Investigating Facilitators and Barriers for Active Breaks among Secondary School Students: Formative Evaluation of Teachers and Students.

Physical activity in the form of "active breaks" can be combined with academic instruction in primary school. However, few studies have examined the feasibility of conducting active breaks in secondary school. To address this gap, we conducted focus groups (FGs) regarding the implementation of an active breaks (ABs) protocol with 20 teachers and 10 secondary school students. Barriers/facilitators toward the implementation of ABs were classified using grounded theory inductive methods framed by the socio-ecological model. Individual-level factors were instrumental for both teachers and students. Teachers highlighted personal fears and concerns regarding using ABs, while students reported fears related to peer behaviour during the activity. Both teachers and students agreed that ABs can improve cognitive skills and time-on-task behaviour. Teachers articulated concerns related to student behaviour during ABs including possible social exclusion and injury. Students felt that ABs might affect classroom management and interfere with maintaining students' academic focus. Teachers underscored that ABs required social support from the administration and colleagues. Students felt that ABs could support teachers' instructional focus and provide them with an energy respite. Collectively, the FGs suggested that environmental limitations could hinder the implementation of ABs. Involving teacher and student feedback during the codesign phase can rationally inform the design of school-based ABs.

Chronic Obstructive Pulmonary Disease Overdiagnosis and Overtreatment: A Meta-Analysis.

This meta-analysis of observational studies aimed at estimating the overall prevalence of overdiagnosis and overtreatment in subjects with a clinical diagnosis of Chronic Obstructive Pulmonary Disease (COPD). MedLine, Scopus, Embase and Cochrane databases were searched, and random-effect meta-analyses of proportions were stratified by spirometry criteria (Global Initiative for COPD (GOLD) or Lower Limit of Normal (LLN)), and setting (hospital or primary care). Forty-two studies were included. Combining the data from 39 datasets, including a total of 23,765 subjects, the pooled prevalence of COPD overdiagnosis, according to the GOLD definition, was 42.0% (95% Confidence Interval (CI): 37.3-46.8%). The pooled prevalence according to the LLN definition was 48.2% (40.6-55.9%). The overdiagnosis rate was higher in primary care than in hospital settings. Fourteen studies, including a total of 8183 individuals, were included in the meta-analysis estimating the prevalence of COPD overtreatment. The pooled rates of overtreatment according to GOLD and LLN definitions were 57.1% (40.9-72.6%) and 36.3% (17.8-57.2%), respectively. When spirometry is not used, a large proportion of patients are erroneously diagnosed with COPD. Approximately half of them are also incorrectly treated, with potential adverse effects and a massive inefficiency of resources allocation. Strategies to increase the compliance to current guidelines on COPD diagnosis are urgently needed.

Predictors of SARS-CoV-2 Infection and Severe and Lethal COVID-19 after Three Years of Follow-Up: A Population-Wide Study.

In this cohort study, the general population of an Italian Province was followed for three years after the start of the pandemic, in order to identify the predictors of SARS-CoV-2 infection and severe or lethal COVID-19. All the National Healthcare System information on biographical records, vaccinations, SARS-CoV-2 swabs, COVID-19 cases, hospitalizations and co-pay exemptions were extracted from 25 February 2020 to 15 February 2023. Cox proportional hazard analysis was used to compute the relative hazards of infection and severe or lethal COVID-19, adjusting for age, gender, vaccine status, hypertension, diabetes, major cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), kidney disease or cancer. Among the 300,079 residents or domiciled citizens, 41.5% had ≥1 positive swabs during the follow-up (which lasted a mean of 932 days). A total of 3.67% of the infected individuals experienced severe COVID-19 (n = 4574) and 1.76% died (n = 2190). Females, the elderly and subjects with diabetes, CVD, COPD, kidney disease and cancer showed a significantly higher risk of SARS-CoV-2 infection. The likelihood of severe or lethal COVID-19 was >90% lower among the youngest, and all comorbidities were independently associated with a higher risk (ranging from +28% to +214%) of both outcomes. Two years after the start of the immunization campaign, the individuals who received ≥2 doses of COVID-19 vaccines still showed a significantly lower likelihood of severe or lethal disease, with the lowest risk observed among subjects who received at least one booster dose.

Association of Socioeconomic Factors and Physical Activity with Health-Related Quality of Life in Italian Middle School Children: An Exploratory Cross-Sectional Study.

Health-related quality of life (HRQoL) provides a broad assessment of an individual's well-being and can serve as a good prognosticator of life's outcomes later for children and adolescents. Understanding the factors associated with HRQoL is crucial for promoting better health and life satisfaction. This study investigated the cross-sectional association of socioeconomic status, cardio fitness, and physical activity levels with HRQoL in 224 Italian early adolescents attending secondary school in the Emilia-Romagna region located in Northern Italy. In a multivariate path regression model, younger students and females reported a higher quality of life (ß = -0.139, p = 0.015, 95% CI: -0.254--0.023 and ß = 0.142, p = 0.019, 95% CI: 0.011-0.273, respectively). Having both parents employed and having a higher familiar educational status were also associated with a higher quality of life (ß = 0.142, p = 0.013, 95% CI 0.027-0.257 and ß = 0.133, p = 0.017, 95% CI 0.022-0.244, respectively). Greater engagement in routine physical activity levels from moderate to vigorous intensity was positively associated with quality of life (ß = 0.429, p < 0.001, 95% CI: 0.304-0.554). Endurance (speed) was positively associated with quality of life (ß = 0.221, p = 0.001, 95% CI: 0.087-0.355), and students with longer times on the shuttle run reported less quality of life (ß = -0.207, p = 0.002, 95% CI: -0.337--0.077). These relations remained intact even when controlling for socioeconomic factors. The current findings reinforce the importance of promoting regular physical activity among younger children and also addressing socioeconomic status disparities to improve children's well-being. Future studies may want to consider expanding the array of measures used to assess physical activity and include additional measures assessing nutrition, cultural factors, and family functioning, all of which can influence a child's willingness to engage in physical activity and their well-being. The emphasis on fitness and physical activity and their contribution to a child's well-being should be the prime focus for stakeholders who work in the education, public health, and health policy sectors.

Effects of School Nurse-Led Interventions in Collaboration with Kinesiologists in Promoting Physical Activity and Reducing Sedentary Behaviors in Children and Adolescents: A Systematic Review.

The World Health Organization (WHO) recommends that schools adopt a whole-school strategy for healthy behaviors involving different health professionals. The present systematic review aimed to evaluate the efficacy of nurse-led interventions in collaboration with kinesiologists on physical activity and lifestyle behaviors' outcomes in school settings. The protocol was registered in PROSPERO (ID: CRD42022343410). The primary research study was developed through the PICOS question: children and adolescence 6-18 years (P); school nurse-led interventions in promoting physical activity (PA) and reducing sedentary behaviors (I); usual lessons, no intervention focusing on PA (C); PA levels, sedentary behaviors, and healthy lifestyle behaviors (O); experimental or observational study with original primary data and full-text studies written in English (S). Seven studies were included. Interventions were heterogeneous: besides physical activities carried out in all studies, the interventions were based on different health models and strategies (counselling, face-to-face motivation, education). Five out of seven articles investigated PA levels or their related behaviors using questionnaires, and two used ActiGraph accelerometers. Lifestyle behaviors were assessed with heterogeneous methods. Five out of seven articles showed an improvement in at least one outcome after the interventions, whereas two papers showed a statistically non-significant improvement. In conclusion, school interventions involving nurses, also in association with other professionals such as kinesiologists, can be effective in reducing sedentary behaviors and improving healthy lifestyles in children and adolescents.

Short-term clinical and radiological comparisons between two Medial Pivot Total Knee Arthroplasty implants with different geometries.

BACKGROUND AND AIM: Different total knee arthroplasty (TKA) implants were created for the treatment of severe symptomatic gonarthrosis and Medial Pivot TKA (MP TKA) seem to reproduce the normal kinematics of the knee. We compare two different prosthetic designs of MP TKA in order to identify whether there is a difference between the two in terms of degree of patient satisfaction.  Methods: A total of 89 patients were analyzed. A group of 46 patients who benefited from a TKA with the Evolution® prosthesis and one of 43 patients who received a TKA with the Persona® prosthesis. KSS, OKS, FJS and the ROM were analyzed at follow up. RESULTS: The values of KSS and OKS were similar between the two groups (p>0,05). Our statistical analysis revealed a statistically significant increase (p <0.05) in ROM in the Persona® group and in FJS in the Evolution® group. No radiolucent lines were observed in both groups at the radiological final follow-up.  Conclusions: MP TKA models analysed are a valuable tool to achieve satisfactory clinical outcomes. This study demonstrates that the FJS is an important score for the evaluation of patient's satisfaction: a ROM's limitation can be accepted by the patient in exchange for a more natural perceived knee.

Anterior shoulder instability: comparison between Latarjet open procedure and arthroscopic capsuloplasty.

BACKGROUND: Latarjet surgery and capsuloplasty are both valid alternatives for the treatment of anterior shoulder instability with limited glenoid bone loss, although in literature there is extensive discussion on it. The purpose of this study was to compare the outcomes of these procedures in patients with similar lesions. METHODS: Between January 2000 to October 2020, 59 nonconsecutive patients suffering from anterior shoulder instability were treated, 33 had arthroscopic capsuloplasty (Group 1) and 26 had open Latarjet procedure (Group 2). The Group 1 was composed by 12% of female and 88% of males with the mean age at surgery 25.6 +/- 9.07 (15-49 years). In the Group 2, the 100% of patients were males with mean age 32.42 +/- 10.74 (16-56). Rowe Score, UCLA score and WOSI score were used to test patients. RESULTS: Only UCLA (average was 22.18 ± 6.13 for the Capsuloplasty and 26.76 ± 6.57 in the Latarjet, p = 0.01) and ROWE scores (average was 70.15 ± 24.75 in Latarjet and 50.15 ± 24.70 in Capsuloplasty, p = 0.002) showed a statistically significant difference between the two procedures, while the WOSI (mean results of Latarjet 0.31 ± 0.16 against 0.24 ± 0.09 of the capsuloplasty, p = 0.069) there was no significant difference between the two groups in question. CONCLUSIONS: Apparently, the Latarjet surgery is better in terms of instability recurrence compared to capsuloplasty but has higher rate of shoulder joint osteoarthtritis. However, there are no significant differences that could decree which procedure is better. (www.actabiomedica.it).

External Validation of the "Tor Vergata" 3D Printed Models of the Upper Urinary Tract and Stones for High-Fidelity Simulation of Retrograde Intrarenal Surgery.

Introduction: Novel training modalities are being investigated to overcome the challenges associated with learning retrograde intrarenal surgery (RIRS). Consequently, a series of 3D printed models of the upper urinary tract and stones designed for ex vivo surgical simulation was introduced in 2021. This study aims to provide external validation of the training model and assess its role in the development of surgical skills. Materials and Methods: A mixed cohort of 20 urologists at different levels of expertise participated in a whole-day live simulation event to examine the model and perform a timed simulation of intrarenal navigation, stone relocation, and laser fragmentation. Operative times were recorded and two independent expert endourologists scored the simulations according to a modified "Objective Structured Assessment of Technical Skills" (OSATS) scale. Five novice urologists from the cohort performed three further simulations in a subsequent event to assess improvement in surgical skills. Results: Face validity was demonstrated with a median score of ≥4/5 in each of the 11 items investigated. Content validity was also effectively reached, with 100% positive impressions with regard to the usefulness for the acquisition of surgical skills. Significant differences were observed among operative times stratified per surgeon experience (all p < 0.0050), thus providing construct validity. Median total OSATS score for novices was 14 (range 8, 25) and was found to be significantly different from expected expert performance (p = 0.0010). Repeated simulations by novices led to a progressive reduction of operative times (p = 0.0313) and increase in median total OSATS (p = 0.0625). Conclusion: The 3D printed models of upper urinary tract and synthetic training stones for the high-fidelity simulation of each phase of RIRS were validated by this study. The results encourage the usage of the models in simulation courses and the evaluation of their potential role in standardized training curricula.

Determination of hair cortisol in horses: comparison of immunoassay vs LC-HRMS/MS.

The measure of hair cortisol concentration (HCC) is becoming an emerging approach to monitor mid-/long-term stress in animals, so it is more and more important to develop accurate and reliable methods. In the light of this, the aim of the present study was to compare mane HCCs of 47 horses with different managements, by means of an immunoassay (ELISA) and liquid chromatography coupled to hybrid high-resolution mass spectrometry (LC-HRMS/MS). After the washing step, the ground hair was extracted with methanol. The extract was evaporated and redissolved in two different aqueous solutions, depending on the detection technique. The methods were validated according to EMA guideline for bioanalytical method validation, in the range 2-50 pg mg-1 (ELISA) and 1-100 pg mg-1 (LC-HRMS/MS). Satisfactory quantitative performances were obtained for both of the approaches, but this latter demonstrated better precision. The detected concentrations in real samples were encompassing the range 1.3-8.8 pg mg-1 and 2.0-17.9 pg mg-1 by means of LC-HRMS/MS and ELISA, respectively. Overall, HCCs measured with ELISA technique were 1.6 times higher. The overestimation of immunoassay results might be caused by cross-reactivity phenomena of laboratory reagents and other structurally similar hormones present in the mane.

Exact Sum-Rule Approach to Polarizability and Asymptotic van der Waals Functionals─Derivation of Exact Single-Particle Benchmarks.

Using a sum-rule approach, we develop an exact theoretical framework for polarizability and asymptotic van der Waals correlation energy functionals of small isolated objects. The functionals require only monomer ground-state properties as input. Functional evaluation proceeds via solution of a single position-space differential equation, without the usual summations over excited states or frequency integrations. Explicit functional forms are reported for reference physical systems, including atomic hydrogen and single electrons subject to harmonic confinement, and immersed in a spherical-well potential. A direct comparison to the popular Vydrov-van Voorhis density functional shows that the best performance is obtained when density decay occurs at atomic scales. The adopted sum-rule approach implies general validity of our theory, enabling exact benchmarking of van der Waals density functionals and direct inspection of the subtle long-range correlation effects that constitute a major challenge for approximate (semi)local density functionals.

Use of a non-medicated plaster in chronic lumbar back pain: a randomized controlled trial.

BACKGROUND: The latest technology on far infrared radiations reflects the radiations emitted by the human body and induces an antalgic and anti-inflammatory effect without active ingredients. Our primary aim was to assess pain level modifications throughout the treatment period with two different types of patches, compared to a placebo. As secondary aims, we focused on addressing patients' quality of life and range of motion changes with each patch. METHODS: We assessed 54 patients with chronic lumbar back pain treated with FIT Therapy (far infrared technology) patch. Three different types of FIT Therapy patches (F4, F3, and placebo) were used according to the different power of action and patients allocated in a randomized fashion into the 3 arms of the study. Every single patient was assessed during the study using the VAS pain scale, the Roland Morris Disability Questionnaire for quality of life, and ROM for a total of 14 days. RESULTS: Only the F4 patch group significantly reduced pain level at T14 compared to the placebo group (p<0.05). Meanwhile, F3 showed only a non-significant decrease compared to placebo (p=0.254). In terms of lifestyle improvements, both F3 and F4 recorded a decrease on the RMDQ of 4 and 6 points, respectively. CONCLUSIONS: Currently, we still need further studies with longer follow-up to consider the FIT Therapy patches F4 a valid alternative as a "non-medicated pain relief", but it proved to have a role in alleviating painful symptoms and improving function in chronic lumbar back pain without adverse events.

Assessment of Welfare in Groups of Horses with Different Management, Environments and Activities by Measuring Cortisol in Horsehair, Using Liquid Chromatography Coupled to Hybrid Orbitrap High-Resolution Mass Spectrometry.

Horses have always been animals used for companionship, work, transportation, and performance purposes over the history of humanity; there are different ways of managing horses, but studies on how horse welfare is influenced by different activities and managements are scanty. Understanding how the management, the environment, and the different uses of horses can affect the level of stress and well-being is important not only for people associated with horses. Three groups of horses with different management, environments, and activities were selected: (1) stabled horses ridden frequently, (2) horses that perform public order service under the Italian state police, and (3) free-ranging horses. Cortisol analysis was carried out on horsehair samples using liquid chromatography coupled to hybrid orbitrap high-resolution mass spectrometry (LC-HRMS/MS), a laboratory technique used for the first time to quantify horsehair cortisol. The selection of horses to be included in the three groups was carried out by including only subjects with positive welfare assessment in accordance with the horse welfare assessment protocol (AWIN). These analyses demonstrated that the cortisol levels detected in the horsehair of free-ranging animals were significantly higher compared to those detected in stabled and working horses. These results may have been a consequence of complex environmental, managerial, and behavioral factors, which should be worth further investigation.

Rotator cuff repair with single row technique provides satisfying clinical results despite consistent MRI retear rate.

BACKGROUND: The number of shoulder arthroscopies is steadily increasing to treat glenohumeral joint disorders, among which the rotator cuff tear is the most common. The prevalence of this condition ranges from 13% to 37% in the general population without considering the number of asymptomatic patients. The gold standard procedure for rotator cuff repair is still undefined. The purpose of this study is to evaluate a population who underwent a single row (SR) rotator cuff repair and correlate their clinical results with MRI findings. MATERIALS AND METHODS: Sixty-seven consecutive rotator cuff procedures were retrospectively selected. All patients were diagnosed with a full-thickness rotator cuff tear and subsequently treated with an arthroscopic SR repair technique. Each patient was clinically assessed with the DASH questionnaire and the Constant-Murley Score to grade their satisfaction. Moreover, rotator cuff repair integrity was evaluated by MRI and graded using the Sugaya score. RESULTS: Mean follow-up was 19.5 ± 5.7 months. The mean Constant score was 82.8 ± 13.0 points, with 55 patients reporting excellent results. No patient scored less than 30 points, which could be deemed as unsatisfying. Meanwhile, on the DASH questionnaire, 6.1% of our patients rated their clinical outcome as unsatisfying, whereas 75.8% rated their outcome as excellent. Postoperative MRI classified 45 patients (83.3%) as either Sugaya type I, II, or III, whereas 9 patients (16.7%) presented a Sugaya type IV consistent with a full-thickness cuff retear. Of these nine patients, five (55.6%) and three (33.3%) reported excellent results for the Constant score and DASH questionnaire, respectively. The Mann-Whitney test reported that the retear group had worse scores than the intact repaired cuff group for pain (8.3 ± 5.0 versus 13.1 ± 3.4), Constant Score (68.8 ± 18.5 versus 83.1 ± 11.6), and DASH (66.2 ± 22.1 versus 44.2 ± 14.9). Still, range of motion (ROM) differences were not significant, except for better forward flexion in the intact group (p < 0.039). CONCLUSIONS: Both groups with intact repaired and retorn cuffs showed improvement in their condition, but unexpectedly, there is no significant  correlation between patient satisfaction and rotator cuff integrity. LEVEL OF EVIDENCE: IV.

Could direct transdeltoid approach to severely displaced proximal humerus fracture be advantageous for a better reduction?

BACKGROUND: Surgical treatment of proximal humeral fractures (PHF) is a challenge for orthopaedic surgeons. Despite the wide application of open reduction and internal fixation with locking plates, the optimal surgical approach of PHF is still debated. This study aims to evaluate the radiological outcomes, defined as anatomical restoration of the greater tuberosity and humeral head-shaft angle, of the deltopectoral (DPA) and the lateral transdeltoid (LTA) approaches in three- and four-part PHF, treated with locking plate. MATERIALS AND METHODS: This retrospective series review identifies 74 PHF surgically treated between January 2012 and December 2019. Patients were divided into two groups according to the surgical approach (DPA vs LTA). Demographic data, duration of surgery, radiological pre- and post-surgery parameters (greater tuberosity displacement and humeral head-shaft angle) were collected. The association between the surgical approach and the quality of fractures reduction was assessed. RESULTS: The use of LTA approach correlates with a better reduction of greater tuberosity displacements compare to DPA (63% in DPA vs 100% LTA). No significant association was found with the humeral head-shaft angle (restored in 89% of the patients in DPA and 86% in LTA group), and surgical times (range 40 - 210 minutes ± DS 33,56 for the DPA; range 45 - 170 minutes ± 29,60 for LTA). CONCLUSIONS: The results of this radiological study suggest that PHF with significant displacement of the grater tuberosity could benefit from the adoption of a lateral transdeltoid approach for the ORIF procedure. Further studies are needed to confirm these findings.

Impalement injuries of the shoulder: a case report with literature review.

The management of penetrating skeletal extremity trauma is a clinical challenge even for experienced surgeons. While the treatment of associated vascular injuries should be prioritized, there is still a lack of evidence regarding the management of foreign bodies in case of bone fractures or neurological injuries. Here we present a case of impalement of the right proximal humerus with a construction steel rod. The 54-year-old man was successfully treated without vascular, neurological, and thoracic sequelae. A review of the current literature about the most appropriate extrication sequences and soft tissue reconstruction following massive foreign body injuries was carried out.

The treatment of irreparable massive rotator cuff tears with inspace balloon: rational and medium-term results.

BACKGROUND AND AIM: The treatment of irreparable massive rotator cuff tears (MIRCTs) represents a challenge for the orthopedic surgeon both for the affected population and for the intrinsic characteristics of the injury. There are different types of treatment ranging from bursectomy to reverse shoulder prosthesis and subacromial spacers. The aim of the work is to establish the clinical and functional improvement of patients treated with subacromial spacer. METHODS: we conducted 2 studies: the first analyzing a sample of 24 patients (14 females and 10 male, mean age 65.7 years) operated between 2015 and 2017 whose last follow up dates back to October 2021 and a second one analyzing 55 patients (including patients of the first sample) (30 females and 25 males, mean age 64 years) over a period of time from 2015 to 2021. The mean follow up was 56 months. All patients were diagnosed with irreparable massive rotator cuff  tears and treated with subacromial spacer. RESULTS: the result in both studies was an increase of Constant score, tripled from the pre-operative values, in ROM, doubled, and a reduction of VAS. CONCLUSIONS: the clinical results are encouraging and the use of the subacromial spacer could be a valid surgical alternative for patients with MIRCTs.  However, we needed randomized trials with long-term follow-up.

Anisotropic Electrostatic Interactions in Coarse-Grained Water Models to Enhance the Accuracy and Speed-Up Factor of Mesoscopic Simulations.

Water models with realistic physical-chemical properties are essential to study a variety of biomedical processes or engineering technologies involving molecules or nanomaterials. Atomistic models of water are constrained by the feasible computational capacity, but calibrated coarse-grained (CG) ones can go beyond these limits. Here, we compare three popular atomistic water models with their corresponding CG model built using finite-size particles such as ellipsoids. Differently from previous approaches, short-range interactions are accounted for with the generalized Gay-Berne potential, while electrostatic and long-range interactions are computed from virtual charges inside the ellipsoids. Such an approach leads to a quantitative agreement between the original atomistic models and their CG counterparts. Results show that a timestep of up to 10 fs can be achieved to integrate the equations of motion without significant degradation of the physical observables extracted from the computed trajectories, thus unlocking a significant acceleration of water-based mesoscopic simulations at a given accuracy.

Moltemplate: A Tool for Coarse-Grained Modeling of Complex Biological Matter and Soft Condensed Matter Physics.

Coarse-grained models have long been considered indispensable tools in the investigation of biomolecular dynamics and assembly. However, the process of simulating such models is arduous because unconventional force fields and particle attributes are often needed, and some systems are not in thermal equilibrium. Although modern molecular dynamics programs are highly adaptable, software designed for preparing all-atom simulations typically makes restrictive assumptions about the nature of the particles and the forces acting on them. Consequently, the use of coarse-grained models has remained challenging. Moltemplate is a file format for storing coarse-grained molecular models and the forces that act on them, as well as a program that converts moltemplate files into input files for LAMMPS, a popular molecular dynamics engine. Moltemplate has broad scope and an emphasis on generality. It accommodates new kinds of forces as they are developed for LAMMPS, making moltemplate a popular tool with thousands of users in computational chemistry, materials science, and structural biology. To demonstrate its wide functionality, we provide examples of using moltemplate to prepare simulations of fluids using many-body forces, coarse-grained organic semiconductors, and the motor-driven supercoiling and condensation of an entire bacterial chromosome.

Simultaneous detection of different chemical classes of selective androgen receptor modulators in urine by liquid chromatography-mass spectrometry-based techniques.

Analytical procedures to detect the misuse of selective androgen receptor modulators in human urine, targeting either the parent drugs and/or their main metabolites, were developed and validated. In detail, 19 target compounds belonging to 9 different chemical classes were considered: arylpropionamide (i.e., andarine (S4), ostarine (S22), S1, S6, S9 and S23), diarylhydantoin (i.e., GLPG0492), indole (i.e., LY2452473, GSK2881078), isoquinoline-carbonyle (i.e., PF-02620414), phenyl-oxadiazole (i.e., RAD140), pyrrolidinyl-benzonitrile (i.e., LGD4033), quinolinone (i.e., LGD2226, LGD3303), steroidal (i.e., Cl-4AS-1, MK0773 and TFM-4AS-1), and tropanol (i.e., AC-262536 and ACP105) derivatives. The metabolites of the target compounds considered were enzymatically synthesized by using human liver microsomes. Sample pre-treatment included enzymatic hydrolysis followed by liquid-liquid extraction at neutral pH. The instrumental analysis was performed by ultra-high-performance liquid chromatography coupled to either high- or low-resolution mass spectrometry. Validation was performed according to the ISO 17025 and the World Anti-Doping Agency guidelines. The analyses carried out on negative samples confirmed the method's selectivity, not showing any significant interferences at the retention times of the analytes of interest. Detection capability was determined in the range of 0.1-1.0 ng/mL for the screening procedure and 0.2-1.0 ng/mL for the confirmation procedure (except for GLPG0492 and GSK2881078). The recovery was greater than 80 % for all analytes, and the matrix effect was smaller than 35 %. The method also matched the criteria of the World Anti-Doping Agency in terms of repeatability of the relative retention times (CV% < 1.0) and of the relative abundances of the selected ion transitions (performed only in the case of triple quadrupole, CV% < 15), ensuring the correct identification of all the analytes considered. Urine samples containing andarine, ostarine, or LGD4033 were used to confirm the actual applicability of the selected analytical strategies. All target compounds (parent drugs and their main metabolites) were detected and correctly identified.