The repair of lower leg defects, not amenable toprimary closure, may be challenging, since the skinat this level is scarcely elastic and difficult to mobilize.Local skin flaps are generally utilized only to restoremoderately sized losses, whereas grafting becomesa realistic choice in presence of larger wounds.We present the case of a 70-year-old man with awide defect on his right leg following the surgicalexcision of a squamous cell carcinoma. The woundwas successfully closed with a combination of threehatchet flaps. The various steps of the procedure andthe subsequent outcome are illustrated. Our choiceproved to be an easy, time-sparing, but effectivereconstructive solution for a large skin defectinvolving the leg.

Objectives

Recent reports have demonstrated a risk of concussion and subconcussive head impacts in collegiate varsity and international elite water polo. We sought to characterize patterns of head impact exposure at the collegiate club level of water polo.

Design

Prospective cohort study.

Methods

Head impact sensors (SIM-G, Triax Technologies) were worn by men's (n=16) and women's (n=15) collegiate club water polo players during 11 games. Peak linear acceleration (PLA) and peak rotational acceleration (PRA) of head impacts were recorded by the sensors. Two streams of competition video were used to verify and describe the nature of head impacts.

Results

Men's players sustained 52 verified head impacts of magnitude 39.7±16.3g PLA and 5.2±3.2 krad/s² PRA, and women's players sustained 43 verified head impacts of magnitude 33.7±12.6g PLA and 4.0±2.8krad/s² PRA. Impacts sustained by men had greater PLA than those sustained by women (p=.045). Athletes were impacted most frequently at the offensive center position, to the back of the head, and by an opponent's torso or limb.

Conclusions

Our cohort of male and female athletes sustained relatively infrequent head impacts during water polo competitions played at the collegiate club level. The amount of head impact exposure in our cohort was dependent on player position, with offensive centers prone to sustaining the most impacts. Head impact sensors are subject to large amounts of false positives and should be used in conjunction with video recordings to verify the validity of impact data.

Blood-based biomarkers of brain injury may be useful for monitoring brain health in athletes at risk for concussions. Two putative biomarkers of sport-related concussion, neurofilament light (NfL), an axonal structural protein, and S100 calcium-binding protein beta (S100B), an astrocyte-derived protein, were measured in saliva, a biofluid which can be sampled in an athletic setting without the risks and burdens associated with blood sampled by venipuncture. Samples were collected from men's and women's collegiate water polo players (n = 65) before and after a competitive tournament. Head impacts were measured using sensors previously evaluated for use in water polo, and video recordings were independently reviewed for the purpose of validating impacts recorded by the sensors. Athletes sustained a total of 107 head impacts, all of which were asymptomatic (i.e., no athlete was diagnosed with a concussion or more serious). Post-tournament salivary NfL was directly associated with head impact frequency (RR = 1.151, p = 0.025) and cumulative head impact magnitude (RR = 1.008, p = 0.014), while controlling for baseline salivary NfL. Change in S100B was not associated with head impact exposure (RR < 1.001, p > 0.483). These patterns suggest that repeated head impacts may cause axonal injury, even in asymptomatic athletes.

Vertical rainfall profile retrieval based on reflectivity data collected by spaceborne rain radars can be improved through the techniques that exploit an estimation of the sea surface Normalised Radar Cross Section (NRCS) as an additional information. However, errors that can currently be made in predicting the sea surface NRCS may significantly affect their performance. Therefore, in this paper we first address the problem to evaluate the NCRS of the sea surface perturbed by rain, when observed at nadir. For this purpose, the dominant effect of ring waves generated by rainfall is considered. The joint effect of wind is also considered. The proposed model is based on the Full Wave Model (FWM) theory. Some comparisons are made with an alternative, less flexible model based on the Integral Equation Model (IEM) theory, and partial comparisons are also made with experimental data, which authorize to consider the proposed model well grounded and exploitable for application. Then, we show that the model can be usefully exploited to improve rainfall rate vertical profile retrieval over the sea surface, in the case of nadir looking, single frequency radars.

A growing body of evidence suggests that chronic, sport-related head impact exposure can impair brain functional integration and brain structure and function. Evidence of a robust inverse relationship between the frequency and magnitude of repeated head impacts and disturbed brain network function is needed to strengthen an argument for causality. In pursuing such a relationship, we used cap-worn inertial sensors to measure the frequency and magnitude of head impacts sustained by eighteen intercollegiate water polo athletes monitored over a single season of play. Participants were evaluated before and after the season using computerized cognitive tests of inhibitory control and resting electroencephalography. Greater head impact exposure was associated with increased phase synchrony [r (16) > 0.626, p < 0.03 corrected], global efficiency [r (16) > 0.601, p < 0.04 corrected], and mean clustering coefficient [r (16) > 0.625, p < 0.03 corrected] in the functional networks formed by slow-wave (delta, theta) oscillations. Head impact exposure was not associated with changes in performance on the inhibitory control tasks. However, those with the greatest impact exposure showed an association between changes in resting-state connectivity and a dissociation between performance on the tasks after the season [r (16) = 0.481, p = 0.043] that could also be attributed to increased slow-wave synchrony [F (4, 135) = 113.546, p < 0.001]. Collectively, our results suggest that athletes sustaining the greatest head impact exposure exhibited changes in whole-brain functional connectivity that were associated with altered information processing and inhibitory control.