Background During the COVID‑19 pandemic, inflammatory myopericardial syndromes have been reported following SARS‑CoV‑2 infection and SARS‑CoV‑2 vaccination. However, the prevalence of such conditions in routine clinical practice, including mild or residual pericardial alterations, remains incompletely characterized. This study aimed to evaluate the association between prior SARS-CoV-2 infection, SARS-CoV-2 vaccination, and echocardiographic pericardial involvement in a real-world outpatient cohort undergoing routine transthoracic echocardiography. Methods This retrospective cohort study analyzed 1,431 consecutive patients undergoing routine outpatient echocardiography from 2018 to 2022 at the Istituto di Medicina Biologica di Milano, Milan, Italy. Pericardial involvement was defined as echocardiographic findings consistent with pericardial inflammation, including pericardial effusion, thickening, hyperechogenicity, and fibrinous strands, encompassing not only clinically evident pericarditis but also minimal pericardial alterations and residual findings. Multivariable logistic regression and average marginal effects were used to assess associations with prior COVID‑19 infection, SARS‑CoV‑2 vaccination status, age, sex, and BMI, adjusting for calendar year and confounders. Results Pre‑pandemic pericardial involvement was detected in 101/459 (22%) examinations (2018-2019), rising to 463/673 (68.8%) during the pandemic years (2020-2022; P < 0.001). Both prior COVID‑19 infection (odds ratio (OR) 1.99, 95% confidence interval (CI) 1.17-3.43, P = 0.012) and vaccination (OR 2.08, 95% CI 1.29-3.35, P = 0.003) were independently associated with pericardial involvement, with a significant interaction suggesting that prior infection attenuated additional risk from vaccination, and vice versa. Female sex, older age, and higher BMI were also associated with higher odds. Conclusions In this real-world echocardiography cohort, both SARS-CoV-2 infection and vaccination were associated with increased odds of echocardiographic pericardial involvement, including minimal and residual alterations. The marked temporal rise during the pandemic may reflect a combination of subclinical inflammatory changes and evolving referral and diagnostic practices, while the absolute risk of vaccine-associated myopericarditis remained low compared with the overall benefits of vaccination.

BACKGROUND:The developmental trajectory of young elite soccer players is influenced by maturation and physiological parameters. This study examined age-based differences in maturation, physical performance, and positional variations among young elite male soccer players using the 30-15 Intermittent Fitness Test (30-15 IFT) among 113 elite male players aged 11-17. METHODS:Assessments included peak height velocity (PHV), maturity offset, maximum running speed from the 30-15 IFT (MRS30-15IFT), and maximal oxygen uptake (VO2max). Age-related and positional differences were analyzed to identify significant variations across categories. RESULTS:Significant age-related differences were observed in maturation and performance parameters. U16 and U17 players differed in PHV (P=0.009), while maturity offset varied significantly across most categories except between U16 and U17. Aerobic performance, measured via MRS30-15IFT and VO2max, improved progressively with age; U12 players showed lower values than older groups (P<0.05). Strong correlations emerged between VO2max and maturity offset (r=0.73, P<0.001) and between MRS30-15IFT and maturity offset (r=0.73, P<0.001). Positional analysis revealed that central backs had lower PHV than midfielders and wingers in U12-U14 (P<0.015), while wingers showed higher VO2max than strikers in U15-U17 (P=0.042). CONCLUSIONS:Maturation and physiological performance parameters vary significantly across age categories in elite young soccer players. Position-specific differences in growth and aerobic capacity emphasize the importance of individualized training approaches to optimize development and performance.

Virtual Reality (VR) is increasingly employed in sports science as it enables ecological and standardized assessments of cognitive-motor skills in immersive, controllable environments. This study examined the influence of lateral dominance on response time (RT) in elite athletes from two situational sports: volleyball (predominantly symmetrical motor demands) and fencing (asymmetrical motor demands). A secondary objective was to explore the relationship between dynamic visual attention and RT. Eighty-five elite athletes (41 volleyball players, 44 fencers) completed VR-based assessments of RT and dynamic visual attention. A mixed-design ANOVA showed significantly faster RT with the dominant hand across both groups (Volleyball: dominant 467.4 ± 60.1 ms vs non-dominant 485.2 ± 68.5 ms, p < 0.001; Fencing: dominant 462.4 ± 47.4 ms vs non-dominant 481.3 ± 65.1 ms, p < 0.001). No significant interaction between sport type and dominance was found (p = 0.851). To examine whether sex influenced lateral dominance (males: n = 44, females: n = 41), we compared the Δ% in RT between the non-dominant and dominant hand. No significant differences were observed between males and females (males: 3.91 ± 6.93%; females: 3.38 ± 4.64%; p = 0.718). Pearson correlations revealed a significant inverse association between attentional index and RT (volleyball: r = -0.460, p = 0.006; fencing: r = -0.418, p = 0.007), indicating that greater attentional capacity relates to shorter RT. These findings suggest that dominance effects persist in elite athletes regardless of sport-specific motor symmetry, and that attentional abilities contribute meaningfully to visuo-motor responsiveness.

To examine associations between physical activity (PA) characteristics and psychosocial outcomes – quality of life (QoL) and fear of hypoglycemia (FH) – in children, adolescents, and young adults with type 1 diabetes (T1D). In this cross-sectional study, 100 insulin pump-treated outpatients T1D completed 7-day PA logs capturing timing, type, intensity, and volume. QoL and FH were assessed using age-appropriate validated instruments. General linear models evaluated associations between PA characteristics and psychosocial outcomes, accounting for age group and, in sensitivity analyses, sex and HbA1c. In pooled analyses (N = 82 complete cases), age group was significantly associated with both QoL (p = 0.037) and FH (p < 0.001), with a large effect size observed for FH. In sensitivity analyses adjusting for sex and HbA1c, the age-group effect on FH remained robust, whereas associations with QoL were attenuated. Exercise timing was associated with FH (p = 0.047), with higher adjusted FH scores observed among individuals reporting evening exercise. However, pairwise comparisons were not significant after correction. No significant AgeGroup×Timing interactions were detected. Preferred exercise type and intensity were not independently associated with psychosocial outcomes. In sensitivity analyses adjusted for sex and HbA1c (N = 62), the age-group effect on FH remained robust, whereas timing showed borderline significance. Developmental stage appears to be a major determinant of fear of hypoglycemia in youths with T1D. Exercise timing may contribute modestly to perceived hypoglycemia risk, particularly for evening activity, although findings were attenuated after adjustment. These cross-sectional associations highlight the importance of developmentally tailored exercise counselling, while longitudinal studies are needed to clarify directionality.

BACKGROUND:Sleep hygiene strategies (SHS) are practical, evidence-informed recommendations to enhance both the quantity and quality of sleep in athletes. However, little is known about how these strategies could be communicated and implemented in practice. The primary objective of this study is to investigate how different methods of delivering SHS (written vs. verbal) affect sleep hygiene and sleep parameters in athletes. METHODS:The study was a three-arms randomized controlled trial (ClinicalTrials.gov Identifier: NCT07083544) involving track and field athletes competing at the regional or national level (N.=66). Athletes were randomized to either a control group (CON=22), a written SHS group (W-SHS=22), or a verbal SHS group (V-SHS=22). Sleep characteristics were assessed by actigraphy and sleep diary during a ten-day baseline period (T0) and a ten-day intervention period (T1). Six objective sleep parameters and the Sleep Regularity Index were assessed. Participants also completed a training diary and the Sleep Hygiene Index (SHI). RESULTS:No statistical differences were found between and within groups in training and sleep parameters, but SHI scores improved significantly in the intervention groups between T0 and T1, with differences compared to the control group. A non-significant improvement in total sleep time was observed in the intervention groups, primarily due to earlier bedtimes. CONCLUSIONS:While significant differences in objective sleep measures were not observed, the trends suggest that both written and verbal SHS interventions can modestly improve sleep-related behaviors, particularly by encouraging earlier bedtimes and slightly extending total sleep duration.

BackgroundTranscranial photobiomodulation (PBM) has been proposed to enhance prefrontal cortex (PFC) oxygenation and modulate central mechanisms of fatigue, potentially improving endurance performance. This study investigated the acute effects of PBM on cycling time-trial (TT) performance in well-trained cyclists.MethodsIn a randomized, double-blind, crossover design, 18 trained cyclists completed two experimental conditions (PBM and SHAM) prior to a constant-load (CL) test at 5% above the first lactate threshold (LT1) and a 25-min self-paced TT on their own bicycles mounted on an ergometer.ResultsNo significant condition × time interactions were found for heart rate, blood lactate, ratings of perceived exertion (RPE), or power-related ratios during either the constant-load or TT trials (p > 0.05).ConclusionAcute transcranial PBM did not influence cycling performance or perceptual and physiological responses in trained athletes. These findings suggest that the applied PBM parameters may have been insufficient to elicit measurable cortical or performance effects. Future research should explore optimized stimulation parameters and chronic application protocols to clarify the potential ergogenic role of PBM in endurance exercise.

Introduction In recent years, doping has increasingly been recognized not just as a health risk for athletes, but also as a factor undermining the credibility of sports as a whole. The scientific discussion is gradually shifting: rather than simply predicting risky behavior, there is growing emphasis on fostering a genuine "clean sport identity," meaning a conscious commitment to shared ethical values. In this study, we draw on both Social Cognitive Theory and moral identity perspectives to explore which socio-cognitive variables may influence the intention to support ethical sporting behavior.Methods A total of 429 track and field athletes from Italy (n = 229) and France (n = 200) participated in the study. Participants completed validated questionnaires measuring moral identity, moral disengagement, self-regulatory efficacy, and clean sport behavior intentions. Structural equation modeling and multigroup invariance analyses were employed to test the theoretical model and examine cross-national differences.Results The results demonstrate that moral identity is negatively associated with moral disengagement and positively associated with self-regulatory efficacy. Moral disengagement was identified as the strongest predictor of clean sports behavior intentions. Mediation analysis indicated that moral identity influences clean sports behavior intentions primarily by inhibiting mechanisms of moral disengagement. When comparing groups, we observed notable cross-national differences. Specifically, the link between moral identity and moral disengagement appeared stronger among French athletes, whereas self-regulatory efficacy had a more pronounced impact on Italian athletes' intentions to engage in clean sports behavior.Discussion These results underscore the importance of incorporating value-driven approaches and fostering moral identity within anti-doping interventions. Preventive strategies should focus on minimizing cognitive rationalizations for unethical conduct and strengthening athletes' ability to self-regulate when facing external pressures, ultimately supporting a long-term dedication to clean sport.

Introduction and Objective: Despite the well-documented benefits of physical activity (PA) for health and diabetes management, individuals with type 1 diabetes (T1D) face significant barriers to exercise. Methods: This cross-sectional study investigated PA determinants and psychometric outcomes in ninety well-controlled individuals with T1D from Northwest Italy (55% female; age: 16 ± 6 years; HbA1c: 6.8 ± 1%). PA timing, type, duration, intensity, and volume were recorded through a 7-day training log, and participants were grouped by exercise timing: morning (6 am-12 pm), afternoon (12 pm-6 pm), and evening (6 pm-12 am). Results: Higher PA volume was associated with improved quality of life (Pearson r = -0.25, P = 0.02) and reduced fear of hypoglycemia (Spearman Rho = -0.23, P = 0.03). Mixed-model analysis revealed that quality of life was significantly influenced by PA type (P = 0.03) and intensity (P = 0.04), with low-intensity aerobic activity yielding better scores than mixed activity (P = 0.009). Fear of hypoglycemia was significantly affected by PA type (P = 0.007) and timing (P = 0.03), with greater anxiety reported for evening (P = 0.01) and anaerobic activities (P = 0.018) compared to afternoon and mixed activities, respectively. Gender had no significant effect on these outcomes. Conclusion: These findings highlight the importance of tailoring exercise recommendations for youth with T1D, emphasizing consistent routines and careful selection of activity types and intensities to enhance quality of life while minimizing fear of hypoglycemia. Promoting adherence to such strategies could optimize both physical and psychological well-being in this population. R. Codella: None. A. Bisio: None. D. Gotti: None. M. Bassi: None. N. Minuto: Consultant; Novo Nordisk. P. Ruggeri: None. L. Luzi: Speaker's Bureau; A. Menarini Diagnostics, Amgen Inc. Research Support; Boehringer-Ingelheim. Advisory Panel; Eli Lilly and Company. Speaker's Bureau; Eli Lilly and Company. Research Support; Medtronic. Speaker's Bureau; Novartis AG, Novo Nordisk. D. Maggi: None. E. Faelli: None.

This study aimed to describe the training leading to the Zwift Academy (ZA) Finals of a world-class road cyclist who earned a professional contract after winning the contest. Four years of daily power meter data were analyzed (male, 25 years old, 68 kg, VO2max: 85 mL·min−1·kg−1, and 20-min power: 6.37 W·kg−1), focusing on load, volume, intensity, and strategies. Early training alternated between long, moderate-intensity sessions and shorter high-intensity sessions, with easy days in between. Gradually, the structure was progressively modified by increasing the duration of moderate-intensity (MIT) and high-intensity (HIT) and, subsequently, moving them to “high-volume days”, creating a sort of “all-in days” with low-intensity (LIT), MIT, and HIT. Moderate use of indoor training and a few double low-volume, low-intensity sessions were noted. These data provide a deep view of a 4-year preparation period of ZA, providing suggestions for talent identification and training, thereby highlighting the importance of gradual progression in MIT and HIT.

Background/Objectives: Photobiomodulation (PBM) is a non-invasive, low-level laser treatment shown to improve insulin resistance, glucose metabolism, and obesity-related inflammation. This study examined whether PBM could acutely enhance mitochondrial efficiency and energy metabolism in women with obesity. Methods: In a randomized, crossover within-subject design, 16 women with obesity (43 ± 5 years; BMI: 36 ± 4 kg/m2) and 16 sedentary normal-weight women (43 ± 5 years; BMI: 22.7 ± 2 kg/m2) underwent PBM (front and back exposure; red light, 633–660 nm; NIR, 850–940 nm) and a sham stimulation (SHAM), as a control, for 12 min. Resting energy expenditure (REE) was assessed via indirect calorimetry before and after exposure. Secondary measures included skin autofluorescence, heart rate, blood pressure, profile of mood states, rate of perceived exertion (RPE), and flexibility. Diet and physical activity were controlled. Results: A 2 × 2 × 2 ANOVA revealed a significant group × time interaction (F3,60 = 3.054, p = 0.03) and a main effect of time (F1,60 = 10.88, p = 0.001). Women with obesity showed a significant increase in REE post-PBM compared to pre-PBM (+9.3%, 1624 ± 314 vs. 1486 ± 327 kcal/day; p < 0.001), with no change in the respiratory exchange ratio. Additionally, RPE decreased and flexibility improved in both groups following PBM. Front and back skin temperatures increased significantly post-PBM, with greater changes observed in the back versus the front. Conclusions: These preliminary findings indicate that PBM acutely enhances energy utilization efficiency in women with obesity, increasing resting energy expenditure without modifying substrate oxidation. PBM may represent a promising non-invasive adjunctive strategy for improving the metabolic health of obese individuals.

To evaluate how the timing, type, and intensity of bout-related physical activity (PA) influence glycemic control across age groups in youths and young adults with type 1 diabetes (T1D). In this cross-sectional study, 100 insulin pump-treated individuals with T1D (55 females; mean age 16.6 ± 6.6 years; HbA1c 6.8 ± 1.0

Cross-education (CE) of strength refers to strength gains in the untrained limb after unilateral resistance training. Despite the long-standing recognition of this phenomenon, its potential implications in clinical and rehabilitation settings have only been studied extensively in recent decades. The implementation of unilateral resistance training in early-stage sports rehabilitation remains underrated, likely due to the lack of consensus on evidence-based guidelines. Thus, this narrative review provides a current overview of the CE of strength, analyzes its practical implications for sports rehabilitation, and examines the training modalities and parameters that should be modulated to optimize CE adaptations, thereby supporting early intervention against post-injury neuromuscular decline. Unilateral resistance training in the healthy limb appears to represent a cost-effective and accessible rehabilitation strategy for athletes who are unable to work on their injured limb from the early stages of rehabilitation. This strategy may ensure the maintenance of muscle strength levels in the trained limb while minimizing neuromuscular decline in the injured and immobilized limb. CE of strength may be implemented as an addition to traditional early-stage rehabilitation strategies, such as pain, swelling, and inflammation reduction, the progressive restoration of joint range of motion, and the progressive strength training in sports injury rehabilitation. Further research is required to make definitive recommendations. Strength gains in the untrained limb following unilateral resistance training is a phenomenon known as cross-education (CE), with origins tracing back to the second half of the 19th century. In sports rehabilitation, it is essential to promptly address the negative effects of injury, immobilization, and detraining starting from the early stages to optimize later rehabilitation phases. Despite the lack of consensus, CE of strength may be a promising strategy in early-stage sports rehabilitation to preserve the neuromuscular function of the injured area. This approach relies on the precise modulation of training parameters, which is critically discussed in this article.

In recent years, cutting-edge technologies have been increasingly integrated into sports to assess physical and cognitive capacities. Virtual Reality (VR) technology has emerged as a powerful tool, offering an immersive and controlled scenario for examining cognitive functions. In light of the growing adoption of VR-systems, this study aimed to investigate the differences in visual attention and response time (RT) between athletes and non-athletes utilizing a VR-system and evaluate the discriminatory power of VR assessments towards the two groups. Sixty-one participants (Age: 22 ± 1.8years; athletes = 33, non-athletes = 28) underwent two visual attention evaluations through the Multiple Object Tracking (MOT) paradigm and three RT evaluations, all within a fully immersive VR environment. The visual attention assessments included the "MOT Assessment" (MOT), which did not have a primary target to select, and the "MOT, Primary Target Onset" (MOT-PT), which required selecting a primary target. The three RT evaluations included Continuous RT (RT-C), RT with Inter-Time between stimuli (RT-I), and Go No-Go RT (RT-GNG). In all RT assessments, participants aimed to touch the target that turned green in the shortest time as possible. In the RT-GNG test, participants responded to green targets by touching them with the hand controllers and refrained from touching red targets. No differences were found between athletes and non-athletes in visual attention tasks. However, athletes outperformed non-athletes in RT assessments (RT-C: 504.8 ± 45.9ms vs. 549.1 ± 45.6ms; p < 0.001. RT-I: 481.1 ± 44.9ms vs. 534.2 ± 58.6ms; p < 0.001. RT-GNG: 502.9 ± 38.8ms vs. 555.6 ± 57.8ms; p < 0.001). ROC curve analysis demonstrated moderate accuracy in differentiating athletes from non-athletes in RT assessments (RT-C: AUC = 0.75, p < 0.001; RT-I: AUC = 0.75, p < 0.001; RT-GNG: AUC = 0.80, p < 0.001). These findings underscore the significant role of RT in distinguishing athletes from non-athletes and highlight the discriminative potential of VR-systems as valuable tools in sports evaluation. Including RT assessments into traditional training regimens could offer new insights for evaluating athletic performance.

BACKGROUND:Prescribing interval training intensity can be challenging due to individual variations in physiological capacity. Traditional methods often rely on maximal aerobic power (MAP), but this may not fully capture the characteristics of different athletes. This study aimed to investigate whether alternative methods, such as anaerobic power reserve (APR) and glycolytic power reserve (GPR), could provide more individualized high-intensity interval training (HIIT) prescriptions. METHODS:Twelve trained cyclists completed a cardiopulmonary test and Wingate test to determine MAP, APR, and GPR (mean power output during the Wingate test minus MAP). Subsequently, participants performed in a randomized order, three HIIT until-exhaustion sessions with 60-s of work and 60-s of active rest, based on APR (HIITAPR: MAP+10% APR), GPR (HIITGPR: MAP+20%GPR) and MAP (HIITMAP: 120%MAP), respectively. Inter-individual variability in time to exhaustion, heart rate, oxygen uptake, and lactate was calculated as the root mean square of residuals and as coefficients of variation (CV). RESULTS:Although no significant differences in inter-individual variability were observed across the three prescription methods for any of the physiological and perceptual variables (P>0.2), HIITMAP leads to lower inter-individual variability in time to exhaustion (CV=21%) compared to HIITAPR (CV=35%) and HIITGPR (CV=45%). CONCLUSIONS:HIIT based on APR and GPR does not reduce inter-individual variability in physiological responses and tolerance compared with MAP-based prescription. This suggests that both APR and GPR fail to accurately differentiate between the aerobic and anaerobic characteristics of an athlete, hindering the normalization of exercise responses during HIIT.

Sarcopenia is a progressive, age-related loss of skeletal muscle mass, strength, and function, strongly associated with frailty, disability, and chronic disease. Its pathogenesis involves chronic low-grade inflammation, hormonal imbalance, and impaired anabolic signaling, making biomarkers essential for diagnosis, prognosis, and intervention monitoring. This review systematically analyzes randomized controlled trials (RCTs) evaluating the impact of physical exercise on biomarkers relevant to sarcopenia. Exercise modulates both pro-inflammatory markers (e.g., IL-6, TNF-α, CRP) and anti-inflammatory cytokines (e.g., IL-10, IL-15), while also affecting growth factors like IGF-1, myostatin, and follistatin. These changes support muscle anabolism, reduce catabolic signaling, and improve physical performance. In addition, we highlight a growing class of emerging exerkines, including irisin, apelin, beta-aminoisobutyric acid (BAIBA), decorin, brain-derived neurotrophic factor (BDNF), and meteorin-like factor (Metrnl). These molecules exhibit promising roles in mitochondrial health, lipid metabolism, muscle regeneration, and immune modulation, key processes in combating inflamm-aging and sarcopenic decline. Despite encouraging findings, biomarker responses remain heterogeneous across studies, limiting translational application. The integration of biomarker profiling with exercise prescription holds the potential to personalize interventions and guide precision medicine approaches in sarcopenia management. Future large-scale, standardized trials are needed to validate these biomarkers and optimize exercise protocols for aging populations.

ABSTRACT Basic motor competencies (BMC) are foundational skills essential for children's participation in sports and physical activities. While normative data exist in countries like Germany and Switzerland, benchmarks for Italian children are lacking. This study addresses this gap by establishing normative data for Italian schoolchildren aged 5–11 years using the MOBAK test battery, which assesses self‐movement (balancing, rolling, jumping, running) and object movement (throwing, catching, bouncing, dribbling) competencies. A total of 1626 children (838 boys, 788 girls) from kindergarten to 10–11 years in Northern Italy were assessed using the MOBAK tests battery. Descriptive statistics, percentile ranks, z‐scores, and T‐scores were used to establish normative values, while analysis of variance (ANOVA) examined differences by sex and grade level. The normative data and the comparison between sexes highlight developmental trends in motor skills, with raw scores increasing steadily across age groups. Boys consistently outperformed girls in object movement tasks, while girls excelled in self‐movement tasks, particularly in grades 5 and 6. Notably, boys had increasing difficulty in achieving high scores with age, as seen in the changing percentile ranks for the same raw scores. In contrast, girls exhibited more stable development, maintaining or improving percentile ranks over time. This study provides the first normative data for BMC in Italian children, highlighting sex‐based differences and developmental trajectories. The benchmarks offer a vital tool for educators and policymakers to design tailored interventions, supporting children's motor competence and promoting lifelong physical activity.