No abstract

No abstract

Initial studies indicated that student mental health was impaired during the early stages of the pandemic and that maintaining/improving physical activity gave some protection from mental illness. However, as the pandemic persists, these data may not reflect current circumstances and may have been confounded by exam stress. Methods: This study used an online survey to assess the changes in, and associations between, mental health and movement behaviours in 255 UK university students from before the COVID-19 pandemic (October 2019) to 9 months following the UK’s first confirmed case (October 2020). Changes in and associations between mental wellbeing, perceived stress, physical activity, and sedentary behaviour were assessed using a mixed model ANOVA; a multiple linear regression model determined the predictive value of variables associated with Δ mental wellbeing. Results: Mental wellbeing and physical activity decreased (45.2 to 42.3 (p < 0.001); 223 to 173 min/week (p < 0.001)), whereas perceived stress and time spent sedentary increased (19.8 to 22.8 (p < 0.001); 66.0 to 71.2 h/week (p = 0.036)). Δ perceived stress, Δ sedentary behaviour and university year accounted for 64.7%, 12.9%, and 10.1% of the variance in Δ mental wellbeing (p < 0.001; p = 0.006; p = 0.035). Conclusion: The COVID-19 pandemic is having a sustained negative impact on student mental health and movement behaviour.

A report of three cases of spontaneous rectus sheath haematoma within a 1-month period in a single hospital. The common feature was the recent treatment with low molecular weight heparin. In contrast to the perceived benign nature of the classically-described haematoma, the cases described were life-threatening and required aggressive intervention.

Objective: We performed a systematic review, meta-analysis and meta-regression of exercise studies that sought to determine the relationship between cardiac troponin (cTn) and left ventricular (LV) function. The second objective was to determine how study-level and exercise factors influenced the variation in the body of literature. Data Sources: A systematic search of Pubmed Central, Science Direct, SPORTDISCUS, and MEDLINE databases. Eligibility Criteria: Original research articles published between 1997-2018 involving >30mins of continuous exercise, measuring cardiac troponin event rates and either LV ejection fraction (LVEF) or the ratio of the peak early (E) to peak late (A) filling velocity (E/A ratio).Design: Random-effects meta-analyses and meta-regressions with four a priori determined covariates (age, exercise heart rate [HR], duration, mass). Registration:The systematic search strategy was registered on the PROSPERO database (CRD42018102176).Results: Pooled cTn event rates were evident in 45.6% of participants (95% CI = 33.6 -58.2%); however, the overall effect was non-significant (P>0.05). There were significant (P<0.05) reductions in E/A ratio of -0.38 (SMD = -1.2, 95% CI [-1.4, -1.0]), and LVEF of -2.02% (SMD = -0.38, 95%CI [-0.7, -0.1]) pre to post-exercise. Increased exercise HR was a significant predictor of troponin release and E/A ratio. Participant age was negatively associated with cTn release. There was a significant negative association between E/A ratio with increased rates of cTn release (P < 0.05). Conclusions:High levels of statistical heterogeneity and methodological variability exist in the majority of EICF studies. Our findings show that exercise intensity and age are the most powerful determinants of cTn release. Diastolic function is influenced by exercise HR and cTn release, which implies that exercise bouts at high intensities are enough to elicit cTn release and reduce LV diastolic function. Future EICF studies should 1) utilise specific echocardiographic techniques such as myocardial speckle tracking, 2) ensure participants are euhydrated during post-exercise measurements, and 3) repeat measures in the hours following exercise to assess symptom progression or recovery. It is also recommended to further explore the relationship between aging, training history, and exercise intensity on cTn release and functional changes. Key Points: The magnitude of exercise induced reductions in diastolic function is related to troponin event rate.  Higher average exercise heart rates are associated with an increased troponin event rate and greater reductions in diastolic function.  Increased age leads to a lower troponin event rate and reduced average exercise heart rates. This may have important implications for older/veteran athletes participating in prolonged endurance events.