An investigation into sleep patterns and the effect of time of day on performance in youth swimmers

The purpose of this study was to investigate sleep patterns in competitive youth swimmers and to establish any time-of-day effect on physiological and psychological variables linked to swimming performance. Twelve swimmers (14.8 ± 2.1 years) underwent physiological and psychological tests in morning and evening and completed sleep diaries over a 2-week period. There was a non-significant effect between morning and evening swimming performance for 800 m (p = 0.068) and 50 m (p = 0.306). Handgrip strength was significantly greater in evening (p = 0.007), back and leg strength were significantly greater in morning (p = 0.013). There was no time-of-day effect for jump height (p = 0.756). The profile of mood states indicated significantly higher anger (p = 0.012) and vigour (p = 0.000) in the morning. Swimming performance was not significantly affected by time of day; however, physiological variables showed varied results. Multiple factors could be influencing results including training time and mood state so should be monitored closely by coaches

Land based resistance training and youth swimming performance

Resistance training has been shown to have both performance-enhancing and injury reducing benefits in youth athletes. The benefits are somewhat overlooked by many swimming coaches, therefore the effects of a structured resistance training programme in highly trained youth swimmers was investigated. Nine competitive youth swimmers (age: 13 ± 1.1 years) underwent a 7 week dry-land resistance training programme. Swimming performance and other relevant physiological parameters were measured pre- and post-training. There was a small non-significant improvement in swimming performance following the 7 week training programme (100m freestyle; p > 0.05, ES = 0.26). Countermovement jump height (p < 0.05, ES = -1.26), back and leg strength (p < 0.05, ES = -1.85) and number of push ups completed in 60 s (p < 0.05, ES = -1.86) all significantly improved. Although the resistance training programme did not significantly improve swimming performance, other physiological parameters, important for success in the pool, did significantly improve. It may be that an adaptation period is needed so the swimmers can learn to efficiently apply their increased force in the water

An overview of the effect of probiotics and exercise on mood and associated health conditions

The present paper provides a review of the current knowledge relating to the health benefits of probiotics, specially focused on the effects they may have together with physical exercise on mood disorders and related chronic medical conditions. With both these conditions being a substantial contributor to the global disease burden any alternative therapy must be considered. Probiotics influence the gut microbiota through a complex network of events which can influence mechanisms leading to development of mood disorders such as depression and anxiety. Similarly, through a complex interaction between psychological and neurobiological mechanisms, exercise has been found to play a key role in mood enhancement

The influence of serial carbohydrate mouth rinsing on power output during a cycle sprint

The objective of the study was to investigate the influence of serial administration of a carbohydrate (CHO) mouth rinse on performance, metabolic and perceptual responses during a cycle sprint. Twelve physically active males (mean (± SD) age: 23.1 (3.0) years, height: 1.83 (0.07) m, body mass (BM): 86.3 (13.5) kg) completed the following mouth rinse trials in a randomized, counterbalanced, double-blind fashion; 1. 8 x 5 second rinses with a 25 ml CHO (6% w/v maltodextrin) solution, 2. 8 x 5 second rinses with a 25 ml placebo (PLA) solution. Following mouth rinse administration, participants completed a 30 second sprint on a cycle ergometer against a 0.075 g·kg-1 BM resistance. Eight participants achieved a greater peak power output (PPO) in the CHO trial, resulting in a significantly greater PPO compared with PLA (13.51 ± 2.19 vs. 13.20 ± 2. 14 W·kg-1, p < 0.05). Magnitude inference analysis reported a likely benefit (81% likelihood) of the CHO mouth rinse on PPO. In the CHO trial, mean power output (MPO) showed a trend for being greater in the first 5 seconds of the sprint and lower for the remainder of the sprint compared with the PLA trial (p > 0.05). No significant between-trials difference was reported for fatigue index, perceived exertion, arousal and nausea levels, or blood lactate and glucose concentrations. Serial administration of a CHO mouth rinse may significantly improve PPO during a cycle sprint. This improvement appears confined to the first 5 seconds of the sprint, and may come at a greater relative cost for the remainder of the sprint

The effect of prior upper body exercise on subsequent wingate performance

It has been reported previously that the upper body musculature is continually active during high intensity cycle ergometry. The aim of this study was to examine the effects of prior upper body exercise on subsequent Wingate (WAnT) performance. Eleven recreationally active males (20.8 ± 2.2 yrs; 77.7 ± 12.0 kg;  1.79 ± 0.04 m) completed two trials in a randomised order. In one trial participants completed 2 × 30 s WAnT tests (WAnT1 and WAnT2) with a 6 min recovery period; in the other trial, this protocol was preceded with 4 sets of biceps curls to induce localised arm fatigue. Prior upper body exercise was found to have a statistically significant detrimental effect on peak power output (PPO) during WAnT1 (P < 0.05) but no effect was observed for mean power output (MPO) (P > 0.05). Handgrip (HG) strength was also found to be significantly lower following the upper body exercise. These results demonstrate that the upper body  is meaningfully involved in the generation of leg power during intense cycling

Weekly vitamin D₃ supplementation improves aerobic performance in combat sport athletes

Vitamin D3 supplementation can affect the strength and power of an athlete, however the effect on endurance performance remains unclear. Twenty-seven recreational male combat athletes with at least 12 months experience within combat sports were recruited (age: 24 ± 4 years, stature: 176 ± 6 cm, weight: 77 ± 14 kg). Participants completed baseline testing for blood haemoglobin and haematocrit, upper and lower body VO2peak and upper and lower body Wingate. Following testing participants were stratified to 50000IU (D1), 80000IU (D2) or 110000IU (D3) of vitamin D3 per week. They then completed a 6-week placebo period followed by a 6-week supplementation period. Retesting was carried out after the placebo and supplementation period. There was a significant effect for time for haemoglobin and haematocrit, upper and lower body VO2peak and upper body Wingate power (p<0.01) but no effect for dose of vitamin D given. Performance data was normalised to vitamin D intake and there was a moderate effect size between D1 and D2 for lower body VO2peak (d=0.6), upper body VO2peak (d=0.13) and upper body average power (d=0.75), with a large effect size between D1 and D2 for haemoglobin (d=1.19), haematocrit (d=0.93) and upper body peak power (d=0.95). There was a large effect size for D1 compared to D3 for all variables (d>0.8). Therefore, there is no additional benefit to increasing dose above 500000IU vitamin D per week. Given the endurance adaptations from vitamin D supplementation and the importance of endurance for combat performance, recreational combat athletes should supplement at 50000IU per week for six weeks

Novel loci for childhood body mass index and shared heritability with adult cardiometabolic traits

The genetic background of childhood body mass index (BMI), and the extent to which the well-known associations of childhood BMI with adult diseases are explained by shared genetic factors, are largely unknown. We performed a genome-wide association study meta-analysis of BMI in 61,111 children aged between 2 and 10 years. Twenty-five independent loci reached genome-wide significance in the combined discovery and replication analyses. Two of these, located nearNEDD4LandSLC45A3, have not previously been reported in relation to either childhood or adult BMI. Positive genetic correlations of childhood BMI with birth weight and adult BMI, waist-to-hip ratio, diastolic blood pressure and type 2 diabetes were detected (R(g)ranging from 0.11 to 0.76, P-values Author summary Although twin studies have shown that body mass index (BMI) is highly heritable, many common genetic variants involved in the development of BMI have not yet been identified, especially in children. We studied associations of more than 40 million genetic variants with childhood BMI in 61,111 children aged between 2 and 10 years. We identified 25 genetic variants that were associated with childhood BMI. Two of these have not been implicated for BMI previously, located close to the genesNEDD4LandSLC45A3. We also show that the genetic background of childhood BMI overlaps with that of birth weight, adult BMI, waist-to-hip-ratio, diastolic blood pressure, type 2 diabetes, and age at menarche. Our results suggest that the biological processes underlying childhood BMI largely overlap with those underlying adult BMI. However, the overlap is not complete. Additionally, the genetic backgrounds of childhood BMI and other cardio-metabolic phenotypes are overlapping. This may mean that the associations of childhood BMI and later cardio-metabolic outcomes are partially explained by shared genetics, but it could also be explained by the strong association of childhood BMI with adult BMI.Peer reviewe

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Targeting DNA Damage Response and Replication Stress in Pancreatic Cancer

Background and aims: Continuing recalcitrance to therapy cements pancreatic cancer (PC) as the most lethal malignancy, which is set to become the second leading cause of cancer death in our society. The study aim was to investigate the association between DNA damage response (DDR), replication stress and novel therapeutic response in PC to develop a biomarker driven therapeutic strategy targeting DDR and replication stress in PC. Methods: We interrogated the transcriptome, genome, proteome and functional characteristics of 61 novel PC patient-derived cell lines to define novel therapeutic strategies targeting DDR and replication stress. Validation was done in patient derived xenografts and human PC organoids. Results: Patient-derived cell lines faithfully recapitulate the epithelial component of pancreatic tumors including previously described molecular subtypes. Biomarkers of DDR deficiency, including a novel signature of homologous recombination deficiency, co-segregates with response to platinum (P < 0.001) and PARP inhibitor therapy (P < 0.001) in vitro and in vivo. We generated a novel signature of replication stress with which predicts response to ATR (P < 0.018) and WEE1 inhibitor (P < 0.029) treatment in both cell lines and human PC organoids. Replication stress was enriched in the squamous subtype of PC (P < 0.001) but not associated with DDR deficiency. Conclusions: Replication stress and DDR deficiency are independent of each other, creating opportunities for therapy in DDR proficient PC, and post-platinum therapy