Historical nectar assessment reveals the fall and rise of floral resources in Britain.

There is considerable concern over declines in insect pollinator communities and potential impacts on the pollination of crops and wildflowers. Among the multiple pressures facing pollinators, decreasing floral resources due to habitat loss and degradation has been suggested as a key contributing factor. However, a lack of quantitative data has hampered testing for historical changes in floral resources. Here we show that overall floral rewards can be estimated at a national scale by combining vegetation surveys and direct nectar measurements. We find evidence for substantial losses in nectar resources in England and Wales between the 1930s and 1970s; however, total nectar provision in Great Britain as a whole had stabilized by 1978, and increased from 1998 to 2007. These findings concur with trends in pollinator diversity, which declined in the mid-twentieth century but stabilized more recently. The diversity of nectar sources declined from 1978 to 1990 and thereafter in some habitats, with four plant species accounting for over 50% of national nectar provision in 2007. Calcareous grassland, broadleaved woodland and neutral grassland are the habitats that produce the greatest amount of nectar per unit area from the most diverse sources, whereas arable land is the poorest with respect to amount of nectar per unit area and diversity of nectar sources. Although agri-environment schemes add resources to arable landscapes, their national contribution is low. Owing to their large area, improved grasslands could add substantially to national nectar provision if they were managed to increase floral resource provision. This national-scale assessment of floral resource provision affords new insights into the links between plant and pollinator declines, and offers considerable opportunities for conservation.

Impact of analysis technique on our understanding of the natural history of labour: a simulation study.

OBJECTIVE: To evaluate the discrepancy between historical and more recent descriptions of the first stage of labour by testing whether the statistical techniques used recently (repeated-measures polynomial and interval-censored regression) were appropriate for detection of periods of rapid acceleration of cervical dilatation as might occur at the time of transition from a latent to an active phase of labour. DESIGN AND SETTING: A simulation study using regression techniques. SAMPLE: We created a simulated data set for 500 000 labours with clearly defined latent and active phases using the parameters described by Friedman. Additionally, we created a data set comprising 500 000 labours with a progressively increasing rate of cervical dilatation. METHODS: Repeated-measures polynomial regression was used to create summary labour curves based on simulated cervical examinations. Interval-censored regression was used to create centimetre-by-centimetre estimates of rates of cervical dilatation and their 95th centiles. MAIN OUTCOME MEASURES: Labour summary curves and rates of cervical dilatation. RESULTS: Repeated-measures polynomial regression did not detect the rapid acceleration in cervical dilatation (i.e. acceleration phase) and overestimated lengths of labour, especially at smaller cervical dilatations. There was a two-fold overestimation in the mean rate of cervical dilatation from 4 to 6 cm. Interval-censored regression overestimated median transit times, at 4- to 5-cm cervical dilatation or when cervical examinations occurred less frequently than 0.5- to 1.5-hourly. CONCLUSION: Repeated-measures polynomial regression and interval-censored regression should not be routinely used to define labour progress because they do not accurately reflect the underlying data. TWEETABLE ABSTRACT: Repeated-measures polynomial and interval-censored regression techniques are not appropriate to model first stage of labour.

Transverse motions in sunspot super-penumbral fibrils.

Sunspots have played a key role in aiding our understanding of magnetohydrodynamic (MHD) wave phenomena in the Sun's atmosphere, and it is well known they demonstrate a number of wave phenomena associated with slow MHD modes. Recent studies have shown that transverse wave modes are present throughout the majority of the chromosphere. Using high-resolution Ca II 8542 Å observations from the Swedish Solar Telescope, we provide the first demonstration that the chromospheric super-penumbral fibrils, which span out from the sunspot, also show ubiquitous transverse motions. We interpret these motions as transverse waves, in particular the MHD kink mode. We compile the statistical properties of over 2000 transverse motions to find distributions for periods and amplitudes, finding they are broadly consistent with previous observations of chromospheric transverse waves in quiet Sun fibrils. The very presence of the waves in super-penumbral fibrils raises important questions about how they are generated, and could have implications for our understanding of how MHD wave energy is transferred through the atmosphere of a sunspot. This article is part of the Theo Murphy meeting issue 'High-resolution wave dynamics in the lower solar atmosphere'.

An overall view of temperature oscillations in the solar chromosphere with ALMA.

By direct measurements of the gas temperature, the Atacama Large Millimeter/submillimeter Array (ALMA) has yielded a new diagnostic tool to study the solar chromosphere. Here, we present an overview of the brightness-temperature fluctuations from several high-quality and high-temporal-resolution (i.e. 1 and 2 s cadence) time series of images obtained during the first 2 years of solar observations with ALMA, in Band 3 and Band 6, centred at around 3 mm (100 GHz) and 1.25 mm (239 GHz), respectively. The various datasets represent solar regions with different levels of magnetic flux. We perform fast Fourier and Lomb-Scargle transforms to measure both the spatial structuring of dominant frequencies and the average global frequency distributions of the oscillations (i.e. averaged over the entire field of view). We find that the observed frequencies significantly vary from one dataset to another, which is discussed in terms of the solar regions captured by the observations (i.e. linked to their underlying magnetic topology). While the presence of enhanced power within the frequency range 3-5 mHz is found for the most magnetically quiescent datasets, lower frequencies dominate when there is significant influence from strong underlying magnetic field concentrations (present inside and/or in the immediate vicinity of the observed field of view). We discuss here a number of reasons which could possibly contribute to the power suppression at around 5.5 mHz in the ALMA observations. However, it remains unclear how other chromospheric diagnostics (with an exception of Hα line-core intensity) are unaffected by similar effects, i.e. they show very pronounced 3-min oscillations dominating the dynamics of the chromosphere, whereas only a very small fraction of all the pixels in the 10 ALMA datasets analysed here show peak power near 5.5 mHz. This article is part of the Theo Murphy meeting issue 'High-resolution wave dynamics in the lower solar atmosphere'.

Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial.

BACKGROUND: This multicentre, randomised, double-blinded, placebo-controlled, phase II/III trial aimed to evaluate an oral THC:CBD (tetrahydrocannabinol:cannabidiol) cannabis extract for prevention of refractory chemotherapy-induced nausea and vomiting (CINV). Here we report the phase II component results. PATIENTS AND METHODS: Eligible patients experienced CINV during moderate-to-high emetogenic intravenous chemotherapy despite guideline-consistent antiemetic prophylaxis. Study treatment consisted of one cycle of 1-4 self-titrated capsules of oral THC 2.5 mg/CBD 2.5 mg (TN-TC11M) three times daily, from days -1 to 5, and 1 cycle of matching placebo in a crossover design, then blinded patient preference for a third cycle. The primary end point was the proportion of participants with complete response during 0-120 h from chemotherapy. A total of 80 participants provided 80% power to detect a 20% absolute improvement with a two-sided P value of 0.1. RESULTS: A total of 81 participants were randomised; 72 completing two cycles were included in the efficacy analyses and 78 not withdrawing consent were included in safety analyses. Median age was 55 years (range 29-80 years); 78% were female. Complete response was improved with THC:CBD from 14% to 25% (relative risk 1.77, 90% confidence interval 1.12-2.79, P = 0.041), with similar effects on absence of emesis, use of rescue medications, absence of significant nausea, and summary scores for the Functional Living Index-Emesis (FLIE). Thirty-one percent experienced moderate or severe cannabinoid-related adverse events such as sedation, dizziness, or disorientation, but 83% of participants preferred cannabis to placebo. No serious adverse events were attributed to THC:CBD. CONCLUSION: The addition of oral THC:CBD to standard antiemetics was associated with less nausea and vomiting but additional side-effects. Most participants preferred THC:CBD to placebo. Based on these promising results, we plan to recruit an additional 170 participants to complete accrual for the definitive, phase III, parallel group analysis. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12616001036404; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370473&isReview=true.

Benefits of a brief psychological intervention targeting fear of cancer recurrence in people at high risk of developing another melanoma: 12-month follow-up results of a randomized controlled trial.

BACKGROUND: People with melanoma want and need effective interventions for living with fear of cancer recurrence (FCR). OBJECTIVES: This study reports the 12-month outcomes of a brief, psychological intervention designed to reduce FCR in people at high risk of developing another primary melanoma compared with usual care. METHODS: In this two-arm randomized controlled trial, adults previously diagnosed with stage 0, I or II melanoma were randomly allocated to the intervention (n = 80) or control (usual care) arm (n = 84). The trial was registered with the Australian and New Zealand Clinical Trials Registry on 19 March 2013 (registration: ACTRN12613000304730). The intervention comprised a 76-page psychoeducational resource and three individually tailored, telephone-based sessions with a psychologist, scheduled at specific time points around participants' dermatological appointments. The primary outcome was the level of self-reported fear of new or recurrent melanoma assessed at 12 months postintervention using the severity subscale of the Fear of Cancer Recurrence Inventory. RESULTS: Compared with the control arm, the intervention group reported significantly lower FCR at 12 months postintervention; the between-group mean difference was -1·41 for FCR severity [95% confidence interval (CI) -2·6 to -0·2; P = 0·02] and -1·32 for FCR triggers (95% CI -2·6 to -0·02; P = 0·04). The odds ratio for FCR severity scores ≥13 (54% intervention, 63% control) was 0·59 (95% CI 0·30-1·14, P = 0·12). There were no differences between groups in secondary outcomes, such as anxiety, depression or health-related quality of life. CONCLUSIONS: The previously reported 6-month benefits of this brief, patient-centred psychological intervention in reducing FCR were found to continue 12 months postintervention, with no known adverse effects, supporting implementation as part of routine melanoma care.

Potential and limitation of air pollution mitigation by vegetation and uncertainties of deposition-based evaluations.

The potential to capture additional air pollutants by introducing more vegetation or changing existing short vegetation to woodland on first sight provides an attractive route for lowering urban pollution. Here, an atmospheric chemistry and transport model was run with a range of landcover scenarios to quantify pollutant removal by the existing total UK vegetation as well as the UK urban vegetation and to quantify the effect of large-scale urban tree planting on urban air pollution. UK vegetation as a whole reduces area (population)-weighted concentrations significantly, by 10% (9%) for PM2.5, 30% (22%) for SO2, 24% (19%) for NH3 and 15% (13%) for O3, compared with a desert scenario. By contrast, urban vegetation reduces average urban PM2.5 by only approximately 1%. Even large-scale conversion of half of existing open urban greenspace to forest would lower urban PM2.5 by only another 1%, suggesting that the effect on air quality needs to be considered in the context of the wider benefits of urban tree planting, e.g. on physical and mental health. The net benefits of UK vegetation for NO2 are small, and urban tree planting is even forecast to increase urban NO2 and NOx concentrations, due to the chemical interaction with changes in BVOC emissions and O3, but the details depend on tree species selection. By extrapolation, green infrastructure projects focusing on non-greenspace (roadside trees, green walls, roof-top gardens) would have to be implemented at very large scales to match this effect. Downscaling of the results to micro-interventions solely aimed at pollutant removal suggests that their impact is too limited for their cost-benefit analysis to compare favourably with emission abatement measures. Urban vegetation planting is less effective for lowering pollution than measures to reduce emissions at source. The results highlight interactions that cannot be captured if benefits are quantified via deposition models using prescribed concentrations, and emission damage costs. This article is part of a discussion meeting issue 'Air quality, past present and future'.

A systematic review and meta-analysis of utility estimates in melanoma.

BACKGROUND: Health-related quality of life (HRQOL) in melanoma is affected by cancer stage. Previous studies have reported limited data on utility-based HRQOL. OBJECTIVES: To determine pooled estimates of utility-based HRQOL (utilities) for people with American Joint Cancer Committee stage I/II, III or IV melanoma for use in economic evaluations. METHODS: We performed a systematic review, meta-analysis and metaregression of utilities for patients with melanoma. HRQOL scores reported with the QLQ-C30, SF-36, SF-12, FACT-G and FACT-M instruments were converted to utilities using published mapping algorithms. Meta-analysis was used to calculate mean utilities. Metaregression was used to examine the effects of baseline patient and study characteristics. RESULTS: We identified 33 studies reporting 213 utilities. From meta-analyses, the mean utility for stage I/II melanoma was 0·97 [95% confidence interval (CI) 0·90-0·98]; for stage III melanoma it was 0·77 (95% CI 0·70-0·83); for stage III/IV 0·76 (95% CI 0·76-0·77); and for stage IV melanoma 0·76 (95% CI 0·71-0·81). The difference in utility between stage III and stage IV was not statistically significant (P = 0·52). For patients with stage I/II, the utility estimate at the time of surgery was 0·77 (95% CI 0·75-0·79), and at 3-12 months postsurgery it was 0·85 (95% CI 0·84-0·86). Utility estimates for patients with stage IV melanoma were 0·65 (95% CI 0·62-0·69) during the first 3 months of treatment and 0·83 (95% CI 0·81-0·86) at 4-12 months on treatment. For patients with stage IV melanoma treated with chemotherapy, the utility estimate was 0·52 (95% CI 0·51-0·52), while for those treated with targeted therapy it was 0·83 (95% CI 0·82-0·85). CONCLUSIONS: These robust, evidence-based estimates of health state utility can be used in economic evaluations of new treatments for patients with early-stage or advanced-stage melanoma.

A review of international clinical practice guidelines for the use of oxygen in the delivery room resuscitation of preterm infants.

AIM: To collate and assess international clinical practice guidelines (CPG) to determine current recommendations guiding oxygen management for respiratory stabilisation of preterm infants at delivery. METHODS: A search of public databases using the terms 'clinical practice guidelines', 'preterm', 'oxygen' and 'resuscitation' was made and complemented by direct query to consensus groups, resuscitation expert committees and clinicians. Data were extracted to include the three criteria for assessment: country of origin, gestation and initial FiO2 and target SpO2 for the first 10 minutes of life. RESULTS: A total of 45 CPGs were identified: 36 provided gestation specific recommendations (<28 to <37 weeks) while eight distinguished only between 'preterm' and 'term'. The most frequently recommended initial FiO2 were between 0.21 and 0.3 (n = 17). Most countries suggested altering FiO2 to meet SpO2 targets recommended by expert committees, However, specific five-minute SpO2 targets differed by up to 20% (70-90%) between guidelines. Five countries did not specify SpO2 targets. CONCLUSION: CPG recommendations for delivery room oxygen management of preterm infants vary greatly, particularly in regard to gestational ages, initial FiO2 and SpO2 targets and most acknowledge the lack of evidence behind these recommendations. Sufficiently large and well-designed randomised studies are needed to inform on this important practice.

Does personalized melanoma genomic risk information trigger conversations about skin cancer prevention and skin examination with family, friends and health professionals?

BACKGROUND: Receiving information about genomic risk of melanoma might trigger conversations about skin cancer prevention and skin examinations. OBJECTIVES: To explore conversations prompted by receiving personalized genomic risk of melanoma with family, friends and health professionals. METHODS: We used a mixed-methods approach. Participants without a personal history and unselected for a family history of melanoma (n = 103, aged 21-69 years, 53% women) completed questionnaires 3 months after receiving a personalized melanoma genomic risk assessment. Semistructured interviews were undertaken with 30 participants in high, average and low genomic risk categories, and data were analysed thematically. RESULTS: From the questionnaires, 74% of participants communicated their genomic risk information with family, and 49% with friends. Communication with a health professional differed by risk level: 41%, 16% and 12% for high, average and low risk, respectively (P = 0·01). Qualitative analysis showed that perceived 'shared risk' and perceived interest of family and friends were motivations for discussing risk or prevention behaviours. The information prompted conversations with family and health professionals about sun protection and skin checks, and general conversations about melanoma risk with friends. Reasons for not discussing with family included existing personal or family health concerns, or existing high levels of sun protection behaviour among family members. CONCLUSIONS: Personalized melanoma genomic risk information can prompt risk-appropriate discussions about skin cancer prevention and skin examinations with family and health professionals. Sharing this information with others might increase its impact on melanoma prevention and skin examination behaviours, and this process could be used to encourage healthy behaviour change within families.

The influence of zero-hours contracts on care worker well-being.

BACKGROUND: Care workers have an important social role which is set to expand with the increasing age of the UK population. However, the majority of care workers are employed on zero-hours contracts. AIMS: Firstly, to investigate the relationship between working conditions and employee outcomes such as engagement and general mental well-being in a sample of UK care workers and management. Secondly, to assess whether the use of zero-hours contracts affects employee well-being. METHODS: A cross-sectional survey of domiciliary care and care home employees, undertaken using the Management Standards Indicator Tool (MSIT), Utrecht Work Engagement Scale (UWES) and General Health Questionnaire (GHQ). T-tests and multivariate linear regression evaluated the differences in scoring between those with differing contractual conditions and job roles, and associations of MSIT scores with UWES and GHQ factors. RESULTS: Employee understanding of their role and job control were found to be priority areas for improvement in the sample. Similarly, care workers reported greater occupational demands and lower levels of control than management. However, while zero-hours contracts did not significantly influence employee well-being, these employees had greater levels of engagement in their jobs. Despite this, a greater proportion of individuals with zero-hours contracts had scores above accepted mental health cut-offs. CONCLUSIONS: Individual understanding of their role as care workers appears to play an important part in determining engagement and general mental well-being. However, more research is needed on the influence of zero-hours contracts on well-being, particularly in groups with increased likelihood of developing mental health disorders.

Misuse of "Power" and Other Mechanical Terms in Sport and Exercise Science Research.

Despite the Système International d'Unitès (SI) that was published in 1960, there continues to be widespread misuse of the terms and nomenclature of mechanics in descriptions of exercise performance. Misuse applies principally to failure to distinguish between mass and weight, velocity and speed, and especially the terms "work" and "power." These terms are incorrectly applied across the spectrum from high-intensity short-duration to long-duration endurance exercise. This review identifies these misapplications and proposes solutions. Solutions include adoption of the term "intensity" in descriptions and categorizations of challenge imposed on an individual as they perform exercise, followed by correct use of SI terms and units appropriate to the specific kind of exercise performed. Such adoption must occur by authors and reviewers of sport and exercise research reports to satisfy the principles and practices of science and for the field to advance.

The impact of over 80 years of land cover changes on bee and wasp pollinator communities in England.

Change in land cover is thought to be one of the key drivers of pollinator declines, and yet there is a dearth of studies exploring the relationships between historical changes in land cover and shifts in pollinator communities. Here, we explore, for the first time, land cover changes in England over more than 80 years, and relate them to concurrent shifts in bee and wasp species richness and community composition. Using historical data from 14 sites across four counties, we quantify the key land cover changes within and around these sites and estimate the changes in richness and composition of pollinators. Land cover changes within sites, as well as changes within a 1 km radius outside the sites, have significant effects on richness and composition of bee and wasp species, with changes in edge habitats between major land classes also having a key influence. Our results highlight not just the land cover changes that may be detrimental to pollinator communities, but also provide an insight into how increases in habitat diversity may benefit species diversity, and could thus help inform policy and practice for future land management.

Clinical practice guidelines for identification, screening and follow-up of individuals at high risk of primary cutaneous melanoma: a systematic review.

Understanding how individuals at high-risk of primary cutaneous melanoma are best identified, screened and followed up will help optimize melanoma prevention strategies and clinical management. We conducted a systematic review of international clinical practice guidelines and documented the quality of supporting evidence for recommendations for clinical management of individuals at high risk of melanoma. Guidelines published between January 2000 and July 2014 were identified from a systematic search of Medline, Embase and four guideline databases; 34 guidelines from 20 countries were included. High-risk characteristics that were consistently reported included many melanocytic naevi, dysplastic naevi, family history, large congenital naevi, and Fitzpatrick Type I and II skin types. Most guidelines identify risk factors and recommend that individuals at high risk of cutaneous melanoma be monitored, but only half of the guidelines provide recommendations for screening based on level of risk. There is disagreement in screening and follow-up recommendations for those with an increased risk of future melanoma. High-level evidence supports long-term screening of individuals at high risk and monitoring using dermoscopy. Evidence is low for defining screening intervals and duration of follow-up, and for skin self-examination, although education about skin self-examination is widely encouraged. Clinical practice guidelines would benefit from a dedicated section for identification, screening and follow-up of individuals at high risk of melanoma. Guidelines could be improved with clear definitions of multiple naevi, family history and frequency of follow-up. Research examining the benefits and costs of alternative management strategies for groups at high risk will enhance the quality of recommendations.

A reliable preloaded cycling time trial for use in conditions of significant thermal stress.

The purpose of this study was to assess the reliability of a 15-min time trial preloaded with 45 min of fixed-intensity cycling under laboratory conditions of thermal stress. Eight trained cyclists/triathletes (41 ± 10 years, VO2 peak: 69 ± 8 mL/kg/min, peak aerobic power: 391 ± 72 W) completed three trials (the first a familiarization) where they cycled at ∼ 55% VO2 peak for 45 min followed by a 15-min time trial (∼75% VO2 peak) under conditions of significant thermal stress (WBGT: 26.7 ± 0.8 °C, frontal convective airflow: 20 km/h). Seven days separated the trials, which were conducted at the same time of day following 24 h of exercise and dietary control. Reliability increased when a familiarization trial was performed, with the resulting coefficient of variation and intraclass correlation coefficient of the work completed during the 15-min time trial, 3.6% and 0.96, respectively. Therefore, these results demonstrate a high level of reliability for a 15-min cycling time trial following a 45-min preload when performed under laboratory conditions of significant thermal stress using trained cyclists/triathletes.

Cost to government and society of chronic kidney disease stage 1-5: a national cohort study.

BACKGROUND: Costs associated with chronic kidney disease (CKD) are not well documented. Understanding such costs is important to inform economic evaluations of prevention strategies and treatment options. AIM: To estimate the costs associated with CKD in Australia. METHODS: We used data from the 2004/2005 AusDiab study, a national longitudinal population-based study of non-institutionalised Australian adults aged ≥25 years. We included 6138 participants with CKD, diabetes and healthcare cost data. The annual age and sex-adjusted costs per person were estimated using a generalised linear model. Costs were inflated from 2005 to 2012 Australian dollars using best practice methods. RESULTS: Among 6138 study participants, there was a significant difference in the per-person annual direct healthcare costs by CKD status, increasing from $1829 (95% confidence interval (CI): $1740-1943) for those without CKD to $14 545 (95% CI: $5680-44 842) for those with stage 4 or 5 CKD (P < 0.01). Similarly, there was a significant difference in the per-person annual direct non-healthcare costs by CKD status from $524 (95% CI: $413-641) for those without CKD to $2349 (95% CI: $386-5156) for those with stage 4 or 5 CKD (P < 0.01). Diabetes is a common cause of CKD and is associated with increased health costs. Costs per person were higher for those with diabetes than those without diabetes in all CKD groups; however, this was significant only for those without CKD and those with early stage (stage 1 or 2) CKD. CONCLUSION: Individuals with CKD incur 85% higher healthcare costs and 50% higher government subsidies than individuals without CKD, and costs increase by CKD stage. Primary and secondary prevention strategies may reduce costs and warrant further consideration.

Strength training increases endurance time to exhaustion during high-intensity exercise despite no change in critical power.

The purpose of this study was to determine whether improvements in endurance exercise performance elicited by strength training were accurately reflected by changes in parameters of the power-duration hyperbola for high-intensity exercise. Before and after 8 weeks of strength training (N = 14) or no exercise, control (N = 5), 19 males (age: 20.6 ± 2.0 years; weight: 78.2 ± 15.9 kg) performed a maximal incremental exercise test on a cycle ergometer and also cycled to exhaustion during 4 constant-power exercise bouts. Critical power (CP) and anaerobic work capacity (W') were estimated using nonlinear and linear models. Subjects in the strength training group improved significantly more than controls (p < 0.05) for strength (~30%), power at V[Combining Dot Above]O2peak (7.9%), and time to exhaustion (TTE) for all 4 constant-power tests (~39%). Contrary to our hypothesis, CP did not change significantly after strength training (p > 0.05 for all models). Strength training improved W' (mean range of improvement = +5.8 to +10.0 kJ; p < 0.05) for both linear models. Increases in W' were consistently positively correlated with improvements in TTE, whereas changes in CP were not. Our findings indicate that strength training alters the power-duration hyperbola such that W' is enhanced without any improvement in CP. Consequently, CP may not be robust enough to track changes in endurance capacity elicited by strength training, and we do not recommend it to be used for this purpose. Conversely, W' may be the better indicator of improvement in endurance performance elicited by strength training.

Increasing humidity affects thermoregulation during low-intensity exercise in women.

INTRODUCTION: Women increasingly occupy manual labor jobs. However, research examining women working under hot-humid conditions is lacking. Therefore, the purpose of our study was to assess how increasing relative humidity (RH) affects women's thermoregulation during low-intensity exercise characteristic of 8 h self-paced manual labor. METHODS: There were 10 women (age: 23 ± 2 yr; body-surface area: 1.68 ± 0.13 m²; Vo2max: 46 ± 6 ml · kg⁻¹ · min⁻¹) who walked 90 min at 35% Vo2max in 35°C at 55% RH (55RH), 70% RH (70RH), and 85% RH (85RH). Investigators obtained: 1) rectal temperature (Tre), mean-weighted skin temperature (Tsk), and heart rate every 5 min; and 2) respiratory measures every 30 min. RESULTS: Heat production (H) and required rate of evaporative cooling (Ereq) remained constant among trials; each RH increment significantly decreased evaporative heat loss (E), but increased heart rate and sweat rate. All other calorimetric and thermometric variables were similar between 55RH and 70RH, but significantly greater in 85RH. Tre only exceeded 38°C in 85RH after walking ∼80 min. Combined, dry and respiratory heat losses only compensated for <30% of the decreases in E. CONCLUSION: Women exercising at low intensities in 35°C experienced most statistically significant physiological changes after 70RH. As H and Ereq remained constant across trials, heat storage increased with each 15% rise in RH because dry and respiratory heat losses minimally offset decreased E. Higher Tre, Tsk, and resultantly higher sweat rates reflected heat storage increases as E decreased in each trial. Overall, at 35°C Ta, we found women exercising for 90 min at low intensities remained at safe rectal temperatures up to 70% RH.

The sustainability of VO2max: effect of decreasing the workload.

The study examined the maintenance of VO(2max) using VO(2max) as the controlling variable instead of power. Therefore, ten subjects performed three exhaustive cycling exercise bouts: (1) an incremental test to determine VO(2max) and the minimal power at VO(2max) (PVO(max)), (2) a constant-power test at PVO(max) and (3) a variable-power test (VPT) during which power was varied to control VO(2) at VO(2max). Stroke volume (SV) was measured by impedance in each test and the stroke volume reserve was calculated as the difference between the maximal and the average 5-s SV. Average power during VPT was significantly lower than PVO(max) (238 ± 79 vs. 305 ± 86 W; p < 0.0001). All subjects, regardless of their VO(2max) values and/or their ability to achieve a VO(2max) plateau during incremental test, were able to sustain VO(2max) for a significantly longer time during VPT compared to constant-power test (CPT) (958 ± 368 s vs. 136 ± 81 s; p < 0.0001). Time to exhaustion at VO(2max) during VPT was correlated with the power drop in the first quarter of the time to exhaustion at VO(2max) (r = 0.71; p < 0.02) and with the stroke volume reserve (r = 0.70, p = 0.02) but was not correlated with VO(2max). This protocol, using VO(2max) rather than power as the controlling variable, demonstrates that the maintenance of exercise at VO(2max) can exceed 15 min independent of the VO(2max) value, suggesting that the ability to sustain exercise at VO(2max) has different limiting factors than those related to the VO(2max) value.