The Patient Symptom Experience After Tisagenlecleucel and Lisocabtagene Maraleucel CAR T-Cell Therapy for Lymphoma.

OBJECTIVES: Chimeric Antigen Receptor (CAR) T-cell treatment is associated with several unique toxicities, and the short-term symptom trajectory in the immediately after therapy is well-documented. However, little is known about patients' long-term symptom experience. The study aimed to elicit the symptom experience of adult patients in remission after CAR T-cell therapy for B cell lymphoma. DATA SOURCES: A qualitative descriptive design with thematic analysis was utilized. Recruitment occurred at a tertiary academic medical center using the following inclusion criteria: adult recipient of CAR T-cell therapy for B-cell lymphoma between 3 and 12 months prior to enrollment, and currently in remission. Semi-structured interviews were conducted, transcripts were inductively coded, and team members met weekly to ensure rigor. The final sample included 10 patients: Seven received tisagenlecleucel and three received lisocabtagene marleucel and were a median of 169 days post-infusion and 65 years of age. CONCLUSIONS: Participants continued to report symptoms, including fatigue, neuropathy, low endurance, insomnia, memory problems, and pain. Most symptoms improved over time. Some symptoms interfered with social activities, work, driving, and physical activity, though participants reported that most symptoms existed prior to CAR T-cell therapy, and overall, found CAR T-cell therapy acceptable. IMPLICATIONS FOR NURSING PRACTICE: Patients in remission after CAR T-cell therapy often continue to experience symptoms. Nurses should continue to assess this growing patient population and determine if patients require additional symptom management or support. Further research is needed to understand long-term symptom trajectory and associations with prior lines of therapy and CAR T-cell therapy.

Currently recommended skin scores correlate highly in the assessment of patients with Juvenile Dermatomyositis (JDM).

BACKGROUND: Juvenile Dermatomyositis (JDM) is a rare, chronic, and life-threatening childhood autoimmune disease. Currently, there are recommended, reliable and validated measurement tools for assessment of skin disease activity in JDM including the Disease Activity Score (skinDAS), Cutaneous Assessment Tool (CAT), and the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI). The Physician's global assessment skin visual analog scale (Skin VAS) is also widely used for skin activity in JDM. For the purpose of comparative international studies, we wanted to compare these tools to the Physician's skin VAS (as a standard) to identify which performs better. OBJECTIVES: We sought to compare the correlations of these scoring tools, and separately assess the responsiveness each tool demonstrates following patient treatment, in order to see if one tool may be preferred. This was determined by assessing how well these tools correlate with each other, and the Physician's skin VAS over time, as well as the responsiveness of each tool after patient treatment. METHODS: Skin scores were recorded at a baseline (first visit after June 1st, 2018) and all follow-up office visits at the Juvenile Dermatomyositis Clinic. Following baseline visits, patients were followed up as clinically indicated. A subset of newly diagnosed patients (inception cohort) was identified. Correlations were assessed at the baseline visit and over time for the whole cohort. The correlations over time were derived using Generalized Estimating Equations (GEEs). Standardized response means with 95% confidence intervals were calculated to test score responsiveness for the nested inception cohort. RESULTS: The skinDAS, CAT and CDASI all correlated highly with each other and with the Physician's skin VAS. The three scoring tools accurately reflected Physician's skin VAS scores over time. In addition, all tools showed moderate to high responsiveness following treatment. CONCLUSION: All studied skin score tools performed well in our study and appear to be useful. Since no tool far outperforms the others, arbitrary consensus will be needed to select a single standard measurement tool for the purposes of efficiency and global comparability.

An Integrative Review of Measures of Spirituality in Experimental Studies of Psilocybin in Serious Illness Populations.

Background: Psilocybin-assisted therapies (PAT) are reemerging as a treatment for complex distress often prompting mystical experiences, enhanced meaning, and spiritual wellbeing. We sought to investigate how measures of spirituality are employed in experimental studies of PAT conducted with seriously ill adults. Methods: We included experimental studies of psilocybin conducted with seriously ill adults, which employed measures that contained spirituality and mysticism concepts within their domains or subdomains. Included studies were peer-reviewed and published in English language (up to December 2021). Results: Seven articles met our inclusion criteria. A total of 12 unique instruments were identified. The most frequently used instruments were the Mystical Experience Questionnaire (MEQ30), the Functional Assessment of Chronic Illness Therapy-Spirituality (FACIT-Sp-12), and the Demoralization Scale (DS-I/II) (used in four studies each), followed by the Persisting Effects Questionnaire (PEQ) (used in three studies). Overall, studies did not consistently define and contextualize spirituality domains and subdomains studied. Conclusions: Despite well-recognized significance of spirituality in PAT, there was considerable heterogeneity in number and types of spirituality measures employed across studies. There also seemed a lack of attention to defining and operationalizing spirituality and its domains and subdomains. This is notable as spirituality and overlapping concepts (eg mystical experiences) contributes substantially to this body of research and patients' therapeutic outcomes. Towards developing more rigorous science of spirituality in PAT research, there is a critical need to evaluate and refine measures of spirituality to enhance their utility and replicability, limit participant burden, and better contextualize spirituality-related findings and outcomes.

Optimizing trilateration estimates for tracking fine-scale movement of wildlife using automated radio telemetry networks.

A major advancement in the use of radio telemetry has been the development of automated radio tracking systems (ARTS), which allow animal movements to be tracked continuously. A new ARTS approach is the use of a network of simple radio receivers (nodes) that collect radio signal strength (RSS) values from animal-borne radio transmitters. However, the use of RSS-based localization methods in wildlife tracking research is new, and analytical approaches critical for determining high-quality location data have lagged behind technological developments. We present an analytical approach to optimize RSS-based localization estimates for a node network designed to track fine-scale animal movements in a localized area. Specifically, we test the application of analytical filters (signal strength, distance among nodes) to data from real and simulated node networks that differ in the density and configuration of nodes. We evaluate how different filters and network configurations (density and regularity of node spacing) may influence the accuracy of RSS-based localization estimates. Overall, the use of signal strength and distance-based filters resulted in a 3- to 9-fold increase in median accuracy of location estimates over unfiltered estimates, with the most stringent filters providing location estimates with a median accuracy ranging from 28 to 73 m depending on the configuration and spacing of the node network. We found that distance filters performed significantly better than RSS filters for networks with evenly spaced nodes, but the advantage diminished when nodes were less uniformly spaced within a network. Our results not only provide analytical approaches to greatly increase the accuracy of RSS-based localization estimates, as well as the computer code to do so, but also provide guidance on how to best configure node networks to maximize the accuracy and capabilities of such systems for wildlife tracking studies.

A roadmap: Social distancing physical activity data collection to protect those with intellectual disabilities.

The novel coronavirus may impact exercise habits of those with intellectual disabilities. Due to the mandated discontinuation of face-to-face research, investigators must adapt projects to protect all involved while collecting objective physical activity metrics. This brief report outlines a modification process of research methods to adhere to social distancing mandates present during COVID-19. Actions taken included electronic consent and assent forms, an electronic survey, and mailing an accelerometer with included instructions. The amended research methods were implemented without risk for virus transmission or undue burden on the research team, participant, or caregiver. Recruitment was likely impacted by the coronavirus-mediated quarantine, plausibly resulting in bias. Objective physical activity data collection can be sufficiently modified to protect those with intellectual disabilities and investigators. Future research designs may require greater participant incentives and the creation of in-home participation.

Effect of somatic maturity on the aerobic and anaerobic adaptations to sprint interval training.

The purpose of this study was to assess the maturity-related differences in the aerobic and anaerobic adaptations to sprint interval training (SIT) among youth male athletes. Twenty-seven youth male athletes were assessed for years from peak height velocity (PHV) and classified into prepubescent (PRE, n = 7, years from PHV = -2.21 ± 0.47 years), peripubescent (PERI, n = 10, years from PHV = 0.25 ± 0.88 years), and postpubescent (POST, n = 10, years from PHV = 2.81 ± 0.50 years) groups based on their years from estimated peak height velocity. Participants completed a ramp exercise protocol on a cycle ergometer to determine maximal aerobic power, maximal oxygen consumption (VO2peak ), and fatigue thresholds. Following baseline, all participants completed a 4-week SIT program that consisted of eight total training sessions. During each session, participants completed repeated 20-s sprints on a cycle ergometer against a resistance of 7.5% of body mass. The number of sprints per sessions increased from four in session 1 to seven in session 7, with four sprints in session 8. Peak and mean power from sessions 1 and 8 were recorded. All participants completed a post-testing ramp exercise protocol that mirrored baseline. Maximal aerobic power increased (p < .001) across all groups from baseline (212.61 ± 57.45 W) to post-testing (223.24 ± 58.90 W); however, VO2peak only increased in POST (3.31 ± 0.43 to 3.54 ± 0.43 L min-1 , p = .003). Similarly, GET, VT, and RCP increased in POST, with no changes in PRE or PERI. In terms of anaerobic performance, PERI and POST had significant increases in peak and mean power. POST improved aerobic and anaerobic performance following SIT, while PERI only experienced improvements in anaerobic performance. Conversely, PRE had no changes in aerobic or anaerobic performance. The adaptations to SIT appear to be influenced by the somatic maturity status.

Comparison of sustained-release and rapid-release ß-alanine formulations on changes in skeletal muscle carnosine and histidine content and isometric performance following a muscle-damaging protocol.

ß-alanine supplementation increases muscle carnosine content and improves anaerobic exercise performance by enhancing intracellular buffering capacity. ß-alanine ingestion in its traditional rapid-release formulation (RR) is associated with the symptoms of paresthesia. A sustained-release formulation (SR) of ß-alanine has been shown to circumvent paresthesia and extend the period of supply to muscle for carnosine synthesis. The purpose of this investigation was to compare 28 days of SR and RR formulations of ß-alanine (6 g day-1) on changes in carnosine content of the vastus lateralis and muscle fatigue. Thirty-nine recreationally active men and women were assigned to one of the three groups: SR, RR, or placebo (PLA). Participants supplementing with SR and RR formulations increased muscle carnosine content by 50.1% (3.87 mmol kg-1ww) and 37.9% (2.62 mmol kg-1ww), respectively. The change in muscle carnosine content in participants consuming SR was significantly different (p = 0.010) from those consuming PLA, but no significant difference was noted between RR and PLA (p = 0.077). Although participants ingesting SR experienced a 16.4% greater increase in muscle carnosine than RR, fatigue during maximal voluntary isometric contractions was significantly attenuated in both SR and RR compared to PLA (p = 0.002 and 0.024, respectively). Symptoms of paresthesia were significantly more frequent in RR compared to SR, the latter of which did not differ from PLA. Results of this study demonstrated that only participants consuming the SR formulation experienced a significant increase in muscle carnosine. Differences in the muscle carnosine response between these formulations may have practical significance for athletic populations in which small changes may have important implications on performance.

A systematic evaluation of advance care planning patient educational resources.

BACKGROUND: Advance care planning (ACP) conversations help individuals exercise autonomy and make informed decisions about their care. There are many ACP resources available to support the process of advance care planning, yet available resources not universally accepted and under-utilized in clinical practice. OBJECTIVE: This study aims to systematically evaluate commonly available general ACP patient educational resources using a comprehensive approach to assess elements ranging from resource inclusion to health literacy. DESIGN: Systematic evaluation of general ACP educational resources METHODS: ACP educational resources were systematically identified and evaluated for: Patient Education Materials Assessment Tool (PEMAT) score, Flesch-Kincaid reading ease and grade level, cost, languages available, and categories of content including Advance directive/Healthcare proxy, Physician Order for Life-Sustaining Treatment (POLST), Living will, values, preferences, and goals. RESULTS: Educational resources (n = 20) were identified. These resources were classified as information resources, workbooks, interactive websites, or and activities/conversation guides. The average PEMAT understandability score was 86 (range 58-100) and the average actionability was 90 (range 40-100). Two resources met Flesch-Kincaid reading ease and grade level. Eight were available in English only, nine in two languages, and three in more than two languages. Three explicitly discussed completion of POLST forms. The majority of the resources adequately addressed the content of advanced directives and health care proxy, values, goals, and preferences for future care. The level of time commitment required to use each resource also varied considerably. CONCLUSION: We present a comprehensive evaluation of resources to support ACP. Using the Transtheoretical Model, we provide a guide for the use of these educational resources based on patient readiness. This review allows clinicians to identify aspects of each resource that may be helpful in preparing older adults for future healthcare decsions. Our analysis has identified the need to continue to refine these educational resources so that they can reach a broad population with varying needs. Advance care planning (ACP) conversations help individuals exercise autonomy and make informed decisions about their care. There are many ACP educational resources available to support the process of advance care planning, yet available resources are not universally accepted and under-utilized in clinical practice. We present a comprehensive evaluation of 20 educational resources to support ACP. Educational resources were identified and evaluated for: Patient Education Materials Assessment Tool (PEMAT) score, Flesch-Kincaid reading ease and grade level, cost, languages available, and categories of content. Using the Transtheoretical Model, we provide a guide for the use of these educational resources based on patient readiness. This review allows clinicians to identify aspects of each resource that may be helpful in preparing older adults for future healthcare decisions. Our analysis has identified the need to continue to refine these educational resources so that they can reach a broad population with varying needs.

Maturity-Related Differences in Systemic Pulmonary and Localized Fatigue Threshold Among Youth Male Athletes.

PURPOSE: To examine the reliability and the maturity-related differences of fatigue thresholds (FTs) among youth males. METHODS: Twenty-nine youth males (11-17 y) completed 2 ramp exercise tests on a cycle ergometer. Systemic FTs were calculated from gas exchange and ventilation variables. Localized FTs were calculated from electromyography and near-infrared spectroscopy of the vastus lateralis. All FTs were determined using the maximal distance method and expressed relative to maximal oxygen consumption. All participants were grouped according to the number of years from peak height velocity into PRE- (< -1.5 y), PERI- (-1.5 to +1.5 y) and POST- (> +1.5 y) peak height velocity. Reliability was assessed with intraclass correlation coefficients, and differences between groups were assessed with analysis of variance and Cohen's d coefficients. RESULTS: Analysis of variance revealed significant group differences with PRE having significantly greater systemic pulmonary FTs than POST, while localized muscular FTs were significantly greater in PRE when compared with PERI and POST. All FTs exhibited excellent reliability (intraclass correlation coefficient > .75) in all maturity groups. CONCLUSION: Maturity status appears to influence the onset of FTs among youth male athletes, with FTs occurring later in younger athletes. Furthermore, all FTs were reliable measures regardless of maturity.

Adolescent Weight and Health Behaviors and Their Associations With Individual, Social, and Parental Factors.

BACKGROUND: To examine the associations and differences between gender and weight classification for physical activity (PA) and individual, social, and parental factors. METHODS: Data from wave 2 of the "Growing up in Ireland" national study were used, resulting in a sample of 7525 13-year-old adolescents. Information on factors affecting adolescents' social, emotional, cognitive, and physical development was collected. RESULTS: Overweight (OW) adolescents were more likely to exercise and restrict food for weight loss and less likely to perform moderate to vigorous PA than normal weight adolescents. Parent body mass index was associated with adolescent body mass index for OW and normal weight adolescents, with the strongest association seen with OW females. Parents of OW adolescents considered themselves to be more OW and less physically active than parents of normal weight adolescents. Furthermore, for all groups, a greater amount of moderate to vigorous PA was associated with less television viewing, greater PA of parents, and a greater number of friends. CONCLUSION: Parental health behaviors play a significant role in adolescents' bodyweight, representing the necessity for more constructive health behaviors and PA among parents. Future interventions may be strengthened by focusing specifically on gender and body mass index, while taking into consideration the importance of parental behaviors on adolescents.

ß-Alanine supplementation elevates intramuscular carnosine content and attenuates fatigue in men and women similarly but does not change muscle l-histidine content.

ß-Alanine (BA) supplementation results in elevated intramuscular carnosine content, enhancing buffering capacity during intense exercise. Although men have greater muscle carnosine content than women, elevations still appear to occur despite high baseline levels. Recent research has suggested that BA supplementation may also reduce muscle l-histidine. Thus, the purpose of this investigation was to compare 28 days of BA (6 g·d-1) supplementation in men and women on performance and muscle carnosine, l-histidine, and BA. We hypothesized that supplementation would result in similar elevations in carnosine and performance between sexes and decrease l-histidine. Twenty-six men and women were assigned either BA or placebo (PLA). At baseline, a trend toward greater carnosine (P = .069) was observed in men, and intramuscular BA content was significantly (P ≤ .05) greater in men. Statistical analysis was performed using magnitude-based inferences. Changes in muscle carnosine were likely and very likely greater after BA supplementation compared with PLA in men and women, respectively, but changes were unclear between sexes (mean sex difference: 2.50 ± 4.30 mmol·kg-1 ww). The attenuation of exercise fatigue was likely greater in BA compared with PLA, but the change was unclear between sexes (mean sex difference: 14.0 ± 39.0 Nm). Changes in muscle BA following supplementation was unclear in men, likely elevated in women, but unclear between sexes (mean sex difference: 0.03 ± 0.42 mmol·kg-1 ww). Changes in muscle l-histidine were unclear in men and women, and unclear between sexes (mean sex difference: 0.09 ± 0.13 mmol·kg-1 ww). In conclusion, BA supplementation increased muscle carnosine and attenuated fatigue in men and women similarly but did not reduce muscle l-histidine.

Influence of Skeletal Muscle Carnosine Content on Fatigue during Repeated Resistance Exercise in Recreationally Active Women.

Carnosine is a naturally occurring intramuscular dipeptide that is thought to attenuate fatigue during high-intensity exercise. Carnosine content is influenced by various factors, including gender and diet. Despite research reporting that carnosine content is lower in women compared to men and lower in vegetarians compared to omnivores, no investigations have examined carnosine content in women based on dietary protein intake and its effect on muscle fatigue. Twenty recreationally active women were assigned to either a high (HI; n = 5), moderate (MOD; n = 10), or low (LO; n = 5) group based upon intramuscular carnosine content of the vastus lateralis. Each participant underwent two unilateral maximal voluntary isometric contractions (MVIC) of the knee extensors separated by an isokinetic exercise protocol consisting of five sets of 50 repeated maximal unilateral contractions. Magnitude-based inferences were used to analyze group differences. Percent decline in rate of force development and peak torque (PT) during the MVICs and changes in PT and mean torque during the muscle-fatiguing protocol were lower in HI compared to both MOD and LO. Additionally, absolute and relative dietary protein intake were greater in HI compared to MOD or LO. Results indicated that greater intramuscular carnosine content was reflective of greater dietary protein intake and that individuals with higher carnosine content displayed a greater attenuation of fatigue compared to those with lower carnosine.

Comparison of Two ß-Alanine Dosing Protocols on Muscle Carnosine Elevations.

OBJECTIVE: ß-alanine (BA) is a nonproteogenic amino acid that combines with histidine to form carnosine. The amount taken orally in individual doses, however, is limited due to symptoms of paresthesia that are associated with higher doses. The use of a sustained-release formulation has been reported to reduce the symptoms of paresthesia, suggesting that a greater daily dose may be possible. The purpose of the present study was to determine whether increasing the daily dose of BA can result in a similar increase in muscle carnosine in a reduced time. METHODS: Eighteen men and twelve women were randomized into either a placebo (PLC), 6-g BA (6G), or 12-g BA (12G) groups. PLC and 6G were supplemented for 4 weeks, while 12G was supplemented for 2 weeks. A resting blood draw and muscle biopsy were obtained prior to (PRE) and following (POST) supplementation. Plasma and muscle metabolites were measured by high-performance liquid chromatography. The loss in peak torque (ΔPT) was calculated from maximal isometric contractions before and after 250 isokinetic kicks at 180°·sec-1 PRE and POST. RESULTS: Both 12G (p = 0.026) and 6G (p = 0.004) increased muscle carnosine compared to PLC. Plasma histidine was decreased from PRE to POST in 12G compared to PLC (p = 0.002) and 6G (p = 0.001), but no group x time interaction (p = 0.662) was observed for muscle histidine. No differences were observed for any hematological measure (e.g., complete blood counts) or in symptoms of paresthesia among the groups. Although no interaction was noted in ΔPT, a trend (p = 0.073) was observed. CONCLUSION: Results of this investigation indicate that a BA supplementation protocol of 12 g/d-1, using a sustained-release formulation, can accelerate the increase in carnosine content in skeletal muscle while attenuating paresthesia.

Mathematical Modeling and Expression of Heart Rate Deflection Point using Heart Rate and Oxygen Consumption.

Heart rate deflection point (HRDP) can be determined through different mathematical-modeling procedures, such as bi-segmental linear regression (2SEG) or maximal distance model (Dmax). The purpose was to compare heart rate (HR) and oxygen consumption (VO2) at HRDP when using 2SEG and Dmax, and to examine their relationships with respiratory compensation point (RCP) and running performance. Nineteen participants completed a graded exercise test (GXT), to determine HRDP and RCP, and a 5km treadmill time trial (5Ktime). No differences were found in HR or VO2 when comparing HRDP2SEG, HRDPDmax, and RCP. Strong correlations were found between HRDP2SEG, HRDPDmax, and RCP when using HR and VO2. No relationships were found between 5Ktime and HR at HRDP or RCP; however, strong relationships were found with VO2. While 2SEG and Dmax may be interchangeable in determining HRDP, VO2 at HRDP and RCP yielded stronger relationships to 5Ktime than HR. Therefore, VO2 at HRDP may be a better predictor of running performance than HR.

Post-resistance exercise ingestion of milk protein attenuates plasma TNFα and TNFr1 expression on monocyte subpopulations.

Attenuating TNFα/TNFr1 signaling in monocytes has been proposed as a means of mitigating inflammation. The purpose of this study was to examine the effects of a milk protein supplement on TNFα and monocyte TNFr1 expression. Ten resistance-trained men (24.7 ± 3.4 years; 90.1 ± 11.3 kg; 176.0 ± 4.9 cm) ingested supplement (SUPP) or placebo (PL) immediately post-exercise in a randomized, cross-over design. Blood samples were obtained at baseline (BL), immediately (IP), 30-min (30P), 1-h (1H), 2-h (2H), and 5-h (5H) post-exercise to assess plasma concentrations of myoglobin; tumor necrosis factor-alpha (TNFα); and expression of tumor necrosis factor receptor 1 (TNFr1) on classical, intermediate, and non-classical monocytes. Magnitude-based inferences were used to provide inferences on the true effects of SUPP compared to PL. Plasma TNFα concentrations were "likely attenuated" (91.6% likelihood effect) from BL to 30P in the SUPP group compared with PL (d = 0.87; mean effect: 2.3 ± 2.4 pg mL-1). TNFr1 expressions on classical (75.9% likelihood effect) and intermediate (93.0% likelihood effect) monocytes were "likely attenuated" from BL to 2H in the SUPP group compared with PL (d = 0.67; mean effect: 510 ± 670 RFU, and d = 1.05; mean effect: 2500 ± 2300 RFU, respectively). TNFr1 expression on non-classical monocytes was "likely attenuated" (77.6% likelihood effect) from BL to 1H in the SUPP group compared with PL (d = 0.69; mean effect: 330 ± 430 RFU). Ingestion of a milk protein supplement immediately post-exercise appears to attenuate both plasma TNFα concentrations and TNFr1 expression on monocyte subpopulations in resistance-trained men.

Resistance exercise increases intramuscular NF-κb signaling in untrained males.

PURPOSE: The NF-κB signaling pathway regulates multiple cellular processes following exercise stress. This study aims to examine the effects of an acute lower-body resistance exercise protocol and subsequent recovery on intramuscular NF-κB signaling. METHODS: Twenty-eight untrained males were assigned to either a control (CON; n = 11) or exercise group (EX; n = 17) and completed a lower-body resistance exercise protocol consisting of the back squat, leg press, and leg extension exercises. Skeletal muscle microbiopsies were obtained from the vastus lateralis pre-exercise (PRE), 1-hour (1H), 5-hours (5H), and 48-hours (48H) post-resistance exercise. Multiplex signaling assay kits (EMD Millipore, Billerica, MA, USA) were used to quantify the total protein (TNFR1, c-Myc) or phosphorylation status of proteins belonging to the NF-κB signaling pathway (IKKa/b, IkBα, NF-κB) using multiplex protein assay. Repeated measures ANOVA analysis was used to determine the effects of the exercise bout on intramuscular signaling at each time point. Additionally, change scores were analyzed by magnitude based inferences to determine a mechanistic interpretation. RESULTS: Repeated measures ANOVA indicated a trend for a two-way interaction between the EX and CON Group (p = 0.064) for c-Myc post resistance exercise. Magnitude based inference analysis suggest a "Very Likely" increase in total c-Myc from PRE-5H and a "Likely" increase in IkBα phosphorylation from PRE-5H post-resistance exercise. CONCLUSION: Results indicated that c-Myc transcription factor is elevated following acute intense resistance exercise in untrained males. Future studies should examine the role that post-resistance exercise NF-κß signaling plays in c-Myc induction, ribosome biogenesis and skeletal muscle regeneration.

The Effect of Post-Resistance Exercise Amino Acids on Plasma MCP-1 and CCR2 Expression.

The recruitment and infiltration of classical monocytes into damaged muscle is critical for optimal tissue remodeling. This study examined the effects of an amino acid supplement on classical monocyte recruitment following an acute bout of lower body resistance exercise. Ten resistance-trained men (24.7 ± 3.4 years; 90.1 ± 11.3 kg; 176.0 ± 4.9 cm) ingested supplement (SUPP) or placebo (PL) immediately post-exercise in a randomized, cross-over design. Blood samples were obtained at baseline (BL), immediately (IP), 30-min (30P), 1-h (1H), 2-h (2H), and 5-h (5H) post-exercise to assess plasma concentrations of monocyte chemoattractant protein 1 (MCP-1), myoglobin, cortisol and insulin concentrations; and expressions of C-C chemokine receptor-2 (CCR2), and macrophage-1 antigen (CD11b) on classical monocytes. Magnitude-based inferences were used to provide inferences on the true effects of SUPP compared to PL. Changes in myoglobin, cortisol, and insulin concentrations were similar between treatments. Compared to PL, plasma MCP-1 was "very likely greater" (98.1% likelihood effect) in SUPP at 2H. CCR2 expression was "likely greater" at IP (84.9% likelihood effect), "likely greater" at 1H (87.7% likelihood effect), "very likely greater" at 2H (97.0% likelihood effect), and "likely greater" at 5H (90.1% likelihood effect) in SUPP, compared to PL. Ingestion of SUPP did not influence CD11b expression. Ingestion of an amino acid supplement immediately post-exercise appears to help maintain plasma MCP-1 concentrations and augment CCR2 expression in resistance trained men.

Changes in Plasma Aldosterone and Electrolytes Following High-Volume and High-Intensity Resistance Exercise Protocols in Trained Men.

Boone, CH, Hoffman, JR, Gonzalez, AM, Jajtner, AR, Townsend, JR, Baker, KM, Fukuda, DH, and Stout, JR. Changes in plasma aldosterone and electrolytes following high-volume and high-intensity resistance exercise protocols in trained men. J Strength Cond Res 30(7): 1917-1923, 2016-Program variables such as training intensity, volume, and rest interval length are known to elicit distinct hormonal, metabolic, and physical responses. However, little is known regarding resistance exercise (RE) program design and the fluid regulatory response. This investigation aimed to compare the plasma aldosterone (ALD), electrolyte, plasma volume (PV), and osmolality (Posm) responses following high-volume (HV; 4-6 × 10-12 reps, 70% 1 repetition maximum [1RM], 60-s rest) and high-intensity (HI; 6 × 3-5 reps, 90% 1RM, 180-second rest) RE protocols. Ten experienced, resistance-trained men (24.7 ± 3.4 years; 90.1 ± 11.3 kg; 176.0 ± 4.9 cm) performed each protocol in a random, counterbalanced order. Blood samples were obtained at baseline (BL), immediately (IP), 30 minutes (30P), and 1 hour (1H) postexercise. Significant trial × time interactions (p < 0.01) were observed in Posm, sodium (Na), and potassium (K), whereas a trend (p = 0.06) was observed for ALD. The PV shift from BL-30P was greater than BL-IP and BL-1H (p ≤ 0.05), but no significant between-trial differences were noted. Comparisons between RE protocols revealed significantly greater (p ≤ 0.05) elevations during HV vs. HI in Posm at IP, 30P, and 1H; and Na at IP and 30P. During HV, significant reductions (p ≤ 0.05) were noted in K at IP compared with HI. Area under the curve analysis indicates a trend (p = 0.07) toward a higher ALD response following HV compared with HI. Results of this study indicate that high-volume, moderate-intensity resistance exercise seems to augment the fluid regulatory response to a greater extent than low-volume, high-intensity training.

Intramuscular MAPK signaling following high volume and high intensity resistance exercise protocols in trained men.

PURPOSE: To examine the mitogen-activated protein kinase (MAPK) family of signaling proteins following typical high volume (HV) and high intensity (HI) lower body resistance exercise protocols in resistance-trained men. METHODS: Ten resistance-trained men (24.7 ± 3.4 year; 90.1 ± 11.3 kg; 176.0 ± 4.9 cm) performed each resistance exercise protocol in a random, counterbalanced order. The HV protocol utilized a load of 70 % 1-RM for sets of 10-12 repetitions with a 1-min rest period length between sets and exercises. The HI protocol utilized a load of 90 % 1-RM for sets of 3-5 repetitions with a 3-min rest period length between sets and exercises. Both protocols included six sets of barbell back squats and four sets of bilateral leg press, bilateral hamstring curls, bilateral leg extensions, and seated calf raises. Fine needle muscle biopsies of the vastus lateralis were completed at baseline (BL) and 1-h post exercise (1H). RESULTS: No significant differences over time were noted for phosphorylation of MEK1, ERK1/2, p38, MSK1, ATF2, p53, or c-Jun (p > 0.05). No significance between trial interactions was noted for phosphorylation of MAPK signaling proteins, including MEK1, ERK1/2, p38, JNK, MSK1, ATF2, STAT1, p53, c-Jun, or HSP27 (p > 0.05). However, significant time effects were observed for phosphorylation of JNK (p < 0.01), HSP27 (p < 0.01), and STAT1 (p = 0.03). Phosphorylation of JNK, HSP27, and STAT1 was significantly elevated from BL at 1H for both HV and HI. CONCLUSIONS: HV and HI lower body resistance exercise protocols appear to elicit similar MAPK activation in resistance-trained men.