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1.
J Pharm Pharmacol ; 2020 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-32246471

RESUMO

OBJECTIVES: To develop of new class of selective and reversible MAO-B inhibitors from enamides. METHODS: Syntheses of the titled derivatives (AD1-AD11) were achieved by reacting cinnamoyl chloride and various primary and secondary amines in basic medium. All eleven compounds were investigated for in vitro inhibitory activities against recombinant human MAO-A and MAO-B. The reversibilities of lead compound inhibitions were analysed by dialysis. MTT assays of lead compounds were performed using normal VERO cell lines. KEY FINDINGS: Compounds AD3 and AD9 exhibited the greatest inhibitory activity against MAO-B with IC50 values of 0.11 and 0.10 µm, respectively, and were followed by AD2 and AD1 (0.51 and 0.71 µm, respectively). Most of the compounds weakly inhibited MAO-A, with the exceptions AD9 and AD7, which had IC50 values of 4.21 and 5.95 µm, respectively. AD3 had the highest selectivity index (SI) value for MAO-B (>363.6) and was followed by AD9 (SI 42.1). AD3 and AD9 were found to be competitive inhibitors of MAO-B with Ki values of 0.044 ± 0.0036 and 0.039 ± 0.0047 µm, respectively. Reversibility experiments showed AD3 and AD9 were reversible inhibitors of MAO-B; dialysis restored the activity of MAO-B to the reference level. MTT assays revealed AD3 and AD9 were non-toxic to normal VERO cell lines with IC50 values of 153.96 and 194.04 µg/ml, respectively. Computational studies provided hypothetical binding modes for AD3 and AD9 in the binding cavities of MAO-A and MAO-B. CONCLUSIONS: These results encourage further studies on the enamide scaffold as potential drug candidates for the treatment of Alzheimer's and Parkinson's diseases.

2.
J Invest Surg ; : 1-11, 2020 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-32151187

RESUMO

Introduction: Continuous intraoperative neural monitoring (C-IONM) is a promising technology used to decrease recurrent laryngeal nerve (RLN) damage during thyroid surgery. However, C-IONM use is limited due to its challenging application. C-IONM requires dissection of the carotid sheath and placement of an electrode around the vagus nerve (VN). In our study, we simultaneously stimulated and monitored the proximal RLN trans-tracheally using surface electrodes that were positioned solely on the endotracheal tube.Methods: We described the design, implementation, and testing of a pre-prototype, combined stimulating and recording endotracheal tube (SRET) that continually delivered current from tube edge, and tested the function of the RLN at the vocal cords (VC). The SRET was tested in vivo on 10 RLNs using 5 pigs as animal models.Results: The SRET was capable of the following, delivery of continuous trans-tracheal stimulation to the proximal RLN, continuous trans-tracheal stimulation-induced VC movement, and standard ipsilateral RLN biphasic waveforms with latency and amplitude; and recording evoked responses were recorded in the ipsilateral RLN.Conclusion: The pre-prototype SRET represents a possible advancement in technology because it simplified the C-IONM. Thus, the SRET provides a minimally invasive, alternative application to the C-IONM vagal nerve cuff electrodes.

3.
Head Neck ; 2020 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-32212355

RESUMO

BACKGROUND: We evaluated the outcomes of patients with papillary thyroid carcinoma (PTC) who underwent transoral robotic thyroidectomy (TORT). METHODS: We retrospectively analyzed the perioperative outcomes of 200 patients (170 women and 30 men) with PTC who underwent TORT at a single center between March 2016 and February 2018. RESULTS: There were 182 and 13 cases of lobectomy and total thyroidectomy, respectively, with corresponding mean operative times of 200.6 ± 31.2 and 265.7 ± 63.0 minutes. On average, 5.6 ± 3.45 lymph nodes were retrieved per patient. There were 12 cases of perioperative morbidity. No conversion to endoscopic or conventional open surgery was noted. In a subgroup analysis for predictors of difficult TORT, patient sex was the only factor showing a significant operative time difference between a difficult and a nondifficult thyroidectomy. CONCLUSION: TORT can be performed safely in patients with PTC without serious complications.

4.
Nanomaterials (Basel) ; 10(3)2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32110885

RESUMO

Nanostructured electrodes and their flexible integrated systems have great potential for many applications, including electrochemical energy storage, electrocatalysis and solid-state memory devices, given their ability to improve faradaic reaction sites by large surface area. Although many processing techniques have been employed to fabricate nanostructured electrodes onto flexible substrates, these present limitations in terms of achieving flexible electrodes with high mechanical stability. In this study, the adhesion, mechanical properties and flexibility of TiN nanotube arrays on a Pt substrate were improved using a Ti interlayer. Highly ordered and well-aligned TiN nanotube arrays were fabricated on a Pt substrate using a template-assisted method with an anodic aluminum oxide (AAO) template and atomic layer deposition (ALD) system. We show that with the use of a Ti interlayer between the TiN nanotube arrays and Pt substrate, the TiN nanotube arrays could perfectly attach to the Pt substrate without delamination and faceted phenomena. Furthermore, the I-V curve measurements confirmed that the electric contact between the TiN nanotube arrays and substrate for use as an electrode was excellent, and its flexibility was also good for use in flexible electronic devices. Future efforts will be directed toward the fabrication of embedded electrodes in flexible plastic substrates by employing the concepts demonstrated in this study.

5.
Artigo em Inglês | MEDLINE | ID: mdl-32160768

RESUMO

The purpose of the present study was to identify the effects of anterior translation and medial rotation of the talus on ankle joint contact forces (AJF) during double-limb vertical hopping. A computational musculoskeletal model was used to calculate AJF under 225 different combinations of 0-10 mm (in 10/15 mm increments) anterior translation and 0-5° (in 5/15° increments) medial rotation for ten subjects. The results show anteroposterior AJF was moderately affected by anterior translation, while mediolateral AJF was strongly affected by medial rotation. Future research should investigate if interventions that manipulate misaligned talus position in-vivo can also reduce AJF.

6.
ChemSusChem ; 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32202385

RESUMO

Hydrogenolysis has emerged as one of the most effective means of converting polymeric lignin into monoaromatic fragments of value. Reported yields may be higher than for other methods and can exceed the theoretical yields estimated from measures of the content of lignin's most readily cleaved alkyl-aryl ether bonds in ß-ether units. The high yields suggest that other units in lignin are being cleaved. Diaryl ether units are important units in lignin, and their cleavage has been examined previously using simple model compounds, such as diphenyl ether. Herein, we analyze the hydrogenolysis of model compounds that closely resemble the native lignin 4-O-5 diaryl ether units. The results provide unexpected insights into the reactivity and partial cleavage of these compounds. The models and lignin polymer produce not only monomers, but also unusual 1,3,5-meta-substituted aromatics that appear to be diagnostic for the presence and the cleavage of the 4-O-5 diaryl ether unit in lignin.

7.
Int J Biol Macromol ; 151: 441-448, 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32087226

RESUMO

Nineteen compounds were isolated from the stems of Maackia amurensis by activity-guided screening for new human monoamine oxidase-B (hMAO-B) inhibitors. Among the compounds isolated, flavonoids calycosin (5) and 8-O-methylretusin (6) were found to potently and selectively inhibit hMAO-B (IC50 = 0.24 and 0.23 µM, respectively) but not hMAO-A with high selectivity index (SI) values (SI = 293.8 and 81.3, respectively). In addition, 5 and 6 reversibly and competitively inhibited hMAO-B with Ki values of 0.057 and 0.054 µM, respectively. A pterocarpan (-)-medicarpin (18) was also observed to strongly inhibit hMAO-B (IC50 = 0.30 µM). Most of the compounds weakly inhibited AChE, except isolupalbigenin (13) (IC50 = 20.6 µM), which suggested 13 be considered a potential dual function inhibitor of MAO-B and AChE. Molecular docking simulation revealed that the binding affinities of 5 and 6 for hMAO-B (both -9.3 kcal/mol) were higher than those for hMAO-A (-7.4 and -7.2 kcal/mol, respectively). Compound 5 was found to interact by hydrogen bonding with hMAO-B at Cys172 residue (distance: 3.250 Å); no hydrogen bonding was predicted between 5 and hMAO-A. These findings suggest that compounds 5 and 6 be considered novel potent, selective, and reversible hMAO-B inhibitors and candidates for the treatment of neurological disorders.

8.
Cancer Cell ; 37(2): 243-257.e7, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32049048

RESUMO

Sporadic gliomas in companion dogs provide a window on the interaction between tumorigenic mechanisms and host environment. We compared the molecular profiles of canine gliomas with those of human pediatric and adult gliomas to characterize evolutionarily conserved mammalian mutational processes in gliomagenesis. Employing whole-genome, exome, transcriptome, and methylation sequencing of 83 canine gliomas, we found alterations shared between canine and human gliomas such as the receptor tyrosine kinases, TP53 and cell-cycle pathways, and IDH1 R132. Canine gliomas showed high similarity with human pediatric gliomas per robust aneuploidy, mutational rates, relative timing of mutations, and DNA-methylation patterns. Our cross-species comparative genomic analysis provides unique insights into glioma etiology and the chronology of glioma-causing somatic alterations.

10.
Pediatr Int ; 2020 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-32037608

RESUMO

BACKGROUND: Aplasia cutis congenita (ACC) is a rare congenital malformation characterized by a localized absence of skin that most commonly affects the scalp. We performed the present study to elucidate the basic clinical data of ACC in Korea including demographics, clinical features, radiologic and therapeutic results. METHODS: Fifty nine patients (70 lesions) with ACC (35 from our department and 24 from a Koreamed database search) were enrolled. We assessed demographics, family and obstetrical histories, clinical features (multiplicity, subtype, size, shape, hair collar sign, location, and Frieden's classification), and radiologic and therapeutic results. RESULTS: The mean age of patients was 2.62 years, with a male to female ratio of 1.03. A minority of patients had a family history (3 patients), birth trauma (1 patient), maternal drug use (2 patients) or HIV infection (1 patient) during pregnancy, and fetus papyraceus of placental infarcts (2 patients). Six patients (6/59, 10.17%) had multiple lesions. Scarring was the most common manifestation (39/70, 55.71%). The scalp was the most commonly affected site (50 cases, 71.43%). Thirty nine patients (66.10%) met Frieden's type I classification (scalp ACC without multiple anomalies). Radiological investigations were performed in 30 patients (30/59, 50.85%) with abnormal findings in 8 patients. Twenty five patients (42.37%) were managed conservatively, and 17 patients (28.81%) were treated with local wound care. CONCLUSIONS: This is the first and largest-scale study assessing the basic clinical data of ACC in Korea. The results of present study could be useful for pediatricians and dermatologists who routinely manage ACC.

12.
PLoS One ; 15(1): e0227969, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31945112

RESUMO

PURPOSE: Although rotation of the distal portion of the tibia below the osteotomy site is considered an inevitable change in the axial plane in open wedge high tibial osteotomy (HTO), several studies on this issue have shown contradictory results. The purpose of this study was, therefore, to determine the direction and amount of distal tibial rotation following open wedge HTO using a three-dimensional reconstructed model. METHODS: This study involved 41 patients (42 knees) undergoing open wedge HTO for primary medial osteoarthritis. Distal tibial rotation was measured on the overlaid tibial plateau of a preoperative and postoperative 3-dimensional reconstructed model based on computed tomography. RESULTS: The mean distal tibial external rotation was 2.7° ± 2.3° (range, -0.9° to 9.9°), and the opening gap was larger in the group with > 3° distal tibial rotation than in the group with ≤ 3° distal tibial rotation (11.4 mm vs. 9.6 mm, P = 0.027). Multiple regression analysis showed that the opening gap was the only predictor of distal tibial rotation. On receiver operating characteristics analysis, an opening gap of 10 mm was found to be the optimal cutoff value for achieving greater than 3° of distal tibial rotation. CONCLUSIONS: Following medial opening wedge HTO, the distal tibial portion below the osteotomy site rotated approximately 3° externally. The magnitude of the external rotation of the distal tibia was affected by the opening gap width.

13.
Curr Med Chem ; 2020 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-31965939

RESUMO

A large plethora of drugs and promising lead compounds contain halogens in their structures. The introduction of such moieties strongly modulates their physical-chemical features as well as pharmacokinetic and pharmacodynamic profile. The most important outcome was shown to be the ability of these halogens to favourably influence the drug-target interaction and energetic stability within the active site by the establishment of halogen bonds. This review attempted to demonstrate the key role exerted by these versatile moieties when correctly located in an organic scaffold to display monoamine oxidase (MAO) inhibition and selectivity towards the B isoform of this important enzyme. Human MAOs are well-recognized as therapeutic targets for mood disorders and neurodegenerative diseases and medicinal chemists were prompted to discover the structural requirements crucial to discriminate the slight differences between the active sits of the two isoforms (MAO-A and MAOB). The analysis of the structure-activity relationships of the most important scaffolds (hydrazothiazoles, coumarins, chromones, chalcones, pyrazolines) and the impact of halogen (F, Cl, Br and I) insertion on this biological activity and isozyme selectivity have been reported being a source of inspiration for the medicinal chemists.

14.
Surg Endosc ; 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31925503

RESUMO

BACKGROUND: Various approaches for thyroid surgery became possible with the use of robotic systems. Transoral robotic thyroidectomy (TORT) is one of the newest approaches and draws attention because of its cosmetic excellence. In this study, we compared the surgical outcomes of TORT and conventional open thyroidectomy (OT). METHODS: We retrospectively reviewed and compared the medical records of consecutive patients who underwent TORT or OT for thyroid carcinoma from March 2009 to January 2018. Propensity score matching using 10 clinico-pathologic factors was used to generate two matched cohorts, each composed of 186 patients. RESULTS: The study included 372 patients who underwent TORT (n = 186) or OT (n = 186). Mean age, tumor size, and gender were not different between both groups. The two groups showed similar surgical outcomes, except for a longer operative time for TORT. There was one patient with immediate postoperative bleeding in the TORT group. The patient underwent re-operation for hemostasis with endoscopic approach. In the OT group, one patient had wound seroma, which was treated by several rounds of needle aspiration without infection. Vocal cord palsy was present in one patient in the TORT group, which was recovered in 3 months. CONCLUSIONS: TORT could be performed safely and had comparable surgical outcomes with OT in the selected patients. TORT may be a suitable operative alternative for patients who do not want to leave scars on the neck.

15.
Ulus Travma Acil Cerrahi Derg ; 26(1): 9-14, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31942745

RESUMO

BACKGROUND: The Tashkent city, the capital of the republic of Uzbekistan, started joint project with Korean emergency physicians to improve the quality of their ambulance services in 2016. Ambulance service in Tashkent city has been facing challenges in processing a large number of calls, and low competency of their staff in providing advanced prehospital emergency care. To design an appropriate capacity building training program for ambulance staff, we analyzed the current ambulance service in Tashkent concerning resources and competency of the staff. METHODS: In this study, ambulance staff participated in the constructed survey and pre-validated written test. Statistics and other information were provided by the Ministry of Health of Uzbekistan. RESULTS: Ninety-eight ambulance staff were participated in this study, and more than half (53.1%) of the participants were physicians. The average years of service in the ambulance were 8.71±6.9 years. In the ambulance, drugs were stocked in enough quantity include injections for critical care, except large volume fluids for resuscitation. Only 19 to 52 percent of the ambulances were equipped with essential monitoring devices. Competency for the basic procedure was surveyed higher than 60%, but critical care skills, such as defibrillation, were as low as 18%. The written test resulted in only 41.1% correct answer rate, though it was higher than 60% in the validation test for Korean ambulance staff. Conventional prehospital knowledge and skillset deemed to be essential for ambulance staff were found to be marginal in the test. CONCLUSION: The ambulance staff in Tashkent, Uzbekistan found to have insufficient medical knowledge and clinical decision-making abilities. Training program for ambulance staff in Tashkent should be developed on the basis of the findings in this study.

16.
Int J Mol Sci ; 21(3)2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31991577

RESUMO

Natural progesterone and synthetic progestin are widely used for the treatment of threatened abortion or in in vitro fertilization (IVF) cycles. This in vitro study aimed to assess whether the treatment with natural progesterone or synthetic progestin influences the germ layer gene expression on the early human embryonic development using human embryonic stem cells (hESCs)-derived embryoid bodies (hEBs) as a surrogate of early stage human embryonic development. Human EBs derived from hESCs were cultured for nine days, and were treated with natural progesterone (P4) or synthetic progestin, medroxyprogesterone acetate (MPA) at 10-7 M for five days. To reverse the effects of treatment, mifepristone (RU486) as progesterone antagonist was added to the hEBs for four days starting one day after the initiation of treatment. Mouse blastocysts (mBLs) were cultured in vitro for 24 h, and P4 or MPA at 10-7 M was treated for an additional 24 h. The treated embryos were further transferred onto in vitro cultured endometrial cells to evaluate chorionic gonadotropin (CG) expression. To analyze the effects of P4 or MPA, the expression of differentiation genes representing the three germ layers was investigated, GATA-binding factor 4 (GATA4), α-fetoprotein (AFP), hepatocyte nuclear factor (HNF)-3ß, hepatocyte nuclear factor (HNF)-4α (endoderm), Brachyury, cardiac actin (cACT) (mesoderm), and Nestin (ectoderm), using quantitative reverse transcription PCR (qRT-PCR) and immunostaining. Significantly lower expressions of HNF-3ß, HNF-4α, Brachyury, and Nestin were observed in MPA-treated hEBs (all p < 0.05), which was negated by RU486 treatment. This inhibitory effect of MPA was also observed in mouse embryos. Conclusively, the effects of natural progesterone and synthetic progestin may differ in the germ layer gene expression in the hEB model, which suggests that caution is necessary in the use of progestogen.

17.
Thorac Cancer ; 11(1): 62-71, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31707767

RESUMO

BACKGROUND: Clinical impact of the Geriatric Nutritional Risk Index (GNRI) in patients with extensive-stage disease small cell lung cancer (ED-SCLC) have not previously been reported. METHODS: This study analyzed 352 patients enrolled in a previous randomized phase III trial comparing the efficacy of irinotecan plus cisplatin with that of etoposide plus cisplatin as the first-line therapy for ED-SCLC. GNRI values were calculated using serum albumin levels and actual and ideal bodyweights. Patients with a GNRI > 98, 92-98, and <92 were grouped into no, low, and moderate/major risk groups, respectively. RESULTS: The objective response rates were 63.2%, 52.6%, and 49.2% in the no, low, and moderate/major risk groups, respectively (P = 0.024). The median progression-free survival (PFS) was shorter in patients with a lower GNRI than in those with a higher GNRI (no vs. low vs. moderate/major risk group; 6.5 vs. 5.8 vs. 5.9 months, respectively; P = 0.028). There were significant differences in median overall survival (OS) according to GNRI (no vs. low vs. moderate/major risk group; 13.2 vs. 10.3 vs. 8.4 months, respectively; P < 0.001). Multivariate analysis revealed that being in the moderate/major risk group was an independent poor prognostic factor for PFS (hazard ratio [HR]: 1.300, 95% confidence interval [CI]: 1.012-1.670; P = 0.040) and OS (HR: 1.539; 95% CI: 1.069-2.216; P = 0.020). CONCLUSIONS: This prospective study shows that a low GNRI value was associated with a poor prognosis, and it supports the relationship between systemic inflammation, nutritional status, and clinical outcomes in patients with ED-SCLC.Key points SIGNIFICANT FINDINGS OF THE STUDY: The lower GNRI group had a low response rate to chemotherapy for ED-SCLC. The HRs for PFS and OS were 1.300 and 1.539 in the patients with GNRI < 92. WHAT THIS STUDY ADDS: Low GNRI is associated with poor prognosis in ED-SCLC.

18.
Bioorg Chem ; 94: 103405, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31806156

RESUMO

This report describes the synthesis of a library of fluorogenic carbapenemase substrates consisting of carbapenem derivatives, fluorescence dyes, and active cleavable linkers and their evaluation for specifically detecting carbapenemase-producing organisms (CPOs). We synthesized a series of compounds having three different types of linkers such as benzyl ether, carbamate, and amine using hydroxymethyl carbapenem 7a and hydroxyallyl carbapenem 7b as key intermediates. Probe 1b exhibited high stability and a prompt turn-on fluorescence signal upon hydrolysis by carbapenemases. In particular, the screening of clinical samples indicated that the probe 1b exhibited excellent selectivity to the CPOs over other ß-lactamases or non-carbapenemase producing bacteria, which may be of clinical use for the rapid and accurate detection of CPOs for timely diagnosis and treatment.

19.
Ophthalmology ; 127(1): 85-94, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31281057

RESUMO

PURPOSE: To develop and evaluate deep learning models that screen multiple abnormal findings in retinal fundus images. DESIGN: Cross-sectional study. PARTICIPANTS: For the development and testing of deep learning models, 309 786 readings from 103 262 images were used. Two additional external datasets (the Indian Diabetic Retinopathy Image Dataset and e-ophtha) were used for testing. A third external dataset (Messidor) was used for comparison of the models with human experts. METHODS: Macula-centered retinal fundus images from the Seoul National University Bundang Hospital Retina Image Archive, obtained at the health screening center and ophthalmology outpatient clinic at Seoul National University Bundang Hospital, were assessed for 12 major findings (hemorrhage, hard exudate, cotton-wool patch, drusen, membrane, macular hole, myelinated nerve fiber, chorioretinal atrophy or scar, any vascular abnormality, retinal nerve fiber layer defect, glaucomatous disc change, and nonglaucomatous disc change) with their regional information using deep learning algorithms. MAIN OUTCOME MEASURES: Area under the receiver operating characteristic curve and sensitivity and specificity of the deep learning algorithms at the highest harmonic mean were evaluated and compared with the performance of retina specialists, and visualization of the lesions was qualitatively analyzed. RESULTS: Areas under the receiver operating characteristic curves for all findings were high at 96.2% to 99.9% when tested in the in-house dataset. Lesion heatmaps highlight salient regions effectively in various findings. Areas under the receiver operating characteristic curves for diabetic retinopathy-related findings tested in the Indian Diabetic Retinopathy Image Dataset and e-ophtha dataset were 94.7% to 98.0%. The model demonstrated a performance that rivaled that of human experts, especially in the detection of hemorrhage, hard exudate, membrane, macular hole, myelinated nerve fiber, and glaucomatous disc change. CONCLUSIONS: Our deep learning algorithms with region guidance showed reliable performance for detection of multiple findings in macula-centered retinal fundus images. These interpretable, as well as reliable, classification outputs open the possibility for clinical use as an automated screening system for retinal fundus images.

20.
Stress ; 23(2): 153-161, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31469025

RESUMO

Successful shooting performance in competition is reliant on several factors such as shooting techniques and competition-associated psychological stresses. This study examined the hypothalamus-pituitary-adrenal (HPA) axis response to upcoming competition and its association with shooting outcomes in elite junior shooting players. The cortisol awakening response (CAR) and dehydroepiandrosterone (DHEA) secretion after awakening were measured for two consecutive days (the day before and on the day of competition for the selection of national shooting team members) in 19 junior men and 21 junior women players, and the shooting scores of the individual players were obtained. The total cortisol secretion during the CAR period (CARauc) increased, but total DHEA secretion during the post-awakening period (Daucawk) decreased on the day of competition, compared with one day before competition. The CARauc was higher in women than in men players, whereas Daucawk was higher in men than in women players across the two consecutive days. Cortisol and DHEA levels were comparable between low-scored (below the mean scores for air pistol or air rifle players) and high-scored players one day before competition. However, the CARauc on the day of competition was higher and the variations in the CARauc and molar CARauc/Daucawk ratios across the two consecutive days were greater in low-scored than in high-scored men and women players. These results indicated that upcoming competition involves alterations of the CAR and DHEA secretion after the awakening period, and greater HPA response to the upcoming competition was adversely associated with shooting scores in junior shooting athletes.Lay summaryAn important upcoming competition was perceived as a strong stressor on awakening that induced alteration in CAR and DHEA secretion after the awakening period in elite shooting players. This study observed that, irrespective of their age and period of shooting practice, the HPA axis function on the day of competition was associated with shooting outcomes in elite shooting players.

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