Michael F. Bergeron

Background: Cognitive impairment significantly impacts the quality of life in patients with neurodegenerative disorders, including Huntington's disease (HD), Parkinson's disease (PD), and Alzheimer's disease (AD). Objective: This study aims to assess the utility of MemTrax, a contemporary digital continuous recognition task platform originally developed for AD, as an effective tool for revealing cognitive and clinical motor impairments in HD and PD populations as aligned with respective disease staging. Methods: A total of 135 healthy controls, 131 HD, and 212 PD participants were included in the study. MemTrax metrics, recognition accuracy (MTx-%C), response time (MTx-RT), and a composite score (MTx-Cp) were correlated with clinical motor and cognition scales and disease staging. Results: MemTrax metrics showed stage-dependent declines in both HD and PD. In HD, both MTx-%C and MTx-Cp decreased significantly from pre-HD stage to stage 2 ( p < 0.001), showing negative correlations with motor impairment and cognitive scales. In PD, MTx-Cp declined across Hoehn and Yahr stages (1–4, p < 0.001), with strong negative correlations to Unified Parkinson's Disease Rating Scale Part III (UPDRS III) and positive links to Montreal Cognitive Assessment/Mini-Mental State Examination. Additionally, MTx-RT increased with disease progression and correlated positively with UPDRS III, indicating it could assess psychomotor slowing in PD ( p < 0.01). Conclusions: MemTrax effectively captures cognitive-motor decline in HD and PD. The responsivity of MemTrax to the severity of these disorders extends its utility beyond AD, positioning MemTrax performance as a cross-disease digital biomarker for early detection in neurodegenerative diseases.

Adolescence is inherently dynamic and non-linear with asynchronous development of numerous physical, physiological, psychological and social attributes within and between individuals. Accordingly, each athlete’s personal development profile uniquely affects their own athletic development and corresponding performance and risk in sport. Whereas an apt discipline-specific or overall AER is arguably warranted, precisely where those respective limits should be sensibly established cannot be easily defined. What is more, an AER alone (although convenient) would not be sufficient in enabling and maintaining a healthy and sustainable development and participation pathway for those youth athletes attempting to navigate their own Olympic journey.

Objective To describe the evidence pertaining to associations between growth, maturation and injury in elite youth athletes. Design Scoping review. Data sources Electronic databases (SPORTDiscus, Embase, PubMed, MEDLINE and Web of Science) searched on 30 May 2023. Eligibility criteria Original studies published since 2000 using quantitative or qualitative designs investigating associations between growth, maturation and injury in elite youth athletes. Results From an initial 518 titles, 36 full-text articles were evaluated, of which 30 were eligible for final inclusion. Most studies were quantitative and employed prospective designs. Significant heterogeneity was evident across samples and in the operationalisation and measurement of growth, maturation and injury. Injury incidence and burden generally increased with maturity status, although growth-related injuries peaked during the adolescent growth spurt. More rapid growth in stature and of the lower limbs was associated with greater injury incidence and burden. While maturity timing did not show a clear or consistent association with injury, it may contribute to risk and burden due to variations in maturity status. Conclusion Evidence suggests that the processes of growth and maturation contribute to injury risk and burden in elite youth athletes, although the nature of the association varies with injury type. More research investigating the main and interactive effects on growth and maturation on injury is warranted, especially in female athletes and across a greater diversity of sports.

With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psychological and social attributes. These non-concurrent changes within and between individuals are accompanied by irregular and unpredictable threats and impediments. Likewise, the evident age-based criteria and conventional path for those youth athletes deemed eligible candidates for the Olympic Games are not well or consistently defined. Furthermore, the unstructured and largely varying policies and practices across the sporting International Federations specific to youth participation underscore the need to establish a contemporary universal paradigm that would enable elite youth athletes to navigate an individualised healthy pathway to personal, athletic and sport success. First, we reviewed and summarised key challenges facing elite youth athletes and the relevant evidence fundamental to facilitating and supporting central aspects of health and well-being, while empowering safe, sustainable and positive engagement during athletic and personal advancement and competition. Second, we developed and present a modern elite youth athlete model that emphasises a child-centred, practical framework with corresponding guidelines and recommendations to protect health and well-being while safely and favourably managing international sport competition. Our proposed evidence-informed paradigm will enable and support individualised pathways for healthy, well-rounded and sustainable positive engagement while achieving sport success for youth contending or aiming to compete at world-class international sporting events.

Objective The objective of this study is to characterise the key factors that influence positive engagement and desirable developmental outcomes in sport among elite youth athletes by summarising the methods, groups and pertinent topical areas examined in the extant published research. Design Scoping review. Data sources We searched the databases SPORTDiscus, APA PsycINFO, Web of Science and Sports Medicine & Education Index for peer-reviewed, published in English articles that considered the factors influencing positive developmental outcomes for athletes under 18 years competing at a national and/or international level. Results The search returned 549 articles, of which 43 met the inclusion criteria. 16 studies used a qualitative approach, 14 collected quantitative data, 2 adopted mixed methods and 11 were reviews. Seven articles involved athletes competing in absolute skill contexts (ie, against the best athletes of any age) while the majority involved athletes competing in relative skill contexts (ie, against the best in a specific age or developmental group). The studies described the characteristics of the athletes, as well as their training, relationships with others, social and physical environments, and/or their overall developmental pathways. Conclusion Existing research on positive engagement in elite youth sport aligned with and mapped onto established models of positive development in youth sport more generally. Our findings further support that, while certain youth athletes may demonstrate extraordinary performance capabilities, they are still children who benefit from positive engagement prompted and reinforced by developmentally appropriate and supportive activities, relationships and environments.

Background There is increasing recognition of the prevalence and risk factors for mental health symptoms and disorders among adult elite athletes, with less research involving elite youth athletes. This scoping review aimed to characterise the mental health and well-being of elite youth athletes who travel internationally and compete for their sport. Method Four databases were searched in March 2023. Inclusion criteria were studies with elite youth athlete populations (mean age 12–17 years) reporting mental health and well-being outcomes. Data from included studies were charted by outcome, and risk/protective factors identified. Results Searches retrieved 3088 records, of which 33 studies met inclusion criteria, encapsulating data from 5826 athletes (2538 males, 3288 females). The most frequently studied issue was disordered eating (k=16), followed by anxiety (k=7), depression (k=5) and mixed anxiety/depression (k=2). Caseness estimates (a symptom level where mental health treatment is typically indicated) for disordered eating were wide ranging (0%–14% for males; 11%–41% for females), whereas only two studies estimated caseness for depression (7% in a mixed-sex sample; 14% for males, 40% for females) and one for anxiety (8% for males, 28% for females). Common risk factors for mental ill-health included sex, athlete status (compared with non-athletes) and social/relationship factors (with coaches/parents/peers). Contradictory evidence was observed for elite/competition level, which was associated with higher and lower rates of disordered eating. Conclusion Further representative research into the mental health and well-being of elite youth athletes is needed to enhance understanding and guide prevention and intervention measures.

Few previous review articles have focused on the associations between inadequate daily water intake (LOW) or urinary biomarkers of dehydration (_UD; low urine volume or high urine osmolality) and multiple diseases. Accordingly, we conducted manual online searches (47 key words) of the PubMed, Embase, and Google Scholar databases with these inclusion criteria: English language, full-text, peer reviewed, no restriction on research design, and three publications minimum. Initially, 3,903 articles were identified based on their titles and abstracts. Evaluations of full length .pdf versions identified 96 studies that were acceptable for inclusion. We concluded that the evidence is insufficient or conflicting for seven disorders or diseases (i.e. suggesting the need for additional clarifying research) and it is lacking for all-cause mortality. Differential characterizations among women and men have been reported in the results of nine studies involving five diseases. Finally, the evidence for associations of LOW or _UD is strong for both kidney stones and type 2 diabetes with hyperglycemia. This suggests that great public health value (i.e. reduced disease risk) may result from increased daily water intake—a simple and cost-effective dietary modification.

First morning urine (FMU) assessment would be a practical and convenient solution for clinically acceptable detection of underhydration prior to competition/training, and for the general public. Thus, we thus sought to determine the diagnostic accuracy of FMU as a valid indicator of recent (previous 24 hr, 5 days average) hydration practices. For 5 consecutive days and one final morning, 67 healthy women (n = 38) and men (n = 29; age: 20 [1] years, body mass index: 25.9 [5.5]) completed 24-hr diet logs for total water intake (from beverages and foods, absolute and relative to body mass), 24-hr urine and FMU collection (last morning only) for osmolality (Osm), specific gravity (SG), and color (Col), and morning blood sampling for plasma osmolality and copeptin. Correlations determined significance and relationship strength among FMU and all other variables. Area under the receiver operating characteristic curves, sensitivity, specificity, and positive likelihood ratios were employed using previously reported values to indicate underhydration (total water intake < 30 ml/kg, osmolality > 500, and >800 mOsm/kg, specific gravity > 1.017, and copeptin > 6.93 pmol/L). FMU_Osm and FMU_SG were significantly correlated (p < .05) to all variables except the previous 5-day plasma osmolality. FMU_Col was only significantly correlated with other color time intervals and total water intake per gram. FMU_Osm held greatest utility (area under the receiver operating characteristic curve, sensitivity, and specificity >80%) overall, with the best outcome being FMU_Osm indicating a previous 24-hr osmolality threshold of 500 mOsm/kg (FMU_Osm criterion >710 mOsm/kg and positive likelihood ratio = 5.9). With less effort and cost restriction, FMU is a viable metric to assess underhydration.

Whereas global prevalence of doping in youth sport is unclear, case reports reveal the phenomena at the elite level. However, non-doping related harassment and abuse is recognisably widespread. Over 10 000 European athletes reported an alarming prevalence of psychological abuse (65%), physical abuse (44%), neglect (37%), and sexual abuse (non-contact: 35%; contact: 20%) during sport while under age 18.1 The Summer Youth Olympic …

The International Olympic Committee (IOC) Medical Commission recognises this, as do the International Sport Federations. New guidelines to minimise clinical risk and injury surveillance tracking systems have been developed and incorporated.1 But more needs to be done, as evidenced by periodic reports of significant performance limitations and sometimes severe or, albeit rare, near-catastrophic incidents of environment-related illness or injury. Notably, the death of 26-year-old Fran Crippen during an open-water race in Abu Dhabi in 2010 speaks of how extreme conditions can challenge an elite athlete to the point of an eventual devastating outcome. Other swimmers at that event complained of very high air and water temperatures and reportedly experienced significant dehydration, excessive fatigue and disorientation, and some were taken to the hospital.