Efficiency of three cooling methods for hyperthermic military personnel linked to water availability.

PURPOSE: Three feasible cooling methods for treatment of hyperthermic individuals in the military, that differed considerably in water volume needed (none to ~80 L), were evaluated. METHODS: Ten male soldiers were cooled following exercise-induced hyperthermia (rectal temperature (Tre) ∼39.5 °C) using ventilation by fanning (1.7 m s-1), ventilation by fanning (1.7 m s-1) while wearing a wet t-shirt (250 mL-27 °C water) and tarp assisted cooling with oscillations (80 L of 27.2 ± 0.5 °C water; TACO). RESULTS: Cooling rates were higher using TACO (0.116 ± 0.032 °C min-1) compared to ventilation (0.065 ± 0.011 °C min-1, P<0.001) and ventilation in combination with a wet t-shirt (0.074 ± 0.020 °C min-1, P=0.002). Time to cool (TTC) to Tre=38.2 °C for TACO was shorter (14 ± 4 min) compared to ventilation only (20 ± 5 min; P=0.018), but not to ventilation while wearing a wet t-shirt (18 ± 6 min; P=0.090). CONCLUSIONS: TACO may be an acceptable, efficient and feasible cooling method in case of exertional heat stroke. However, in case of limited water availability, transportat should be prioritized, and cooling of any form should be implemented while waiting for and during transport.

Heat Strain and Use of Heat Mitigation Strategies among COVID-19 Healthcare Workers Wearing Personal Protective Equipment-A Retrospective Study.

The combination of an exacerbated workload and impermeable nature of the personal protective equipment (PPE) worn by COVID-19 healthcare workers increases heat strain. We aimed to compare the prevalence of heat strain symptoms before (routine care without PPE) versus during the COVID-19 pandemic (COVID-19 care with PPE), identify risk factors associated with experiencing heat strain, and evaluate the access to and use of heat mitigation strategies. Dutch healthcare workers (n = 791) working at COVID-19 wards for ≥1 week, completed an online questionnaire to assess personal characteristics, heat strain symptoms before and during the COVID-19 pandemic, and the access to and use of heat mitigation strategies. Healthcare workers experienced ~25× more often heat strain symptoms during medical duties with PPE (93% of healthcare workers) compared to without PPE (30% of healthcare workers; OR = 25.57 (95% CI = 18.17-35.98)). Female healthcare workers and those with an age <40 years were most affected by heat strain, whereas exposure time and sports activity level were not significantly associated with heat strain prevalence. Cold drinks and ice slurry ingestion were the most frequently used heat mitigation strategies and were available in 63.5% and 30.1% of participants, respectively. Our findings indicate that heat strain is a major challenge for COVID-19 healthcare workers, and heat mitigations strategies are often used to counteract heat strain.

Training-Induced Muscle Adaptations During Competitive Preparation in Elite Female Rowers.

Training-induced adaptations in muscle morphology, including their magnitude and individual variation, remain relatively unknown in elite athletes. We reported changes in rowing performance and muscle morphology during the general and competitive preparation phases in elite rowers. Nineteen female rowers completed 8 weeks of general preparation, including concurrent endurance and high-load resistance training (HLRT). Seven rowers were monitored during a subsequent 16 weeks of competitive preparation, including concurrent endurance and resistance training with additional plyometric loading (APL). Vastus lateralis muscle volume, physiological cross-sectional area (PCSA), fascicle length, and pennation angle were measured using 3D ultrasonography. Rowing ergometer power output was measured as mean power in the final 4 minutes of an incremental test. Rowing ergometer power output improved during general preparation [+2 ± 2%, effect size (ES) = 0.22, P = 0.004], while fascicle length decreased (-5 ± 8%, ES = -0.47, P = 0.020). Rowing power output further improved during competitive preparation (+5 ± 3%, ES = 0.52, P = 0.010). Here, morphological adaptations were not significant, but demonstrated large ESs for fascicle length (+13 ± 19%, ES = 0.93), medium for pennation angle (-9 ± 15%, ES = -0.71), and small for muscle volume (+8 ± 13%, ES = 0.32). Importantly, rowers showed large individual differences in their training-induced muscle adaptations. In conclusion, vastus lateralis muscles of elite female athletes are highly adaptive to specific training stimuli, and adaptations largely differ between individual athletes. Therefore, coaches are encouraged to closely monitor their athletes' individual (muscle) adaptations to better evaluate the effectiveness of their training programs and finetune them to the athlete's individual needs.

Cycling at Altitude: Lower Absolute Power Output as the Main Cause of Lower Gross Efficiency.

BACKGROUND: Although cyclists often compete at altitude, the effect of altitude on gross efficiency (GE) remains inconclusive. PURPOSE: To investigate the effect of altitude on GE at the same relative exercise intensity and at the same absolute power output (PO) and to determine the effect of altitude on the change in GE during high-intensity exercise. METHODS: Twenty-one trained men performed 3 maximal incremental tests and 5 GE tests at sea level, 1500 m, and 2500 m of acute simulated altitude. The GE tests at altitude were performed once at the same relative exercise intensity and once at the same absolute PO as at sea level. RESULTS: Altitude resulted in an unclear effect at 1500 m (-3.8%; ±3.3% [90% confidence limit]) and most likely negative effect at 2500 m (-6.3%; ±1.7%) on pre-GE, when determined at the same relative exercise intensity. When pre-GE was determined at the same absolute PO, unclear differences in GE were found (-1.5%; ±2.6% at 1500 m; -1.7%; ±2.4% at 2500 m). The effect of altitude on the decrease in GE during high-intensity exercise was unclear when determined at the same relative exercise intensity (-0.4%; ±2.8% at 1500 m; -0.7%; ±1.9% at 2500 m). When GE was determined at the same absolute PO, altitude resulted in a substantially smaller decrease in GE (2.8%; ±2.4% at 1500 m; 5.5%; ±2.9% at 2500 m). CONCLUSION: The lower GE found at altitude when exercise is performed at the same relative exercise intensity is mainly caused by the lower PO at which cyclists exercise.

Recovery of Cycling Gross Efficiency After Time-Trial Exercise.

BACKGROUND: Research has shown that gross efficiency (GE) declines during high-intensity exercise, but the time course of recovery of GE after high-intensity exercise has not yet been investigated. PURPOSE: To determine the time course of the recovery of GE after time trials (TTs) of different lengths. METHODS: Nineteen trained male cyclists participated in this study. Before and after TTs of 2000 and 20,000 m, subjects performed submaximal exercise at 55% of the power output attained at maximal oxygen uptake (PVO2max). The postmeasurement continued until 30 min after the end of the TT, during which GE was determined over 3-min intervals. The magnitude-based-inferences approach was used for statistical analysis. RESULTS: GE decreased substantially during the 2000-m and 20,000-m TTs (-11.8% [3.6%] and -6.2% [4.0%], respectively). A most likely and very likely recovery of GE was found during the first half of the submaximal exercise bout performed after the 2000-m, with only a possible increase in GE during the first part of the submaximal exercise bout performed after the 20,000-m. After both distances, GE did not fully recover to the initial pre-TT values, as the difference between the pre-TT value and average GE value of minutes 26-29 was still most likely negative for both the 2000- and 20,000-m (-6.1% [2.8%] and -7.0% [4.5%], respectively). CONCLUSIONS: It is impossible to fully recover GE after TTs of 2000- or 20,000-m during 30 min of submaximal cycling exercise performed at an intensity of 55% PVO2max.

Muscle morphology of the vastus lateralis is strongly related to ergometer performance, sprint capacity and endurance capacity in Olympic rowers.

Rowers need to combine high sprint and endurance capacities. Muscle morphology largely explains muscle power generating capacity, however, little is known on how muscle morphology relates to rowing performance measures. The aim was to determine how muscle morphology of the vastus lateralis relates to rowing ergometer performance, sprint and endurance capacity of Olympic rowers. Eighteen rowers (12♂, 6♀, who competed at 2016 Olympics) performed an incremental rowing test to obtain maximal oxygen consumption, reflecting endurance capacity. Sprint capacity was assessed by Wingate cycling peak power. M. vastus lateralis morphology (volume, physiological cross-sectional area, fascicle length and pennation angle) was derived from 3-dimensional ultrasound imaging. Thirteen rowers (7♂, 6♀) completed a 2000-m rowing ergometer time trial. Muscle volume largely explained variance in 2000-m rowing performance (R2 = 0.85), maximal oxygen consumption (R2 = 0.65), and Wingate peak power (R2 = 0.82). When normalized for differences in body size, maximal oxygen consumption and Wingate peak power were negatively related in males (r = -0.94). Fascicle length, not physiological cross-sectional area, attributed to normalized peak power. In conclusion, vastus lateralis volume largely explains variance in rowing ergometer performance, sprint and endurance capacity. For a high normalized sprint capacity, athletes may benefit from long fascicles rather than a large physiological cross-sectional area.

Critical determinants of combined sprint and endurance performance: an integrative analysis from muscle fiber to the human body.

Optimizing physical performance is a major goal in current physiology. However, basic understanding of combining high sprint and endurance performance is currently lacking. This study identifies critical determinants of combined sprint and endurance performance using multiple regression analyses of physiologic determinants at different biologic levels. Cyclists, including 6 international sprint, 8 team pursuit, and 14 road cyclists, completed a Wingate test and 15-km time trial to obtain sprint and endurance performance results, respectively. Performance was normalized to lean body mass2/3 to eliminate the influence of body size. Performance determinants were obtained from whole-body oxygen consumption, blood sampling, knee-extensor maximal force, muscle oxygenation, whole-muscle morphology, and muscle fiber histochemistry of musculus vastus lateralis. Normalized sprint performance was explained by percentage of fast-type fibers and muscle volume ( R2 = 0.65; P < 0.001) and normalized endurance performance by performance oxygen consumption ( V̇o2), mean corpuscular hemoglobin concentration, and muscle oxygenation ( R2 = 0.92; P < 0.001). Combined sprint and endurance performance was explained by gross efficiency, performance V̇o2, and likely by muscle volume and fascicle length ( P = 0.056; P = 0.059). High performance V̇o2 related to a high oxidative capacity, high capillarization × myoglobin, and small physiologic cross-sectional area ( R2 = 0.67; P < 0.001). Results suggest that fascicle length and capillarization are important targets for training to optimize sprint and endurance performance simultaneously.-Van der Zwaard, S., van der Laarse, W. J., Weide, G., Bloemers, F. W., Hofmijster, M. J., Levels, K., Noordhof, D. A., de Koning, J. J., de Ruiter, C. J., Jaspers, R. T. Critical determinants of combined sprint and endurance performance: an integrative analysis from muscle fiber to the human body.

Oxygenation Threshold Derived from Near-Infrared Spectroscopy: Reliability and Its Relationship with the First Ventilatory Threshold.

BACKGROUND: Near-infrared spectroscopy (NIRS) measurements of oxygenation reflect O2 delivery and utilization in exercising muscle and may improve detection of a critical exercise threshold. PURPOSE: First, to detect an oxygenation breakpoint (Δ[O2HbMb-HHbMb]-BP) and compare this breakpoint to ventilatory thresholds during a maximal incremental test across sexes and training status. Second, to assess reproducibility of NIRS signals and exercise thresholds and investigate confounding effects of adipose tissue thickness on NIRS measurements. METHODS: Forty subjects (10 trained male cyclists, 10 trained female cyclists, 11 endurance trained males and 9 recreationally trained males) performed maximal incremental cycling exercise to determine Δ[O2HbMb-HHbMb]-BP and ventilatory thresholds (VT1 and VT2). Muscle haemoglobin and myoglobin O2 oxygenation ([HHbMb], [O2HbMb], SmO2) was determined in m. vastus lateralis. Δ[O2HbMb-HHbMb]-BP was determined by double linear regression. Trained cyclists performed the maximal incremental test twice to assess reproducibility. Adipose tissue thickness (ATT) was determined by skinfold measurements. RESULTS: Δ[O2HbMb-HHbMb]-BP was not different from VT1, but only moderately related (r = 0.58-0.63, p<0.001). VT1 was different across sexes and training status, whereas Δ[O2HbMb-HHbMb]-BP differed only across sexes. Reproducibility was high for SmO2 (ICC = 0.69-0.97), Δ[O2HbMb-HHbMb]-BP (ICC = 0.80-0.88) and ventilatory thresholds (ICC = 0.96-0.99). SmO2 at peak exercise and at occlusion were strongly related to adipose tissue thickness (r2 = 0.81, p<0.001; r2 = 0.79, p<0.001). Moreover, ATT was related to asymmetric changes in Δ[HHbMb] and Δ[O2HbMb] during incremental exercise (r = -0.64, p<0.001) and during occlusion (r = -0.50, p<0.05). CONCLUSION: Although the oxygenation threshold is reproducible and potentially a suitable exercise threshold, VT1 discriminates better across sexes and training status during maximal stepwise incremental exercise. Continuous-wave NIRS measurements are reproducible, but strongly affected by adipose tissue thickness.

Ad-libitum drinking and performance during a 40-km cycling time trial in the heat.

The aim of this study was to investigate if drinking ad-libitum can counteract potential negative effects of a hypohydrated start caused by fluid restriction during a 40-km time trial (TT) in the heat. Twelve trained males performed one 40-km cycling TT euhydrated (EU: no water during the TT) and two 40-km cycling TTs hypohydrated. During one hypohydrated trial no fluid was ingested (HYPO), during the other trial ad-libitum water ingestion was allowed (FLUID). Ambient temperature was 35.2 ± 0.2 °C, relative humidity 51 ± 3% and airflow 7 m·s(-1). Body mass (BM) was determined at the start of the test, and before and after the TT. During the TT, power output, heart rate (HR), gastrointestinal temperature, mean skin temperature, rating of perceived exertion (RPE), thermal sensation, thermal comfort and thirst sensation were measured. Prior to the start of the TT, BM was 1.2% lower in HYPO and FLUID compared to EU. During the TT, BM loss in FLUID was lower compared to EU and HYPO (1.0 ± 0.8%, 2.7 ± 0.2% and 2.6 ± 0.3%, respectively). Hydration status had no effect on power output (EU: 223 ± 32 W, HYPO: 217 ± 39 W, FLUID: 224 ± 35 W), HR, gastrointestinal temperature, mean skin temperature, RPE, thermal sensation and thermal comfort. Thirst sensation was higher in HYPO than in EU and FLUID. It was concluded that hypohydration did not adversely affect performance during a 40-km cycling TT in the heat. Therefore, whether or not participants consumed fluid during exercise did not influence their TT performance.

Core temperature affects scalp skin temperature during scalp cooling.

BACKGROUND: The efficacy of hair loss prevention by scalp cooling to prevent chemotherapy induced hair loss has been shown to be related to scalp skin temperature. Scalp skin temperature, however, is dependent not only on local cooling but also on the thermal status of the body. OBJECTIVES: This study was conducted to investigate the effect of body temperature on scalp skin temperature. METHODS: We conducted experiments in which 13 healthy subjects consumed ice slurry to lower body temperature for 15 minutes after the start of scalp cooling and then performed two 12-minute cycle exercise sessions to increase body core temperature. Esophageal temperature (Tes ), rectal temperature (Tre ), mean skin temperature (eight locations, Tskin ), and mean scalp temperature (five locations, Tscalp ) were recorded. RESULTS: During the initial 10 minutes of scalp cooling, Tscalp decreased by >15 °C, whereas Tes decreased by 0.2 °C. After ice slurry ingestion, Tes , Tre , and Tskin were 35.8, 36.5, and 31.3 °C, respectively, and increased after exercise to 36.3, 37.3, and 33.0 °C, respectively. Tscalp was significantly correlated to Tes (r = 0.39, P < 0.01): an increase of 1 °C in Tes corresponded to an increase of 1.6 °C in Tscalp . CONCLUSIONS: Slight cooling of patients with an elevated body temperature during scalp cooling contributes to the decrease in scalp temperature and may improve the prevention of hair loss. This may be useful if the desired decrease of scalp temperature cannot be obtained by scalp cooling systems.

Effect of thermal state and thermal comfort on cycling performance in the heat.

PURPOSE: To determine the effect of thermal state and thermal comfort on cycling performance in the heat. METHODS: Seven well-trained male triathletes completed 3 performance trials consisting of 60 min cycling at a fixed rating of perceived exertion (14) followed immediately by a 20-km time trial in hot (30°C) and humid (80% relative humidity) conditions. In a randomized order, cyclists either drank ambient-temperature (30°C) fluid ad libitum during exercise (CON), drank ice slurry (-1°C) ad libitum during exercise (ICE), or precooled with iced towels and ice slurry ingestion (15 g/kg) before drinking ice slurry ad libitum during exercise (PC+ICE). Power output, rectal temperature, and ratings of thermal comfort were measured. RESULTS: Overall mean power output was possibly higher in ICE (+1.4%±1.8% [90% confidence limit]; 0.4> smallest worthwhile change [SWC]) and likely higher PC+ICE (+2.5%±1.9%; 1.5>SWC) than in CON; however, no substantial differences were shown between PC+ICE and ICE (unclear). Time-trial performance was likely enhanced in ICE compared with CON (+2.4%±2.7%; 1.4>SWC) and PC+ICE (+2.9%±3.2%; 1.9>SWC). Differences in mean rectal temperature during exercise were unclear between trials. Ratings of thermal comfort were likely and very likely lower during exercise in ICE and PC+ICE, respectively, than in CON. CONCLUSIONS: While PC+ICE had a stronger effect on mean power output compared with CON than ICE did, the ICE strategy enhanced late-stage time-trial performance the most. Findings suggest that thermal comfort may be as important as thermal state for maximizing performance in the heat.

The effect of pre-warming on performance during simulated firefighting exercise.

This study examined the effect of active pre-warming on speed and quality of performance during simulated firefighting exercise. Twelve male firefighters performed two trials in counterbalanced order. They were either pre-warmed by 20-min cycling at 1.5 Watt kg(-)(1) body mass (WARM) or remained thermoneutral (CON) prior to a simulated firefighting activity. After the pre-warming, gastrointestinal temperature (P < 0.001), skin temperature (P = 0.002), and heart rate (P < 0.001) were higher in WARM than in CON. During the firefighting activity, rating of perceived exertion, thermal sensation and discomfort were higher for WARM than for CON. Finish time of the firefighting activity was similar, but the last task of the activity was completed slower in WARM than in CON (P = 0.04). In WARM, self-reported performance quality was lower than in CON (P = 0.04). It is concluded that pre-warming reduces the speed during the last part of simulated firefighting activity and reduces self-reported quality of performance.

Effects of radiant heat exposure on pacing pattern during a 15-km cycling time trial.

The goal of this study was to investigate the effects of different durations of skin temperature manipulation on pacing patterns and performance during a 15-km cycling time trial. Nineteen well-trained men completed three 15-km cycling time trials in 18 °C and 50% relative humidity with 4.5-km (short-heat), 9.0-km (long-heat) or without (control) radiant heat exposure applied by infrared heaters after 1.5 km in the time trial. During the time trials, power output, mean skin temperature, rectal temperature, heart rate and rating of perceived exertion were assessed. The radiant heat exposure resulted in higher mean skin temperature during the time trial for short-heat (35.0 ± 0.6 °C) and long-heat (35.3 ± 0.5 °C) than for control (32.5 ± 1.0 °C; P < 0.001), whereas rectal temperature was similar (P = 0.55). The mean power output was less for short-heat (273 ± 8 W; P = 0.001) and long-heat (271 ± 9 W; P = 0.02) than for control (287 ± 7 W), but pacing patterns did not differ (P = 0.55). Heart rate was greatest in control (177 ± 9 beats · min(-1); P < 0.001), whereas the rating of perceived exertion remained similar. We concluded that a radiant heat exposure and associated higher skin temperature reduced overall performance, but did not modify pacing pattern during a 15-km cycling time trial, regardless of the duration of the exposure.

Effect of warm-up and precooling on pacing during a 15-km cycling time trial in the heat.

PURPOSE: The best way to apply precooling for endurance exercise in the heat is still unclear. The authors analyzed the effect of different preparation regimens on pacing during a 15-km cycling time trial in the heat. METHODS: Ten male subjects completed four 15-km time trials (30°C), preceded by different preparation regimes: 10 min cycling (WARM-UP), 30 min scalp cooling of which 10 min was cycling (SC+WARM-UP), ice-slurry ingestion (ICE), and ice slurry ingestion + 30 min scalp cooling (SC+ICE). RESULTS: No differences were observed in finish time and mean power output, although power output was lower for WARM-UP than for SC+ICE during km 13-14 (17 ± 16 and 19 ± 14 W, respectively) and for ICE during km 13 (16 ± 16 W). Rectal temperature at the start of the time trial was lower for both ICE conditions (~36.7°C) than both WARMUP conditions (~37.1°C) and remained lower during the first part of the trial. Skin temperature and thermal sensation were lower at the start for SC+ICE. CONCLUSIONS: The preparation regimen providing the lowest body-heat content and sensation of coolness at the start (SC+ICE) was most beneficial for pacing during the latter stages of the time trial, although overall performance did not differ.

The effect of skin temperature on performance during a 7.5-km cycling time trial.

Aerobic exercise performance is seriously compromised in the heat. Possibly, a high skin temperature causes a rating of perceived exertion (RPE)-mediated decrease in exercise intensity. The purpose of this study was to determine the effect of skin temperature on power output during a 7.5-km cycling time trial. Thirteen well-trained male subjects performed a 7.5-km cycling time trial at 15°C and 50% relative humidity (CONTROL), with radiative heat stress during the time trial, and with (PRECOOL) or without (HEAT) precooling. Heat stress was applied by infrared heaters positioned in front of the cycle ergometer between 1.5 and 6.0 km. Skin, rectal, and pill temperature, power output, heart rate, and RPE were measured during the trial. Despite the lower mean skin temperature at the start of the time trial for PRECOOL compared to HEAT (-2.1 ± 0.7°C; P < 0.01) and CONTROL (-1.8 ± 0.6°C; P < 0.05), and a greater increase in mean skin temperature during the heat stress period for PRECOOL (4.5 ± 1.0°C) and HEAT (3.9 ± 0.8°C) than for CONTROL (-0.3 ± 0.6°C; P < 0.01), no differences in power output were found between HEAT (273 ± 45 W) and CONTROL (284 ± 43 W; P = 0.11) and between HEAT and PRECOOL (266 ± 50 W; P = 0.47). Power output during the time trial was greater for CONTROL than for PRECOOL (P < 0.05). Additionally, no differences were observed in core temperature measures, HR, and RPE. Skin temperature does not affect the selection and modulation of exercise intensity in a 7.5-km cycling time trial.

Classification of cortical microcircuits based on micro-electrode-array data from slices of rat barrel cortex.

The bewildering complexity of cortical microcircuits at the single cell level gives rise to surprisingly robust emergent activity patterns at the level of laminar and columnar local field potentials (LFPs) in response to targeted local stimuli. Here we report the results of our multivariate data-analytic approach based on simultaneous multi-site recordings using micro-electrode-array chips for investigation of the microcircuitry of rat somatosensory (barrel) cortex. We find high repeatability of stimulus-induced responses, and typical spatial distributions of LFP responses to stimuli in supragranular, granular, and infragranular layers, where the last form a particularly distinct class. Population spikes appear to travel with about 33 cm/s from granular to infragranular layers. Responses within barrel related columns have different profiles than those in neighbouring columns to the left or interchangeably to the right. Variations between slices occur, but can be minimized by strictly obeying controlled experimental protocols. Cluster analysis on normalized recordings indicates specific spatial distributions of time series reflecting the location of sources and sinks independent of the stimulus layer. Although the precise correspondences between single cell activity and LFPs are still far from clear, a sophisticated neuroinformatics approach in combination with multi-site LFP recordings in the standardized slice preparation is suitable for comparing normal conditions to genetically or pharmacologically altered situations based on real cortical microcircuitry.