The aim of this study was to investigate the effects of four different training periodizations, based on two different training intensity distributions during a 16week training block in well-trained endurance runners. Sixty well-trained male runners were divided into four groups. Each runner completed one of the following 16-week training interventions: a pyramidal periodization (PYR); a polarized periodization (POL); a pyramidal periodization followed by a polarized periodization (PYR → POL); and a polarized periodization followed by a pyramidal periodization (POL → PYR). The PYR and POL groups trained with a pyramidal or polarized distribution for 16 weeks. To allow for the change in periodization for the PYR → POL and POL → PYR groups, the 16-week intervention was split into two 8-week phases, starting with pyramidal or polarized distribution and then switching to the other. The periodization patterns were isolated manipulations of training intensity distribution, while training load was kept constant.Participants were tested pre-, mid-and post-intervention for body mass, velocity at 2 and 4 mmol•L −1 of blood lactate concentration (vBLa2, vBLa4), absolute and relative peak oxygen consumption ( V O 2peak ) and 5-km running time trial performance. There were significant group × time interactions for relative V O 2peak (p < 0.0001), vBLa2 (p < 0.0001) and vBLa4 (p < 0.0001) and 5-km running time trial performance (p = 0.0001). Specifically, participants in the PYR → POL group showed the largest improvement in all these variables (~3.0% for relative V O 2peak , ~1.7% for vBLa2, ~1.5% for vBLa4, ~1.5% for 5-km running time trial performance). No significant interactions were observed for body mass, absolute V O 2peak , peak heart rate, lactate peak and rating of perceived exertion. Each intervention effectively improved endurance surrogates and performance in welltrained endurance runners. However, the change from pyramidal to polarized distribution maximized performance improvements, with relative V O 2peak representing the only physiological correlate.

Background Vaccines against COVID-19 are a powerful tool to control the current SARS-CoV-2 pandemic. A thorough description of their immunogenicity among people living with HIV (PLWHIV) is necessary. We aimed to assess the immunogenicity of the mRNA-1273 vaccine among PLWHIV. Methods In this prospective cohort, adult PLWHIV outpatients were enrolled during the Italian vaccination campaign. Enrolment was allowed irrespective of ongoing combination antiretroviral therapy (ART), plasma HIV viral load and CD4+ T cell count. A two-dose regimen of mRNA-1273, with administrations performed 28 days apart, was employed. The primary outcomes were anti-spike (anti-S) antibody titres and neutralising antibody activity, assessed 28 days after completing the vaccination schedule. A convenient sample of individuals not affected by HIV was also collected to serve as control (referred as healthy-donors, HDs). Findings We enrolled 71 PLWHIV, mostly male (84·5%), with a mean age of 47 years, a median CD4+ T cell count of 747·0 cells per µL and a median HIV viral load <50 copies/mL. COVID-19-experienced PLWHIV displayed higher anti-S antibody titres (p=0·0007) and neutralising antibody activity in sera (p=0·0007) than COVID-19-naïve PLWHIV. When stratified according to CD4+ T cell count (<350 cells/μL, 350-500 cells/μL, >500 cells/μL), anti-S antibody titres (6/71, median 2173 U/mL [IQR 987-4109]; 7/71, 5763 IU/mL [IQR 4801->12500]; 58/71, 2449 U/mL [IQR 1524-5704]) were not lower to those observed among HDs (10, median 1425 U/mL [IQR 599-6131]). In addition, neutralising antibody activity, stratified according to the CD4+ T cell count (6/71, median 1314 [IQR 606-2477]; 7/71, 3329 IU/mL [IQR 1905-10508]; 58/71, 1227 U/mL [IQR 761-3032]), was like those displayed by HDs (10, median 2112 U/mL [IQR 719-8889]). Interpretation In our cohort of PLWHIV with well-controlled ART, stable viral suppression and robust CD4+ T cell count, inoculation with mRNA-1273 vaccine given 4 weeks apart produced detectable humoral immune response, similar to individuals without HIV infection, supporting vaccination in PLWHIV. Funding This study was partially supported by Italian Ministry of Health Ricerca Corrente 2021, by Intesa San Paolo COVID-19 emergency 2020 funds, and by Fondazione Cariplo Grant (INNATE-CoV).

Purpose This study investigates the effect of a mentally demanding response inhibitory task on time trial performance in sub-elite under 23 cyclists. Methods Ten under 23 road cyclists completed two separate testing sessions during which they performed two different cognitive tasks before completing a 30-min time trial on the cycle ergometer. In the experimental condition, 30 min of a standard cognitive task (Stroop task) was used to elicit mental fatigue; in the control condition, a non-demanding activity was carried out. Subjective workload and mood were measured before and after the treatments, and motivation was recorded before the time-trial. During the time trial, power, cadence, heart rate, and rate of perceived exertion were assessed. Blood lactate concentrations and heart rate variability (using the root mean square of the successive differences) were measured before and after the time trial. Results The Stroop task was rated more mentally (P < 0.001) and temporally (P < 0.001) demanding, effortful (P < 0.001), and frustrating (P = 0.001) than the control task; fatigue (P = 0.002) and vigor (P = 0.018) after the cognitive tasks were respectively higher and lower than in the control task. Mean power output (P = 0.007) and cadence (P = 0.043) were negatively affected by the Stroop task, while heart rate (P = 0.349), rating of perceived exertion (P = 0.710), blood lactate concentration (P = 0.850), and root mean square of the successive differences (P = 0.355) did not differ between the two conditions. Conclusion A mentally demanding activity reduced the subsequent physical performance in sub-elite under 23 cyclists. Thus, avoiding cognitive efforts before training and races could improve performance of high-level athletes.

Background: The effects of anodal transcranial direct-current stimulation (tDCS) on endurance exercise performance are not yet fully understood. Different stimulated areas and low focality of classical tDCS technique may have led to discordant results. Purpose: This study investigated the effect of a bilateral anodal high-definition tDCS (HD-tDCS) of the dorsolateral prefrontal cortex on the cycling time-trial (TT) performance and physiological and perceptual response at moderate intensity in elite cyclists. Methods: A total of 8 elite cyclists (maximal oxygen consumption: 72.2 [4.3] mL·min−1·kg−1) underwent in a double-blind, counterbalanced, and randomized order the experimental treatment (HD-tDCS) or control treatment (SHAM). After 20 minutes of receiving either HD-tDCS on the dorsolateral prefrontal cortex (F3 and F4) or SHAM stimulation, the participants completed a constant-load trial (CLT) at 75% of the second ventilatory threshold. Thereafter, they performed a simulated 15-km TT. The ratings of perceived exertion, heart rate, cadence,  oxygen consumption, and respiratory exchange ratio were recorded during the CLT; the ratings of perceived exertion and heart rate were recorded during the TT. Results: The total time to complete the TT was 1.3% faster (HD-tDCS: 1212 [52] s vs SHAM: 1228 [56] s; P = .04) and associated with a higher heart rate (P < .001) and a tendency toward higher mean power output (P = .05). None of the physiological and perceptual variables measured during the CLT highlighted differences between the HD-tDCS and SHAM condition. Conclusions: The findings suggest that bilateral HD-tDCS on the dorsolateral prefrontal cortex improves cycling TT performance without altering the physiological and perceptual response at moderate intensity, indicating that an upregulation of the prefrontal cortex could enhance endurance exercise performance.

Purpose: To investigate the effects of bilateral dorsolateral prefrontal cortex high-definition transcranial direct-current stimulation (HD-tDCS) on physiological and performance responses during exercise at the upper limit of the severe-intensity exercise domain in elite-level road cyclists. Methods: Eleven elite-level road cyclists (VO2peak: 71.8 [3.1] mL·kg−1·min−1) underwent the HD-tDCS or SHAM condition in a double-blind, counterbalanced, and randomized order. After 20 minutes of receiving either HD-tDCS on dorsolateral prefrontal cortex (F3 and F4) or SHAM stimulation, participants completed a 10-minute constant-load trial (CLT1) at 90% of the first ventilatory threshold and a 2-minute CLT (CLT2) at peak power output. Thereafter, they performed a simulated 2-km time trial (TT). Maximal oxygen uptake, respiratory exchange ratio, heart rate, and rating of perceived exertion were recorded during CLT1 and CLT2, whereas performance parameters were recorded during the TT. Results: In 6 out of 11 cyclists, the total time to complete the TT was 3.0% faster in HD-tDCS compared to SHAM. Physiological and perceptual variables measured during CLT1 and CLT2 did not change between HD‐tDCS and SHAM. Conclusions: HD-tDCS over the dorsolateral prefrontal cortex seemed to improve cycling TT performance within the upper limit of the severe-intensity exercise domain, suggesting that an upregulation of the prefrontal cortex could be critical even in this exercise intensity domain. However, the limited dimension and the high interindividual variability require further studies to test these putative ergogenic effects.