Orthobiologics is a subset of regenerative medicine, which focuses on treating the musculoskeletal system. The main therapeutics utilized include plateletrich plasma, stem cells, exosomes, and scaffolding matrices. Continuous discoveries and new innovations have led to an increase in both popularity and usage of these therapeutics by various medical and scientific communities. Despite its potential, however, the field is viewed with significant skepticism secondary to poor documentation, a lack of standardization, vague nomenclature, disorganized research protocols, and an absence of a clear understanding of the mechanisms underlying the effects of the various therapeutics. This ambiguity led to a surge in direct-to-consumer marketing by "Stem Cell Clinics", putting patient's health at risk and further delegitimizing the field. These shortcomings led to a recent push for standardization by both professionals and organizations alike; a move that has put Orthobiologics on the path toward becoming a guideline-driven, protocol-based, and researchbacked specialty. And with these rapid changes comes the need for an updated definition of "Orthobiologics", a crucial element of any legitimate and standardized medical field.

Under pressure, when one perceives much is at stake and dependent on one's performance, it is a challenge to manage one's emotions. This is especially true in competitive sports where an important part of being a successful athlete involves developing strategies to regulate one's own emotions [1]. Sports performance today has become increasingly more focused on the psychological aspects of the sport rather than just the physicality of the athlete. Athletes and coaches have recently acknowledged the importance of a pre-performance routine to reach peak performance. In this paper, we will review the literature on emotion regulation and then consider pre-performance routines (PPRs) as an emotion regulation strategy. We will introduce basic definitions and provide supporting research. We will conclude by suggesting future directions on research regarding PPRs. Emotion RegulationEmotion regulation refers to mental and behavioral processes by which we shape and change the trajectory of our emotions. Gross [2] defined emotion regulation as "the processes by which individuals influence the emotions they have, when they have them, and how they experience and express these emotions" (p. 275). He outlined the essential strategies of emotion regulation as follows: (1) situation modification, which involves avoiding or altering situations that typically stimulate to an emotion; (2) attentional deployment, which most commonly involves distraction or redirection away from a situation or aspects of it; (3) cognitive reappraisal or change, which involves altering or reframing how one interprets and thus experiences a situation; (4) response modulation or suppression, which involves any exercise or technique to inhibit an emotion.Research on emotion regulation has largely been focused on the neural mechanisms involved in emotion regulation and comparisons of the different regulation strategies. The research regarding the neural mechanisms in emotion regulation supports the idea of "top down regulation," which involves control of the limbic system (regarded as the system responsible for emotion generation) by the prefrontal cortex, a region implicated in cognitive control [3,4]. Research has shown that cognitive reappraisal increases activity in the prefrontal and cingulate regions (cognitive control centers) and decreases activity in the structures of the limbic system such as the amygdala, insula and striatum (the emotion generation centers [5][6][7]).Research comparing the different strategies has found reappraisal, distraction and suppression to all be effective. However, reappraisal was shown to be significantly more effective at increasing and decreasing neural activity in the prefrontal cortex and limbic system respectively [8,9]. Gross et al. [9] also found that the use of regulation strategies varied among individuals, but that the greater the use of reappraisal, the better the mental health of Mini Review Research & Investigations in Sports Medicine C CRIMSON PUBLISHERS Wings to the Research 244

Objective: Antipsychotics are frequently used for managing both acute and chronic neuropsychiatric disorders. While antipsychotics are known to be associated with increased mortality due to cardiac arrhythmia, there is a lack of consensus on the timing and frequency of electrocardiogram (ECG) monitoring.  The goal of this study was to examine current ECG monitoring practices for adults receiving antipsychotics, specifically during hospital admission. Methods: The study involved a multisite retrospective chart review of adults admitted across 8 hospitals between January 2010 and December 2015 who received antipsychotics during hospitalization. The primary outcome was the presence of an ECG after receiving an antipsychotic. Results: During the study period, there were 26,353 hospitalizations during which adults received antipsychotic medication; the average age of the patients was 61.4 years, 50.1% were female, and 64.8% were white. The average comorbidity score was 1.4 with a median length of stay of 8.3 days. Of the 26,353 patients who were hospitalized, 60.6% (n=15,977) of patients in the sample had an ECG during their hospitalization, and 41.2% (n=10,865) had the ECG following antipsychotic administration. Patients who received a follow-up ECG had a longer length of stay (median: 11.3 d) compared with those who did not receive a follow-up ECG (median: 7.0 d). Follow-up ECGs were more likely among patients who had a history of heart failure [odds ratio (OR)=1.17, 95% confidence interval (CI): 1.06-1.30, P=0.002], who were receiving multiple antipsychotics (OR=1.3, 95% CI: 1.24-1.36, P<0.001) or other QT-prolonging medications (OR=1.09, 95% CI: 1.07-1.1, P<0.001), who were receiving risperidone (OR=1.12, 95% CI: 1.004-1.25, P=0.04), and who showed an increase in QTc duration (OR per 10 ms increase=1.02, 95% CI: 1.01-1.04, P=0.003). Follow-up ECGs were less likely to be administered to patients who were receiving antipsychotics before admission (OR=0.93, 95% CI: 0.87-0.997, P=0.04). Conclusions: This study demonstrated that, in a large health system, ECG monitoring is not routinely practiced for hospitalized patients receiving antipsychotics. Further studies are needed to identify patients who would most benefit from ECG monitoring in the acute care setting.