Are EPB41 and alpha-synuclein diagnostic biomarkers of sport-related concussion? Findings from the NCAA and Department of Defense CARE Consortium

BackgroundCurrent protein biomarkers are only moderately predictive at identifying individuals with mild traumatic brain injury or concussion. Therefore, more accurate diagnostic markers are needed for sport-related concussion.MethodsThis was a multicenter, prospective, case-control study of athletes who provided blood samples and were diagnosed with a concussion or were a matched non-concussed control within the National Collegiate Athletic Association–Department of Defense Concussion Assessment, Research, and Education Consortium conducted between 2015 and 2019. The blood was collected within 48 h of injury to identify protein abnormalities at the acute and subacute timepoints. Athletes with concussion were divided into 6 h post-injury (0–6 h post-injury) and after 6 h post-injury (7–48 h post-injury) groups. We applied a highly multiplexed proteomic technique that used a DNA aptamers assay to target 1305 proteins in plasma samples from athletes with and without sport-related concussion.ResultsA total of 140 athletes with concussion (79.3% males; aged 18.71 ± 1.10 years, mean ± SD) and 21 non-concussed athletes (76.2% males; 19.14 ± 1.10 years) were included in this study. We identified 338 plasma proteins that significantly differed in abundance (319 upregulated and 19 downregulated) in concussed athletes compared to non-concussed athletes. The top 20 most differentially abundant proteins discriminated concussed athletes from non-concussed athletes with an area under the curve (AUC) of 0.954 (95% confidence interval: 0.922‒0.986). Specifically, after 6 h of injury, the individual AUC of plasma erythrocyte membrane protein band 4.1 (EPB41) and alpha-synuclein (SNCA) were 0.956 and 0.875, respectively. The combination of EPB41 and SNCA provided the best AUC (1.000), which suggests this combination of candidate plasma biomarkers is the best for diagnosing concussion in athletes after 6 h of injury.ConclusionOur data suggest that proteomic profiling may provide novel diagnostic protein markers and that a combination of EPB41 and SNCA is the most predictive biomarker of concussion after 6 h of injury.     

What Are the Contributory and Compensatory Relationships Between Physical Education and Physical Activity in Children?

Limited data are available on the contributory and compensatory relationships between physical education and physical activity in children. Four hundred eighty-five (280 girls) children in first through sixth grades wore sealed pedometers during waking hours, including normally scheduled physical education lessons. The least, moderately, and most active children accumulated approximately 1,700, 1,100, and 2,500 more steps/day, respectively, on school days with physical education. No compensatory increases in physical activity were found on school days that did not offer physical education. The implications of the contributory relationship are highlighted by the evidence that 50% of the least active children were at risk for overweight or overweight and that no compensatory increases in physical activity were found on school days when physical education classes were not scheduled.     

For the Good of the Game? The Legacy of the Football Trust,the Football Pools,and the Dangerous Seduction of Political Promise

During the late twentieth century, the United Kingdom’s football infrastructure and spectatorship underwent transformation as successive stadia disasters heightened political and public scrutiny of the game and prompted industry change. Central to this process was the government’s formation of an independent charitable organization to oversee subsequent policy implementation and grant-aid provision to clubs for safety, crowd, and spectator requirements. This entity, which began in 1975 focusing on ground improvement, developed into the Football Trust. The Trust was funded directly by the football pools companies who ran popular low-stakes football betting enterprises. Working in association with the Pools Promoters Association (PPA), and demonstrating their social responsibility towards the game’s constituents, the pools resourced a wide array of Trust activities. Yet irrespective of government mandate, the PPA and Trust were continually confronted by political and economic obstacles that threatened the effectiveness of their arrangements. In this paper the history of the Football Trust is investigated, along with its partnership with the PPA, and its relationship with the government within the context of broader political shifts, stadia catastrophes, official inquiries, and commercial threats. It is contended that while the Trust/PPA partnership had a respectable legacy, their history afforded little protection against adverse contemporary conditions.     

Sport to the Rescue of the Suburbs: Sport to Educate? Sport to Reassure? When Politicians Respond to the Signs of Disturbance of Law and Order

Since the beginning of the 1980s, sport has appeared to be the last recourse against the worsening of living conditions, lack of job security and the ghettoisation of certain boroughs that stand out mostly because of continuing urban riots and juvenile violence. All of this is continually exaggerated by the media and politicians in their continual desire to dramatise and exaggerate. Certain sub-issues immediately emerge: what are the theoretical or ideological foundations on which this concept of making sport a lever for preventive policies is based? And what sport are we talking about? Is it the physical activities and sport (PAS) practised in the schools and institutes, civil sport or sport in the streets? Why do young people increasingly abandon civil/federated sport to practise ‘adventure sports’ or self-organised sports? Can self-organised sports and, more precisely, sport played outside the tower blocks favour the ‘self-control of impulses’? And if they can, under what conditions can they favour socialisation and contribute to preventing vandalism or violent acts? If it must be admitted that the links between sport and education, sport and prevention, sport and insertion, etc., are considered to be self-evident, they are rarely analysed or questioned.     

What Are the Barriers to Mobilizing Intensive Care Patients?

Purpose

Recently there has been increased interest in early mobilization of critically ill patients. Proposed benefits include improvements in respiratory function, muscle wasting, intensive care unit (ICU), and hospital length of stay. We studied the frequency of early mobilization in our intensive care unit in order to identify barriers to early mobilization.

Methods

A 4-week prospective audit of 106 patients admitted to a mixed medical-surgical tertiary ICU (mean age 60 ± 20 years, mean APACHE II score 14.7 ± 7.8) was performed. Outcome measures included number of patient days mobilized, type of mobilization, adverse events, and reasons for inability to mobilize.

Results

Patients were mobilized on 176 (54%) of 327 patient days. Adverse events occurred in 2 of 176 mobilization episodes (1.1%). In 71 (47%) of the 151 patient days where mobilization did not occur, potentially avoidable factors were identified, including vascular access devices sited in the femoral region, timing of procedures and agitation or reduced level of consciousness.

Conclusions

Critically ill patients can be safely mobilized for much of their ICU stay. Interventions that may allow more patients to mobilize include: changing the site of vascular catheters, careful scheduling of procedures, and improved sedation management.Key Words: intensive care units, mobility, physical therapy     

Are athletes on the right track? The effect of availability of an all-weather athletics track on athletics performance

In February of 2011, an earthquake destroyed the only all-weather athletics facility in the city of Christchurch, New Zealand. The all-weather track has yet to be replaced, and so since the loss of the track, local Christchurch athletes have only had a grass track for training and preparation for championship events. The present study considers what effect the loss of the training facility has had on the performance of athletes from Christchurch at national championship events. Not surprisingly, the study finds that there has been a deterioration in the performance in events that are heavily dependent upon the all-weather surface. However, somewhat more surprisingly, the loss of the track appears to have caused a significant improvement in the performance of Christchurch athletes in events that, while on the standard athletics programme, are not heavily dependent on track surface.     

Have we underestimated the kinematic and kinetic benefits of non-ballistic motion?

Explosive upper-body movements, with which the load is not thrown (non-ballistic), may comprise a phase during which forces are produced in opposition to the motion of the load. Thirty men completed three test sessions (free weight, ballistic, and pneumatic), each consisting of a one-repetition maximum (1-RM) and four explosive repetitions of a bench press at six loads (15, 30, 45, 60, 75, and 90% 1-RM). The end of the lifting phase for the non-ballistic conditions (free weight and pneumatic) was defined by: the point of peak barbell displacement and the point at which the vertical force became negative (positive work). When analysed by peak displacement, the ballistic condition elicited significantly greater mean velocity, force, and power at loads of 15–60% 1-RM compared with the free weight condition. When the period of negative work was removed, the mean free weight velocity, force, and power at loads below 60% 1-RM increased. Consequently, the only differences between the free weight and ballistic conditions were found at loads of 15% and 30% 1-RM. Including a period of negative work may underestimate all kinematic and kinetic variables dependent on the time to, or position of, the end of the lifting phase, for non-ballistic efforts.     

Have we underestimated the kinematic and kinetic benefits of non-ballistic motion?

Explosive upper-body movements, with which the load is not thrown (non-ballistic), may comprise a phase during which forces are produced in opposition to the motion of the load. Thirty men completed three test sessions (free weight, ballistic, and pneumatic), each consisting of a one-repetition maximum (1-RM) and four explosive repetitions of a bench press at six loads (15, 30, 45, 60, 75, and 90% 1-RM). The end of the lifting phase for the non-ballistic conditions (free weight and pneumatic) was defined by: the point of peak barbell displacement and the point at which the vertical force became negative (positive work). When analysed by peak displacement, the ballistic condition elicited significantly greater mean velocity, force, and power at loads of 15-60% 1-RM compared with the free weight condition. When the period of negative work was removed, the mean free weight velocity, force, and power at loads below 60% 1-RM increased. Consequently, the only differences between the free weight and ballistic conditions were found at loads of 15% and 30% 1-RM. Including a period of negative work may underestimate all kinematic and kinetic variables dependent on the time to, or position of, the end of the lifting phase, for non-ballistic efforts.     

Wicked Wikipedia? Communities of Practice,the Production of Knowledge and Australian Sport History

Academic responses to Wikipedia since its inception in 2001 have shifted from scepticism and hostility to serious critique. Wikipedia is a project driven by a community of amateur, and sometimes professional, scholars and it is this community – and associated rules and practices – that shapes the site's publicly viewable content. Despite the centrality of egalitarianism and communal wisdom to the Wikipedian ethos, the encyclopaedia is not filled equitably with historical knowledge or topics. This article addresses the role of Wikipedia in the production of knowledge in a sport history context. An analysis of 115 Wikipedia articles written about notable Australian sportspeople revealed a disproportionately large group of high-quality cricket biographies. Further investigation revealed that a small group of Wikipedians were responsible for writing these articles. The work of this community of practice is indicative of the influence that dedicated special interest groups can have over the production of knowledge on Wikipedia and raises broader questions about the production of knowledge in sport history.     

Not Quite Free? Irish Postcoloniality and the Career of Pat O'Callaghan

This paper explores the career of the Irish Olympian Pat O'Callaghan. He won successive hammer-throwing titles in the 1924 and 1928 Olympics as a representative of the independent Irish state. The paper argues that in these Olympics, O'Callaghan can be considered as representing a postcolonial state, in line with much scholarship on other aspects of Irish culture. However, the Irish later fell into a dispute with the International Amateur Athletics Federation and the International Olympic Committee, which were largely steered by the British in dealing with contentious issues over the Irish border, and the Irish were thus effectively banned from the 1936 games. The paper concludes with a discussion over the nature of postcolonial identities in sport, and the complexities around the issue in relation to the constant mediation over what national identities mean within the context of rule-making by international sporting bodies.     

Major League Baseball and the Dominican Republic: What is in the best interest of the players?

This case is about Major League Baseball and the Dominican Republic. We explore how Major League Baseball has used this Caribbean island as an inexpensive labor market and the social problems of the situation. Specifically, we examine Corporate Social Responsibility, the leadership of Sandy Alderson, ethics and the various stakeholders involved. We also look into possible reform alternatives while addressing the central question: What is in the best interest of the players?     

Are the Multidimensional Body Self-Relations Questionnaire Scales stable or transient?

Body image is an important concept when assessing mental health and, thus, a target for intervention work. The common approach to assess body image is via self-report and, consequently, it is important to assess stability and susceptibility of items to random change. Participants (N = 99, aged: 18–30 years) completed the 34-item Multidimensional Body Self-Relations Questionnaire-Appearance Scales (MBSRQ-AS) twice, separated by two weeks. Stability was quantified by calculating the test–retest differences for each item, with a stable item showing 90% of respondents’ differences within a criterion of ≤±1. This method was used in preference to correlation, which is a test of association rather than agreement. Analyses identified 29 stable items. Five items were found to be unstable including the entire “Appearance Evaluation” scale. One particular unstable question, Q9 = “Most people would consider me good-looking”, revealed strong associations with both gender and weight status. Forty-four per cent of “overweight” respondents changed their minds by more than ±1 compared with only 10% of “normal-weight” participants, suggesting that being overweight is associated with uncertainty and instability. We suggest that future research is needed to investigate why such factors as being overweight appear to be linked to instability in self-report measures of body image.     

Isokinetic knee extension and vertical jumping: Are they related?

The aim of this study was to examine joint power generation during a concentric knee extension isokinetic test and a squat vertical jump. The isokinetic test joint power was calculated using four different methods. Five participants performed concentric knee extensions at 0.52, 1.57, 3.14 and 5.23 rad?·?s^?1 on a Lido isokinetic dynamometer. The squat vertical jump was performed on a Kistler force plate. Kinematic data from both tests were collected and analysed using an ELITE optoelectronic system. An inverse dynamics model was applied to measure knee joint moment in the vertical jump. Knee angular position data from the kinematic analysis in the isokinetic test were used to derive the actual knee angular velocity and acceleration, which, in turn, was used to correct the dynamometer moment for inertial effects. Power was measured as the product of angular velocity and moment at the knee joint in both tests. Significant differences (P <?0.05) were found between mean (?± s) peak knee joint power in the two tests (squat vertical jump: 2255?±?434W; isokinetic knee extension: 771?±?81W). Correlation analysis revealed that there is no relationship between the peak knee joint power during the vertical jump and the slow velocity isokinetic tests. Higher isokinetic velocity tests show better relationships with the vertical jump but only if the correct method for joint power calculation is used in the isokinetic test. These findings suggest that there are important differences in muscle activation and knee joint power development that must be taken into consideration when isokinetic tests are used to predict jumping performance.     

Mixed messages: pre-service Health and Physical Education teachers’ understandings of health and the body and the expectations of the Australian curriculum

This paper explores how a cohort of pre-service Health and Physical Education (HPE) teachers from an Australian university describe and construct their understandings of health and the body. Given that the courses that these undergraduates take in their degree programme present different perspectives on health and the body, a relevant question is to what extent these perspectives adequately equip these future HPE teachers to successfully teach the recently released Australian HPE curriculum. The participants in this study were 14 pre-service teachers, 11 females and 3 males, aged between 18 and 26 at the time of the first interview. The data used for this paper were taken from a larger study and were generated through interviews, the analysis of two undergraduate course profiles and an analysis of the new National HPE curriculum. Results reveal that there are some dominant discourses in health-related courses that may have a significant impact on these students. The purpose of HPE, the role of the HPE teacher and the idea of the HPE teacher as role model are also discussed. The results suggest that pre-service teachers face several challenges and dissonances between what they learn during their undergraduate programme and what the Australian HPE curriculum expects them to teach. How pre-service HPE teachers think about and relate to health and the body is important in terms of how they think about their professional practice and the influence they may have on their future pupils.     

Teachers in school sports: between the fields of education and sport?

According to the cultural sociologist Pierre Bourdieu, gaining access to a social space or a position within a social space requires a specific capital. For teachers, this is normally indicated by a valid teaching certificate with relevant subject knowledge. However, when no qualified teachers are available, which is the case for the subject of school sports in Sweden, other assets gain recognition. Drawing on Bourdieu's conceptual framework, this paper examined the conditions for school sports in Sweden, and based on questionnaires answered by 109 teachers, explored the competencies, education and backgrounds teachers in upper secondary school sports possess. The paper address the question: what valuable resources are required to become a teacher of school sports and gain recognition as symbolic capital? The results show that while school sports in Sweden are carried out through a school subject and thus regulated by the government, it is influenced by both the fields of education and sport. Furthermore, the questionnaire results show that a majority of the teachers are employed as coaches instead of teachers and that less than half of them (45%) have a teacher education background, while 95% have a coaching education background. However, the results also show that teachers assessed their competencies for teaching school sports as high, especially with regard to competencies in specific sport skills. In conclusion, this paper shows how coaching education and experience in competitive sports are an important resource required to become a teacher in school sports and is thus recognized as symbolic capital. Therefore, school sports cannot be viewed as a legitimate part of the field of education but can be viewed as a part of the field of sport.