The International Olympic Committee framework on fairness, inclusion and nondiscrimination on the basis of gender identity and sex variations does not protect fairness for female athletes

The International Olympic Committee (IOC) recently published a framework on fairness, inclusion, and nondiscrimination on the basis of gender identity and sex variations. Although we appreciate the IOC's recognition of the role of sports science and medicine in policy development, we disagree with the assertion that the IOC framework is consistent with existing scientific and medical evidence and question its recommendations for implementation. Testosterone exposure during male development results in physical differences between male and female bodies; this process underpins male athletic advantage in muscle mass, strength and power, and endurance and aerobic capacity. The IOC's "no presumption of advantage" principle disregards this reality. Studies show that transgender women (male-born individuals who identify as women) with suppressed testosterone retain muscle mass, strength, and other physical advantages compared to females; male performance advantage cannot be eliminated with testosterone suppression. The IOC's concept of "meaningful competition" is flawed because fairness of category does not hinge on closely matched performances. The female category ensures fair competition for female athletes by excluding male advantages. Case-by-case testing for transgender women may lead to stigmatization and cannot be robustly managed in practice. We argue that eligibility criteria for female competition must consider male development rather than relying on current testosterone levels. Female athletes should be recognized as the key stakeholders in the consultation and decision-making processes. We urge the IOC to reevaluate the recommendations of their Framework to include a comprehensive understanding of the biological advantages of male development to ensure fairness and safety in female sports.

The Effects of Biofeedback on Performance and Technique of the Boxing Jab

A growing body of research has addressed the application of movement-based biofeedback techniques for improving sports performers’ gross motor skills. Unlike in previous research, we aimed in this study to quantify the effects of this “external” biofeedback on selected performance and technique variables for the boxing jab among both novices and experts. The technical setup included two inertial measurement units linked wirelessly to a video game system with audio output. The units were configured to provide auditory external biofeedback, based on the peak acceleration of the bag (i.e., biofeedback with an external attentional focus). Sixteen participants (8 novices and 8 experts) performed boxing jabs against the bag in blocked phases of biofeedback. When compared to baseline, the acute effects of externally focused biofeedback on peak bag acceleration were possibly positive in both retention phases for novices (d = 0.29; d = 0.41) and likely positive for experts (d = 0.41; d = 0.30), respectively. The experts’ performance improvements were accompanied by substantive increases in trunk rotation, though this was not true for the novices. Thus, technique improvements can be promoted indirectly via externally focused biofeedback, but only when these actions are within the performers’ motor repertoire. Overall, biofeedback via inertial sensors appears to be a potent technique for modifying human movement patterns in both experts and novices. This low-cost technology could be used to support training across sports, rehabilitation and human-computer interactions.

Competitive Performance Effects of Psychological Skill Training for Youth Swimmers

This study assessed the effect of two different psychological methods of skills training-self-talk and goal setting-on the swimming performance of youth swimmers. We allocated a convenience sample of club and county level youth swimmers (N = 49; M_age = 10.8, SD = 1.25) to one of the three groups: self-talk, goal setting, or a control group engaged in no systematic psychological method of skills training. The groups were balanced in terms of competitive performance ability, age, and gender. Participants in the experimental conditions (self-talk and goal setting) completed a 5-week psychological skills intervention program and were measured on pre- and post-200-m swimming time in competition. After controlling for level of engagement in the program, analysis of covariance revealed a significant omnibus effect (p = .006, ηp2  = .20) with post hoc pairwise comparisons using magnitude-based statistics demonstrating that goal setting had a small positive effect compared with self-talk (η²= .40; ± 0.45). Both self-talk (η²= .50; ±0.48) and goal setting (η²= .71; ±0.4) showed a small and moderate positive effect, respectively, relative to the control group. A social validation check confirmed that the swimmers found the intervention to be relevant, beneficial, and meaningful for improving performance. Psychological skills training may be effective in improving youth swimming performance; specific mechanisms underlying these benefits need further exploration.

Relationships Between Flow, Mental Toughness, and Subjective Performance Perception in Various Triathletes

This study examined the relationship between mental toughness (MT), subjectively perceived performance, and dispositional flow in a sample of 114 high-performing ironmen and standard distance triathletes ( M_age = 28.81 years, SD = 3.45) recruited from triathlon clubs. Participants completed the Mental Toughness Questionnaire, Dispositional Flow Scale, and self-rated subjectively perceived performance. Pearson's correlations between these measures revealed a significant, positive relationship between global MT and subjective performance ratings ( r = .62, p < .01) and between global MT and all Dispositional Flow subscales ( r = .67-.81, p < .05). Linear regression analyses found that MT subscales accounted for 64% of the variance in dispositional flow. Subjective performance ratings did not add significantly to the regression model. Overall, these findings suggest that MT may contribute positively to ironman competitors' and triathletes' exertion of the cognitive and emotional control necessary to experience flow and perform better. We discuss these results in the context of ironman and triathlon competitions.

Mental toughness of mixed martial arts athletes at different levels of competition

This study investigated whether mental toughness distinguishes mixed martial arts (MMA) athletes competing at different levels. It was theorized that higher mental toughness would separate those competing at the professional level compared to lower levels. Male MMA competitors (N = 136, M age = 27.1 yr., SD = 4.8) were categorized as amateur, semi-professional, or professional and assessed by questionnaire using the Psychological Performance Inventory-A and the Sports Mental Toughness Questionnaire. There were statistically significant differences between the three groups on mental toughness. The professional group had higher scores compared to semi-professional and amateur groups with regard to confidence, positive cognition, and determination. The findings supported previous work that athletes performing at higher levels have superior mental toughness.

Echocardiographic Assessment of Dyssynchrony for Predicting a Favorable Response to Cardiac Resynchronization Therapy

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The role of external loop regions in serotonin transport. Loop scanning mutagenesis of the serotonin transporter external domain

Chimeric transporters were constructed in which the predicted external loops of the serotonin transporter (SERT) were replaced one at a time with a corresponding sequence from the norepinephrine transporter (NET). All of the chimeric transporters were expressed at levels equal to or greater than those of wild type SERT, but the transport and binding activity of the mutants varied greatly. In particular, mutants in which the NET sequence replaced external loops 4 or 6 of SERT had transport activity 5% or less than that of wild type, and the loop 5 replacement was essentially inactive. In some of these mutants, binding of a high affinity cocaine analog was less affected than transport, suggesting that the mutation had less effect on the initial binding steps in transport than on subsequent conformational changes. The more severely affected mutants also displayed an altered response to Na(+). In contrast to the dramatic reduction in transport and binding, the specificity of ligand binding was essentially unchanged. Chimeric transporters did not gain affinity for dopamine, a NET substrate, or desipramine, an inhibitor, at the expense of affinity for serotonin or paroxetine, a selective SERT inhibitor. The results suggest that external loops are not the primary determinants of substrate and inhibitor binding sites. However, they are not merely passive structures connecting transmembrane segments but rather active elements responsible for maintaining the stability and conformational flexibility of the transporter.

An extracellular loop region of the serotonin transporter may be involved in the translocation mechanism

The serotonin transporter (SERT) is a member of a highly homologous family of proteins responsible for the reuptake of biogenic amines from the synaptic cleft. We took advantage of native restriction sites in SERT to construct a chimeric transporter containing a small (34 amino acid) region of the norepinephrine transporter. The substituted region corresponds to about half of the largest extracellular loop. This chimera transports serotonin very slowly compared to wild type SERT. However, it binds serotonin and the cocaine analog 2beta-carbomethoxy-3beta-(4-[125I]iodophenyl)tropane with a high affinity indistinguishable from wild type. It has the same specificity as wild type SERT for the antidepressants paroxetine and desipramine. The low rate of transport does not appear to be due to poor expression, since the chimeric transporter is expressed at the membrane surface at close to wild type levels as measured by cell surface biotinylation. These observations lead us to conclude that, rather than playing a role in substrate or drug binding, this region of the large extracellular loop may be involved in the conformational changes associated with substrate translocation into the cell.

Preservation of endothelium-dependent vasodilation with low-potassium University of Wisconsin solution

University of Wisconsin solution has provided excellent myocardial preservation. However, the high potassium content of the currently available University of Wisconsin solution has been implicated in coronary artery endothelial damage. We placed 16 neonatal (age 1 to 3 days) Duroc piglet hearts on an isolated nonworking perfusion circuit. Endothelium-dependent and endothelium-independent vasodilation were tested by measuring coronary blood flow after intracoronary infusion of bradykinin (10(-6) mol/L) and nitroprusside (10(-6) mol/L), respectively. In addition, nitric oxide levels were measured after bradykinin infusion. The hearts were then arrested blindly with either a modified University of Wisconsin solution (group 1; n = 8, K+ = 25 mEq/L) or standard University of Wisconsin solution (group 2; n = 8, K+ = 129 mEq/L) by infusion of cardioplegic solution every 20 minutes for a total of 2 hours. After bradykinin infusion, the mean coronary blood flow increased by 237.1% +/- 14.0% of baseline valves before arrest and by 232.8% +/- 16.0% after arrest in group 1 (p = not significant). As in the first group, the mean coronary blood flow in group 2 increased by 231.1% +/- 13.7% before arrest; however, the increase in mean coronary blood flow after arrest was significantly attenuated (163.3% +/- 12.8%, p < 0.01). The loss of endothelium-dependent coronary blood flow response in group 2 correlated with a decreased capacity to release nitric oxide after arrest (prearrest 8.25 +/- 2.30 nmol/min per gram versus postarrest -2.46 +/- 2.29 nmol/min per gram, p < 0.01). Endothelium-independent vasodilatory response revealed no significant difference between groups before and after arrest. These results suggest that the low-potassium University of Wisconsin solution provides superior protection of the endothelium by preserving the endothelium-dependent vasodilatory response to nitric oxide release.

Mutations of keratin 9 in two families with palmoplantar epidermolytic hyperkeratosis

The hereditary palmoplantar keratodermas are a heterogeneous group of diseases unified by thickening of the stratum corneum of the palms and soles with consequent painful fissuring, discomfort on pressure, and resultant disability. One of the histologic patterns underlying palmoplantar hyperkeratosis is that of epidermolytic hyperkeratosis. Because that histologic pattern has been found in its generalized form to be due to keratin gene mutations, we assessed the inheritance of the form localized to the palms and soles. In each of two families studied, the mutant gene causing the disease is linked strongly to the chromosome 17 cluster of genes encoding type I keratins, and mutations are present in the conserved helix initiation region of keratin 9 in affected members of both kindreds. These data, as well as those generated recently by others, indicate that keratin gene mutations may underlie not only the generalized phenotype but also this more localized phenotype of epidermolytic hyperkeratosis and suggest one mechanism by which skin diseases can achieve their characteristic localization.

Evidence against keratin gene mutations in a family with ichthyosis hystrix Curth-Macklin

Ichthyosis hystrix Curth-Macklin is a rare autosomal dominant disease characterized clinically by hyperkeratosis and ultrastructurally by disruption of the keratin intermediate filament network of suprabasal keratinocytes. We have used linkage analysis to test whether a keratin gene mutation might underlie this disease. This analysis excluded the keratin gene loci as the sites for the disease-causing mutation in one affected kindred.

Linkage of the epidermolytic hyperkeratosis phenotype and the region of the type II keratin gene cluster on chromosome 12

Bullous congenital ichthyosiform erythroderma (epidermolytic hyperkeratosis) is a severe, generalized, lifelong disease of the skin. As in epidermolysis bullosa simplex, intraepidermal blisters and clumping of keratin intermediate filaments are characteristic. We report here linkage of the inheritance of this disease to the region of chromosome 12q containing the genes encoding type II keratins. This suggests that keratin gene mutations may underlie this complex hyperproliferative and hyperkeratotic phenotype.