Analgecine

Antioxidants and nitric oxide (NO) precursors may improve endurance exercise performance by reducing oxidative stress and increasing NO production. Almonds, dried grapes, and cranberries (AGC) are good sources of antioxidants and NO precursors.

To determine whether AGC consumption improved physiological responses and endurance cycling time-trial performance in response to training.

After 1 wk of light training (LT), 96 male recreationally trained cyclists consumed 125 g of AGC or control (CON: isocaloric oat bar) daily during 2 wk of heavy training (HT) and a 2-wk taper (T). At the end of LT, HT, and T, endurance exercise performance (5-min cycling time-trial; 5CTT), NO bioavailability (plasma and urine nitrate and nitrite), oxidative stress [plasma F2-isoprostanes (F₂-Isop)], muscle damage (creatine kinase) and subjective measures of wellbeing were assessed, as well as physiological responses during exercise at 70% maximal aerobic power output.

Compared to LT, 5CTT performance was impaired at HT (d = -0.27, P = 0.01) and improved at T (d = 0.79, P < 0.001), with no difference between treatments (P > 0.81). Compared with CON, during submaximal exercise at 70%, maximal aerobic power output AGC demonstrated higher oxygen consumption (HT: d = 0.46; T: d = 0.38, P < 0.001) and lower respiratory exchange ratio (HT: d = -0.61; T: d = -0.23, P < 0.032). At HT, urine F₂-Isop was higher compared with LT (d = 0.21, P = 0.036), but plasma F₂-Isop was lower (d = -0.22, P = 0.008), with no difference between treatments. At HT, AGC had higher subjective energy concentrations (d = 0.21, P = 0.02) and urinary nitrite (d = 0.23, P = 0.03) compared with CON and higher creatine kinase (d = 0.24, P = 0.02) and less fatigue (d = -0.20; P = 0.05) at T.

Although not beneficial for 5CTT performance or exercise efficiency, AGC increases fat oxidation during exercise, NO bioavailability, and subjective energy concentrations, which may confer benefits for health and wellbeing.This trial was registered at www.anzctr.org.au as ACTRN12618000360213.

Objective. To evaluate the impact of setup uncertainty reduction (SUR) and adaptation to geometrical changes (AGC) on normal tissue complication probability (NTCP) when using online adaptive head and neck intensity modulated proton therapy (IMPT). Approach. A cohort of ten retrospective head and neck cancer patients with daily scatter corrected cone-beam CT (CBCT) was studied. For each patient, two IMPT treatment plans were created: one with a 3 mm setup uncertainty robustness setting and one with no explicit setup robustness. Both plans were recalculated on the daily CBCT considering three scenarios: the robust plan without adaptation, the non-robust plan without adaptation and the non-robust plan with daily online adaptation. Online-adaptation was simulated using an in-house developed workflow based on GPU-accelerated Monte Carlo dose calculation and partial spot-intensity re-optimization. Dose distributions associated with each scenario were accumulated on the planning CT, where NTCP models for six toxicities were applied. NTCP values from each scenario were intercompared to quantify the reduction in toxicity risk induced by SUR alone, AGC alone and SUR and AGC combined. Finally, a decision tree was implemented to assess the clinical significance of the toxicity reduction associated with each mechanism. Main results. For most patients, clinically meaningful NTCP reductions were only achieved when SUR and AGC were performed together. In these conditions, total reductions in NTCP of up to 30.48 pp were obtained, with noticeable NTCP reductions for aspiration, dysphagia and xerostomia (mean reductions of 8.25, 5.42 and 5.12 pp respectively). While SUR had a generally larger impact than AGC on NTCP reductions, SUR alone did not induce clinically meaningful toxicity reductions in any patient, compared to only one for AGC alone. Significance Online adaptive head and neck proton therapy can only yield clinically significant reductions in the risk of long-term side effects when combining the benefits of SUR and AGC.