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Frontiers in Psychology 2022This study aimed to synthesize literature data on male judo combat time in international competitions between 2010 and 2019. The search was carried out from May 8th to...
This study aimed to synthesize literature data on male judo combat time in international competitions between 2010 and 2019. The search was carried out from May 8th to June 11th, 2021, in electronic databases using the following keywords: ("technical-tactical" OR "time motion" OR "combat time") AND ("judo" OR "combat sports" OR "martial arts"). After the selection process, 8 articles were included in the systematic review and 7 in the meta-analysis. These studies analyzed 2,562 international male judo combats over the years 2010-2019. We observed that the average male judo combat time changed (2010 = 202.8; 2011-2012 = 304.8; 2016 = 237.4; 2018-2019 = 189.8 s) after each rule change (2010, 2013, 2017, and 2018). There was a significant difference between combats that ended up to the regular time and those that needed overtime (Golden Score: 2013 = 3% vs. 2018-2019 = 21%; = 0.03). There were differences between 60 kg ( ≤ 0.019) and + 100 kg ( ≤ 0.04) categories and the others in 2011-2012. However, no significant difference was found between the combat time by weight division after the 2017 rule changes, although there are still differences in relation to the end of the combats ( < 0.001). There were significant changes in the male judo combat time with each rule change (2010, 2013, 2017, and 2018), and the data from the included studies point to a trend of homogeneity in the combat time spent between the weight divisions over the years, and an increase in the occurrence of Golden Score. More studies need to be carried out to identify the new temporal behaviors of athletes.
PubMed: 35369231
DOI: 10.3389/fpsyg.2022.817210 -
The Cochrane Database of Systematic... May 2010Sleepiness leads to a deterioration in performance and attention, and is associated with an increased risk of injury. Jet lag and shift work disorder are circadian... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Sleepiness leads to a deterioration in performance and attention, and is associated with an increased risk of injury. Jet lag and shift work disorder are circadian rhythm sleep disorders which result in sleepiness and can elevate injury risk. They create a need for individuals to operate at times which are different to those dictated by their circadian rhythms. Consequently there is also a need for interventions to help ensure that these persons can do so safely. Caffeine has a potential role in promoting alertness during times of desired wakefulness in persons with jet lag or shift work disorder, however its effects on injury and error are unclear.
OBJECTIVES
To assess the effects of caffeine for preventing injuries caused by impaired alertness in persons with jet lag or shift work disorder.
SEARCH STRATEGY
We searched the Cochrane Injuries Group Specialised Register, CENTRAL (The Cochrane Library), MEDLINE, EMBASE, PsycINFO, CINAHL, TRANSPORT (to July 2008); and PubMed databases (to April 2010). We also searched the Internet and checked reference lists of relevant papers.
SELECTION CRITERIA
Randomised controlled trials investigating the effects of caffeine on injury, error or cognitive performance in people with jet lag or shift work disorder.
DATA COLLECTION AND ANALYSIS
Two authors independently screened search results and assessed full texts for inclusion. Data were extracted and risk of bias was assessed. Estimates of treatment effect (odds ratio and standardised mean difference (SMD)) and 95% confidence intervals (CI) were calculated and pooled using the fixed-effect model.
MAIN RESULTS
Thirteen trials were included. None measured an injury outcome. Two trials measured error, and the remaining trials used neuropsychological tests to assess cognitive performance. The trials assessing the impact on errors found that caffeine significantly reduced the number of errors compared to placebo. The pooled effect estimates on performance by cognitive domain suggest that, when compared to placebo, caffeine improved concept formation and reasoning (SMD -0.41; 95% CI -1.04 to 0.23), memory (SMD -1.08; 95% CI -2.07 to -0.09), orientation and attention (SMD -0.55; 95% CI -0.83 to -0.27) and perception (SMD -0.77; 95% CI -1.73 to 0.20); although there was no beneficial effect on verbal functioning and language skills (SMD 0.18; 95% CI -0.50 to 0.87). One trial comparing the effects of caffeine with a nap found that there were significantly less errors made in the caffeine group. Other trials comparing caffeine with other active interventions (for example nap, bright light, modafinil) found no significant differences. There is a high risk of bias for the adequacy of allocation concealment and presence of selective outcome reporting amongst the trials.
AUTHORS' CONCLUSIONS
Caffeine may be an effective intervention for improving performance in shift workers however, there are no trials from which we can assess its effect on injuries. The results largely originate from studies involving young participants under simulated conditions, and the extent to which the findings are generalisable to older workers and real world shift work is unclear. Based on the current evidence, there is no reason for healthy individuals who already use caffeine within recommended levels to improve their alertness to stop doing so. The assessment of the relative effects of caffeine to other potential countermeasures should be a focus of future research.
Topics: Accidents, Occupational; Caffeine; Central Nervous System Stimulants; Cognition Disorders; Humans; Neuropsychological Tests; Psychomotor Performance; Randomized Controlled Trials as Topic; Sleep Disorders, Circadian Rhythm; Work Schedule Tolerance
PubMed: 20464765
DOI: 10.1002/14651858.CD008508 -
BMC Pharmacology & Toxicology Nov 2019As a new generation antihistamine, fexofenadine has been widely used in allergic diseases. However, there is still a lack of collective evidence regarding the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
As a new generation antihistamine, fexofenadine has been widely used in allergic diseases. However, there is still a lack of collective evidence regarding the antihistamine effects and safety profiles of fexofenadine relative to other antihistamine drugs and placebo. Therefore, we aimed to systematically evaluate the antihistamine effects and safety of fexofenadine.
METHODS
An electronic literature search of randomized controlled trials (RCTs) was performed using Embase, Cochrane and PubMed from establishment to January 1st, 2018. RCTs comparing the antihistamine effects or safety (adverse events, sedative effects, and cognitive/psychomotor function) of fexofenadine with either other antihistamines or placebo for healthy subjects and patients with allergy were selected.
RESULTS
Fifty-one studies of 14,551 participants met the inclusion criteria. When compared with the first-generation antihistamines, fexofenadine produced significantly lower adverse events frequency (OR = 0.446; 95% CI: 0.214 to 0.929, P = 0.031), significantly lower sedative effects frequency (OR = 0.265; 95% CI: 0.072 to 0.976, P = 0.046) and significantly less change of all cognitive/psychomotor function. When compared with the second-generation antihistamines, fexofenadine produced significantly marginal sedative effects (OR = 0.59; 95% CI, 0.38 to 0.93; P = 0.02) and significantly less change of most of the cognitive/psychomotor function. When compared with placebo, fexofenadine produced more significant antihistamine effects.
CONCLUSIONS
Fexofenadine has a positive antihistamine effect, which is probably no worse than the second-generation antihistamines. Fexofenadine probably has a favorable safety profile, which is more likely better than that of the first-generation antihistamines. There is lack of data to support that fexofenadine has a better overall safety profile compared to the second-generation antihistamines, however, some presently available evidence on sedative effects and certain aspects of cognitive/psychomotor function favors fexofenadine. Therefore, fexofenadine may be worthy of recommendation for safety related workers.
Topics: Cognition; Drug-Related Side Effects and Adverse Reactions; Histamine H1 Antagonists, Non-Sedating; Humans; Psychomotor Performance; Randomized Controlled Trials as Topic; Terfenadine
PubMed: 31783781
DOI: 10.1186/s40360-019-0363-1 -
Neuroscience and Biobehavioral Reviews Jul 2021The increasing legal availability of cannabis has important implications for road safety. This systematic review characterised the acute effects of Δ-THC on driving... (Meta-Analysis)
Meta-Analysis Review
The increasing legal availability of cannabis has important implications for road safety. This systematic review characterised the acute effects of Δ-THC on driving performance and driving-related cognitive skills, with a particular focus on the duration of Δ-THC-induced impairment. Eighty publications and 1534 outcomes were reviewed. Several measures of driving performance and driving-related cognitive skills (e.g. lateral control, tracking, divided attention) demonstrated impairment in meta-analyses of "peak" Δ-THC effects (p's<0.05). Multiple meta-regression analyses further found that regular cannabis users experianced less impairment than 'other' (mostly occasional) cannabis users (p = 0.003) and that the magnitude of oral (n = 243 effect estimates [EE]) and inhaled (n = 481 EEs) Δ-THC-induced impairment depended on various factors (dose, post-treatment time interval, the performance domain (skill) assessed) in other cannabis users (p's<0.05). The latter model predicted that most driving-related cognitive skills would 'recover' (Hedges' g=-0.25) within ∼5-hs (and almost all within ∼7-hs) of inhaling 20 mg of Δ-THC; oral Δ-THC-induced impairment may take longer to subside. These results suggest individuals should wait at least 5 -hs following inhaled cannabis use before performing safety-sensitive tasks.
Topics: Attention; Cognitive Dysfunction; Dronabinol; Humans; Marijuana Smoking; Psychomotor Performance
PubMed: 33497784
DOI: 10.1016/j.neubiorev.2021.01.003 -
Clinical Toxicology (Philadelphia, Pa.) Jul 2017To review the evidence for "the Mellanby effect", that is, whether the response to a given blood alcohol concentration (BAC) is more marked when BAC is rising than at... (Review)
Review
OBJECTIVE
To review the evidence for "the Mellanby effect", that is, whether the response to a given blood alcohol concentration (BAC) is more marked when BAC is rising than at the same concentration when BAC is falling.
METHODS
We systematically searched the databases EMBASE, Medline, and Scopus up to and including December 2016 using text words "tolerance", "ascending", "descending" or "Mellanby" with Medline term "exp *alcohol/" or "exp *drinking behavior/" or equivalent. Articles were identified for further examination by title or abstract; full text articles were retained for analysis if they dealt with acute (within dose) alcohol tolerance in human subjects and provided quantitative data on both the ascending and descending parts of the BAC-time curve. Reference lists of identified works were scanned for other potentially relevant material. We extracted and analyzed data on the subjective and objective assessment of alcohol effects.
RESULTS
We identified and screened 386 unique articles, of which 127 full-text articles were assessed; one provided no qualitative results, 62 involved no human study, 25 did not consider acute tolerance within dose, and 13 failed to provide data on both ascending and descending BAC. We extracted data from the 26 remaining articles. The studies were highly heterogeneous. Most were small, examining a total of 770 subjects, of whom 564 received alcohol and were analyzed in groups of median size 10 (range 5-38), sometimes subdivided on the basis of drinking or family history. Subjects were often young white men. Doses of alcohol and rates of administration differed. Performance was assessed by at least 26 different methods, some of which measured many variables. We examined only results of studies which compared results for a given alcohol concentration (C) measured on the ascending limb (C) and the descending limb (C) of the BAC-time curve, whether in paired or parallel-group studies. When subjects were given alcohol in more than one session, we considered results from the first session only. Rating at C was better than at C for some measures, as expected if the Mellanby effect were operating. For example, subjects rated themselves less intoxicated on the descending limb than at the same concentration on the ascending limb in 12/13 trials including 229 subjects that gave statistically significant results. In 9 trials with a total of 139 subjects, mean difference could be calculated; weighted for study size, it was 29% [range 24-74%]. Willingness to drive was significantly greater in 4 of 6 studies including a total of 105 subjects; weighted mean difference increased by 207% [range 79-300%]. By contrast, measure of driving ability in three groups of a total of 200 trials in 57 subjects showed worse performance by a weighted mean of 96% [range 3-566%]. In three trials that tested inhibitory control (cued go or no-go response times), weighted mean performance was 30% [range 14-65%] worse on the descending limb.
CONCLUSIONS
The "Mellanby effect" has been demonstrated for subjective intoxication and willingness to drive, both of which are more affected at a stated ethanol concentration when BAC is rising than at the same concentration when BAC is falling. By contrast, objective measures of skills necessary for safe driving, such as response to inhibitory cues and skills measured on driving simulators, were generally worse on the descending part of the BAC-time curve for the same BAC.
Topics: Alcohol Drinking; Alcoholic Intoxication; Automobile Driving; Cues; Drug Tolerance; Ethanol; Humans; Inhibition, Psychological; Psychomotor Performance; Reaction Time
PubMed: 28277803
DOI: 10.1080/15563650.2017.1296576 -
PloS One 2022Augmented feedback, including that provided using technology, can elicit multifaceted benefits on perceptual-motor learning and performance of sporting skills. However,... (Meta-Analysis)
Meta-Analysis
Augmented feedback, including that provided using technology, can elicit multifaceted benefits on perceptual-motor learning and performance of sporting skills. However, current considerations of the applied value in supporting learning and teaching cricket skill is limited. This systematic review with meta-analysis aimed to understand the role and effectiveness of feedback-involved interventions on skill-based performance outcomes in cricket-related research. Six electronic databases were searched (SPORTDiscus, CINAHL, MEDLINE, Scopus, Web of Science and PsycINFO). Of 8,262 records identified, 11 studies met inclusion criteria; five of which were included in meta-analyses. Given no studies with an isolated feedback intervention-arm were identified, the two meta-analyses explored anticipation-based studies consisting of an intervention that included augmented feedback; positioned with respect to the key motor skill concepts of perception (anticipation accuracy) and action (performance success). Despite results highlighting improved performance outcomes for the feedback-involved intervention groups, with a large effect size for improved anticipation accuracy (Hedge's g = 1.21, 95% CIs [-0.37, 2.78]) and a medium effect size for overall performance success (Hedge's g = 0.55, 95% CIs [-0.39, 1.50]), results were not statistically significant and should be interpreted with caution given the wide confidence intervals. Considering the small number of studies available, in addition to the lack of isolated feedback protocols, further research is warranted to thoroughly explore the impact of augmented feedback on skill-based performance in cricket. Beyond the meta-analyses, the review also explored all included studies from an ecological dynamics perspective; presenting future avenues of research framed around evaluating the applied value of using augmented feedback (mediated with or without technology) for learning and teaching skill in cricket. Trial registration The protocol was preregistered with Open Science Framework (osf.io/384pd).
Topics: Feedback; Learning; Motor Skills; Clinical Competence; Technology
PubMed: 36525446
DOI: 10.1371/journal.pone.0279121 -
Journal of Robotic Surgery Aug 2023Due to its advantages over open surgery and conventional laparoscopy, uptake of robot-assisted surgery has rapidly increased. It is important to know whether the... (Review)
Review
Due to its advantages over open surgery and conventional laparoscopy, uptake of robot-assisted surgery has rapidly increased. It is important to know whether the existing open or laparoscopic skills of robotic novices shorten the robotic surgery learning curve, potentially reducing the amount of training required. This systematic review aims to assess psychomotor skill transfer to the robot in clinical and simulated settings. PubMed, EMBASE, Cochrane Library and Scopus databases were systematically searched in accordance with PRISMA guidelines from inception to August 2021 alongside website searching and citation chaining. Article screening, data extraction and quality assessment were undertaken by two independent reviewers. Outcomes included simulator performance metrics or in the case of clinical studies, peri- and post-operative metrics. Twenty-nine studies met the eligibility criteria. All studies were judged to be at high or moderate overall risk of bias. Results were narratively synthesised due to heterogeneity in study designs and outcome measures. Two of the three studies assessing open surgical skill transfer found evidence of successful skill transfer while nine of twenty-seven studies evaluating laparoscopic skill transfer found no evidence. Skill transfer from both modalities is most apparent when advanced robotic tasks are performed in the initial phase of the learning curve but quality and methodological limitations of the existing literature prevent definitive conclusions. The impact of incorporating laparoscopic simulation into robotic training curricula and on the cost effectiveness of training should be investigated.
Topics: Humans; Robotic Surgical Procedures; Clinical Competence; Robotics; Computer Simulation; Laparoscopy
PubMed: 36418717
DOI: 10.1007/s11701-022-01492-9 -
BMJ Open Sep 2018For physicians in independent practice, we synthesised evidence on the (1) impacts of insufficient sleep and fatigue on health and performance, and patient safety and... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
For physicians in independent practice, we synthesised evidence on the (1) impacts of insufficient sleep and fatigue on health and performance, and patient safety and (2) effectiveness of interventions targeting insufficient sleep and fatigue.
DESIGN
We systematically reviewed online literature. After piloting, one reviewer selected studies by title and abstract; full texts were then reviewed in duplicate. One reviewer extracted data; another verified a random 10% sample. Two reviewers assessed risk of bias. We pooled findings via meta-analysis when appropriate or narratively.
DATA SOURCES
We searched Medline, Embase, PsycINFO, CINAHL and PubMed for published studies in April 2016; Medline was updated in November 2017. We searched Embase for conference proceedings, and hand-searched meeting abstracts, association and foundation websites.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
English or French language primary research studies published from 2000 to 2017 examining the effect of fatigue-related or sleep-related exposures or interventions on any outcome among physicians in independent practice and their patients.
RESULTS
Of 16 154 records identified, we included 47 quantitative studies of variable quality. 28 studies showed associations between fatigue or insufficient sleep and physician health and well-being outcomes. 21 studies showed no association with surgical performance, and mixed findings for psychomotor performance, work performance and medical errors. We pooled data from six cohort studies for patient outcomes. For sleep deprived versus non-sleep deprived surgeons, we found no difference in patient mortality (n=60 436, relative risk (RR) 0.98, 95% CI 0.84 to 1.15, I=0% (p=0.87)) nor postoperative complications (n=60 201, RR 0.99, 95% CI 0.95 to 1.03, I=0% (p=0.45)). The findings for intraoperative complications and length of stay were considerably heterogeneous.
CONCLUSIONS
Fatigue and insufficient sleep may be associated with negative physician health outcomes. Current evidence is inadequate to inform practice recommendations.
Topics: Fatigue; Health Status; Humans; Intraoperative Complications; Length of Stay; Medical Errors; Patient Safety; Physicians; Postoperative Complications; Psychomotor Performance; Sleep Deprivation; Surgical Procedures, Operative; Work Performance
PubMed: 30244211
DOI: 10.1136/bmjopen-2018-021967 -
The Journal of Surgical Research Jan 2024There has been widespread international implementation of duration-hour restrictions to prevent surgical resident burnout and promote patient safety and wellbeing of... (Review)
Review
INTRODUCTION
There has been widespread international implementation of duration-hour restrictions to prevent surgical resident burnout and promote patient safety and wellbeing of doctors. A variety of Extended-Duration Work Shifts (EDWS) have been implemented, with a variety of studies examining the effect of shift systems on both surgical performance and the stress response unestablished in the literature.
METHODS
This was a systematic review evaluating the impact of extended working hours on surgical performance, cognitive impairment, and physiological stress responses. The review used PubMed, Ovid Medline, Embase, and Google Scholar search engines between September and October 2021 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Filters including studies carried out after 2002 and published in the English language were applied.
RESULTS
In total, 30 studies were included for analysis. General surgery was the most commonly studied rotation, with Neurosurgical, Orthopedic, and ear, nose and throat specialties also included. The majority of studies found no difference or a significant improvement in post-EDWS on simulated performance. EDWS appeared to have the greatest impact on physiological stress markers in junior surgical trainees.
CONCLUSIONS
Experience appears to confer a protective element in the postcall period, with preservation of skill demonstrated. More experienced clinicians yielded lower levels of physiological markers of stress, although variability in hierarchical workload should be considered. Heterogeneity of findings across physiological, cognitive, and psychomotor assessments highlights the need for robust research on the optimum shift pattern prevents worker burnout and promotes patient safety. Future research to evaluate correlation between stress, on-call workload, and performance in the postcall period is warranted.
Topics: Humans; Internship and Residency; Specialties, Surgical; Workload; Physicians
PubMed: 37827031
DOI: 10.1016/j.jss.2023.08.024 -
Nutrients Feb 2020The purpose of this paper was to conduct a systematic review and a meta-analysis of studies examining the acute effects of caffeine ingestion on measures of rowing... (Meta-Analysis)
Meta-Analysis
The purpose of this paper was to conduct a systematic review and a meta-analysis of studies examining the acute effects of caffeine ingestion on measures of rowing performance. Crossover and placebo-controlled experiments that investigated the effects of caffeine ingestion on measures of rowing performance were included. The PEDro checklist was used to assess the methodological quality of the included studies. Seven studies of good and excellent methodological quality were included. None of the included studies examined on-water rowing. The majority of studies that were included in the meta-analysis used a 2000m rowing distance with only one using 1000m distance. Results of the main meta-analysis indicated that caffeine enhances performance on a rowing ergometer compared to placebo with a mean difference of -4.1 s (95% confidence interval (CI): -6.4, -1.8 s). These values remained consistent in the analysis in which the study that used a 1000m distance was excluded (mean difference: -4.3 s; 95% CI: -6.9, -1.8 s). We also found a significant increase in mean power (mean difference: 5.7 W; 95% CI: 2.1, 9.3 W) and minute ventilation (mean difference: 3.4 L/min; 95% CI: 1.7, 5.1 L/min) following caffeine ingestion. No significant differences between caffeine and placebo were found for the rating of perceived exertion, oxygen consumption, respiratory exchange ratio, and heart rate. This meta-analysis found that acute caffeine ingestion improves 2000m rowing ergometer performance by ~4 s. Our results support the use of caffeine pre-exercise as an ergogenic aid for rowing performance.
Topics: Caffeine; Exercise; Female; Humans; Male; Oxygen Consumption; Performance-Enhancing Substances; Physical Exertion; Pulmonary Gas Exchange; Ships; Sports; Task Performance and Analysis
PubMed: 32046330
DOI: 10.3390/nu12020434