guidelines for prolonged altitude exposure suggest altitude levels ranging from 2000 to 2500m to optimize an increase in total hemoglobin mass (Hbmass). However, natural low altitude locations (<2000m) remain popular, highlighting the interest to investigate any possible benefit of low altitude camps for endurance athletes. Ten elite racewalkers (4 women and 6 men) underwent a 4-week "live high-train high" (LHTH) camp at an altitude of 1720m (PIO2=121mmHg; 20.1°C; 67% relative humidity [RH]), followed by a 3-week tapering phase (20m; PIO2=150mmHg; 28.3°C; 53% RH) in preparation for the World Athletics Championships (WC). Venous blood samples were withdrawn weekly during the entire observation period. In addition, blood volumes were determined weekly by carbon monoxide rebreathing during altitude exposure and 2weeks after return to sea level. High-level performances were achieved at the WC (five placings among the Top 10 WC races and three all-time career personal bests). A slight but significant increase in absolute (+1.7%, p=0.03) and relative Hbmass (+2.3%, p=0.02) was observed after 4-week LHTH. In addition, as usually observed during LHTH protocols, weekly training distance (+28%, p=0.02) and duration (+30%, p=0.04) significantly increased during altitude compared to the pre-LHTH period. Therefore, although direct causation cannot be inferred, these results suggest that the combination of increased training load at low altitudes with a subsequent tapering period in a warm environment is a suitable competition-preparation strategy for elite endurance athletes.

Assessing multilevel barriers to hydroxyurea adherence in youth with sickle cell disease using pharmacy-based refill records.

Suboptimal medication adherence is common across youth with chronic health conditions and may contribute to health disparities and adverse health outcomes, especially in underserved communities. Using pharmacy prescription records and guided by the World Health Organization Multidimensional Adherence Model, we examined patient-, treatment-, and health system-related factors that may affect hydroxyurea adherence in 72 youth with sickle cell disease (SCD), 10-18 years who had participated in the multisite "Hydroxyurea Adherence for Personal Best in SCD" (HABIT) feasibility (6 months) and efficacy (12 months) trials. Pharmacy data were collected from the year prior to study entry through the duration of each trial. We also examined hydroxyurea dose at baseline, prescribing patterns (hydroxyurea formulation and dose prescribed), quantity of hydroxyurea dispensed, and number of daily capsules/tablets prescribed. Data were analyzed using descriptive statistics. On average, youth were prescribed 1095±402mg hydroxyurea per day, requiring ingestion of 3 or more capsules for 39.4% of youth. Frequently identified potential barriers were complex medication regimens in which dose of hydroxyurea differed by day of week (47.2%); receipt of an inadequate (<30 days) supply of hydroxyurea from the pharmacy≥3 times during record collection period (29.2%); and prescription of hydroxyurea suspension suggesting problems swallowing capsules (22.2%). In this sample, most youth were exclusively prescribed 500mg capsules (62.5%), which was associated with complex medication regimens (RR 3.0, 95% CI 1.4-6.7). Potential barriers were common, occurred at all levels and are potentially modifiable with targeted interventions at the treatment- and health system-related levels.

Effect Of Improving Lumbar Mobility, Spinal Stability ; With Core Stability Training To Achieve Per-sonal Best Runner

Running consists of simple basic movements, and to achieve these simple basic movements requires good mobility and stability, because the weakening of mobility and stability of the body causes misalignment or weakness of the legs so as to interfere with the absorption or propulsion phase in leg movement while running. Apply appropriate exercise methods to improve lumbar mobility and spinal stability. One training method that can be used is the core stability training method. Core stability is an exercise model to improve the ability to control the position of trunk movement through the pelvis and legs to allow optimal motion production. This study aims to ascertain whether core stability training can improve lumbar mobility and spinal stability in running athletes. The study used an experimental method with a research pattern using a group pretest-posttest design. 10 running athletes were sampled according to the criteria to be treated in the form of core stability training for 6 weeks. The athletes were assessed before and after training using the Functional Reach Test and Unilateral Hip Bridge Endurance. This study showed that there was a significant effect between core stability training and lumbar mobility (P = 0.000) and spinal stability (P = 0.000) in athletes. The results of this study show that the application of core stability exercises can increase the ability of lumbar mobility and spinal stability, so if the core stability exercises are done properly, they can increase stability in the spine and mobility in the lumbar, which causes dynamic limb movement to be more efficient. Key Words: athletics; Core Stability; Lumbar Mobility; spine stability.

Metacognitive Awareness as the Predictor of Positive Self-Critical Rumination, Personal Best Goals (PBs), and Language Achievement

Metacognitive Awareness as the Predictor of Positive Self-Critical Rumination, Personal Best Goals (PBs), and Language Achievement

Association of COMT rs4680 Polymorphism with High-Level Performance in Track Field Athletes

The catechol-O-methyltransferase (COMT) gene rs4680 polymorphism, primarily linked to psychological traits, has been limitedly studied in the key athletic abilities including endurance, speed, and power. Thus, the current investigation sought to explore any possible connections between the rs4680 polymorphism in the COMT gene and competitive performance among Turkish high-level track &amp; field athletes. As a part of an ongoing project, this study engaged 60 elite athletes, categorized into two distinct groups based on their specialty (31 sprint/power athletes and 29 endurance athletes). To provide a comparative baseline, a control group consisting of twenty sedentary individuals aged between 18 and 35 was also incorporated. The assessment of participants' performance levels is conducted using the methodology established by the International Association of Track &amp; Field Federations (IAAF), which is based on personal bests (PBs). Whole exome sequencing (WES) was used in the research to analyze genomic DNA that was taken out of participant blood samples. The distribution of the COMT gene rs4680 polymorphism in terms of genotypes (AA, GA, and GG) did not change significantly between the athlete and the control group or within the athletic groups, according to the research (p&gt;0.05). In a similar vein, the research did not discover any connections of note between athletes' PBs in the sprint/power or endurance categories and the rs4680 polymorphism. Based on these findings, the research concludes that there is no meaningful relationship between the COMT gene's rs4680 polymorphism and the competitive performance of the Turkish high-level track and field athletes under investigation.

Personal Bests and Gender

Abstract We connect two large bodies of scientific inquiry. First, important theories in the social sciences establish that human preferences are reference-dependent. Second, a separate field of research documents substantial differences in preferences and attitudes across genders. Specifically, we examine the universe of official classic chess games (more than 250,000 subjects and 22 million games). This allows us to study differences across genders both in cognitive performance (intensive margin) and in competitive participation (extensive margin), using the fact that personal bests act as reference points. We find that males and females behave very differently around their personal bests in both margins.

Hydroxyurea Adherence for Personal Best in Sickle Cell Treatment (HABIT) efficacy trial: Community health worker support may increase hydroxyurea adherence of youth with sickle cell disease.

Despite disease-modifying effects of hydroxyurea on sickle cell disease (SCD), poor adherence among affected youth commonly impedes treatment impact. Following our prior feasibility trial, the "Hydroxyurea Adherence for Personal Best in Sickle Cell Treatment (HABIT)" multi-site randomized controlled efficacy trial aimed to increase hydroxyurea adherence for youth with SCD ages 10-18years. Impaired adherence was identified primarily through flagging hydroxyurea-induced fetal hemoglobin (HbF) levels compared to prior highest treatment-related HbF. Eligible youth were enrolled as dyads with their primary caregivers for the 1-year trial. This novel semi-structured supportive, multidimensional dyad intervention led by community health workers (CHW), was augmented by daily tailored text message reminders, compared to standard care during a 6-month intervention phase, followed by a 6-month sustainability phase. Primary outcomes from the intervention phase were improved Month 6 HbF levels compared to enrollment and proportion of days covered (PDC) for hydroxyurea versus pre-trial year. The secondary outcome was sustainability of changes up to Month 12. The 2020-2021 peak coronavirus disease 2019 (COVID-19) pandemic disrupted enrollment and clinic-based procedures; CHW in-person visits shifted to virtual scheduled interactions. We enrolled 50 dyads, missing target enrollment. Compared to enrollment levels, both HbF level and PDC significantly - but not sustainably - improved within the intervention group (p=.03 and .01, respectively)with parallel increased mean corpuscular volume (MCV) (p=.05), but not within controls. No significant between-group differences were found at Months 6 or 12. These findings suggest that our community-based, multimodal support for youth-caregiver dyads had temporarily improved hydroxyurea usage. Durability of impact should be tested in a trial with longer duration of CHW-led and mobile health support.

The AMPD1 Gene’s rs17602729 Polymorphism and Athletic Performance in Track and Field Athletes

The aim of the current study was to determine whether the rs17602729 polymorphism in the Adenosine monophosphate deaminase-1 (AMPD1) gene is related to elite athlete performance. A total of 60 elite athletes, aged 18–35, who were split into two groups—31 sprinters/power athletes and 29 endurance athletes—as well as 20 control/sedentary individuals, willingly participated in the study. The performance levels of the athletes, based on their personal bests (PBs), were rated using the World Athletics (WA) score. Whole exome sequencing (WES) was performed on the genomic DNA that was extracted from the subjects’ blood samples. Using linear regression models, the study sought to determine the relationship between the athletes’ PB, sex, and sport type and the rs17602729 polymorphism both within and between the groups. The distribution of the GG, GA, and AA genotypes of the rs17602729 polymorphism differed significantly within and between the groups, according to the data (p &lt; 0.05). Nonetheless, no statistically significant variations were observed in the correlation between the athletes’ PBs and the rs17602729 polymorphism among the groups (p &gt; 0.05). In conclusion, the G allele of the ADMP1 rs17602729 polymorphism appears to provide a benefit to sprinters and power athletes. Nonetheless, to confirm this hypothesis, additional research with more participants and a multi-genetic analysis approach is required.

Retrospective and Contemporary Predictors of National Collegiate Athletic Association Division I Cross-Country Performance Are Sex Specific.

Carder, MJ, Scudamore, EM, Savanna, KN, Pribyslavska, V, Bowling, LR, and O'Neal, EK. Retrospective and contemporary predictors of National Collegiate Athletic Association Division I cross-country performance are sex specific. J Strength Cond Res 37(11): 2267-2272, 2023-The purpose of this study was to identify National Collegiate Athletic Association (NCAA) Division I cross-country (XC) performance potential using laboratory-based and field-based parameters and retrospective high school (HS) personal best (PB) data at various distances of current collegiate XC runners. Fifteen female and 17 male NCAA XC runners provided their PB for 5-km (women) and 8-km (men) distances from the previous season. Bivariate correlation and stepwise and hierarchical regression modeling were used to predict XC performance. Single squat jump height and multijump reactive strength index displayed r < 0.27 for both sexes, suggesting lower-body power is a poor predictor of XC performance or masked by other factors of greater importance. Triceps skinfold thickness approached significance (r = 0.43; p = 0.09) for men but was unrelated to women's performance (r = -0.05; p = 0.86). HS XC PB neared significance (r = 0.55, p = 0.054), but no other single or combination of variables reached significance for female runners. Aerobic capacity displayed a moderate to strong relationship (r = 0.65) for male runners. High school 3,200-m PB for men produced a robust prediction capacity (r = 0.85; p = 0.005, SEE = ± 0.65 minutes), and predicted 8-km PB within 30 seconds for approximately two-thirds of runners. These outcomes suggest when recruiting HS or transfer athletes, male and female XC runners should not be recruited on the same factors. Women's XC PB is more difficult to predict, but skinfold thickness was statistically the least valuable predictor of all factors.

ASSOCIATION BETWEEN MCT1 GENE POLYMORPHISM (rs1049434) WITH THE ATHLETİC PERFORMANCE OF ELITE TRACK AND FIELD ATHLETES

Monocarboxylate transporter 1 (MCT1; SLC16A1) is a proton-dependent cotransporter/exchanger, located on the apical membrane of cells. MCT1 is able to transport several monocarboxylates including lactate, pyruvate and acetate, which makes this protein critical in terms of the athletic performances. The rs1049434 polymorphism in the MCT1gene was frequently associated with the performance of the athletes in different populations. The present study aims to decipher any possible association of the rs1049434 polymorphism with the personal best of elite track and field athletes. A total of sixty elite athletes (31 sprint/power and 29 endurance) and twenty control/sedentary with the ages of 18-35 voluntarily participated in the study. The International Association of Athletics Federations (IAAF) score scale was used to determine the performance levels of the personal best (PB) of the athletes. Whole exome sequencing (WES) was performed by the genomic DNA isolated from blood of the participants. Sport type, sex and PB were chosen as the parameters to compare within and between the groups by logistic regression models. The sex was not the criterion that was significantly different between or within the groups. Although PB scores were not significant within the sprint/power group, it was significant within the endurance group by the codominant (p=0.044), dominant (p=0.016) and over-dominant (p=0.048) models. The rs1049434 polymorphism in the MCT1 gene may be linked to the PB of the endurance athletes. However, other genetic alterations should be regarded to conclude the effect of this polymorphism. The multi-factorial genetic background that could associate with the athletic performance is still under investigation in our research group. Nevertheless, further studies with more participants are needed.

Аналіз селф-хелп-бізнес-літератури в Китаї на основі книги Лі Кайфу “Будь найкращою версією себе”

The article investigates the self-help business literature in hyper-competitive social system of China. The need to succeed stimulates the wish for self-actualization and self-realization in the context of high social pressure. The self-help business books are being studied by adopting the interdisciplinary approach to the study of discourse that views language as a form of social practice – Discourse Analysis. So, the discourse in the article is understood as the main component of sociocultural interaction. Despite its popularity, the field of self-help discourse is under-researched and undervalued. Self-help books’ main intention is to give us the source to help ourselves. In self-help books, concepts, not the human characters, are the main characters. The content of self-help discourse varies greatly. It is very rhetorical, persuasive, and manipulative. The step-like how-to format is prevailing in this genre, such books give simple steps, implementation of which would lead to achieving the big goal step-by-step along with supportive techniques to strengthen the newly gained knowledge. The book Be Your Personal Best (“做最好的自己”, 2005) written by Li Kaifu (李开复, born December 3, 1961) is a typical representative of self-help literature which responses the user’s needs, it is a part of personal growth and transformational literature which is a branch of self-help literature that covers life and self-improvement. The main aim of the book is to show the reader how to be more effective in achieving private and professional success by means of developing habits. It gives advice and instructions on improving of personal qualities and social relations by increasing one’s potential and raising personal productivity. It includes many formal characteristics of self-help books, such as: lists, application exercises and practices, visualization, metaphors, repetition of core concepts and ideas. The main intention is in the educational purpose, sharing of ideas, knowledge, life experience, concepts, it is a pragmatic advice-giving text.

Evaluation of the Association of VDR rs2228570 Polymorphism with Elite Track and Field Athletes' Competitive Performance.

The present study aimed to examine the vitamin D receptor (VDR), rs2228570 polymorphism, and its effect on elite athletes' performance. A total of 60 elite athletes (31 sprint/power and 29 endurance) and 20 control/ physically inactive, aged 18-35, voluntarily participated in the study. The International Association of Athletics Federations (IAAF) score scale was used to determine the performance levels of the athletes' personal best (PB). Whole exome sequencing (WES) was performed by the genomic DNA isolated from the peripheral blood of the participants. Sports type, sex, and competitive performance were chosen as the parameters to compare within and between the groups by linear regression models. The results showed no statistically significant difference between the CC, TC, and TT genotypes within and between the groups (p > 0.05). Additionally, our results underlined that there were no statistically significant differences for the association of rs2228570 polymorphism with PBs within the groups of the (p > 0.05) athletes. The genetic profile in the selected gene was similar in elite endurance, sprint athletes, and in controls, suggesting that rs2228570 polymorphism does not determine competitive performance in the analyzed athlete cohort.

Case Studies in Physiology: Is blackout in breath-hold diving related to cardiac arrhythmias?

Syncope or "blackout" (BO) in breath-hold diving (freediving) is generally considered to be caused by hypoxia. However, it has been suggested that cardiac arrhythmias affecting the pumping effectivity could contribute to BO. BO is fairly common in competitive freediving, where athletes aim for maximal performance. We recorded heart rate (HR) during a static apnea (STA) competition, to reveal if arrhythmias occur. Four male freedivers with STA personal best (PB) of 349 ± 43 s, volunteered during national championships, where they performed STA floating face down in a shallow indoor pool. A non-coded Polar T31 chest strap recorded R-R intervals and a water- and pressure-proof pulse oximeter arterial oxygen saturation. Three divers produced STA near their PB without problems, whereas one diver ended with BO at 5 min 17s, which was 12 s beyond his PB. He was immediately brought up by safety divers and resumed breathing within 10 s. All divers attained similar lowest diving HR (47 ± 4 beats/min), but HR recordings displayed a different pattern for the diver ending with BO. After a short tachycardia, the three successful divers developed bradycardia, which became more pronounced during the second half of the apnea. The fourth diver developed pronounced bradycardia earlier, and at 2.5 min into the apnea, HR started alternating between approximately 50 and 140 beats/min, until the diver lost consciousness. At resumed breathing, HR returned to baseline. Nadir oxygen saturation was similar for all divers. We speculate that arrhythmia could have contributed to BO, by lowering stroke volume leading to a systolic blood pressure drop, affecting brain perfusion.NEW & NOTEWORTHY Heart rate during prolonged breath-holding until the point of loss of consciousness has not previously been published. The recordings show that blackout was preceded by a period of persistent alterations in R-R intervals, whereby an ectopic beat followed every normal heartbeat. Explanations for this deviating heart rate pattern could be either premature atrial contractions or premature ventricular contractions following every atrial beat, i.e., bigeminy, which could have compromised cardiac pumping function and caused/contributed to blackout.

Probing into the influence of EFL learners’ self-assessment and evaluation apprehension in predicting their personal best goals and self-efficacy skills: a structural equation modeling

Effective instruction and assessment are greatly affected by many factors. The ever-growing literature on assessment outlined some cognitive, social, and emotional factors that directly or indirectly influence the learners’ academic achievement. In spite of the rosy literature on assessment, the possible interplay among the Core of Self-assessment (CSA), the Student Evaluation Apprehension (SEA), the Personal Best Goal (PBG), and Self-efficacy (SE) were untouched. To this end, this study intended to propose a model to disclose the association between CSA, SEA, PBG, and SE in higher education. Therefore, the Core of Self-assessment Questionnaire (CSAQ), the Student Evaluation Apprehension Scale (SEAS), the Personal Best Goal Scale (PBGS), and the Self-efficacy Scale (SES) were administered to 467 Iranian EFL university students at MA level. The results of confirmatory factor analysis (CFA) and structural equation modelling (SEM) indicated that CSA and SEA can contribute to PBG and SE. It means that learners’ investment in CSA and positive SEA can flourish and upgrade goal-settings and sense of efficacy beliefs among EFL university students. The implications and suggestions for future avenues are also discussed.

A model of academic buoyancy, L2 grit, academic emotion regulation, and personal best: An evidence from EFL context

Students are the products of educational system and every strategy taken in education may foster or hinder their learning progress. Efficient instruction is achieved when emotional and cognitive heath of the learners is warranted. Despite the critical roles of Academic Buoyancy (AB), L2 grit, Academic Emotion Regulation (AER), and Personal Best (PB), studies on their reciprocal relationships are still under shadow. Thus, this investigation suggested a model to depict the interplay among AB, L2 grit, AER, and PB. In so doing, The Academic Buoyancy Scale (ABS), The Language-domain-specific Grit Scale (L2-Grit S), The Academic Emotion Regulation Questionnaire (AERQ), and The Personal Best Scale (PBS) were distributed to 435 Iranian EFL university learners at BA level. The data screening based on Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM) reflected that buoyant as well as gritter EFL learners are more aware of evaluating their academic emotional experiences as well as perusing their goals. More precisely, the mediator roles of AB and L2 grit on AER and PB were uncovered. The implications of this study, which advance psychology of language learning and teaching are thoroughly discussed.

The PPARGC1A Gly482Ser polymorphism is associated with elite long-distance running performance

ABSTRACT Success in long-distance running relies on multiple factors including oxygen utilisation and lactate metabolism, and genetic associations with athlete status suggest elite competitors are heritably predisposed to superior performance. The Gly allele of the PPARGC1A Gly482Ser rs8192678 polymorphism has been associated with endurance athlete status and favourable aerobic training adaptations. However, the association of this polymorphism with performance amongst long-distance runners remains unclear. Accordingly, this study investigated whether rs8192678 was associated with elite status and competitive performance of long-distance runners. Genomic DNA from 656 Caucasian participants including 288 long-distance runners (201 men, 87 women) and 368 non-athletes (285 men, 83 women) was analysed. Medians of the 10 best UK times (Top10) for 10 km, half-marathon and marathon races were calculated, with all included athletes having personal best (PB) performances within 20% of Top10 (this study’s definition of “elite”). Genotype and allele frequencies were compared between athletes and non-athletes, and athlete PB compared between genotypes. There were no differences in genotype frequency between athletes and non-athletes, but athlete Ser allele carriers were 2.5% faster than Gly/Gly homozygotes (p = 0.030). This study demonstrates that performance differences between elite long-distance runners are associated with rs8192678 genotype, with the Ser allele appearing to enhance performance.

Assessing Multi-Level Barriers to Medication Adherence in Youth with Sickle Cell Disease Using Pharmacy-Based Prescription Refill Data

Background: Across chronic diseases, suboptimal adherence to prescribed therapies compromises therapeutic benefits. In sickle cell disease (SCD), adherence to hydroxyurea (HU) in adolescents and young adults is often poor. Poor adherence may be either intentional or unintentional related to lack of capacity or resources. We used prescription refill data to examine barriers to adherence in two samples of 10-18 year old youth with SCD, known to be poorly adherent to HU, who participated in the multi-site "Hydroxyurea Adherence for Personal Best in SCD" (HABIT) feasibility and efficacy trials. Methods: Parents provided written consent to contact their pharmacy(ies) for release of their child's HU prescription records for the year prior to study entry and duration of participation in the HABIT 6-month feasibility [2013-2015] (NCT02029742) and 12-month efficacy [2017-2021] (NCT03462511) trials. Refill data were retrieved by fax, email or in person. HU dose prescriptions were verified by electronic health record review at each study site. Data collected were pharmacy name, HU dispensation dates, formulation (capsule/tablet versus suspension), concentration (mg/capsule or tablet or mg/ml suspension), prescribed HU dose, number of capsules/tablets or volume of HU suspension dispensed, directions for use and number of days for which drug was dispensed, and number of times the HU prescription was filled. Data retrieval was considered complete if the interval for participants' HU dispensed reflected 80% or greater of the trial prescribing period (1.5 years feasibility; 2 years efficacy). Using the World Health Organization Multidimensional Adherence Model, we categorized factors as patient-related (prescription of HU suspension reflecting problems with swallowing capsules/tablets); treatment-related (complex HU regimen defined as different dosing patterns on different days of the week), and health care system related (prescription of HU capsule other than 500 mg reflecting potential need for prior authorization, use of more than one pharmacy, lack of dosing directions for HU dispensed; dispensing less than 30 days of HU during a dispensing period). Data were analyzed using descriptive statistics; sample barriers were compared using chi-square. Results: Of 78 enrolled participants (28 feasibility trial, 50 efficacy trial), pharmacy data were available for 92.3% (27 feasibility trial, 45 efficacy trial; mean age 13.6±2.2 years, 72.2% Black, 30.6% Hispanic) (Table 1). On average, refill data collected spanned 81.9% of the trial period (74% feasibility trial; 86.7% efficacy trial). On average, HU prescriptions were filled 10.6±5.6 times within 18 months and 16.0±7.6 times within 24 months for feasibility and efficacy participants, respectively. The most frequently identified potential barriers to adherence in this sample were lack of dosing directions (66.7%), complex HU regimens (47.2%) and lack of direction specificity (i.e., the day(s) HU dose should be different) when complex regimens were prescribed (47.1%) (Table 2). Over 20% of youth were prescribed liquid HU formulation, while HU capsules/tabs other than 500 mg/capsule were infrequently prescribed (27.8%). No significant differences in barriers were seen between the two trials reflecting a period of 8 years. Discussion: Use of individual patient prescription refill data provides insight into multi-level barriers at the patient-, treatment- and health system-related levels, each of which is likely unintentional. Despite recent availability of HU capsules/tablets in varying concentrations, complex HU regimens, often lacking specific dosing directions, were common in this socially vulnerable multi-site sample. These findings suggest that barriers to adherence occur at all levels and did not change across the two trial periods. Reducing adherence barriers likely require development and testing of multi-level interventions which simplify medication schedules, incorporate more recent dose formulations of HU capsules/tablets when needed, provide explicit dosing directions on bottle labels and facilitate convenient HU access including dispensing greater than 30 day quantity of HU via pharmacy or mail order. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal