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Intact serum parathyroid hormone levels increase during running exercise in well-trained men.

The purpose of this study was to examine the influence of exercise on the serum concentrations of intact parathyroid hormone (PTH). Serum PTH and plasma lactate were measured in 15 well-trained men, 9 long-distance runners and 6 fire-fighters, during two running exercises. Test one consisted of 40-minute treadmill running with a step-wise increased load and test two consisted of 50-minute treadmill running with a constant velocity. When the load was step-wise increased, the PTH concentrations increased moderately at the slower running paces but reached a final value that was about 50% higher than the starting value. This rise occurred despite a concomitant increase of total serum calcium from 2.38 +/- 0.06 to 2.49 +/- 0.05 mmol/liter (P < 0.01). During the constant running exercise, the long-distance runners, but not the fire-fighters, displayed a significant increase in PTH concentrations although the rise in total serum calcium was similar in both groups. There was a weak correlation between the changes in PTH and lactate in both exercises. The findings demonstrate that both high and low intensity exercise enhance release of PTH in long-distance runners through a mechanism that does not involve serum calcium. This relationship might be of importance for bone mass in men performing long-distance training.

Adult↗

Marathon running accompanied by transient decreases in urinary calcium and serum osteocalcin levels.

We evaluated the effects of marathon running on bone metabolism in 23 noncompetitive athletes (15 women, 8 men, age range 23-55 years). The volunteers were studied 10 days before, immediately after, and 1, 3, and 5 days after the run. Serum osteocalcin levels were decreased on average by 20% (from 4.9 to 3.9 micrograms/liter, P = 0.005) in men and by 10% (from 4.9 to 4.4 micrograms/liter, P < 0.05) in women at the end of the marathon, with lowest osteocalcin levels (67-55% of the prerun levels) encountered 1 day after the marathon. The activity of bone alkaline phosphatase was decreased in women (from 66.3 to 62.3 U/liter, P < 0.05) after the run, and this drop was detectable at each checkup after the run. Urinary excretion of calcium was lowered on average by 82% in men (from 2.8 to 0.5 mumol/minute, P < 0.05) and by 76% in women (from 2.5 to 0.6 mumol/minute, P < 0.005) after the run, but had already returned to prerun levels 1 day after the marathon. Urinary excretion of hydroxyproline tended to rise in both men and women, but the change did not reach statistical significance in either sex. These changes suggest a transient suppression in osteoblast function during the marathon.

Adult↗

Effects of aerobic long distance running training (up to 40 km.day-1) of 1-year duration on blood and endocrine parameters of female beagle dogs.

The effects of long distance running training on blood parameters, hormone responses and bone growth were studied in young growing dogs. A genetically uniform group of female beagles matched with respect to age and body mass were used. The runner dogs (n = 10) underwent gradually increased running exercise up to 40 km.day-1 on a treadmill with 15 degrees uphill gradient 5 days each week during a period of 1 year, while the littermate control dogs (n = 10) were kept in their cages throughout the study. Low plasma lactate concentrations of the runners measured immediately after the running training indicated the aerobic metabolism of the dogs while running. Significant decreases of blood haemoglobin concentrations (11%), blood erythrocyte number (10%), and erythrocyte packed cell volume (12%) were found in the runner group. Throughout the experiment, the value of thyroxine was slightly lower (13%) in the runners but no changes were found in tri-iodothyronine, free thyroxine, or cortisol serum concentrations. Serum oestradiol concentration at 56 weeks was significantly lower (42%) in the runner group than in the control group but was not as low (27%) at 70 weeks. Somatomedin-C concentration had decreased significantly by 37% at the age of 56 weeks in the runner group but was again at the level of the control dogs at the end of experiment (at 70 weeks). Ulna and radius bone mass as a ratio to the body mass had significantly increased in the runners. It would seem from our study that long distance running has a positive effect on bone growth.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

The effect of long-distance running on plasma immunoreactive glucagon levels.

Twelve highly conditioned long-distance runners were studied to determine the effects of marathon (42 km) and 10,000 m running on plasma immunoreactive glucagon (IRG), serum immunoreactive insulin (IRI), and serum glucose (G) levels. Blood samples were drawn just prior to and immediately upon completion of the run. Marathon running resulted in no significant change in G, IRI, or IRG levels. After running 10,000 m, plasma IRG levels did not change significantly, while IRI and G increased significantly. In evaluating the pooled data from both runs, a significant inverse correlation was observed between delta G and delta IRG. This relationship between delta G and delta IRG suggests that glucagon plays a role in maintaining normal blood glucose levels during strenuous exercise.

Adult↗

Cardiorespiratory functions in children with high and low performances in endurance running.

To elucidate the characteristics of cardiorespiratory functions during exercise in young children in relation to their performances in endurance running. Twenty six 6-hear-old children participated in the present study. They were divided into two groups (fast and slow) from the results of three endurance performances (1,500 m, 4,000 m, and 8,850 m). Maximal oxygen uptake VO2max) in the fast group (X +/- SD; 45.3 +/- 5.5 ml x kg-1 x min-1) was significantly greater (p less than 0.05) than the slow group (39.8 +/- 5.9 ml x kg-1 x min-1). The performances in endurance running were also significantly different between the two groups (p less than 0.01). There was, therefore, a significant correlation between VO2max and endurance performance in 6-year-old children (p less than 0.05 or p less than 0.01), but the relationship was less than that of adults. During endurance running, the heart rate of the best performer stayed constant, while that of the worst performer decreased. This may indicate that the worst performer used a smaller percentage of VO2max, which might be derived from a lower motivation for running. In conclusion, endurance performances in 6-year-old children was influenced by VO2max as well as by the constant mobilization of cardiorespiratory functions throughout endurance running, probably due to high motivation.

Child↗

Mechanical energy states during running.

Changes in total mechanical work and its partitioning into different energy states (kinetic, potential and rotational) during a step cycle of running were investigated on six well trained athletes who ran at the test speeds of 40, 60, 80, and 100% (9.3 +/- 0.3 m/s) of maximum. Cinematographic techniques were utilized to calculate the mechanical energy states as described by Norman et al. (1976), using a 13 segment mechanical model of a runner as the basis for the computations. The data showed that both the kinetic and rotational energy increased parabolically but the potential energy decreased linearly with increases in running velocity. The calculated power of the positive work phase increased quadratically with running speed. During the phase when the runner was in contact with the ground, the applied calculations gave similar increases for the positive and negative works, and the power ratio (Wneg/Wpos) stayed the same at all measured speeds. Therefore, it is likely that the method used to calculate the various mechanical energy states did not reflect accurately enough the physiological energy costs at higher running speeds. It may, however, be quite acceptable for estimating the mechanical energy states during walking and slow running, in which case the role of negative work is less and consequently the storage and utilization of elastic energy is small.

Biomechanical Phenomena↗

Training effects of cross-country skiing and running on maximal aerobic cycle performance and on blood lipids.

Two experiments were carried out to compare the cardiorespiratory and metabolic effects of cross-country skiing and running training during two successive winters. Forty-year-old men were randomly assigned into skiing (n = 15 in study 1, n = 16 in study 2), running (n = 16 in study 1 and n = 16 in study 2) and control (n = 17 in study 1 and n = 16 in study 2) groups. Three subjects dropped out of the programme. The training lasted 9-10 weeks with 40-min exercise sessions three times each week. The training intensity was controlled at 75%-85% of the maximal oxygen consumption (VO2max) using portable heart rate metres and the mean heart rate was 156-157 beats.min-1 in the training groups. In the pooled data of the two studies the mean increase in the VO2max (in ml.min-1.kg-1) on a cycle ergometer was 17% for the skiing group, 13% for the running group and 2% for the control group. The increase in VO2max was highly significant in the combined exercise group compared to the control group but did not differ significantly between the skiing and running groups. The fasting serum concentrations of lipoproteins and insulin did not change significantly in any of the groups. These results suggested that training by cross-country skiing and running of the same duration and intensity at each session for 9-10 weeks improved equally the cardiorespiratory fitness of untrained middle-aged men.

Adult↗

Oxygen uptake during running as related to body mass in circumpubertal boys: a longitudinal study.

To investigate the effect of endurance training on physiological characteristics during circumpubertal growth, eight young runners (mean starting age 12 years) were studied every 6 months for 8 years. Four other boys served as untrained controls. Oxygen uptake (VO2) and blood lactate concentrations were measured during submaximal and maximal treadmill running. The data were aligned with each individual's age of peak height velocity. The maximal oxygen uptake (VO2max; ml.kg-1.min-1) decreased with growth in the untrained group but remained almost constant in the training group. The oxygen cost of running at 15 km.h-1 (VO2 15, ml.kg-1.min-1) was persistently lower in the trained group but decreased similarly with age in both groups. The development of VO2max and VO2 15 (l.min-1) was related to each individual's increase in body mass so that power functions were obtained. The mean body mass scaling factor was 0.78 (SEM 0.07) and 1.01 (SEM 0.04) for VO2max and 0.75 (SEM 0.09) and 0.75 (SEM 0.02) for VO2 15 in the untrained and trained groups, respectively. Therefore, expressed as ml.kg-0.75.min-1, VO2 15 was unchanged in both groups and VO2max increased only in the trained group. The running velocity corresponding to 4 mmol.l-1 of blood lactate (nu la4) increased only in the trained group. Blood lactate concentration at exhaustion remained constant in both groups over the years studied. In conclusion, recent and the present findings would suggest that changes in the oxygen cost of running and VO2max (ml.kg-1.min-1) during growth may mainly be due to an overestimation of the body mass dependency of VO2 during running.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Perceived exertion and blood lactate concentration during graded treadmill running.

The purpose of this study was to investigate the influences of treadmill gradients on the rating of perceived exertion (RPE) at two fixed blood lactate concentrations ([La-]b). Ten subjects performed three different incremental treadmill protocols by running either uphill (concentrically-biased), downhill (eccentrically-biased), or on the flat (non-biased). Individual data of each protocol were interpolated to reflect [La-]b corresponding to 2.0 and 4.0 mmol.l-1. At 2.0 mmol.l-1 [La-]b, RPE and treadmill speed during downhill running were greater than during level running which was greater than during uphill running (p < 0.05). Also, the downhill heart rate (HR) was greater than the uphill HR, and downhill minute ventilation (VE) was greater than the level VE. Treadmill speed was the only measure at 4.0 mmol.l-1 [La-]b to differ between gradients. There was a moderate correlation of RPE with HR at both [La-]b (r = 0.73 at 2.0 mmol.l-1; r = 0.48 at 4.0 mmol.l-1) while treadmill speed was moderately correlated with RPE only at 2.0 mmol.l-1 [La-]b (r = 0.70). The results of this study demonstrated that the degree of eccentric-bias during running exercise is an influence of perceived exertion at a moderate but not at a high exercise intensity.

Adult↗

Effects of specific versus cross-training on running performance.

The cross-training (XT) hypothesis suggests that despite the principle of specificity of training, athletes may improve performance in one mode of exercise by training using another mode. To test this hypothesis we studied 30 well-trained individuals (10 men, 20 women) in a randomized longitudinal trail. Subjects were evaluated before and after 8 weeks of enhanced training (+10%/week), accomplished by adding either running (R) or swimming (XT) to baseline running, versus continued baseline running (C). Both R (-26.4s) and XT (-13.2s) improved time trial (3.2 km) performance, whereas C did not (-5.4s). There were no significant changes during treadmill running in maximum oxygen uptake (VO2peak; -0.2, -6.0, and +2.7%), steady state submaximal VO2 at 2.68 m.s-1 (-1.2, -3.3 and +0.2 ml.kg-1.min-1), velocity at VO2peak (+0.05, +0.25 and +0.09 m.s-1) or accumulated O2 deficit (+11.2, -6.1 and +9.4%) in the R, XT or C groups, respectively. There was a significant increase in velocity associated with a blood lactate concentration of 4 mmol.l-1 in R but not in XT or C (+0.32, +0.07 and +0.08 m.s-1). There were significant changes in arm crank VO2peak (+5%) and arm crank VO2 at 4 mmol.l-1 (+6.4%) in XT. There was no significant changes in arm crank VO2peak (+1.3 and -7.7%) or arm crank VO2 at 4 mmol.l-1 (+0.8 and +0.4%) in R or C, respectively. The data suggest that muscularly non-similar XT may contribute to improved running performance but not to the same degree as increased specific training.

Adult↗

Plasma renin activity, aldosterone and catecholamine levels when swimming and running.

The purpose of this study was to determine the response of plasma renin activity (PRA), plasma aldosterone concentration (PAC) and catecholamines to two graded exercises differing by posture. Seven male subjects (19-25 years) performed successively a running rest on a treadmill and a swimming test in a 50-m swimming pool. Each exercise was increased in severity in 5-min steps with intervals of 1 min. Oxygen consumption, heart rate and blood lactate, measured every 5 min, showed a similar progression in energy expenditure until exhaustion, but there was a shorter time to exhaustion in the last step of the running test. PRA, PAC and catecholamines were increased after both types of exercise. The PRA increase was higher after the running test (20.9 ng AngI X ml-1 X h-1) than after swimming (8.66 ng AngI X ml-1 X h-1). The PAC increase was slightly greater after running (123 pg X ml-1) than swimming (102 pg X ml-1), buth the difference was not significant. Plasma catecholamine was higher after the swimming test. These results suggest that the volume shift induced by the supine position and water pressure during swimming decreased the PRA response. The association after swimming compared to running of a decreased PRA and an enhanced catecholamine response rule out a strict dependence of renin release under the effect of plasma catecholamines and is evidence of the major role of neural pathways for renin secretion during physical exercise.

Adult↗

Effects of treadmill running on plasma beta-endorphin, corticotropin, and cortisol levels in male and female 10K runners.

Reports of plasma beta-endorphin (B-EN) levels in response to submaximal exercise have been highly disparate. Variations in experimental design have complicated interpretation of previous research. The present study was designed to determine whether a sequential change in plasma beta-endorphin (B-EN), corticotropin (ACTH), and cortisol levels occurs in response to a 30-min submaximal run. Twenty-three subjects were divided into four groups: male runners, female runners, sedentary males and sedentary females. Subjects ran on a treadmill at 80% of previously determined maximum heart rate. Five plasma samples were obtained through an indwelling catheter before exercise (-30 and 0 min), at 15 and 30 min of exercise, and after 30 minutes of recovery. The run resulted in no rise in B-EN, ACTH, and cortisol despite an elevated rectal temperature. B-EN values were significantly higher in males than in females (p less than 0.01). No sex or training differences were seen with respect to change of hormone concentrations over the course of the run. Three male runners developed symptoms of vasovagal syncope after the catheter placement and had high initial B-EN, ACTH, and cortisol concentrations which decreased throughout the run. These data indicate that gender and training do not affect ACTH and cortisol concentrations before, during, and after 30 min of treadmill running at 80% of maximum heart rate, whereas B-EN concentrations are higher in males under these conditions.

Adrenocorticotropic Hormone↗

Running training alters fiber type composition in spinal muscles.

The issue of whether exercise can induce changes in muscle fiber types has been long debated. Knowledge about the alterations in spinal muscle fiber types is scarce. In this study, the alterations initiated by long-distance running on spinal muscle fiber type distribution was studied. Ten young dogs were run on a treadmill for 55 weeks, 5 days a week, and ten dogs from the same litters served as controls. The daily running distance was gradually increased to 40 km and maintained at that level for the final 15 weeks. Histological sections were prepared from the cervical, thoracic, and lumbar multifidus muscles and the medial and lateral heads of triceps brachii and analyzed for the fiber type composition and cross-sectional area of fibers. In the lumbar multifidus, the numerical percentage of the muscle fibers with low oxidative capacity (type II) increased significantly in the running group. However, in the thoracic and cervical spine multifidus, the response to running resembled more of the significant shift from type II to type I fibers (with high oxidative capacity), which was also observed in the triceps brachii muscle. In these muscles, the quantitative image analysis of nicotinamide adenine dinucleotide tetrazolium reductase (NADH-TR) reaction also demonstrated a shift towards a higher oxidative capacity within the type II fibers. The results show that training can induce changes in fiber type composition not only in limb muscles but also in the stabilizing spinal muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Running velocities and heart rates at fixed blood lactate concentrations in young soccer players.

The purpose of this study was to examine the running velocities and heart rates at fixed lactate concentrations of young soccer players according to playing position and age. A total of 223 young male soccer players participated in this study. Each player performed incremental exercise tests on a treadmill. Running velocities and heart rates at 2 mmol/L-1, 2.5 mmol/L-1, 3 mmol/L-1, and 4 mmol/L-1 blood lactate concentrations were calculated with use of the spline function. Data were analyzed through analysis of variance to examine differences among various playing positions (ie, defenders, midfielders, and forwards) and 3 age groups (U17, under 17 y; U19, under 19 y; and U21, under 21 y). No significant differences were discerned between defenders, midfielders, and forwards in terms of running velocities and heart rates in accordance with specified lactate concentrations. Running velocities corresponding to all lactate concentrations showed no significant differences at all age groups, but heart rates in soccer players in the U21 and U19 age groups were significantly lower than in the U17 age group. Following a 3-y trial of 20 players, running velocities increased and heart rates decreased at all corresponding lactate concentrations. Results of this study suggest that (1) the endurance performance level of young soccer players is similar for all positions, and (2) heart rates are lowered with age and with training.

Adolescent↗

Does marathon running cause acute lesions of the knee? Evaluation with magnetic resonance imaging.

An investigation was conducted into whether running a marathon causes acute alterations in menisci, cartilage, bone marrow, ligaments, or joint effusions, which could be evaluated by magnetic resonance imaging (MRI). Twenty-two non-professional marathon runners underwent MRI of the knee before and immediately after running a marathon. Lesions of menisci and cartilage (five-point scale), bone marrow, ligaments (three-point scale), joint effusion, and additional findings were evaluated and a total score was assessed. Before the marathon, grade 1 lesions of the menisci were found in eight runners, and grade 2 lesions in five runners. After the marathon, an upgrading from a meniscal lesion grade 1 to grade 2 was observed in one runner. Before the marathon, grade 1 cartilage lesions were found in three runners, and grade 2 lesions in one runner, all of which remained unchanged after the marathon. Before and after the marathon, unchanged bone marrow edema was present in three runners and unchanged anterior cruciate ligament lesions (grade 1) were seen in two runners. Joint effusions were present in 13 runners in the pre-run scans, slightly increased in four runners after the marathon, and newly occurred in one runner after the marathon. A total score comprising all knee lesions in each runner showed an increase after the marathon in two runners, whereas no runner showed an improvement of the radiological findings (Wilcoxon signed-rank test, P>0.05). The evaluation of lesions of the knee with MRI shows that marathon running does not cause severe, acute lesions of cartilage, ligaments, or bone marrow of the knee in well-trained runners. Only subtle changes, such as joint effusions or increased intrameniscal signal alterations, were imaged after running a marathon.

Acute Disease↗

Chronic arginine aspartate supplementation in runners reduces total plasma amino acid level at rest and during a marathon run.

BACKGROUND: Athletes consume arginine and/or aspartate as potential nutritional ergogenics. Their metabolic effects are controversial and there is some evidence that ingestion of large doses of single amino acids can adversely affect the nitrogen balance or induce an amino acid imbalance. Nevertheless, the general metabolic influence of an arginine aspartate supplementation during a prolonged exercise bout has not yet been investigated. AIM OF THE STUDY: The aim of this study was, therefore, to investigate the general metabolic impact of a chronic supplementation with arginine aspartate in endurance-trained athletes at rest and during a marathon run. METHODS: Fourteen endurance-trained runners participated in this field study which was carried out according to a double-blind crossover design. 15 g of arginine aspartate or a carbohydrate-based placebo were supplemented daily for 14 days before a marathon run. Blood samples for analysis of metabolites and hormones were collected shortly before the run, after 31 km, at the end of the run, and after a recovery period of two hours. Additionally, the respiratory exchange ratio was determined during the run. RESULTS: The plasma level of carbohydrate (glucose, lactate, pyruvate) and fat metabolites (fatty acids, glycerol, beta-hydroxybutyrate), cortisol, insulin, ammonia, lactate dehydrogenase, and creatine kinase as well as the respiratory exchange ratio were unaffected by the supplementation. In contrast, the plasma level of somatotropic hormone, glucagon, urea, and arginine were significantly increased, and the level of most of the remaining plasma amino acids as well as their sum was significantly reduced. CONCLUSIONS: There was no obvious metabolic benefit derived from the chronic supplementation with arginine aspartate. And since furthermore the consequences of a reduction of the total plasma amino acid level are not known, the practice of using single amino acid supplements as potential ergogenics should be critically reevaluated.

3-Hydroxybutyric Acid↗

Oxygen uptake kinetics during treadmill running across exercise intensity domains.

The purpose of the present study was to examine comprehensively the kinetics of oxygen uptake (VO2) during treadmill running across the moderate, heavy and severe exercise intensity domains. Nine subjects [mean (SD age, 27 (7) years; mass, 69.8 (9.0) kg; maximum VO2, VO2max, 4,137 (697) ml x min(-1)] performed a series of "square-wave" rest-to-exercise transitions of 6 min duration at running speeds equivalent to 80% and 100% of the VO2 at lactate threshold (LT; moderate exercise); and at 20%, 40%, 60%, 80% and 100% of the difference between the VO2 at LT and VO2max (delta heavy and severe exercise). Critical velocity (CV) was also determined using four maximal treadmill runs designed to result in exhaustion in 2-15 min. The VO2 response was modelled using non-linear regression techniques. As expected, the amplitude of the VO2 primary component increased with exercise intensity [from 1,868 (136) ml x min-( 1) at 80% LT to 3,296 (218) ml x min-(1) at 100% delta, P < 0.05]. However, there was a non-significant trend for the "gain" of the primary component to decrease as exercise intensity increased [181 (7) ml x kg(-1) x km(-1) at 80% LT to 160 (6) ml x kg(-1) x km(-1) at 100% delta]. The time constant of the primary component was not different between supra-LT running speeds (mean value range = 17.9-19.1 s), but was significantly shorter during the 80% LT trial [12.7 (1.4) s, P < 0 .05]. The VO2 slow component increased with exercise intensity from 139 (39) ml x min(-1) at 20% delta to 487 (57) ml x min(-1) at 80% delta (P < 0.05), but decreased to 317 (84) ml x min(-1) during the 100% delta trial (P < 0.05). During both the 80% delta and 100% delta trials, the VO2 at the end of exercise reached VOmax [4,152 (242) ml x min(-1) and 4,154 (114) ml x min(-1), respectively]. Our results suggest that the "gain" of the primary component is not constant as exercise intensity increases across the moderate, heavy and severe domains of treadmill running. These intensity-dependent changes in the amplitudes and kinetics of the VO2 response profiles may be associated with the changing patterns of muscle fibre recruitment that occur as exercise intensity increases.

Adult↗

Optimising high-intensity treadmill training using the running speed at maximal O(2) uptake and the time for which this can be maintained.

The aim of this study was to compare the effects of two high-intensity, treadmill interval-training programs on 3000-m and 5000-m running performance. Maximal oxygen uptake (.VO(2max)), the running speed associated with .VO(2max) (v.VO(2max)), the time for which v.VO(2max) can be maintained (T(max)), running economy (RE), ventilatory threshold (VT) and 3000-m and 5000-m running times were determined in 27 well-trained runners. Subjects were then randomly assigned to three groups; (1) 60% T(max), (2) 70% T(max) and (3) control. Subjects in the control group continued their normal training and subjects in the two T(max) groups undertook a 4-week treadmill interval-training program with the intensity set at v.VO(2max) and the interval duration at the assigned T(max). These subjects completed two interval-training sessions per week (60% T(max)=six intervals/session, 70% T(max) group=five intervals/session). Subjects were re-tested on all parameters at the completion of the training program. There was a significant improvement between pre- and post-training values in 3000-m time trial (TT) performance in the 60% T(max) group compared to the 70% T(max) and control groups [mean (SE); 60% T(max)=17.6 (3.5) s, 70% T(max) =6.3 (4.2) s, control=0.5 (7.7) s]. There was no significant effect of the training program on 5000-m TT performance [60% T(max)=25.8 (13.8) s, 70% T(max)=3.7 (11.6) s, control=9.9 (13.1) s]. Although there were no significant improvements in .VO(2max), v.VO(2max) and RE between groups, changes in .VO(2max) and RE were significantly correlated with the improvement in the 3000-m TT. Furthermore, VT and T(max) were significantly higher in the 60% T(max) group post- compared to pre-training. In conclusion, 3000-m running performance can be significantly improved in a group of well-trained runners, using a 4-week treadmill interval training program at v.VO(2max) with interval durations of 60% T(max).

Adult↗