Sculthorpe et al (2010) has shown that a 5 day (25g/d) loading protocol of creatine supplementation followed by a further 3 days of 5 g/d negatively influence both active ankle dorsiflexion and shoulder abduction and extension range of movement (ROM) in young men. There are two possible theories to explain these effects: 1) Creatine supplementation increases intracellular water content resulting in increased muscle stiffness and resistance to stretch; 2) Neural outflow from the muscle spindles is affected due to an increased volume of the muscle cell. The authors highlight that the active ROM measures were taken immediately after the loading phase and the reduced active ROM may not be seen after several weeks of maintenance phase [45]. Hile et al [46] observed an increase in compartment pressure in the anterior compartment of the lower leg, which may also have been responsible for a reduced active ROM.
However, in the beginning weeks of starting a new workout routine, the majority of strength gains aren't actually a result of this muscle protein synthesis and hypertrophy. Rather, they are a result of the body's neurological system learning when and how to fire the needed muscle cells, explains Abbie E. Smith-Ryan, associate professor of exercise physiology at the department of exercise and sport science at the University of North Carolina–Chapel Hill. Think of it this way: The first time you perform a new exercise, say a bench press, you likely feel pretty shaky. Your arms aren't totally in sync and the weights may sway a bit from side to side. But by the time you perform your second or third set of that same exercise, the practice gets a little smoother. That's your neurological system at work.
“Compared to training for strength, intensity is going to drop during the hypertrophy phase of a program, with intensity sitting between 50 and 75 percent of the person’s 1RM, the maximum weight he or she can lift for one rep,” says Ava Fitzgerald, C.S.C.S., C.P.T., a sports performance coach with the Professional Athletic Performance Center in New York.

Creatine is most commonly used for improving exercise performance and increasing muscle mass in athletes and older adults. There is some science supporting the use of creatine in improving the athletic performance of young, healthy people during brief high-intensity activity such as sprinting. Because of this, creatine is often used as a dietary supplement to improve muscle strength and athletic performance. In the U.S., a majority of sports nutrition supplements, which total $2.7 billion in annual sales, contain creatine.
The last survivors of the pro-hormone supplements, which were removed from sale last January, estrogen-blocking supplements aren't pro-hormones but do inhibit the enzyme aromatase, which converts androgens into estrogens. In normal men that enzyme is ubiquitous, being present in such tissues as muscle, brain and skin. About 20 percent of the free testosterone circulating in the blood is converted into estrogen by way of aromatase.
At the end of the day, yes, strength training does impact your metabolism, but any boost you get will be minimal and completely secondary to all of the other health benefits of strength training. Any change in metabolism or increase in calorie burn will vary widely from person to person, and depends on so many factors: your genetics, eating habits, health conditions, what workout you do that day, how much sleep you’re getting, and even how stressed you are on any given day. But incorporating a couple of strength training sessions into your fitness routine is worth doing no matter what—you’ll feel yourself get stronger, and put yourself in a position to say healthier throughout life. Those are the best, most promising benefits to work for.

Lyoo, I. K., Yoon, S., Kim, T. S., Hwang, J., Kim, J. E., Won, W., Bae, S., & Renshaw, P. F. (2012, September). A randomized, double-blind placebo-controlled trial of oral creatine monohydrate augmentation for enhanced response to a selective serotonin reuptake inhibitor in women with major depressive disorder. American Journal of Psychiatry. 169(9):937-45. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22864465
Perform the exercise pairs (marked A and B) as alternating sets, resting 60 seconds between sets. You’ll complete one set of exercise A and rest; then one set of B and rest again; and repeat until you’ve completed all sets for that pair. On your very first training day, perform only one set for each exercise. Progress to two or more sets (as the set prescriptions below dictate) from your second workout on.
2. What's your training like? Are you crushing 25 sets for chest like the average juiced out bodybuilder? If so, there's a pretty good chance you might be working above your MRV (maximal recoverable volume) and as such any physiological adaptation which could have taken place is going to be minimal given the cellular environment which occurs in a state of functional overreaching.
Your glutes serve as the main mover and power output to most of your major and accessory lifts—squat, deadlift, kettbell swings, box jumps—so the more you develop and stimulate your gluteal muscles, the more you’re able to maximize control, strength, and stability. (It doesn’t hurt that women love watching you do leg and glute work in the gym, either.)

A pre-workout may contain a variety of different ingredients, but some common ones include caffeine (energy booster), citruline malate (fatigue killer), creatine (muscle recovery), and beta-alanine (reduces fatigue and gives increased feelings of sensation). If you find you are exhausted and need a little pick me up to power through your workouts, consider implementing a pre-workout supplement into your stack.


Bodybuilders may supplement their diets with protein for reasons of convenience, lower cost (relative to meat and fish products), ease of preparation, and to avoid the concurrent consumption of carbohydrates and fats. Additionally, some argue that bodybuilders, by virtue of their unique training and goals, require higher-than-average quantities of protein to support maximal muscle growth.[19][20][21][22][23][24][25] However, there is no scientific consensus for bodybuilders to consume more protein than the recommended dietary allowance.[18][26] Protein supplements are sold in ready-to-drink shakes, bars, meal replacement products (see below), bites, oats, gels and powders. Protein powders are the most popular and may have flavoring added for palatability. The powder is usually mixed with water, milk or fruit juice and is generally consumed immediately before and after exercising or in place of a meal. The sources of protein are as follows and differ in protein quality depending on their amino acid profile and digestibility:
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.
Of course, cardio is an important part of fitness too, but the benefits of strength training are major. Strength training helps build muscle, and lean muscle is better at burning calories when the body is at rest, which is important whether you're trying to lose weight or maintain it. It also helps strengthens joints and bones, avoid injury, improve your muscular endurance, and will help you give it your all during your other workouts, whether that means setting a new PR if you're a runner or pushing (and pulling) a little harder with your legs during your favorite indoor cycling class.
How much of a difference does EPOC make? Well, in one research study of young women, basal metabolic rate spiked by 4.2 percent 16 hours following a strength-training session that lasted an hour and 40 minutes—the equivalent of burning an extra 60 calories, on average. That’s a long workout, and 60 extra calories isn’t exactly huge. Plus, EPOC is not a permanent boost. Research suggests it may last anywhere from 12 hours to a few days, depending on the workout and who is doing it. The calories you burn through EPOC can add up over time, especially if you’re lifting weights three or four times a week, but all in all, it doesn’t have a very big effect on your metabolism.
A commercially available pre-workout formula comprised of 2.05 g of caffeine, taurine and glucuronolactone, 7.9 g of L-leucine, L-valine, L-arginine and L-glutamine, 5 g of di-creatine citrate and 2.5 g of β-alanine mixed with 500 ml of water taken 10 minutes prior to exercise has been shown to enhance time to exhaustion during moderate intensity endurance exercise and to increase feelings of focus, energy and reduce subjective feelings of fatigue before and during endurance exercise due to a synergistic effect of the before mentioned ingredients [72]. The role of creatine in this formulation is to provide a neuroprotective function by enhancing the energy metabolism in the brain tissue, promoting antioxidant activities, improving cerebral vasculation and protecting the brain from hyperosmotic shock by acting as a brain cell osmolyte. Creatine can provide other neuroprotective benefits through stabilisation of mitochondrial membranes, stimulation of glutamate uptake into synaptic vesicles and balance of intracellular calcium homeostasis [72].

Natural remedies for treating erectile dysfunction Erectile dysfunction has many causes, can affect any male, and is often distressing? Some people advocate several different natural remedies, mostly herbs and other plants. Here, we look at their merits and side effects, plus lifestyle changes, and alternative therapies that may bring relief for erectile dysfunction. Read now
Teresa Giudice, who's best known as a personality on Bravo's Real Housewives of New Jersey, competed in her first bodybuilding contest Saturday. — Carly Mallenbaum, USA TODAY, "'Real Housewives' star Teresa Giudice shows off new muscles at bodybuilding competition," 10 June 2018 His first wife, Sitora Yusufiy, suggested in an interview with Time magazine, with little evidence other than his penchant for bodybuilding and mirror-gazing, that Omar Mateen could have been gay. — Tim Fitzsimons /, NBC News, "What really happened that night at Pulse," 12 June 2018 The physique competition will be held at McGlohon Theater and includes the following categories: bodybuilding, fitness, men’s physique, figure, bikini, classic physique and women’s physique. — Courtney Devores, charlotteobserver, "Your 5-minute guide to the best things to do in Charlotte | June 22-28," 21 June 2018 Fans who have been following Giudice closely on social media have watched the reality star workout in videos, but Giudice hasn't posted publicly about her first bodybuilding competition. — Carly Mallenbaum, USA TODAY, "'Real Housewives' star Teresa Giudice shows off new muscles at bodybuilding competition," 10 June 2018 Carolyn Marvin, who served as the graduate adviser for both Prosper and Nirenberg, pointed to his thesis, an autoethnography about the subculture of bodybuilding. — Josh Baugh, San Antonio Express-News, "Nirenberg knew immediately that he’d eventually marry Erika Prosper," 17 Mar. 2018 The bodybuilding competition is one of two hosted produced each year in Louisville by Kentucky Muscle promoter Brent L. Jones. — Matt Stone, The Courier-Journal, "Bodybuilders, fitness athletes go flex at 2018 KDF Derby Championships," 29 Apr. 2018 Father John Brown is basically a bodybuilding legend, having won two Mr. Universe titles and three Mr. World crowns. — Jr Radcliffe, Milwaukee Journal Sentinel, "Facts you may have missed about each Packers draft choice in 2018," 4 May 2018 The affable Louisville man helped bring back the bodybuilding show culture in 2011 with 90 competitors. — Matt Stone, The Courier-Journal, "Bodybuilders, fitness athletes go flex at 2018 KDF Derby Championships," 29 Apr. 2018
Put simply, "strength training means using resistance to create work for your muscles," says Hannah Davis, C.S.C.S. and author of Operation Bikini Body. So even if your mind jumps straight to those hardcore machines and massive weights, there are a lot of ways to create this resistance that require minimal equipment (or none at all). Bodyweight workouts can be an incredibly effective way to strength train. Squats and push-ups FTW. You can also use tools like dumbbells, medicine balls, TRX bands, resistance bands, kettlebells, and slider disks, to help get the job done, explains Davis. But if that sounds like gibberish don't worry about it. Keep it simple and focus on equipment-free routines first. No matter what you do, the most important thing is to find something that challenges you, says Davis.

However, not all proteins are created equal in the muscle building stakes. Always remember the better the quality (biological value) of protein consumed, the more of it will be used for muscle building. To maximise muscle growth, stick to high-quality proteins, such as whey, milk, eggs, fish or lean meats. However, combining lower quality or incomplete protein from plant-based sources, such as nuts and beans, can still be a valuable protein source for muscle building.
Despite the fact that BCAAs may offer some benefits, you should keep in mind that these three amino acids are also present in any quality whey protein that you purchase. You can also get these essential amino acids from food sources. Basically, as long as you’re meeting your daily protein intake goals, you’re probably getting enough of these essential amino acids. Research supports this approach. So, why spend more on another supplement?
Daily, Heath usually eats five to six pounds of protein-rich meats — filet mignon, chicken, turkey, salmon and tilapia, mostly. He consumes up to 75 grams of carbohydrates in the form of grits or oatmeal, white or brown rice, and various types of potatoes, including sweet potatoes. Mornings might bring 16 ounces of scrambled egg whites. He tries to drink two gallons of water a day. His off-season weight usually reaches 275 pounds or more, still chiseled.

The function of the gluteus maximus is primarily upper leg (thigh) extension, such as moving the upper leg backward—think rising from a squat position. Another way of thinking about this is bringing the torso upright after being hinged forward. Think of a kettlebell swing and you’ll get a good visual for the major action of the gluteus maximus muscle.
Do standard/oblique crunches. Lie down on a mat and position both arms behind your head without locking the hands. Bend your knees so that your feet are flat on the ground. Pushing the small of your back into the ground, slowly roll your shoulders off the ground only a couple of inches (not to a full sitting position). Don't use your momentum to help you up; use slow, regulated movements. Repeat 3 x 20.
A loading phase of 10g creatine monohydrate for two weeks and 4g for the final week in subjects with MELAS (Mitochondrial Encephalomyopathy Lactic Acidosis and Stroke-like episodes) has been noted to increase physical strength relative to baseline, although the poor VO2 max seen in these subjects was not affected.[549] A case study exists in which a patient with a relatively novel mutation in their mitochondrial function (affecting cytochrome B) experienced benefits from creatine at 10g daily.[550] Researchers examining another case of MELAS found both cognitive and physical benefits with 5g creatine supplementation,[551] while four controlled case studies of 100-200mg/kg daily in children with myopathies found improved muscular endurance (30-57%) and muscular power (8-17%) after 100-200mg/kg daily for at least three months.[552]
This move can help lean abs really pop, especially once you've lost any extra belly fat. Sit on the floor, knees bent and heels down. Lean back, keep your back straight, and tense your abs. Place the kettlebell on the floor, switching from one side to the other. For faster results, hold your feet off the floor, but only if you can still use good form.
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Creatine ethyl ester increases muscle levels of creatine to a lesser degree than creatine monohydrate.[72] It may also result in higher serum creatinine levels[73] due to creatine ethyl ester being converted into creatinine via non-enzymatic means in an environment similar to the digestive tract.[74][75] At equal doses to creatine monohydrate, ethyl ester has failed to increase water weight after 28 days of administration (indicative of muscle deposition rates of creatine, which are seemingly absent with ethyl ester).[76] 
Hip flexor “crescent” lunge — Kneel down on one knee, with the front knee bent and thigh parallel to the ground. Lift your hands overhead and form a straight line between your head, spine and pelvis. Alternate about five times between straightening your front leg and bringing your hands down to frame the front foot, then bending your front knee again and lifting your arms back up. Hold each position for about 10 seconds at a time.
If you want to take creatine as a supplement for bigger and stronger muscles, then the standard protocol is to have a “loading period” where you significantly increase your creatine intake for a few days or weeks. “This can prime your muscles to increase the amount of creatine that they ‘hold,’” explains Bates. “During the loading period, you generally take 5 g of creatine four times per day. After the loading period, you decrease the amount of creatine you take to a ‘maintenance’ level of 3 to 5 g per day.” (That’s also the recommendation from the International Society of Sports Nutrition.) (5)
These protective effects are similar to those seen with trimethylglycine, since they both cause an increase in liver concentrations of phosphatidylcholine (PC, causing an increase in vLDL production and efflux of triglycerides from the liver).[497] Both TMG and creatine are thought to work indirectly by preserving SAMe concentrations,[125][498] since PC synthesis requires SAMe as well (via PEMT[499]) and genes involved in fatty acid metabolism in the liver that were not affected by the diet (VLCAD and CD36) were unaffected by creatine.[125]
If you’re looking to put on extra muscle mass and build strength, there are a few things that need to occur. The first of these, even though it may seem obvious, is that you will need to have an exercise routine. To stimulate maximum muscle growth, you’ll need to challenge yourself in the gym, forcing your muscles to adapt to heavier workloads by increasing in size and strength.
Tongkat Ali, biologically called Eurycoma longifolia, is a herb found in Southeast Asia which is primarily used to boost male fertility. However, it is also known to boost testosterone levels significantly. Tongkat Ali has a low side-effect profile, been found to be generally safe and well-tolerated. A common side effect reported by users is trouble falling asleep which you can avoid by taking the supplement in the morning, preferably with breakfast.
Studies measuring extracellular water versus intracellular water note similar increases in both, associated with creatine. Creatine does not tend to disturb the ratios of water to dry mass in various tissues measured.[609] At least one study in older men (48-72 years) has failed to find a significant difference in both intracellular and extracellular water concentration after 14 weeks of 5g creatine daily (with gatorade) relative to gatorade in isolation, with the ratio being maintained.[615]
Similarly to complex training, contrast loading relies upon the enhanced activation of the nervous system and increased muscle fibre recruitment from the heavy set, to allow the lighter set to be performed more powerfully.[41] Such a physiological effect is commonly referred to as post-activation potentiation, or the PAP effect. Contrast loading can effectively demonstrate the PAP effect: if a light weight is lifted, and then a heavy weight is lifted, and then the same light weight is lifted again, then the light weight will feel lighter the second time it has been lifted. This is due to the enhanced PAP effect which occurs as a result of the heavy lift being utilised in the subsequent lighter lift; thus making the weight feel lighter and allowing the lift to be performed more powerfully.

Bodybuilders may supplement their diets with protein for reasons of convenience, lower cost (relative to meat and fish products), ease of preparation, and to avoid the concurrent consumption of carbohydrates and fats. Additionally, some argue that bodybuilders, by virtue of their unique training and goals, require higher-than-average quantities of protein to support maximal muscle growth.[19][20][21][22][23][24][25] However, there is no scientific consensus for bodybuilders to consume more protein than the recommended dietary allowance.[18][26] Protein supplements are sold in ready-to-drink shakes, bars, meal replacement products (see below), bites, oats, gels and powders. Protein powders are the most popular and may have flavoring added for palatability. The powder is usually mixed with water, milk or fruit juice and is generally consumed immediately before and after exercising or in place of a meal. The sources of protein are as follows and differ in protein quality depending on their amino acid profile and digestibility:
Sally has a Bachelor's Degree in Biomedical Sciences (B.Sc.). She is a specialist in reviewing and summarising the latest findings across all areas of medicine covered in major, high-impact, world-leading international medical journals, international press conferences and bulletins from governmental agencies and regulatory bodies. At News-Medical, Sally generates daily news features, life science articles and interview coverage.
Most folks work a 9 to 5 position but if you’re not in the corporate world yet then odds are you’re a student with classes scattered throughout the day and it takes up the vast portion of your free time. That being said, you’re likely going to have to work out in the morning or the evening in order to fit in your session amidst the hectic commitments in your everyday life. Here are a few things to consider in regards to each time period:
Mr. Olympia is part of the International Federation of Bodybuilding Professional League. The I.F.B.B. says that it operates under the guidelines of the World Anti-Doping Agency and that competitors are subject to drug testing. Chang, who oversees the Mr. Olympia contest, said that I.F.B.B. testing is random, but is not conducted during the Mr. Olympia contest itself.
We’re so confident that you’re going to love our supplements that we offer a 30-day guarantee. If you have any questions about any of our products, please don’t hesitate to call our friendly experts at (512) 394-7995, or feel free to email us at [email protected] The right supplements can make a tremendous difference in your workouts, so don’t wait to get started. Shop the best bodybuilding supplements at Bare Performance Nutrition now.

Testosterone begins with cholesterol. In fact, every single sex hormone you make you synthesize from cholesterol – that’s one reason a “heart healthy” low-fat, low-cholesterol diet limits your performance. Fat and cholesterol don’t make you fat. They give your body the building blocks to create abundant testosterone and other sex hormones, which actually makes you lose weight and build muscle, especially if your current testosterone levels are low [1].
These protective effects are similar to those seen with trimethylglycine, since they both cause an increase in liver concentrations of phosphatidylcholine (PC, causing an increase in vLDL production and efflux of triglycerides from the liver).[497] Both TMG and creatine are thought to work indirectly by preserving SAMe concentrations,[125][498] since PC synthesis requires SAMe as well (via PEMT[499]) and genes involved in fatty acid metabolism in the liver that were not affected by the diet (VLCAD and CD36) were unaffected by creatine.[125]
show that total testosterone levels increase after exercising, especially after resistance training. Low testosterone levels can affect your sex drive and your mood. The good news is that exercise improves mood and stimulates brain chemicals to help you feel happier and more confident. Exercise also boosts energy and endurance, and helps you to sleep better. Fitness experts recommend 30 minutes of exercise every day.
These supplements can vary considerably from product to product in ingredients, serving sizes, and more. But the goal of each of them is generally quite similar. Most bodybuilding supplements are designed to help stimulate new muscle growth, cut away excess fat, and improve the recovery process so that you can get the most out of each trip to the gym.
Yes, you can pack on size while only doing bodyweight exercises – I did it while traveling the world – and gymnasts train mostly with bodyweight movements. However, this can feel like playing Halo on Legendary difficulty. It can be done, but damn it can be challenging – especially for lower body movements. If your sole goal is to get bigger as fast as possible, access to a barbell for squats and deadlift is almost a requirement.

Still, it's important to realize that for everyone, at a certain point, building muscle becomes more difficult. "We all have an endpoint to our genetic potential," Matheny says. "Someone who is starting strength training for the first time can build muscle with a lower percentage of their 1RM [the maximum amount of weight they can lift one time] than a more tenured athlete. The longer you train and the closer you to get to your natural potential, the more specific you need to get with your training and nutrition to keep making progress. And that week-by-week progress will likely be much smaller than it once was."


Begin in a standing position with one leg planted firmly on a slightly elevated surface – like a step. Raise the opposite hip and pelvis by hiking your hip towards the sky. Hold for 3-5 seconds. Slowly lower your hip and pelvis down towards the floor. Repeat this exercise as many times as you can until you feel fatigue (1-2min), then switch sides. Ensure the standing leg is straight and do not sway your shoulders side to side.
The majority of creatine in the human body is in two forms, either the phosphorylated form making up 60% of the stores or in the free form which makes up 40% of the stores. The average 70 kg young male has a creatine pool of around 120-140 g which varies between individuals [10,11] depending on the skeletal muscle fiber type [1] and quantity of muscle mass [11]. The endogenous production and dietary intake matches the rate of creatinine production from the degradation of phosphocreatine and creatine at 2.6% and 1.1%/d respectively. In general, oral creatine supplementation leads to an increase of creatine levels within the body. Creatine can be cleared from the blood by saturation into various organs and cells or by renal filtration [1].
That being said, men aren’t the only ones who suffer from low testosterone levels. Women can also suffer from testosterone deficiency which can affect their overall well-being in addition to their sex drive. If you’re a woman or man concerned about your testosterone levels, in addition to using supplements like the ones below, you should contact your doctor who will be able to diagnose any deficiencies and recommend additional treatments.
Higher percieved effort during heat (or due to elevations in body heat) are thought to be mediated by either the serotonergic system (suppresses performance)[388] or the dopaminergic system (enhances performance),[389][234] and creatine is thought to be involved in percieved effort during heat training since it has been noted previously to interact with neurotransmission by enhancing both serotonergic[253] and dopaminergic[230] neurotransmission.
Cranking up the levels of testosterone within the body, XPI's Testosyn is formulated with 100% natural and powerful ingredients to build lean muscle, boost sex drive, and increase energy levels. Using a high-performance testosterone complex that contains D-Aspartic Acid, Fenusterols, and Tribulus Terrestris, this potent supplement will aid in the enhancement of each workout and promote free testosterone. Testosyn's ingredients have the ability to increase testosterone levels nearly twice as much as other products for more strength, mass, and sexual vigor. Keep Reading »
The bodybuilding community has been the source of many weight training principles, techniques, vocabulary, and customs. Weight training does allow tremendous flexibility in exercises and weights which can allow bodybuilders to target specific muscles and muscle groups, as well as attain specific goals. Not all bodybuilding is undertaken to compete in bodybuilding contests and, in fact, the vast majority of bodybuilders never compete, but bodybuild for their own personal reasons.
If you are doing this on your own, but are overwhelmed and confused about strength training, I know how that feels. It can be scary enough to keep MOST people from starting, which is actually why we created our 1-on-1 Coaching Program. Our coach gets to know you, builds a program based on your experience and goals, will check your form on each movement (via video), and keep you accountable and on track!
Creatine supplementation at 300mg/kg for one week (loading with no maintenance) in youth subject to six repeated 35m sprints (10s rest, known as the Running-based Anaerobic Sprint Test or RAST) noted that the increased average and peak power output seen in creatine was not met with a reduction in fatigue, although there was an attenuation in inflammation from exercise (TNFα and CRP).[299]
Hip flexor “crescent” lunge — Kneel down on one knee, with the front knee bent and thigh parallel to the ground. Lift your hands overhead and form a straight line between your head, spine and pelvis. Alternate about five times between straightening your front leg and bringing your hands down to frame the front foot, then bending your front knee again and lifting your arms back up. Hold each position for about 10 seconds at a time.
^ Jump up to: a b Lazaridis I, Charalampopoulos I, Alexaki VI, Avlonitis N, Pediaditakis I, Efstathopoulos P, Calogeropoulou T, Castanas E, Gravanis A (2011). "Neurosteroid dehydroepiandrosterone interacts with nerve growth factor (NGF) receptors, preventing neuronal apoptosis". PLoS Biol. 9 (4): e1001051. doi:10.1371/journal.pbio.1001051. PMC 3082517. PMID 21541365. 
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