Influence of Participant Perceptions of Adherence-Related Interactions with Study/Study Team on Drug Levels: HPTN069 Analysis of Self-Reported Adherence Experiences While on Study.

Adherence to HIV pre-exposure prophylaxis (PrEP) study drug is critical for safety, tolerability, and efficacy trials, and may be affected by how adherence is communicated by the study staff to trial participants. Increasingly, clinical trials investigating PrEP are creating and implementing 'participant-centered' approaches that discuss potential non-adherence neutrally (without negative judgement) and support efforts to adhere versus insisting on perfect adherence. In the HPTN069/ACTG A5305 study, we evaluated participant experiences of potentially negative adherence-related interactions with study teams using ten items to characterize the frequency of such experiences. We related these individual items and a combined set of seven negative experience items (total negative experience score) to drug concentrations (detectable or consistent with daily-dosing). The exploratory analyses used logistic regression for each experience item on the full sample and disaggregated by sex. Several experiences were related to drug detection and to daily-dosing, although more so for participants identifying as men than women. Total negative experience scores associated with not having detection drug concentrations for the full sample, and remained significant even when controlling for sex, age, and race. Daily dosing was associated with total negative experience score for men in the sample. Additional investigations into adherence-related interactions with study teams that are most problematic or helpful in general and uniquely for men and women are warranted.

Safety and tolerability of injectable Rilpivirine LA in HPTN 076: A phase 2 HIV pre-exposure prophylaxis study in women.

BACKGROUND: Daily oral TDF/FTC is protective against HIV infection when used for pre-exposure prophylaxis (PrEP). However, daily adherence to oral PrEP is difficult for many; therefore, finding alternative PrEP strategies remains a priority. HPTN 076 evaluated the long-acting injectable form of rilpivirine (RPV), known as RPV LA for safety, pharmacokinetics and acceptability. METHODS: HPTN 076 (NTC 02165202) was a phase 2, double-blind, 2:1 randomized trial comparing the safety of 1200mg RPV LA (LA) to placebo (P). The study included a 28-day oral run-in phase of daily, self- administered oral RPV (25 mg), with directly observed oral dosing about six times. Of 136 enrolled sexually active, HIV-uninfected, low HIV-risk African (100) and US (36) adult women, injectable product was administered in two gluteal, intramuscular (IM) injections once every eight weeks to 122 participants following the oral run-in phase. A maximum of six injection time points occurred over a 48-week period. Acceptability, safety, tolerability and pharmacokinetic (PK) data were collected throughout the study. This paper includes primary endpoint data collected up to the week 52 post enrollment. FINDINGS: The median age of the enrolled population was 31 years (IQR: 25,38), median weight 75 kg (IQR: 64, 89), median body mass index (BMI) 30 (IQR: 27, 35), 46% married, 94% Black and 60% unemployed. A total of 122 (80 LA, 42 P) women received at least one injection and 98 (64 LA, 34 P) received all six injections. During the injection phase, three women withdrew from the study (2 LA, 1 P) and 16 women discontinued study product (10 LA, 6 P). Fourteen women (11 LA and 3 P) discontinued oral study product and did not enter the injection phase. Study product discontinuations were not significantly different between the two arms throughout. Of the product discontinuations in the injection phase, 8% in LA and 5% in P arm were due to adverse events (AEs), including one randomized to the P arm with prolonged QTc interval on EKG. The proportion of women who experienced Grade 2 or higher AEs during the injection phase as the primary outcome was not significantly different between the two arms [73.8%, 95% CI: (63.2%, 82.1%) for LA and 73.8%, 95% CI: (58.9%, 84.7%), p>0.99]. Transient Grade ≥2 liver abnormalities occurred in 14% of women in the LA arm compared with 12% in P arm. Three LA women (4%) developed Grade 3 injection site reactions compared with none in P arm. In participants who received at least 1 injection, the geometric mean of overall RPV trough concentrations (Ctrough) was 62.2 ng/mL. In participants who received all six injections, the geometric mean of CTrough through the injection phase and after the last injection were 72.8 ng/mL and 100.9 ng/mL, respectively. At week 52 (eight weeks after last injection), the geometric mean of RPV Ctrough was 75.0 ng/mL. At the last injection visit (Week 44), 80 % of women who answered acceptability questions strongly agreed that they would think about using- and 68% that they would definitely use a PrEP injectable in the future. INTERPRETATION: RPV LA IM injections every eight weeks in African and US women were safe and acceptable. Overall, despite more injection site reactions and pain in the participants receiving RPV LA the injections were well tolerated. Data from this study support the further development of injectable PrEP agents.

Detection of Rickettsiae, Borreliae, and Ehrlichiae in Ticks Collected from Walker County, Texas, 2017-2018.

Cases of tick-borne diseases, including spotted fever rickettsioses, borreliosis, babesiosis, anaplasmosis and ehrlichiosis, in the United States and territories have more than doubled from 2004 to 2016 and account for 77% of all vector-borne disease reports. In an effort to inform control efforts, the presence of tick-borne pathogens and their vectors was assessed in a recreational park in Walker County, Texas. Here we report data from questing ticks collected on three dates from June 2017 to June 2018. The majority of ticks collected were Amblyomma americanum (96.69%) followed by three additional tick species: Dermacentor variabilis (2.59%), Ixodes scapularis (0.52%), and A. maculatum (0.21%). Ticks were pooled and tested for molecular evidence of bacterial and viral pathogens, respectively. All of the 68 pools of A. americanum had molecular evidence of the spotted fever group rickettsia, Rickettsia amblyommatis. Additionally, six (8.82%) of the A. americanum pools contained sequences matching Ehrlichia chaffeensis, the pathogen responsible for human monocytotropic ehrlichiosis, and 11 (16.18%) for E. ewingii. Three of the A. americanum pools demonstrated evidence of Borrelia lonestari. The presence of etiologic agents of known human disease in this study merits the continued surveillance efforts of ticks and their pathogens in areas where they could pose risks to public health.

Oral and vaginal HIV pre-exposure prophylaxis product attribute preferences among female sex workers in the Mexico-US border region.

To assess the potential uptake of HIV pre-exposure prophylaxis (PrEP) products among female sex workers (FSWs) vulnerable to HIV infection, we examined the influence of product attributes on willingness to use products among 271 HIV-negative FSWs in Tijuana and Ciudad Juarez, Mexico (2016-2017). Via five-point Likert scale ratings, participants indicated their willingness to use hypothetical products with six attributes: formulation (pill, gel, liquid, or ring), frequency of use (daily, on-demand, or monthly), cost per use (10 or 200 pesos), effectiveness (40% or 80%), side effects (none or mild), and access point (healthcare clinic or non-governmental organization). Conjoint analysis was used to determine the impact of attributes on product ratings and identify preferred product attributes. Multinomial logistic regression was used to identify factors associated with formulation preferences. In both cities, formulation and frequency of use had the greatest impact on ratings. Participants in Ciudad Juarez indicated a strong preference for oral pills, whereas participants in Tijuana indicated roughly equal preferences for oral pills and vaginal gels. Monthly product use was preferred in both cities. Compared to preferring oral pills (38%), preferring vaginal gels (28%) was associated with practicing vaginal lubrication (adjusted odds ratio = 2.08; 95% confidence interval: 1.07-4.04). Oral PrEP may be acceptable to many FSWs in Tijuana and Ciudad Juarez; however, continued development of behaviorally-congruent vaginal PrEP products may also facilitate uptake and ensure sufficient coverage.

Physiological changes in the pallidum in a progressive model of Parkinson's disease: Are oscillations enough?

Neurophysiological changes in the basal ganglia thalamo-cortical circuit associated with the development of parkinsonian motor signs remain poorly understood. Theoretical models have ranged from those emphasizing changes in mean discharge rate to increased oscillatory activity within the beta range. The present study characterized neuronal activity within and across the internal and external segments of the globus pallidus as a function of motor severity using a staged, progressively severe 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine model of Parkinsonism in three rhesus monkeys. An increase in coherence between neuronal pairs across the external and internal globus pallidus was present in multiple frequency bands in the parkinsonian state; both the peak frequency of oscillatory coherence and the variability were reduced in the parkinsonian state. The incidence of 8-20Hz oscillatory activity in the internal globus pallidus increased with the progression of the disease when pooling the data across the three animals; however it did not correlate with motor severity when assessed individually and increased progressively in only one of three animals. No systematic relationship between mean discharge rates or the incidence or structure of bursting activity and motor severity was observed. These data suggest that exaggerated coupling across pallidal segments contribute to the development of the parkinsonian state by inducing an exaggerated level of synchrony and loss of focusing within the basal ganglia. These data further point to the lack of a defined relationship between rate changes, the mere presence of oscillatory activity in the beta range and bursting activity in the basal ganglia to the motor signs of Parkinson's disease.

The role of 5-HT1A receptors in mediating acute negative effects of antidepressants: implications in pediatric depression.

Acute antidepressant exposure elevates the frequency of impulsive behavior and suicidal thoughts in children and adolescents with major depressive disorder (MDD). Long-term antidepressant treatment, however, is beneficial for pediatric MDD, so it is necessary to explore novel treatments that prevent the potentially dangerous consequences of acute antidepressant initiation. In the present study, a treatment strategy designed to reverse the acute negative behavioral effects of antidepressants was tested in rodents. Co-administration of the 5-HT1A receptor (5-HT1AR) antagonist WAY-100635 reversed the negative effects of acute fluoxetine, a serotonin reuptake inhibitor, but not reboxetine, a norepinephrine reuptake inhibitor, supporting the involvement of 5-HT1AR in mediating the negative consequences of acute selective serotonin reuptake inhibitor (SSRI) treatment. No 5-HT1AR antagonists are currently approved for use in pediatric populations, so alternative strategies should be explored. One such strategy was suggested based on the hypothesis that the rate of 5-HT1AR activation and the subsequent inhibition of serotonergic neuron activity caused by acute SSRI administration is proportional to the loading rate of an antidepressant. Existing pharmacological data were examined, and significant correlations were observed between the half-life of antidepressants and the rate of suicide-related events (SREs). Specifically, antidepressants with longer half-lives have lower rates of SREs. On the basis of these data, novel dosing strategies were developed for five antidepressants to mimic the pharmacological profile of the antidepressant with the longest half-life, fluoxetine. These dosing strategies could be used to decrease the rate of SREs associated with acute antidepressant treatment in pediatric MDD until an improved pharmacological treatment is developed.

Linking the population pharmacokinetics of tenofovir and its metabolites with its cellular uptake and metabolism.

Empirical pharmacokinetic models are used to explain the pharmacokinetics of the antiviral drug tenofovir (TFV) and its metabolite TFV diphosphate (TFV-DP) in peripheral blood mononuclear cells. These empirical models lack the ability to explain differences between the disposition of TFV-DP in HIV-infected patients vs. healthy individuals. Such differences may lie in the mechanisms of TFV transport and phosphorylation. Therefore, we developed an exploratory model based on mechanistic mass transport principles and enzyme kinetics to examine the uptake and phosphorylation kinetics of TFV. TFV-DP median Cmax from the model was 38.5 fmol/10(6) cells, which is bracketed by two reported healthy volunteer studies (38 and 51 fmol/10(6) cells). The model presented provides a foundation for exploration of TFV uptake and phosphorylation kinetics for various routes of TFV administration and can be updated as more is known on actual mechanisms of cellular transport of TFV.

Safety and pharmacokinetics of XOMA 3AB, a novel mixture of three monoclonal antibodies against botulinum toxin A.

Botulinum neurotoxin A is a category A bioterrorism agent. Current antitoxin therapies are scarce and produce adverse reactions. XOMA 3AB consists of 3 IgG1 monoclonal antibodies (MAbs), each with a distinct human or humanized variable region, which bind to distinct epitopes on botulinum neurotoxin serotype A. This first-in-human study evaluated the safety and pharmacokinetics (PK) of escalating doses of XOMA 3AB administered intravenously (i.v.) to healthy adults. In this double-blind placebo-controlled dose escalation study, 3 cohorts of 8 healthy subjects received a single intravenous dose of XOMA 3AB or placebo at a 3:1 ratio. Follow-up examinations included physical examinations, hematology and chemistry blood tests, electrocardiograms, and pharmacokinetics. Pharmacokinetic parameters were estimated using noncompartmental methods. There were no infusion discontinuations or hypersensitivity reactions. Two or more subjects experienced headache, hyperglycemia, or anemia; none was dose related. All adverse events (AEs) were mild to moderate except for an episode of exercise-induced elevation of a subject's creatine phosphokinase (CPK) level, unrelated to XOMA 3AB. Concentration-time plots demonstrated a peak in MAb concentrations 1 to 2 h after completion of the infusion, after which the levels declined in a biexponential decay pattern for all analytes. For each MAb, the maximum concentration of drug in serum (Cmax) and the area under the concentration-time curve from 0 to infinity (AUCinf) increased as the dose increased. Clearance of the humanized mouse MAb was more rapid than that of the two fully human MAbs, particularly at the lowest dose. None of the MAbs was immunogenic. At the doses administered, XOMA 3AB was well tolerated. These safety findings support further investigation of XOMA 3AB as a potential agent for botulism treatment and postexposure prophylaxis. (This study has been registered at ClinicalTrials.gov under registration no. NCT01357213.).

Developmental coordination disorder and overweight and obesity in children: a systematic review.

Children with developmental coordination disorder (DCD) find themselves less competent than typically developing children with regard to their physical abilities and often experience failure. They are therefore likely to avoid physical activity. Physical inactivity is considered an important risk factor for developing overweight and obesity. The aim of this study is to assess the association between DCD and overweight and obesity in children and whether this association is influenced by age and/or gender. Six electronic databases were systematically searched. Titles and abstracts were screened for relevance. Remaining studies were subjected to full paper review. The quality of the included articles was assessed and relevant data were extracted for comparison. The search yielded 273 results. Twenty-one studies, based on 10 cohorts, were included. Participants' ages ranged from 4 to 14 years. In all cohorts, children with DCD had higher body mass index scores, larger waist circumference and greater percentage body fat compared with controls. Seven studies assessed the effect of gender and four studies provided information on the effect of age. Children with DCD seem to be at greater risk for overweight and obesity. This risk may be higher for boys and seems to increase with age and with the severity of motor impairment.

Protein-free efavirenz concentrations in cerebrospinal fluid and blood plasma are equivalent: applying the law of mass action to predict protein-free drug concentration.

Efavirenz (EFV) is one of the most commonly prescribed antiretroviral drugs (ARVs) for the treatment of HIV. Highly protein-bound drugs, like EFV, have limited central nervous system (CNS) penetration when measured using total drug concentration gradients between blood plasma (BP) and cerebrospinal fluid (CSF). However, the more relevant pharmacologically active protein-free drug concentrations are rarely assessed directly in clinical studies. Using paired BP and CSF samples obtained from 13 subjects on an EFV-containing regimen, both the protein-free and total concentrations of EFV were determined. Despite a median (interquartile range [IQR]) total EFV BP/CSF concentration ratio of 134 (116 to 198), the protein-free EFV BP/CSF concentration ratio was 1.20 (0.97 to 2.12). EFV median (IQR) protein binding was 99.78% (99.74 to 99.80%) in BP and 76.19% (74.47 to 77.15%) in CSF. In addition, using the law of mass action and an in vitro-derived EFV-human serum albumin dissociation constant, we have demonstrated that the predicted median (IQR) protein-free concentration in BP, 4.59 ng/ml (4.02 to 9.44 ng/ml), compared well to that observed in BP, 4.77 ng/ml (3.68 to 6.75 ng/ml). Similar results were also observed in CSF and seminal plasma. This method provides a useful predictive tool for estimating protein binding in varied anatomic compartments. Our results of equivalent protein-free EFV concentrations in BP and CSF do not support prior concerns of the CNS as a pharmacological sanctuary from EFV. As CSF penetration of ARVs may increase our understanding of HIV-associated neurological dysfunction and antiretroviral effect, assessment of protein-free CSF concentrations of other highly protein-bound ARVs is warranted.

Electromyographic and mechanomyographic responses across repeated maximal isometric and concentric muscle actions of the leg extensors.

The purpose of the present study was to examine the patterns of responses for torque, electromyographic (EMG) amplitude, EMG mean power frequency (MPF), mechanomyographic (MMG) amplitude, and MMG MPF across 30 repeated maximal isometric (ISO) and concentric (CON) muscle actions of the leg extensors. Twelve female subjects (21.1±1.4yrs; 63.3±7.4kg) performed ISO and CON fatigue protocols with EMG and MMG signals recorded from the vastus lateralis. The relationships for torque, EMG amplitude, EMG MPF, MMG amplitude, and MMG MPF versus repetition number were examined using polynomial regression. The results indicated there were decreases (p<0.05) across the ISO muscle actions for torque (r(2)=0.95), EMG amplitude (R(2)=0.44), EMG MPF (r(2)=0.62), and MMG MPF (r(2)=0.48), but no change in MMG amplitude (r(2)=0.07). In addition, there were decreases across the CON muscle actions for torque (R(2)=0.97), EMG amplitude (R(2)=0.46), EMG MPF (R(2)=0.86), MMG amplitude (R(2)=0.44), and MMG MPF (R(2)=0.80). Thus, the current findings suggested that the mechanisms of fatigue and motor control strategies used to modulate torque production were similar between maximal ISO and CON muscle actions.

Effects of ritonavir-boosted lopinavir on the pharmacokinetics of quinine.

The centuries-old antimalarial drug, quinine, continues to play a critical role in the treatment of severe falciparum malaria and uncomplicated malaria in pregnant women. It shares cytochrome P450 (CYP )-mediated metabolic pathways with several commonly used antiretroviral drugs, raising the potential for clinically important drug­drug interactions. A phase I pharmacokinetic study was conducted to assess the impact of long-term use of ritonavir-boosted lopinavir (LPV/r) on quinine pharmacokinetics in healthy volunteers. LP V/r significantly decreased the exposure of quinine and its major active metabolite, 3-hydroxyquinine, in both total and free (unbound) forms. These findings highlight the complex nature of the influence exerted by LPV/r on several of the drug-metabolizing enzymes involved in quinine disposition,including CYP 3A4, UDP-glucuronosyltransferase (UG T), and P-glycoprotein (P-gp). A decline in quinine exposure may compromise clinical efficacy. Further studies are warranted to assess changes in quinine pharmacokinetics and treatment outcomes in patients with acute malaria receiving antiretroviral therapy that includes LPV/r.

The effects of creatine monohydrate loading on anaerobic performance and one-repetition maximum strength.

The purpose of this study was to examine the effects of 7 days of supplementation with 20 g·d⁻¹ of creatine monohydrate (CM) on mean power (MP) and peak power (PP) from the Wingate anaerobic test (WAnT), body weight (BW), 1-repetition maximum (1RM) bilateral leg extension (LE) strength, and 1RM bench press (BP) strength. This study used a randomized, double-blind, placebo-controlled design. Twenty-two men (mean ± SD: age = 22.1 ± 2.0 years; height = 178.0 ± 5.8 cm; body weight [BW] = 77.6 ± 7.6 kg) were randomly assigned to either a supplement (SUPP; n = 10) or placebo (PLAC; n = 12) group. The SUPP group ingested 20 g·d⁻¹ of CM powder for 7 days, whereas the PLAC ingested 20 g·d⁻¹ of maltodextrin powder. Measurements for the PLAC and SUPP groups included BW, PP, and MP from two 30-second WAnTs (separated by 7 minutes), and 1RM strength for LE and BP. Testing was conducted before (PRE) and after (POST) 7 days of ingesting either the supplement or placebo. The results of this study indicated that there was a significant (p ≤ 0.05) increase from PRE to POST testing in MP for the SUPP group (5.4%) but not for the PLAC group (-0.3%). There were no between-group differences, however, for 1RM LE and 1RM BP strength. Furthermore, there were no changes in PP or BW for either group. The findings of this study indicated that loading with 20 g·d⁻¹ of CM for 7 days increased MP (5.4% increase) from the WAnT, but it had no effect on strength (1RM LE and 1RM BP), PP, or BW.

The male genital tract is not a pharmacological sanctuary from efavirenz.

Many antiretroviral (ARV) drugs have large blood plasma-to-seminal plasma (BP/SP) concentration ratios. Concern exists that these drugs do not adequately penetrate the male genital tract (MGT), resulting in the MGT becoming a "pharmacological sanctuary" from these agents, with ineffective MGT concentrations despite effective blood concentrations. Efavirenz (EFV) is the most highly protein-bound ARV drug, with >99% binding in blood plasma and the largest BP/SP total EFV concentration ratio, reportedly ranging from 11 to 33. To evaluate protein binding as an explanation for the differences between the drug concentrations in blood and semen, we developed a novel ultrafiltration method, corrected for the duration of centrifugation, to measure protein binding in the two matrices. In six subjects, protein-free EFV concentrations were the same in blood and semen; the median (interquartile range (IQR)) protein-free EFV SP/BP ratio was 1.21 (0.99-1.35); EFV protein binding was 99.82% (99.79-99.86) in BP and 95.26% (93.24-96.67) in SP. This shows that the MGT is not a sanctuary from EFV.

The effects of skinfold thicknesses and innervation zone on the mechanomyographic signal during cycle ergometry.

The purpose of this study was to examine the effects of skinfold (SF) thicknesses at four locations on the vastus lateralis (VL) muscle and the placement of accelerometers relative to the innervation zone (IZ) on the mechanomyographic (MMG) amplitude and mean power frequency (MPF) responses during incremental cycle ergometry. Twenty adults (age±SD=23.8±3.0 years) participated in the investigation. The MMG signals were detected during incremental cycle ergometry using four accelerometers placed on the right VL. Prior to the cycle ergometer test, SF thicknesses were measured. Simple linear regression analyses and one-way repeated measures analyses of variance (ANOVAs) were performed. The present study found that only 10% of the regression analyses and mean comparisons were significant (p<0.05). Furthermore, the accelerometer placed at the most proximal site (Prox 2) had significantly greater MMG amplitude and MMG MPF than accelerometers placed at more distal sites (Prox 1, Over IZ, and Dist). There were no significant differences, however, in SF thickness between accelerometer placement sites. In addition, the IZ had no effect on MMG amplitude and little effect on MMG MPF values. The results of the present study indicated that the SF thickness values and IZ did not affect the MMG signal.

Gender comparisons of anthropometric characteristics of young sprint swimmers.

The purpose of this study was to compare the body composition, body build, and anthropometric characteristics of boy and girl sprint swimmers. Two groups (boys, n = 38 and girls, n = 31) of sprint swimmers (mean age ± SD = 11.03 ± 2.29 and 10.45 ± 2.29 years, respectively) volunteered for this study. The subjects were members of local swimming clubs who competed in sprint swimming events (≤ 200 m). Gender comparisons were made for age, body weight (BW), height (HT), fat-free weight (FFW), percent body fat (%fat), endomorphic rating, mesomorphic rating, ectomorphic rating, sum of 12 diameters, sum of 11 circumferences, biacromial diameter/biiliac diameter, and FFW/HT. The results of the independent t-tests indicated that the only mean differences between the boy and girl sprint swimmers were for % fat (boys = 9.40 ± 5.35% fat; girls = 12.73 ± 6.19% fat) and endomorphic rating (boys = 2.87 ± 0.96; girls = 4.29 ± 1.22). For the current age group of sprint swimmers the only gender differences were for measures associated with body fatness, and there were no differences for body build measures associated with musculoskeletal size, muscularity, skeletal size, total body mass, or body breadth dimensions. These findings suggest that the swimming performance for girls may be improved through training programs designed to reduce body fatness.

Yearly changes in the anthropometric dimensions of female high school gymnasts.

The purpose of the present study was to compare the age-related patterns of anthropometric dimensions of female high school gymnasts to those of a national representative sample of teenage girls. One hundred and one female high school gymnasts (X ± SD age = 15.8 ± 1.1 year; height [HT] = 162.2 ± 5.7 cm; body weight [BW] = 54.1 ± 6.5 kg) volunteered as subjects in the present study. The sample was divided into 4 independent age groups: age group 14 (AG14) = 14.00 to 14.99 years (n = 26); AG15 = 15.00 to 15.99 years (n = 27); AG16 = 16.00 to 16.99 years (n = 29); and AG17 = 17.00 to 17.99 years (n = 19). Nine variables including BW; HT; body mass index (BMI); subscapular and triceps skinfolds; and waist, mid-arm, maximal calf, and mid-thigh circumferences were assessed on each subject. Independent t-tests indicated that for all age groups, the female high school gymnasts exhibited lower BW, BMI, circumferences (waist, mid-arm, maximal calf, and mid-thigh) and skinfolds (subscapular and triceps) than the national sample, except AG 17 for BW and maximal calf and mid-thigh circumferences. There were no significant differences in HT between samples for any of the age groups. Furthermore, there were no differences between the high school gymnasts and the national sample for the slope coefficients for the anthropometric dimensions vs. age relationships. These findings indicated that in females, participation in high school gymnastics does not adversely affect yearly changes in anthropometric dimensions.

A test for determining critical heart rate using the critical power model.

The purposes of this study were to (a) determine if the mathematical model that has previously been used to estimate the critical power (CP) was applicable to heart rate (HR) to estimate the critical heart rate (CHR), and (b) compare the CHR to the HR values at the CP (CP(HR)), ventilatory threshold (VT(HR)), and respiratory compensation point (RCP(HR)). Fifteen women (mean age ± SD = 21.7 ± 2.1 years) performed an incremental test to exhaustion to determine VO2peak, VT(HR), and RCP(HR). The subjects also performed 4 exhaustive workbouts at different power outputs for the determination of CP and CHR. For each power output, the total number of heart beats (HB(lim)) was calculated as the product of the average 5-second HR (bpm) and total time to exhaustion (T(lim) in minutes). The HB(lim) and total work (W(lim) in kilograms-meters) were plotted as a function of the T(lim) at each power output, and the slope coefficients of the regression lines between HB(lim) or W(lim) and T(lim) were defined as the CHR and CP, respectively. A 1-way repeated-measures analysis of variance (ANOVA) indicated that CHR (172 ± 11 bpm, 92.9 ± 2.7%HRmax) was similar to RCP(HR) (172 ± 9 bpm, 92.9 ± 2.2%HRmax) but was higher (p < 0.05) than CP(HR) (154 ± 10 bpm, 83.2 ± 4.0%HRmax) and VT(HR) (152 ± 12 bpm, 82.1 ± 4.3%HRmax). The relationship between HR and T(lim) from the CHR test can be described by the CP model. The CHR test may be a practical method for estimating RCP without the need to measure expired gas samples. Furthermore, like the RCP, the CHR test may be used to demarcate the heavy from severe exercise intensity domains, predict endurance exercise performance, and prescribe a training intensity for competitive cyclists.

The influence of the muscle fiber pennation angle and innervation zone on the identification of neuromuscular fatigue during cycle ergometry.

The purpose of the present investigation was to compare the electromyographic (EMG) responses and the estimated physical working capacity at the fatigue threshold (PWC(FT)) values recorded from electrode arrangements placed: (1) parallel to the muscle fiber pennation angle (MFPA), (2) parallel to the long axis of the femur, and (3) over the innervation zone (IZ) during incremental cycle ergometry. Thirteen college-aged males and females (mean age ± SD=22.4 ± 3.4 years) performed an incremental test to exhaustion on a cycle ergometer. A linear electrode array was utilized to determine the MFPA and location of the IZ of the vastus lateralis (VL). For determination of the PWC(FT) values, EMG signals were recorded from three bipolar electrode arrangements at different locations over the VL. The results of a one-way repeated measures ANOVA indicated there were no significant (p<0.05) mean differences in PWC(FT) values among the electrode arrangements (parallel to the MFPA=190 ± 36 W; parallel to the long axis of the femur=194 ± 40 W; and over the IZ=199 ± 51 W) or the EMG amplitude and MPF values at the common power outputs. There were also significant correlations (r=0.75-0.91) among the three electrode arrangements for PWC(FT) values. These findings suggested that the PWC(FT), like absolute EMG amplitude and MPF, is robust to the influence of electrode placement over the IZ as well as the orientation with respect to the MFPA during cycle ergometry.

The effects of polyethylene glycosylated creatine supplementation on muscular strength and power.

The purpose of the present investigation was to examine the effects of 28 days of polyethylene glycosylated creatine (PEG-creatine) supplementation on 1-repetition maximum bench press (1RMBP) and leg extension (1RMLE), mean power (MP), and peak power (PP) from the Wingate Anaerobic test and body weight (BW). This study used a randomized, double-blind, placebo-controlled, parallel design. Twenty-two untrained men (mean age ± SD = 22.1 ± 2.1 years) were randomly assigned to either a Creatine (n = 10) or Placebo (n = 12) group. The Creatine group ingested PEG-creatine (5 g·d), whereas the Placebo group ingested maltodextrin powder (5 g·d). All subjects performed bench press and bilateral leg extension exercises to determine their 1RM values, and 2 consecutive Wingate Anaerobic Tests (separated by 7 minutes) on a cycle ergometer to determine MP and PP before supplementation (day 0) and after 7 (day 7) and 28 (day 28) days of supplementation. The results indicated that there was a significant (p < 0.05) increase in 1RMBP between days 0 and 28 for the Creatine group but not for the Placebo group. There were no significant changes, however, in 1RMLE, MP, PP, or BW for the Creatine or Placebo group. These findings indicated that 28 days of PEG-creatine supplementation without resistance training increased upper body strength but not lower body strength or muscular power. These findings supported the use of the PEG-creatine supplement for increasing 1RMBP strength in untrained individuals.