Morning versus evening dosing of desloratadine in seasonal allergic rhinitis: a randomized controlled study [ISRCTN23032971].

BACKGROUND: A circadian rhythm of symptoms has been reported in allergic rhinitis and some studies have shown the dosing time of antihistamines to be of importance for optimizing symptom relief in this disease. The objective of this study was to examine the efficacy of morning vs. evening dosing of the antihistamine desloratadine at different time points during the day. METHODS: Patients >/= 18 years, with seasonal allergic rhinitis received desloratadine 5 mg orally once daily in the morning (AM-group) or evening (PM-group) for two weeks. Rhinorrhea, nasal congestion, sneezing and eye symptoms were scored morning and evening. Wilcoxon rank sum and 2-way ANOVA test were used. RESULTS: Six-hundred and sixty-three patients were randomized; 336 in the AM-group; 327 in the PM-group. No statistically significant differences were seen between the AM and PM group at any time points. In the sub-groups with higher morning or evening total symptom score no difference in treatment efficacy was seen whether the dose was taken 12 or 24 hours before the higher score time. There was a circadian variation in baseline total symptom score; highest during daytime and lowest at night. The circadian variation in symptoms was reduced during treatment. This reduction was highest for daytime symptoms. CONCLUSIONS: A circadian rhythm was seen for most symptoms being more pronounced during daytime. This was less apparent after treatment with desloratadine. No statistically significant difference in efficacy was seen whether desloratadine was given in the morning or in the evening. This gives the patients more flexibility in choosing dosing time.     

Optimal cycling time trial position models: Aerodynamics versus power output and metabolic energy

The aerodynamic drag of a cyclist in time trial (TT) position is strongly influenced by the torso angle. While decreasing the torso angle reduces the drag, it limits the physiological functioning of the cyclist. Therefore the aims of this study were to predict the optimal TT cycling position as function of the cycling speed and to determine at which speed the aerodynamic power losses start to dominate. Two models were developed to determine the optimal torso angle: a ‘Metabolic Energy Model’ and a ‘Power Output Model’. The Metabolic Energy Model minimised the required cycling energy expenditure, while the Power Output Model maximised the cyclists? power output. The input parameters were experimentally collected from 19 TT cyclists at different torso angle positions (0–24°). The results showed that for both models, the optimal torso angle depends strongly on the cycling speed, with decreasing torso angles at increasing speeds. The aerodynamic losses outweigh the power losses at cycling speeds above 46 km/h. However, a fully horizontal torso is not optimal. For speeds below 30 km/h, it is beneficial to ride in a more upright TT position. The two model outputs were not completely similar, due to the different model approaches. The Metabolic Energy Model could be applied for endurance events, while the Power Output Model is more suitable in sprinting or in variable conditions (wind, undulating course, etc.). It is suggested that despite some limitations, the models give valuable information about improving the cycling performance by optimising the TT cycling position.     

Relationships between isokinetic knee strength, single-sprint performance, and repeated-sprint ability in football players

Previous research has demonstrated that muscular strength of the knee extensors is related to the speed an athlete can produce during a single-sprint performance. Football players, as well as many other athletes on the field and the court, execute multiple sprints during the course of a match. The purpose of this study was to examine the relationships between leg strength, single-sprint speed, and repeated-sprint ability. Thirty-eight football players from 3 codes (soccer, rugby league, rugby union) completed a 12- x 20-m repeated-sprint protocol and were evaluated for peak isokinetic knee extension and flexion torque at 60 degrees .s(-1), 150 degrees .s(-1), and 240 degrees .s(-1). Although single-sprint performance correlated with peak extensor and flexor torque at all velocities, the strongest correlation was observed between relative knee extensor torque at 240 degrees .s(-1) and the initial acceleration phase (0-10 m) of the single-sprint performance (r = -0.714, p < 0.01). However, the data suggest that factors other than strength contribute to repeated-sprint ability. This finding provides new evidence in elucidating the relationship between strength and repeated-sprint performance.     

Frequency-dependent power output and skeletal muscle design

Cyclically contracting muscles provide power for a variety of processes including locomotion, pumping blood, respiration, and sound production. In the current study, we apply a computational model derived from force–velocity relationships to explore how sustained power output is systematically affected by shortening velocity, operational frequency, and strain amplitude. Our results demonstrate that patterns of frequency dependent power output are based on a precise balance between a muscle's intrinsic shortening velocity and strain amplitude. We discuss the implications of this constraint for skeletal muscle design, and then explore implications for physiological processes based on cyclical muscle contraction. One such process is animal locomotion, where musculoskeletal systems make use of resonant properties to reduce the amount of metabolic energy used for running, swimming, or flying. We propose that skeletal muscle phenotype is tuned to this operational frequency, since each muscle has a limited range of frequencies at which power can be produced efficiently. This principle also has important implications for our understanding muscle plasticity, because skeletal muscles are capable of altering their active contractile properties in response to a number of different stimuli. We discuss the possibility that muscles are dynamically tuned to match the resonant properties of the entire musculoskeletal system.     

Optimizing power output by varying repetition tempo

The effects of varying interrepetition rest and eccentric velocity on power output (PO) and the number of repetitions performed during a bench press set were examined in 24 college-aged resistance trained men. On 6 separate occasions, subjects performed a set of bench press at 80% 1 repetition maximum until volitional fatigue. For each of the 6 repetition tempo trials, the bench press set was paced by metronome to a unique repetition tempo involving a combination of the following: interrepetition rest of 0 or 4 seconds; eccentric velocity of 1 or 4 seconds and bottom rest of 0 or 3 seconds. The velocity of concentric contraction was maximal during all 6 tempo trials. During each trial, video data were captured to determine PO variables and number of successful repetitions completed at each tempo. One-way repeated measures analysis of variance showed tempos with a fast eccentric phase (1 second), and no bottom rest produced significantly greater (p ≤ 0.05) PO and repetitions than tempos involving slower eccentric velocity (4 seconds) or greater bottom rest (4 seconds). This combination of greater repetitions and PO resulted in a greater volume of work. Varying interrepetition rest (1 or 4 seconds) did not significantly affect PO or repetitions. The results of this study support the use of fast eccentric speed and no bottom rest during acute performance testing to maximize PO and number of repetitions during a set of bench press.     

Effect of interrepetition rest on power output in the power clean

The effect of interrepetition rest (IRR) periods on power output during performance of multiple sets of power cleans is unknown. It is possible that IRR periods may attenuate the decrease in power output commonly observed within multiple sets. This may be of benefit for maximizing improvements in power with training. This investigation involved 10 college-aged men with proficiency in weightlifting. The subjects performed 3 sets of 6 repetitions of power cleans at 80% of their 1 repetition maximum with 0 (P0), 20 (P20), or 40 seconds (P40) of IRR. Each protocol (P0, P20, P40) was performed in a randomized order on different days each separated by at least 72 hours. The subjects performed the power cleans while standing on a force plate with 2 linear position transducers attached to the bar. Peak power, force, and velocity were obtained for each repetition and set. Peak power significantly decreased by 15.7% during P0 in comparison with a decrease of 5.5% (R1: 4,303 ± 567 W, R6: 4,055 ± 582 W) during P20 and a decrease of 3.3% (R1: 4,549 ± 659 W, R6: 4,363 ± 476 W) during P40. Peak force significantly decreased by 7.3% (R1: 2,861 ± 247 N, R6: 2,657 ± 225 N) during P0 in comparison with a decrease of 2.7% (R1: 2,811 ± 327 N, R6: 2,730 ± 285 N) during P20 and an increase of 0.4% (R1: 2,861 ± 323 N, R6: 2,862 ± 280 N) during P40. Peak velocity significantly decreased by 10.2% (R1: 1.97 ± 0.15 m·s(-1), R6: 1.79 ± 0.11 m·s(-1)) during P0 in comparison with a decrease of 3.8% (R1: 1.89 ± 0.13 m·s(-1), R6: 1.82 ± 0.12 m·s(-1)) during P20 and a decrease of 1.7% (R1: 1.93 ± 0.17 m·s(-1), R6: 1.89 ± 0.14 m·s(-1)) during P40. The results demonstrate that IRR periods allow for the maintenance of power in the power clean during a multiple set exercise protocol and that this may have implications for improved training adaptations.     

Protein crystallization for genomics: throughput versus output

Structural genomics involves many steps in order to reach from Gene to structure. This article focuses on the crystallization step in this chain of tasks. It is becoming increasingly evident that the current high throughput procedures for crystallising proteins do not always produce the expected output of high quality crystals required for structure determination by x-ray crystallography. This problem is discussed and suggestions for raising the output are presented.     

Alteration of internal circadian phase relationships after morning versus evening carbohydrate-rich meals in humans

The effects of a single morning and evening carbohydrate-rich meal for 3 consecutive days on circadian phase of core body temperature (CBT), heart rate, and salivary melatonin rhythms were compared under controlled constant routine conditions. In 10 healthy young men entrained to a natural light-dark cycle with regular sleep timing, CBT and heart rate were significantly elevated for approximately 8 h after the last evening carbohydrate-rich meal (EM), and nocturnal melatonin secretion (as measured by salivary melatonin and urinary 6-sulphatoxymelatonin levels) was reduced, compared to the morning carbohydrate-rich meal (MM) condition. Thus, circadian phase could not be measured until the following day due to this acute masking effect. The day after the last meal intervention, MM showed a significant advanced circadian phase position in CBT (+59+/-12 min) and heart rate (+43+/-18 min) compared to EM. However, dim-light melatonin onset was not significantly changed (+15+/-13 min). The results are discussed with respect to central (light-entrainable) and peripheral (food-entrainable) oscillators. Food may be a zeitgeber in humans for the food-entrainable peripheral oscillators, but melatonin data do not support such a conclusion for the light-entrainable oscillator in the suprachiasmatic nucleus.     

Maximal mechanical power output and capacity of cyclists and young adults

The maximal average power output (Wmax) has been examined in 10 male students, 22 pursuit and 12 sprint cyclists. In 24 of these subjects (8 students, 10 pursuit and 6 sprint cyclists), estimates of the maximal capacity (Wcap) of the short-term anaerobic energy yielding processes were made. The results show that the sprinters had a higher absolute Wmax (1241 +/- 266 W) and Wcap (16.7 +/- 4.9 kJ) than either the students (1019 +/- 183 W, 14.7 +/- 2.8 kJ) or the pursuit cyclists (962 +/- 206 W, 14.0 +/- 2.9 kJ). However, the differences were removed when the values were standardised for muscle size. In the sprinters the Wmax was attained at an optimal pedal frequency Vopt of 132 +/- 3 min-1 and the estimated maximal velocity of pedalling (V0) was 262 +/- 8 min-1. The comparable figures in the students and pursuit cyclists were 118 +/- 8 min-1, 235 +/- 17 min-1 and 122 +/- 6 min-1, 242 +/- 12 min-1 respectively. The coefficient of variation of duplicate measurements of Wcap was found to be +/- 9%. Using data of Wilkie (1968) for muscle phosphagen and glycolytic stores (27 mmol.kg-1), it was estimated that the probable efficiency of the anaerobic processes during maximal cycling was 0.22. It was concluded that Wmax and Wcap are largely determined by body size and muscularity. The efficiency of anaerobiosis appears to be of the same order of magnitude as found for oxidative work.     

Wavelength-dependent effects of evening light exposure on sleep architecture and sleep EEG power density in men

Light strongly influences the circadian timing system in humans via non-image-forming photoreceptors in the retinal ganglion cells. Their spectral sensitivity is highest in the short-wavelength range of the visible light spectrum as demonstrated by melatonin suppression, circadian phase shifting, acute physiological responses, and subjective alertness. We tested the impact of short wavelength light (460 nm) on sleep EEG power spectra and sleep architecture. We hypothesized that its acute action on sleep is similar in magnitude to reported effects for polychromatic light at higher intensities and stronger than longer wavelength light (550 nm). The sleep EEGs of eight young men were analyzed after 2-h evening exposure to blue (460 nm) and green (550 nm) light of equal photon densities (2.8 x 10(13) photons x cm(-2) x s(-1)) and to dark (0 lux) under constant posture conditions. The time course of EEG slow-wave activity (SWA; 0.75-4.5 Hz) across sleep cycles after blue light at 460 nm was changed such that SWA was slightly reduced in the first and significantly increased during the third sleep cycle in parietal and occipital brain regions. Moreover, blue light significantly shortened rapid eye movement (REM) sleep duration during these two sleep cycles. Thus the light effects on the dynamics of SWA and REM sleep durations were blue shifted relative to the three-cone visual photopic system probably mediated by the circadian, non-image-forming visual system. Our results can be interpreted in terms of an induction of a circadian phase delay and/or repercussions of a stronger alerting effect after blue light, persisting into the sleep episode.     

Comparison of the efficacy of morning versus evening administration of olmesartan in uncomplicated essential hypertension

A total of 18 diurnally active subjects with uncomplicated, mild to moderate, essential hypertension were studied to compare the efficacy of the morning versus evening administration of an oral olmesartan medication. After a two-week, wash-out/placebo run-in period, subjects with clinic diastolic blood pressure (DBP) > or = 90 mm Hg and <110 mm Hg began 12 weeks of 20 mg olmesartan medoxomil tablet therapy at 08:00 h daily. Four of the 18 subjects required dose escalation to 40 mg at eight weeks because of clinic DBP > or = 90 mm Hg. After the 12-week period of once-a-day 08:00 h treatment, subjects were immediately switched to an evening (20:00 h) drug-ingestion schedule for another 12-week period without change in dose. Subjects underwent 24 h ambulatory blood pressure monitoring (ABPM) before the initiation of morning treatment and at the end of both the 12-week morning and evening treatment arms. Dosing time did not exert statistically significant differences on the efficacy of olmesartan: the reduction from baseline in the 24 h mean systolic (SBP) and DBP was, respectively, 18.8 and 14.6 mm Hg with morning dosing and 16.1 and 13.2 mm Hg with evening dosing (p>0.152 between groups). The amplitude of the BP 24 h pattern did not vary with dosing time, indicating full 24 h BP reduction no matter the clock hour of treatment. Although, the BP-lowering effect was somewhat better with morning dosing, the results of this study suggest that the studied olmesartan medoxomil preparation efficiently reduces BP when ingested in the morning (08:00 h) or evening (20:00 h) in equivalent manner, based on statistical testing, throughout the 24 h.     

Influence of hip orientation on Wingate power output and cycling technique

The effect of altered hip orientation angle ([HOA] angle of hip joint center to bottom bracket relative to horizontal) on Wingate anaerobic test results and cycling technique while maintaining a constant body configuration angle (included angle between torso, hip, and bottom bracket) and maximum hip-to-pedal distance was examined. Nineteen recreational cyclists, all men, with no recent recumbent cycling experience completed 30-second Wingate tests in 3 recumbent positions (HOA = -20 degrees, -10 degrees, and 0 degrees ) and the standard cycling position (SCP) (HOA = 75 degrees ). Peak, average, and minimum power output, as well as fatigue index, were not significantly different across all positions (p < 0.01). Average hip and knee extension angles increased slightly, and ankle angle did not change as HOA increased. These findings indicate that although HOA does have a small effect on cycling kinematics, these effects are not large enough to alter short-term power output. Therefore, anaerobic power output may be evaluated and compared in the recumbent positions and the SCP.     

Acute effect of alternating heavy and light resistances on power output during upper-body complex power training

This study investigated the effect on upper-body power output of manipulating resistances during contrast or complex power training. This power-training strategy typically entails the athlete alternating sets of a heavy resistance in a strength-oriented exercise with sets of lighter resistances in a power-oriented exercise. Sixteen rugby league players, who were experienced in power training and who performed complex training on a regular basis, served as subjects for this study and were divided equally into a control (Con) or experimental (Exp) group. Both groups were pre- and posttested for power output while performing explosive bench press throws in a Smith machine with a resistance of 50 kg (BT P50). The Exp group performed an intervention strategy of a 6-repetition set of bench presses with a resistance of 65% of 1 repetition maximum (65% 1RM) between tests. At the pretest occasion, no differences were observed between the groups in power output; however, at the posttesting, a significant difference in power output was observed between the groups in the BT P50. The 4.5% increase in the power output recorded during the posttesting BT P50 for the Exp group was determined to be significantly different from all other scores (p < or = 0.05). These data indicate that the performance of a set of heavy resistance strength training exercise between power training sets will acutely enhance power output in the second power training set. This effect has been previously theorized as possibly due to some combination of acute neural or mechanical adaptations.     

Comparison of a field-based test to estimate functional threshold power and power output at lactate threshold

It has been proposed that field-based tests (FT) used to estimate functional threshold power (FTP) result in power output (PO) equivalent to PO at lactate threshold (LT). However, anecdotal evidence from regional cycling teams tested for LT in our laboratory suggested that PO at LT underestimated FTP. It was hypothesized that estimated FTP is not equivalent to PO at LT. The LT and estimated FTP were measured in 7 trained male competitive cyclists (VO2max = 65.3 ± 1.6 ml O2·kg(-1)·min(-1)). The FTP was estimated from an 8-minute FT and compared with PO at LT using 2 methods; LT(Δ1), a 1 mmol·L(-1) or greater rise in blood lactate in response to an increase in workload and LT(4.0), blood lactate of 4.0 mmol·L(-1). The estimated FTP was equivalent to PO at LT(4.0) and greater than PO at LT(Δ1). VO2max explained 93% of the variance in individual PO during the 8-minute FT. When the 8-minute FT PO was expressed relative to maximal PO from the VO2max test (individual exercise performance), VO2max explained 64% of the variance in individual exercise performance. The PO at LT was not related to 8-minute FT PO. In conclusion, FTP estimated from an 8-minute FT is equivalent to PO at LT if LT(4.0) is used but is not equivalent for all methods of LT determination including LT(Δ1).     

Relationship between optimal lactate removal power output and Olympic triathlon performance

To investigate the relationships between race performance and parameters at the optimal power output for lactate removal, 10 male triathletes were examined. Exercise intensities for lactate removal were defined by calculating 50% of difference (DeltaT) between running velocity (V(r)) at individual anaerobic threshold (IAT) and at individual ventilatory threshold (IVT), then choosing 3 V(r): at IVT plus 50% DeltaT (IVT(+50%DeltaT)), at IVT, and at IVT minus 50% DeltaT (IVT(-50%DeltaT)). After a 6-minute treadmill run at 75% of difference between IAT and V(.-)O2max, all triathletes performed a 30-minute active recovery run at IVT(+50%DeltaT), IVT, and IVT(-50%DeltaT). Capillary blood lactate was determined at 1, 3, 6, 9, 12, 15, 20, 25, and 30 minutes of recovery. The IVT(-50%DeltaT) recovery was the most efficient V(r) for lactate removal. Running velocities at IVT and IVT(-50%DeltaT) were highly (p < 0.01) related to cycle, run, and overall race time. V(.-)O2max values at IAT, IVT(+50%DeltaT), and IVT were less (p < 0.05) related to split and overall race time. The variable most related to overall race time, as determined by stepwise multiple linear regression analysis, was the V(r) at IVT(-50%DeltaT) (r = 0.87, p = 0.001). The R(2) value of 0.76 indicated that V(r) at IVT(-50%DeltaT) could account for 76% of the variance in triathlon race time. This study shows that the race performances of triathletes are highly related to the V(r) at which the most efficient lactate removal (IVT(-50%DeltaT)) occurs. These findings suggest that the assessment of V(r) at IVT and IAT (from which V(r) at IVT(-50%DeltaT) are calculated) may be a useful method for monitoring training-induced adaptations and performance improvements in athletes who participate in Olympic triathlons.