Acid-Base Balance and Electrolyte Management

Perhaps the most ubiquitous set of interlinked clinical issues to be addressed in inpatient medicine is fluids, electrolytes, and acid-base balance. Decision making for the first two directly and measurably impacts the latter. Unlike most other critical therapies whose management is tied to a specific skill set and competency, every practitioner is empowered to prescribe and direct fluid and electrolyte management and, secondarily, pH. Downstream consequences in terms of compensation, both pulmonary and renal, may be singularly important for those with preexisting conditions that impact organ function and drive the need for unanticipated monitoring and therapy, including organ support. Therefore, the basics of fluid and electrolyte management are essential to be mastered, as is specific knowledge of the consequences of that prescription to enhance recovery and avoid preventable errors with important sequelae. Accordingly, current different but complementary methods of assessing acid-base balance are presented so that the reader may have a systematic approach to determining pH before intervention as well as after the initiation of fluid and electrolyte therapy. This review contains 12 figures, 7 tables, and 38 references Keywords: acid, base, electrolyte disturbances, Henderson-Hasselbach, maintenance, proton, resuscitation, Stewart methodology

Player Chronotype Does Not Affect In-Game Performance during the Evening (>18:00 h) in Professional Male Basketball Players

Sport-specific skills display diurnal variation across various team sports such as badminton and tennis serving accuracy and soccer dribbling, volleying, and chipping execution. However, the effects of athlete chronotype on in-game sport-specific skill performance according to time of day across team sports is not well understood. Therefore, the aim of this study was to identify the effect of player chronotype on in-game basketball performance during evening games. Professional male basketball players (n = 11) completed a morningness–eveningness questionnaire and were categorized according to chronotype (morning-type: n = 4; neither-type: n = 6; evening-type: n = 1). Box score data from the 2019/20 season were utilized to determine individual in-game performance during evening games played after 18:00 h. Composite metrics (i.e., effective field goal percentage, offensive rating, defensive rating, and player efficiency) were used as indicators of player performance. Non-significant (p ≥ 0.21) differences were evident between M-types and N-types for most performance measures. Small to very large effects were observed in the number of rebounds favoring M-types, and three-point shots attempted and made, assists, and steals favored N-types. In-game performance appeared to not be affected by chronotype (i.e., M-type vs. N-type) in evening games among professional male basketball players. The lack of observed effect between chronotype and in-game performance suggest coaching staff may not need to consider player chronotype when developing a match strategy or assigning player roles if largely dealing with M-types and N-types. However, to ensure the greatest specificity, coaching staff may endeavor to schedule habitual training times in line with that of competition in an effort to align player circadian rhythms to games.

Effects of Cool-Down Exercise and Cold-Water Immersion Ther-apy on Basic Fitness and Sport-Specific Skills among Korean College Soccer Players

Background: We aimed to examine the effects of cool-down exercise and cold-water immersion therapy on agility, speed, power, balance, and sport-specific skill performance in college soccer players, and to provide baseline data for the development of effective recovery programs. Methods: In August 2020, 21 male college soccer players in Seoul, Korea, were randomly divided into the following groups: control group (CG, n=7), cool-down exercise group (CDG, n=7), and cool-down exercise plus cold-water immersion group (CDCWG, n=7). Agility, speed, power, balance, and sport-specific skill performance were assessed before and after the intervention. Results: No significant differences in Southeast Missouri (SEMO) Agility Test, 20-m sprint test, vertical jump test, or Y-balance test (right) were observed among the groups; however, there was a significant effect of time (P<0.05) and a significant time × group interaction (P<0.05). Significant effects of time (P<0.001), group (P=0.043), and a time × group interaction (P=0.009) were observed in the Y-balance test (left). There were no between-group differences in the 22-m dribble test, shooting test (left), or shooting test (right); however, there were significant effects of time (P<0.05) and significant time × group interactions (P<0.05). No significant effects of group or time × group interactions were observed for the kicking test (left or right); however, there were significant effects of time (P<0.001). Conclusion: Addition of cold-water immersion therapy to a recovery program including cool-down exercise can promote recovery of basic and sport-specific abilities among college soccer players.

Dimensions of Skill Use in the Unified Protocol: Exploring Unique Effects on Anxiety and Depression

Objective: Although the Unified Protocol contains multiple distinct skills to target anxiety, depression, and related conditions, researchers have yet to establish if patients' use of these skills contributes to symptom change. Using data from the first-stage randomization of a sequential multiple assignment randomized trial, we tested whether general skillfulness, defined by skill knowledge, frequency, quality, and effectiveness, predicted within- or between-person changes in anxiety and depression. We further tested whether use of particular UP skills (e.g., mindfulness, behavior change) predicted changes in these outcomes. Method: Participants (N = 70; Mage = 33.74, 67% female, 74% white) completed six sessions of core UP modules and reported on their skillfulness and specific skill use using two novel measures, along with their symptoms of anxiety (OASIS) and depression (ODSIS) before each session, and their alliance (WAI) after each session. We disaggregated between- from within-person effects to test session- to-session effects of skillfulness, skill use, and the alliance on symptom change. Results: Greater within-person skillfulness predicted decreases in anxiety and depression. More frequent within- person use of all UP skills predicted decreases in anxiety, whereas more frequent within-person use of alternative actions specifically predicted decreases in depression. Conclusions: This pattern of results provides guidance on the specific aspects of skill training to prioritize in transdiagnostic treatments depending on whether therapists are targeting anxiety or depression.

Association of Performance in Strength and Plyometric Tests with Change of Direction Performance in Young Female Team-Sport Athletes

The change of direction (COD) ability is a task-specific skill dependent on different factors such as the degree of the turn, which has led to differentiating CODs as more force- (>90°) or velocity-oriented (<90°). Considering force and velocity requirements is of importance when designing sport-specific training programs for enhancing COD performance. Thus, 25 female handball and soccer players participated in this study, which investigated the association between three different strength and plyometric exercises and force- and velocity-oriented COD performance. By utilizing the median split analysis, the participants were further divided into a fast (n = 8) and a slow (n = 8) COD group, to investigate differences in step kinematics between fast and slow performers. The correlational analysis revealed that the bilateral back squat and unilateral quarter squat were significantly associated with several force- and velocity-oriented COD performance (r = −0.46 to −0.64), while the association between plyometric and COD performance was limited (r < 0.44). The fast COD group revealed higher levels of strength, jump height, peak velocities, higher step frequencies, shorter ground contact times, and greater acceleration and braking power (d > 1.29, p < 0.03). It was concluded that the observed correlation between strength and COD performance might be due to stronger athletes being able to produce more workload in a shorter time, which was supported by the step kinematics.

Personalized CAPTCHA Using Cognitive Cryptography

Cognitive Cryptography is used to improve personal verification process using the individual’s characteristics. The personal information contained can be biometrics because it is the unique information that identifies the owner. In advanced cryptographic protocol oriented for authentication of user, there is a possibility of using personal characteristics and perception abilities are required to create a new authentication procedure. This paper presents a new approach for creation of advanced multilevel user authentication protocol by using Image grid CAPTCHA codes. Here the user needs the special skills or knowledge while verifying, this is because of cognitive CAPTCHA’s. Instead of generating some random numbers or text while authentication procedure these CAPTCHA’s can be used. In multilevel authentication code the user verification can be realized in several iterations, in which the user attention can be oriented on different visual elements, region of interest or semantic content. This cognitive code will able to identify the recognition abilities of the user. Cognitive codes are having high security feature similar to traditional CAPTCHA’s because of understanding or recognizing the blurred or distorted patterns and also requires background knowledge to experience the connection with evaluated patterns. This feature guarantees the high level of security and allows to get succeeded in authentication process because the user possess specific skill that or not available for computers or answering systems. The traditional authentication protocols are to be involved with human mental capability is the vital idea of the proposed solution.

Comparison of Static Balance among Cricket, Badminton, Football and Track and Field Athletes

BACKGROUND The balance plays an indispensable role in many sports. Static balance is crucial for a postural control and has an exceptional effect on the performance of sports players and for injury prevention. Sports like cricket, football, track and field, and badminton requires static balance for the execution of a sports-specific skill. Single leg stance test was used to assess balance on a surface during a 30 sec single-leg standing posture with eyes open and eyes closed. The main goal of this study was to determine that, in which sport the static balance was more and in which sport the static balance was inferior. The objectives were to assess the static balance in cricket, badminton, track and field, football athletes and compare the static balance in all 4 sports [cricket, badminton, track and field, football] METHODS A total of one hundred and twenty - four athletes [124], cricket {N = 31}, football {N = 31}, badminton {N = 31}, track and field {N = 31} voluntarily participated in the study. Static balance was assessed by using single leg stance test with eyes open and eyes closed. RESULTS By comparing all sports, it showed that there was a statistically significant difference between cricket, football, badminton and track and field athletes in dominant and non - dominant leg with eyes open and eyes closed. With eyes open, a static balance was demonstrated superior in track and field followed by football, cricket and least in badminton players in the dominant leg and non-dominant leg. (P < 0.0001) Whereas, with eyes closed, comparing between sports individually, there showed no such significant difference between dominant and non-dominant leg. Static balance was superior in track and field followed by football, by cricket and least in badminton in dominant and non-dominant leg (P < 0.0001). CONCLUSIONS Track and field players did not differ in dominant and non-dominant legs. In contrast, badminton players displayed mediocre static balance with eyes open and football players displayed mediocre static balance with eyes closed. There was no significant difference between open and closed eyes. But the balance score showed superior balance in open eyes when compared with closed eyes. KEY WORDS Athletes, Static Balance, Single Leg Stance Test, Balance, and Sports Performance.

LET’S TALK ABOUT SEXUAL HEALTH EDUCATION

Sexual Health Education must be is on important field of education. The purpose of our article is to synthesize the diverse aspects founded in the literature of sexual health education. We conducted a search of the literature on sexual health education and specific results of subject. We synthetized there information about standards and specific skill elements, teaching sexual health education, pedagogical, methodological and theoretical approach. During the workshops organized with teachers, students and parents, the topic of sex education was debated, the topic giving rise to controversy, especially due to the religious aspect. Important is the role of parents in sexual health education and finally is important to know the perceptions of adolescents.

Plasticity and tool use in the body schema

The ability of humans to manufacture objects and represent physical causality makes them the master species in the use of tools. What is the impact of such a specific skill on the processing of bodily body-related spatial information? To what extent does the skilful manipulation of tools require specific embodiment of the device into one’s body representation? The present chapter reviews the effect of tool use on the representation of the body and space surrounding it, by analysing the cognitive effects of tool use and its neural representations. Studies on animals, healthy humans, and neuropsychological patients suggest that multisensory integration of stimuli far from the body is enhanced when a tool can reach those stimuli. Such a spatial remapping indicates that the body schema may adapt to include the device into one’s body representation. Notably, tool use-related changes are not limited to spatial processing, but also to the processing of body-related sensory-motor information. Understanding the cognitive mechanisms underlying tool use and the effect of tool use in the representation of the space around us is a paramount challenge to the understanding of body representation, especially considering that modern and more sophisticated technological tools, such as functional prostheses, robotic interfaces, and virtual reality devices, continually shape the central role of the body in human–environment interactions.

Targeted Re-Instruction for Hearing Aid Use and Care Skills

Purpose The purpose of this study was to determine if re-instructing a hearing aid (HA) user on the specific skill(s) they could not successfully perform on the Practical Hearing Aid Skills Test–Revised (PHAST-R) resulted in better HA use and care skills than a traditional fitting method. This is referred to as “targeted re-instruction.” Also, factors that might affect HA use and care skills, including memory function, hearing handicap, and hearing aid–related attitudes, were assessed. Method This study was a randomized control trial. Twenty-six new HA users (13 experimental; 13 control) were fit with HAs and provided a standard HA orientation. HA use and care skills were measured immediately following the HA fitting and then again at 4 weeks post-HA fitting. The experimental group was administered the PHAST-R twice during the trial period to identify the HA use and care skills that participants needed re-instruction on. Results Participants in the experimental group maintained their HA use and care skills over the 4-week HA trial period, whereas participants in the control group showed a significant decline. Working memory, hearing handicap, and HA-related attitudes were not found to be correlated with HA use and care skills. Conclusions Participants who did not receive targeted re-instruction showed a decline in their HA use and care skills after only 4 weeks of HA use, whereas targeted re-instruction prevented a decline in HA use and care skills. It took an average of less than 10 min to administer the PHAST-R and provide targeted re-instruction, indicating that it would be appropriate to use in a clinical setting.