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Background/Objectives: This study assessed the individual and combined effects of green tea extract and ginger supplementation on endurance performance, metabolic responses, perceived exertion, thermal sensation, and muscle soreness in normothermic and cold environmental conditions. Methods: In a randomized, double-blind crossover trial, sixteen recreationally active males (age: 23.4 ± 0.4 years; VO2 max: 46.8 ± 2.8 mL/kg/min) were tested in eight conditions (placebo [maltodextrin], green tea [500 mg], ginger [1000 mg], combined), all in normothermic (21–24 °C) and cold (5–7 °C) environments. All supplements and the placebo were encapsulated in identical capsules to ensure blinding. Participants completed a submaximal time-to-exhaustion (TTE) test at 70% VO2 max on a cycle ergometer. TTE, respiratory exchange ratio (RER), perceived exertion (RPE), thermal sensation (TSS), and muscle soreness via a visual analog scale (VAS), assessed 24 h post-exercise, were measured. Results: In normothermic condition, green tea and combined supplementation significantly increased TTE and reduced RER compared to the placebo (p < 0.05), and that combined supplementation lowered RPE relative to the placebo and ginger (all p < 0.05). In cold conditions, combined supplementation significantly enhanced TTE, reduced RER, and improved TSS compared to the placebo and ginger (p < 0.05), while all supplements decreased VAS relative to the placebo (p < 0.05). Ginger alone showed no significant effect on TTE or RER but improved TSS and VAS in cold compared to the placebo (p < 0.05). Cold placebo conditions exhibited significantly higher RPE and VAS than all normothermic conditions (p < 0.05). Conclusions: Green tea enhances endurance and fat oxidation in normothermic conditions, while its combination with ginger can optimize performance, thermal comfort, and recovery in cold environments. These findings suggest a practical nutritional strategy for mitigating environmental stress during exercise, specific to the acute supplementation in males. Trial Registration: This trial was registered at ClinicalTrials.gov (Identifier: NCT07150533).

Topically applied high-concentration capsaicin induces reversible dermo-epidermal denervation and depletion of capsaicin-sensitive nociceptors. This causes desensitization of distinct sensory modalities and is used to treat peripheral neuropathic pain and itch. For high-concentration capsaicin, the selectivity of loss of function and functional recovery rates of various afferent fibers subpopulations are unknown. This study used comprehensive quantitative sensory testing and vasomotor imaging to assess effectiveness, duration and sensory selectivity of high-concentration 8% capsaicin–ablation. Skin areas in 14 healthy volunteers were randomized to treatment with 8% capsaicin/vehicle patches for 1 and 24 h and underwent comprehensive sensory and vasomotor testing at 1, 7 and 21 days postpatch removal. Tests consisted of thermal detection and pain thresholds, tactile and vibration detection thresholds, mechanical pain threshold and mechanical pain sensitivity as well as micro-vascular and itch reactivity to histamine provocations. The 24 h capsaicin drastically inhibited warmth detection (P < 0.001), heat pain (P < 0.001) as well as histamine-induced itch (P < 0.05) and neurogenic flare (P < 0.001), but had no impact on tactile sensitivity, cold detection and cold pain. A marginal decrease in mechanical pain sensitivity was observed (P < 0.05). Capsaicin for 1 h had limited and transient sensory effects only affecting warmth and heat sensations. Time-dependent functional recovery was almost complete 21 days after the 24 h capsaicin exposure, while recovery of neurogenic inflammatory responsiveness remained partial. The psychophysically assessed sensory deficiencies induced by the used 8% capsaicin–ablation correspond well with a predominant effect on TRPV1+–cutaneous fibers. The method is easy to apply, well tolerated, and utilizable for studies on, e.g., interactions between skin barrier, inflammation and capsaicin-sensitive afferents.

The current study compared mouth swills containing carbohydrate (CHO), menthol (MEN) or a combination (BOTH) on 40 km cycling time trial (TT) performance in the heat (32 °C, 40% humidity, 1000 W radiant load) and investigates associated physiological (rectal temperature (Trec), heart rate (HR)) and subjective measures (thermal comfort (TC), thermal sensation (TS), thirst, oral cooling (OC) and RPE (legs and lungs)). Eight recreationally trained male cyclists (32 ± 9 y; height: 180.9 ± 7.0 cm; weight: 76.3 ± 10.4 kg) completed familiarisation and three experimental trials, swilling either MEN, CHO or BOTH at 10 km intervals (5, 15, 25, 35 km). The 40 km TT performance did not differ significantly between conditions (F2,14 = 0.343; p = 0.715; η2 = 0.047), yet post-hoc testing indicated small differences between MEN and CHO (d = 0.225) and MEN and BOTH (d = 0.275). Subjective measures (TC, TS, RPE) were significantly affected by distance but showed no significant differences between solutions. Within-subject analysis found significant interactions between solution and location upon OC intensity (F28,196 = 2.577; p < 0.001; η2 = 0.269). While solutions containing MEN resulted in a greater sensation of OC, solutions containing CHO experienced small improvements in TT performance. Stimulation of central CHO pathways during self-paced cycling TT in the heat may be of more importance to performance than perceptual cooling interventions. However, no detrimental effects are seen when interventions are combined.

Abstract Socially warm experiences, when one feels connected to others, have been linked with physical warmth. Opioids, hypothesized to support social bonding with close others and, separately, physical warmth, may underlie both experiences. In order to test this hypothesis, 80 participants were randomly assigned to the opioid antagonist, naltrexone or placebo before neural and emotional responses to social and physical warmth were collected. Social and physical warmth led to similar increases in ventral striatum (VS) and middle-insula (MI) activity. Further, feelings of social connection were positively related to neural activity to social warmth. However, naltrexone (vs placebo) disrupted these effects by (i) reducing VS and MI activity to social and physical warmth, (ii) erasing the subjective experience–brain association to social warmth and (iii) disrupting the neural overlap between social and physical warmth. Results provide additional support for the theory that social and physical warmth share neurobiological, opioid receptor-dependent mechanisms and suggest multiple routes by which social connections may be maintained.

Increased brain dopamine availability improves prolonged exercise tolerance in the heat. It is unclear whether supplementing the amino-acid precursor of dopamine increases exercise capacity in the heat. Eight healthy male volunteers [mean age 32 ± 11 (SD) years; body mass 75.3 ± 8.1 kg; peak oxygen uptake ( ) 3.5 ± 0.3 L min −1 ] performed two exercise trials separated by at least 7 days in a randomised, crossover design. Subjects consumed 500 mL of a flavoured sugar-free drink (PLA), or the same drink with 150 mg kg body mass −1 tyrosine (TYR) in a double-blind manner 1 h before cycling to exhaustion at a constant exercise intensity equivalent to 68 ± 5% in 30°C and 60% relative humidity. Pre-exercise plasma tyrosine:large neutral amino acids increased 2.9-fold in TYR ( P  < 0.01), while there was no change in PLA ( P  > 0.05). Subjects cycled longer in TYR compared to PLA (80.3 ± 19.7 min vs. 69.2 ± 14.0 min; P  < 0.01). Core temperature, mean weighted skin temperature, heart rate, ratings of perceived exertion and thermal sensation were similar in TYR and PLA during exercise and at exhaustion ( P  > 0.05) despite longer exercise time in TYR. The results show that acute tyrosine supplementation is associated with increased endurance capacity in the heat in moderately trained subjects. The results also suggest for the first time that the availability of tyrosine, a nutritional dopamine precursor, can influence the ability to subjectively tolerate prolonged submaximal constant-load exercise in the heat.

This study implemented an intra-oral test-platform to assess the sensory, psychophysical, and vasomotor responses to nicotine and menthol, alone or in combination. Two double-blinded, placebo-controlled, randomized, cross-over studies, including healthy nonsmoking participants were performed. Study I: A dose-response relationship (N = 20) between 0, 2, and 4 mg nicotine gum. Study II: An interaction response (N = 22) to 30 mg menthol and 4 mg nicotine alone or in combination. Heart rate, blood pressure, tactile and thermosensory thresholds, intra-oral blood flow and temperature, pain/irritation intensities/locations, McGill Pain Questionnaire, and taste experience were assessed before, during or after the completion of a standardized chewing regime. A dose-response elevation in heart rate was attenuated when nicotine was combined with menthol. Blood flow, temperature, and warm-detection thresholds, as assessed on the tongue, similarly increased for all gums. Pain intensity and taste experiences were similar between nicotine doses. Nicotine attenuated the sweet, cooling, and freshening sensation of menthol. Within the first 4 minutes, menthol reduced the intensity but not the area of nicotine-induced pain and irritation. The 4-mg nicotine dose led to a continued increase in the intensity and area of irritation in the throat post-chewing. Moreover, one-half of participants responded to menthol as an irritant, and these individuals demonstrated larger areas of nicotine-induced irritation in the throat post-chewing. The intra-oral test platform provides a basis to optimize the assessment of nicotine-related taste and sensory experiences and can be used in future studies for profiling nicotine gum.

Background Menthol chemically triggers cold-sensitive receptors in the skin without conductive skin cooling. We investigated the effects of menthol-induced activation of cutaneous cold receptors on the cold-induced vasodilation (CIVD) of the finger. We hypothesized that the menthol application would attenuate typical CIVD responses. Methods 1.5% l -menthol was fully applied over the left hand and forearm, and then, the middle finger of the left hand was immersed into 4 °C water for 30 min. A trial consisted of 10-min rest followed by 30-min immersion and 20-min recovery in 28 °C air temperature with 20% relative humidity. Another trial without the menthol application was carried out as a control. Seventeen females (24.2 ± 2.6 years in age, 160.5 ± 5.1 cm in height, and 51.2 ± 5.7 kg in body weight) participated in the two trials. Results The results showed that the maximum and average temperatures of the finger during the water immersion were lower in the menthol application when compared to control ( P  < 0.05), whereas no significant differences appeared in the onset time of CIVD, the frequency of CIVD, and minimum finger temperature. These results imply that stronger stimulation of cold receptors without additional conductive skin cooling did not attenuate the triggering of CIVD responses but intensified vasoconstriction after the first occurrence of CIVD. Conclusion It is suggested that substantial and conductive heat loss through the skin along with activation of cold receptors may be required to retain rewarming at a certain level.

Background:The deep peroneal nerve is 1 of 5 nerves anesthetized when performing an ankle block. Multiple techniques of blocking the deep peroneal nerve have been described, but little evidence exists to delineate the efficacy of any one technique. We hypothesized that ultrasound would increase both the success rate and the quality of a deep peroneal nerve block at the ankle.Methods:Eighteen healthy volunteers participated in this randomized, controlled, prospective study. Each subject was randomly assigned to receive an ultrasound-guided deep peroneal nerve block of either the right or the left ankle. The deep peroneal nerve on the opposite side was blocked using a conventional landmark technique. Subjects were blinded to the technique used. All blocks were preformed with 5 mL of 3% 2-chloroprocaine. We evaluated both sensory and motor blocks at 10-min intervals for 60 mins.Results:Blocks were maximal in both groups at 20 to 30 mins. There was a statistically significant difference in temperature sensation and motor function at 10 mins favoring the ultrasound group. There was no statistical difference in motor function, temperature, or pinprick sensation between 20 and 60 mins.Conclusions:The use of ultrasound seems to improve the onset of deep peroneal nerve block at the ankle but does not improve the overall quality of the block.

Background Chronic thoracic pain after cardiac surgery is prevalent (11 to 56%) and may affect patients’ physical and mental health status. Despite its favorable pharmacokinetic and pharmacodynamic properties, high doses of remifentanil administered during surgery are reported to cause acute postoperative pain and increased requirements for analgesics. Recently, an association between remifentanil use and the incidence of chronic thoracic pain in the long term was also reported. Our objective is to investigate the influence of the intraoperative remifentanil on chronic postoperative pain in a prospective randomized controlled trial. Methods/design In this prospective, randomized, single-blind clinical trial, all patients (N =126) between 18 and 85 years undergoing cardiac surgery via sternotomy receive a continuous infusion of propofol together with intermittent intravenous fentanyl at predetermined times perioperatively. Patients are randomized to receive either an additional continuous infusion of remifentanil (0.15 μg -1 kgIBW -1  min -1 ) or additional fentanyl (200 to 500 μg) as needed during surgery. The primary end point is the prevalence of chronic thoracic pain 12 months after surgery. Secondary end points include acute postoperative pain; postoperative analgesic use; chronic thoracic pain 3 and 6 months after surgery; quality of life (SF-12) at 3, 6 and 12 months after surgery; work productivity; and use of health care. In addition, thermal detection and pain thresholds are measured preoperatively, 3 days after surgery and 12 months after surgery using quantitative sensory testing (QST). Finally, the influence of several genetic variances on the different outcomes will be measured. Discussion Chronic thoracic pain is prevalent after cardiac surgery, and research is needed to minimize the risk of chronic persistent postoperative pain, which is an invalidating, long-term complication of surgery. The objective of this trial is to determine the influence of perioperative remifentanil on long-term pain outcomes for cardiac patients in a prospective randomized trial. The results may be used to optimize perioperative analgesia techniques and, thereby, improve quality of life after cardiac surgery. Trial registration Clinicaltrials.gov NCT02031016 on 13 December 2013.

Background Cold hypersensitivity in the hands and feet (CHHF) is one of the most common complaints among Asians, especially in women. Korean red ginseng (KRG), which is a steamed form of Panax ginseng, has vasodilating action in the peripheral vessels and increases blood flow under cold stress. However, few studies have evaluated the effect of KRG on cold hypersensitivity. Methods/Design This trial is a randomized, double-blind, placebo-controlled trial in 80 CHHF patients. The trial will be implemented at Kyung Hee University Hospital at Gangdong in Seoul, Korea. The participants will take KRG or a placebo for eight weeks, after which they will be followed-up for four weeks. During the administration period, six capsules of 500 mg KRG or placebo will be provided twice a day. The primary outcome is change of skin temperature in the hands between baseline and after treatment. The secondary outcomes include the visual analogue scale scores of cold hypersensitivity in the hands, change of skin temperature and the VAS scores of cold hypersensitivity in the feet, the recovery rate of the skin temperature by the cold stress test of the hands, the distal-dorsal difference of the hands, power variables of heart rate variability, and the 36-item short form health survey. Discussion This study is the first trial to evaluate the efficacy of KRG on CHHF by using infrared thermography. Our study will provide basic evidence regarding CHHF. Trial registration CliniacalTrials.gov NCT01664156