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ABSTRACT Soil steady water infiltration rate (SIR) is a key variable in hydrological modeling, but its relationship to antecedent soil moisture is not yet well understood. We tested the hypothesis that the SIR decreases with the increase in antecedent moisture, and that this relationship depends on permeability to water on the soil surface, the measurement method, and the measurement period. We conducted an experiment in an Argissolo Vermelho-Amarelo Distrófico abrúptico (Psammentic Paleudult – Soil Taxonomy), measuring infiltration in up to 14 antecedent moisture conditions under two soil structural conditions (no-till and no-till with subsoiling), with two measurement methods (double ring and Cornell infiltrometers), and for up to 48 h, with ten replications. In addition, vertical effective hydraulic conductivity of the saturated profile (Kef) was determined with Darcy’s equation for N layers. Crop succession used in the area was black oats and ryegrass in the winter and soybean in the summer. The SIR decreased to as little as 7.7 % of its original value with the increase in antecedent moisture; it was ~200 % greater in the treatment with subsoiling compared to no-till alone, and ~80 % greater when measured with the Cornell infiltrometer than with the double ring infiltrometer. Nevertheless, the effects of the method and the soil structural condition declined with the increase in antecedent moisture, confirming our hypothesis. In soil initially nearly saturated (degree of saturation ~90 %), the SIR drew near Kef (12.7 mm h-1) under the two soil structural conditions, especially when measured with the double ring infiltrometer. In contrast, increasing the time for measuring infiltration (>2 h) did not generate a new lower SIR level. The SIR decreases with the increase in antecedent soil moisture, and this relationship depends on the permeability to water of the surface layers and the measurement method. The SIR determined with infiltrometers better corresponds to vertical infiltration the nearer the soil is to saturation before beginning measurement.

ABSTRACT In hydrological modeling and for the development of projects related to soil and water conservation and civil engineering, determination of water infiltration variables into the soil plays a key role. However, measuring infiltration with manual infiltrometers is work-intensive and requires several people, which casts doubts on the consistency of the process description. Our objective was to develop automated and compact systems for data acquisition by double-concentric-ring and Cornell infiltrometers. The systems are based on air differential pressure sensors and microcontrollers using open-source software and a simple construction. We developed ten sets of automatic infiltrometers for each method that were properly calibrated. The equipment was validated in the field, and the alignment of the automatically measured with the hand-measured infiltration data was considered satisfactory. The proposed systems make data records of infiltration and associated variables possible, with less operator dependence than manual measurement strategies. In addition, the enhanced resolution resulting from infiltrometer automation makes the infiltration curve more representative, especially in the initial infiltration stage.

Integrated crop-livestock systems are being increasingly used to intensify food production and make it more sustainable. On the other hand, most studies have focused on extensive systems. This paper analyzed the effects of different managements on soil and plants in an intensive integrated system for milk production. An experiment of management systems was installed in southern Brazil, Rio Grande do Sul, on a Latossolo Vermelho (Oxisol), in 2015 to evaluate: rotational grazing of dairy cows in the winter; rotational grazing of dairy cows in winter followed by soil chiseling; and ungrazed area (control). Soil physical properties and yields of crops were evaluated. Trampling by dairy cows increased soil bulk density by 24 % (0.0-0.05 m), but did not influence yields of subsequent soybean or maize. Chiseling reduced the bulk density of the uppermost layer by 19 %, but did not affect the yields of subsequent crops. It was concluded that in years with abundant water, dairy cattle grazing in an integrated crop-livestock system in Southern Brazil compacts the soil surface, but does not compromise the soil physical processes related to the growth and development of subsequent crops.

ABSTRACT A widespread assumption among researchers and technicians is that stony soils are more susceptible to degradation. However, the role of rock fragments in the hydrology of stony soils, especially in regard to infiltration, is still a research gap. The aim of this study was to test the hypothesis that an increase in rock fragments in the soil profile increases the water infiltration rate. Infiltration tests using a double-ring infiltrometer were conducted on February 11, 2021, and December 11, 2022, at three sites of Entisols with different fractions of rock fragments. The results supported the hypothesis of this study. The infiltration rate was up to sixteen times greater in profiles whose horizons had at least 60 % rock fragments in relation to profiles with a lower fraction of rock fragments. These findings provide evidence that some stony soils may not be as susceptible to degradation by water erosion as it was suposed.

Introduction: Fiberglass Posts (FGPs) associated with composite resin foundation materials have become the primary alternative to restoring teeth with root canal treatment presenting excessive coronal destruction. Despite technical evolution, loss of retention between FGP and root dentine continues to be reported. Aim: To examine the effect of endodontic retreatment protocols on the bond strength of FGP to radicular dentine. Materials and Methods: This in-vitro study was conducted at Evangelical University of Goiás, Brazil from August 2019 to June 2020. A total of 30 freshly extracted bovine incisors were instrumented, filled and distributed into three experimental groups with 10 incisors in each groups. Group 1 was control, group 2 had incisors with gutta-percha removed using K-type files and group 3 had incisors with gutta-percha removed using ProTaper Universal Retreatment instruments. After root canal retreatment and re-sealing, the fiber posts were cemented into prepared post spaces using a resin-based cement. Roots were transversally sectioned into six 1 mm thick specimens. The push-out test was performed, and the modes of failure were evaluated. Data were analyzed with two-way Analysis of Variance (ANOVA) and Tukey’s test. Results: There was no significant difference between the mean bond strength values in group 1, 2 and 3 with p-value>0.05. The cervical third of root canal presented higher bond strength values compared with the middle and apical thirds. However, significant differences were observed only for the control group (p-value=0.005). Adhesive failure between resin cement and radicular dentine was the most prevalent type of failure. Conclusion: The endodontic retreatment protocol did not influence the bond strength of FGP to radicular dentine.

Abstract Human scabies affects all social classes and different races around the world. It is highly contagious, but the exact figures on its prevalence are unknown. A 19-year-old male patient was admitted to the emergency room reporting fever (38°C) and multiple lesions throughout the body, except face, soles, and palms. Lesions were non-pruritic, which hampered the initial diagnostic suspicion. Skin biopsy was performed, and the final diagnosis was crusted scabies (Norwegian). It was concluded that human scabies is a significant epidemic disease, due to its different clinical manifestations, and because it is extremely contagious.

Climate change is a health-risk and health-inequity multiplier with excessive heat exposure a direct climate change impact already affecting the health and livelihood of billions globally. Women face greater risks and burdens from climate change impacts. Biological sex may or may not influence an individual's thermoregulatory capacity, heat tolerance or heat susceptibility. However at a population level, sex differences in physiological characteristics (anthropometrics, aerobic capacity, etc.) likely affect thermoregulatory capacity. Still, gender appears to play the most significant role in heat exposure and resulting health impacts. For climate change resilience and adaptation strategies to be effective, public health and occupational guidance/governance must be based on comprehensive and representative evidence. The current dearth of empirical evidence on how excessive heat exposure affects women prohibits this. Environmental and exercise physiology can help address this lack of empirical evidence by adhering to inclusive research guidelines. This paper is based on a symposium presentation given at Physiology 2023 in Harrogate, UK. Using a multi-year cohort study on industrial agricultural workers (the Adelante Initiative) as a case study, this review discusses the role of environmental and exercise physiology in generating inclusive research and evidence to inform occupational and public health guidance/governance for climate change resilience and adaptation, specifically heat exposure., (© 2024 The Author(s). Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)

Introduction: Individuals with higher neurological levels of spinal cord injury (SCI) at or above the sixth thoracic segment (≥T6), exhibit impaired resting cardiovascular control and responses during upper-body exercise. Over time, impaired cardiovascular control predisposes individuals to lower cardiorespiratory fitness and thus a greater risk for cardiovascular disease and mortality. Non-invasive transcutaneous spinal cord stimulation (TSCS) has been shown to modulate cardiovascular responses at rest in individuals with SCI, yet its effectiveness to enhance exercise performance acutely, or promote superior physiological adaptations to exercise following an intervention, in an adequately powered cohort is unknown. Therefore, this study aims to explore the efficacy of acute TSCS for restoring autonomic function at rest and during arm-crank exercise to exhaustion (AIM 1) and investigate its longer-term impact on cardiorespiratory fitness and its concomitant benefits on cardiometabolic health and health-related quality of life (HRQoL) outcomes following an 8-week exercise intervention (AIM 2)., Methods and Analysis: Sixteen individuals aged ≥16 years with a chronic, motor-complete SCI between the fifth cervical and sixth thoracic segments will undergo a baseline TSCS mapping session followed by an autonomic nervous system (ANS) stress test battery, with and without cardiovascular-optimised TSCS (CV-TSCS). Participants will then perform acute, single-session arm-crank exercise (ACE) trials to exhaustion with CV-TSCS or sham TSCS (SHAM-TSCS) in a randomised order. Twelve healthy, age- and sex-matched non-injured control participants will be recruited and will undergo the same ANS tests and exercise trials but without TSCS. Thereafter, the SCI cohort will be randomly assigned to an experimental (CV-TSCS+ACE) or control (SHAM-TSCS+ACE) group. All participants will perform 48 min of ACE twice per week (at workloads corresponding to 73-79% peak oxygen uptake), over a period of 8 weeks, either with (CV-TSCS) or without (SHAM-TSCS) cardiovascular-optimised stimulation. The primary outcomes are time to exhaustion (AIM 1) and cardiorespiratory fitness (AIM 2). Secondary outcomes for AIM 1 include arterial blood pressure, respiratory function, cerebral blood velocity, skeletal muscle tissue oxygenation, along with concentrations of catecholamines, brain-derived neurotrophic factor and immune cell dynamics via venous blood sampling pre, post and 90 min post-exercise. Secondary outcomes for AIM 2 include cardiometabolic health biomarkers, cardiac function, arterial stiffness, 24-hour blood pressure lability, energy expenditure, respiratory function, neural drive to respiratory muscles, seated balance and HRQoL (eg, bowel, bladder and sexual function). Outcome measures will be assessed at baseline, pre-intervention, post-intervention and after a 6-week follow-up period (HRQoL questionnaires only)., Ethics and Dissemination: Ethical approval has been obtained from the Wales Research Ethics Committee 7 (23/WA/0284; 03/11/2024). The recruitment process began in February 2024, with the first enrolment in July 2024. Recruitment is expected to be completed by January 2026. The results will be presented at international SCI and sport-medicine conferences and will be submitted for publication in peer-reviewed journals., Trial Registration Number: ISRCTN17856698., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Joyce, Kelsey E., Catherine A. Campbell, Arthur R. Bradwell, Samuel J.E. Lucas, Christopher T. Lewis, Rebekah A.I. Lucas, and Mark Edsell. The environmental impact of a high-altitude medical research expedition. High Alt Med Biol. 00:00-00, 2024. Introduction: Scientists must begin examining the environmental cost(s) of their research. The purpose of this study was to evaluate a component of the environmental impact of a high-altitude medical research expedition by totaling the carbon dioxide (CO 2 ) emissions calculated from as many direct and indirect sources as possible. Methods: Eighteen individuals flew from London to Bagdogra (via Delhi), and then drove onward to Lachung (via Gangtok) where they began their ascent on foot to 4,800 m (Kanchenjunga National Park, Sikkim). Several research experiments were conducted throughout the expedition, which required use of a laboratory centrifuge, solid CO 2 (specimen storage), rechargeable laptop computers and battery-powered oximeters. International Civil Aviation Organization calculators estimated aviation CO 2 production. Land emissions were calculated for Mahindra vehicles. Solid waste was weighed and CO 2 emissions estimated for its incineration. Results : Total CO 2 emissions equated to ∼16.7 tonnes from the following sources: air and land transportation of expedition team (87.3%); sublimation and transportation of solid CO 2 (7.7%), waste incineration (0.58%), generator transportation and gasoline (12 l) combustion (0.48%), and battery transportation (3.3%). Conclusions : Air travel contributed the most to the overall environmental cost of the research expedition. Further investigation is required to contextualize these findings in relation to lab-based alternative(s).

Purpose: To examine heat exposure at work and home and the work-recovery cycle and temporal variation of kidney strain, muscle injury and inflammation biomarkers in sugarcane workers., Methods: 20 male sugarcane workers (age: 33 ± 7 years) with a workplace Rest.Shade.Hydration (RSH) intervention were observed over 4 days, at the end (18 h post-shift recovery) and beginning of a work week (42 h post-shift recovery). Measures included work intensity (heart rate), gastro-intestinal temperature, estimated body core temperature (using heart rate), fluid consumption, pre- and post-work blood and urine samples, physical activity (accelerometery) away from work, plus ambient heat exposure at work and home., Results: On workdays, workers awakened at approx. 02:40 after 5 h sleep in ~ 30 °C. Across work shifts, daily average WBGT ranged from 26 to 29 °C (cooler than normal) and average workload intensity ranged from 55 to 58%HR max . Workers reported consuming ~ 8 L of water and ~ 4 × 300 mL bags of electrolyte fluid each day. Serum creatinine, cystatin C and creatine phosphokinase markedly increased post-work and decreased during recovery; serum potassium did the opposite (all p < 0.01). Biomarker concentration changes were similar between recovery periods (18 h vs. 42 h; all p > 0.27). C-reactive protein was the highest at the end of the work week (p = 0.01)., Conclusion: Despite RSH intervention, cross-shift kidney strain was marked (recovering overnight) and systemic inflammation increased over the work week. Thus, biomonitoring of kidney function in occupational populations should be performed before a work shift at any point in the work week. This is essential knowledge for field studies and surveillance., (© 2024. The Author(s).)

Objectives: Assess the impact of environmental heat and a rest-shade-hydration (RSH) intervention against heat stress on productivity of piece-paid Mesoamerican sugarcane cutters. These workers are at a high risk of chronic kidney disease of non-traditional origin (CKDnt), from the severe heat stress they experience due to heavy work under hot conditions. RSH interventions in these populations improve kidney health outcomes, but their impact on productivity has yet to be examined., Methods: We accessed routine productivity data from seed (SC, N = 749) and burned (BCC, N = 535) sugarcane cutters observed over five harvest seasons with increasing RSH intervention at a large Nicaraguan sugarcane mill. Hourly field-site wet-bulb globe temperature (WBGT) was recorded by mill staff and summarized as a daily mean. Mixed linear regression was used to model daily productivity, adjusting for age (18-29, 30-44, and >45 years), sex, WBGT (<28, 28-29, 29-30, 30-31, and >31 °C) on the same and preceding day, harvest season (2017-18 to 2021-22), month, and acclimatization status (<1, 1-2, and >2 weeks)., Results: There was an inverse dose-response relationship between SC productivity and WBGT on the same and preceding days, decreasing by approximately 3%/°C WBGT. Productivity increased during the study period, i.e. coinciding with RSH scale-up, by approximately 19% in SC and 9% in BCC., Conclusion: Agricultural worker productivity was expected lower on hotter days, strengthening the interest in all stakeholders to mitigate increasing global temperatures and their impact. Despite decreasing the total time allocated for work each day, an RSH intervention appears to result in increased productivity and no apparent loss in productivity., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Background: Mesoamerican sugarcane cutters are at a high risk of chronic kidney disease of non-traditional origin, a disease likely linked to heat-related acute kidney injury (AKI). Studies in general populations have described a positive association between high environmental temperatures and clinically assessed kidney outcomes, but there are no studies in occupational settings., Method: We accessed routine records of clinically diagnosed AKI (AKI-CD) and wet bulb globe temperatures (WBGT) at a large Nicaraguan sugarcane plantation and modeled the relationship between these using negative binomial regression. A rest-shade-hydration intervention was gradually enhanced during the study period, and efforts were made to increase the referral of workers with suspected AKI to healthcare., Results: Each 1°C WBGT was associated with an 18% (95% confidence interval [CI]: [4, 33%]) higher AKI-CD rate on the same day and a 14% (95% CI [-5, 37%]) higher rate over a week. AKI-CD rates and severity, and time between symptoms onset and diagnosis decreased during the study period, that is, with increasing rest-shade-hydration intervention. Symptoms and biochemical signs of systemic inflammation were common among AKI-CD cases., Discussion: Occupational heat stress, resulting from heavy work in environmental heat, was associated with a higher rate of clinically diagnosed AKI in a population at risk of CKDnt. Promoting rest-shade-hydration may have contributed to reducing AKI rates during the study period. Occupational health and safety personnel have key roles to play in enforcing rest, shade, and hydration practices, referring workers with suspected AKI to healthcare as well as collecting and analyzing the data needed to support workplace heat stress interventions., Competing Interests: Conflict of InterestThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: EH, CW, DW, JG, KJ and RL declare no conflicts of interest. DC is employed by ISA, but the views expressed here are his own and not the views of his employer.

Heat and cold stress influence cerebral blood flow (CBF) regulatory factors (e.g., arterial CO 2 partial pressure). However, it is unclear whether the CBF response to a CO 2 stimulus (i.e., cerebrovascular-CO 2 responsiveness) is maintained under different thermal conditions. This study aimed to compare cerebrovascular-CO 2 responsiveness between normothermia, passive heat, and cold stress conditions. Sixteen participants (8 females; 25 ± 7 yr) completed two experimental sessions (randomized) comprising normothermic and either passive heat or cold stress conditions. Middle and posterior cerebral artery velocity (MCA v , PCA v ) were measured during rest, hypercapnia (5% CO 2 inhalation), and hypocapnia (voluntary hyperventilation to an end-tidal CO 2 of 30 mmHg). The linear slope of the cerebral blood velocity (CB v ) response to changing end-tidal CO 2 was calculated to measure cerebrovascular-CO 2 responsiveness, and cerebrovascular conductance (CVC) was used to examine responsiveness independent of blood pressure. CB v -CVC-CO 2 responsiveness to hypocapnia was greater during heat stress compared with cold stress (MCA: +0.05 ± 0.08 cm/s/mmHg/mmHg, P = 0.04; PCA: +0.02 ± 0.02 cm/s/mmHg/mmHg, P = 0.002). CB v -CO 2 responsiveness to hypercapnia decreased during heat stress (MCA: -0.67 ± 0.89 cm/s/mmHg, P = 0.02; PCA: -0.64 ± 0.62 cm/s/mmHg; P = 0.01) and increased during cold stress (MCA: +0.98 ± 1.33 cm/s/mmHg, P = 0.03; PCA: +1.00 ± 0.82 cm/s/mmHg; P = 0.01) compared with normothermia. However, CB v -CVC-CO 2 responsiveness to hypercapnia was not different between thermal conditions ( P > 0.08). Overall, passive heat, but not cold, stress challenges the maintenance of cerebral perfusion. A greater cerebrovascular responsiveness to hypocapnia during heat stress likely reduces an already impaired cerebrovascular reserve capacity and may contribute to adverse events (e.g., syncope). NEW & NOTEWORTHY This study demonstrates that thermoregulatory-driven perfusion pressure changes, from either cold or heat stress, impact cerebrovascular responsiveness to hypercapnia. Compared with cold stress, heat stress poses a greater challenge to the maintenance of cerebral perfusion during hypocapnia, challenging cerebrovascular reserve capacity while increasing cerebrovascular-CO 2 responsiveness. This likely exacerbates cerebral hypoperfusion during heat stress since hyperthermia-induced hyperventilation results in hypocapnia. No regional differences in middle and posterior cerebral artery responsiveness were found with thermal stress.

Background and aims: Sex differences in the rate and occurrence of cerebrovascular diseases (e.g., stroke) indicate a role for female sex hormones (i.e., oestrogen and progesterone) in cerebrovascular function and regulation. However, it remains unclear how cerebrovascular function differs between the sexes, and between distinct phases of the menstrual cycle. This study aimed to compare cerebrovascular-CO 2 responsiveness in 1) females during the early follicular (EF), ovulatory (O) and mid-luteal (ML) phases of their menstrual cycle; and 2) males compared to females during phases of lower oestrogen (EF) and higher oestrogen (O). Methods: Eleven females (25 ± 5 years) complete experimental sessions in the EF ( n = 11), O ( n = 9) and ML ( n = 11) phases of the menstrual cycle. Nine males (22 ± 3 years) completed two experimental sessions, approximately 2 weeks apart for comparison to females. Middle and posterior cerebral artery velocity (MCAv, PCAv) was measured at rest, during two stages of hypercapnia (2% and 5% CO 2 inhalation) and hypocapnia (voluntary hyperventilation to an end-tidal CO 2 of 30 and 24 mmHg). The linear slope of the cerebral blood velocity response to changes in end-tidal CO 2 was calculated to measure cerebrovascular-CO 2 responsiveness.. Results: In females, MCAv-CO 2 responsiveness to hypocapnia was lower during EF (-.78 ± .45 cm/s/mmHg) when compared to the O phase (-1.17 ± .52 cm/s/mmHg; p < .05) and the ML phase (-1.30 ± .82; p < .05). MCAv-CO 2 responsiveness to hypercapnia and hypo-to-hypercapnia, and PCAv-CO 2 responsiveness across the CO 2 range were similar between menstrual phases ( p ≥ .20). MCAv-CO 2 responsiveness to hypo-to hypercapnia was greater in females compared to males (3.12 ± .91 cm/s/mmHg vs. 2.31 ± .46 cm/s/mmHg; p = .03), irrespective of menstrual phase (EF or O). Conclusion: Females during O and ML phases have an enhanced vasoconstrictive capacity of the MCA compared to the EF phase. Additionally, biological sex differences can influence cerebrovascular-CO 2 responsiveness, dependent on the insonated vessel., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Skinner, Weaver, Lucas and Lucas.)

Objective: The aim of this study was to quantify the physiological workload of manual laborers in industrial sugarcane and assess the effect of receiving a rest, shade, and hydration intervention to reduce heat stress exposure risk., Methods: In an observational study, physiological workload was evaluated for burned cane cutters (BCC), seed cutters (SC) and drip irrigation repair workers (DIRW) using heart rate (HR) recorded continuously (Polar®) across a work shift. Workers' percentage of maximal HR (%HR max ), time spent in different HR zones, and estimated core temperature (ECTemp) were calculated. The effect of increasing rest across two harvests was evaluated for BCC and SC., Results: A total of 162 workers participated in this study [52 BCC (all male), 71 SC (13 female) and 39 DIRW (16 female)]. Average %HRmax across a work shift was similar between BCC and SC (BCC: 58%, SC: 59%), but lower in DIRW (51%). BCC and SC spent similar proportions of work shifts at hard/very hard intensities (BCC: 13%, SC: 15%), versus DIRW who worked mostly at light (46%) or light-moderate (39%) intensities. SC maximum ECTemp reached 38.2°C, BCC 38.1°C; while DIRW only reached 37.7°C. Females performed at a higher %HR max than males across work shifts (SC 64% versus 58%; DIRW 55% versus 49%). An additional rest period was associated with a lower average %HR max across a work shift in BCC., Conclusion: In this setting, BCC and SC both undertake very physiologically demanding work. Females maintained a higher workload than male co-workers. Regulated rest periods each hour, with water and shade access, appears to reduce physiological workload/strain.

The most common non-pharmacological intervention for both peripheral and cerebral vascular health is regular physical activity (e.g., exercise training), which improves function across a range of exercise intensities and modalities. Numerous non-exercising approaches have also been suggested to improved vascular function, including repeated ischemic preconditioning (IPC); heat therapy such as hot water bathing and sauna; and pneumatic compression. Chronic adaptive responses have been observed across a number of these approaches, yet the precise mechanisms that underlie these effects in humans are not fully understood. Acute increases in blood flow and circulating signalling factors that induce responses in endothelial function are likely to be key moderators driving these adaptations. While the impact on circulating factors and environmental mechanisms for adaptation may vary between approaches, in essence, they all centre around acutely elevating blood flow throughout the circulation and stimulating improved endothelium-dependent vascular function and ultimately vascular health. Here, we review our current understanding of the mechanisms driving endothelial adaptation to repeated exposure to elevated blood flow, and the interplay between this response and changes in circulating factors. In addition, we will consider the limitations in our current knowledge base and how these may be best addressed through the selection of more physiologically relevant experimental models and research. Ultimately, improving our understanding of the unique impact that non-pharmacological interventions have on the vasculature will allow us to develop superior strategies to tackle declining vascular function across the lifespan, prevent avoidable vascular-related disease, and alleviate dependency on drug-based interventions., (© 2022. The Author(s).)

Purpose: Leg cycling exercise acutely augments radial artery low-flow mediated constriction (L-FMC). Herein, we sought to determine whether this is associated with exercise-induced changes in arterial shear rate (SR)., Methods: Ten healthy and recreationally active young men (23 ± 2 years) participated in 30 min of incremental leg cycling exercise (50, 100, 150 Watts). Trials were repeated with (Exercise + WC) and without (Exercise) the use of a wrist cuff (75 mmHg) placed distal to the radial artery to increase local retrograde SR while reducing mean and anterograde SR. Radial artery characteristics were measured throughout the trial, and L-FMC and flow mediated dilatation (FMD) were assessed before and acutely (~ 10 min) after leg cycling., Results: Exercise increased radial artery mean and anterograde SR, along with radial artery diameter, velocity, blood flow and conductance (P < 0.05). Exercise + WC attenuated the exercise-induced increase in mean and anterograde SR (P > 0.05) but also increased retrograde SR (P < 0.05). In addition, increases in radial artery blood flow and diameter were reduced during Exercise + WC (Exercise + WC vs. Exercise, P < 0.05). After Exercise, L-FMC was augmented (- 4.4 ± 1.4 vs. - 13.1 ± 1.6%, P < 0.05), compared to no change in L-FMC after Exercise + WC (- 5.2 ± 2.0 vs. - 3.0 ± 1.6%, P > 0.05). In contrast, no change in FMD was observed in either Exercise or Exercise + WC trials (P > 0.05)., Conclusions: These findings indicate that increases in L-FMC following exercise are abolished by the prevention of increases radial artery diameter, mean and anterograde SR, and by elevation of retrograde SR, during exercise in young men., (© 2022. The Author(s).)

Heat stress is associated with numerous health effects that potentially harm workers, especially in a warming world. This investigation occurred in a setting where laborers are confronted with occupational heat stress from physically demanding work in high environmental temperatures. Collaboration with a major Nicaraguan sugarcane producer offered the opportunity to study interventions to prevent occupational heat-stress-related kidney disease. Two aims for this study of a rest-shade-water intervention program were: (1) describe the evolving intervention, summarize findings that motivated proposed improvements, assess impact of those improvements, and identify challenges to successful implementation and (2) extract primary lessons learned about intervention research that have both general relevance to investigations of work-related disease prevention and specific relevance to this setting. The learning curve for the various stakeholders as well as the barriers to success demonstrate that effectiveness of an intervention cannot be adequately assessed without considerations of implementation. Designing, effectively implementing, and assessing both health impacts and implementation quality is a resource-intensive endeavor requiring a transdisciplinary approach. Both general and specific lessons learned are presented for decisions on study design and study elements, implementation assessment, and management engagement in understanding how productivity and health can be successfully balanced and for building effective communication between investigators and all levels of management.

Occupational heat exposure is linked to the development of kidney injury and disease in individuals who frequently perform physically demanding work in the heat. For instance, in Central America, an epidemic of chronic kidney disease of nontraditional origin (CKDnt) is occurring among manual laborers, whereas potentially related epidemics have emerged in India and Sri Lanka. There is growing concern that workers in the United States suffer with CKDnt, but reports are limited. One of the leading hypotheses is that repetitive kidney injury caused by physical work in the heat can progress to CKDnt. Whether heat stress is the primary causal agent or accelerates existing underlying pathology remains contested. However, the current evidence supports that heat stress induces tubular kidney injury, which is worsened by higher core temperatures, dehydration, longer work durations, muscle damaging exercise, and consumption of beverages containing high levels of fructose. The purpose of this narrative review is to identify occupations that may place US workers at greater risk of kidney injury and CKDnt. Specifically, we reviewed the scientific literature to characterize the demographics, environmental conditions, physiological strain (i.e., core temperature increase, dehydration, heart rate), and work durations in sectors typically experiencing occupational heat exposure, including farming, wildland firefighting, landscaping, and utilities. Overall, the surprisingly limited available evidence characterizing occupational heat exposure in US workers supports the need for future investigations to understand this risk of CKDnt.

Background: The purpose of this study was to investigate the effect of sex on the efficacy of intermittent post-exercise sauna bathing to induce heat acclimation and improve markers of temperate exercise performance in trained athletes., Methods: Twenty-six trained runners (16 female; mean ± SD, age 19 ± 1 years, V̇O 2max F: 52.6 ± 6.9 mL⋅kg -1 ⋅min -1 , M: 64.6 ± 2.4 mL⋅kg -1 ⋅min -1 ) performed a running heat tolerance test (30 min, 9 km⋅h -1 /2% gradient, 40 °C/40%RH; HTT) and temperate (18 °C) exercise tests (maximal aerobic capacity [V̇O 2max ] and lactate profile) pre and post 3 weeks of normal exercise training plus 29 ± 1 min post-exercise sauna bathing (101-108 °C) 3 ± 1 times per week., Results: Females and males exhibited similar reductions (interactions p > 0.05) in peak rectal temperature (- 0.3 °C; p < 0.001), skin temperature (- 0.9 °C; p < 0.001) and heart rate (- 9 beats·min -1 ; p = 0.001) during the HTT at post- vs pre-intervention. Only females exhibited an increase in active sweat glands on the forearm (measured via modified iodine technique; F: + 57%, p < 0.001; M: + 1%, p = 0.47). Conversely, only males increased forearm blood flow (measured via venous occlusion plethysmography; F: + 31%, p = 0.61; M: + 123%; p < 0.001). Females and males showed similar (interactions p > 0.05) improvements in V̇O 2max (+ 5%; p = 0.02) and running speed at 4 mmol·L -1 blood lactate concentration (+ 0.4 km·h -1 ; p = 0.001)., Conclusions: Three weeks of post-exercise sauna bathing effectively induces heat acclimation in females and males, though possibly amid different thermoeffector adaptations. Post-exercise sauna bathing is also an effective ergogenic aid for both sexes., (© 2021. The Author(s).)

Sex differences in cerebrovascular disease rates indicate a possible role for ovarian sex steroid hormones in cerebrovascular function. To synthesise and identify knowledge gaps, a systematic review and meta-analysis was conducted to assess how ovarian sex steroid hormone changes across the lifespan affect cerebrovascular function in women. Three databases (EMBASE, MEDLINE and Web of Science) were systematically searched for studies on adult cerebrovascular function and ovarian sex steroid hormones. Forty-five studies met pre-defined inclusion criteria. Studied hormone groups included hormone replacement therapy (HRT; n = 17), pregnancy ( n = 12), menstrual cycle ( n = 7), menopause ( n = 5), oral contraception ( n = 2), and ovarian hyperstimulation ( n = 2). Outcome measures included pulsatility index (PI), cerebral blood flow/velocity (CBF), resistance index (RI), cerebral autoregulation, and cerebrovascular reactivity. Meta-analysis was carried out on HRT studies. PI significantly decreased [-0.05, 95% CI: (-0.10, -0.01); p = 0.01] in post-menopausal women undergoing HRT compared to post-menopausal women who were not, though there was considerable heterogeneity ( I 2 = 96.8%). No effects of HRT were seen in CBF ( p = 0.24) or RI ( p = 0.77). This review indicates that HRT improves PI in post-menopausal women. However, there remains insufficient evidence to determine how changing ovarian sex steroid hormone levels affects cerebrovascular function in women during other hormonal phases (e.g., pregnancy, oral contraception)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Skinner, Davies, Weaver, Cable, Lucas and Lucas.)

Purpose: This study investigated whether intermittent post-exercise sauna bathing across three-weeks endurance training improves exercise heat tolerance and exercise performance markers in temperate conditions, compared to endurance training alone. The subsidiary aim was to determine whether exercise-heat tolerance would further improve following 7-Weeks post-exercise sauna bathing., Methods: Twenty middle-distance runners (13 female; mean ± SD, age 20 ± 2 years, [Formula: see text]O 2max 56.1 ± 8.7 ml kg -1  min -1 ) performed a running heat tolerance test (30-min, 9 km h -1 /2% gradient, 40 °C/40%RH; HTT) and temperate (18 °C) exercise tests (maximal aerobic capacity [[Formula: see text]O 2max ], speed at 4 mmol L -1 blood lactate concentration ([La - ]) before (Pre) and following three-weeks (3-Weeks) normal training (CON; n = 8) or normal training with 28 ± 2 min post-exercise sauna bathing (101-108 °C, 5-10%RH) 3 ± 1 times per week (SAUNA; n = 12). Changes from Pre to 3-Weeks were compared between-groups using an analysis of co-variance. Six SAUNA participants continued the intervention for 7 weeks, completing an additional HTT (7-Weeks; data compared using a one-way repeated-measures analysis of variance)., Results: During the HTT, SAUNA reduced peak rectal temperature (T rec ; - 0.2 °C), skin temperature (- 0.8 °C), and heart rate (- 11 beats min -1 ) more than CON at 3-Weeks compared to Pre (all p < 0.05). SAUNA also improved [Formula: see text]O 2max (+ 0.27 L -1  min -1 ; p = 0.02) and speed at 4 mmol L -1 [La - ] (+ 0.6 km h -1 ; p = 0.01) more than CON at 3-Weeks compared to Pre. Only peak T rec (- 0.1 °C; p = 0.03 decreased further from 3-Weeks to 7-Weeks in SAUNA (other physiological variables p > 0.05)., Conclusions: Three-weeks post-exercise sauna bathing is an effective and pragmatic method of heat acclimation, and an effective ergogenic aid. Extending the intervention to seven weeks only marginally improved T rec .

This study examined acute cerebral hemodynamic and circulating neurotrophic factor responses to moderate intensity continuous exercise (MICT), guideline-based high intensity interval exercise (HIIT), and sprint interval exercise (SIT). We hypothesized that the pattern of middle cerebral artery velocity (MCAv) response would differ between interval and continuous exercise, with SIT inducing the smallest increase from rest, while increases in neurotrophic factors would be intensity-dependent. In a randomized crossover design, 24 healthy adults (nine females) performed three exercise protocols: (i) MICT (30 min), (ii) HIIT (4 × 4 min at 85% HR max ), and (iii) SIT (4 × 30 s supramaximal). MCAv significantly increased from rest across MICT (Δ13.1 ± 8.5 cm⋅s -1 , p < 0.001) and all bouts of HIIT (Δ15.2 ± 9.8 cm⋅s -1 , p < 0.001), but only for the initial bout of SIT (Δ17.3 ± 11.6 cm⋅s -1 , p < 0.001). Immediately following each interval bout, MCAv increased (i.e., rebounded) for the SIT (9-14% above rest, p ≤ 0.04), but not HIIT protocol. SIT alone induced significant elevations from rest to end-exercise in vascular endothelial growth factor (VEGF; Δ28 ± 36%, p = 0.017) and brain-derived neurotrophic factor (BDNF, Δ149% ± 162%, p < 0.001) and there were greater increases in lactate than in either other protocol (>5-fold greater in SIT, p < 0.001), alongside a small significant reduction at the end of active recovery in insulin-like growth factor 1 (IGF-1, Δ22 ± 21%, p = 0.002). In conclusion, while the nature of the response may differ, both guideline-based and sprint-based interval exercise have the potential to induce significant changes in factors linked to improved cerebrovascular and brain health., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Weaver, Skinner, Furlong, Lucas, Cable, Rendeiro, McGettrick and Lucas.)

We sought to determine how whole body heating acutely influences radial artery function, characterized using flow-mediated dilation (FMD) and low-flow-mediated constriction (L-FMC), and the mechanistic role of shear rate modification on radial artery functional characteristics during heating. Eleven young healthy men underwent whole body heating (water-perfused suit) sufficient to raise the core temperature by +1°C. Trials were repeated with (heat + WC) and without (heat) the application of a wrist cuff located distal to the radial artery examined, known to prevent increases in mean and anterograde shear rates but increase retrograde shear rate. Radial artery characteristics were assessed throughout each trial, with FMD and L-FMC assessed before and upon reaching the target core temperature. Heat markedly increased radial artery mean and anterograde shear rates, along with radial artery diameter and blood flow ( P < 0.05). Heat + WC abolished the heat-induced increase in mean and anterograde shear rates ( P > 0.05) but markedly increased retrograde shear rate ( P < 0.05). Concomitantly, increases in radial artery diameter and blood flow were decreased (heat + WC vs. heat, P < 0.05). Heat attenuated FMD (8.6 ± 1.2% vs. 2.2 ± 1.4%, P < 0.05), whereas no change in FMD was observed in heat + WC (7.8 ± 1.2% vs. 10.8 ± 1.2%, P > 0.05). In contrast, L-FMC was not different in either trial ( P > 0.05). In summary, acute whole body heating markedly elevates radial artery shear rate, diameter, and blood flow and diminishes FMD. However, marked radial artery vasodilation and diminished FMD are absent when these shear rate changes are prevented. Shear rate modifications underpin the radial artery response to acute whole body heat stress, but further endothelium-dependent vasodilation (FMD) is attenuated likely as the vasodilatory range limit is approached. NEW & NOTEWORTHY We observed that acute whole body heating elevates radial artery shear rate, diameter, and blood flow. This results in a diminished flow-meditated dilatation (FMD) but does not change low-flow-mediated constriction (L-FMC). Preventing shear rate changes during whole body heating reduces radial artery vasodilation and reverses FMD reductions but has no effect on L-FMC. These findings indicate that shear rate changes underpin conduit artery responses to acute whole body heat stress, but further endothelium-dependent flow-mediated vasodilation is attenuated as the vasodilatory range limit is approached.

The optimal exercise intensity and modality for maximizing cerebral blood flow (CBF) and hence potential exposure to positive, hemodynamically derived cerebral adaptations is yet to be fully determined. This study compared CBF velocity responses between running and cycling across a range of exercise intensities. Twenty-six participants (12 females; age: 26 ± 8 years) completed four exercise sessions; two mode-specific maximal oxygen consumption (VO 2max ) tests, followed by (order randomized) two incremental exercise protocols (3-min stages at 35%, 50%, 65%, 80%, 95% VO 2max ). Continuous measures of middle cerebral artery velocity (MCAv), oxygen consumption, end-tidal CO 2 (P ET CO 2 ), and heart rate were obtained. Modality-specific MCAv changes were observed for the whole group (interaction effect: p = .01). Exercise-induced increases in MCAv mean during cycling followed an inverted-U pattern, peaking at 65% VO 2max (Δ12 ± 7 cm/s from rest), whereas MCAv mean during running increased linearly up to 95% VO 2max (change from rest: Δ12 ± 13 vs. Δ7 ± 8 cm/s for running vs. cycling at 95% VO 2max ; p = .01). In contrast, both modalities had an inverted-U pattern for P ET CO 2 changes, although peaked at different intensities (running: 50% VO 2max , Δ6 ± 2 mmHg; cycling: 65% VO 2max , Δ7 ± 2 mmHg; interaction effect: p = .01). Further subgroup analysis revealed that the running-specific linear MCAv mean response was fitness dependent (Fitness*modality*intensity interaction effect: p = .04). Above 65% VO 2max , fitter participants (n = 16; male > 45 mL/min/kg and female > 40 mL/min/kg) increased MCAv mean up to 95% VO 2max , whereas in unfit participants (n = 7, male < mL/min/kg and female < 35 mL/min/kg) MCAv mean returned toward resting values. Findings demonstrate that modality- and fitness-specific profiles for MCAv mean are seen at exercise intensities exceeding 65% VO 2max ., (© 2020 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Background: Chronic kidney disease of non-traditional origin (CKDnt) is common among Mesoamerican sugarcane workers. Recurrent heat stress and dehydration is a leading hypothesis. Evidence indicate a key role of inflammation., Methods: Starting in sports and heat pathophysiology literature, we develop a theoretical framework of how strenuous work in heat could induce kidney inflammation. We describe the release of pro-inflammatory substances from a leaky gut and/or injured muscle, alone or in combination with tubular fructose and uric acid, aggravation by reduced renal blood flow and increased tubular metabolic demands. Then, we analyze longitudinal data from >800 sugarcane cutters followed across harvest and review the CKDnt literature to assess empirical support of the theoretical framework., Results: Inflammation (CRP elevation and fever) and hyperuricemia was tightly linked to kidney injury. Rehydrating with sugary liquids and NSAID intake increased the risk of kidney injury, whereas electrolyte solution consumption was protective. Hypokalemia and hypomagnesemia were associated with kidney injury., Discussion: Heat stress, muscle injury, reduced renal blood flow and fructose metabolism may induce kidney inflammation, the successful resolution of which may be impaired by daily repeating pro-inflammatory triggers. We outline further descriptive, experimental and intervention studies addressing the factors identified in this study.

New Findings: What is the central question of this study? Cerebrovascular reactivity (CVR) is a common functional test to assess brain health, and impaired CVR has been associated with all-cause cardiovascular mortality: does the duration of the CO 2 stimulus and the time point used for data extraction alter the CVR outcome measure? What is the main finding and its importance? This study demonstrated CVR measures calculated from 1 and 2 min CO 2 stimulus durations were significantly higher than CVR calculated from a 4 min CO 2 stimulus. CVRs calculated from the first 2 min of the CO 2 stimulus were significantly higher than CVR values calculated from the final minute if the duration was ≥4 min. This study highlights the need for consistent methodological approaches., Abstract: Cerebrovascular reactivity to carbon dioxide (CVR) is a common functional test to assess brain vascular health, though conflicting age and fitness effects have been reported. Studies have used different CO 2 stimulus durations to induce CVR and extracted data from different time points for analysis. Therefore, this study examined whether these differences alter CVR and explain conflicting findings. Eighteen healthy volunteers (24 ± 5 years) inhaled CO 2 for four stimulus durations (1, 2, 4 and 5 min) of 5% CO 2 (in air) via the open-circuit Douglas bag method, in a randomized order. CVR data were derived from transcranial Doppler (TCD) measures of middle cerebral artery blood velocity (MCAv), with concurrent ventilatory sensitivity to the CO 2 stimulus ( V ̇ E , C O 2 ). Repeated measures ANOVAs compared CVR and V ̇ E , C O 2 measures between stimulus durations and steady-state time points. An effect of stimulus duration was observed (P = 0.002, η² = 0.140), with 1 min (P = 0.010) and 2 min (P < 0.001) differing from 4 min, and 2 min differing from 5 min (P = 0.019) durations. V ̇ E , C O 2 sensitivity increased ∼3-fold from 1 min to 4 and 5 min durations (P < 0.001, η² = 0.485). CVRs calculated from different steady-state time points within each stimulus duration were different (P < 0.001, η² = 0.454), specifically for 4 min (P = 0.001) and 5 min (P < 0.001), but not 2 min stimulus durations (P = 0.273). These findings demonstrate that methodological differences alter the CVR measure., (© 2020 The Authors. Experimental Physiology © 2020 The Physiological Society.)

Many workers are exposed to heat stress that can be exacerbated by the type of clothing they wear. The resulted heat strain can lead to short or long-term heat-related disorders. This study aimed to measure clothing properties of sugarcane field workers and evaluate the heat strain by an international standard, predicted heat strain model (PHS). The clothing thermal insulation and evaporative resistance values of sugarcane cutter and chemical sprayer outfits were acquired for the whole body, body regions and specific body parts via thermal manikin measurements. The detailed clothing insulation values of body parts can be utilized in advanced thermo-physiological models, while in this study, the values for the whole body together with weather data were used in PHS. Estimated duration limited exposure times (DLE) for an hour-by-hour prediction over a workday and for a range of high humidity scenarios were calculated. Such evaluation tools can be used for risk assessment and management to support organizational measures and prepare equipment and materials in the case of hot weather events in order to avoid dehydration and other heat-related disorders.

Objective: Menopausal hot flushes negatively impact quality of life and may be a biomarker of cardiovascular and metabolic disease risk; therefore understanding the physiology of hot flushes is important. Current thinking is that a small elevation (∼0.03-0.05C) in core temperature surpasses a sweating threshold (that is reduced in the menopause), sweating is activated, and a hot flush ensues. Nevertheless, more recent studies examining thermoregulatory control question whether core temperature per se can explain the trigger for a hot flush. The primary aim of this study was to assess the contribution of increases in core temperature on the occurrence of menopausal hot flushes., Methods: For this purpose, 108 hot flushes were objectively assessed in a laboratory setting in 72 symptomatic postmenopausal women (aged 45.8 ± 5.1 years; body mass index 25.9 ± 4.5 kg/m) from five previously reported studies. Women rested, wearing a tube-lined suit (or trousers), which was perfused with 34C water. A subset then underwent mild heat stress (48°C water). Sweat rate, skin blood flow, blood pressure, heart rate, skin, and core temperature were measured continuously throughout. A hot flush was objectively identified during rest (spontaneous hot flush) or mild heating as an abrupt increase in sternal sweat rate. Further, a subset of symptomatic postmenopausal women (n = 22) underwent whole-body passive heating for 60 minutes to identify core temperature thresholds and sensitivities for sweat rate and cutaneous vasodilation, which were compared to a subset of premenopausal women (n = 18). Data were analyzed using t tests and/or general linear modeling, and are presented as mean (95% confidence interval)., Results: In the 20 minutes before a spontaneous hot flush, core temperature increased by 0.03 ± 0.12C (P < 0.05), but only 51% of hot flushes were preceded by an increase in core temperature. During mild heating, 76% of hot flushes were preceded by an increase in core temperature. The temperature thresholds for sweating were similar, but the vasodilatory threshold was higher in postmenopausal compared with premenopausal women (37.1 ± 0.2 vs 36.8 ± 0.3°C; P = 0.06)., Conclusion: We provide new evidence that menopausal hot flushes are unlikely triggered by an increase in core temperature. These findings provide important information about the physiology of hot flushes that have implications for treatment and management options for menopausal hot flushes.

Although emerging as a cost and time efficient way to prepare for competition in the heat, recent evidence indicates that "short-term" heat acclimation (<7 days) may not be sufficient for females to adapt to repeated heat stress. Furthermore, self-paced performance following either short-term, or longer (>7 days) heat acclimation has not been examined in a female cohort. Therefore, the aim of this study was to investigate self-paced endurance performance in hot conditions following 4- and 9-days of a high-intensity isothermic heat acclimation protocol in a female cohort. Eight female endurance athletes (mean ± SD, age 27 ± 5 years, mass 61 ± 5 kg, VO 2peak 47 ± 6 ml⋅kg⋅min -1 ) performed 15-min self-paced cycling time trials in hot conditions (35°C, 30%RH) before (HTT1), and after 4-days (HTT2), and 9-days (HTT3) isothermic heat acclimation (HA, with power output manipulated to increase and maintain rectal temperature ( T rec ) at ∼38.5°C for 90-min cycling in 40°C, 30%RH) with permissive dehydration. There were no significant changes in distance cycled ( p = 0.47), mean power output ( p = 0.55) or cycling speed ( p = 0.44) following 4-days HA (i.e., from HTT1 to HTT2). Distance cycled (+3.2%, p = 0.01; +1.8%, p = 0.04), mean power output (+8.1%, p = 0.01; +4.8%, p = 0.05) and cycling speed (+3.0%, p = 0.01; +1.6%, p = 0.05) were significantly greater in HTT3 than in HTT1 and HTT2, respectively. There was an increase in the number of active sweat glands per cm 2 in HTT3 as compared to HTT1 (+32%; p = 0.02) and HTT2 (+22%; p < 0.01), whereas thermal sensation immediately before HTT3 decreased ("Slightly Warm," p = 0.03) compared to ratings taken before HTT1 ("Warm") in 35°C, 30%RH. Four-days HA was insufficient to improve performance in the heat in females as observed following 9-days HA.

New Findings: What is the central question of this study? Does inspiratory resistance breathing improve tolerance to simulated haemorrhage in individuals with elevated internal temperatures? What is the main finding and its importance? The main finding of this study is that inspiratory resistance breathing modestly improves tolerance to a simulated progressive haemorrhagic challenge during heat stress. These findings demonstrate a scenario in which exploitation of the respiratory pump can ameliorate serious conditions related to systemic hypotension., Abstract: Heat exposure impairs human blood pressure control and markedly reduces tolerance to a simulated haemorrhagic challenge. Inspiratory resistance breathing enhances blood pressure control and improves tolerance during simulated haemorrhage in normothermic individuals. However, it is unknown whether similar improvements occur with this manoeuvre in heat stress conditions. In this study, we tested the hypothesis that inspiratory resistance breathing improves tolerance to simulated haemorrhage in individuals with elevated internal temperatures. On two separate days, eight subjects performed a simulated haemorrhage challenge [lower-body negative pressure (LBNP)] to presyncope after an increase in internal temperature of 1.3 ± 0.1°C. During one trial, subjects breathed through an inspiratory impedance device set at 0 cmH 2 O of resistance (Sham), whereas on a subsequent day the device was set at -7 cmH 2 O of resistance (ITD). Tolerance was quantified as the cumulative stress index. Subjects were more tolerant to the LBNP challenge during the ITD protocol, as indicated by a > 30% larger cumulative stress index (Sham, 520 ± 306 mmHg min; ITD, 682 ± 324 mmHg min; P < 0.01). These data indicate that inspiratory resistance breathing modestly improves tolerance to a simulated progressive haemorrhagic challenge during heat stress., (© 2018 The Authors. Experimental Physiology © 2018 The Physiological Society.)

The purpose of this study was to identify the dose-dependent effects of heat strain and orthostasis [via lower body negative pressure (LBNP)], with and without mild hypohydration, on systemic function and cerebral perfusion. Eleven men (means ± SD: 27 ± 7 y; body mass 77 ± 6 kg), resting supine in a water-perfused suit, underwent progressive passive heating [0.5°C increments in core temperature (T c ; esophageal to +2.0°C)] while euhydrated (EUH) or hypohydrated (HYPO; 1.5-2% body mass deficit). At each thermal state, mean cerebral artery blood velocity (MCAv mean ; transcranial Doppler), partial pressure of end-tidal carbon dioxide ([Formula: see text]), heart rate (HR) and mean arterial blood pressure (MAP; photoplethysmography) were measured continuously during LBNP (0, -15, -30, and -45 mmHg). Four subjects became intolerant before +2.0°C T c , unrelated to hydration status. Without LBNP, decreases in [Formula: see text] accounted fully for reductions in MCAv mean across all T c . With LBNP at heat tolerance (+1.5 or +2.0°C), [Formula: see text] accounted for 69 ± 25% of the change in MCAv mean . The HYPO condition did not affect MCAv mean or any cardiovascular variables during combined LBNP and passive heat stress (all P > 0.13). These findings indicate that hypocapnia accounted fully for the reduction in MCAv mean when passively heat stressed in the absence of LBNP and for two- thirds of the reduction when at heat tolerance combined with LBNP. Furthermore, when elevations in T c are matched, mild hypohydration does not influence cerebrovascular or cardiovascular responses to LBNP, even when stressed by a combination of hyperthermia and LBNP.

Objective The aim of this study was to assess the potential to reduce kidney function damage during the implementation of a water, rest, shade (WRS) and efficiency intervention program among sugarcane workers. Methods A WRS intervention program adapted from the US Occupational Safety and Health Administration (OSHA) coupled with an efficiency program began two months into the 5-month harvest. One of the two groups of workers studied was provided with portable water reservoirs, mobile shaded tents, and scheduled rest periods. Health data (anthropometric and questionnaires), blood, and urine were collected at baseline and at three subsequent times over the course of the harvest. Daily wet bulb globe temperatures (WBGT) were recorded. Results Across a working day there were changes in biomarkers indicating dehydration (urine osmolality) and serum albumin and reduced estimated glomerular filtration rate (eGFR). Cross-shift eGFR decrease was present in both groups; -10.5 mL/min/1.73m2 [95% confidence interval (95% CI) -11.8- -9.1], but smaller for the intervention group after receiving the program. Decreased eGFR over the 5-month harvest was seen in both groups: in the one receiving the intervention -3.4 mL/min/1.73m 2 (95% CI -5.5- -1.3) and in the other -5.3 (95% CI -7.9- -2.7). The decrease appeared to halt after the introduction of the intervention in the group receiving the program. Conclusion A WRS and efficiency intervention program was successfully introduced for workers in sugarcane fields and appears to reduce the impact of heat stress on acute and over-harvest biomarkers of kidney function. Further research is needed to determine whether biomarker changes predict reduced risk of chronic kidney disease in this type of work.

This is the first structured review to identify and summarize research on lifestyle choices that improve health and have the greatest potential to mitigate climate change. Two literature searches were conducted on: (1) active transport health co-benefits, and (2) dietary health co-benefits. Articles needed to quantify both greenhouse gas emissions and health or nutrition outcomes resulting from active transport or diet changes. A data extraction tool (PRISMA) was created for article selection and evaluation. A rubric was devised to assess the biases, limitations and uncertainties of included articles. For active transport 790 articles were retrieved, nine meeting the inclusion criteria. For diet 2524 articles were retrieved, 23 meeting the inclusion criteria. A total of 31 articles were reviewed and assessed using the rubric, as one article met the inclusion criteria for both active transport and diet co-benefits. Methods used to estimate the effect of diet or active transport modification vary greatly precluding meta-analysis. The scale of impact on health and greenhouse gas emissions (GHGE) outcomes depends predominately on the aggressiveness of the diet or active transport scenario modelled, versus the modelling technique. Effective mitigation policies, infrastructure that supports active transport and low GHGE food delivery, plus community engagement are integral in achieving optimal health and GHGE outcomes. Variation in culture, nutritional and health status, plus geographic density will determine which mitigation scenario(s) best suit individual communities.