Acute effects of a commercially-available pre-workout supplement on markers of training: a double-blind study

Background: Pre-workout supplements containing numerous ingredients claim to increase performance and strength. Product-specific research is important for identifying efficacy of combined ingredients. The purpose of this study was to evaluate the effects of a proprietary pre-workout dietary supplement containing creatine monohydrate, beta-alanine, L-Tarurine, L-Leucine, and caffeine, on anaerobic power, muscular strength, body composition, and mood states. Methods: In a double-blind, randomized, matched-pair design, twenty male subjects (mean ± SD; 22.4 ± 9.5 yrs, 76.9 ± 11.2 kg, 22.7 ± 9.5% body fat), consumed either 30 g of a pre-workout supplement (SUP) or maltodextrin placebo (PLC) 30 minutes before a resistance training workout, after completing baseline testing. Body composition was determined via dual-energy x-ray absorptiometry (DEXA). Subjects completed 12 vertical jumps for height (VJ) and one repetition maximum (1RM) and repetitions to failure lifts on bench (BPM) and leg press (LPM). Finally, subjects completed a Wingate power test on a cycle ergometer [mean power (WMP) and peak power (WPP)]. After baseline testing, participants completed eight days of supplementation and four split-body resistance-training bouts. Side effect questionnaires were completed daily 30 minutes after consuming the supplement. Subjects completed post-supplement testing on Day 8. Data were analyzed utilizing a 2 × 2 repeated measures ANOVA [treatment (PLC vs SUP) × time (T1 vs T2)] and ninety-five percent confidence intervals. Results: There were no significant treatment × time interactions (p > 0.05). There were no significant changes in %body fat (%BF; Δ-0.43 ± 0.58; p = 0.920), fat mass (Δ-2.45 ± 5.72; p = 0.988), or lean body mass (LBM; 10.9 ± 12.2; p = 0.848). 95% CI demonstrated significant LBM increases for both groups. There was a main effect for time for WPP (Δ100.5 ± 42.7W; p = 0.001), BPM (Δ8.0 ± 12.9 lbs; p = 0.001), and LPM (Δ80.0 ± 28.8 lbs; p = 0.001), with no significant differences between treatments. There was no significant difference in mood states between groups or over time. Conclusion: The proprietary pre-workout blend combined with eight days of training did not significantly (ANOVA) improve body composition or performance. While not significant, greater gains in LPM were demonstrated in the SUP group for lean body mass and lower body strength. Future studies should evaluate more chronic effects of proprietary pre-workout blends on total training volume and performance outcomes

Effects of a pre-and post-workout protein-carbohydrate supplement in trained crossfit individuals

Abstract Purpose The purpose was to assess effects of a pre- and a post-workout protein-carbohydrate supplement on CrossFit-specific performance and body composition. Methods In an open label randomized study, 13 male and 16 female trained Crossfit participants (mean ± SD; age: 31.87 ± 7.61 yrs, weight: 78.68 ± 16.45 kg, percent body fat: 21.97 ± 9.02) were assessed at 0 and 6 weeks for body composition, VO2max, Wingate peak (WPP) and mean power (WMP), in addition to sport-specific workouts (WOD1: 500 m row, 40 wall balls, 30 push-ups, 20 box jumps, 10 thrusters for time; WOD2: 15 minutes to complete an 800 m run "buy in", followed by as many rounds as possible (AMRAP) of 5 burpees, 10 Kettlebell swings, 15 air squats). The supplement (SUP) group consisted of 19 g of a pre-workout drink (extracts of pomegranate, tart cherry, green and black tea) taken 30 minutes before and a post-workout protein (females: 20 g; males: 40 g) and carbohydrate (females: 40 g; males: 80 g) supplement consumed immediately after each workout. The control (CTL) group consumed only water one hour before or after workouts. Participants completed three (minimum) varied workouts per week at a CrossFit gym as typical to habitual training throughout the six week study. Data were analyzed by repeated measures ANOVA (p <0 .05), 95% Confidence Intervals, and Magnitude Inferences. Results There were no time × group interactions for body composition, WMP, or WOD1 based on ANOVA statistics. VO2MAX, WPP, and WOD2 results revealed that the pre/post supplements were likely beneficial after 95% Confidence Intervals and Magnitude Inferences analysis. Conclusion The combination of proprietary supplements taken for 6 weeks may provide benefits during certain sport-specific performance in trained CrossFit athletes but not others

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Effects of a High Protein and Omega-3-Enriched Diet with or Without Creatine Supplementation on Markers of Soreness and Inflammation During 5 Consecutive Days of High Volume Resistance Exercise in Females

We examined if two different dietary interventions affected markers of soreness and inflammation over a 5-day high-volume resistance training protocol in females that resistance-trained 8 weeks prior. Twenty-eight females (age: 20 ± 1 yr; body mass: 63.5 ± 1.6 kg, height: 1.67 ± 0.01 m) completed 4 weeks of pre-training (weeks 1-4) followed by a subsequent 4-week training period along with a dietary intervention (weeks 5-8). Dietary interventions from weeks 5-8 included: a) no intervention (CTL, n = 10) b) a higher-protein diet supplemented with hydrolyzed whey protein (50 g/d) and omega-3 fatty acids (900 mg/d) (DI, n = 8), and c) the DI condition as well as creatine monohydrate (5 g/d) (DI+C, n = 10). During week 9, participants resistance-trained for five consecutive days whereby 8 sets of 10 target repetitions at 70% one repetition maximum (1RM) were performed each day for bench press, back squat, deadlift, and hip-thrusters with the intent of eliciting muscle soreness and inflammation. Prior to and 24 h following each of the 5 bouts muscle soreness (DOMS) was assessed via questionnaire, and fasting blood was obtained and analyzed for serum cortisol, interleukin-6 (IL-6) and C-reactive protein (CRP). No group*time (G*T) or time effects were observed for training volume over the 5-d overreaching protocol. Furthermore, no group*time (G*T) or time effects were observed for serum cortisol, IL-6 or CRP, and DOMS actually decreased in all groups 24 h following the fifth day training bout. This study demonstrates that, regardless of protein, omega-3 fatty acid and/or creatine supplementation, 5 days of consecutive resistance training does not alter perceived muscle soreness, training volume, and/or markers of inflammation in novice resistance-trained females

Enhanced infection prophylaxis reduces mortality in severely immunosuppressed HIV-infected adults and older children initiating antiretroviral therapy in Kenya, Malawi, Uganda and Zimbabwe: the REALITY trial

Meeting abstract FRAB0101LB from 21st International AIDS Conference 18–22 July 2016, Durban, South Africa. Introduction: Mortality from infections is high in the first 6 months of antiretroviral therapy (ART) among HIV‐infected adults and children with advanced disease in sub‐Saharan Africa. Whether an enhanced package of infection prophylaxis at ART initiation would reduce mortality is unknown. Methods: The REALITY 2×2×2 factorial open‐label trial (ISRCTN43622374) randomized ART‐naïve HIV‐infected adults and children >5 years with CD4 <100 cells/mm3. This randomization compared initiating ART with enhanced prophylaxis (continuous cotrimoxazole plus 12 weeks isoniazid/pyridoxine (anti‐tuberculosis) and fluconazole (anti‐cryptococcal/candida), 5 days azithromycin (anti‐bacterial/protozoal) and single‐dose albendazole (anti‐helminth)), versus standard‐of‐care cotrimoxazole. Isoniazid/pyridoxine/cotrimoxazole was formulated as a scored fixed‐dose combination. Two other randomizations investigated 12‐week adjunctive raltegravir or supplementary food. The primary endpoint was 24‐week mortality. Results: 1805 eligible adults (n = 1733; 96.0%) and children/adolescents (n = 72; 4.0%) (median 36 years; 53.2% male) were randomized to enhanced (n = 906) or standard prophylaxis (n = 899) and followed for 48 weeks (3.8% loss‐to‐follow‐up). Median baseline CD4 was 36 cells/mm3 (IQR: 16–62) but 47.3% were WHO Stage 1/2. 80 (8.9%) enhanced versus 108(12.2%) standard prophylaxis died before 24 weeks (adjusted hazard ratio (aHR) = 0.73 (95% CI: 0.54–0.97) p = 0.03; Figure 1) and 98(11.0%) versus 127(14.4%) respectively died before 48 weeks (aHR = 0.75 (0.58–0.98) p = 0.04), with no evidence of interaction with the two other randomizations (p > 0.8). Enhanced prophylaxis significantly reduced incidence of tuberculosis (p = 0.02), cryptococcal disease (p = 0.01), oral/oesophageal candidiasis (p = 0.02), deaths of unknown cause (p = 0.02) and (marginally) hospitalisations (p = 0.06) but not presumed severe bacterial infections (p = 0.38). Serious and grade 4 adverse events were marginally less common with enhanced prophylaxis (p = 0.06). CD4 increases and VL suppression were similar between groups (p > 0.2). Conclusions: Enhanced infection prophylaxis at ART initiation reduces early mortality by 25% among HIV‐infected adults and children with advanced disease. The pill burden did not adversely affect VL suppression. Policy makers should consider adopting and implementing this low‐cost broad infection prevention package which could save 3.3 lives for every 100 individuals treated

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least 4 m. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the 6.5 m James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 yr, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit