Field-based tests for the assessment of physical fitness in children and adolescents practicing sport: A systematic review within the ESA program

High levels of physical fitness (PF) can positively affect both health and cognitive function, thus monitoring its levels in youth can help increase health and quality of life in adult populations later on. This systematic review aims to identify PF field-based tests used in young European populations practicing sport to find tools that are adequate for the considered target involving a new battery within the Enriched Sport Activities (ESA) project. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed. In the 83 identified articles, the main tests used were: vertical/horizontal jumps (for muscular strength/power); push-ups, running at maximum effort, sit-ups (for muscular strength/endurance); multistage non-intermittent and intermittent tests (for aerobic endurance); sit and reach (for flexibility); sprinting and agility T-tests (for speed and agility, respectively); 10 x 5 m shuttle run (SR) (for both speed and agility). Few studies assessed coordination, reaction time, power, and balance. Although the selected tests are widely used and validated, they do not determine all PF aspects and do not reflect sport-specific features. A final decision was made for the inclusion of the following tests: standing broad jump, seated medicine ball throw, 20 m SR test, 30 m sprint, Illinois test, and a new test, i.e., the crunning test, to assess different skill-related components at once. The use of this combination of tests allows for the assessment of all PF components and can help planning eective training programs and cultivate sporting talent

Continuity Culture: A Key Factor for Building Resilience and Sound Recovery Capabilities

This article investigates the extent to which Jordanian service organizations seek to establish continuity culture through testing, training, and updating of their business continuity plans. A survey strategy was adopted in this research. Primary and secondary data were used. Semistructured interviews were conducted with five senior managers from five large Jordanian service organizations registered with the Amman Stock Exchange. The selection of organizations was made on the basis of simple random sampling. Interviews targeted the headquarters only in order to obtain a homogenous sample. Three out of five organizations could be regarded as crisis prepared and have better chances for recovery. The other two organizations exhibited characteristics of standard practice that only emphasizes the recovery aspect of business continuity management (BCM), while paying less attention to establishing resilient cultures and embedding BCM. The findings reveal that the ability to recover following major incidents can be improved by embedding BCM in the culture of the organization and by making BCM an enterprise-wide process. This is one of few meticulous studies that have been undertaken in the Middle East and the first in Jordan to investigate the extent to which service organizations focus on embedding BCM in the organizational culture

The effect of chronic quercetin supplementation on bone health in postmenopausal women: A double-blind placebo-controlled investigation

Currently, there is limited research investigating the effects of quercetin on bone turnover and density. Therefore, this study aimed to examine the efficacy of 90-day quercetin supplementation on bone turnover, inflammation, body composition, and physical function in postmenopausal women. Thirty-four healthy postmenopausal women (59.2 ± 7.0 yrs, 80.7 ± 15.6 kg, 29.8 ± 6.1 kg⸱m2) participated in the double-blind placebo-controlled investigation. Participants were randomly assigned to one of two groups: 500 mg of Q or 500 mg of fiber (placebo; PLB). Data collected during the pre-and post-supplementation assessments included: bone turnover (osteocalcin, P1NP, CTX), inflammation markers (IL-6, TNF-alpha, CRP), body composition, dominant handgrip strength, and timed up and go test. Independent samples t-tests were used for between-group comparisons of baseline values and the percent change for each dependent variable. A significant difference in percent change for osteocalcin (Q: 20.5±25.7; PLB: 1.3±17.2; p=0.016; d=0.89), P1NP (Q: 28.9 (6.0–57.3); PLB: 4.6 (-7.6 – 8.5); p=0.030; d=0.64), and CTX (Q: 39.0 (-10.0 – 84.6); PLB: -7.74 (-28.9 – 18.5); p=0.023; d=0.91) was found between Q and PLB, with greater increases in Q. Changes in the inflammation markers IL-6 (Q: -17.6±24.1; PLB: 2.90±31.1; p=0.045; d=0.73) and TNF-alpha (Q: -4.9± (-15.3 – [-3.2]); PLB: 1.9 (-7.8 – 4.0); p=0.021; d=0.90) between the two groups were significant. No significant changes were found between groups for CRP, body composition, and physical function (p\u3e0.05). The data suggest that Q may improve bone health status in postmenopausal women through its ability to decrease pro-inflammatory mediators and increase turnover markers

Wider translations and rotations in posterior-stabilised mobile-bearing total knee arthroplasty compared to fixed-bearing both implanted with mechanical alignment: a dynamic RSA study

Purpose: The purpose of this study was to investigate the in vivo kinematics of the same femoral design mechanically aligned posterior-stabilised (PS) total knee arthroplasty (TKA) with either fixed-bearing (FB) or mobile-bearing (MB) inlay, implanted by the same surgeon, using model-based dynamic radiostereometric analysis (RSA). The hypothesis of the present study was that the MB design would show wider axial rotation than the FB design, without affecting the clinical outcomes. Materials and methods: A cohort of 21 non-randomised patients (21 DePuy Attune PS-FB) was evaluated by dynamic RSA analysis at a minimum 9-month follow-up, while performing differently demanding daily living activities such as sit to stand (STS) and deep knee lunge (DKL). Kinematic data were compared with those of a cohort of 22 patients implanted with the same prosthetic design but with MB inlay. Anterior–posterior (AP) translations, varus–valgus (VV) and internal–external (IE) rotations of the femoral component with respect to the tibial baseplate were investigated. Translation of medial and lateral compartment was analysed using the low point method according to Freeman et al. Questionnaires to calculate objective and subjective clinical scores were administered preoperatively and during follow-up visit by the same investigator. Results: The FB TKA design showed lower AP translation during STS (6.8 ± 3.3 mm in FB vs 9.9 ± 3.7 mm in MB, p = 0.006*), lower VV rotation (1.9 ± 0.8° in FB vs 5.3 ± 3.3° in MB, p = 0.005) and lower IE rotation (2.8 ± 1.1° in FB vs 9.5 ± 4.3° in MB, p = 0.001) during DKL than the mobile-bearing TKA design. Posterior-stabilised FB group showed significant lower translation of the low point of the medial compartment than the MB group (p = 0.008). The percentage of patients performing medial pivot in the FB group was higher compared to MB group in the examined motor tasks. No significant differences in post-operative range of motion (117° ± 16° for FB group and 124° ± 13° for MB group) and in clinical outcomes emerged between the two cohort. Conclusions: The FB and MB designs differed in AP translations, VV rotations and IE rotations of the femoral component with respect to the tibial component in STS and DKL. Furthermore, FB cohort reported a significant higher percentage of medial pivot with respect to MB cohort. Despite this, no differences in clinical outcomes were detected between groups. Both designs showed stable kinematics and represent a viable option in primary TKA. Level of evidence: Prospective cohort study, II

Variations in bone mineral density after joint replacement: A systematic review examining different anatomical regions, fixation techniques and implant design

PurposeThis study aims to evaluate postoperative periprosthetic bone mineral density (BMD) at various time points following joint replacement with different implant designs and fixation techniques.MethodsDatabase search was conducted on MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and CINAHL for studies analyzing bone remodelling after joint replacement (March 2002-January 2024). Inclusion criteria: English-language articles; total joint replacement; at least two BMD evaluations; observational studies, cross-sectional, prospective, retrospective, randomised controlled trials, and clinical trials. Exclusion criteria: no BMD measurement within one month after surgery; BMD data only expressed as percentage changes or graphs without numerical values; no Gruen zone evaluation for hip replacement; no periprosthetic bone evaluation for knee replacement; pharmacological treatment or comorbidities affecting BMD; revision joint replacements; irrelevant articles; no full text or no original data.ResultsSixty-eight articles matched the selection criteria. Fifty-five focused on the hip joint, 12 on the knee, and one on the shoulder. After total hip arthroplasty, the greatest bone resorption occurred in the proximal femur, peaking at 6 months. Cemented implants and tapered stems showed greater bone resorption than cementless implants and anatomical stems. BMD around the acetabular component decreased during the first 6 months but increased in regions subjected to higher loads. In total knee arthroplasty, bone loss occurred in the anterior distal femur and medial tibial plateau, with cemented and posterior-stabilised implants showing greater bone loss than cementless and cruciate-retaining designs.ConclusionsThe periprosthetic BMD decreases progressively after joint replacement. The fixation technique and implant design influence the extent and pattern of this decline. These factors must be considered during the surgical planning, as they can have long-term implications for bone health and implant longevity. Further research is needed to optimise implant design and surgical techniques to mitigate BMD loss and improve patient outcomes.Level of EvidenceLevel IV

The Effect of Quercetin on Bone Turnover Markers, Inflammatory Markers, and Bone Mineral Density in Postmenopausal Women: A Double-Blind Placebo-Controlled Investigation

Maintaining optimal bone health prevents major bone disorders (e.g., osteoporosis) and prolongs longevity. Quercetin is a plant-based flavonoid that is suggested to have anti-inflammatory effects and may improve bone health. PURPOSE: To investigate the effects of quercetin supplementation over 90-days on prominent bone turnover markers (BTMs), inflammatory markers, bone mineral density (BMD), body composition, and physical functioning in postmenopausal women. METHODS: Thirty-three healthy, nonosteoporotic, postmenopausal women (59.2±7.0 years) participated in a double-blind, placebo-controlled investigation. Participants were randomized into one of two supplement groups: 1) 500 mg of quercetin (QUE) once daily or 2) 500 mg of methylcellulose (placebo; PLB) once daily. Pre- and post-testing visits included assessments of BTMs (i.e., osteocalcin [OC], procollagen type-I N-terminal propeptide [PINP], and type-I collagen cross-linked C-terminal telopeptide [CTX]), inflammatory markers (i.e., interleukin [IL]-6, tumor necrosis factor-alpha [TNF-a], and C-reactive protein [CRP]), BMD measurements, body composition measurements (i.e., body fat percentage), and physical function. RESULTS: The QUE group increased OC (p=0.016; d=0.89), PINP (p=0.030; d=0.64), and CTX (p=0.023; d=0.91) levels and decreased IL-6 (p=0.045; d=0.73) and TNF-a (p=0.021; d=0.90) levels compared to PLB. CRP (p=0.448; d=0.34), BMD, body composition, and physical function remained unchanged. CONCLUSION: The results indicate that QUE may maintain optimal bone health by mediating bone formation and decreasing pro-inflammatory cytokines

Emotional Competence in Primary School Children: Examining the Effect of a Psycho-Educational Group Intervention: A Pilot Prospective Study

Emotional competence (EC) is a key component of children's psychological, cognitive, and social development, and it is a central element of learning. The primary goal of this study was to evaluate the effectiveness of implementing a psycho-educational group intervention aimed at improving children's emotional competence (EC), quality of integration and scholastic skills. A total of 229 children (123 females; M Age = 7.22 years; SD = 0.97 years) completed the Pictures of Facial Affect (POFA), the Drawn Stories Technique, the Classroom Drawing, and the Colored Progressive Matrices. The total sample was randomly divided into an intervention group (N = 116) who took part in psycho-educational activities and a control (no-intervention) group (N = 84). Both groups were tested at baseline, before the intervention started, and at the end of the intervention (4 months from baseline). Results from mixed-model ANOVA revealed a significant main effect for POFA score over time (F = 6.24, p = 0.01) and an interaction effect between POFA and group (F = 4.82, p = 0.03). No significant main effect was found for classroom drawing over time (F = 0.81, p > 0.05) or for quality of integration and group intervention. These findings support the importance of developing psycho-educational programmes in school for promotion of emotional health for preventing not only the onset of problematic behaviours at school such as bullying but also the development of clinical conditions linked to difficulties in emotional recognition, expression, and regulation such as alexithymia

First evidence of maternally inherited mosaicism in TGFBR1 and subtle primary myocardial changes in Loeys-Dietz syndrome: a case report

Background: Loeys-Dietz syndrome (LDS) is a rare multisystemic disorder characterized by vascular and skeletal abnormalities, with considerable intra- and interfamilial variability. Case presentation: We report the case of an 8-year-old male with clinical features of two distinct genetic disorders, namely LDS, manifesting in the first months by progressive aortic root dilatation, arterial tortuosity, bifid uvula, and inguinal hernias and oculocutaneous albinism (OCA) manifesting by white hair and skin that does not tan, nystagmus, reduced iris pigment with iris translucency, and reduced retinal pigment). We identified previously reported, homozygous mutations of TYR, c.1A > G (p.Met1Val) and heterozygous, missense mutation of TGFBR1, c.1460G > A (p.Arg487Gln). Family history revealed that his mother underwent multiple surgical repairs for recurrent hemorrhage originating from the buccal artery. Molecular studies confirmed a maternally inherited low grade TGFBR1 mutation somatic mosaicism (18% in peripheral blood leukocytes, 18% in buccal cells and 10% in hair root cells). Maternal cardiac investigations revealed peculiar cardiovascular features: mild tortuosity at the aortic arch, dilatation of the proximal abdominal aorta, multiple deep left ventricular myocardial crypts, and dysplastic mitral valve. TGFBR2 germline mosaicism has been described in three fathers of children carrying TGFBR2 mutations but, to the best of our knowledge, no case of maternally inherited TGFBR1 mutation mosaicism has been reported so far. Conclusions: This case report suggests that individuals with somatic mosaicism might be at risk for mild and unusual forms of LDS but germline mosaicism can lead to full blown picture of the disease in offspring

Severity of respiratory failure and outcome of patients needing a ventilatory support in the Emergency Department during Italian novel coronavirus SARS-CoV2 outbreak: Preliminary data on the role of Helmet CPAP and Non-Invasive Positive Pressure Ventilation

Background: Novel Coronavirus SARS-CoV-2 pandemic is spreading around the world. At the end of February, the outburst of the pandemic has hit hard on northern Italian's hospitals. As of today, no data have been published regarding the severity of respiratory failure of patients presenting to the Emergency Departments. Moreover, the outcome the patients forced to undergo Continuous Positive Airway Pressure (CPAP) or Non-Invasive Positive Pressure Ventilation (NIPPV) due to lack of Intensive Care resources is unknown. “Papa Giovanni XXIII” hospital (HPG23) of Bergamo is one of the largest hospitals in the Country, with an Emergency Department (ED) managing over 100,000 patients per year. Methods: This is a retrospective observational study based on chart review of patients presenting to the Emergency Department of HPG23 from 29/02/2020 to 10/03/2020 with a clinical condition highly suspicious for COVID-19 infection. Registration of admission rates, severity of respiratory failure (ARDS classification), need of respiratory support, SARS-CoV-2 PCR test and outcome of patients treated with a ventilatory support were registered on 10th of May 2020. Findings: From 29/02 to 10/03 611 patients with a suspected diagnosis of COVID-19 infection were evaluated in our ED; 320 (52%) met the criteria for hospital admission and 99 (31%) needed to be immediately started on ventilatory support (81% CPAP, 7% NIPPV, 12% Invasive Mechanical Ventilation). Eighty-five (86%) of the 99 patients needing a ventilatory support eventually had SARS-CoV-2 infection confirmed by PCR test on nasal-pharyngeal swab. Their median PO2/FiO2 ratio was 128 (IQR 85–168), with 23 patients (29.5%) classified as severe ARDS. Mortality rate as of 10th of May was 76.5%, ranging from 44.4% within patients <60 years old to 85% within those older than 60 years (p = 0.001). NIPPV/CPAP failure occurred in 91.5% of patients. Interpretation: The population of patients suspected for COVID-19 infection presenting at our ED showed a very high rate of severe respiratory failure, with urgent need of a large amount of intensive care resources. Mortality rates of critically ill patients with confirmed COVID-19 (76.5%) are similar to previously reported studies with similar population. CPAP/NIPPV could be a valid strategy to treat severely hypoxic patients that cannot be intubated in the ED due to lack of intensive care resources. Funding: No funds were received for this research project

Expanding the spectrum of EWSR1-PATZ1 rearranged CNS tumors: An infantile case with leptomeningeal dissemination

We report on a case of EWSR1-PATZ1 rearranged brain tumor occurring in a 17 month-old child, originally interpreted as an infantile glioblastoma. Our case shows important analogies with the 2 previously reported cases, including the intraventricular location, the histologic appearance (pushing borders, oligodendrocyte-like morphology, rich vascular network) and the glioneural immunophenotype, supporting the role of these features as relevant clues to the diagnosis. On the other hand, our case displays unique characteristics, i.e. the onset in an infant, the presence of a focal high-grade component and the leptomeningeal dissemination, pointing to the importance of considering this entity in the differential diagnosis of an infantile glial/glioneural tumor