human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The present investigation compared responses in previously identified physiological , biochemical , and psychological markers of overreaching in triathletes . Sixteen experienced male triathletes ( .VO(2max ) [ mean + /- SD ] = 55.7 + /- 4.9 mL . kg ( -1 ) . min ( -1 ) , age = 31.3 + /- 11.7 yr ) were divided into matched groups according to physical and performance characteristics , and were r and omly assigned to either intensified training ( IT ) or normal training ( NT ) groups . Physiological , biochemical , and psychological measures were taken at baseline , following four weeks of overload training and following a two-week taper . The IT group completed 290 % greater physical training load than the NT group during the overload period . The subjects completed a 3-km run time trial ( 3-km RTT ) each week in order to assess the time course of change in endurance performance . 3-km RTT performance was significantly reduced ( 3.7 + /- 7.5 % ; p < 0.05 ) following four weeks of overload training in the IT group confirming a state of overreaching . During the same period , 3-km RTT performance significantly improved in the NT group ( 3.0 + /- 1.1 % ; p < 0.05 ) . Following the two-week taper , 3-km RTT performance significantly improved in the IT group ( 7.0 + /- 5.6 % ; p < 0.05 ) . Hemoglobin concentration significantly decreased and urea increased in both groups during the overload period ( p < 0.05 ) . During the taper hemoglobin normalized with a greater increase in the IT group compared to the NT group ( p < 0.05 ) . A significant increase in free testosterone to cortisol ratio was also observed in the IT group compared to the NT group during the taper ( p < 0.05 ) . No significant changes were observed for any other biochemical variables during the period of investigation . The RESTQ-76 Sport question naire showed an impaired recovery-stress state with increased training load , which improved following the taper in the IT group ( p < 0.05 ) . These present results suggest that none of the physiological and biochemical variables measured in this study were effective for the early identification of overreaching in experienced triathletes . However , the RESTQ-76 Sport question naire may provide a practical tool for recognizing overreaching in its early stages . These findings have implication s for monitoring training status in athletes in a practical training setting The aim of this study was to identify indicators of non-functional overreaching ( NFOR ) in team sport athletes undertaking intensive training loads . Eighteen semi-professional rugby league players were r and omly assigned into two pair matched groups . One group completed 6 weeks of normal training ( NT ) whilst the other group was deliberately overreached through intensified training ( IT ) . Both groups then completed the same 7-day stepwise training load reduction taper . Multistage fitness test ( MSFT ) performance , $ $ \ifmmode\exp and after\dot\else\exp and after\.\fi{V}{\text{O}}_{{2\max } } $ $ , peak aerobic running velocity ( Vmax ) , maximal heart rate , vertical jump , 10-s cycle sprint performance and body mass were measured pre- and post-training period and following the taper . Hormonal , haematological and immunological parameters were also measured pre-training and following weeks 2 , 4 and 6 of training and post-taper . MANOVA for repeated measures with contrast analysis indicated that MSFT performance and $ $ \ifmmode\exp and after\dot\else\exp and after\.\fi{V}{\text{O}}_{{2\max } } $ $ were significantly reduced in the IT group over time and condition , indicating that a state of overreaching was attained . However , the only biochemical measure that was significantly different between the IT and NT group was the glutamine to glutamate ( Gln/Glu ) ratio even though testosterone , testosterone to cortisol ( T/C ) ratio , plasma glutamate , and CK activity were significantly changed after training in both groups . Positive endurance and power performance changes were observed post-taper in the IT group confirming NFOR . These changes were associated with increases in the T/C ratio and the Gln/Glu ratio and decreases in plasma glutamate and CK activity . These results indicate that although there was no single reliable biochemical marker of NFOR in these athletes , the Gln/Glu ratio and MSFT test may be useful measures for monitoring responses to IT in team sport athletes Objective To verify if in male elite junior soccer players a minimum 1-month performance decrease is accompanied by a mood profile and hormone levels typical of non-functional over-reaching ( NFOR ) . Design A prospect i ve case-control study using a monthly performance monitor with a st and ardised field test to detect the performance changes . Players with a performance decrease lasting at least 1 month were compared with control players without a performance decrease on mood scores and pre-exercise and postexercise levels of stress hormones . Setting Sporting field and sports medical laboratory . Participants Ninety-four young elite soccer players were monitored during the 2006–2008 seasons . Twenty-one players were invited to the laboratory , seven of whom showed a significant performance decrease . Main outcome measures Performance change over time , scores on the profile of mood states and premaximal and postmaximal exercise serum levels of adrenocorticotropic hormone ( ACTH ) , growth hormone ( GH ) and cortisol . Results Players with a performance decrease showed psychological and hormonal changes typical of the non-functional state of over-reaching . Scores were higher on depression and anger , whereas the resting GH levels and ACTH levels after maximal exercise were reduced . ACTH and GH were capable of classifying all but one player correctly as either NFOR or control . Conclusions Performance-related criteria in field tests are capable of identifying players with worsened mood and adaptations of the endocrine system that fit the definition of NFOR . Performance , mood and hormone levels may therefore be considered as valid instruments to diagnose NFOR in young elite soccer players The aim of the present prospect i ve longitudinal study was to investigate the hormonal response in overtrained athletes at rest and during exercise consisting of a short-term exhaustive endurance test on a cycle ergometer at an intensity 10 % above the individual anaerobic threshold . Over a period of 19+/-1 months , 17 male endurance athletes ( cyclists and triathletes ; age 23.4+/-1.6 yr ; VO2max . 61.2+/-1.8 mL x min(-1 ) x kg(-1 ) ; means+/-SEM ) were examined five times on two separate days under st and ardized conditions . Short-term overtraining states ( OT , N=15 ) were primarily induced by an increase of frequency of high-intensive bouts of exercise or competitions without increase of the total amount of training . OT was compared with normal training states intraindividually ( NS , N=62 ) . During OT , the time to exhaustion of the exercise test was significantly decreased by 27 % on average . At rest and during exercise , the concentrations in plasma and the nocturnal excretion in urine of free epinephrine and norepinephrine were not significantly changed during OT . At physical rest , the concentrations of ( free ) testosterone , cortisol , luteinizing hormone , follicle-stimulating hormone , adrenocorticotropic hormone , growth hormone , and insulin during OT were comparable with those during NS . A significantly ( P < 0.025 ) lower maximal exercise-induced increase of the adrenocorticotropic hormone and growth hormone , as well as a trend for a decrease of cortisol ( P=0.060 ) and insulin ( P=0.036 ) , was measured . The response of free catecholamines as well as the ergometric performance of an all-out 30-s test was unchanged . Serum urea , uric acid , ferritin , and activity of creatine kinase showed no differences between conditions . In conclusion , the results confirm the hypothesis of a hypothalamo-pituitary dysregulation during OT expressed by an impaired response of pituitary hormones to exhaustive short-endurance exercise Objective To study whether field performance tests can make a valid distinction between non-functionally overreaching ( NFO ) athletes and control athletes . Design Monthly field performance tests were used to determine a performance decrement ( PD ) throughout a season . Athletes with a minimum of 1 month PD were compared with control athletes without a PD on mood characteristics and resting levels of stress hormones . Setting Sporting field and sports medical laboratory . Participants 129 young elite athletes , 77 soccer players and 52 middle-long distance runners were followed prospect ively during the 2006–2007 season . Fifteen of them were invited to the laboratory . Eight athletes showed a performance decrease lasting longer than 1 month , and seven athletes without a performance decrease acted as their controls . Main outcome measures Performance changes over time were measured using field tests .  Profile of Mood States and resting levels of adrenocorticotrophic hormone ( ACTH ) and cortisol in blood were measured in the laboratory . Results PD athletes showed several symptoms typical of the non-functional state of overreaching ( OR ) . The PD group scored higher on depression and anger than controls . They also showed a specific pattern of correlations between negative mood subscales ( tension , fatigue and depression ) , which was absent in controls . ACTH levels at rest were similar , but lower cortisol levels in PD athletes pointed at a blunted cortisol response . Cortisol levels were decoupled from ACTH levels only in PD athletes . Conclusions Implementing performance-related criteria in field tests can help coaches and sports physicians to distinguish NFO athletes from athletes with balanced workload and recovery The purpose of the study was to investigate whether severe fatigue , possibly leading to overreaching , could be diagnosed at an early stage by a combination of parameters . Seven well-trained male subjects ( age [ mean + /- SD ] : 25.3 + /- 4.7 yr ; body mass : 76 + /- 6.6 kg ; VO2max : 61.1 + /- 7 ml.kg(-1).min(-1 ) ) increased their training load by doubling their training volume and increasing the intensity by 15 % over a period of two weeks . Before and after this intensified training period subjects underwent a series of tests including a maximal incremental cycle ergometer test ( Wmax ) with continuous ventilatory measurements and blood lactate values , time trial , basal blood parameter tests ( red and white blood profile ) , hormones [ growth hormone ( GH ) , insulin-like growth factor 1(IGF-1 ) , adreno-corticotropic hormone ( ACTH ) , cortisol ] , neuro-endocrine stress test [ short insulin tolerance test ( SITT ) , combined anterior pituitary test ( CAPT ) and exercise ] , a shortened Profile of Mood State ( POMS ) , the estimated rate of perceived exertion ( RPE ) and a cognitive reaction time test . The intensified training period result ed in a significant increase of the training load ( p < 0.01 ) , training monotony ( p < 0.01 ) and training strain ( p < 0.01 ) . The RPE during training increased significantly ( p < 0.01 ) during the intensified training period . Total mood score obtained from the POMS tended to increase ( p=0.06 ) , reflecting an increase in worse mood state . A novel finding was that reaction times increased significantly , indicating that overreaching might adversely affect speed of information processing by the brain , especially for the most difficult conditions . After the intensified training period , neither changes in exercise-induced plasma hormone values , nor SITT values were observed . During the CAPT only cortisol showed a significant decrease after the intensified training period . Hemoglobin showed a significant decrease after the intensified training period whereas hematocrit , red blood cell count ( RBC ) and MCV tended to decrease . The intensified training had no effect on physical performance ( Wmax or time trial ) , maximal blood lactate , maximal heart rate and white blood cell profile . The most sensitive parameters for detecting overreaching are reaction time performance ( indicative for cognitive brain functioning ) , RPE and to a lesser extend the shortened POMS . This strongly suggests , that central fatigue precedes peripheral fatigue . All other systems , including the neuro-endocrine , are more robust and react most likely at a later stage in exhaustive training periods Seventeen weight-trained males were divided into an  overtraining group [ OT ; n = 11 ; age = 22.0 + /- 0.9 ( SE ) yr ] that weight trained their legs daily for 2 wk with 100 % 1 repetition maximum relative intensity on a squat machine and a control group ( n = 6 ; age = 23.7 + /- 2.4 yr )  that exercised 1 day/wk with low relative intensity ( 50 % 1 repetition maximum ) . Test batteries including strength assessment s and resting and exercise-induced concentrations of epinephrine and norepinephrine were conducted at the beginning , middle , and end ( tests 1 - 3 , respectively ) of the study . Strength capabilities decreased by test 3 for the OT group ( P < 0.05 ) . Resting catecholamine concentrations did not change for either group during the study , whereas exercise-induced concentrations of both epinephrine ( test 1 = 3,407.9 + /- 666.6 pmol/l , test 2 = 7,563.7 + /- 1,210.6 pmol/l , test 3 = 6,931.6 + /- 919.3 pmol/l ) and norepinephrine ( test 1 = 42.9 + /- 7.4 nmol/l , test 2 = 70.0 + /- 8.8 nmol/l , test 3 = 85.2 + /- 14.5 nmol/l ) significantly increased by tests 2 
    Output:
    
agent
Basal levels of hormones were mostly normal in athletes with OTS/FOR/NFOR compared with healthy athletes .
Distinctly , stimulation tests , mainly performed in maximal exercise conditions , showed blunted GH and ACTH responses in OTS/FOR/NFOR athletes , whereas cortisol and plasma catecholamines showed conflicting findings and the other hormones responded normally .
Conclusion Basal hormone levels are not good predictor but blunted ACTH and GH responses to stimulation tests may be good predictors of OTS/FOR/NFOR
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The present investigation compared responses in previously identified physiological , biochemical , and psychological markers of overreaching in triathletes . Sixteen experienced male triathletes ( .VO(2max ) [ mean + /- SD ] = 55.7 + /- 4.9 mL . kg ( -1 ) . min ( -1 ) , age = 31.3 + /- 11.7 yr ) were divided into matched groups according to physical and performance characteristics , and were r and omly assigned to either intensified training ( IT ) or normal training ( NT ) groups . Physiological , biochemical , and psychological measures were taken at baseline , following four weeks of overload training and following a two-week taper . The IT group completed 290 % greater physical training load than the NT group during the overload period . The subjects completed a 3-km run time trial ( 3-km RTT ) each week in order to assess the time course of change in endurance performance . 3-km RTT performance was significantly reduced ( 3.7 + /- 7.5 % ; p < 0.05 ) following four weeks of overload training in the IT group confirming a state of overreaching . During the same period , 3-km RTT performance significantly improved in the NT group ( 3.0 + /- 1.1 % ; p < 0.05 ) . Following the two-week taper , 3-km RTT performance significantly improved in the IT group ( 7.0 + /- 5.6 % ; p < 0.05 ) . Hemoglobin concentration significantly decreased and urea increased in both groups during the overload period ( p < 0.05 ) . During the taper hemoglobin normalized with a greater increase in the IT group compared to the NT group ( p < 0.05 ) . A significant increase in free testosterone to cortisol ratio was also observed in the IT group compared to the NT group during the taper ( p < 0.05 ) . No significant changes were observed for any other biochemical variables during the period of investigation . The RESTQ-76 Sport question naire showed an impaired recovery-stress state with increased training load , which improved following the taper in the IT group ( p < 0.05 ) . These present results suggest that none of the physiological and biochemical variables measured in this study were effective for the early identification of overreaching in experienced triathletes . However , the RESTQ-76 Sport question naire may provide a practical tool for recognizing overreaching in its early stages . These findings have implication s for monitoring training status in athletes in a practical training setting The aim of this study was to identify indicators of non-functional overreaching ( NFOR ) in team sport athletes undertaking intensive training loads . Eighteen semi-professional rugby league players were r and omly assigned into two pair matched groups . One group completed 6 weeks of normal training ( NT ) whilst the other group was deliberately overreached through intensified training ( IT ) . Both groups then completed the same 7-day stepwise training load reduction taper . Multistage fitness test ( MSFT ) performance , $ $ \ifmmode\exp and after\dot\else\exp and after\.\fi{V}{\text{O}}_{{2\max } } $ $ , peak aerobic running velocity ( Vmax ) , maximal heart rate , vertical jump , 10-s cycle sprint performance and body mass were measured pre- and post-training period and following the taper . Hormonal , haematological and immunological parameters were also measured pre-training and following weeks 2 , 4 and 6 of training and post-taper . MANOVA for repeated measures with contrast analysis indicated that MSFT performance and $ $ \ifmmode\exp and after\dot\else\exp and after\.\fi{V}{\text{O}}_{{2\max } } $ $ were significantly reduced in the IT group over time and condition , indicating that a state of overreaching was attained . However , the only biochemical measure that was significantly different between the IT and NT group was the glutamine to glutamate ( Gln/Glu ) ratio even though testosterone , testosterone to cortisol ( T/C ) ratio , plasma glutamate , and CK activity were significantly changed after training in both groups . Positive endurance and power performance changes were observed post-taper in the IT group confirming NFOR . These changes were associated with increases in the T/C ratio and the Gln/Glu ratio and decreases in plasma glutamate and CK activity . These results indicate that although there was no single reliable biochemical marker of NFOR in these athletes , the Gln/Glu ratio and MSFT test may be useful measures for monitoring responses to IT in team sport athletes Objective To verify if in male elite junior soccer players a minimum 1-month performance decrease is accompanied by a mood profile and hormone levels typical of non-functional over-reaching ( NFOR ) . Design A prospect i ve case-control study using a monthly performance monitor with a st and ardised field test to detect the performance changes . Players with a performance decrease lasting at least 1 month were compared with control players without a performance decrease on mood scores and pre-exercise and postexercise levels of stress hormones . Setting Sporting field and sports medical laboratory . Participants Ninety-four young elite soccer players were monitored during the 2006–2008 seasons . Twenty-one players were invited to the laboratory , seven of whom showed a significant performance decrease . Main outcome measures Performance change over time , scores on the profile of mood states and premaximal and postmaximal exercise serum levels of adrenocorticotropic hormone ( ACTH ) , growth hormone ( GH ) and cortisol . Results Players with a performance decrease showed psychological and hormonal changes typical of the non-functional state of over-reaching . Scores were higher on depression and anger , whereas the resting GH levels and ACTH levels after maximal exercise were reduced . ACTH and GH were capable of classifying all but one player correctly as either NFOR or control . Conclusions Performance-related criteria in field tests are capable of identifying players with worsened mood and adaptations of the endocrine system that fit the definition of NFOR . Performance , mood and hormone levels may therefore be considered as valid instruments to diagnose NFOR in young elite soccer players The aim of the present prospect i ve longitudinal study was to investigate the hormonal response in overtrained athletes at rest and during exercise consisting of a short-term exhaustive endurance test on a cycle ergometer at an intensity 10 % above the individual anaerobic threshold . Over a period of 19+/-1 months , 17 male endurance athletes ( cyclists and triathletes ; age 23.4+/-1.6 yr ; VO2max . 61.2+/-1.8 mL x min(-1 ) x kg(-1 ) ; means+/-SEM ) were examined five times on two separate days under st and ardized conditions . Short-term overtraining states ( OT , N=15 ) were primarily induced by an increase of frequency of high-intensive bouts of exercise or competitions without increase of the total amount of training . OT was compared with normal training states intraindividually ( NS , N=62 ) . During OT , the time to exhaustion of the exercise test was significantly decreased by 27 % on average . At rest and during exercise , the concentrations in plasma and the nocturnal excretion in urine of free epinephrine and norepinephrine were not significantly changed during OT . At physical rest , the concentrations of ( free ) testosterone , cortisol , luteinizing hormone , follicle-stimulating hormone , adrenocorticotropic hormone , growth hormone , and insulin during OT were comparable with those during NS . A significantly ( P < 0.025 ) lower maximal exercise-induced increase of the adrenocorticotropic hormone and growth hormone , as well as a trend for a decrease of cortisol ( P=0.060 ) and insulin ( P=0.036 ) , was measured . The response of free catecholamines as well as the ergometric performance of an all-out 30-s test was unchanged . Serum urea , uric acid , ferritin , and activity of creatine kinase showed no differences between conditions . In conclusion , the results confirm the hypothesis of a hypothalamo-pituitary dysregulation during OT expressed by an impaired response of pituitary hormones to exhaustive short-endurance exercise Objective To study whether field performance tests can make a valid distinction between non-functionally overreaching ( NFO ) athletes and control athletes . Design Monthly field performance tests were used to determine a performance decrement ( PD ) throughout a season . Athletes with a minimum of 1 month PD were compared with control athletes without a PD on mood characteristics and resting levels of stress hormones . Setting Sporting field and sports medical laboratory . Participants 129 young elite athletes , 77 soccer players and 52 middle-long distance runners were followed prospect ively during the 2006–2007 season . Fifteen of them were invited to the laboratory . Eight athletes showed a performance decrease lasting longer than 1 month , and seven athletes without a performance decrease acted as their controls . Main outcome measures Performance changes over time were measured using field tests .  Profile of Mood States and resting levels of adrenocorticotrophic hormone ( ACTH ) and cortisol in blood were measured in the laboratory . Results PD athletes showed several symptoms typical of the non-functional state of overreaching ( OR ) . The PD group scored higher on depression and anger than controls . They also showed a specific pattern of correlations between negative mood subscales ( tension , fatigue and depression ) , which was absent in controls . ACTH levels at rest were similar , but lower cortisol levels in PD athletes pointed at a blunted cortisol response . Cortisol levels were decoupled from ACTH levels only in PD athletes . Conclusions Implementing performance-related criteria in field tests can help coaches and sports physicians to distinguish NFO athletes from athletes with balanced workload and recovery The purpose of the study was to investigate whether severe fatigue , possibly leading to overreaching , could be diagnosed at an early stage by a combination of parameters . Seven well-trained male subjects ( age [ mean + /- SD ] : 25.3 + /- 4.7 yr ; body mass : 76 + /- 6.6 kg ; VO2max : 61.1 + /- 7 ml.kg(-1).min(-1 ) ) increased their training load by doubling their training volume and increasing the intensity by 15 % over a period of two weeks . Before and after this intensified training period subjects underwent a series of tests including a maximal incremental cycle ergometer test ( Wmax ) with continuous ventilatory measurements and blood lactate values , time trial , basal blood parameter tests ( red and white blood profile ) , hormones [ growth hormone ( GH ) , insulin-like growth factor 1(IGF-1 ) , adreno-corticotropic hormone ( ACTH ) , cortisol ] , neuro-endocrine stress test [ short insulin tolerance test ( SITT ) , combined anterior pituitary test ( CAPT ) and exercise ] , a shortened Profile of Mood State ( POMS ) , the estimated rate of perceived exertion ( RPE ) and a cognitive reaction time test . The intensified training period result ed in a significant increase of the training load ( p < 0.01 ) , training monotony ( p < 0.01 ) and training strain ( p < 0.01 ) . The RPE during training increased significantly ( p < 0.01 ) during the intensified training period . Total mood score obtained from the POMS tended to increase ( p=0.06 ) , reflecting an increase in worse mood state . A novel finding was that reaction times increased significantly , indicating that overreaching might adversely affect speed of information processing by the brain , especially for the most difficult conditions . After the intensified training period , neither changes in exercise-induced plasma hormone values , nor SITT values were observed . During the CAPT only cortisol showed a significant decrease after the intensified training period . Hemoglobin showed a significant decrease after the intensified training period whereas hematocrit , red blood cell count ( RBC ) and MCV tended to decrease . The intensified training had no effect on physical performance ( Wmax or time trial ) , maximal blood lactate , maximal heart rate and white blood cell profile . The most sensitive parameters for detecting overreaching are reaction time performance ( indicative for cognitive brain functioning ) , RPE and to a lesser extend the shortened POMS . This strongly suggests , that central fatigue precedes peripheral fatigue . All other systems , including the neuro-endocrine , are more robust and react most likely at a later stage in exhaustive training periods Seventeen weight-trained males were divided into an  overtraining group [ OT ; n = 11 ; age = 22.0 + /- 0.9 ( SE ) yr ] that weight trained their legs daily for 2 wk with 100 % 1 repetition maximum relative intensity on a squat machine and a control group ( n = 6 ; age = 23.7 + /- 2.4 yr )  that exercised 1 day/wk with low relative intensity ( 50 % 1 repetition maximum ) . Test batteries including strength assessment s and resting and exercise-induced concentrations of epinephrine and norepinephrine were conducted at the beginning , middle , and end ( tests 1 - 3 , respectively ) of the study . Strength capabilities decreased by test 3 for the OT group ( P < 0.05 ) . Resting catecholamine concentrations did not change for either group during the study , whereas exercise-induced concentrations of both epinephrine ( test 1 = 3,407.9 + /- 666.6 pmol/l , test 2 = 7,563.7 + /- 1,210.6 pmol/l , test 3 = 6,931.6 + /- 919.3 pmol/l ) and norepinephrine ( test 1 = 42.9 + /- 7.4 nmol/l , test 2 = 70.0 + /- 8.8 nmol/l , test 3 = 85.2 + /- 14.5 nmol/l ) significantly increased by tests 2 
    Output:
    