Biomechanics Related to Increased Softball Pitcher Shoulder Stress: Implications for Injury Prevention

Background: Softball pitchers exhibit high throwing shoulder distraction force, which is a theorized mechanism of throwing shoulder overuse injury. Windmill pitching involves a variety of highly individualistic pitching styles, and certain kinematics preceding ball release likely influence the amount of shoulder stress that a pitcher accrues. Purpose: To examine the association of trunk and throwing arm kinematics, kinetics, and timing variables with peak throwing shoulder distraction force in high school softball pitchers. Study Design: Descriptive laboratory study. Methods: A total of 37 high school pitchers (mean ± SD; height, 1.71 ± 0.06 m; weight, 75.53 ± 16.12 kg; age, 16 ± 2 years) threw 10 fastball pitches at regulation distance (43 ft [13.1 m]) and with maximum effort. Kinematic data were collected at 240 Hz using an electromagnetic motion capture system synced with motion analysis software. The 3 fastest pitches were averaged and analyzed. Kinematic, kinetic, and timing variables were entered into a stepwise linear regression analysis. Results: Four variables were included in the significant model ( F4,39 = 147.51; P < .001) and explained peak shoulder distraction force ( R2 = 0.944; adjusted R2 = 0.938; SE = 0.036): increased peak elbow distraction force ( t = 19.90; P < .001) and extension moment ( t = 3.63; P = .001), as well as decreased elbow flexion velocity ( t = −2.37; P = .023) and trunk flexion at foot contact of the pitch ( t = −3.00; P = .005). Conclusion: Elbow kinetics and angular velocity, as well as trunk positioning at foot contact, are associated with peak throwing shoulder distraction force in high school softball pitchers. Clinical Relevance: Variables associated with peak throwing shoulder distraction force provide information regarding injury mechanism and coachable cues that might reduce shoulder injury risk among pitchers.

Pet Attachment and Its Relevant Factors among Undergraduates

Objective To explore the characteristics of pet attachment and its relevant factors among undergraduates. Methods 547 undergraduate pet owners were selected by stratified random sampling from 7 universities in Guangzhou City. They were investigated with Lexington Attachment to Pets Scale (LAPS), College Students Interpersonal Comprehensive Diagnostic Scale (ICDSCS), Revised UCLA Loneliness Scale-Version 3 (UCLALS), Simplified Coping Style Questionnaire (SCSQ) and a self-edited questionnaire on the general personal information. Results ⑴ The total score of LAPS, ICDSCS and UCLALS, as well as score of coping style disposition were (41.71±10.05), (9.12±5.62), (44.51±7.87) and (-.22±1.50), respectively. ⑵ 20.9% of undergraduates were moderate to severe pet attachment. ⑶ Multiple stepwise linear regression analysis showed that the total score of LAPS was positively correlated with 7 factors such as total score of UCLALS and ICDSCS, school category, how many pets have you kept, origin, gender and monthly family income (β=.119 to .668, all P < 0.05), while the reasons for keeping pets and coping style disposition were negatively correlated with the total score of LAPS (β=-.537 and -.621, P < 0.05). Conclusion College students' pet attachment is a common behavioral problem, which is closely related to such factors as family rearing, community cultural atmosphere, school education and the personality of the undergraduates.

Different clinical parameters inform epicardial fat thickness in pre- and post-menopausal women with obstructive sleep apnea

Background Obstructive sleep apnea (OSA) is a sleep-related disorder with breathing difficulties. Previous studies revealed that epicardial fat thickness (EFT) correlates with OSA severity. Interestingly, female patients display a stronger EFT-OSA correlation than males. The purpose of this study is to investigate the relationship between EFT and different clinical characteristics in pre- and post-menopausal women diagnosed with OSA. Methods Patients diagnosed with OSA were divided into pre/early peri-menopausal (Group 1) and post/late peri-menopausal (Group 2) according to the menopause status. EFT was obtained from parasternal long-axis echocardiographic images. We also collected general clinical characteristics of patients involved in this study, and performed spearman correlation analysis to explore the correlations between EFT and the general clinical characteristics. We further applied Multiple stepwise linear regression analysis to explore the predictors for EFT in both groups. Results A total number of 23 and 59 patients were enrolled in Group 1 and Group 2 respectively. EFT in Group 2 was significantly higher than that of Group 1. In both groups, EFT was positively correlated with apnea–hypopnea index (AHI), percentage of total sleep time when blood oxygen saturation was less than 90% (T90), oxygen desaturation index (ODI) and glucose; while EFT was negatively correlated with mean and lowest SaO2 (oxygen saturation) levels. However, EFT was positively correlated with total cholesterol (TC) only in Group 1 and body mass index (BMI) only in Group2, respectively. Multiple stepwise linear regression analysis showed that AHI was independently associated with EFT in Group 1. However, both AHI and BMI were independent predictors of EFT in Group 2. Conclusion EFT was notably correlated with menopausal status in women with OSA. AHI was the independent predictor of EFT in women with OSA. BMI was the independent predictor of EFT in post/late peri-menopausal women with OSA.

Impact of the COVID-19 pandemic on migraine in Japan: a multicentre cross-sectional study

Objectives To assess the impacts of social situation changes due to the coronavirus disease 2019 (COVID-19) pandemic on headache-related disability and other symptoms in patients with migraine in Japan. Methods We conducted a multicentre, cross-sectional study including 659 outpatients with migraine diagnosed by headache specialists. The participants were asked about the impacts of the first wave of the COVID-19 pandemic on headache-related disability, headache days, headache intensity, stress, physical activity, hospital access and their work and home lives. For headache-related disability, the total Migraine Disability Assessment (MIDAS) score and part A and B scores were analysed. Multivariate stepwise linear regression analysis was performed to identify the clinical predictors of changes in the total MIDAS score before and during the COVID-19 pandemic. Logistic regression analysis was performed to determine the factors related to new-onset headache during the COVID-19 pandemic. Results Finally, 606 migraine patients (73 M/533 F; age, 45.2 ± 12.0 years) were included in the study, excluding those with incomplete data. Increased stress, substantial concern about COVID-19 and negative impacts of the first wave of the COVID-19 pandemic on daily life were reported in 56.8 %, 55.1 and 45.0 % of the participants, respectively. The total MIDAS and A and B scores did not significantly change after the first wave of the COVID-19 pandemic. New-onset headache, which was observed in 95 patients (15.7 %), was associated with younger age and worsened mood and sleep in the logistic regression analysis. The multivariate stepwise linear regression analysis of changes in the total MIDAS score before and during the first wave of COVID-19 pandemic identified worsened sleep, increased acute medication use, increased stress, medication shortages, comorbidities, the absence of an aura and new-onset headache were determinants of an increased total MIDAS score during the first wave of the COVID-19 pandemic. Conclusions In this multicentre study, clinical factors relevant to headache-related disability, such as new-onset headache, stress and sleep disturbances, were identified, highlighting the importance of symptom management in migraine patients during the first wave of the COVID-19 pandemic.

Digital Learning Games Scale (DLGS): A Scale Development Study

The purpose of this study is to develop a valid and reliable measurement tool for measuring contribution of digital learning games in the learning process . The study group consists of 280 teachers working in elementary schools in Palestine in the 2020-2021 academic year. The construct validity of the scale was examined by exploratory factor analysis. According to the results of the analysis, the scale measures a six- dimensions structure. The six - dimensions structure of the scale was confirmed by stepwise linear regression analysis. The total variance ratio explained by the scale was determined as 68.38. In order to determine the reliability of the scale, the internal consistency coefficient of Cronbach’s alpha was evaluated and this value was determined as .914. The results of all validity and reliability analyzes show that the digital leaning game as a valid and reliable measurement tool in the future studies about digital learning games.

Pollutants and climatic conditions related to the formation of photochemical oxidants

Solar radiation produces harmful compounds such as atmospheric oxidants and pharmaceutical intermediates through photochemical reactions. To clarify the variables related to the formation of photochemical oxidants, hourly data of air pollutants and climatic conditions in the Tokyo region of Japan from late May to early June 2020 were analyzed. Air pollutants, NO, NO2, CO, SO2, NMHCs and CH4, were significantly lower in 2020 than those in 2019. It seems to indicate that Japan's economic activity was suppressed by the COVID-19 emergency. Photochemical oxidants and NO were significantly higher during the day than at night. It shows the photochemical reaction is progressing during the day. Stepwise linear regression analysis revealed that relative humidity, ambient temperature, NO, CO, wind speed and NMHCs (non-methane hydrocarbons) were significant independent variables for photochemical oxidants formation.

More Pace Variation and Pack Formation in Successful World-Class 10,000-m Runners Than in Less Successful Competitors

Purpose: To determine different relationships between, and predictive ability of, performance variables at intermediate distances with finishing time in elite male 10,000-m runners. Methods: Official electronic finishing and 100-m split times of the men’s 10,000-m finals at the 2008 and 2016 Olympic Games and IAAF World Championships in 2013 and 2017 were obtained (125 athlete performances in total). Correlations were calculated between finishing times and positions and performance variables related to speed, position, time to the leader, and time to the runner in front at 2000, 4000, 6000, 8000, and 9900 m. Stepwise linear-regression analysis was conducted between finishing times and positions and these variables across the race. One-way analysis of variance was performed to identify differences between intermediate distances. Results: The SD and kurtosis of mean time, skewness of mean time, and position and time difference to the leader were either correlated with or significantly contributed to predictions of finishing time and position at at least one of the analyzed distances (.81 ≥ r ≥ .30 and .001 ≤ P ≤ .03, respectively). These variables also displayed variation across the race (.001 ≤ P ≤ .05). Conclusions: The ability to undertake a high degree of pace variability, mostly characterized by acceleration in the final stages, is strongly associated with achievement of high finishing positions in championship 10,000-m racing. Furthermore, the adoption and maintenance of positions close to the front of the race from the early stages are important to achieve a high finishing position.

A Prediction Equation to Assess Resting Energy Expenditure in Japanese Patients with COPD

Background: Medical nutrition therapy is important in the management of chronic obstructive pulmonary disease (COPD) patients. Determination of resting energy expenditure is essential to define therapeutic goals for medical nutrition. Previous studies proposed the use of equations to predict resting energy expenditure. No prediction equation is currently available for the Japanese population. The objective of this study was to develop an equation to predict resting energy expenditure in Japanese chronic obstructive pulmonary disease patients. To this end, we investigated clinical variables that correlate with the resting energy expenditure. Methods: This study included 102 COPD patients admitted at the Matsusaka Municipal Hospital Respiratory Center. We measured resting energy expenditure by indirect calorimetry and explored the relationship of resting energy expenditure with clinical variables by univariate and stepwise linear regression analysis. Results: The resting energy expenditure by indirect calorimetry was significantly correlated with fat-free mass, body weight, body mass index, height, gender, and pulmonary function test by univariate analysis. In the stepwise linear regression analysis, the fat-free mass, body weight, and age remained significantly correlated with indirect calorimetry’s resting energy expenditure. The fat-free mass, body weight, and age explained 50.5% of the resting energy expenditure variation. Conclusion: Fat-free mass, body weight, and age were significantly correlated with resting energy expenditure by stepwise linear regression analysis, and they were used to define a predictive equation for Japanese COPD patients.

Factors determining different death rates because of the COVID-19 outbreak among countries

Background During the coronavirus disease 2019 (COVID-19) pandemic, all European countries were hit, but mortality rates were heterogenous. The aim of the current paper was to identify factors responsible for this heterogeneity. Methods Data concerning 40 countries were gathered, concerning demographics, vulnerability factors and characteristics of the national response. These variables were tested against the rate of deaths per million in each country. The statistical analysis included Person correlation coefficient and Forward Stepwise Linear Regression Analysis (FSLRA). Results The FSLRA results suggested that ‘days since first national death for the implementation of ban of all public events’ was the only variable significantly contributing to the final model, explaining 44% of observed variability. Discussion The current study suggests that the crucial factor for the different death rates because of COVID-19 outbreak was the fast implementation of public events ban. This does not necessarily mean that the other measures were useless, especially since most countries implemented all of them as a ‘package’. However, it does imply that this is a possibility and focused research is needed to clarify it, and is in accord with a model of spreading where only a few superspreaders infect large numbers through prolonged exposure.

Evolved adaptation to low ultraviolet radiation may be the main cause of malignant melanoma independent of high ultraviolet radiation exposure

Objective:The low melanin production (depigmentation) evolved from low ultraviolet radiation may be the principal determinant of malignant melanoma of skin (C43).Design:Country-specific estimates of C43 incidence, daily UVR exposure, skin colour (EEL), socioeconomic status (GDP PPP), magnitude of reduced natural selection (Ibs), ageing, urbanization, percentage of European descendants (Eu%), and depigmentation measured by blonde hair colour, were subjected to statistical analyses. Data were derived from WHO, United Nations, World Bank databases and the literature.Setting:Ecological analysisParticipants:182 individual countries.Main outcome measures:Parametric and non-parametric correlations, partial correlation analyses keeping confounders statistically constant, multivariate regressions and analyses of variance.Results:Worldwide, UVR exposure was in negative correlation with C43 (“rho” = -0.515, p < 0.001). This relationship remained significant and negative in parametric partial correlation (r = -0.513, p < 0.001) when GDP PPP, Ibs, ageing and urbanization were statistically kept constant.In stepwise linear regression analysis, UVR was the variable having greatest negative influence on C43 incidence (R2=0.301).Worldwide, C43 incidence was in strong correlation with Eu% (r = 0.711, p<0.001). The inverse relationships between C43 and UVR exposure (r = -0.498, r<0.001) and Eu% (r = 0.477, p<0.001) remained significant in partial correlation analysis.When C43 incidence rate was standardized on Eu% it did not correlate at all with UVR (“rho”=0.004, p=0.967, n=127). The country-specific depigmentation level strongly correlated with C43 incidence (r = 0.705, p<0.001, n= 48). Partial correlation analysis revealed that C43 correlated to depigmentation significantly (r=0.315, p<0.01). However, UVR showed almost nil correlation with C43 when depigmentation, together with the other four potential confounders was included as the controlled variable.Conclusions:C43 incidence may not be attributable to UVR exposure. Low melanin production, genetically determined, that has adaptively evolved over generations represents an ultimate risk factor for C43.