Search

Purpose: Cold water immersion (CWI) is the most effective treatment for exertional heat stroke (EHS). However, knowledge on core temperature response during CWI treatment and the relation with patient characteristics (i.e., sex, anthropometrics) is limited. Therefore, the current study aimed to examine the core temperature response (in °C) during CWI treatment of recreational athletes participating in large running events and investigate the impact of sex and anthropometric characteristics on the cooling rate (in °C·min -1 )., Methods: This observational study includes 57 athletes ( n = 22 females; 39%) who suffered from EHS during an exercise event in the Netherlands. After admission to the medical facilities, a rectal temperature ( Trec ) probe was inserted and all clothing was removed before immersion in an ice bath (6.4 ± 1.6°C). Rectal temperature was continuously measured throughout treatment, and treatment was continued until Trec ≤ 38.9°C or based on the decision of the emergency physician., Results: Initial Trec did not differ between males (41.3 ± 0.9°C) and females (41.2 ± 0.8°C, P = 0.83). A nonlinear response to CWI was observed, with the decrease in Trec beginning after 6 min of CWI. The decrease in Trec did not differ between both sexes (p time*sex = 0.96). The cooling rate did not differ between males (0.21 ± 0.15°C·min -1 ) and females (0.19 ± 0.08°C·min -1 , P = 0.55), and was not related to body mass, body surface area and body surface area to mass ratio (all P values >0.05)., Conclusions: We demonstrated that the cooling rate during CWI did not differ between men and women suffering from EHS, and that the Trec response to CWI is nonlinear and not dependent on anthropometric characteristics. This suggests that no sex differentiation is needed in the EHS treatment guidelines and confirms the necessity to continuously monitor Trec during treatment., (Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

(1) Background: The recovery method is important and decisive in the training system. This study aimed to assess the effects of various post-training recovery methods on muscle damage and strength indicators in Paralympic powerlifting athletes. (2) Methods: A crossover study was conducted involving eleven male athletes (25.4 ± 3.3 years, 70.3 ± 12.1 kg). Muscle damage was assessed using blood biochemical markers (cytokines IL-6, IL-10, and TNF-α) and isometric force indicators, including the maximum isometric force (MIF), time to MIF, and Rate of Force Development. The following assessments were performed before, immediately after, and at 24 and 48 h after the recovery protocol: (a) passive recovery (RP) or (b) cold-water immersion (CWI). (3) Results: The main results indicated that maximum isometric force (MIF) significantly improved after 48 h of CWI application ( p < 0.05; for all comparison). The analysis of biochemical markers did not yield significant differences between the recovery methods at different time points ( p > 0.05). For IL-6, there were significant differences between CWI before (2.29 ± 1.08, 95% CI 1.57-3.01) and CWI 2 h later (2 h) (4.59 ± 2.96, 95% CI 2.60-6.57; p = 0.045), and between CWI 15 min later (15 min) (4.14 ± 2.24, 95% CI 2.63-5.64) and CWI 48 h later (48 h) (2.33 ± 1.25, 95% CI 1.49-3.17; p = 0.034). There were differences between CWI 2 h (4.14 ± 2.24, 95% CI 2.63-5.64) and CWI 48 h later (2.33 ± 1.25, 95% CI 1.49-3.17; p = 0.035; F = 9.202; η 2 p = 0.479; high effect). (4) Conclusions: CWI significantly improved the post-resistance training muscle damage and strength in Paralympic powerlifting athletes.

The growing prevalence of heat stroke as a public health issue, exacerbated by climate change and increasing global temperatures, demands an immediate and strategic response to prevent weather-related morbidity and mortality. Heat stroke results from the body's inability to cope with excessive heat, leading to systemic inflammatory responses, cellular apoptosis, and potential multiorgan dysfunction or failure. However, little information explicitly outlines how to perform cold-water immersion in the emergency department (ED), including potential patient selection, how much water or ice to use, target temperatures, when to stop, and complications or challenges with the process. This narrative explores implementing a comprehensive protocol for total-body cold-water immersion developed in an ED setting, a method proven effective in rapidly reducing core body temperatures, with the goal of reducing mortality and morbidity rates associated with heat-related illnesses. The protocol involves immediate temperature assessment, followed by cold-water immersion for patients with altered mental status and core temperatures above 40 °C. Discussion about the development of the process and results from applying the protocol during the summer of 2023, including cooling rates and patient outcomes, is also included. Additionally, the article addresses challenges and lessons learned during the protocol's implementation, emphasizing the importance of multidisciplinary collaboration, staff education, and the adaptation of ED infrastructure to support this lifesaving treatment based on its use during the last 3 years. The successful resolution of the presented cases, along with the protocol's potential for widespread adoption, illustrates the critical role of cold-water immersion in enhancing ED responses to heat stroke, offering a blueprint for future research and the development of similar protocols across health care settings. This work contributes to the evolving landscape of emergency medicine and aligns with the global effort to combat the adverse health effects of climate change., (Copyright © 2024 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.)

Abstract The extraction of coal seams with high gas content and low permeability presents significant challenges, particularly due to the extended period required for gas extraction to meet safety standards and the inherently low extraction efficiency. Hydraulic fracturing technology, widely employed in the permeability enhancement of soft and low-permeability coal seams, serves as a key intervention. This study focuses on the high-rank raw coal from the No. 13 coal seam at Xinjing Mine, utilizing a vacuum pressure saturation system, low-field nuclear magnetic resonance (LF-NMR) testing, and uniaxial compression mechanical testing to investigate the changes in porosity and connectivity of coal samples under conditions of high-pressure continuous immersion and high-low pressure cyclic immersion. Additionally, the uniaxial compression mechanical properties of the coal under various experimental conditions were analyzed. The findings reveal that the porosity of coal samples subjected to high-pressure continuous immersion and high-low pressure cyclic immersion initially decreases slightly before increasing as the immersion cycle progresses. The maximum porosity enhancements observed were 1.55% and 2.93%, respectively, while the total connectivity increased by 19.07% and 24.79%, respectively. Furthermore, The peak stresses of the coal samples were found to be 1.23–1.65 times, 1.65–3.21 times, and 1.56–4.24 times greater than those of the atmospheric-pressure continuous immersion, high-pressure continuous immersion, and high- and low-pressure cyclic immersion samples, respectively. The cyclic application of high and low confining pressures was shown to significantly promote the development of pore structures and enhance pore connectivity, leading to a more pronounced deterioration in coal body strength. These results provide a theoretical foundation and practical support for the application of hydraulic fracturing to improve permeability and the use of water injection to suppress gas outflow in coal seams with high gas content and low permeability within coal mines.

Cardiovascular disease is more prevalent in individuals of Black-African (BA) and South-Asian (SA) descent than White-European (WE) counterparts, with vascular dysfunction identified as contributing to this disparity. Chronic heat therapy can elicit positive vascular adaptations, potentially underpinned by the repeated cardiovascular strain experienced during acute heat exposures. This study examined the cutaneous peripheral microvascular responses following acute hot (HWI) and thermoneutral (CON) water immersion between males of WE, BA, and SA descent. Thirty-one young, healthy WE (n = 10), BA (n = 10), SA (n = 11) males completed 60 minutes of HWI (39°C) and CON (36°C) with thermoregulatory, cardiovascular, and perceptual responses measured throughout. Following 60 minutes of thermoneutral rest, forearm and Great toe cutaneous vascular conductance (CVC) were recorded during cutaneous post-occlusive reactive hyperemia (PORH) and local heating (LH). Baseline CVC was similar between groups (p ≥ 0.08). During PORH, BA had lower peak forearm and Great toe CVC than WE and SA, and a reduced CVC area under the curve compared to WE (p ≤ 0.01). Furthermore, BA Great toe CVC was blunted compared to WE and SA during both 42°C (p ≤ 0.033) and 44°C (p ≤ 0.02) LH, respectively. Great toe CVC was acutely increased following HWI in responses to 44°C LH compared to CON (p ≤ 0.039), with no race × condition interaction effects. In conclusion, despite blunted microvascular responses in BA, acute HWI did not elicit distinct effects between males of WE, BA, and SA descent, although microvascular responses to LH were greater following HWI. [ABSTRACT FROM AUTHOR]

Air exposure stress can induce stress response of Eriocheir sinensis and affect its normal life activities. The goal of this study was to investigate the effects of water immersion on the recovery of hepatopancreas immune-related enzyme activity, intestinal microbial diversity and metabolic level of Chinese mitten crabs after exposure to air. The results show that immersion can effectively alleviate the adverse effects of air exposure on the antioxidant capacity and immune capacity of Chinese mitten crabs, and the longer the time of immersion, the more obvious the recovery effect. Among them, the levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and acid phosphatase significantly increased after exposure to air (P < 0.05), reached a peak at 3 h, began to decline after immersion, and returned to a level close to the initial value at 24 h (P < 0.05). In addition, after exposure to air, the glucose and total cholesterol in haemolymph of Eriocheir sinensis were significantly different from the initial values (P < 0.05), gradually recovered to the initial level after re-immersion. However, changes in intestinal flora and hepatopancreas metabolism caused by air exposure did not fully recover after water exposure, and its negative effects did not completely disappear. The sequencing results showed that the species composition and diversity of intestinal microorganisms of Chinese mitten crab changed after air exposure and immersion treatment. The relative abundance of Actinomycetes increased significantly, while that of Proteobacteria and Firmicutes decreased significantly. Metabolomics analysis showed that air exposure and immersion destroyed the metabolic balance of amino acids and carnitine, reduced the level of carnitine metabolism, hindered the absorption of nutrients, and led to the accumulation of harmful substances., Competing Interests: Declaration of competing interest All authors participated and shared the work, and no part of this study has been submitted or published elsewhere. There are no competing financial interests or personal relationships that would affect the work reported in this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The aim of this this study was to evaluate the surface roughness and color stability of resin composites (RCs) with color adjustment potential (CAP): Omnichroma (OM), (Tokuyama Dental, Tokyo, Japan); Neo Spectra ST (NS) (Dentsply Sirona, York, PA,USA); and Charisma Diamond One (CD) (Kulzer, Hanau, Germany), compared to a conventional RC, Filtek Z350XT (FZ) (3M ESPE, St. Paul, MN,USA), after immersion in three staining solutions, cola, coffee, and black tea, with distilled water as a control. Forty specimens (8 mm diameter x 2 mm thickness) were prepared for each RC material and divided into subgroups (n=10/group) based on the immersion solution. Surface roughness was measured at baseline and after 21 days of immersion using a non-contact optical profilometer. Color change (ΔE00) was evaluated at baseline, 1, 7, and 21 days with a spectrophotometer. The results showed that FZ demonstrated the lowest surface roughness (0.14), significantly differing from that of the other RCs with CAP (p<0.05), while no significant differences in surface roughness were observed between RCs with CAP (p>0.05). There were no significant changes in surface roughness before and after immersion in various solutions. The results for color change (ΔE00) were statistically significant. Neo Spectra ST showed the lowest tendency for color change, while Filtek Z350XT displayed a moderate potential, and Omnichroma and Charisma Diamond One showed the highest potential for color change., (©Operative Dentistry, 2025.)

Abstract To further elucidate the variations of secondary oxidation spontaneous combustion risk of lignite under different air flows and immersion time. Secondary oxidation experiments of short-term water-immersed coal and long-term water-immersed coal were conducted under four air flows. The results show that, the presence of a temperature inflection point during primary oxidation process, when coal temperature exceeds it, both the oxygen consumption rate and heat release intensity of long-term water-immersed coal are lower, furthermore, decrease in air flow leads to reduction in the temperature inflection point. The oxygen consumption rate and heat release intensity during the primary oxidation process exceed those observed during the subsequent secondary oxidation process. In the secondary oxidation process, long-term water-immersed coal exhibits higher rates of oxygen consumption and heat release intensity compared to short-term water-immersed coal. Additionally, the oxygen-consuming activation energy for oxygen consumption of long-term water-immersed coal is lower. The increase in air flow and water immersion time generally leads to the extreme value of the limit parameters, such as the local maximum of minimal thickness of residual coal and the lower limit oxygen fraction, the local minimum of the maximal air leakage intensity develops in the direction of increasing the risk of spontaneous combustion of coal in goaf.

Abstract Intangible cultural heritage (ICH) is essential for promoting the sustainable development of the global economy and society. The rapid advancement of digital ICH technology and consumer hesitance underscore the necessity to examine customers’ willingness to adopt it. There is substantial research on the acceptability of digital ICH. However, various studies have yielded conflicting results regarding the impact of immersion technology on willingness to adopt it. Some studies claimed immersion technology provided users with a positive experience, while others argued it could lead to simulator sickness and distraction. This study utilised the unified theory of acceptance and use of technology (UTAUT2) and the immersion theory to develop a three-layer analytical framework. This framework examined consumer attitudes towards digital ICH from the perspectives of the target, context and process. This study evaluated the interconnections and collective impacts of factors to determine the willingness of customers to adopt digital ICH. A survey was designed, and 311 valid responses were received from individuals with prior exposure to digital ICH. The collected data was analysed using fuzzy-set qualitative comparative analysis (fsQCA) and necessary condition analysis (NCA). The study revealed important factors that strongly motivated customers to adopt digital ICH and the interaction between these factors. The research distinguished the characteristics of four distinct customer groups that are more willing to adopt digital ICH. This study provides theoretical insights and practical assistance for the safeguarding and advancement of ICH in the era of digital technology.

This study systematically analyzes and emphasizes the importance of VR exhibition experiences, a relatively under-researched area. It examines the effects of VR exhibition experiences on presence and interaction and the influence of interaction on presence. Additionally, how these factors impact user immersion and satisfaction is explored, and the relationship between exhibition immersion and satisfaction is analyzed. Specifically, this study investigates how virtual exhibition experiences, similar to those in physical galleries, provide a sense of reality, leading to immersion in the artwork and ultimately resulting in satisfaction. The findings reveal that, among the VR exhibition experience factors, entertainment, escapism, and aesthetic experiences positively (+) affected interaction, while educational experiences negatively (−) influenced it. Furthermore, entertainment, escapism, and educational experiences positively influenced presence, whereas aesthetic experiences did not significantly impact it. Interaction significantly affected presence and positively influenced both immersion and satisfaction. Presence positively affected immersion but did not significantly affect satisfaction. Finally, immersion positively affected satisfaction. This study suggests that strategies that enhance interaction and presence are crucial in designing VR exhibition experiences. They also provide an important foundation for future research by systematically analyzing the relationships between presence, interaction, immersion, and satisfaction in VR exhibition experiences.

Underground reservoir technology in coal mines enables the effective storage and utilization of water resources disturbed by mining activities. Owing to the effects of mining operations and water extraction/injection activities, the water head in underground reservoirs fluctuates dynamically. The total bearing capacity of a coal pillar dam is significantly reduced due to the combined effects of overlying rock stress, dynamic and static water pressures, and mining-induced stresses, which are critical for ensuring the safe operation of underground reservoirs. Based on the correlation between different water head heights and the corresponding water pressures on the coal pillar dam, a custom-made coal rock pressure water immersion test device was used to saturate the coal samples under various water pressure conditions. The mechanical deformation and failure characteristics of the samples and fracture propagation patterns under different water pressure conditions were studied using uniaxial compression, acoustic emission (AE), and three-dimensional X-ray microimaging. The results indicated that, compared with the dry state, the peak strain of the water-immersed coal samples increased to varying degrees with increasing water pressure. Additionally, the average porosity and the number of pores with diameters in the range of 0 to 150 μm significantly increased in water-immersed coal samples. Under the combined influence of water immersion pressure and uniaxial stress, loading the water-saturated coal samples to the fracture damage threshold significantly intensified deformation, failure, and fracture propagation within the samples, and the failure mode changed from tension to a composite tensile–shear failure. [ABSTRACT FROM AUTHOR]

Liquid culture systems, including bioreactors, are valuable tools for the scaling up of production. Their involvement leads to the automation of the highly efficient, reproducible somatic embryogenesis of Narcissus L. 'Carlton'. Alternative procedures for efficient embryogenic tissue and early somatic embryo multiplication have been developed. The long-term embryogenic callus of narcissus 'Carlton', obtained by repetitive somatic embryogenesis, was multiplicated and differentiated in different liquid culture systems. For multiplication, the Rita® temporary immersion bioreactor and the rotary shaker at 60 rpm and 100 rpm were used, and, for differentiation, the rotary shaker at 60 rpm and solid cultures were investigated. Cultures immersed with a frequency of 15 min every 24 h during multiplication were characterized by the greatest increase in biomass (1.3), and the greatest number of embryos (152.6 embryos per 1 g of inoculum) was seen during differentiation. Higher immersion frequencies (15 min every 8 and 12 h) decreased the tissue quality and yield. The use of a bioreactor during multiplication promoted the number of embryos obtained during differentiation. In turn, cultivation in a rotary shaker during differentiation, regardless of the multiplication system, stimulated the multiplication of embryogenic tissue. The liquid medium used for the multiplication and differentiation of somatic embryos improved the synchronization of their development, which reached up to 95–99% depending on the system. [ABSTRACT FROM AUTHOR]

This present study explored the experiences of Filipino learner-participants in a 6-day cross-cultural immersion held in Indonesia, aiming to understand how they interpreted their cultural learning over a year later. Employing phenomenology as the research design, data was collected through in-depth interviews, focus group discussion, participant observation and document analysis. The findings indicate that interactions with the host community helped participants recognize cultural diversity, respect cultural differences and reassess their cultural prejudices, leading to lasting changes in their perceptions and behaviors after returning home. However, the limitations brought by the restrictions on movements due to the COVID-19 pandemic, and the lack of pre-immersion and post-immersion activities have presented challenges to the breadth and depth of these changes. These findings underscore not only the importance of cross-cultural immersions in fostering intercultural sensitivity and competence but also the significance of continuous guidance from educators during the different stages of the experience. Furthermore, it was shown that despite the short time spent in the immersion, significant changes were still experienced by the participants, contrary to what some studies suggest.

Underground traffic structures can ease the traffic pressure on ground traffic and alleviate the effect of urban heat wave. The structural failure of underground structures caused by earthquakes is one of the crucial hazards in the field of urban underground transportation engineering. The structural safety is an important symbol of urban sustainability and resilience. To investigate the failure modes and mechanical performances of immersion joints under the effects of spatially varying seismic ground motions, an eccentric cyclic loading method has been proposed in the study. For comparison, both the conventional centric cyclic loading condition and novel eccentric cyclic loading condition have been considered in the research. Based on the numerical results, the failure modes, load-carrying properties, ductility, stiffness, and energy dissipation characteristics of the immersion joint have been synthetically analyzed. The results show that the loading conditions have obvious influence on the internal force evolution mechanism of the immersion joint. Under eccentric cyclic loading, the plastic damages occur at the horizontal shear keys, vertical shear keys, and even the left side wall of the tunnel element. As a result of comparison, the ductility coefficient value of the immersion joint under eccentric cyclic loading in the negative direction is 12.4% smaller than that under centric cyclic loading. The immersion joint exposed to eccentric cyclic loading exhibits worse aseismic performance than that under centric cyclic loading.

The association between connectedness to nature and happiness has been investigated in studies on nature-based recreation. However, few studies have explored the mechanisms underlying this relationship. Drawing upon the concept of ecological self, the present study investigated the associations among connectedness to nature, immersion, tourist inspiration, and happiness and explored the mediating roles of immersion and tourist inspiration in the context of mountaineering. We surveyed 359 mountain climbers who climbed high-altitude mountains in Taiwan. The results revealed that the direct path from connectedness to nature to happiness was nonsignificant. Connectedness to nature indirectly affected happiness through immersion and tourist inspiration, and the tourist inspiration had a stronger mediating influence than immersion. This study contributes to the literature by identifying two variables – immersion and tourist inspiration – that mediate the relationship between connectedness to nature and happiness. Managerial implications and suggestions for future research are also discussed. [ABSTRACT FROM AUTHOR]

Two-way dual-language immersion (TWDL) programs aim to combine English speakers and speakers of a partner language in the same classroom to receive content instruction in both languages. Stated goals include bilingualism and biliteracy, high academic achievement, and sociocultural competence. In school districts aiming to reduce segregation, TWDL programs also can integrate students from diverse linguistic, racial, and economic backgrounds, although mounting evidence shows that equitable integration does not always happen. Using school-level enrollments and district data on TWDL program growth from 2000 to 2021, this paper describes enrollment and segregation patterns across the Los Angeles Unified School District elementary schools with TWDL programs. We find that elementary schools with TWDL programs are enrolling increasing numbers of racially, linguistically, and economically marginalized students and are generally more diverse than schools without TWDL programs, although there appear to be limits on the potential of TWDL programs to foster diversity, especially in a segregated urban context.

Objective Community-engaged immersive rural experiences were limited during the COVID-19 pandemic when online learning was instigated across medical institutions globally. This study aimed to explore the impact of online learning on medical students’ satisfaction levels and intentions to practice in a rural area after graduation.Design, setting and participants We conducted a natural quasi-experimental longitudinal retrospective cross-sectional study during 2011–2022 for all Australian domestic medical students who undertook a Rural and Remote Medicine (RRM) placement at the University of Queensland. Anonymous administrative course evaluation data were collected for the same two questions in each cohort over 12 years, between 2011 and 2022.Outcome measures Change in students’ intention to pursue a rural medical career and teaching and placement satisfaction levels was determined. Longitudinal data illustrated trends in students’ intention and overall satisfaction across cohorts before and during COVID-19 disruptions.Results 2695 students participated in the surveys with an average response rate of 81%. Intention levels remained steady between 2011 and 2019, during which students experienced a consistent face-to-face orientation and rural placement immersion. During the COVID-19 disruption phase, primarily in 2020 and 2021, students’ intention to pursue a rural medical career significantly decreased when online-only learning placements were implemented, with only 25% of students in the most impacted rotation indicating a strong positive intention, compared with a previous steady 75%. Comparatively, students’ satisfaction with the RRM programme remained steady across all the years at about 85–90%.Conclusions There appears to be a detrimental impact of a lack of immersive community-engaged education experiences on medical student’s intention to pursue a rural medical career. This natural experiment demonstrates that while online learning maintains student satisfaction levels, it lacks value and authenticity and does not inspire students to consider future rural careers. The value of face-to-face and immersive community-engaged experiences is fundamentally an important contributor to inspiring students to work in rural areas in the future.

Underground traffic structures can ease the traffic pressure on ground traffic and alleviate the effect of urban heat wave. The structural failure of underground structures caused by earthquakes is one of the crucial hazards in the field of urban underground transportation engineering. The structural safety is an important symbol of urban sustainability and resilience. To investigate the failure modes and mechanical performances of immersion joints under the effects of spatially varying seismic ground motions, an eccentric cyclic loading method has been proposed in the study. For comparison, both the conventional centric cyclic loading condition and novel eccentric cyclic loading condition have been considered in the research. Based on the numerical results, the failure modes, load‐carrying properties, ductility, stiffness, and energy dissipation characteristics of the immersion joint have been synthetically analyzed. The results show that the loading conditions have obvious influence on the internal force evolution mechanism of the immersion joint. Under eccentric cyclic loading, the plastic damages occur at the horizontal shear keys, vertical shear keys, and even the left side wall of the tunnel element. As a result of comparison, the ductility coefficient value of the immersion joint under eccentric cyclic loading in the negative direction is 12.4% smaller than that under centric cyclic loading. The immersion joint exposed to eccentric cyclic loading exhibits worse aseismic performance than that under centric cyclic loading. [ABSTRACT FROM AUTHOR]

ObjectivesMethodResultsConclusionsHigh levels of change are linked to the flexibility between immersion and distancing, as well as to higher levels of therapeutic alliance. This study aims to explore the evolution of flexibility between immersion and distancing throughout the entire therapeutic process and its relationship with therapeutic alliance and depressive symptoms in a clinical case.We analyzed five sessions of a good outcome case of depression undergoing cognitive–behavioral therapy. We assessed the distancing/immersion of these sessions using the Measure of Immersed and Distanced Speech, and therapeutic alliance with the Working Alliance Inventory-Short Form. The depressive symptoms were assessed from the Beck Depression Inventory-II.Flexibility and therapeutic alliance from both client’s and therapist’s perspectives increased throughout the therapeutic process. A strong negative correlation was found between flexibility and depressive symptoms.The increase in flexibility can be an adaptive pattern associated with the decrease in depressive symptoms, the increase in therapeutic alliance (from both the client's and the therapist's perspective), and therapeutic success. [ABSTRACT FROM AUTHOR]