Strategies to mitigate acute kidney injury risk during physical work in hot environments.

Prolonged physical work in the heat can reduce renal function and increase the risk of acute kidney injury (AKI). This is concerning given that the latest climate change projections forecast a rise in global temperature as well as the frequency, intensity, and duration of heatwaves. This means that outdoor and indoor workers in the agriculture or construction industries will be exposed to higher heat stress in the years ahead. Several studies indicate a higher incidence of chronic kidney disease from nontraditional origins (CKDnt) in individuals exposed to high temperatures, intense physical work, and/or recurrent dehydration. It has been proposed that prolonged physical work in the heat accompanied by dehydration results in recurrent episodes of AKI that ultimately lead to permanent kidney damage and the development of CKDnt. Thus, there is a need to identify and test strategies that can alleviate AKI risk during physical work in the heat. The purpose of this review is to present strategies that might prevent and mitigate the risk of AKI induced by physical work in the heat.

Effect of heat stress on heat shock protein expression and hypertrophy-related signaling in the skeletal muscle of trained individuals.

Muscle mass is balanced between hypertrophy and atrophy by cellular processes, including activation of the protein kinase B-mechanistic target of rapamycin (Akt-mTOR) signaling cascade. Stressors apart from exercise and nutrition, such as heat stress, can stimulate the heat shock protein A (HSPA) and C (HSPC) families alongside hypertrophic signaling factors and muscle growth. The effects of heat stress on HSP expression and Akt-mTOR activation in human skeletal muscle and their magnitude of activation compared with known hypertrophic stimuli are unclear. Here, we show a single session of whole body heat stress following resistance exercise increases the expression of HSPA and activation of the Akt-mTOR cascade in skeletal muscle compared with resistance exercise in a healthy, resistance-trained population. Heat stress alone may also exert similar effects, though the responses are notably variable and require further investigation. In addition, acute heat stress in C2C12 muscle cells enhanced myotube growth and myogenic fusion, albeit to a lesser degree than growth factor-mediated hypertrophy. Though the mechanisms by which heat stress stimulates hypertrophy-related signaling and the potential mechanistic role of HSPs remain unclear, these findings provide additional evidence implicating heat stress as a novel growth stimulus when combined with resistance exercise in human skeletal muscle and alone in isolated murine muscle cells. We believe these findings will help drive further applied and mechanistic investigation into how heat stress influences muscular hypertrophy and atrophy.NEW & NOTEWORTHY We show that acute resistance exercise followed by whole body heat stress increases the expression of HSPA and increases activation of the Akt-mTOR cascade in a physically active and resistance-trained population.

The heat shock connection: skeletal muscle hypertrophy and atrophy.

Skeletal muscle is an integral tissue system that plays a crucial role in the physical function of all vertebrates and is a key target for maintaining or improving health and performance across the lifespan. Based largely on cellular and animal models, there is some evidence that various forms of heat stress with or without resistance exercise may enhance skeletal muscle growth or reduce its loss. It is not clear whether these stimuli are similarly effective in humans or meaningful compared with exercise alone across various heating methodologies. Furthermore, the magnitude by which heat stress may influence whole body thermoregulatory responses and the connection to skeletal muscle adaptation remains ambiguous. Finally, the underlying mechanisms, which may include interaction between relevant heat shock proteins and intracellular hypertrophy and atrophy related factors, remain unclear. In this narrative review, we examine the relevant literature regarding heat stress alone or in combination with resistance exercise emphasizing skeletal muscle hypertrophy and atrophy across cellular and animal models, as well as human investigations. In addition, we present working mechanistic theories for heat shock protein-mediated signaling effects regarding hypertrophy and atrophy-related signaling processes. Importantly, continued research is necessary to determine the practical effects and mechanisms of heat stress with and without resistance exercise on skeletal muscle function via growth and maintenance.

High-altitude exposures and intestinal barrier dysfunction.

Gastrointestinal complaints are often reported during ascents to high altitude (>2,500 m), though their etiology is not known. One potential explanation is injury to the intestinal barrier which has been implicated in the pathophysiology of several diseases. High-altitude exposures can reduce splanchnic perfusion and blood oxygen levels causing hypoxic and oxidative stress. These stressors might injure the intestinal barrier leading to consequences such as bacterial translocation and local/systemic inflammatory responses. The purpose of this mini-review is to 1) discuss the impact of high-altitude exposures on intestinal barrier dysfunction and 2) present medications and dietary supplements which may have relevant impacts on the intestinal barrier during high-altitude exposures. There is a small but growing body of evidence which shows that acute exposures to high altitudes can damage the intestinal barrier. Initial data also suggest that prolonged hypoxic exposures can compromise the intestinal barrier through alterations in immunological function, microbiota, or mucosal layers. Exertion may worsen high-altitude-related intestinal injury via additional reductions in splanchnic circulation and greater hypoxemia. Collectively these responses can result in increased intestinal permeability and bacterial translocation causing local and systemic inflammation. More research is needed to determine the impact of various medications and dietary supplements on the intestinal barrier during high-altitude exposures.

Exercise in hypobaric hypoxia increases markers of intestinal injury and symptoms of gastrointestinal distress.

NEW FINDINGS: What is the central question of this study? What is the effect of hypobaric hypoxia on markers of exercise-induced intestinal injury and symptoms of gastrointestinal (GI) distress? What is the main finding and its importance? Exercise performed at 4300 m of simulated altitude increased intestinal fatty acid binding protein (I-FABP), claudin-3 (CLDN-3) and lipopolysaccharide binding protein (LBP), which together suggest that exercise-induced intestinal injury may be aggravated by concurrent hypoxic exposure. Increases in I-FABP, LBP and CLDN-3 were correlated to exercise-induced GI symptoms, providing some evidence of a link between intestinal barrier injury and symptoms of GI distress. ABSTRACT: We sought to determine the effect of exercise in hypobaric hypoxia on markers of intestinal injury and gastrointestinal (GI) symptoms. Using a randomized and counterbalanced design, nine males completed two experimental trials: one at local altitude of 1585 m (NORM) and one at 4300 m of simulated hypobaric hypoxia (HYP). Participants performed 60 min of cycling at a workload that elicited 65% of their NORM V̇O2max${\dot V_{{{\rm{O}}_{\rm{2}}}{\rm{max}}}}$ . GI symptoms were assessed before and every 15 min during exercise. Pre- and post-exercise blood samples were assessed for intestinal fatty acid binding protein (I-FABP), claudin-3 (CLDN-3) and lipopolysaccharide binding protein (LBP). All participants reported at least one GI symptom in HYP compared to just one participant in NORM. I-FABP significantly increased from pre- to post-exercise in HYP (708 ± 191 to 1215 ± 518 pg ml-1 ; P = 0.011, d = 1.10) but not NORM (759 ± 224 to 828 ± 288 pg ml-1 ; P > 0.99, d = 0.27). CLDN-3 significantly increased from pre- to post-exercise in HYP (13.8 ± 0.9 to 15.3 ± 1.2 ng ml-1 ; P = 0.003, d = 1.19) but not NORM (13.7 ± 1.8 to 14.2 ± 1.6 ng ml-1 ; P = 0.435, d = 0.45). LBP significantly increased from pre- to post-exercise in HYP (10.8 ± 1.2 to 13.9 ± 2.8 µg ml-1 ; P = 0.006, d = 1.12) but not NORM (11.3 ± 1.1 to 11.7 ± 0.9 µg ml-1 ; P > 0.99, d = 0.32). I-FABP (d = 0.85), CLDN-3 (d = 0.95) and LBP (d = 0.69) were all significantly higher post-exercise in HYP compared to NORM (P ≤ 0.05). Overall GI discomfort was significantly correlated to ΔI-FABP (r = 0.71), ΔCLDN-3 (r = 0.70) and ΔLBP (r = 0.86). These data indicate that cycling exercise performed in hypobaric hypoxia can cause intestinal injury, which might cause some commonly reported GI symptoms.

The effect of repetition tempo on cardiovascular and metabolic stress when time under tension is matched during lower body exercise.

PURPOSE: To investigate the effect of repetition tempo on cardiovascular and metabolic stress when time under tension (TUT) and effort are matched during sessions of lower body resistance training (RT). METHODS: In a repeated-measures, cross-over design, 11 recreationally trained females (n = 5) and males (n = 6) performed 5 sets of belt squats under the following conditions: slow-repetition tempo (SLOW; 10 reps with 4-s eccentric and 2-s concentric) and traditional-repetition tempo (TRAD; 20 reps with 2-s eccentric and 1-s concentric). TUT (60 s) was matched between conditions and external load was adjusted so that lifters were close to concentric muscular failure at the end of each set. External load, total volume load (TVL), impulse (IMP), blood lactate, ratings of perceived exertion (RPE), HR, and muscle oxygenation were measured. RESULTS: Data indicated that TVL (p < 0.001), blood lactate (p = 0.017), RPE (p = 0.015), and HR (p < 0.001) were significantly greater during TRAD while external load (p = 0.030) and IMP (p = 0.002) were significantly greater during SLOW. Whether it was expressed as minimal values or change scores, muscle oxygenation was not different between protocols. CONCLUSION: When TUT is matched, TVL, cardiovascular stress, metabolic stress, and perceived exertion are greater when faster repetition tempos are used. In contrast, IMP and external load are greater when slower repetition tempos are used.

Heat acclimation during low-intensity exercise increases V̇O2max and Hsp72, but not markers of mitochondrial biogenesis and oxidative phosphorylation, in skeletal tissue.

NEW FINDINGS: What is the central question of this study? Heat acclimation increases tolerance to exercise performed in the heat and may improve maximal oxygen uptake (VO2 max) and performance in temperate environments. However, it is unknown if HA affects the expression of proteins related to mitochondrial biogenesis and oxidative capacity in skeletal muscle. What is the main finding and its importance? We showed that heat acclimation increased VO2 max in a temperate environment but did not change markers of mitochondrial biogenesis and oxidative phosphorylation in the skeletal muscle. ABSTRACT: Heat acclimation (HA) increases tolerance to exercise performed in the heat and may improve maximal oxygen uptake ( V̇O2max ) in temperate environments. However, it is unknown if HA affects the expression of proteins related to mitochondrial biogenesis and oxidative capacity in skeletal muscle. The purpose of this study was to investigate the effect of HA on skeletal muscle markers of mitochondrial biogenesis and oxidative phosphorylation in recreationally trained adults. Thirteen (7 males and 6 females) individuals underwent 10 days of HA. Participants performed two 45 min bouts of exercise (walking at 30-40% maximal velocity at 3% grade) with 10 min rest per session in a hot environment (∼42°C and 30-50% relative humidity). V̇O2max , ventilatory thresholds (VT), and protein expression of peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α), mitochondrial transcription factor A (TFAM), calcium/calmodulin-dependent protein kinase (CaMK), electron transport chain (ETC) complexes I-IV, and heat shock protein 72 (Hsp72) in skeletal muscle were measured pre- and post-HA. Comparing day 1 to day 10, HA was confirmed by lower resting core temperature (Tcore ) (P = 0.026), final Tcore (P < 0.0001), mean heart rate (HR) (P = 0.002), final HR (P = 0.003), mean ratings of perceived exertion (RPE) (P = 0.026) and final RPE (P = 0.028). Pre- to post-HA V̇O2max (P = 0.045) increased but VT1 (P = 0.263) and VT2 (P = 0.239) were unchanged. Hsp72 (P = 0.007) increased, but skeletal muscle protein expression (PGC-1α, P = 0.119; TFAM, P = 0.763; CaMK, P = 0.19; ETC I, P = 0.629; ETC II, P = 0.724; ETC III, P = 0.206; ETC IV, P = 0.496) were not affected with HA. HA during low-intensity exercise increased V̇O2max in a temperate environment and Hsp72 but it did not affect markers of mitochondrial biogenesis and oxidative phosphorylation in the skeletal muscle.

Metabolic effects of two high-intensity circuit training protocols: Does sequence matter?

BACKGROUND/OBJECTIVE: The integration of high-intensity interval training (HIIT) and circuit weight training (CWT) is seamless and practical for meeting recommended exercise guidelines. The purpose of this study was to determine the ideal combination of HIIT and CWT to elicit desired acute cardiorespiratory and metabolic responses in variables such as energy expenditure (EE), oxygen consumption (VO2), heart rate (HR), blood lactate (BLa-), excess post-exercise oxygen consumption (EPOC), rating of perceived exertion (RPE), and enjoyment. METHODS: Fourteen trained males (25.7 ±â€¯4.4 yr) completed two exercise protocols matched for volume and recovery periods. On one day, participants performed six HIIT bouts prior to three rounds of a nine exercise CWT protocol (HIC). The second day (separated by ≥ 72 h) consisted of three rounds of three mini-circuits (three exercises per circuit) integrated with three HIIT bouts between the first and second and second and third mini-circuits (TRI). VO2, HR, and EE were monitored throughout both protocols. EPOC for a 20-min duration, [BLa-] (five time points), RPE, and enjoyment were measured post-exercise. RESULTS: Energy expenditure was significantly higher during the HIC compared to the TRI protocol (p = .012), as well as EPOC (p = .034). [BLa-] was significantly greater immediate-, 5min-, 10min- and 20min-post-exercise following HIC as compared to TRI. Mean values for HIC and TRI were similar (p > .05) for HR and RPE. CONCLUSION: Performing HIIT prior to CWT elicits a higher metabolic perturbation compared to the TRI protocol. Although a significant EE difference was detected between the two trials, the practical difference (∼20 kcal) between protocols indicates both protocols are similarly effective for caloric expenditure, metabolic and cardiorespiratory response.

Telemedicine-Based Health Coaching Is Effective for Inducing Weight Loss and Improving Metabolic Markers.

BACKGROUND: To assess the efficacy of health coaching (HC) delivered through videoconferencing (VC) to favorably change physical activity (PA), weight, and metabolic markers in adults with high body mass index (BMI). MATERIALS AND METHODS: Thirty adults (BMI ≥30 kg/m2) were randomly assigned to one of three groups: VC, in-person (IP), or control group (CG). Participants received wireless watches and weight scales to sync with their personal smartphones; recorded data were wirelessly uploaded to a secure database. Participants assigned to VC and IP received individualized HC by a multidisciplinary team (registered dietitian, exercise physiologist, and medical doctor) based on data uploaded over the 12-week intervention. Steps/day and weight loss were analyzed through analyses of covariance. RESULTS: Within- and between-group changes in weight (kg), glucose, insulin, hemoglobin A1c (HbA1c), and Homeostasis Model Assessment estimate of insulin resistance (HOMA-IR) were analyzed through analyses of variance. Weight loss was greater (p < 0.05) for VC (8.23 ± 4.5 kg; 7.7%) than IP (3.2 ± 2.6 kg; 3.4%) and CG (2.9 ± 3.9 kg; 3.3%), respectively. Steps/day were significantly higher in VC than IP at week 4 and VC was significantly higher than the CG at weeks 6, 8, 9, and 11 (p ≤ 0.05). No within- or between-group differences were found for glucose, insulin, or HbA1C. HOMA-IR decreased for VC only (p ≤ 0.05). CONCLUSIONS: Our innovative, multidisciplinary, telemedicine HC delivered through VC led to more favorable changes in weight loss, PA (steps/day), and HOMA-IR than IP or no HC. VC may be an economical approach to improve health and promote behavior change in obese adults. CLINICAL TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier NCT03278951.

The effect of insulin resistance and exercise on the percentage of CD16(+) monocyte subset in obese individuals.

UNLABELLED: Obesity is a low-grade chronic inflammation condition, and macrophages, and possibly monocytes, are involved in the pathological outcomes of obesity. Physical exercise is a low-cost strategy to prevent and treat obesity, probably because of its anti-inflammatory action. We evaluated the percentage of CD16(-) and CD16(+) monocyte subsets in obese insulin-resistant individuals and the effect of an exercise bout on the percentage of these cells. Twenty-seven volunteers were divided into three experimental groups: lean insulin sensitive, obese insulin sensitive and obese insulin resistant. Venous blood samples collected before and 1 h after an aerobic exercise session on a cycle ergometer were used for determination of monocyte subsets by flow cytometry. Insulin-resistant obese individuals have a higher percentage of CD16(+) monocytes (14.8 ± 2.4%) than the lean group (10.0 ± 1.3%). A positive correlation of the percentage of CD16(+) monocytes with body mass index and fasting plasma insulin levels was found. One bout of moderate exercise reduced the percentage of CD16(+) monocytes by 10% in all the groups evaluated. Also, the absolute monocyte count, as well as all other leukocyte populations, in lean and obese individuals, increased after exercise. This fact may partially account for the observed reduction in the percentage of CD16(+) cells in response to exercise. Insulin-resistant, but not insulin-sensitive obese individuals, have an increased percentage of CD16(+) monocytes that can be slightly modulated by a single bout of moderate aerobic exercise. These findings may be clinically relevant to the population studied, considering the involvement of CD16(+) monocytes in the pathophysiology of obesity. Copyright © 2016 John Wiley & Sons, Ltd. SIGNIFICANCE OF THE STUDY: Obesity is now considered to be an inflammatory condition associated with many pathological consequences, including insulin resistance. It is proposed that insulin resistance contributes to the aggravation of the inflammatory dysfunction in obesity. The effect of obesity on the percentage of monocytes was previously observed in class II and III obese individuals who presented other alterations in addition to insulin resistance. In this study we observed that insulin-resistant obese individuals, but not insulin-sensitive ones, had an increased percentage of CD14(+) CD16(+) monocytes. This fact shows that a dysfunction of the monocyte percentage in class I obese individuals is only seen when this condition is associated with insulin resistance.

Autophagy in peripheral blood mononuclear cells is associated with body fat percentage.

CONTEXT: Numerous chronic conditions including obesity exhibit autophagic dysfunction. Association of immune cell autophagic marker regulation by body fat percentage (%BF) is unknown. OBJECTIVE: Investigate autophagy activity in peripheral blood mononuclear cells (PBMCs) of adults with distinct %BFs and obesity-related circulating inflammatory markers. MATERIALS AND METHODS: Sixteen individuals (eight males) with %BF above (n = 8, 36.9 ± 3.6 years, 27.1 ± 8.1%BF) and below (n = 8, 37.1 ± 3.7 years, 13.3 ± 3.7%BF) their age- and sex-specific 50th percentile value based on the American College Sports Medicine guidelines participated. Body fat percentage was calculated from hydrostatic weighing. PBMCs were isolated from venous blood, and PBMC autophagic flux markers (LC3-I, LC3-II, and p62) were measured via Western blot. CRP, resistin, leptin, and adiponectin were measured via ELISA. RESULTS: LC3-II/LC3-I ratio correlated with %BF (r=-0.56, p=.023). Insulin (p=.05) and CRP (p=.018) were higher in high %BF participants. DISCUSSION AND CONCLUSIONS: Autophagic activity markers in PBMCs correlate with %BF, but are not different between %BF groups.

The physiological, perceptual, and thermoregulatory responses to facemask use during exercise.

The use of masks in public settings and when around people has been recommended to limit the spread of Coronavirus disease 2019 (COVID-19) by major public health agencies. Several different types of masks classified as either medical- or non-medical grade are commonly used among the public. However, concerns with difficulty breathing, re-breathing exhaled carbon dioxide, a decrease in arterial oxygen saturation, and a decrease in exercise performance have been raised regarding the use of mask during exercise. We review the current knowledge related to the effect of different masks during exercise on cardiorespiratory, metabolic, thermoregulatory, and perceptual responses. As such, the current literature seems to suggest that there are minimal changes to cardiovascular, metabolic, and no changes to thermoregulatory parameters with facemask use. However, differences in ventilatory parameters have been reported with submaximal and maximal intensity exercise to volitional fatigue. Literature on perceptual responses to exercise indicate an impact on ratings of perceived exertion, dyspnea, and overall discomfort dependent on mask use as well as exercise intensity. In conclusion, data from the current literature suggests a minimal impact on physiological, perceptual, and thermoregulatory responses dependent on the type of mask used during exercise.

Reduced running performance and greater perceived exertion, but similar post-exercise neuromuscular fatigue in tropical natives subjected to a 10 km self-paced run in a hot compared to a temperate environment.

Environmental heat stress impairs endurance performance by enhancing exercise-induced physiological and perceptual responses. However, the time course of these responses during self-paced running, particularly when comparing hot and temperate conditions, still needs further clarification. Moreover, monitoring fatigue induced by exercise is paramount to prescribing training and recovery adequately, but investigations on the effects of a hot environment on post-exercise neuromuscular fatigue are scarce. This study compared the time course of physiological and perceptual responses during a 10 km self-paced treadmill run (as fast as possible) between temperate (25°C) and hot (35°C) conditions. We also investigated the changes in countermovement jump (CMJ) performance following exercise in these two ambient temperatures. Thirteen recreational long-distance runners (11 men and 2 women), inhabitants of a tropical region, completed the two experimental trials in a randomized order. Compared to 25°C, participants had transiently higher body core temperature (TCORE) and consistently greater perceived exertion while running at 35°C (p < 0.05). These changes were associated with a slower pace, evidenced by an additional 14 ± 5 min (mean ± SD) to complete the 10 km at 35°C than at 25°C (p < 0.05). Before, immediately after, and 1 h after the self-paced run, the participants performed CMJs to evaluate lower limb neuromuscular fatigue. CMJ height was reduced by 7.0% (2.3 ± 2.4 cm) at 1 h after the race (p < 0.05) compared to pre-exercise values; environmental conditions did not influence this reduction. In conclusion, despite the reduced endurance performance, higher perceived exertion, and transiently augmented TCORE caused by environmental heat stress, post-exercise neuromuscular fatigue is similar between temperate and hot conditions. This finding suggests that the higher external load (faster speed) at 25°C compensates for the effects of more significant perceptual responses at 35°C in inducing neuromuscular fatigue.

Ibuprofen Increases Markers of Intestinal Barrier Injury But Suppresses Inflammation at Rest and After Exercise in Hypoxia.

PURPOSE: The purpose of this study was to evaluate the effects of acute ibuprofen consumption (2 × 600-mg doses) on markers of enterocyte injury, intestinal barrier dysfunction, inflammation, and symptoms of gastrointestinal (GI) distress at rest and after exercise in hypobaric hypoxia. METHODS: Using a randomized double-blind placebo-controlled crossover design, nine men (age, 28 ± 3 yr; weight, 75.4 ± 10.5 kg; height, 175 ± 7 cm; body fat, 12.9% ± 5%; V̇O 2 peak at 440 torr, 3.11 ± 0.65 L·min -1 ) completed a total of three visits including baseline testing and two experimental trials (placebo and ibuprofen) in a hypobaric chamber simulating an altitude of 4300 m. Preexercise and postexercise blood samples were assayed for intestinal fatty acid binding protein (I-FABP), ileal bile acid binding protein, soluble cluster of differentiation 14, lipopolysaccharide binding protein, monocyte chemoattractant protein-1, tumor necrosis factor α (TNF-α), interleukin-1ß, and interleukin-10. Intestinal permeability was assessed using a dual sugar absorption test (urine lactulose-to-rhamnose ratio). RESULTS: Resting I-FABP (906 ± 395 vs 1168 ± 581 pg·mL -1 ; P = 0.008) and soluble cluster of differentiation 14 (1512 ± 297 vs 1642 ± 313 ng·mL -1 ; P = 0.014) were elevated in the ibuprofen trial. Likewise, the urine lactulose-to-rhamnose ratio (0.217 vs 0.295; P = 0.047) and the preexercise to postexercise change in I-FABP (277 ± 308 vs 498 ± 479 pg·mL -1 ; P = 0.021) were greater in the ibuprofen trial. Participants also reported greater upper GI symptoms in the ibuprofen trial ( P = 0.031). However, monocyte chemoattractant protein-1 ( P = 0.007) and TNF-α ( P = 0.047) were lower throughout the ibuprofen trial compared with placebo (main effect of condition). CONCLUSIONS: These data demonstrate that acute ibuprofen ingestion aggravates markers of enterocyte injury and intestinal barrier dysfunction at rest and after exercise in hypoxia. However, ibuprofen seems to suppress circulating markers of inflammation.

A comprehensive evaluation of heat stress and heat strain in a sample of sugarcane cutters in Brazil.

Sugarcane cutters are vulnerable to extreme heat and are at risk for heat-related illness and chronic kidney disease, potentially due to high heat strain. We performed a comprehensive assessment of the physiological demands of sugarcane cutters via measurements of metabolic, thermal, and cardiovascular responses. In addition, we assessed cross-shift changes in markers of kidney function. Nine male sugarcane cutters were monitored while working during the spring harvest season in Brazil. Core temperature (Tcore) and heart rate (HR) were continuously recorded, and oxygen consumption was measured during the work shift. Urine and blood samples were collected pre- and postwork shifts. Total sweat loss was calculated using body weight changes and adjusting for water ingestion and urine output. A wet-bulb globe temperature (WBGT) station was used to monitor environmental heat stress. WBGT was ≥30°C on 7 of the 8 study days. Mean and peak Tcore during the work shift were 37.96 ± 0.47°C and 38.60 ± 0.41°C, respectively, with all participants surpassing a Tcore of 38°C. Mean and peak HR during the work shift were 137 ± 14 and 164 ± 11 beats/min, respectively. Percent of maximal oxygen consumption was, on average, 53 ± 11%. Workers had a total sweat loss of 7.63 ± 2.31 L and ingested 6.04 ± 1.95 L of fluid. Kidney function (estimated glomerular filtration rate) was reduced from pre- to postwork shift (Δ -20 ± 18 mL·min·1.73 m2). We demonstrated that sugarcane cutters performing prolonged work during a period of high environmental heat stress display high levels of heat strain, high water turnover, and reduced kidney function.NEW & NOTEWORTHY We demonstrate that a shift of sugarcane cutting performed outdoors during the spring harvest season results in a high level of heat strain. In fact, all the studied workers sustained core temperatures above 38°C and heart rates above 75% of the measured maximum heart rate. Additionally, workers displayed a high water turnover with sweat loss close to 10% of their body weight. Finally, we report elevated muscle damage and reductions in kidney function following the work shift.

Practicing COVID-19 Public Health Measures Is Associated With Anxiety and Depression in Undergraduate University Students.

Background: COVID-19 has affected mental health globally, increasing depression and anxiety. This study examined relationships between practicing COVID-19-related public health measures and depression and anxiety in young adult students. Methods: A sample of 755 undergraduate students 18-25 years of age at a large public university completed a cross-sectional survey in fall 2020 during the pandemic (response rate = 18.9%). The survey included demographic questions, anxiety and depression screeners (GAD-7 and PHQ-9), and questions on practicing public health measures (stay-at-home orders, quarantining, social distancing, etc.) since March 2020. Multivariate logistic regression was utilized to calculated adjusted odds between practicing public health measures and anxiety and depression. Results: The majority of respondents reported practicing public health measures; however, 53% experienced anxiety (GAD-7 score >10) and 57% experienced depression (PHQ-9 score >10) in the 2 weeks prior to completing the survey. Participants who quarantined had significantly higher odds of anxiety (AOR = 1.44; 95% CL 1.07, 1.96) and depression (AOR = 1.77; 95% CL 1.30, 2.41) than those who did not. Participants who self-isolated also had significantly higher odds of anxiety (AOR = 1.53; 95% CL 1.13, 2.08) and depression (AOR = 1.87; 95% CL 1.37, 2.56) compared to those who did not. Moving/changing living situations in response to the pandemic also increased odds of depression (AOR = 1.86; 95% CL 1.33, 2.60). Conclusion: Young adult undergraduate students experienced a high prevalence of anxiety and depression. Quarantining, self-isolating, and moving/changing living situations increased odds of anxiety and/or depression. The public health measures necessary for COVID-19 control and prevention may adversely affect mental health.

A Latent Class Analysis of Mental Health Severity and Alcohol Consumption: Associations with COVID-19-Related Quarantining, Isolation, Suicidal Ideations, and Physical Activity.

The present study examined latent class cluster group patterns based on measures of depression and anxiety symptom severity and alcohol consumption during the COVID-19 pandemic. Hypothesized correlates with latent class cluster groups including quarantining, self-isolation, suicidal ideations, sitting hours per day, and physical activity (vigorous intensity exercise in minutes per week) were examined. The delimited participant sample consisted of 606 university young adults 18 to 25 years of age (M = 21.24 ± 1.62). Latent cluster analysis (LCA) modeled patterns of depression and anxiety symptom severity and alcohol consumption during the COVID-19 pandemic. Between group analysis and multinomial logistic regression analysis were used to examine relationships between latent class clusters and correlates including quarantining, self-isolation, suicidal ideations, sitting hours per day, and physical activity (vigorous intensity exercise in minutes per week). LCA results showed that six latent cluster groups provided optimal model-to-date fit based on mental health symptom severity and alcohol consumption (L 2 = 56.31, BIC = 5012.79, AIC = 4849.74, and the bootstrap L 2 p-value = .88; Entropy R 2 = .89). Identified latent class clusters were as follows: cluster one = moderate anxiety and depression severity and moderate alcohol consumption (n = 156; 25.7%); cluster two = high mental health severity and alcohol consumption (n = 133; 21.9%); cluster three = low mental health symptoms and moderate alcohol consumption (n = 105; 17.3%); cluster four = lowest mental health severity and alcohol consumption (n = 95; 15.7%); cluster five = moderate depression severity, low anxiety severity, and low alcohol consumptions (n = 74; 12.2%); and cluster six = moderate anxiety severity, low depression severity, and low alcohol consumption (n = 43; 7.1%). Multinomial logistic regression analysis results found that quarantining, self-isolation, suicidal ideations, sedentary behavior, and physical activity were differentially associated with cluster group membership. Findings from this study demonstrate associations between COVID-19 public health restrictions, suicidal ideations, and declines in mental health and increases in alcohol consumption among young adult university students.

A Metabolic Profile of Peripheral Heart Action Training.

Purpose: Peripheral heart action (PHA) is a style of circuit training that alternates upper and lower body resistance exercises with minimal rest between sets. The purpose of this study was to compare the metabolic demands of PHA to traditional hypertrophy training (TRAD) and to provide between sex comparison for both types of resistance training (RT). Methods: Twenty resistance-trained individuals underwent two bouts of volume-load matched RT: PHA and TRAD. We measured oxygen uptake (VO2), heart rate (HR), blood lactate (BL) concentration, rating of perceived exertion (RPE), excess post-exercise oxygen consumption (EPOC), and duration of each session. Results: PHA elicited significantly greater %VO2max (p < .001), %HRmax (p < .001), RPE (p < .001), and EPOC (p < .001) compared to TRAD. PHA was also completed in less time (p < .001). Compared to TRAD, BL was significantly higher at mid-exercise (p < .001), post-exercise (p < .001), and 5-min post-exercise (p < .001) during PHA. There were no between-sex differences for BL at any time-point for TRAD. However, during PHA, BL was significantly higher for males at mid-exercise (p = .04), post-exercise (p = .02), and 5-min post-exercise (p = .002). No between-sex differences were detected for HR, VO2, RPE, or duration for either style of RT. Conclusions: PHA is a time-effective and metabolically demanding circuit that may lead to strength and cardiorespiratory adaptations. Males produced more BL than females during PHA, but not TRAD, suggesting that they incurred more metabolic stress during the bout of circuit training.

Expanding the Gap: An Updated Look Into Sex Differences in Running Performance.

Males consistently outperform females in athletic endeavors, including running events of standard Olympic distances (100 m to Marathon). The magnitude of this percentage sex difference, i.e., the sex gap, has evolved over time. Two clear trends in sex gap evolution are evident; a narrowing of the gap during the 20th century, followed by a period of stability thereafter. However, an updated perspective on the average sex gap from top 20 athlete performances over the past two decades reveals nuanced trends over time, indicating the sex gap is not fixed. Additionally, the sex gap varies with performance level; the difference in absolute running performance between males and females is lowest for world record/world lead performances and increases in lower-ranked elite athletes. This observation of an increased sex gap with world rank is evident in events 400 m and longer and indicates a lower depth in female competitive standards. Explanations for the sex difference in absolute performance and competition depth include physical (physiological, anatomical, neuromuscular, biomechanical), sociocultural, psychological, and sport-specific factors. It is apparent that females are the disadvantaged sex in sport; therefore, measures should be taken to reduce this discrepancy and enable both sexes to reach their biological performance potential. There is scope to narrow the sex performance gap by addressing inequalities between the sexes in opportunities, provisions, incentives, attitudes/perceptions, research, and media representation.