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Background: The objective of soccer training load (TL) is enhancing players' performance while minimizing the possible negative effects induced by fatigue. In this regard, monitoring workloads and recovery is necessary to avoid overload and injuries. Given the controversial results found in literature, this study aims to better understand the complex relationship between internal training load (IL) by using rating of perceived exertion (RPE), recovery, and availability (i.e., subjective players' readiness status). Methods: In this cross-sectional study, twenty-two-professional soccer players (age: 18.5 ± 0.4 years, height: 177 ± 6 cm, weight: 67 ± 6.7 kg) competing in the U19 Italian Championship were monitored using RPE scale to assess IL, and TreS scale to detect information about recovery and training/match availability during an entire season (2021-2022). Results: Autocorrelation analysis showed a repeated pattern with 7 days lag (weekly microcycle pattern) for all the variables considered (i.e., TL, recovery, and availability). For recovery (r = 0.64, p < 0.001) and availability (r = 0.63, p < 0.001) the best lag for both of them is 1 day. It indicates that recovery and availability are related to the past day value. Moreover, TL was found to be negatively affected by recovery and availability of the current day (lag = 0 day). Cross-correlation analysis indicates that TL is negatively affected by recovery (r = 0.46, p < 0.001) and availability (r = 0.42, p < 0.001) of the current day (lag = 0 day). In particular, lower recovery and availability will result in following lower TL. Furthermore, we found that TL negatively affects recovery (r = 0.52, p < 0.001) and availability (r = 0.39, p < 0.01) of the next day (lag = 1 day). In fact, the higher the TL in a current day is, the lower the recovery and availability in the next day will be. Conclusion: In conclusion, this study highlights that there is a relationship between TL and recovery and that these components influence each other both on the same day and on the next one. The use of RPE and TreS scale to evaluate TL and recovery/availability of players allows practitioners to better adjust and schedule training within the microcycle to enhance performance while reducing injury risk.

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PURPOSE: To investigate the relationship between the training load (TL = rate of perceived exertion × training time) and wellness index (WI) in soccer. METHODS: The WI and TL data were recorded from 28 subelite players (age = 20.9 [2.4] y; height = 181.0 [5.8] cm; body mass = 72.0 [4.4] kg) throughout the 2017/2018 season. Predictive models were constructed using a supervised machine learning method that predicts the WI according to the planned TL. The validity of our predictive model was assessed by comparing the classification's accuracy with the one computed from a baseline that randomly assigns a class to an example by respecting the distribution of classes (B1). RESULTS: A higher TL was reported after the games and during match day (MD)-5 and MD-4, while a higher WI was recorded on the following days (MD-6, MD-4, and MD-3, respectively). A significant correlation was reported between daily TL (TLMDi) and WI measured the day after (WIMDi+1) (r = .72, P < .001). Additionally, a similar weekly pattern seems to be repeating itself throughout the season in both TL and WI. Nevertheless, the higher accuracy of ordinal regression (39% [2%]) compared with the results obtained by baseline B1 (21% [1%]) demonstrated that the machine learning approach used in this study can predict the WI according to the TL performed the day before (MD

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OBJECTIVES: There is sparse information on the safety of early primary discharge from the emergency department (ED) after rule-out of myocardial infarction in suspected acute coronary syndrome (ACS). This prospective registry aimed to confirm randomised study results in patients at low-to-intermediate risk, with a broader spectrum of symptoms, across different institutional standards and with a range of local troponin assays including high-sensitivity cTn (hs-cTn), cardiac troponin (cTn) and point-of-care troponin (POC Tn). DESIGN: Prospective, multicentre European registry. SETTING: 18 emergency departments in nine European countries (Germany, Austria, Switzerland, France, Spain, UK, Turkey, Lithuania and Hungary) PARTICIPANTS: The final study cohort consisted of 2294 patients (57.2% males, median age 57 years) with suspected ACS. INTERVENTIONS: Using the new dual markers strategy, 1477 patients were eligible for direct discharge, which was realised in 974 (42.5%) of patients. MAIN OUTCOME MEASURES: The primary endpoint was all-cause mortality at 30 days. RESULTS: Compared with conventional workup after dual marker measurement, the median length of ED stay was 60 min shorter (228 min, 95% CI: 219 to 239 min vs 288 min, 95% CI: 279 to 300 min) in the primary dual marker strategy (DMS) discharge group. All-cause mortality was 0.1% (95% CI: 0% to 0.6%) in the primary DMS discharge group versus 1.1% (95% CI: 0.6% to 1.8%) in the conventional workup group after dual marker measurement. Conventional workup instead of discharge despite negative DMS biomarkers was observed in 503 patients (21.9%) and associated with higher prevalence of ACS (17.1% vs 0.9%, p<0.001), cardiac diagnoses (55.2% vs 23.5%, p<0.001) and risk factors (p<0.01), but with a similar all-cause mortality of 0.2% (95% CI: 0% to 1.1%) versus primary DMS discharge (p=0.64). CONCLUSIONS: Copeptin on top of cardiac troponin supports safe discharge in patients with chest pain or other symptoms suggestive of ACS under routine conditions with the use of a broad spectrum of local standard POC, conventional and high-sensitivity troponin assays. TRIAL REGISTRATION NUMBER: NCT02490969.

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