Bodybuilding Coaching Strategies Meet Evidence-Based Recommendations: A Qualitative Approach.

Bodybuilding is a sport where coaches commonly recommend a variety of nutrition and exercise protocols, supplements, and, sometimes, performance-enhancing drugs (PEDs). The present study sought to gain an understanding of the common decisions and rationales employed by bodybuilding coaches. Focusing on coaches of the more muscular divisions in the National Physique Committee/IFBB Professional League federations (men's classic physique, men's bodybuilding, women's physique, women's bodybuilding) for both natural and enhanced athletes, coaches were recruited via word of mouth and social media, and 33 responded to an anonymous online survey. Survey responses indicated that participant coaches recommend three-to-seven meals per day and no less than 2 g/kg/day of protein regardless of sex, division, or PED usage. During contest preparation, participant coaches alter a natural competitor's protein intake by -25% to +10% and an enhanced competitor's protein intake by 0% to +25%. Regarding cardiovascular exercise protocols, approximately two-thirds of participant coaches recommend fasted cardiovascular exercise, with the common rationale of combining the exercise with thermogenic supplements while considering the athlete's preference. Low- and moderate-intensity steady state were the most commonly recommended types of cardiovascular exercise among participant coaches; high-intensity interval training was the least popular. Creatine was ranked in the top two supplements for all surveyed categories. Regarding PEDs, testosterone, growth hormone, and methenolone were consistently ranked in the top five recommended PEDs by participant coaches. The results of this study provide insight into common themes in the decisions made by bodybuilding coaches, and highlight areas in which more research is needed to empirically support those decisions.

The Role of Immunotherapy and Radiation Therapy in Tumor Chemosensitivity in Advanced Head and Neck Cancer.

BACKGROUND Cancer is the second leading cause of death internationally, resulting in millions of deaths each year. While treatment in the past has heavily relied on surgery and radiotherapy, chemotherapy and immunotherapy are being increasingly utilized depending on disease presentation. CASE REPORT A 56-year-old male presented to the Emergency Department with a 3-week history of a rapidly enlarging left supraclavicular neck mass. Computed tomography scan revealed a 12×13 cm mass extending from the angle of the mandible to the supraclavicular area. A biopsy confirmed advanced stage squamous cell carcinoma of the head and neck. The patient was started on a chemotherapy regimen of docetaxel, cisplatin, and 5-fluorouracil (TCF). The tumor progressed through chemotherapy, which was switched to cetuximab; however, this therapy was discontinued after an anaphylactic reaction. Palliative radiation treatment was begun along with pembrolizumab. Pembrolizumab was continued, and after 9 cycles, the patient's cancer was almost in complete remission. Three months later, disease progression was once again noted with pembrolizumab treatment, which was subsequently discontinued. The patient was started on paclitaxel and carboplatin chemotherapy regimen as a last resort, despite failure of prior TCF treatment, and the patient responded, this time with complete remission in 4 months. CONCLUSIONS This case demonstrates a unique outcome in which a patient who previously was resistant to chemotherapy, later responded to chemotherapy after a trial of radiation therapy and immunotherapy. Immunotherapy may have a synergistic effect with radiation therapy and play a role in tumor sensitivity to chemotherapy in head and neck cancer treatment.

Hyperbranched crystalline nanostructure produced from ionic π-conjugated molecules.

Self-assembled crystalline nanostructures with sheaf-like morphology fabricated from tetra(4-aminophenyl)porphyrin and tetra(4-sulfonatophenyl)porphyrin are reported for the first time. The hierarchical sheaf-like growth of the assemblies exhibits Arrhenius behaviour. The observed morphology results from crystal splitting during initial oriented attachment growth followed by Ostwald ripening.