Under Armour’s sportsmask. Should you order it?

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As WHO and CDC have started recommending the use of masks, many people have started using them. However, for sports and especially for contact sports, the standard masks are relatively inconvenient as they have not been designed for the conditions encountered in sports, neither designed to facilitate fast breathing.

On June 11, Under Armour released a $30 sports mask with anti-microbial treatment that sold out within an hour! Of course, Under Armour plans to make many more and has promised to improve the design based on customer recommendations. It has also announced that it will make the mask available in many different colors and expand the availability in many countries around the world. Under Armour allows customers to preorder the mask which will be ship some time by August 17.

However, before you order this mask, here are some important facts to help you take an informed decision.

When it comes to covid-19, Under Armour’s website is very careful on the statements. In the main page, it writes: “PROTX2 has been shown in laboratory tests to destroy COVID-19, and is being reviewed by the US Environmental Protection Agency (EPA) to confirm the efficacy of the substance as it is applied to the UA SPORTSMASK. Under Armour also has a patent pending on its design and construction of the mask.” However, on the selling page, the information is presented differently: Under a `Product DNA’ bullet list, Under Armour simply mentions “Anti-microbial treatment on the inside layer to help keep mask fresh” and “3-layer system meets WHO recommendation for fabric mask” with the added statement “Non-medical & non-surgical mask, does not protect against viruses”.

It is already clear that if you plan to buy this mask for protection against covid-19, your plan is not going to work. But just in case, here are two statements from medical experts: Dr. John Torres, medical correspondent for NBC News, said “my guess is that [the Under Armour face mask] is as good, but probably not much better, than most triple-layer cloth masks.” Dr. Derek Chu, a clinical scholar of medicine at McMaster University, has also stated to TODAY that “the most effective masks are surgical masks or cotton masks with 12 to 16 layers of fabric.”

Although we have presented the answer to the question we asked, it is worthwhile to understand deeper where the antimicrobial claim comes from. This will reveal some additional issues which you may never have thought of. And they go beyond this mask.

Gyms smell badly. This is a fact that everyone can attest to. In addition, everyone knows the underlying reason: sweat. However, sweat is mostly odorless! Hence, it is not the complete answer. Our body is full of microbes which feed on certain oily compounds in our sweat; this results in the creation of the odors. The final piece of information is our clothes. They absorb the sweat and became a natural breeding habitat for the microbes. Cotton is hydrophilic (water loving); it absorbs the sweat and, if left wet, it can can help bacteria, fungi and mildew thrive. But cotton is actually the good `guy’ in this story. It can be dried and washed and the bacteria will be gone. On the other hand, modern athletic apparel is mostly made of polyester or similar materials which are hydrophobic (water fearing). This means that they repel the water which then evaporates fast. This is why we get a dry feeling. However, these materials are oleophilic (oil loving). The oily compounds from the sweat are absorbed by the clothes and can persist for a very long time since they bind with the material very strongly. Multiple washes are often not enough to remove them and the bacteria find the optimal breeding environment.

Switching to cotton apparel (if not for all, at least for many products) would be a healthier and environmentally friendlier choice. Unfortunately, sports manufacturers exacerbate the problem by stressing to buyers the `dry feeling’ and omitting any hazards, thus selling cheap products at a hefty price. To resolve the odor problem, some manufacturers are turning to PROTX2. (A simple search on Amazon, for example, will show to you some such products.) When added to clothes, PROTX2 inhibits the breeding of the microbes. As seen in the announcement of the mask, this substance is behind Under Armour’s antimicrobial claim.

PROTX2 is a pesticide trademarked by IFTNA Inc. According to the official information PROTX2 is “zinc, zinc pyrithione”. In Under Armour announcement we read that “… PROTX2™, a non-metal anti-microbial technology which inhibits growth of bacteria on the mask.” But zinc is a metal and zinc pyrithione is a coordination complex of zinc.

And PROTX2 is not technology; it is a not-very innocent pesticide. First of all here is some environmental hazards: “This pesticide is toxic to fish. Do not discharge effluent containing this product into lakes, ponds, streams, estuaries, oceans or other waters…” Then, here is some precautionary statements: “Corrosive. Causes irreversible eye damage. May be fatal if swallowed. Harmful if absorbed through skin or inhaled. Do not get in eyes, on skin or on clothing. Do not breathe dust. Users must wear protective eyewear (goggles, safety glasses, or face shield), long sleeved shirt and long pants, socks, chemical resistant gloves and chemical resistant footwear… Remove and wash contaminated clothing and wash clothing before reuse.”

If zinc pyrithione is necessary for medical uses, then we should use it. But we should let the medical community decide for it, not manufacturing corporations. Should we really buy products laced with PROTX2 when not being a necessity? Official precautionary statements direct us to wash contaminated clothes to remove PROTX2 and yet we are willing to pay corporations for such products? Small amounts of the chemical will certainly diffuse to our body. Even if we assume that these products are produced with our safety in mind and absolutely no leaking occurs, eventually all of them will be thrown to the trash and end up as microplastics. Rain will wash away the pesticide to the rivers, lakes and oceans. Not only fish are in danger but all animals and, in particular, us. We drink this water.

Is Wayne Rooney more susceptible to covid-19 than other people?

Wayne Rooney is an English professional soccer player who is considered as one of the best players of his generation. A record goalscorer for Manchester United and the England national team, he played for D.C. United during 2018-19 and he is currently the captain of Derby County FC which plays in the EFL Championship (English 2nd tier).

Leaving aside Rooney’s headlines in the media for various controversies, one of the characteristics that soccer fans have noticed about him during the years he has been a prominent player is his receding hairline. Obviously, we do not mention this to criticize him about his looks. After all, this is something he did not choose and everyone should stand against unjust and prejudicial treatment of other people. Instead, it is our way to draw your attention to a medical study between covid-19 and male-pattern hair loss (MPHL).

Although the female-pattern hair loss (FPHL) is not well understood, more details are known for the MPHL which is believed to be the result of a combination of genetics and the male hormone dihydrotestosterone.

In a letter to the editor (i.e. a quick article) published on April 7, 2020 in the Journal of Cosmetic Dermatology, doctors in Spain reported a possible association in the severeness of covid-19 symptoms and MPHL.

In order to explain the differential effect between men, women and children, the Spanish doctors hypothesized that this outcome is due to the different amounts of androgens in the three populations (i.e. hormones that regulate the development and maintenance of male characteristics). To test their hypothesis, they looked at the male patients hospitalized for covid-19 between March 23 and April 6 at two Spanish tertiary hospitals and tested them for MPHL using the Hamilton-Norwood scale, a scale that assigns a number from 1 to 7 for the stages of MPHL. The result was that only 29% did not have MPHL; 71% had significant MPHL. In fact, 39% had severe MPHL.

Two months have elapsed since the previous study and the link between androgens and covid-19 appears to gain more momentum. Some researchers believe that this relation is so tight that it should be used as an indicator and they have proposed to call it the Gabrin sign, after Dr Frank Gabrin who was the first American doctor to die of covid-19.

Part of the supporting evidence comes from prostate cancer research. The Spanish study links TMPRSS2, a membrane bound enzyme, as a facilitator for covid-19. A study by a team of researchers in Italian and Swiss institutions published online in the Annals of Oncology on May 6, 2020 established that cancer patients have an increased risk to develop covid-19 compared to non-cancer patients. In particular, TMPRSS2 plays an important role for prostate cancer. Hence, many prostate cancer patients receive androgen-deprivation therapies. The study found that such patients are partially protected from the infection hence demonstrating the relation between covid-19 and androgens.

There are many additional studies pointing in the same direction. Obviously, such accumulated evidence can help point the way for possible treatments. However, one open question at the moment is if androgens control TMPRSS2 in the lung as they do in the prostate since lung infection is a key manifestation in covid-19.

We can now answer the question asked with the post’s title: Unfortunately, evidence says that Rooney is at higher risk than many other players. Perhaps, he should think twice before English soccer matches restart on June 17. And you, my dear reader, if you are an avid soccer player who has MPHL, please be careful!

Read the Spanish study: A preliminary observation: Male pattern hair loss among hospitalized COVID-19 patients in Spain — A potential clue to the role of androgens in COVID-19 severity by A. Goren et al.

Read the Italian-Swiss study: Androgen-deprivation therapies for prostate cancer and risk of infection by SARS-CoV-2: a population-based study (N = 4532) by M. Montopoli et al.

Current status of covid-19 in FL

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As all of us are currently debating what our next step should be for playing sports, we thought to present some data related to covid-19 so you can take some informed decisions.

With the reopening of the activities, unfortunately the spreading of the virus continues to follow an upward motion. The two graphs below present data from John Hopkins University for the entire US and the state Florida. The data were downloaded on June 4, 2020.

Confirmed covid-19 cases in the USA.

Florida (with 60,183 confirmed cases, 10,923 hospitalizations, and 2,607 deaths) ranks eighth in the number of cases nationwide after New York, New Jersey, Illinois, California, Massachusetts, Pennsylvania, and Texas. Unfortunately, there was no data on the number of recovered people; so it is not clear if every case is still active.

Confirmed covid-19 cases in the state of Florida.

For those of us who live in Orange County, FL the curve is similar. Orange County has 2,169 confirmed cases and ranks fifth in the number of cases after Maimi-Dade, Broward, Palm Beach and Hillsborough counties. Especially worrisome for Orange County is the median age which has fluctuated between 44 and 48 year old. That is, half of all confirmed cases are people younger than 44-48 years old.

Of particular concern for the state of Florida is the fast spreading of the virus in Latin America due to the strong connection of Florida’s population to countries from Latin America and since there appears not to be any travel restrictions currently. Worldwide, Brazil is already the second country after USA in confirmed cases (584,0161 vs. 1,870,156) with all indicators showing that it rises too fast. In addition, the cases in Peru and Chile are also increasing very fast (183,198 and 118,292 confirmed cases respectively).

Finally, as an important additional remark, we should report the following new finding from a medical study: Having type blood A appears to increase the chances to need oxygen or a ventilator by 50%. Hence, your blood type is something else that you may need to take into account before you start socializing and/or playing soccer again.

Episkyros is always on the side of families and bases all decisions on scientific data. We are currently holding our activities until the curves have started their downward motion. Those of you who would like to plan a more secure season 2020-2021 are encouraged to contact us at EpiskyrosInfo@gmail.com.

Spread of covid-19 during soccer matches

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Any person who is involved in a contact sport is currently in a state of uncertainty as data about the behavior of covid-19 are still unavailable. The scientific community is feverishly working to produce such data.

If you have asked “what are the chances to get infected by playing soccer?”, you are not alone. This question is in the minds of every player (pro or otherwise) and every organization (again, pro or otherwise). A paper providing some data towards the answer of this question has appeared in the preprint server for health sciences.

The paper’s authors used data from 14 matches of the Danish Superliga. They assumed a single infected player and they defined the Danger Zone (DZ) as a circular area of radius 1.5 meters. Then, they used data from GPS trackers and calculated the time each of the remaining players spent inside the DZ. In addition, they had to add some reasonable assumptions about the effect on a healthy player passing through an area previously occupied by the infected player. They quantified the final result for each player with an exposure score which can be converted to an exposure time.

The conclusion of the paper is that the average exposure time for each player is 1 minute and 28 seconds. However, there is a big variation to actual exposure time from zero to as much as 15 minutes depending on position and tasks performed in the pitch. In general, strikers are at risk the most and goalkeepers the least.

Given the present understanding of the virus, it is not clear what exactly the previous statements imply. We only know that the longer the exposure, the greater the chances to get infected and the higher the severity of the illness. But what is long and short exposure, as well as intensity of exposure is still unknown.

The study has also certain inherent limitations. First of all, the assumptions introduced for the calculation are based on educated guesses and not accepted medical standards. The latter will be the outcome of the current research activity and will become available only in the future. Then, the study takes into account only one infected player. However, more may exist. The authors state that for more players the effect is linear (i.e. just multiply by the number of players). However, this statement needs a thorough checking.

Finally, the study limits itself only to the `risk through proximity’ and ignores transmission through other mechanisms, for example through physical contact of the players or transmission through contact with a third object. Perhaps the virus can pass to the clothes of a healthy player even during a brief exposure and later he/she can get infected after touching his/her clothes. Or a healthy player may get infected through long distance after the virus transfers to the ball and from there to the player.

As a final remark, players in youth leagues do not have the same mobility as pro players. Their games also last slightly less time. Therefore, the exposure will be less, whatever that means.

Read the actual paper: Spread of virus during soccer matches by N.S. Knudsen, M.M.D. Thomasen, T.B. Andersen.

Curated soccer-related playlists on Apple music

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If you like music and you wish to listen some soccer related songs, Episkyros is now publishing curated playlists on Apple music. We save you the time to search and comb the vast library of Apple music for the songs you would enjoy.

To find the playlists, just go to your Apple music app and search for Episkyros. The actual location is https://music.apple.com/profile/episkyrosfc.

Currently, there are four playlists: a playlist on UEFA Champions League, a playlist on FIFA World Cup, a playlist on Pele and Maradona and a playlist with songs from Greek soccer.

Additional playlists will be added on a regular basis. The title of the playlist will always be associated with the focus of the playlist. You can see the songs included in each playlist by clicking on that particular playlist. For example, below is shown a screenshot of the UEFA Champions League playlist.

As Apple music adds and deletes songs from its library, these playlists will be updated accordingly.

We hope you enjoy our playlists. We will always be glad to hear comments and suggestions on them.

As a final comment, we would like to remind you that some of the hip-hop lyrics contain explicit language that may not be appropriate for younger listeners. If you are concerned about this, please pay attention to Apple’s special indicators; you can always turn off explicit content by using the parental controls of your device. (If you are not sure how to do this, visit Apple’s online support center for directions.)

Covid-19, Soccer and Arthur C. Clarke.

Our life has certainly changed during the past month. Activities that we were considering as automatic (such as playing and watching soccer) are not there any more. We certainly appreciate them much more now and we wish we had them back. The question in everyone’s mind is `Is it worth?’ Unfortunately, there is too much misinformation spreading and, sometimes, it may feel hard to decide what we should believe and what we should reject. Episkyros is founded on true scientific principles for all aspects of its activities; it is committed to disseminate precise and accurate information. Hence for those of you who may want a little more reliable information about the Covid-19 spreading and understand why all countries around the world have stopped all sports activities (and not only them), the following article does a great job in summarizing all known data and knowledge: Coronavirus: The Hammer and the Dance.

However, if you already had too much reading on covid-19 and you wish something lighter and more amusing here is a suggestion. Arthur C. Clarke was a British sci-fi writer who received many awards for his stories. He is best known as the cowriter of the screenplay of the high-grossing film `2001: A Space Odyssey‘ which has become one of the most influential films Hollywood has ever produced.

In 1962, Clarke published a collection of short stories entitled `Tales of Ten Worlds.’ Among them, the story `A Slight Case of Sunstroke‘ is of interest to every passionate soccer fan who has felt that his/her team has been treated unfairly by referees. It is also a cautionary tale for crooked referees who underestimate the wrath of the fans. And a great reading for kids excited about science, looking for new ways to apply it! (Although, in this case, the application is not well intended!)

We will not spoil the fun for you. If you are curious to know what is about, listen to the story:

The story `A Slight Case of Sunstroke‘ starts at 4:51:03. If the audiobook does not automatically start at that place, please advance the player. Of course, you can always enjoy the other stories too.

Free practice on Wednesday, September 25

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Our next free practices have been scheduled for

WEDNESDAY,  SEPTEMBER 25, 2019:  6.30-8.00 p.m.

WEDNESDAY, OCTOBER 2, 2019: 6.30-8.00 p.m.

Both practices will take place at the

Arcadia Acres Park, 7768 Lady Frances Way, Orlando, FL 32807.

If you would like to participate and you have not registered,  please register using the registration for free practices form. It is quick. No obligation. No commitment.

Soccer is becoming boring!

An important element for soccer’s vast popularity is its unpredictability. Since the goal is so rare, surprises due to many different factors can happen. Ajax’s successful run in the last Champions League to reach the semifinals was a welcome change from the previous years. Only the top clubs from the top four European leagues usually reach the quarter finals with Portugal to be the only country from the other leagues to have one of its teams reach the later stages. Before Ajax, there had not been a Dutch representative at quarter finals since 2007.

In a paper that was posted on the Cornell archives on August 23, 2019,  Victor Martins Maimone of Oxford University and Taha Yaserri of the Alan Turing Institute in London looked at the predictability of the football during the last 26 years. In particular, they looked at the matches of 11 major European leagues (Belgium, England, France, Germany, Greece, Italy, Netherlands, Portugal, Scotland, Spain, Turkey) which had a winner and they checked if one could establish the winner using the  teams’ performances of the previous games.  To avoid  the obvious limitation arising from the fact that the set of previous teams is different for each team, the two researchers established  a directed network of matches and created a fair weighting system to establish the probability of winning the next match. Using their rules, they established that the predictability has increased over the years in seven leagues (England, France, Germany, Netherlands, Portugal, Scotland and Spain) and has remained almost stable in two leagues (Belgium and Italy). In the remaining two leagues (Greece and Turkey), the predictability was high in the past, then dropped and in recent years there is an increasing trend.  [Looking at the data, my personal view is that the curve of the Italian league follows the same pattern as that of the Greek league.]

The data also demonstrated that, although the home advantage still exists, it decreases over time for all leagues.

Finally, the trends of predictability are increasing very fast for the richer leagues (England, Germany, Spain).  [Why the Italian league (which completes the top four leagues)  does not follow the same pattern is a curiosity that deserves to be studied.]  This is something we all know through our experience: Richer clubs win games with greater frequency and we are not surprised when they do. To establish this correlation between predictability and influx of money, the researchers used the so-called Gini coefficient which is a way economists use to measure wealth inequality. The result is as expected. To say it in the words of the researchers: “There is a high correlation between predictability in a football league and inequality amongst teams playing in that league, uncovering evidence in favour of the `gentrification of football’ argument.”

Read the full paper “Football is becoming boring; Network analysis of 88 thousands matches in 11 major leagues” at https://arxiv.org/abs/1908.08991

FIFA laws of the game changes

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The FIFA soccer laws, known as the Laws of the Game, are a set of 17 rules that every soccer club and organization follows. The rules are regulated (not by FIFA if you thought so) but by the Internation Football Association Board (IFAB). IFAB, which became an independent association in 2014, is the true guardian of the Laws of the Game.

FIFA is one of the voting members but not the only one. The four British associations (England, Scotland, Wales and Northern Ireland) are also voting members. During voting, FIFA has four votes and each British association one vote. To pass a motion three-quarters majority is required.

Every year, during the spring Anual General Meeting of IFAB the changes of the Laws of the Game which will take effect in the following season (starting June 1) are announced. Most often the changes are improvement of language or refinement of terms to remove ambiguities. However, sometimes the changes introduced are really serious game changers.

It appears that some of the changes that were introduced this year will probably have a serious effect on the game. Let’s review them.

Handballs: In the current form of the laws, an accidental (unintentional) handball by an attacking player that results in a goal or creates a goal-scoring opportunity allows the goal to count or the game to continue. In the new version of the laws, the referee must award a free kick to the defending team.

Penalties: The current rules allow goalkeepers during a penalty to stand behind the goal line. This helps them to start a forward motion before the kick is taken, enabling them to move forward a bigger distance as the ball approaches the goalpost and hence close down a bigger fraction of the exposed area. Also the current rules, do not forbid a goalkeeper to shake the goalpost as a way to intimidate the kicker. The new rules require that the goalkeeper has part of one foot on the goal line and that the posts, crossbar, and nets are not moving during the kick.

Substitutions: The current laws have no requirement at which place a substituted player must exit the pitch. As a result, this is used as a delay mechanism with many players exiting at the halfway line as slowly as possible. The new rules require that the player exits the field at the nearest point of the touchline or goal line.

Walls: The current laws allow offensive players to interfere with the wall of the defensive team during a free kick. The new laws require that all offensive players are at least one meter away.

Goalkicks: The current form of the rules require that a defender cannot play the ball after a goalkick unless it has exited the penalty area. The new laws allow him/her to play it inside the penalty area. Offensive players must stay outside the area but once the ball is kicked they can challenge it.

There are some additional changes (such as allowing referees to show cards to team officials, introduce cooling breaks of 3 minutes versus drinks breaks of 1 minute, changing the rules of the dropped ball, etc) but we predict that it is the previous five changes will make a big impact. (Download the official IFAB document to read all changes.) Among all changes, we have mixed feelings for the penalty and wall changes since they interfere with tactical decisions. The coaches and players should have plans on how to act during these situations. It should not be IFAB who helps one of the teams; it should be their plans.

What Sunscreen are you using?

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Soccer is an outdoor sport. Therefore, soccer players are subject to all environmental conditions. Most importantly, soccer players have to put up with the sun. The sun’s ultraviolet (UV) radiation is very beneficial for kids and adults. However, excessive amounts of UV radiation can have harmful effects. For this reason protection from the UV radation is strongly recommended. For soccer players who cannot be under shade and cannot adjust their clothing (which is subject to strict requirements),  the protection comes from the application of sunscreens.

Sunscreens come in two kinds: physical (which are based on natural minerals) and chemical (which are based on the advances of nanoscience). The former works as a `mirror’ which reflects the UV radiation; the latter as an absorber converting it to non-harmful radiation (heat).

Infographic about sunscreens by the American Academy of Dermatology
Infographic about sunscreens by the American Academy of Dermatology.

During the past decades the use of sunscreens has skyrocketed. In particular, the vast majority of people are using chemical sunscreens since physical sunscreens create a white layer on the skin surface which many find unattractive. FDA classifies the physical sunscreens as safe.  However, it has expressed a concern for chemical sunscreens. Simply said, there is not enough research on the effects of the chemical ingredients on the human body.  Even more, current data point out that people should use chemical sunscreens with caution and suspicion. In the following, we report some of these data.

It is known that oxybenzone (which is in two-thirds of all chemical sunscreens) is the most common cause of contact allergies. A 10-year study (from 2001 to 2010) found that 70% of people had a positive patch test when exposed to it (see https://www.ncbi.nlm.nih.gov/pubmed/23857015).

In 2008, the US Centers for Disease Control and Prevention analyzed urine samples collected by a government study and found oxybenzone in 97% of the samples. Another analysis of breast milk samples found oxybenzone or other sunscreen chemicals in 85% of the samples (see https://doi.org/10.2533/chimia.2008.345).

Other studies have indicated:  a possible connection between oxybenzone and lower testosterone levels in adolescent boys (see https://ehp.niehs.nih.gov/doi/10.1289/ehp150); hormone changes in men (see https://www.ncbi.nlm.nih.gov/pubmed/15191542);  shorter pregnancies and disrupted birth weights in babies (see https://doi.org/10.1016/j.reprotox.2017.08.015); disruptions of endocrine systems (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997468/).

A recently released study (see https://jamanetwork.com/journals/jama/article-abstract/2733085) on the most common chemical incredients of avobenzone, oxybenzone, octocrylene, and ecamsule found that it takes only a day of use for the ingredients to enter the bloondstream at levels which are high enough. It also found that their concentration increased as the use increased and, finally, the chemicals remained in the body one day after the sunscreen use had stopped.

In addition to possible human physiological effects, oxybenzone and octinoxate  cause coral bleaching and are dangerous to marine ecosystems.  Hawaii and Key West, FL  recently banned sunscreens containing them.

As a result of the elevated concern, in February, the FDA called manufacturers to do safety investigations of 12 commonly used sunscreen chemicals.

Episkyros, LLC  has a deep commitment to natural and organic practices as a way to protect the youth. Hence, given the current state of knowledge, we side with The Environment Working Group which recommends choosing a mineral sunscreen containing titanium dioxide and zinc oxide when possible.