Injury and illness in short-course triathletes:A systematic review

Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies.This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes.Methods:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Studies reporting health problems(injury and illness)in triathletes(all sexes,ages,and experience levels)training and/or competing in short-course distances were included.Six electronic databases(Cochrane Central Register of Controlled Trials,MEDLINE,Embase,APA PsychINFO,Web of Science Core Collection,and SPORTDiscus)were searched.Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale.Two authors independently completed data extraction.Results:The search yielded 7998 studies,with 42 studies eligible for inclusion.Twenty-three studies investigated injuries,24 studies investigated illnesses,and 5 studies investigated both injuries and illnesses.The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures,and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days.Injury and illness prevalence ranged between 2%-15%and 6%-84%,respectively.Most injuries reported occurred during running(45%-92%),and the most frequently reported illnesses affected the gastrointestinal(7%-70%),cardiovascular(14%-59%),and respiratory systems(5%-60%).Conclusion:The most frequently reported health problems in short-course triathletes were:overuse and lower limb injuries associated with running;gastrointestinal illnesses and altered cardiac function,primarily attributable to environmental factors;and respiratory illness mostly caused by infection.

Increased number of symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged time to return to full sports performance—AWAREⅧ

Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR<1 was predictive of higher percentage chance of prolonged RTFP.Significance was p<0.05.Results Days to RTFP were 30 days(IQR:23–40)for asymptomatic and 64 days(IQR:42–91)for symptomatic participants(p>0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.

How University Athletics Can Impact Mental Health among Student Athletes at the University of Evansville

In recent years, the NCAA student athlete population in the United States has surpassed 500,000, and is continuing to rise each year [1]. These student athletes work their entire lives academically and athletically to reach the ultimate goal: competing in university athletics. However, when these athletes reach university, they are met with non-stop training, homework, exams, and evolving social lives. We have conducted a study at the University of Evansville evaluating how participation in university athletics may impact mental health status among these student athletes, as well as measuring players’ awareness of accessible mental health resources. Over fifty percent of participants reported experiencing at least one mental health condition while competing in their sport;eighty percent reported having knowledge of the mental health resources available to them on campus, however, nearly thirty percent of those knowledgeable reported not knowing how to access these resources. This has indicated a gap in awareness and utilization of mental health resources among student athletes at the University of Evansville.

Barriers and Motivators of Young Dutch Elite Athletes for Optimizing Their Nutritional Intake

Many young elite athletes do not meet their daily energy and nutrient requirements. However, little research has been done on why these athletes do not meet their daily needs. The aim was to research the barriers and motivators of young Dutch elite athletes to optimize their nutritional intake. Quantitative and qualitative research was conducted among 8 handball and 4 volleyball players at the Dutch National Sports Center (17.2 ± 0.8 years). First, the nutritional intake was tracked through food diaries and analyzed in Nutritics. Thereupon, five semi-structured interviews based on the COM-B model were carried out. The interviews were transcribed and coded. The athletes had a reduced intake of energy, carbohydrates, vitamins A, C, E, D, calcium, potassium, zinc, and iron compared to their requirements. Seven themes for optimizing their nutritional intake emerged in the interviews: needs assessment, practical translation, portion size, lack of time, involvement, individuality, and food distribution. Barriers that the athletes experienced were that they did not know what their total daily nutritional needs were and how this translates into practice. In addition, the portion size at dinner was too small. They also had little time to eat a full meal due to time pressure from training and school. On the other hand, motivators were receiving meal options to translate their needs into practice with a distribution of moments when they need to eat. Covering these topics in nutritional workshops where athletes actively participate with more individual focus, could contribute to the optimization of their nutritional intake.

Review and update on the management of triangular fibrocartilage complex injuries in professional athletes

Triangular fibrocartilage complex injuries are common in amateur and professional sports.These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist,particularly on the ulnar side and in association with rotations or radial/ulnar deviations.In order to treat professional athletes,a detailed specific knowledge of the pathology is needed.Moreover,the clinician should fully understand the specific and unique environment and needs of the athletes,their priorities and goals,the type of sport,the time of the season,and the position played.An early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon.A compromise between conservative vs surgical indications,athletes’needs and expectations,and financial implications should be achieved.Arthroscopic procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same time.Conservative measures are often used as first line treatment when possible.Peripheral lesions are treated by arthroscopic repair,whilst central lesions are treated by arthroscopic debridement.Further procedures(such as the Wafer procedure,ulnar osteotomies,etc.)have specific indications and great implications with regard to rehabilitation.

The Influence of Swimming Athletes’ Burnout on Their Sports Participation Motivation in Hunan, China

Objective:This study aims to explore the effect of swimming athletes’burnout on their sports motivation in Hunan University,China.It seeks to understand how burnout influences various motivational factors,providing insights for optimizing swimming sports courses and enhancing student participation.Method:Employing random sampling,the study surveyed 260 swimming athletes from Hunan University.The research utilized a questionnaire divided into three parts:demographic information,the Athlete Burnout Questionnaire(ABQ),and the Intrinsic Motivation Inventory(IMI).Pearson’s r correlation analysis was conducted using SPSS to examine the relationships between burnout dimensions and motivational factors.Results:The study found significant correlations between a reduced sense of accomplishment and various motivational dimensions,including“interest/enjoyment,”“perceived competence,”“perceived choice,”and particularly“perceived tension.”Physical exhaustion showed a significant correlation only with“perceived tension,”indicating a strong link between psychological stress and physical fatigue.Sports devaluation was significantly correlated with“perceived tension,”suggesting that psychological stress impacts athletes’valuation of their sport.Conclusion:The findings highlight the complex interplay between burnout and motivation in swimming athletes.Psychological stress,as indicated by“perceived tension,”emerges as a key factor influencing both the physical and emotional aspects of burnout.The study underscores the need for holistic training approaches that balance physical training with psychological well-being,personalized coaching,and supportive environments to enhance intrinsic motivation and manage stress effectively.

Heart Rate Variability as an Indicator of Stress in Students’ Athletes

Introduction: The wellbeing of student’s athletes has a paramount importance, a prolonged period of cognitive and physical performance that characterizes the life of student’s athletes often leads to fatigue, and a psychobiological state that increases the risk of injury and accidents. The use of Heart rate variability (HRV) has become increasingly popular as a non-invasive methodology that provides an indirect insight into the autonomic nervous system. HRV can be utilized as a diagnostic tool in detection of autonomic nervous system impairment and sympatho-vagal imbalance. HRV technology is employed to monitor the internal response of athletes to workload and identify athletes’s psychophysical stress to predict and therefore prevent injuries. Objective: The objective of the investigation is to establish whether the use of Polar H10 sensor heart rate monitors worn by athletes in a sitting position (inclination 60 degrees) during periods characterized by stress can provide a valid and non-invasive method to assess the psychophysiological state during sports competition and school exams. Method and Statistics: In the study, the HRV of 12 basketball students athletes and 4 students non-athletes was analyzed as a control group. The autonomic nervous system activity was assessed based on heart variability parameters (HRV): SDNN, rMSSD, LF, HF, and LF/HF. The measurements were made after establishing the baseline at rest, during the training phase (CT), competition phase (CC) and during the acute phase of stressors due to school exams coinciding with the competitive season (CC + E). Results: Compared to the respective values prior to the stress of the competitions and exams, a significant decrease in HRV indices was found: SDNN (P Conclusions: The analysis and examination of the data on the sample of the student population also showed a statistically significant correlation between decreased cardiac variability and injuries or indisposition to physical exertion.

基于SHERPA和HEART的老年人车载信息系统界面设计研究

目的改善老年驾驶员对车载信息系统界面的使用体验。方法提出基于SHERPA(系统人为错误减少与预测方法)和HEART(人误评估与减少技术)的老年人车载信息系统界面设计研究方法。首先,成立焦点小组对评估界面进行SHERPA定性分析,绘制车载信息系统界面层次任务分析图,通过错误分类表定义错误类型;其次,运用HEART定量分析错误类型,设定差错诱发条件,确定各条件的影响评估比例,从而计算人误概率;最后,在此基础上,分析差错诱发条件,归纳差错发生原因,根据差错纠正措施进行设计改良,对改良界面进行结果验证。结论该方法可以有效发现与老年人车载信息系统界面显著相关的差错诱发条件,既可帮助设计师找到交互设计改良的重点,也可减少老年驾驶员对车载信息系统界面的误操作情况。

Regeneration of the heart:f rom molecular mechanisms to clinical therapeutics

Heart injury such as myocardial infarction leads to cardiomyocyte loss,fibrotic tissue deposition,and scar formation.These changes reduce cardiac contractility,resulting in heart failure,which causes a huge public health burden.Military personnel,compared with civilians,is exposed to more stress,a risk factor for heart diseases,making cardiovascular health management and treatment innovation an important topic for military medicine.So far,medical intervention can slow down cardiovascular disease progression,but not yet induce heart regeneration.In the past decades,studies have focused on mechanisms underlying the regenerative capability of the heart and applicable approaches to reverse heart injury.Insights have emerged from studies in animal models and early clinical trials.Clinical interventions show the potential to reduce scar formation and enhance cardiomyocyte proliferation that counteracts the pathogenesis of heart disease.In this review,we discuss the signaling events controlling the regeneration of heart tissue and summarize current therapeutic approaches to promote heart regeneration after injury.

The good,the bad,and the ugly of consumer sleep technologies use among athletes:A call for action

1.Introduction For athletes,the quality and quantity of sleep are essential elements for optimizing recovery and subsequent performance.1 Unfortunately,athletes frequently face challenges getting sufficient,high-quality sleep.2 A recent systematic review and meta-analysis of 81 studies involving 1830 athletes concluded that compared to healthy non-athletes,athletes'sleep duration was shorter with poorer sleep efficiency.

Association between ACTN3 R577X genotype and risk of non-contact injury in trained athletes:A systematic review

Purpose:The aim of this study was to review,systematically,evidence concerning the link between the ACTN3 R577X polymorphism and the rates and severity of non-contact injuries and exercise-induced muscle damage in athletes and individuals enrolled in exercise training programs.Methods:A computerized literature search was performed in the electronic databases PubMed,Web of Science,and SPORTDiscus,from inception until November 2020.All included studies compared the epidemiological characteristics of non-contact injury between the different genotypes of the ACTN3 R577X polymorphism.Results:Our search identified 492 records.After the screening of titles,abstracts,and full texts,13 studies examining the association between the ACTN3 genotypes and the rate and severity of non-contact injury were included in the analysis.These studies were performed in 6 different countries(Spain,Japan,Brazil,China,the Republic of Korea,and Italy)and involved a total participant pool of 1093 participants.Of the studies,2 studies involved only women,5 studies involved only men,and 6 studies involved both men and women.All the studies included were classified as highquality studies(≥6 points in the Physiotherapy Evidence Database(PEDro)scale score).Overall,evidence suggests there is an association between the ACTN3 R577X genotype and non-contact injury in 12 investigations.Six studies observed a significant association between A CTN3 R577X polymorphism and exercise induced muscle damage:2 with non-contact ankle injury,3 with non-contact muscle injury,and 1 with overall non-contact injury.Conclusion:The present findings support the premise that possessing the ACTN3 XX genotype may predispose athletes to a higher probability of some non-contact injuries,such as muscle injury,ankle sprains,and higher levels of exercise-induced muscle damage.

Evaluation of autonomic nervous system by heart rate variability and differential count of leukocytes in athletes

Top Japanese sprinters were evaluated for their physical condition, autonomic function, blood chemistry, differential leukocyte count and blood lactate level before and after short, maximal exercise to explore methods of quantifying their conditioning level. Statistical analysis of data obtained before and 10 min after exercise were used to estimate the athletes’ autonomic capacity during recovery. Pre and post exercise variances in differential leukocyte count revealed strong correlations between neutrophil and sympathetic activity, and lymphocyte and parasympathetic activity. The results of the study demonstrated significant alterations in autonomic parameters and differential white blood cell count in response to maximal exercise.

Lower serum magnesium concentration and higher 24-h urinary magnesium excretion despite higher dietary magnesium intake in athletes:a systematic review and meta-analysis

Magnesium plays a critical role in the human's life activities and energy metabolism. This study aimed to evaluate the magnesium status of athletes via a systematic review of cross-sectional studies. A comprehensive systematic search was conducted in PubMed, Web of Science, SPORTDiscus, Cochrane Library electronic databases, and other sources before April 5, 2021. Fourteen studies were included in the systematic review, involving 855 athletes and 521 control subjects. Serum magnesium concentration was significantly lower in athletes(mean difference(MD):-0.04 mmol/L;95% confidence interval(CI):-0.06 to-0.01;P = 0.02)in spite of significantly higher dietary magnesium intake(MD: 51.72 mg/day;95% CI: 14.62 to 88.83;P = 0.006). Meta-analysis showed that 24-h urinary magnesium excretion in athletes was significantly higher than that in the untrained population(MD: 0.76 mmol/day;95% CI: 0.11 to 1.41;P = 0.02). Despite higher total dietary magnesium intake, athletes generally have lower serum magnesium concentration and higher 24-h urinary magnesium excretion, demonstrating that the magnesium requirement of athletes is higher than the untrained population. It is necessary to carry out a dietary assessment and nutrition counseling to help athletes adopt proper diets to meet their nutritional needs in exercise.

Serum cystatin C,monocyte/high-density lipoprotein-C ratio,and uric acid for the diagnosis of coronary heart disease and heart failure

BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.

Investigating the Effect of COVID-19 Infection on Professional Athletes’ Post-Infection with a Focus on Fatigue and Chronic Fatigue Syndrome

Introduction and Objectives: COVID-19 has been reported to cause long-term sequela including persistent fatigue and Chronic Fatigue Syndrome (CFS) in the general population. However, it remains to be seen if similar effects are observed in an athlete population. The aetiology and pathophysiology are poorly understood but is thought to be multi-factorial. Patient reported outcome measures are commonly used to improve patient-centred outcomes (PROMs). They are essential to assess patient quality of life post-COVID infection. This paper aims to assess the effect of COVID-19 on athletes’ long-term fatigue and CFS and identify the PROMs used to characterise this. Methodology: Articles were selected for extraction based on the eligibility criteria and PRISMA guidelines. The inclusion criteria required papers to assess competitive athletes over eighteen years of age who were clinically diagnosed with COVID-19. Articles were extracted to assess different variables including type of sport, type of athlete and ethnicity. Key terms were obtained using MeSH trees and utilised with Web of Science and NCBI Pubmed. Papers were graded by quality using the Hawker quality assessment tool. Results and Discussion: Forty articles (N = 40) were identified for full-text screening (N = 8). Eight were selected for extraction based on the eligibility criteria. Data was obtained on athlete characteristics, sport characteristics, properties of PROM measurement techniques and fatigue presentation. Male athletes were found to be 10% - 50% more likely than female athletes to suffer from persistent fatigue symptoms (N = 2). Persistent fatigue was present in 9% - 10% Athletes from mixed backgrounds and genders (N = 2). Initial fatigue was documented to be between 47% - 56% (N = 2). A heterogenous range of PROMs were utilised to assess symptoms including fatigue and excluded emotional or mental fatigue. Conclusion: COVID-19 is associated with signs of persisting fatigue and potentially CFS in athlete populations. More work needs to be done to develop standardised and validated PROMs specific to CFS.

Left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

BACKGROUND Left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIM To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of LBBP-CRT.METHODS Systematic review and Meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology section.RESULTS In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with BiVP-CRT.CONCLUSION A significant reduction in New York Heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT group.Lastly,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

Assessment of functional prognosis of anterior cruciate ligament reconstruction in athletes based on a body shape index

BACKGROUND A healthy body shape is essential to maintain athletes’sports level.At present,little is known about the effect of athletes’body shape on anterior cruciate ligament reconstruction(ACLR).Moreover,the relationship between body shape and variables such as knee joint function after operation and return to the field has not been well studied.AIM To verify the relationship between a body shape index(ABSI)and the functional prognosis of the knee after ACLR in athletes with ACL injuries.METHODS We reviewed 76 athletes with unilateral ACL ruptures who underwent ACLR surgery in the First Hospital of Shanxi Medical University between 2017 and 2020,with a follow-up period of more than 24 mo.First,all populations were divided into a High-ABSI group(ABSI>0.835,n=38)and a Low-ABSI group(ABSI<0.835,n=38)based on the arithmetic median(0.835)of ABSI values.The primary exposure factor was ABSI,and the outcome indicators were knee function scores as well as postoperative complications.The correlation between ABSI and postoperative knee function scores and postoperative complications after ACLR were analyzed using multifactorial logistic regression.RESULTS The preoperative knee function scores of the two groups were similar.The surgery and postoperative rehabilitation exercises,range of motion(ROM)compliance rate,Lysholm score,and Knee Injury and Osteoarthritis Outcome Score of the two groups gradually increased,whereas the quadriceps atrophy index gradually decreased.The knee function scores were higher in the Low-ABSI group than in the High-ABSI group at the 24-mo postoperative follow-up(P<0.05).In multifactorial logistic regression,ABSI was a risk factor of low knee joint function score after surgery,specifically low ROM scores(odds ratio[OR]=1.31,95%confidence interval[CI][1.10-1.44];P<0.001),low quadriceps atrophy index(OR=1.11,95%CI[0.97-1.29];P<0.05),low Lysholm scores(OR=2.34,95%CI[1.78-2.94];P<0.001),low symptoms(OR=1.14,95%CI[1.02-1.34];P<0.05),low activity of daily living(OR=1.34,95%CI[1.18-1.65];P<0.05),low sports(OR=2.47,95%CI[1.78-2.84];P<0.001),and low quality of life(OR=3.34,95%CI[2.88-3.94];P<0.001).ABSI was also a risk factor for deep vein thrombosis of the lower limb(OR=2.14,95%CI[1.88-2.36],P<0.05]and ACL recurrent rupture(OR=1.24,95%CI[0.98-1.44],P<0.05)after ACLR.CONCLUSION ABSI is a risk factor for the poor prognosis of knee function in ACL athletes after ACLR,and the risk of poor knee function after ACLR,deep vein thrombosis of lower limb,and ACL recurrent rupture gradually increases with the rise of ABSI.

Establishing delivery route-dependent safety and efficacy of living biodrug mesenchymal stem cells in heart failure patients

BACKGROUND Mesenchymal stem cells(MSCs)as living biopharmaceuticals with unique properties,i.e.,stemness,viability,phenotypes,paracrine activity,etc.,need to be administered such that they reach the target site,maintaining these properties unchanged and are retained at the injury site to participate in the repair process.Route of delivery(RoD)remains one of the critical determinants of safety and efficacy.This study elucidates the safety and effectiveness of different RoDs of MSC treatment in heart failure(HF)based on phase II randomized clinical trials(RCTs).We hypothesize that the RoD modulates the safety and efficacy of MSCbased therapy and determines the outcome of the intervention.AIM To investigate the effect of RoD of MSCs on safety and efficacy in HF patients.METHODS RCTs were retrieved from six databases.Safety endpoints included mortality and serious adverse events(SAEs),while efficacy outcomes encompassed changes in left ventricular ejection fraction(LVEF),6-minute walk distance(6MWD),and pro-B-type natriuretic peptide(pro-BNP).Subgroup analyses on RoD were performed for all study endpoints.RESULTS Twelve RCTs were included.Overall,MSC therapy demonstrated a significant decrease in mortality[relative risk(RR):0.55,95%confidence interval(95%CI):0.33-0.92,P=0.02]compared to control,while SAE outcomes showed no significant difference(RR:0.84,95%CI:0.66-1.05,P=0.11).RoD subgroup analysis revealed a significant difference in SAE among the transendocardial(TESI)injection subgroup(RR=0.71,95%CI:0.54-0.95,P=0.04).The pooled weighted mean difference(WMD)demonstrated an overall significant improvement of LVEF by 2.44%(WMD:2.44%,95%CI:0.80-4.29,P value≤0.001),with only intracoronary(IC)subgroup showing significant improvement(WMD:7.26%,95%CI:5.61-8.92,P≤0.001).Furthermore,the IC delivery route significantly improved 6MWD by 115 m(WMD=114.99 m,95%CI:91.48-138.50),respectively.In biochemical efficacy outcomes,only the IC subgroup showed a significant reduction in pro-BNP by-860.64 pg/mL(WMD:-860.64 pg/Ml,95%CI:-944.02 to-777.26,P=0.001).CONCLUSION Our study concluded that all delivery methods of MSC-based therapy are safe.Despite the overall benefits in efficacy,the TESI and IC routes provided better outcomes than other methods.Larger-scale trials are warranted before implementing MSC-based therapy in routine clinical practice.

The Problem of Rehospitalisation for Heart Failure at the Cardiology Department of the Hôpital National Ignace Deen

Introduction: Despite current therapeutic advances, heart failure in sub-Saharan Africa remains a common, serious and costly disease, particularly due to rehospitalizations. The objective of this work was to determine the proportion of rehospitalizations for heart failure and to identify etiological factors. Methodology: This was a retrospective descriptive study with a duration of 8 months from April 1 to November 30, 2021. This study included all patients rehospitalized in the department for Heart Failure and who agreed to participate in our study. Results: During the period of our study, 437 patients were hospitalized in the HF department, among which we collected 126 cases of rehospitalization for HF with a frequency of 28.83%. The mean age of our patients was 46.32 ± 18.98 years with the extremes of 15 to 84 years. The most affected age group was between 35 and 44 years old in 24 cases, i.e. a frequency of 19%. We observed a female predominance of 64 cases, i.e. a frequency of 50.8% compared to 62 cases, i.e. a frequency of 49.2% with a sex ratio (M/F) equal to 0.96. 98 cases of our patients, i.e. a frequency of 77.8%, were mutual insurance companies who felt they had the necessary support from those around them. In our sample, the underlying heart disease was mainly represented by valvular heart disease in 59 cases, followed by hypertensive heart disease in 42 cases with the respective frequencies of 46.82% and 33.33%. The majority of our patients were rehospitalized (1 - 3) times after a first episode of HF flare-up in 117 cases or 92.9%. Irregularity at control and therapeutic break were the most common decompensation factors with frequencies of 75.8% and 74.2% respectively. The majority of our patients were rehospitalized (1 - 3) times after a first episode of HF flare-up in 117 cases or 92.9%. Irregularity at control and therapeutic break were the most common decompensation factors with frequencies of 75.8% and 74.2% respectively. Conclusion: It appears in this study that rehospitalizations for heart failure are frequent, linked to irregularity in control and the lack of therapeutic education.

HEART五步沟通模式对乳腺癌化疗患者心理弹性及癌因性疲乏的影响

目的探讨HEART五步沟通模式对乳腺癌化疗患者心理弹性及癌因性疲乏的影响。方法本研究为随机单盲对照试验,采用方便抽样法,选取无锡市人民医院肿瘤科于2022年1月—12月收治的84例乳腺癌化疗患者为研究对象,采用随机数字表法将其分为对照组与观察组,每组各42例。为避免组间沾染,将对照组安排至肿瘤一科,实施常规化疗护理;将观察组安排至肿瘤二科,在常规化疗护理的基础上实施HEART五步沟通模式。两组患者均化疗4个周期,比较两组患者首次化疗入院当天(干预前)、末次化疗出院当天(干预后)的心理弹性及癌因性疲乏。结果干预后,观察组的心理弹性评分明显高于对照组(P<0.05);观察组的癌因性疲乏评分明显低于对照组(P<0.05)。结论对乳腺癌化疗患者在常规化疗护理的基础上实施HEART五步沟通模式,能够明显提高患者的心理弹性,缓解患者的癌因性疲乏症状。