Nourishing Physical Productivity and Performance On a Warming Planet - Challenges and Nutritional Strategies to Mitigate Exertional Heat Stress.

PURPOSE OF REVIEW: Climate change is predicted to increase the frequency and severity of exposure to hot environments. This can impair health, physical performance, and productivity for active individuals in occupational and athletic settings. This review summarizes current knowledge and recent advancements in nutritional strategies to minimize the impact of exertional-heat stress (EHS). RECENT FINDINGS: Hydration strategies limiting body mass loss to < 3% during EHS are performance-beneficial in weight-supported activities, although evidence regarding smaller fluid deficits (< 2% body mass loss) and weight-dependent activities is less clear due to a lack of well-designed studies with adequate blinding. Sodium replacement requirements during EHS depends on both sweat losses and the extent of fluid replacement, with quantified sodium replacement only necessary once fluid replacement > 60-80% of losses. Ice ingestion lowers core temperature and may improve thermal comfort and performance outcomes when consumed before, but less so during activity. Prevention and management of gastrointestinal disturbances during EHS should focus on high carbohydrate but low FODMAP availability before and during exercise, frequent provision of carbohydrate and/or protein during exercise, adequate hydration, and body temperature regulation. Evidence for these approaches is lacking in occupational settings. Acute kidney injury is a potential concern resulting from inadequate fluid replacement during and post-EHS, and emerging evidence suggests that repeated exposures may increase the risk of developing chronic kidney disease. Nutritional strategies can help regulate hydration, body temperature, and gastrointestinal status during EHS. Doing so minimizes the impact of EHS on health and safety and optimizes productivity and performance outcomes on a warming planet.

Exertional heat stress promotes the presence of bacterial DNA in plasma: A counterbalanced randomised controlled trial.

OBJECTIVES: The primary aim was to explore the impact of exertional-heat stress (EHS) promoted exercise-associated bacteraemia. A secondary aim was to examine if an amino acid beverage (AAB) intervention may mitigate exercise-associated bacteraemia. DESIGN: Counterbalanced randomised control trial. METHODS: Twenty endurance trained male participants completed two randomised EHS trials. On one occasion, participants consumed a 237 mL AAB twice daily for 7 days prior, immediately before and every 20 min during EHS (2 h running at 60 % V̇O2max in 35 °C). On the other occasion, a water volume control (CON) equivalent was consumed. Whole blood samples were collected pre- and immediately post-EHS, and were analysed for plasma DNA concentration by fluorometer quantification after microbial extraction, and bacterial relative abundance by next generation 16s rRNA gene sequencing. RESULTS: Increased concentration of microbial DNA in plasma pre- to post-EHS was observed on CON (pre-EHS 0.014 ng/µL, post-EHS 0.039 ng/µL) (p < 0.001) and AAB (pre-EHS 0.015 ng/µL, post-EHS 0.031 ng/µL) (p < 0.001). The magnitude of change from pre- to post-exercise on AAB was 40 % lower, but no significant difference was observed versus CON (p = 0.455). Predominant bacterial groups identified included: phyla-Proteobacteria (88.0 %), family-Burkholderiaceae (59.1 %), and genus-Curvibacter (58.6 %). No significant variation in absolute and relative change in α-diversity and relative abundance for phyla, family, and genus bacterial groups was observed in AAB versus CON. CONCLUSIONS: The increased presence of microbial-bacterial DNA in systemic circulation in response to EHS appears positive in all participants. An amino acid beverage supplementation period prior to and consumption during EHS did not provide significant attenuation of EHS-associated bacteraemia.

Long-term hyperuricemia impact on atrial fibrillation outcomes.

BACKGROUND: No studies have been conducted to analyze the impact of serum uric acid (UA) levels on the outcome of atrial fibrillation (AF) patients. We aimed to evaluate the effect of hyperuricemia (HU) on the prognosis of AF. METHODS AND RESULTS: Consecutive patients who consulted our emergency room for an episode of AF, already known or newly diagnosed, between January 1, 2010, and December 31, 2015 (n=2017) were enrolled. After applying exclusion criteria, 1772 patients were included. Serum UA levels in the 6 months before or after the date of the episode were recorded and classified into quartiles: Q1 (n=443) serum UA levels <4.6 mg/dL; Q2 (n=430) 4.6-5.6 mg/dL; Q3 (n=435) 5.7-6.9 mg/dL; and Q4 (n=464) ≥7 mg/dL. Two groups were differentiated: patients without HU (Q1-Q3) and those with HU (Q4). The mean follow-up was 3.7 ± 1.4 years. The primary endpoint was all-cause mortality during follow-up. Mortality during follow-up in the bivariate analysis was higher (p < 0.001) in patients with HU (52.1 %) compared to those without it (35.3 %), confirming multivariate Cox analysis of HU as an independent risk factor for death [hazard ratio 1.89 (1.59-2.25)]. Kaplan-Meier survival analysis showed a shorter survival time in patients with HU (log-rank test, p<0.001). Cox analysis confirmed significant differences in the risk of heart failure (30 % vs. 22 %) in patients with HU. CONCLUSIONS: HU is independently associated with an increased risk for all-cause mortality and hospitalization for heart failure in patients with AF.

Compilations and updates on residual feed intake in sheep.

The increasing global demand for food and the strong effect of climate change have forced animal science to advance regarding new methods of selection in search of more efficient animals in production systems. Feed consumption represents more than 70% of the costs of sheep farms, and more efficient animals can increase the farmers' profitability. One of the main measures of feed efficiency is estimated residual feed intake (RFI), created in 1963 by Robert Koch for estimation in cattle and later adapted for sheep. Animals with negative RFI values (RFI-) are more efficient than animals with positive values (RFI+), with influence on the variables of performance, carcass quality and production of enteric gases. The RFI is the most common and accepted metric of the feed efficiency trait for genetic selection, since it is independent of growth traits, unlike the feed conversion ratio. The purpose of this review article was to present updated literature information on the relationship of RFI estimates with performance measures, molecular markers, greenhouse gas production and feed efficiency, the technical aspects and physiological basis of metabolic in sheep.

Impacto do volume de contraste utilizado após intervenção coronária percutânea / Impact of contrast volume used after percutaneous coronary intervention

INTRODUÇÃO: A nefropatia induzida por contraste (NIC) é uma complicação de procedimentos angiográficos que requerem a administração de meios de contraste. Sua ocorrência está diretamente correlacionada à quantidade de volume de contraste administrado, porém não está claro se o tipo de contraste utilizado (baixo ou iso-osmolar) afeta sua ocorrência. OBJETIVO: Nosso objetivo foi avaliar se existe interação entre volume e tipo de contraste (iso ou baixa osmolaridade) no desenvolvimento de NIC. MÉTODOS: Subanálise post hoc do estudo Ioxaglate Versus IoDixanol randomizado de centro único para a prevenção da nefropatia induzida por contraste (estudo IDPC - NCT02991742), incluindo pacientes consecutivos submetidos a procedimentos coronarianos diagnósticos e terapêuticos entre 2016 e 2018. Os pacientes foram randomizados 1: 1 para receber contraste baixo ou iso-osmolaridade. Para a presente análise, a amostra total foi dividida em dois grupos, em relação ao volume de contraste utilizado. (Grupo I menor 150ml e Grupo 2 ≥150ml) e comparados conforme o tipo de contraste. O desfecho primário foi ocorrência de NIC entre 48 e 96 horas após o procedimento. NIC foi definida como um aumento na creatinina sérica superior a 25% ou ≥0,5 mg/dl em relação ao valor basal após 48 horas. Para avaliar o efeito do contrato e do volume na ocorrência de NIC foi utilizado um modelo de regressão logística com efeito de interação. Este modelo também foi avaliado ajustado para síndrome coronariana aguda, disfunção ventricular, creatinina basal, sexo e idade. Os dados foram analisados no software R versão 4.1.2. RESULTADOS: Foram incluídos consecutivamente 2.268 pacientes, sendo 2/3 do sexo masculino e com alta prevalência de hipertensão (85%), diabetes mellitus (52%) e doença renal crônica (31%). Não houve diferença na incidência de NIC entre os grupos (p >0,999). O modelo de regressão logística com efeito de interação entre contraste e volume não apresentou correlação (p-valor > 0,05). CONCLUSÃO: Neste estudo, o uso de maior volume de contraste não foi associado ao aumento da incidência de NIC. O tipo de contraste utilizado (iso ou baixa osmolaridade) não se correlacionou com a ocorrência de NIC.

Infarto agudo do miocárdio com elevação do segmento st secundário à dissecção espontânea da artéria coronária: relato de caso / Acute myocardial infarction with ST segment elevation secondary to spontaneous coronary artery dissection: case report

INTRODUÇÃO: A dissecção espontânea da artéria coronária (DEAC) é uma causa incomum de síndrome coronária aguda (SCA) e ocorre predominantemente em mulheres jovens. Caracteriza- -se pela dissecção e separação das camadasíntima e média das artérias coronárias, produzindo um hematoma que resulta em compressão parcial ou total da luz arterial, redução do fluxo sanguíneo e comprometimento da perfusão com oclusão total ou parcial do vaso. Este relato descreve um caso de uma mulher jovem com DEAC, cuja apresentação clínica foi um infarto agudo do miocárdio com elevação do segmento ST (IAMCESST). RELATO DE CASO: mulher de 40 anos, sem fatores de risco conhecidos para aterosclerose coronária, apresentou dor torácica em queimação, associada a náuseas após estresse emocional. Ela procurou atendimento de emergência, com diagnóstico de IAMCESST de parede anterior (V1-V6). Foi submetida à trombólise (alteplase), sem critérios de reperfusão. Foi transferida para nosso hospital para estratificação invasiva, em vigência de dor intensa. A cinecoronariografia revelou oclusão no terço médio da artéria descendente anterior (DA). Após a passagem do fio-guia intracoronário, o fluxo sanguíneo foi restabelecido com melhora dos sintomas e observou-se imagem sugestiva de dissecção coronária, confirmada por ultrassom coronário (USIC), acometendo as porções proximal e média do vaso com extenso hematoma sub-intimal. Stent coronário não foi implantado, sendo a paciente encaminhada à UTI para tratamento farmacológico com dupla antiagregação plaquetária (DAPT) e anticoagulação com enoxaparina.Ecocardiograma revelou fração de ejeção de 42% e acinesia da região apical e do segmento médio do septo e parede anterior. Evoluiu estável, assintomática e recebeu alta após 10 dias em uso de DAPT, betabloqueador e estatina. Retornou aos 30 dias assintomática e realizou angiotomografia coronária que revelou a presença de linha de dissecção focal no terço médio da artéria. Após três meses, foi submetida a nova cinecoronariografia com USIC que demonstrou ausência de dissecção, com resolução completa do hematoma intramural em comparação com o exame anterior. CONCLUSÃO: A DEAC é uma causa infrequente de SCA em mulheres jovens, diagnosticada por cinecoronariografia e confirmada por USIC. Na ausência de comprometimento hemodinâmico, melhora da dor e anatomia coronária de baixo risco deve ser tratada de forma conservadora e sem implante de stent. Nesses casos a evolução clínica é favorável enfatizando-se o acompanhamento cuidadoso com tratamento farmacológico e aconselhamento psicossocial.

Impacto da seleção para participar de um estudo randomizado no perfil clínico/angiográfico e nos resultados: hospitalares de pacientes diabéticos submetidos à intervenção coronária percutânea / Impact of selection to participate in a randomized study on the clinical/angiographic profile and results: hospital admissions of diabetic patients undergoing percutaneous coronary intervention

INTRODUÇÃO: Em geral, pacientes (p) incluídos em estudos randomizados são selecionados e exibem perfil clínico/angiográfico de menor gravidade do que os do mundo real. Na última década, ensaios clínicos envolvendo intervenções coronárias percutâneas (ICP) com novos modelos de stents far- macológicos (SF) tem primado por estabelecer apenas critérios clínicos de avaliação dos resultados, evitando a necessidade de reestudo angiográfico compulsório na evolução, o que pode atenuar discre- pâncias significativas entre casos selecionados ou não para participar dos estudos, assim como per- mitir a inclusão de mais p. OBJETIVO: O objetivo desta investigação foi avaliar a hipótese supracitada. Métodos: Recentemente foi realizada em nosso Serviço a inclusão de p diabéticos (PD) de forma prospectiva e randomizada num estudo que avaliou um novo modelo de SF, quando comparado a outro modelo utilizado na rotina. Havia critérios de exclusão restritos. Decidimos comparar os perfis clínico e angiográfico de PD incluídos ou não no estudo, finalizando aleatoriamente a amostra quan- do fosse incluído o centésimo p. Desta forma, entre 10/2020 e 07/2021, foram realizadas 336 ICP em PD de forma prospectiva, subdivididos em 2 grupos: A) 100(29%) PD incluídos no estudo; B) os 236(71%) restantes. Estabeleceram-se como significativos valores de p<0.05. RESULTADOS: Sexo, ida- de, diabetes dependente de insulina e extensão da doença coronária não diferiram entre os grupos. Predominaram significativamente no grupo B: disfunção renal crônica(21% vs 7%; p=0.0033), idade superior a 70 anos(37% vs 23% p=0.015), antecedente de ICP(32% vs 13%; p=<0.001) ), ICP para pontes de veia safena(5% vs 0% p=0.03) e infarto com elevação de ST(19% vs 8%; p=0.017); antece- dente de cirurgia de revascularização miocárdica previa(10% vs 4% P=0.08) e ICP uniarterial (69% vs 57% p=0.054) também foram mais observados em B, mas não de forma significante. Predominaram no grupo A: ICP de múltiplos vasos (43% vs 25%; p=0.0016), apresentação clínica de angina estável (47% vs 31%; p=0.009) e revascularização completa (62% vs 47%; p=0.0016). Embora a permanência de UTI do grupo B foi maior (1.1(±3.5) vs 0.27(±1.5) P=0.024) os resultados imediatos da fase hospitalar, em conjunto ou individualmente, não diferiram. CONCLUSÕES: 1)Cerca de um em cada três PD tratados foram incluídos no estudo; 2) mesmo com critérios de inclusão/exclusão menos rígidos, observamos perfil clínico/angiográfico de menor complexidade nos casos incluídos.

Assessment of the adaptive capacity of Morada Nova ewes with different coat coloration.

Coat color is a factor affecting heat tolerance in tropical ruminant and a particular coat color can determine which is more resilient to environmental changes. The aim of this study was to measure the level of adaptation of Morada Nova sheep with different coat color by using an Adaptability Index (AI). Adult ewes were used, including two different coat colors of Morada Nova sheep (red and white) with mean of body weight of 28.02 ± 5.70 kg and 31.47 ± 3.41 kg, respectively. Physiology parameters, hematology, electrolytes, acid-base status, mineral, renal functions, metabolites, enzymes, and proteins were measured. AI was designed using a multivariate approach (principal component analysis) to "weigh" the influence of each variable in the animal responses. The variables more important for adaptive aspects of Red Morada Nova were: haematology, electrolytes and acid-base status. The hemoglobin (HG), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), sodium (Na+), oxygen pressure (PO2), glucose (GLU) and albumin (ALB) were significantly higher in Red Morada Nova sheep and hydrogen carbonate (HCO3), base excess (BE), total carbon dioxide concentration (TCO2) and URE were significantly higher in the white phenotype. The variables more important for adaptive aspects of White Morada Nova sheep were: (K+), total protein (TP), PO2, HG, cholesterol (CHO), rectal temperature (RT) and glucose (GLU). Both phenotypes showed a high adaptation level, however, a higher value was generated for the Red Morada Nova sheep (81.97). This study concludes that both phenotypes of the Morada Nova sheep breed are well adapted to the climatic condition of the Brazilian tropical region using different adaptive mechanisms.

Computational Framework to Model the Selective Laser Sintering Process.

Selective laser sintering (SLS) is one of the most well-regarded additive manufacturing (AM) sub-processes, whose popularity has been increasing among numerous critical and demanding industries due to its capabilities, mainly manufacturing parts with highly complex geometries and desirable mechanical properties, with potential to replace other, more expensive, conventional processes. However, due to its various underlying multi-physics phenomena, the intrinsic complexity of the SLS process often hampers its industrial implementation. Such limitation has motivated academic interest in obtaining better insights into the process to optimize it and attain the required standards. In that regard, the usual experimental optimization methods are time-consuming and expensive and can fail to provide the optimal configurations, leading researchers to resort to computational modeling to better understand the process. The main objective of the present work is to develop a computational model capable of simulating the SLS process for polymeric applications, within an open-source framework, at a particle-length scale to assess the main process parameters' impact. Following previous developments, virgin and used polymer granules with different viscosities are implemented to better represent the actual process feedstock. The results obtained agree with the available experimental data, leading to a powerful tool to study, in greater detail, the SLS process and its physical parameters and material properties, contributing to its optimization.

The BALA project: A pioneering monitoring of Azorean forest invertebrates over two decades (1999-2022).

Globally, there is a concerning decline in many insect populations, and this trend likely extends to all arthropods, potentially impacting unique island biota. Native non-endemic and endemic species on islands are under threat due to habitat destruction, with the introduction of exotic, and potentially invasive, species, further contributing to this decline. While long-term studies of plants and vertebrate fauna are available, long-term arthropod datasets are limited, hindering comparisons with better-studied taxa. The Biodiversity of Arthropods of the Laurisilva of the Azores (BALA) project has allowed gathering comprehensive data since 1997 in the Azorean Islands (Portugal), using standardised sampling methods across islands. The dataset includes arthropod counts from epigean (pitfall traps) and canopy-dwelling (beating samples) communities, enriched with species information, biogeographic origins, and IUCN categories. Metadata associated with the sample protocol and events, like sample identifier, archive number, sampled tree species, and trap type are also recorded. The database is available in multiple formats, including Darwin Core, which facilitates the ecological analysis of pressing environmental concerns, such as arthropod population declines and biological invasions.

The increase in core body temperature in response to exertional-heat stress can predict exercise-induced gastrointestinal syndrome.

Utilizing metadata from existing exertional and exertional-heat stress studies, the study aimed to determine if the exercise-associated increase in core body temperature can predict the change in exercise-induced gastrointestinal syndrome (EIGS) biomarkers and exercise-associated gastrointestinal symptoms (Ex-GIS). Endurance-trained individuals completed 2 h of running exercise in temperate (21.2-30.0°C) to hot (35.0-37.2°C) ambient conditions (n = 132 trials). Blood samples were collected pre- and post-exercise to determine the change in gastrointestinal integrity biomarkers and systemic inflammatory cytokines. Physiological and thermoregulatory strain variables were assessed every 10-15 min during exercise. The strength of the linear relationship between maximal (M-Tre) and change (Δ Tre) in rectal temperature and EIGS variables was determined via Spearman's rank correlation coefficients. While the strength of prediction was determined via simple and multiple linear regression analyses dependent on screened EIGS and Ex-GIS confounding factors. Significant positive correlations between Tre maximum (M-Tre) and change (Δ Tre) with I-FABP (rs = 0.434, p < 0.001; and rs = 0.305, p < 0.001; respectively), sCD14 (rs = 0.358, p < 0.001; and rs = 0.362, p < 0.001), systemic inflammatory response profile (SIR-Profile) (p < 0.001), and total Ex-GIS (p < 0.05) were observed. M-Tre and Δ Tre significantly predicted (adjusted R2) magnitude of change in I-FABP (R2(2,123)=0.164, p < 0.001; and R2(2,119)=0.058, p = 0.011; respectively), sCD14 (R2(2,81)=0.249, p < 0.001; and R2(2,77)=0.214, p < 0.001), SIR-Profile (p < 0.001), and total Ex-GIS (p < 0.05). Strong to weak correlations were observed between M-Tre and Δ Tre with plasma concentrations of I-FABP, sCD14, SIR-Profile, and Ex-GIS in response to exercise. M-Tre and Δ Tre can predict the magnitude of these EIGS variables and Ex-GIS in response to exercise.

Evaluation of the supply of Duddingtonia flagrans for the control of gastrointestinal parasites in sheep.

Parasitic resistance imposes alternative control methods, like nematophagous fungi. In this study, two experiments were conducted supplying Duddingtonia flagrans aiming to evaluate the biological control of parasites in sheep. In the first, 24 sheep naturally infected by gastrointestinal nematodes were allocated, in randomized blocks, following the treatments: control or treated group, 0.5g/animal product containing D. flagrans, chlamydospores. Weight, body score, Famacha©, egg count per gram of feces (EPG), and larval percentage were evaluated. In the second experiment, D. flagrans (0.25 and 0.5g product) was infested with manure, plus or not protein concentrate, in a completely randomized design. In both experiments the dose was intentionally lower than recommended. Recovery and larval identification were performed. The SAS analyzed the variables by the MIXED procedure, repeated measures in time. Weight, body score, hematocrit, and Famacha© did not show differences between treatments (p>0.05); however, EPG (p<0.001) and the percentage of larvae identified in coproculture were different. In the second experiment, the inclusion of the fungus did not influence the recovery of larvae (p>0.05). In both experiments, colonization and advancement of the fungus were visualized. Under the experimental conditions, the fungus D. flagrans was not effective in the biological control of parasitic infection in sheep.

Flavonoids and phenolic acids from sugarcane: Distribution in the plant, changes during processing, and potential benefits to industry and health.

Sugarcane (Saccharum sp.) plants are grown in warmer climates throughout the world and processed to produce sugar as well as other useful byproducts such as molasses and bagasse. Sugarcane is rich in (poly)phenols, but there has been no attempt to critically evaluate the published information based on the use of suitable methodologies. The objective of this review is to evaluate the quantitative and qualitative (poly)phenolic profiles of individual parts of the sugarcane plant and its multiple industrial products, which will help develop new processes and uses for sugarcane (poly)phenols. The quantitative analysis involves the examination of extraction, concentration, and analytical techniques used in each study for each plant part and product. The qualitative analysis indicates the identification of various (poly)phenols throughout the sugarcane processing chain, using only compounds elucidated through robust analytical methodologies such as mass spectrometry or nuclear magnetic resonance. In conclusion, sugarcane (poly)phenols are predominantly flavonoids and phenolic acids. The main flavonoids, derivatives of apigenin, luteolin, and tricin, with a substantial proportion of C-glycosides, are consistently found across all phases of sugarcane processing. The principal phenolic acids reported throughout the process include chlorogenic acids, as well as ferulic and caffeic acids mostly observed after hydrolysis. The derivation of precise quantitative information across publications is impeded by inconsistencies in analytical methodologies. The presence of multiple (poly)phenols with potential benefits for industrial applications and for health suggests sugarcane could be a useful provider of valuable compounds for future use in research and industrial processes.

The impact of 48 h high carbohydrate diets with high and low FODMAP content on gastrointestinal status and symptoms in response to endurance exercise, and subsequent endurance performance.

This study investigated the effects of a high carbohydrate diet, with varied fermentable oligo-, di-, and mono-saccharide and polyol (FODMAP) content, before endurance exercise on gastrointestinal integrity, motility, and symptoms; and subsequent exercise performance. Twelve endurance athletes were provided with a 48 h high carbohydrate (mean ± SD: 12.1 ± 1.8 g kg day-1) diet on two separate occasions, composed of high (54.8 ± 10.5 g day-1) and low FODMAP (3.0 ± 0.2 g day-1) content. Thereafter, participants completed a 2 h steady-state running exercise at 60% of V ˙ O 2 max (22.9 ± 1.2 °C, 46.4 ± 7.9% RH), followed by a 1 h distance performance test. Pre-exercise and every 20 min during steady-state exercise, 100 mL maltodextrin (10% w/v) solution was consumed. A 150 mL lactulose (20 g) solution was consumed 30 min into the distance performance test to determine orocecal transit time (OCTT) during exercise. Blood was collected pre- and post exercise to determine gastrointestinal integrity biomarkers (i.e., I-FABP, sCD14, and CRP). Breath hydrogen (H2) and gastrointestinal symptoms (GIS) were determined pre-exercise, every 15 min, during and throughout recovery. No differences in gastrointestinal integrity biomarkers, OCTT, or distance completed were observed between trials. Pre-exercise total-GIS (1.3 ± 2.9 vs. 4.3 ± 4.4), gut discomfort (9.9 ± 8.1 vs. 15.8 ± 9.0), and upper-GIS (2.8 ± 2.6 vs. 5.7 ± 4.8) during exercise were less severe on high carbohydrate low FODMAP (HC-LFOD) versus high carbohydrate high FODMAP (HC-HFOD) (p < 0.05). Gut discomfort (3.4 ± 4.4 vs. 0.2 ± 0.6) and total-GIS (4.9 ± 6.8 vs. 0.2 ± 0.6) were higher during recovery on HC-LFOD versus HC-HFOD (p < 0.05). The FODMAP content of a 48 h high carbohydrate diet does not impact gastrointestinal integrity or motility in response to endurance exercise. However, a high FODMAP content exacerbates GIS before and during exercise, but this does not impact performance outcomes.

Performance, feed efficiency, feeding behavior, and cortisol concentration of lambs ranked for Residual Feed Intake and Residual Intake and Gain.

This study aimed to evaluate the performance, feed efficiency, feeding behavior, and cortisol concentrations of lambs ranked into different groups of Residual Feed Intake (RFI) and Residual Intake and Gain (RIG). Forty Santa Inês lambs with a mean initial age of 120 ± 30 days and mean initial (IBW) and final body weight (FBW) of 28.9 ± 3.2 and 43.7 ± 3.9 kg, respectively, were used. The animals were fed at an automatic feed and water station (Intergado®) for 60 days and classified at the end of the experiment as low-RFI/RIG, medium-RFI/RIG, and high-RFI/RIG according to RFI and RIG. Performance, feed efficiency measures, ingestive behavior, temperament, and cortisol concentrations were measured, and Pearson's correlation analysis was performed to evaluate the relationship between the variables studied. The variables that differed most between RFI groups were dry matter intake, feed conversion, and feed efficiency, with better values in efficient animals (RFI-). Regarding the RGI groups, the average daily gain of animals classified as RIG- was 19.37% lower than that of animals classified as RIG± and 39.28% lower than that of animals classified as RIG+. Only the hourly feeding rate per day (p = 0.04) differed significantly between RFI and RIG classes, while no differences were observed for the ingestive behavior variables or cortisol. The number of visits to the feed bunk (total, with or without intake) showed no correlation with any performance or efficiency measure. Identifying animals ranked into different RFI and RIG classes shows that more efficient animals have a lower feed intake for the same weight gain and spend less time at the feed bunk.

Exertional Stress-induced Pathogenic Luminal Content Translocation - Friend or Foe?

The incidence of perturbed gastrointestinal integrity, as well as resulting systemic immune responses and gastrointestinal symptoms, otherwise known as exercised-induced gastrointestinal syndrome (EIGS), is common among individuals who partake in prolonged exercise. EIGS may cause the translocation of pathogenic material, including whole bacteria and bacterial endotoxins, from the lumen into circulation, which may progress into clinical consequences such as sepsis, and potentially subsequent fatality. However, further investigation is warranted to assess the possibility of food allergen and/or digestive enzyme luminal to circulatory translocation in response to exercise, and the clinical consequences. Findings from this narrative literature review demonstrate evidence that whole bacteria and bacterial endotoxins translocation from the gastrointestinal lumen to systemic circulation occurs in response to exercise stress, with a greater propensity of translocation occurring with accompanying heat exposure. It has also been demonstrated that food allergens can translocate from the lumen to systemic circulation in response to exercise stress and initiate anaphylaxis. To date, no research investigating the effect of exercise on the translocation of digestive enzymes from the lumen into systemic circulation exists. It is evident that EIGS and consequential pathogenic translocation presents life-threatening clinical implications, warranting the development and implementation of effective management strategies in at-risk populations.

Does Age Influence Gastrointestinal Status Responses to Exertional-heat Stress?

This meta-data exploration aimed to determine the impact of exertional-heat stress (EHS) on gastrointestinal status of masters age and young adult endurance athletes. Sixteen MASTERS (mean: 44y) and twenty-one YOUNG (26y) recreational endurance athletes completed 2 h of running at 60% ˙V O2max in 35˚C ambient conditions. Blood samples were collected pre-, immediately and 1 h post-EHS, and analyzed for markers of exercise-induced gastrointestinal syndrome (EIGS). Thermo-physiological measures and gastrointestinal symptoms (GIS) were recorded every 10-20 min during EHS. Peak Δ pre- to post-EHS did not substantially differ (p>0.05) between MASTERS and YOUNG for intestinal epithelial injury [I-FABP: 1652pg/ml vs. 1524pg/ml, respectively], bacterial endotoxic translocation [sCD14: -0.09µg/mL vs. 0.84µg/mL, respectively], lipopolysaccharide-binding protein [LBP: 0.26µg/mL vs. 1.76µg/mL, respectively], and systemic inflammatory response profile (SIR-Profile: 92.0arb.unit vs. 154arb.unit, respectively). A significantly higher peak Δ pre- to post-EHS in endogenous endotoxin anti-body IgM (p=0.042), and pro-inflammatory cytokine IL-1ß (p=0.038), was observed in YOUNG compared to MASTERS. No difference was observed between incidence (81% and 80%, respectively) and severity (summative accumulation: 21 and 30, respectively) of reported GIS during EHS between MASTERS and YOUNG. Pathophysiology of EIGS in response to EHS does not substantially differ with age progression, since masters and younger adult endurance athletes responded comparably.

Effect of Personalized Sodium Replacement on Fluid and Sodium Balance and Thermophysiological Strain During and After Ultraendurance Running in the Heat.

PURPOSE: To investigate the effect of personalized sweat sodium replacement on drinking behavior, sodium and water balance, and thermophysiological responses during and after ultraendurance running in hot conditions. METHODS: Nine participants (7 male, 2 female) completed two 5-hour treadmill runs (60% maximum oxygen uptake, 30°C ambient temperature), in a double-blind randomized crossover design, consuming sodium chloride (SODIUM) capsules to replace 100% of previously assessed losses or placebo (PLACEBO). Fluid was consumed ad libitum. RESULTS: No effect of SODIUM was observed for ad libitum fluid intake or net fluid balance (P > .05). Plasma sodium concentration increased in both trials, but to a greater extent in SODIUM at 2.5 hours (mean [SD]: 4 [4] mmol·L-1 vs 1 [5] mmol·L-1; P < .05) and postexercise (4 [3] mmol·L-1 vs 1 [5] mmol·L-1; P < .05). Plasma volume change was not different between trials (P > .05) but was strongly correlated with sodium balance in SODIUM (r = .880, P < .01). No effect of sodium replacement was observed for heart rate, rectal temperature, thermal comfort, perceived exertion, or physiological strain index. During the 24 hours postexercise, ad libitum fluid intake was greater following SODIUM (2541 [711] mL vs 1998 [727] mL; P = .04), as was urinary sodium excretion (NaCl: 66 [35] mmol, Pl: 21 [12] mmol; P < .01). CONCLUSIONS: Personalized sweat sodium replacement during ultraendurance running in hot conditions, with ad libitum fluid intake, exacerbated the rise in plasma sodium concentration compared to no sodium replacement but did not substantially influence overall body-water balance or thermophysiological strain. A large sodium deficit incurred during exercise leads to substantial renal sodium conservation postexercise.

Pediatric COVID-19: clinical and epidemiological data of 1303 cases in a general hospital in Brazil / COVID-19 pediátrico: dados clínicos e epidemiológicos de 1303 casos em um hospital geral no Brasil

ABSTRACT Objective: This study aimed to describe the clinical characteristics of the pediatric population with COVID-19 in an Emergency Department (ED) of a Brazilian general hospital. Methods: Epidemiological and clinical data of patients younger than 20 years old were collected from patients' medical records from February 2020 to July 2021. Most of the epidemiological data described pertains to hospitalized patients. We also reviewed coinfections, treatment, and outcomes and compared the first and second waves of COVID-19. Results: We identified a total of 1303 episodes of SARS-CoV-2 infection. The median time from symptom onset to diagnosis was three days. Symptoms were present in 92.3% of the patients. The most common symptoms were fever (45.2%), nasal congestion/discharge (44.2%), and cough (39.4%). Chest radiography and tomography were performed in 7.7 and 3.3% of cases, with abnormal findings in 29.7 and 53.4%, respectively. Hospital admissions occurred in 3.5% of patients, mainly in the presence of comorbidities, in children under five years old and in those who presented to the ED during the first wave of COVID-19. Coinfection with a viral agent was identified in 20% of the 71 cases tested in this study, and a positive rapid test for Streptococcus pyogenes was found in 8% of the 174 cases tested, with no impact of these coinfections on hospitalization. Conclusions: We found that COVID-19 was a mild disease in most children in our study population, with most hospitalizations and readmissions occurring during the first wave of COVID-19.

RESUMO Objetivo: Este estudo teve como objetivo descrever as características clínicas da população pediátrica com COVID-19 no setor de emergência de um hospital geral brasileiro. Métodos: Os dados epidemiológicos e clínicos de pacientes idade inferior a 20 anos foram coletados dos prontuários dos pacientes de fevereiro de 2020 a julho de 2021. A maior parte dos dados epidemiológicos descritos refere-se a pacientes hospitalizados. Também foram revisados as coinfecções, o tratamento e os desfechos de internação e comparadas a primeira e a segunda ondas de COVID-19. Resultados: Foi identificado o total de 1.303 episódios de infecção por SARS-CoV-2. A mediana de tempo desde o início dos sintomas até o diagnóstico foi de três dias. Os sintomas estiveram presentes em 92,3% dos pacientes. Os sintomas mais comuns foram febre (45,2%), congestão/secreção nasal (44,2%) e tosse (39,4%). Radiografia e tomografia de tórax foram realizadas em 7,7 e 3,3% dos casos, com achados anormais em 29,7 e 53,4%, respectivamente. As internações hospitalares ocorreram em 3,5% dos pacientes, principalmente na presença de comorbidades, em crianças menores de cinco anos e naqueles que se apresentaram no pronto-socorro durante a primeira onda de COVID-19. Foi identificada coinfecção viral em 20% dos 71 casos testados e teste rápido positivo para Streptococcus pyogenes em 8% dos 174 casos testados, não havendo impacto dessas coinfecções quanto à internação hospitalar. Conclusões: Observamos que a COVID-19 foi uma doença leve na maioria das crianças de nossa população, com a maior parte das hospitalizações e readmissões ocorrendo durante a primeira onda de COVID-19.