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A reliable non-invasive method to assess autonomic nervous system activity involves the evaluation of the time course of heart rate variability (HRV). HRV may vary in accordance with the degree and duration of training, and the circadian fluctuation of this variable is crucial for human health since the heart adapts to the needs of different activity levels during sleep phases or in the daytime. In the present review, time-of-day and chronotype effect on HRV in response to acute sessions of physical activity are discussed. Results are sparse and controversial; however, it seems that evening-type subjects have a higher perturbation of the autonomic nervous system (ANS), with slowed vagal reactivation and higher heart rate values in response to morning exercise than morning types. Conversely, both chronotype categories showed similar ANS activity during evening physical tasks, suggesting that this time of day seems to perturb the HRV circadian rhythm to a lesser extent. The control for chronotype and time-of-day effect represents a key strategy for individual training schedules, and, in perspective, for primary injury prevention.

Background: Investigations of Star Excursion Balance Test (SEBT) performance differences between competition levels and sports are limited and results are inconsistent. The aim of the present study are: 1) to compare SEBT performance between elite and semi-professional female volleyball players; 2) to evaluate differences in SEBT scores between positions (Hitters, Middle Blockers, Setters, and Liberoes); and 3) to compare dynamic balance characteristics between professional female Italian volleyball players with NCAA Division I female athletes practicing six different sports (hockey, football, basketball, golf, softball, and volleyball). For the latter comparison, previously published data obtained from a study were used., Methods: Fifty-one female volleyball players were grouped in two groups, elite athletes (EG; N.=27) and semi-professional players (SG; N.=24), and further categorized into hitters, middle blockers, setters, and liberos. Anterior (A), posteromedial (PM), and posterolateral (PL) distances, and composite score (COMP) of SEBT short form were studied. COMP was calculated as the average of the normalized distances across the three directions., Results: Significant differences were observed for the A (right, P=0.014 and left, P=0.011), PL (right, P=0.017 and left, P=0.008), PM (P<0.001) directions, and COMP scores (right, P=0.008 and left, P=0.009), with higher normalized distances noted for the EG and no differences between different positions. COMP scores were lower for the EG than the NCAA Division I female hockey (P<0.001) and football players (P=0.031) but similar to those of basketball, golf, softball, and volleyball players., Conclusions: The EG scored higher on dynamic postural-control tasks than the SG. SEBT performance varied significantly between sports. Clinicians and strength coaches need to be aware of sport specific differences in dynamic postural control measurements in both rehabilitation and athletic development.

The correct expression of circadian rhythmicity is crucial for the body homeostasis. The rest-activity circadian rhythms (RARs) are involved in the control of the sleep-wake cycle and altered RARs could lead to a compromised health status. Many studies focused on examining sleep behavior and circadian rhythms in physically active subjects or athletes but, unexpectedly, no data on RARs are available. Therefore, we studied the existence of the RAR in athletes and the possible difference in RAR's characteristics among sport disciplines. The study had a prospective observational design and RARs were recorded for five consecutive training days through actigraphy (Actiwatch 2 actigraph; Philips Respironics, OR, USA) in 43 athletes (mean age: 25.6 ± 3.2 years). Athletes competed in three different disciplines and had different training schedules and competition levels: professional triathletes (N = 10; 6 females and 4 males) had 2 morning (08:30-12:00) and 1 afternoon (15:00-17:00) training sessions, professional volleyball players (N = 19; 12 females and 7 males) used to train once in the morning (09:00-11:30) and once in the afternoon (15:00-18:00), and non-professional soccer players (N = 14; all males) trained always late in the evening (20:30-22:30). To determine the existence of RARs, the activity counts (A.C.) data were analyzed using the single and the population mean cosinor method; a one-way analysis of variance (ANOVA) followed by the Tukey-Kramer post-hoc test was used for the comparison of RAR characteristics among soccer, volleyball and triathlon athletes. Partial eta squared (ή p 2 ) was used to determine the magnitude of the effect for significant outcomes (α = 0.05) in ANOVA. The presence of a significant RAR both for each of the 43 athletes (p < 0.001) and for the three categories of athletes (p < 0.001) was observed. RARs differed among sport disciplines: the Midline Estimating Statistic of Rhythm (MESOR) was significantly higher in triathletes (mean: 347 A.C. with 95% Confidence Interval [CI]: 314-379) compared to both volleyball (mean: 188 A.C. with 95% CI: 173-203; p < 0.001) and soccer players (mean: 289 A.C. with 95% CI: 267-312; p < 0.01) with ή p 2  = 0.72. Amplitude (A) values showed the same significant trend of MESOR data (ANOVA: p < 0.001; ή p 2  = 0.65) while the acrophase (Φ) occurred at 18:28 for soccer players, significantly later than triathlon (15:20 h; p < 0.001) and volleyball players (16:24 h; p < 0.001) (ANOVA: p < 0.001; ήp2 = 0.84). The higher training duration and intensity reached by triathlon athletes in the morning sessions caused a phase advance of their RAR's acrophase Φ and higher MESOR and A amplitude compared to volleyball players and triathletes. Therefore, different sport disciplines require different training schedules, training loads and intensities that translate into different RARs. Strength coaches and medical staff of professional teams should strongly consider actigraphy as a practical and powerful tool to monitor RARs, sleep behavior, and the activity levels of their athletes; highlighting potential circadian disruptions through actigraphy could be helpful to prevent musculoskeletal injuries.

Purpose: To evaluate actigraphy-based sleep quality and perceived recovery before and after a night game in top-level volleyball athletes., Methods: Data on sleep parameters were collected by actigraphy for 3 consecutive nights with 24 elite athletes (12 male and 12 female; mean age [SD] = 26.0 [3.4] y, age range = 20-33 y) during the competitive season 2016-17. Data from 1 night before and 2 nights after an official night match were studied, and athletes' subjective perception of recovery was evaluated by the Total Quality Recovery scale. The following actigraphic parameters were studied: time in bed, sleep latency, sleep efficiency, wake after sleep onset, total sleep time, immobility time, moving time, and fragmentation index., Results: The analysis highlighted significant differences for all sleep variables. Total sleep time was lower the first night after the match compared with prematch sleep (P = .02) and the second night (P = .0009) after night competition (P = .0001, F 2,23  = 22.93, η p 2   =   .66 ). Similarly, sleep efficiency was lower immediately after the night competition compared with both prematch values (P = .03) and the second night (P = .0003) after competition (P = .0005, F 2,23  = 8.93, η p 2   =   .44 ). The same differences were observed in the perceived recovery values (P = .001, F 2,23  = 13.37, η p 2   =   .54 )., Conclusions: Coaches and medical staff should use these findings to develop a greater knowledge of how sleep differs during different phases of competition and to implement behavioral and sleep-hygiene strategies in top-level athletes.

Purpose: The aim of this study was to investigate objective and subjective sleep quality, daytime tiredness and sleepiness in response to a late-evening high intensity interval training (HIIT) session in neither-type soccer players that habitually trained late in the day. This is the first study that considered both athletes' chronotype and habitual training time as crucial factors when assessing sleep quality in relation to an evening physical task. Methods: In this longitudinal, prospective, observational study, 14 Italian soccer players were recruited (mean age: 26.1 ± 4.5 years; height: 1.81 ± 0.06 m; weight: 78.9 ± 6.1 kg) and performed an extra-routine 4 × 4-min HIIT session at 09:00 p.m. Players used to train always between 09:00 and 11:00 p.m during the competitive season. All subjects wore an actigraph to evaluate their objective sleep parameters and a sleep diary was used to record subjective values of sleep quality, daytime tiredness, and daytime sleepiness. All data were analyzed as: the mean of the two nights before (PRE), the night after (POST 1), and the mean of the two nights after (POST 2) the extra-routine HIIT session. The subjects' chronotype was assessed by the morningness-eveningness questionnaire (MEQ). Results: All players were classified as N-types (mean MEQ score: 49.4 ± 3.7). None of the actigraph parameters nor the subjective values of sleep quality, tiredness, and sleepiness showed significant changes in PRE, POST 1, and POST 2. Conclusion: The results of our study added more information regarding sleep quality outcomes in response to a late-evening HIIT session. Athletic trainers and medical staff should always control for chronotype and habitual training time when assessing variations to sleep quality in athletes.

There is not enough evidence on the impact of different speed endurance training regimes on footballers' ability to perform multiple shuttle run performance. This study examined the effect of 4 weeks of speed endurance maintenance (SEM) and speed endurance production (SEP) training on the 5-meter multiple shuttle run test (5-m MST) performance in young elite soccer players. A parallel two-groups, longitudinal design was used. Fifteen players were divided to either SEM (8 repetitions of 20-s all-out sprint interspersed with 40 s of recovery) or SEP (8 repetitions of 20-s all-out bout interspersed with 120 s of recovery) training group. SEM improved the ability to tolerate fatigue and maintained the performance development during the 5-m MST while SEP increased only the 1 st sprint showing, simultaneously, an increased fatigue index and performance decrement. The selection of which training regimes to prioritize should be based on the players' characteristics and individual game requirements Abbreviations: SEP: Speed Endurance Production; SEM: Speed Endurance Maintenance; PRE: Baseline; POST: End of experimental protocol; 5-m MST: 5-meters Multiple Shuttle Run Test; TD: Total Distance; FI: Fatigue Index; MSTdec: Percentage Decrement Score; BMI: Body Mass Index.

Rhythms can be observed at all levels of the biologic integration in humans. The observation that a biological or physiological variable shows a circadian rhythm can be explained by several multifactorial systems including external (exogenous), internal (endogenous) and psychobiological (lifestyle) mechanisms. Our body clock can be synchronized with the environment by external factors, called "synchronizers", i.e. the light-dark cycle, but it is also negatively influenced by some pathological conditions or factors, called "chronodisruptors," i.e. aging or low physical activity (PA). The desynchronization of a 24-h rhythm in a chronic manner has been recently defined "chronodisruption" or "circadian disruption." A very large number of hormonal variables, such as adrenal and gonadal stress steroids, are governed by circadian rhythmicity. Such hormones, in normal conditions, show a peak in the first part of the day, while their typical diurnal fluctuations are totally out of sync in subjects affected by cancer or metabolic diseases, such as obesity, diabetes and metabolic syndrome. In general, a flatter slope with altered peaks in cortisol and testosterone circadian rhythms has been observed in pathological individuals. PA, specifically chronic exercise, seems to play a key role as synchronizer for the whole circadian system in such pathologies even if specific data on steroids circadian pattern are still sparse and contradictory. Recently, it has been proposed that low-intensity chronic PA could be an effective intervention to decrease morning cortisol levels in pathological subjects. The standardization of all confounding factors is needed to reach more clear evidence-based results.

Background: Previous studies attempted to identify possible risk factors for acute and overuse injuries in several sports disciplines such as running, gymnastics or team sports. Given the lack of scientific works focused on risk factors for lower limb injuries in martial arts, the present study was aimed to investigate foot anatomy, anthropometric measures, and other background information as possible risk factors of injury in barefoot athletes practicing judo, karate, kung fu, Thai boxing, or aikido. In addition, the injury rates were evaluated in relation with the different martial art styles., Methods: One group of 130 martial artists was retrospectively evaluated. Data of three morphological variables of the foot were collected: navicular height (NH), navicular drop (ND), and the rear foot (RF). In addition, each participant filled an interview questionnaire providing the following information: age, sex, body weight, height, Body Mass Index, hours of training per week, the kind of injury occurred to the lower limbs in the preceding year., Results: Of 130 subjects, 70 (53.8%) did not sustain injuries, 35 (27.0%) suffered an acute injury and the remaining 25 (19.2%) reported an overuse injury. No significant differences were observed in the injury rates in relation to style and kind of martial art. Age, training volume and BMI were found as significant predictors of injury, while NH, ND, and RF were not able to predict acute or overuse injury at lower limbs., Conclusions: The injury rates were similar in karate, judo, kung fu, aikido, and Thai boxing. The foot morphology variables were not related with the presence or absence of acute and overuse injuries. Conversely, older and heavier martial artists, performing more hours of barefoot training, are at higher risk of acute and overuse injury. Athletic trainers should strongly take into account the present information in order to develop more accurate and specific injury prevention programs for martial artists.

Background: Oxidative stress is associated with delayed recovery and higher risk of post-training pain in triathlon athletes. Therefore, supplementation with antioxidant compounds may have a role in enhancing recovery. Quercetin presents marked antioxidant activity. In this pilot registry study, we evaluated the effects of the supplementation with a novel proprietary delivery form (phytosome®) of quercetin in amateur triathlon athletes., Methods: We employed a specific study model of triathlon according to the "Sprint" distance. The individual triathlon training included repetition of the run 8 times in 14 days. A group of athletes used quercetin phytosome® supplementation (one tablet of 250 mg quercetin phytosome® twice daily). A control group did not use supplementation. All subjects attended a baseline measurement run and a second final measurement run at day 14. At the end of the study, subjective performance, post-training pain, cramps, time to full recovery and oxidative stress were measured., Results: In total, 23 subjects used the supplement and 25 did not. No side effects were reported. The improvement of time to complete the run was greater in subjects on quercetin supplementation compared with the control group (-11.3% vs. -3.9%; P<0.05). Training was considered more valuable in the quercetin group compared with controls (P<0.05). Similarly, post-run muscular pain, cramps, localized pain and the post-exercise recovery time were all considered better with the supplementation (P<0.05). Oxidative stress was also reduced (P<0.05)., Conclusions: This pilot study suggests that the oral supplementation with quercetin phytosome® may result in improved training and performance in amateur triathlon athletes.

Vitamin D is essential for the maintenance and promotion of musculoskeletal health, for the functioning of the immune, cardiovascular and reproductive systems, and its main action is to keep calcium and phosphate plasmatic physiological concentrations at intestinal, renal and bony level. Vitamin D affects several parameters related to physical performance too and a particularly high percentage of vitamin D insufficiency and deficiency in professional athletes has been observed. Several variables are able to impair the synthesis of 25(OH)D in athletes, specifically both genetic and environmental factors, but the most probable explanation for the deficient/insufficient vitamin D levels is the insufficient ultraviolet B light (UVB) exposure during winter. To confirm this, the existence of a circannual rhythm of vitamin D in professional soccer players, highlighting a peak in summer and lowest values in winter regardless the period of the season, has been documented. Nonetheless, from what we are aware of, no other study adopted a chronobiologic approach to better understand and describe the circannual variations of serum 25(OH)D in other sport disciplines. Therefore, we studied serum vitamin D in a cohort of top-level professional skiers, during a period of three consecutive competitive seasons (2015, 2016 and 2017), in order to evaluate, with a rhythmometric approach, the vitamin D behavior along the year. The study population was composed by 152 professional Italian alpine skiers of FISI (Winter Sport Italian Federation), 63 females and 89 males (mean age: 24.1 ± 3.2 years) and a total of 298 blood drawings were carried out to determine plasma 25(OH)D. Vitamin D data were compared between genders and then processed with the population mean cosinor tests to evaluate the presence of a circannual rhythm, both for female and male athletes. In total, 77 skiers (50.7%) showed, at least once during the three competitive seasons, an insufficient level of 25(OH)D and other 45 subjects (29.6%) showed a deficient status; no differences were observed between genders (mean for females: 26.9 ± 8.1 ng/mL; mean for males: 27.4 ± 7.6 ng/mL). In addition, the rhythmometric analysis highlighted the existence of a significant circannual rhythm for both female and male professional skiers; the acrophases (Φ) occurred in July and both MESOR (M) and amplitude (A) were comparable between the two groups. Our data indicate that, despite the physical effort spent, vitamin D follows a classical season-associated rhythm with a peak in summer and a nadir in winter. Moreover, the percentage of insufficiency and deficiency is in line with that of the general population. In conclusion, our findings reinforce the hypothesis that there is no direct effect of physical activity on vitamin D metabolism and that the factors involved in the determination of vitamin D levels in the general population are valid also for athletes.

Vitale, JA, La Torre, A, Banfi, G, and Bonato, M. Effects of an 8-week body-weight neuromuscular training on dynamic balance and vertical jump performances in elite junior skiing athletes: a randomized controlled trial. J Strength Cond Res 32(4): 911-920, 2018-The aim of the present randomized controlled trial was to evaluate the effects of an 8-week neuromuscular training program focused on core stability, plyometric, and body-weight strengthening exercises on dynamic postural control and vertical jump performance in elite junior skiers. Twenty-four Italian elite junior male skiers were recruited and randomized to either an experimental group (EG), performing neuromuscular warm-up exercises, (EG; n = 12; age 18 ± 1 years; body mass 66 ± 21 kg; height 1.70 ± 0.1 m) or a control group (CG) involved in a standard warm-up (CG; n = 12; age 18 ± 1 years; body mass 62 ± 14 kg; height 1.73 ± 0.1 m). lower quarter Y-Balance Test (YBT), countermovement jump (CMJ), and drop jump (DJ) at baseline (PRE) and at the end (POST) of the experimental procedures were performed. No significant differences between EG and CG were observed at baseline. Results showed that EG achieved positive effects from PRE to POST measures in the anterior, posteromedial, posterolateral directions, and composite score of YBT for both lower limbs, whereas no significant differences were detected for CG. Furthermore, 2-way analysis of variance with Bonferroni's multiple comparisons test did not reveal any significant differences in CMJ and DJ for both EG and CG. The inclusion of an 8-week neuromuscular warm-up program led to positive effects in dynamic balance ability but not in vertical jump performance in elite junior skiers. Neuromuscular training may be an effective intervention to specifically increase lower limb joint awareness and postural control.

[This corrects the article DOI: 10.21037/qims.2018.01.01.].

Osteoporosis and sarcopenia represent two major health problems with an increasing prevalence in the elderly population. The correlation between these diseases has been widely reported, leading to the development of the term "osteosarcopenia" to diagnose those patients suffering from both diseases. Several imaging methods for the diagnosis and management of osteoporosis exist, with dual-energy X-ray absorptiometry (DXA) being the most commonly used for measuring bone mineral density (BMD). Imaging technique other than DXA is represented by conventional radiography, computed tomography (CT) and ultrasound (US). Similarly, the imaging technologies used to detect loss of skeletal muscle mass in sarcopenia include DXA, CT, US and magnetic resonance imaging (MRI). These methods differ in terms of reliability, radiation exposure and costs. CT and MRI represent the gold standard for evaluating body composition (BC), but are costly and time-consuming. DXA remains the most often used technology for studying BC, being quick, widely available and with low radiation exposure., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

Background: Many variables related to sport have been shown to have circadian rhythms. Chronotype is the expression of circadian rhythmicity in an individual, and three categories of chronotype are defined: morning types (M-types), evening types (E-types), and neither types (N-types). M-types show earlier peaks of several psychophysiological variables during the day than E-types. The effect of chronotype on athletic performance has not been extensively investigated., Objective: The objective of the present review was to study the effect of chronotype on athletic performance and the psychophysiological responses to physical activity., Methods: The present review adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines. We searched PubMed, Scopus, and Web of Science for scientific papers using the keywords "chronotype", "circadian typology", "morningness", and "eveningness" in combination with each of the words "sport", "performance", and "athletic." Relevant reference lists were inspected. We limited the search results to peer-reviewed papers published in English from 1985 to 2015., Results: Ten papers met our inclusion criteria. Rating of perceived exertion and fatigue scores in relation to athletic performances are influenced by chronotype: M-types perceived less effort when performing a submaximal physical task in the morning than did N- and E-types. In addition, M-types generally showed better athletic performances, as measured by race times, in the morning than did N- and E-types. Other results concerning chronotype effect on physiological responses to physical activity were not always consistent: heterogeneous samples and different kinds of physical activity could partially explain these discrepancies., Conclusions: Sports trainers and coaches should take into account the influence of both the time of day and chronotype effect when scheduling training sessions into specific time periods.

Objective: To evaluate plasma vitamin D and cross-linked C-telopeptides of type I (CTx-I) and type II (CTx-II) collagen concentrations in males with lumbar intervertebral disc degeneration (IVD) compared to healthy controls. Improved knowledge might suggest to optimize the vitamin D status of IVD patients and contribute to clarify mechanisms of cartilage degradation., Methods: 79 Italian males with lumbar IVD assessed by Magnetic Resonance Imaging (MRI) and 79 age, sex and BMI-matched healthy controls were enrolled. Plasma 25hydroxyvitamin D (25(OH)D), CTx-I and CTx-II were measured by immunoassays. Circannual seasonality, correlation between biomarkers concentrations and clinical variables were assessed., Results: Overall subjects 25(OH)D and CTx-II showed month rhythmicity with acrophase in August/September and October/November, and nadir in February/March and April/May, respectively. An inverse correlation between 25(OH)D and CTx-I, and a direct correlation between CTx-II and CTx-I were observed. IVD patients, particularly with osteochondrosis, showed higher CTx-II than healthy controls., Conclusions: Month of sampling may affect plasma 25(OH)D and CTx-II concentrations. The correlation between CTx-I and CTx-II suggests an interplay between the osteo-cartilaginous endplate and the fibro-cartilaginous disc. The results of this study highlighted that osteochondrosis associates with increased cartilaginous catabolism. Vitamin D supplementation seems more necessary in winter for lumbar IVD patients., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The aim of this study was to investigate the influence of chronotype on mood state and ratings of perceived exertion (RPE) before and in response to acute high intensity interval exercise (HIIE) performed at different times of the day. Based on the morningness-eveningness questionnaire, 12 morning-types (M-types; N = 12; age 21 ± 2 years; height 179 ± 5 cm; body mass 74 ± 12 kg) and 11 evening-types (E-types; N = 11; age 21 ± 2 years; height 181 ± 11 cm; body mass 76 ± 11 kg) were enrolled in a randomized crossover study. All subjects underwent measurements of Profile of Mood States (POMS), before (PRE), after 12 (POST12) and 24 h (POST24) the completion of both morning (08.00 am) and evening (08.00 p.m.) training. Additionally, Global Mood Disturbance and Energy Index (EI) were calculated. RPE was obtained PRE and 30 min POST HIIE. Two-way ANOVA with Tukey's multiple comparisons test of POMS parameters during morning training showed significant differences in fatigue, vigor and EI at PRE and POST24 between M-types and E-types. In addition, significant chronotype differences were found only in POST12 after the evening HIIE for fatigue, vigor and EI. For what concerns Borg perceived exertion, comparing morning versus evening values in PRE condition, a higher RPE was observed in relation to evening training for M-types ( P = 0.0107) while E-types showed higher RPE values in the morning ( P = 0.008). Finally, intragroup differences showed that E-types had a higher RPE respect to M-types before ( P = 0.002) and after 30 min ( P = 0.042) the morning session of HIIE. No significant changes during the evening training session were found. In conclusion, chronotype seems to significantly influence fatigue values, perceived exertions and vigor in relation to HIIE performed at different times of the day. Specifically, E-types will meet more of a burden when undertaking a physical task early in the day. Practical results suggest that performing a HIIE at those times of day that do not correspond to subjects' circadian preference can lead to increased mood disturbances and perceived exertion. Therefore, an athlete's chronotype should be taken into account when scheduling HIIE. Trial registration : ACTRN12617000432314, registered 24 March 2017, "retrospectively registered". Web address of trial : https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371862&showOriginal=true&isReview=true.

The purpose of this study was to evaluate if the time of the day (8.00 a.m. vs 8.00 p.m.) and chronotype could influence autonomic cardiac control in soccer players in relation to an acute session of high-intensity interval training. The morningness-eveningness questionnaire was administered to recruit Morning-type and Evening-type collegiate male soccer players. Therefore, 24 players (12 Morning-types and 12 Evening-types) were randomly assigned, to either morning (n = 12; age 23 ± 3 years; height 1.75 ± 0.07 m; body mass 73 ± 10 kg; weekly training volume 8 2 hours), or evening (n = 12; age 21 ± 3 years; height 1.76 ± 0.05 m; body mass 75 ± 11 kg; weekly training volume 8 ± 3 hours) training. Heart Rate Variability vagal and sympatho/vagal indices were calculated in time, frequency and complexity domains at rest, before, after 12 and 24 hours of high-intensity interval training. Before evening training session, a higher resting heart rate was observed which was determined by a marked parasympathetic withdrawal with a sympathetic predominance. Moreover, Evening-type subjects during morning training session, present a significant higher heart rate that corresponded to significant higher vagal indices with a significant lower parasympathetic tone that returned to the rest values after 24 hours of the cessation of high-intensity interval training exercise. On the contrary, Morning-type subjects did not reveal any significant differences with Evening-Type subjects during evening high-intensity interval training session. Stress response of high-intensity interval training is influenced by both the time of the day and by the chronotype. Understanding the Heart Rate Variability response to high-intensity interval training can be an additional important procedure for evaluating of cardiovascular recovery in soccer players. Moreover, these results suggest that an athlete's chronotype should be taken into account when scheduling a high-intensity interval training exercise.

Hypotheses: Sleep disorders are associated with an increased risk of cancer, including breast cancer (BC). Physical activity (PA) can produce beneficial effects on sleep., Study Design: We designed a randomized controlled trial to test the effect of 3 months of physical activity on sleep and circadian rhythm activity level evaluated by actigraphy., Methods: 40 BC women, aged 35-70 years, were randomized into an intervention (IG) and a control group (CG). IG performed a 3 month of aerobic exercise. At baseline and after 3 months, the following parameters were evaluated both for IG and CG: anthropometric and body composition measurements, energy expenditure and motion level; sleep parameters (Actual Sleep Time-AST, Actual Wake Time-AWT, Sleep Efficiency-SE, Sleep Latency-SL, Mean Activity Score-MAS, Movement and Fragmentation Index-MFI and Immobility Time-IT) and activity level circadian rhythm using the Actigraph Actiwatch., Results: The CG showed a deterioration of sleep, whereas the IG showed a stable pattern. In the CG the SE, AST and IT decreased and the AWT, SL, MAS and MFI increased. In the IG, the SE, IT, AWT, SL, and MAS showed no changes and AST and MFI showed a less pronounced change in the IG than in the CG. The rhythmometric analysis revealed a significant circadian rhythm in two groups. After 3 months of PA, IG showed reduced fat mass %, while CG had improved weight and BMI., Conclusion: Physical activity may be beneficial against sleep disruption. Indeed, PA prevented sleep worsening in IG. PA can represent an integrative intervention therapy able to modify sleep behaviour.

Background: An individual's chronotype influences his or her physiological rhythms. Some studies have looked at the effect of time of day on the responses to exercise, but studies on the effect of long-term training are lacking., Objective: To report the effects of an 8-week training period during the polar night in non-athletes of different chronotypes living at 70°N., Design: In all, 10 morning (M), 10 neither (N) and 10 evening (E) types were recruited, and their aerobic capacity (VO 2max ), strength, flexibility and balance before and after the training period were tested., Results: 3 E-types, 5 N-types and 6 M-types completed the protocol. An increase in VO 2max and strength was observed for the whole group. The best negative correlation (r=-0.5287) was found between the Morningness-Eveningness Questionnaire (MEQ) score and the increase in VO2max, and the best positive correlation (r=0.4395) was found between MEQ and the increase in strength. Changes in balance and flexibility did not show any clear trends., Conclusion: In an environment with no outdoor daylight, it seems that the response to 8 weeks of aerobic training is larger in the E- than in the M-types, although the M-types showed a larger improvement in strength.

Due to personal and working necessities, the time for exercise is often short, and scheduled early in the morning or late in the afternoon. Cortisol plays a central role in the physiological and behavioral response to a physical challenge and can be considered as an index of exercise stress. Therefore, the aim of this study was to evaluate the influence of the circadian phenotype classification on salivary cortisol concentration in relation to an acute session of high-intensity interval exercise (HIIE) performed at different times of the day. Based on the morningness-eveningness questionnaire, 12 M-types (N = 12; age 21 ± 2 years; height 179 ± 5 cm; body mass 74 ± 12 kg, weekly training volume 8 ± 1 hours) and 11 E-types (N = 11; age 21 ± 2 years; height 181 ± 11 cm; body mass 76 ± 11 kg, weekly training volume 7 ± 2 hours) were enrolled in a randomized crossover study. All subjects underwent measurements of salivary cortisol secretion before (PRE), immediately after (POST), and 15 min (+15 min), 30 min (+30 min), 45 min (+45 min) and 60 min (+60 min) after the completion of both morning (08.00 am) and evening (08.00 p.m.) high-intensity interval exercise. Two-way analysis of variance with Tuckey's multiple comparisons test showed significant increments over PRE-cortisol concentrations in POSTcondition both in the morning (4.88 ± 1.19 ng · mL -1 vs 6.60 ± 1.86 ng · mL -1 , +26.1%, P < 0.0001, d > 0.8) and in the evening (1.56 ± 0.48 ng · mL -1 vs 2.34 ± 0.37, +33.4%, P = 0.034, d > 0.6) exercise in all the 23 subject that performed the morning and the evening HIIE. In addition, during morning exercise, significant differences in cortisol concentration between M-types and E-types at POST (5.49 ± 0.98 ng · mL -1 versus 8.44 ± 1.08 ng · mL -1 , +35%, P < 0.0001, d > 0.8), +15 min (4.52 ± 0.42 ng · mL -1 versus 6.61 ± 0.62 ng · mL -1 , +31.6%, P < 0.0001, d > 0.8), +30 min (4.10 ± 1.44 ng · mL -1 versus 6.21 ± 1.60 ng · mL -1 , +34.0%, P < 0.0001, d = 0.7), + 45 min (3.78 ± 0.55 ng · mL -1 versus 5.80 ± 0.72 ng · mL -1 , +34.9%, P < 0.0001, d = 0.7), and + 60 min condition(3.53 ± 0.45 ng · mL -1 versus 5.78 ± 1.13 ng · mL -1 , 38.9%, P = 0.0008, d = 0.7) were noted. No statistical significant differences between M-types and E-types during evening HIIE on post-exercise cortisol concentration were detected. E-types showed a higher morning peak of salivary cortisol respect to M-types when performing a HIIE early in the morning and produced higher salivary cortisol concentrations after the cessation of the exercise. Practical applications suggest that it is increasingly important for the exercise professionals to identify the compatibility between time of day for exercising and chronotype to find the individual's favorable circadian time to perform a HIIE.

Adequate plasmatic Vitamin D levels are crucial to maintain calcium homeostasis and bone metabolism both in the general population and in athletes. Correct dietary supply and a regular sun exposure are fundamental for allowing the desired and effective fitness level. Past studies highlighted a scenario of Vitamin D insufficiency among professional soccer players in several countries, especially in North Europe, whilst a real deficiency in athletes is rare. The typical seasonal fluctuations of Vitamin D are wrongly described transversally in athletes belonging to teams that play at different latitudes and a chronobiologic approach studying the Vitamin D circannual rhythm in soccer players has not been described yet. Therefore, we studied plasma vitamin D, cortisol, testosterone, and creatin kinase (CK) concentrations in three different Italian professional teams training at the same latitude during a period of two consecutive competitive seasons (2013 and 2014). In this retrospective observational study, 167 professional soccer players were recruited (mean age at sampling 25.1 ± 4.7 years) and a total of 667 blood drawings were carried out to determine plasma 25(OH)D, serum cortisol, serum testosterone and CK levels. Testosterone to cortisol ratio (TC) was calculated based as a surrogate marker of overtraining and psychophysical stress and each athlete was drawn until a maximum of 5 times per season. Data extracted by a subgroup of players that underwent at least 4 sample drawings along a year (N = 45) were processed with the single and population mean cosinor tests to evaluate the presence of circannual rhythms: the amplitude (A), acrophase (Φ) and the MESOR (M) are described. In total, 55 players (32.9%) had an insufficient level of 25(OH)D during the seasons and other 15 athletes (9.0%) showed, at least once, a deficiency status of Vitamin D. The rhythmometric analyses applied to the data of Vitamin D revealed the presence of a significant circannual rhythm (p < 0.001) with the acrophase that occurred in August; the rhythms of Vitamin D levels were not different neither among the three soccer teams nor between competitive seasons. Cortisol, testosterone and TC showed significant circannual rhythms (p < 0.001): cortisol registered an acrophase during winter (February) while testosterone and TC registered their peaks in the summer months (July). On the contrary, CK did not display any seasonal fluctuations. In addition, we observed weak but significant correlations between 25(OH)D versus testosterone (r = 0.29 and p < 0.001), cortisol (r = -0.27 and p < 0.001) and TC (r = 0.37 and p < 0.001). No correlation was detected between Vitamin D and CK. In conclusion, the correct chronobiologic approach in the study of annual variations of Vitamin D, cortisol and testosterone could be decisive in the development of more specific supplementation and injury prevention strategies by athletic trainers and physicians.

The influence of the chronotype on the sleep quality in male collegiate soccer players in response to acute high intensity interval training (HIIT) performed at two different times of day was evaluated. The sleep quality was poorer in the morning-type than in the evening-type players after the evening HIIT session, whereas no significant changes in the sleep quality of the two chronotypes after the morning HIIT session was observed. The results suggest that an athlete's chronotype should be taken into account when scheduling training sessions and to promote faster recovery processes.

Vitale, JA, Caumo, A, Roveda, E, Montaruli, A, La Torre, A, Battaglini, CL, and Carandente, F. Physical attributes and NFL Combine performance tests between Italian National League and American football players: a comparative study. J Strength Cond Res 30(10): 2802-2808, 2016-The purpose of this study was to examine anthropometric measurements and the results of a battery of performance tests administered during the National Football League (NFL) Combine between American football players who were declared eligible to participate in the NFL Combine and football players of a top Italian team (Rhinos Milan). Participants (N = 50) were categorized by position into 1 of 3 groups based on playing position: skill players (SP) included wide receivers, cornerbacks, free safeties, strong safeties, and running backs; big skill players (BSP) consisted of fullbacks, linebackers, tight ends, and defensive ends; lineman (LM) included centers, offensive guards, offensive tackles, and defensive tackles. A 1-way analysis of variance followed by the Tukey-Kramer post hoc test was used for comparisons between Italian players by playing position. Ninety-five percent CIs were used for comparisons between American and Italian football for the NFL Combine performance tests. Significant differences for all the variables between the 3 playing categories were observed among the Italian players; LM had higher anthropometric and body composition values than SP (p < 0.001) and BSP (p < 0.001), whereas LM performed significantly worse in the physical tests, except for the 225-lb bench press test when compared with SP (p < 0.002). American football players presented significantly higher anthropometric values and test performance scores when compared with Italian players. Administrators of professional football teams in Italy need to improve the player's physical attributes, so the gap that currently exists between American and Italian players can be reduced, which could significantly improve the quality of American football in Italy.

It was hypothesized that an individual's chronotype might influence the response to physical activity at a given time of day. This study aimed to analyze the psychophysiological responses during a walking task at different times of day in individuals with different chronotypes. 46 students (M age=24.8 yr., SD=7.2) filled in the Morningness-Eveningness Questionnaire to determine chronotypes. Heart rate, walking time, and the rating of perceived exertion (RPE) were measured during two self-paced walking sessions: one in the morning (08:30) and one in the afternoon (15:30). A multivariate analysis of variance found a significant interaction between chronotype and time of day. The post hoc analysis showed a significant difference for RPE in the morning session, with evening types reporing a higher RPE compared with the morning types. The chronotype and the time of day when a physical task is undertaken can influence the RPE response, although it might not influence physiological or performance parameters. This has to be taken into account, because it can affect test reliability as well as possibly have a negative influence on the affective responses to a given task.

Several studies have shown the differences among chronotypes in the circadian rhythm of different physiological variables. Individuals show variation in their preference for the daily timing of activity; additionally, there is an association between chronotype and sleep duration/sleep complaints. Few studies have investigated sleep quality during the week days and weekends in relation to the circadian typology using self-assessment questionnaires or actigraphy. The purpose of this study was to use actigraphy to assess the relationship between the three chronotypes and the circadian rhythm of activity levels and to determine whether sleep parameters respond differently with respect to time (weekdays versus the weekend) in Morning-types (M-types), Neither-types (N-types) and Evening-types (E-types). The morningness-eveningness questionnaire (MEQ) was administered to 502 college students to determine their chronotypes. Fifty subjects (16 M-types, 15 N-types and 19 E-types) were recruited to undergo a 7-days monitoring period with an actigraph (Actiwacth® actometers, CNT, Cambridge, UK) to evaluate their sleep parameters and the circadian rhythm of their activity levels. To compare the amplitude and the acrophase among the three chronotypes, we used a one-way ANOVA followed by the Tukey-Kramer post-hoc test. To compare the Midline Estimating Statistic of Rhythm (MESOR) among the three chronotypes, we used a Kruskal-Wallis non-parametric test followed by pairwise comparisons that were performed using Dunn's procedure with a Bonferroni correction for multiple comparisons. The analysis of each sleep parameter was conducted using the mixed ANOVA procedure. The results showed that the chronotype was influenced by sex (χ(2) with p = 0.011) and the photoperiod at birth (χ(2) with p < 0.05). Though the MESOR and amplitude of the activity levels were not different among the three chronotypes, the acrophases compared by the ANOVA post-hoc test were significantly different (p < 0.001). The ANOVA post-hoc test revealed the presence of a significant difference (p < 0.001) between the M-types (14:32 h) and E-types (16:53 h). There was also a significant interaction between the chronotype and four sleep parameters: Sleep end, Assumed Sleep, Immobility Time and Sleep Efficiency. Sleep Efficiency showed the same patterns as did Assumed Sleep and Immobility Time: the Sleep Efficiency of the E-types was poorer than that of the M- and N-types during weekdays (77.9% ± 7.0 versus 84.1% ± 4.9 and 84.1% ± 5.2) but was similar to that measured in the M- and N-types during the weekend. Sleep Latency and Movement and Fragmentation Index were not different among the three chronotypes and did not change on the weekend compared with weekdays. This study highlights two key findings: first, we observed that the circadian rhythm of activity levels was influenced by the chronotype; second, the chronotype had a significant effect on sleep parameters: the E-types had a reduced sleep quality and quantity compared with the M- and N-types during weekdays, whereas the E-types reached the same levels as the other chronotypes during the weekends. These findings suggest that E-types accumulate a sleep deficit during weekdays due to social and academic commitments and that they recover from this deficit during "free days" on the weekend.

The response to sub-maximal physical activity performed in the morning and late afternoon by individuals with different chronotypes was investigated. 22 participants filled out the Morningness-Eveningness Questionnaire and underwent a self-paced walking task that consisted of walking from the top to the bottom of a hill and back three times (1,836 meters, with a slope of 14.16%). The task was repeated twice: late afternoon (16:30) and early morning (08:30). Walking speed (time for completion in seconds), heart rate, and perceived exertion were measured during each task, with overall results given as a general descriptive analysis. Preliminary findings suggest that chronotype is likely to influence the responses to exercise, mostly with evening-types seeming at a disadvantage when performing a physical task in the morning. Individuals can be classified by circadian typology or chronotype, which is the propensity to be a morning-type, evening-type, or neither-type. The circadian typology, commonly referred to as being a morning person or an evening person or somewhere in between, is involved not only in the expression of physiological rhythms, but also in habits and lifestyles, such as sleeping patterns (Park, Matsumoto, Seo, & Shinkoda, 1999) that emerge especially during adolescence (Park, Matsumoto, Seo, Kang, & Nagashima, 2002) and remain throughout adult life (Koukkari & Sothern, 2006).

We report the first successful production of transgenic goats that express a heterologous protein in their milk. The production of a glycosylation variant of human tPA (LAtPA--longer acting tissue plasminogen activator) from an expression vector containing the murine whey acid promoter (WAP) operatively linked to the cDNA of a modified version of human tPA was examined in transgenic dairy goats. Two transgenic goats were identified from 29 animals born. The first animal, a female, was mated and allowed to carry the pregnancy to term. Milk was obtained upon parturition and was shown to contain enzymatically active LAtPA at a concentration of 3 micrograms/ml.

Central cardiovascular sites of action for dermorphin were determined by injecting 40 pmol of the peptide into discrete sites within the hypothalamus of halothane anesthetized rats. Blood pressure and heart rate in 101 rats were 88 +/- 1 mm Hg and 338 +/- 3 beats/min, respectively, prior to 100 nl intrahypothalamic injections of either vehicle or dermorphin. In the caudal anterior hypothalamic nucleus (A5800-5300), dermorphin, but not vehicle, increased blood pressure 8% and heart rate 26%, without changing respiration rate. The peak response was at 32 +/- 5 min, the duration greater than 90 min. Injections of naloxone (30 nmol) into the same anterior hypothalamic site, or 3 mg/kg naloxone administered i.m., completely reversed the cardiovascular actions. Similar increases in heart rate and blood pressure occurred at A6600-6300, the region between medial preoptic and anterior hypothalamic nuclei. Small increases in heart rate, but not blood pressure, resulted from dermorphin injections into the septal area, medial preoptic nucleus, paraventricular hypothalamic nucleus and the lateral ventricle, while injections in the posterior and dorsomedial hypothalamic nuclei were without effect on blood pressure and heart rate. These data provide support for anterior hypothalamic and medial preoptic sites for the cardiovascular actions of the opiate receptor agonist, dermorphin, and indicate greatest effects with this dose (primarily on heart rate) are produced at discrete sites (A6600-6300 and A5800-5300) within these nuclei.