Risk of bias in exercise science: A systematic review of 340 studies.

Risk of bias can contribute to irreproducible science and mislead decision making. Analyses of smaller subsections of the exercise science literature suggest many exercise science studies have unclear or high risk of bias. The current review (osf.io/jznv8) assesses whether this unclear or high risk of bias is more widespread in the exercise science literature and whether this bias has decreased since the publication of the 1996 Consolidated Standards of Reporting Trials (CONSORT) guidelines. We report significant reductions in selection, performance, detection, and reporting biases in 2020 compared with 1995 in the 340 of 5,451 studies assessed using the Cochrane Risk of Bias tool. Despite these improvements, most 2020 studies still had unclear or high risks of bias. These results underscore the need for methodological vigilance, adherence to reporting standards, and education on experimental bias. Factors contributing to these improvements, such advancements in education and journal requirements, remain uncertain.

Time to return to full training and recurrence of rectus femoris injuries in elite track and field athletes 2010-2019; a 9-year study using the British Athletics Muscle Injury Classification.

Rectus femoris (RF) injuries are common in sports requiring maximal acceleration and sprinting. The British Athletics Muscle Injury Classification (BAMIC) describes acute muscle injury based on the anatomical site of injury and has been associated with return to play in hamstring and calf muscle injury. The aim of this study was to describe and compare the time to return to full training (TRFT) and injury recurrence for BAMIC-classified RF injuries sustained by elite track and field (T&F) athletes over a 9-year period. All rectus femoris injuries sustained by elite T&F athletes on the British Athletics World Class Program between September 2010 and September 2019 that were investigated with an MRI within 7 days of acute onset anterior thigh pain were included. Injuries were graded from the MRI by a specialist musculoskeletal radiologist using the BAMIC, and TRFT and injury recurrence were determined by evaluation of the Electronic Medical Record. Athlete demographics and World Athletics event discipline were recorded. Specific injury details including mechanism, location of injury, and whether surgical or rehabilitation management was undertaken were recorded. There were 38 RF injuries in 27 athletes (24.7 ± 2.3 years; 10 male, 17 female). Average TRFT for rehabilitation managed cases was 20.4 ± 14.8 days. Grade 1 injuries had significantly shorter TRFT compared with grades 2 (p = 0.04) and 3 (p = 0.01). Intratendinous (c) and surgically managed RF injuries each had significantly longer TRFT compared with other injury classes (p < 0.001). Myofascial (a) injuries had reduced repeat injury rates compared with b or c classes (p = 0.048). Grade 3 injuries had an increased repeat injury rate compared with other grades (p = 0.02). There were 4 complete (4c) proximal free tendon injuries sustained during sprinting and all in female athletes. The average TRFT for RF injuries in elite T&F is similar to that previously identified in elite football and Australian Rules. Similar to previous research in hamstring and calf injury, RF injuries extending into the tendon (BAMIC class c) had delayed TRFT which may reflect the longer duration required for tendon healing and adaptation. Grade 3 injuries had in increased repeat injury rate compared with grades 1 and 2. The BAMIC diagnostic framework may provide useful information for clinicians managing rectus femoris injuries in T&F.

A 4-year study of hamstring injury outcomes in elite track and field using the British Athletics rehabilitation approach.

OBJECTIVES: The British Athletics Muscle Injury Classification (BAMIC) correlates with return to play in muscle injury. The aim of this study was to examine hamstring injury diagnoses and outcomes within elite track and field athletes following implementation of the British Athletics hamstring rehabilitation approach. METHODS: All hamstring injuries sustained by elite track and field athletes on the British Athletics World Class Programme between December 2015 and November 2019 that underwent an MRI and had British Athletics medical team prescribed rehabilitation were included. Athlete demographics and specific injury details, including mechanism of injury, self-reported gait phase, MRI characteristics and time to return to full training (TRFT) were contemporaneously recorded. RESULTS: 70 hamstring injuries in 46 athletes (24 women and 22 men, 24.6±3.7 years) were included. BAMIC grade and the intratendon c classification correlated with increased TRFT. Mean TRFT was 18.6 days for the entire cohort. Mean TRFT for intratendon classifications was 34±7 days (2c) and 48±17 days (3c). The overall reinjury rate was 2.9% and no reinjuries were sustained in the intratendon classifications. MRI variables of length and cross-sectional (CSA) area of muscle oedema, CSA of tendon injury and loss of tendon tension were associated with TRFT. Longitudinal length of tendon injury, in the intratendon classes, was not associated with TRFT. CONCLUSION: The application of BAMIC to inform hamstring rehabilitation in British Athletics results in low reinjury rates and favourable TRFT following hamstring injury. The key MRI variables associated with longer recovery are length and CSA of muscle oedema, CSA of tendon injury and loss of tendon tension.

Stress and Burnout Among Mental Health Staff During the COVID-19 Pandemic.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has deeply altered social and working environments among health care workers. These health care workers are therefore at risk of additional psychosocial strain and ensuing metal health symptoms, which indirectly affects patient care. In this study, we aimed to assess the psychosocial and psychopathological impact of COVID-19 among acute care mental health and addictions staff. METHODS: This study is a cross-sectional survey and contains a sample size of 60 mental health and addiction acute care workers recruited from within Nova Scotia Health Authority. The survey was constructed using the online survey system, Opinio, and consisted of three sections: demographic variables (gender, age group and profession); the DASS-21 Questionnaire (which provides dimensional measures of stress, anxiety and depression); and the MBI-HSS (MP) Questionnaire (which measures three dimensions of burnout-emotional exhaustion, depersonalization and personal achievement). RESULTS: The majority of participants had at least one pathologic score on the DASS-21 and MBI-HSS (MP) sections (75.5% and 93.5%, respectively). The median severity on the DASS-21 and MBI-HSS (MP) were both moderate, with the younger age group (20-35 years) having more significant burnout scores (p = 0.0494). Simple logistic regression showed a significant relationship between burnout severity and pathologic distress, and simple linear regression showed significant correlation between DASS-21 and MBI-HSS (MP) scores, with a R2 value of 0.4633. CONCLUSION: More planning, programs, resources and further research are needed to support wellness and recovery of all health care professionals who work at the mental health and addictions acute care unit.

Eccentric hamstring strength in elite track and field athletes on the British Athletics world class performance program.

OBJECTIVES: This novel study aims to provide unique data on eccentric hamstring strength in elite track and field athletes. DESIGN: Clinical measurement, cross-sectional study. SETTING: Across two British Athletics performance centres. PARTICIPANTS: 44 elite British track and field athletes. MAIN OUTCOME MEASURES: Eccentric hamstring force and torque were evaluated using the Nordbord device. Injury history and demographic data was collected to assess whether differences between gender, event group, limb symmetry and previous injury history were present. RESULTS: Average peak force for males and females was 418.38N and 318.54N. Relative to body weight there were no gender differences (Male 5.21N.kg-1, Female 4.99N.kg-1) (p = 0.62). The right limb was significantly stronger in long sprint (400m athletes) (p = 0.00018) (d = 0.56). No differences in relative force or torque were observed between previously injured and non-injured limbs. CONCLUSIONS: This study provides unique data in elite track and field athletes. Relative force per kilogram should be used when comparing male and female athletes. Unlike other studies, we found no difference in eccentric strength between previously injured and non-injured limbs. The novel finding of increased eccentric strength demonstrated in the right limb in 400m sprinters may be due to the asymmetric demands of bend running and may be considered normal.

Effects of digging by a native and introduced ecosystem engineer on soil physical and chemical properties in temperate grassy woodland.

Temperate grasslands and woodlands are the focus of extensive restoration efforts worldwide. Reintroduction of locally extinct soil-foraging and burrowing animals has been suggested as a means to restore soil function in these ecosystems. Yet little is known about the physical and chemical effects of digging on soil over time and how these effects differ between species of digging animal, vegetation types or ecosystems. We compared foraging pits of a native reintroduced marsupial, the eastern bettong (Bettongia gaimardi) and that of the exotic European rabbit (Oryctolagus cuniculus). We simulated pits of these animals and measured pit dimensions and soil chemical properties over a period of 2 years. We showed that bettong and rabbit pits differed in their morphology and longevity, and that pits had a strong moderating effect on soil surface temperatures. Over 75% of the simulated pits were still visible after 2 years, and bettong pits infilled faster than rabbit pits. Bettong pits reduced diurnal temperature range by up to 25 °C compared to the soil surface. We did not find any effects of digging on soil chemistry that were consistent across vegetation types, between bettong and rabbit pits, and with time since digging, which is contrary to studies conducted in arid biomes. Our findings show that animal foraging pits in temperate ecosystems cause physical alteration of the soil surface and microclimatic conditions rather than nutrient changes often observed in arid areas.

Hamstring rehabilitation in elite track and field athletes: applying the British Athletics Muscle Injury Classification in clinical practice.

RATIONALE: Hamstring injuries are common in elite sports. Muscle injury classification systems aim to provide a framework for diagnosis. The British Athletics Muscle Injury Classification (BAMIC) describes an MRI classification system with clearly defined, anatomically focused classes based on the site of injury: (a) myofascial, (b) muscle-tendon junction or (c) intratendinous; and the extent of the injury, graded from 0 to 4. However, there are no clinical guidelines that link the specific diagnosis (as above) with a focused rehabilitation plan. OBJECTIVE: We present an overview of the general principles of, and rationale for, exercise-based hamstring injury rehabilitation in British Athletics. We describe how British Athletics clinicians use the BAMIC to help manage elite track and field athletes with hamstring injury. Within each class of injury, we discuss four topics: clinical presentation, healing physiology, how we prescribe and progress rehabilitation and how we make the shared decision to return to full training. We recommend a structured and targeted diagnostic and rehabilitation approach to improve outcomes after hamstring injury.

Returning a lost process by reintroducing a locally extinct digging marsupial.

The eastern bettong (Bettongia gaimardi), a medium-sized digging marsupial, was reintroduced to a predator-free reserve after 100 years of absence from the Australian mainland. The bettong may have the potential to restore temperate woodlands degraded by a history of livestock grazing, by creating numerous small disturbances by digging. We investigated the digging capacity of the bettong and compared this to extant fauna, to answer the first key question of whether this species could be considered an ecosystem engineer, and ultimately if it has the capacity to restore lost ecological processes. We found that eastern bettongs were frequent diggers and, at a density of 0.3-0.4 animals ha-1, accounted for over half the total foraging pits observed (55%), with echidnas (Tachyglossus aculeatus), birds and feral rabbits (Oryctolagus cuniculus) accounting for the rest. We estimated that the population of bettongs present dug 985 kg of soil per ha per year in our study area. Bettongs dug more where available phosphorus was higher, where there was greater basal area of Acacia spp. and where kangaroo grazing was less. There was no effect on digging of eucalypt stem density or volume of logs on the ground. While bettong digging activity was more frequent under trees, digging also occurred in open grassland, and bettongs were the only species observed to dig in scalds (areas where topsoil has eroded to the B Horizon). These results highlight the potential for bettongs to enhance soil processes in a way not demonstrated by the existing fauna (native birds and echidna), and introduced rabbit.

Single-Leg Roman Chair Hold Is More Effective Than the Nordic Hamstring Curl in Improving Hamstring Strength-Endurance in Gaelic Footballers With Previous Hamstring Injury.

Macdonald, B, O'Neill, J, Pollock, N, and Van Hooren, B. Single-leg Roman chair hold is more effective than the Nordic hamstring curl in improving hamstring strength-endurance in Gaelic footballers with previous hamstring injury. J Strength Cond Res 33(12): 3302-3308, 2019-Poor hamstring strength-endurance is a risk factor for hamstring injuries. This study investigated the effectiveness of the single-leg Roman hold and Nordic hamstring curl in improving hamstring strength-endurance. Twelve Gaelic footballers (mean ± SD age, height, and mass were 25.17 ± 3.46 years, 179.25 ± 5.88 cm, 85.75 ± 4.75 kg, respectively) with a history of hamstring injury were randomized into 2 groups that performed 6 weeks of either Nordic hamstring curl or single-leg Roman chair hold training. The single-leg hamstring bridge (SLHB) was measured before and after intervention. The Roman chair group showed a very likely moderate magnitude improvement on SLHB performance for both legs (23.7% for the previously injured leg [90% confidence interval 9.6-39.6%] and 16.9% for the noninjured leg [6.2-28.8%]). The Nordic curl group showed a likely trivial change in SLHB performance for the noninjured leg (-2.1% [-6.7 to 2.6%]) and an unclear, but possibly trivial change for the previously injured leg (0.3% [-5.6 to 6.6%]). The Roman chair group improved very likely more with a moderate magnitude in both the noninjured (19.5% [8.0-32.2%]) and the previously injured leg (23.3% [8.5-40.0%]) compared with the Nordic curl group. This study demonstrated that 6-week single-leg Roman chair training substantially improved SLHB performance, suggesting that it may be an efficacious strategy to mitigate hamstring (re-) injury risk. Conversely, 6-week Nordic curl training did not substantially improve SLHB performance, suggesting this may not be the intervention of choice for modifying this risk factor.

An investigation into the immediate effects of pelvic taping on hamstring eccentric force in an elite male sprinter - A case report.

BACKGROUND: Hamstring Injuries commonly cause missed training and competition time in elite sports. Injury surveillance studies have demonstrated high injury and re-injury rates, which have not improved across sports despite screening and prevention programmes being commonplace. The most commonly suggested intervention for hamstring prevention and rehabilitation is eccentric strength assessment and training. CASE DESCRIPTION: This case study describes the management of an elite sprinter with a history of hamstring injury. A multi-variate screening process based around lumbar-pelvic dysfunction and hamstring strength assessment using the Nordbord is employed. The effect of external pelvic compression using a taping technique, on eccentric hamstring strength is evaluated. OUTCOMES: A persistent eccentric strength asymmetry of 17% was recorded as well as lumbar-pelvic control deficits. Pelvic taping appears to improve load transfer capability across the pelvis, resulting in correction of eccentric strength asymmetry. DISCUSSION: Screening strategies and interventions to prevent hamstring injury have failed to consistently improve injury rates across various sports. In this case study external pelvic compression resulted in normalising eccentric strength deficits assessed using the Nordbord. The inclusion of lumbar-pelvic motor control assessment, in relation to hamstring strength and function, as part of a multi-variate screening strategy requires further research.

Tracking short-term effects of nitrogen-15 addition on nitrous oxide fluxes using fourier-transform infrared spectroscopy.

Synthetic fertilizer N additions to soils have significantly increased atmospheric NO concentrations, and advanced methods are needed to track the amount of applied N that is transformed to NO in the field. We have developed a method for continuous measurement of NO isotopologues (NNO, NNO, NNO, and NNO) following 0.4 and 0.8 g N m of N-labeled substrate as KNO or urea [CO(NH)] using Fourier-transform infrared (FTIR) spectroscopy. We evaluated this method using two 4-wk experimental trials on a coastal floodplain site near Nowra, New South Wales, Australia, which is managed for silage production. We deployed an automated five-chamber system connected to a portable FTIR spectrometer with multipass cell to measure NO isotopologue fluxes. Emissions of all isotopologues were evident immediately following N addition. All isotopologues responded positively to rainfall events, but only for 7 to 10 d following N addition. Cumulative N-NO fluxes (sum of the three N isotopologues) per chamber for the 14 d following N addition ranged from 1.5 to 10.3 mg N m. Approximately 1% (range 0.7-1.9%) of the total amount of N applied was emitted as NO. Repeatability (1σ) for all isotopologue measurements was better than 0.5 nmol mol for 1-min average concentration measurements, and minimum detectable fluxes for each isotopologue were <0.1 ng N m s. The results indicate that the portable FTIR spectroscopic technique can effectively trace transfer of N to the atmosphere as NO after N addition, allowing powerful quantification of NO emissions under field conditions.

Species traits predict assemblage dynamics at ephemeral resource patches created by carrion.

Carrion is an ephemeral and spatially patchy resource that supports a diverse subset of species linked to nutrient cycling and the decomposition process. A number of studies have separately documented changes in the diversity of plants, arthropods and vertebrates at individual carcasses, but there are few studies that have examined how functional traits of different groups of organisms underpin their responses to carrion patches. We used a carrion addition experiment to compare changes in composition and functional traits of insect and plant assemblages at carcasses compared with control sites. We found that significant changes in insect assemblage evenness and heterogeneity was associated with species' dispersal traits, and that plant assemblage responses to subsequent soil nitrogen changes was most apparent among graminoids and exotic species. Beetles at carcasses were twice as large as their counterparts at control sites during the first week of carrion decomposition, and also had higher wing loadings. Plants with high specific leaf area responded faster to the carcass addition, and twice as many species recolonised the centre of carcasses in exotic-dominated grassland compared with carcasses in native-dominated grassland. These results provide an example of how traits of opportunist species enable them to exploit patchy and dynamic resources. This increases our understanding of how carcasses can drive biodiversity dynamics, and has implications for the way carrion might be managed in ecosystems, such as appropriate consideration of spatial and temporal continuity in carrion resources to promote heterogeneity in nutrient cycling and species diversity within landscapes.

Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey.

BACKGROUND AND PURPOSE: Epidemiological studies of restless legs syndrome (RLS) have been limited by lack of a well validated patient-completed diagnostic questionnaire that has a high enough specificity to provide a reasonable positive predictive value. Most of the currently used patient completed diagnostic questionnaires have neither been validated nor included items facilitating the differential diagnosis of RLS from conditions producing similar symptoms. The Cambridge-Hopkins diagnostic questionnaire for RLS (CH-RLSq) was developed with several iterations to include items covering the basic diagnostic features of RLS and to provide some basic differential diagnosis. This validation study sought to determine the sensitivity and specificity of the RLS diagnosis based on this questionnaire. PATIENTS AND METHODS: The CH-RLSq was completed by 2005 blood donors who were asked to consent to being contacted for a telephone diagnostic interview. A scoring criterion was established for ascertainment of RLS based on the clinical definition of the disorder and the exclusion of "mimic" conditions. A weighted sample (N=185) of all completed questionnaires was selected for expert clinical diagnosis of RLS using the validated Hopkins Telephone Diagnostic Interview (HDTI). The telephone interviewers were blinded to all questionnaire responses. RESULTS: A telephone diagnosis was obtained on 183 of the sample's 185 questionnaires. The questionnaire's normalized sensitivity and specificity were 87.2% and 94.4%, respectively, for RLS compared to not RLS. The positive predictive values in this sample were 85.5%. CONCLUSIONS: The Cambridge-Hopkins RLS questionnaire provides a reasonable level of sensitivity and specificity for ascertainment of RLS in population-based studies.

Mind the sustainability gap.

Despite increasing efforts to reach sustainability, key global biophysical indicators such as climate change and biodiversity loss continue to deteriorate rather than improve. Ongoing failure to move towards sustainability calls into question the focus of current research and policy. We recommend two strategies for progress. First, sustainability must be conceptualized as a hierarchy of considerations, with the biophysical limits of the Earth setting the ultimate boundaries within which social and economic goals must be achieved. Second, transdisciplinary research programs must confront key normative questions facing modern consumer societies. The humanities should have a key role in such programs. Assisted by these strategies, ambitious targets that realistically reflect the biophysical limits of the life-support system of the Earth must be set and relentlessly worked towards.