1
|
Kang Z, Chen Z, Liu G. Can heat conditions affect the heart rate responses, perception of effort, and technical performance of young male football players during small-sided games? a comparative study. BMC Sports Sci Med Rehabil 2024; 16:174. [PMID: 39160597 PMCID: PMC11331650 DOI: 10.1186/s13102-024-00970-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 08/14/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Soccer coaches often employ small-sided games (SSGs) to elicit both physiological and technical responses from players. However, numerous contextual factors can influence the outcomes of these games. This comparative study aimed to investigate how environmental temperature (< 21ºC and > 29ºC) impacts heart rate responses, perception of effort, and technical performance in young male football players during SSGs. METHODS This study compares temperatures below 21ºC (∼ 20.4 ± 0.4ºC) with temperatures above 29ºC (∼ 29.7 ± 0.6ºC). This repeated measures study design involved 60 male football players at a trained/developmental level, selected from under-16 and under-19 teams. It aimed to assess the effects of the 3v3 format, conducted repeatedly under conditions of 21ºC and above 29ºC. Throughout the games, mean heart rate responses (HRmean), measured via heart rate sensors; rate of perceived exertion (RPE), assessed using the CR-10 Borg scale; and successful passes and lost balls, tracked through an ad hoc observational analysis tool, were monitored. RESULTS No significant interactions were observed (time*age group) in meanHR (F = 0.159; p = 0.691; [Formula: see text]=0.003), RPE (F=0.646; p=0.425; [Formula: see text]=0.011), number of passes completed (F=0.204; p=0.654; [Formula: see text]=0.003), and number of lost balls (F = 0.157; p = 0.694; [Formula: see text]=0.003). Overall, significantly higher heart rate responses in mean HR (p<0.001) and RPE (p<0.001) were observed at temperatures above 29ºC, while significantly more passes were completed at temperatures below 21ºC (p<0.001). CONCLUSIONS Heat conditions significantly intensified the psychophysiological responses in players, concurrently leading to a significant impairment in the number of passes. Coaches should contemplate implementing mitigation strategies to avert performance declines during heat conditions when utilizing SSGs.
Collapse
Affiliation(s)
- ZhiHui Kang
- Public Sports Department, Ningbo University of Finance and Economics, Ningbo, 315175, Zhejiang, China
| | - Zhongju Chen
- School of Physical Education, Chizhou University, Chizhou, 247000, Anhui, China.
| | - GuiYang Liu
- Physical Education and Health Education, Udon Thani Rajabhat University, 64 Thaharn Road, Muang, Udon Thani, 41000, Thailand
| |
Collapse
|
2
|
Niu Z, Goto T. Effects of individual characteristics and local body functions on sweating response: A review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02758-7. [PMID: 39141136 DOI: 10.1007/s00484-024-02758-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/29/2024] [Accepted: 08/07/2024] [Indexed: 08/15/2024]
Abstract
In this study, we conducted a literature review to deepen our understanding of the sweating response of the thermoregulatory system, focusing on the influence of individual characteristics and local body functions. Among the factors related to individual characteristics, improvement in aerobic fitness had a positive effect on the sweating response, whereas aging exerted an inhibitory effect. Short-term artificial acclimation and seasonal heat acclimatization promoted sweating, whereas long-term geographical acclimatization suppressed sweating. Male exhibited higher sweat rates than female when the metabolic heat production was high. Individuals with smaller surface area-to-mass ratios tended to have higher sweat rates than those with larger ratios. Regarding local body functions, sweat distribution in the resting state showed high regional sweat rates in the lower limbs and torso, with higher values in the lower limbs when in the supine position and higher values in the torso when in the seated position. During exercise, the regional sweat rates was high in the torso, whereas the limbs exhibited relatively low sweat rates. These differences in sweat distribution stem from the thermoregulatory potential of each body region, which aims to efficiently regulate body temperature. Local effects have only been examined in the thigh and forearm, with temperature coefficient Q10 ranging from 2 to 5. Only the forehead showed significantly high thermosensitivity among all body regions.
Collapse
Affiliation(s)
- Zhuoxi Niu
- Department of Architecture and Building Science, Tohoku University, Sendai, Japan.
| | - Tomonobu Goto
- Department of Architecture and Building Science, Tohoku University, Sendai, Japan
| |
Collapse
|
3
|
Moyen NE, Barnes MJ, Perry BG, Fujii N, Amano T, Kondo N, Mündel T. Nicotine exacerbates exertional heat strain in trained men: a randomized, placebo-controlled, double-blind study. J Appl Physiol (1985) 2024; 137:421-428. [PMID: 38961822 DOI: 10.1152/japplphysiol.00403.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/02/2024] [Accepted: 07/02/2024] [Indexed: 07/05/2024] Open
Abstract
To determine whether using nicotine exacerbates exertional heat strain through an increased metabolic heat production (Hprod) or decreased skin blood flow (SkBF), 10 nicotine-naïve trained males [37 ± 12 yr; peak oxygen consumption (V̇o2peak): 66 ± 10 mL·min-1·kg-1] completed four trials at 20°C and 30°C following overnight transdermal nicotine (7 mg·24 h-1) and placebo use in a crossover, double-blind design. They cycled for 60 min (55% V̇o2peak) followed by a time trial (∼75% V̇o2peak) during which measures of gastrointestinal (Tgi) and mean weighted skin ([Formula: see text]sk) temperatures, SkBF, Hprod, and mean arterial pressure (MAP) were made. The difference in ΔTgi between nicotine and placebo trials was greater during 30°C (0.4 ± 0.5°C) than 20°C (0.1 ± 0.7°C), with [Formula: see text]sk higher during nicotine than placebo trials (0.5 ± 0.5°C, P = 0.02). SkBF became progressively lower during nicotine than placebo trials (P = 0.01) and progressively higher during 30°C than 20°C trials (P < 0.01); MAP increased from baseline (P < 0.01) and remained elevated in all trials. The difference in Hprod between 30°C and 20°C trials was lower during nicotine than placebo (P = 0.01) and became progressively higher during 30°C than 20°C trials with exercise duration (P = 0.03). Mean power output during the time trial was lower during 30°C than 20°C trials (24 ± 25 W, P = 0.02), and although no effect of nicotine was observed (P > 0.59), two participants (20%) were unable to complete their 30°C nicotine trials as one reached the ethical limit for Tgi (40.0°C), whereas the other withdrew due to "nausea and chills" (Tgi = 39.7°C). These results demonstrate that nicotine use increases thermal strain and risk of exertional heat exhaustion by reducing SkBF.NEW & NOTEWORTHY In naïve participants, acute nicotine use exerts a hyperthermic effect that increases the risk of heat exhaustion during exertional heat strain, which is driven by a blunted skin blood flow response. This has implications for 1) populations that face exertional heat strain and demonstrate high nicotine use (e.g., athletes and military, 25%-50%) and 2) study design whereby screening and exclusion for nicotine use or standardization of prior use (e.g., overnight abstinence) is encouraged.
Collapse
Affiliation(s)
| | - Matthew J Barnes
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Blake G Perry
- School of Health Sciences, Massey University, Wellington, New Zealand
| | - Naoto Fujii
- Advanced Research Initiative for Human High Performance, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tatsuro Amano
- Laboratory for Exercise and Environmental Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Narihiko Kondo
- Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Toby Mündel
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
- Hydration Exercise and Temperature Laboratory, Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| |
Collapse
|
4
|
Cole R, Ferguson L, Heaviside C, Murage P, Macintyre HL, Taylor J, Simpson CH, Brousse O, Symonds P, Davies M, Hajat S. Systemic inequalities in heat risk for greater London. ENVIRONMENT INTERNATIONAL 2024; 190:108925. [PMID: 39137688 DOI: 10.1016/j.envint.2024.108925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/02/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024]
Abstract
The temperature rise and increases in extreme heat events related to global climate change is a growing public health threat. Populations in temperate climates, including the UK, must urgently adapt to increased hot weather as current infrastructure primarily focusses on resilience to cold. As we adapt, care should be taken to ensure existing health inequalities are reduced. Lessons can be learned from regions that experience warmer climates and applied to adaptation in the UK. We identified known indicators of heat-health risk and explored their distribution across area level income for London. Understanding these indicators and their distributions across populations can support the development of interventions that have the dual aim of improving health and reducing inequalities. An exploratory analysis was conducted for each indicator at neighbourhood level to assess existence of disparities in their distributions across London. A systems-thinking approach was employed to deduce if these amount to systemic inequalities in heat risk, whereby those most exposed to heat are more susceptible and less able to adapt. Using this information, we proposed interventions and made recommendations for their implementation. We find inequalities across indicators relating to exposure, vulnerability, and adaptive capacity. Including inequalities in urban greening and access to greenspace, physical and mental health and access to communication and support. Through a system diagram we demonstrate how these indicators interact and suggest that systemic inequalities in risk exist and will become more evident as exposure increases with rising temperatures, depending on how we adapt. We use this information to identify barriers to the effective implementation of adaptation strategies and make recommendations on the implementation of interventions. This includes effective and wide-reaching communication considering the various channels and accessibility requirements of the population and consideration of all dwelling tenures when implementing policies relating to home improvements in the context of heat.
Collapse
Affiliation(s)
- Rebecca Cole
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom; Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | | | - Clare Heaviside
- UCL Institute for Environmental Design and Engineering, The Bartlett Faculty of Environment, University College London, London, United Kingdom
| | - Peninah Murage
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom; Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Helen L Macintyre
- Centre for Climate and Health Security, UK Health Security Agency, Chilton, United Kingdom; School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Jonathon Taylor
- Department of Civil Engineering, Tampere University, Tampere, Finland
| | - Charles H Simpson
- UCL Institute for Environmental Design and Engineering, The Bartlett Faculty of Environment, University College London, London, United Kingdom
| | - Oscar Brousse
- UCL Institute for Environmental Design and Engineering, The Bartlett Faculty of Environment, University College London, London, United Kingdom
| | - Phil Symonds
- UCL Institute for Environmental Design and Engineering, The Bartlett Faculty of Environment, University College London, London, United Kingdom
| | - Michael Davies
- UCL Institute for Environmental Design and Engineering, The Bartlett Faculty of Environment, University College London, London, United Kingdom
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom; Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
5
|
Rashidi M, Kalenkov G, Green DJ, Mclaughlin RA. Improved microvascular imaging with optical coherence tomography using 3D neural networks and a channel attention mechanism. Sci Rep 2024; 14:17809. [PMID: 39090263 PMCID: PMC11294560 DOI: 10.1038/s41598-024-68296-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024] Open
Abstract
Skin microvasculature is vital for human cardiovascular health and thermoregulation, but its imaging and analysis presents significant challenges. Statistical methods such as speckle decorrelation in optical coherence tomography angiography (OCTA) often require multiple co-located B-scans, leading to lengthy acquisitions prone to motion artefacts. Deep learning has shown promise in enhancing accuracy and reducing measurement time by leveraging local information. However, both statistical and deep learning methods typically focus solely on processing individual 2D B-scans, neglecting contextual information from neighbouring B-scans. This limitation compromises spatial context and disregards the 3D features within tissue, potentially affecting OCTA image accuracy. In this study, we propose a novel approach utilising 3D convolutional neural networks (CNNs) to address this limitation. By considering the 3D spatial context, these 3D CNNs mitigate information loss, preserving fine details and boundaries in OCTA images. Our method reduces the required number of B-scans while enhancing accuracy, thereby increasing clinical applicability. This advancement holds promise for improving clinical practices and understanding skin microvascular dynamics crucial for cardiovascular health and thermoregulation.
Collapse
Affiliation(s)
- Mohammad Rashidi
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia.
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Georgy Kalenkov
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, 6009, Australia
| | - Robert A Mclaughlin
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA, 5005, Australia
- School of Engineering, The University of Western Australia, Crawley, WA, 6009, Australia
| |
Collapse
|
6
|
Bandiera D, Racinais S, Garrandes F, Adami PE, Bermon S, Pitsiladis YP, Tessitore A. Heat-related risk at Paris 2024: a proposal for classification and review of International Federations policies. Br J Sports Med 2024; 58:860-869. [PMID: 38950917 DOI: 10.1136/bjsports-2024-108310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2024] [Indexed: 07/03/2024]
Abstract
Several International Federations (IFs) employ specific policies to protect athletes' health from the danger of heat. Most policies rely on the measurement of thermal indices such as the Wet Bulb Globe Temperature (WBGT) to estimate the risk of heat-related illness. This review summarises the policies implemented by the 32 IFs of the 45 sports included in the Paris 2024 Olympic Games. It provides details into the venue type, measured parameters, used thermal indices, measurement procedures, mitigation strategies and specifies whether the policy is a recommendation or a requirement. Additionally, a categorisation of sports' heat stress risk is proposed. Among the 15 sports identified as high, very high or extreme risk, one did not have a heat policy, three did not specify any parameter measurement, one relied on water temperature, two on air temperature and relative humidity, seven on WBGT (six measured on-site and one estimated) and one on the Heat Stress Index. However, indices currently used in sports have been developed for soldiers or workers and may not adequately reflect the thermal strain endured by athletes. Notably, they do not account for the athletes' high metabolic heat production and their level of acclimation. It is, therefore, worthwhile listing the relevance of the thermal indices used by IFs to quantify the risk of heat stress, and in the near future, develop an index adapted to the specific needs of athletes.
Collapse
Affiliation(s)
- David Bandiera
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Roma, Italy
- Environmental Stress Unit, CREPS Montpellier-Font Romeu, Montpellier, France
| | - Sebastien Racinais
- Environmental Stress Unit, CREPS Montpellier-Font Romeu, Montpellier, France
- UMR 866 INRAE Université de Montpellier, Montpellier, France
| | | | | | | | - Yannis P Pitsiladis
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Roma, Italy
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, Kowloon, Hong Kong
| | - Antonio Tessitore
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Roma, Italy
| |
Collapse
|
7
|
De León-Muñoz A, Priego-Quesada JI, Marzano-Felisatti JM, Sanchez-Jimenez JL, Sendra-Pérez C, Aparicio-Aparicio I. Preliminary Application of Infrared Thermography to Monitoring of Skin Temperature Asymmetries in Professional Padel Players. SENSORS (BASEL, SWITZERLAND) 2024; 24:4534. [PMID: 39065931 PMCID: PMC11280937 DOI: 10.3390/s24144534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/05/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
The aim of the present study was to evaluate skin temperature (Tsk) asymmetries, using infrared thermography, in professional padel players before (PRE), after (POST) and 10 min after training (POST10), and their relationship with perceptual variables and training characteristics. Thermal images were taken of 10 players before, after and 10 min after a standardized technical training. After training, Tsk of the dominant side was higher than before training in the anterior forearm (30.8 ± 0.4 °C vs. 29.1 ± 1.2 °C, p < 0.01; ES = 1.9), anterior shoulder (31.6 ± 0.6 °C vs. 30.9 ± 0.6 °C, p < 0.05; ES = 1.0) posterior arm (29.5 ± 1.0 °C vs. 28.3 ± 1.2 °C, p < 0.05; ES = 1.0), and posterior forearm (30.8 ± 0.9 °C vs. 29.3 ± 1.6 °C, p < 0.05; ES = 1.1). Likewise, these differences were significant POST10 in the anterior arm, anterior forearm, anterior shoulder, posterior arm and posterior forearm. Comparing the different moments of measurement (PRE, POST and POST10), the temperature was higher POST10 in all the regions analyzed except for the shoulder, abdominals, and lower back. Also, correlations were found between fatigue variation and temperature variation between limbs (Tsk dominance), and no correlation was found except between age and posterior thigh (|r| = 0.69; p < 0.05), and between the racket mass and anterior knee (|r| = 0.81; p < 0.01). In conclusion, infrared thermography allows monitoring of skin asymmetries between limbs in professional padel players, but these asymmetries were not related to overall fatigue variation, overall pain variation, years of experience and training hours.
Collapse
Affiliation(s)
- Alberto De León-Muñoz
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, 46010 Valencia, Spain (J.I.P.-Q.); (I.A.-A.)
| | - Jose Ignacio Priego-Quesada
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, 46010 Valencia, Spain (J.I.P.-Q.); (I.A.-A.)
- Research Group in Medical Physics (GIFIME), Department of Physiology, University of Valencia, 46010 Valencia, Spain
| | - Joaquín Martín Marzano-Felisatti
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, 46010 Valencia, Spain (J.I.P.-Q.); (I.A.-A.)
| | - Jose Luis Sanchez-Jimenez
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, 46010 Valencia, Spain (J.I.P.-Q.); (I.A.-A.)
| | - Carlos Sendra-Pérez
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, 46010 Valencia, Spain (J.I.P.-Q.); (I.A.-A.)
| | - Inmaculada Aparicio-Aparicio
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, 46010 Valencia, Spain (J.I.P.-Q.); (I.A.-A.)
| |
Collapse
|
8
|
Shaban M, Amer FGM, Shaban MM. The impact of nursing sustainable prevention program on heat strain among agricultural elderly workers in the context of climate change. Geriatr Nurs 2024; 58:215-224. [PMID: 38838403 DOI: 10.1016/j.gerinurse.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND This study assesses a geriatric nursing-led sustainable heat prevention program for elderly agricultural workers. It targets those aged 60 and above, addressing the heightened risk of heat strain in the era of climate change. METHODS A community-based quasi-experimental design involved 120 elderly agricultural workers, divided into intervention and control groups. The program, spanning three months, included education on hydration, rest, protective clothing, and recognition of heat-related illnesses. RESULTS The intervention led by geriatric nursing professionals showed significant improvements in heat strain metrics. The Heat Strain Score Index (HSSI) and the Observational-Perceptual Heat Strain Risk Assessment (OPHSRA) Index indicated increased safety levels and reduced risk categories among participants. CONCLUSIONS The study demonstrates the effectiveness of a geriatric nursing-led, tailored prevention program in reducing heat strain among elderly agricultural workers. It highlights the crucial role of nursing in adapting healthcare practices to the challenges posed by climate change. TRIAL REGISTRATION ClinicalTrials.gov, ID NCT06192069 retrospectively registered.
Collapse
|
9
|
Wang L, Zhang C, Di J, Wang Q, Ren M, Huang A, Chen S, Zhao W, Hu H, Wang A, Di Q, Ji JS, Liang W, Huang C. Increased risk of preterm birth due to heat exposure during pregnancy: Exploring the mechanism of fetal physiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 931:172730. [PMID: 38663596 DOI: 10.1016/j.scitotenv.2024.172730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/07/2024] [Accepted: 04/22/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND Heat exposure during pregnancy can increase the risk of preterm birth (PTB) through a range of potential mechanisms including pregnancy complications, hormone secretion and infections. However, current research mainly focuses on the effect of heat exposure on pathophysiological pathways of pregnant women, but ignore that maternal heat exposure can also cause physiological changes to the fetus, which will affect the risk of PTB. OBJECTIVE In this study, we aimed to explore the mediating role of fetal heart rate (FHR) in the relationship between maternal heat exposure and PTB incidence. METHODS We assigned heat exposure to a multi-center birth cohort in China during 2015-2018, which included all 162,407 singleton live births with several times FHR measurements during the second and third trimesters. We examined the associations between heat exposure, FHR and PTB in the entire pregnancy, each trimester and the last gestational month. The inverse odds ratio-weighted approach applied to the Cox regression was used to identify the mediation effect of heat exposure on PTB and its clinical subtypes via FHR. FINDINGS Exposure to heat significantly increased the risk of PTB during the third trimester and the entire pregnancy, hazard ratios and 95 % CIs were 1.266 (1.161, 1.379) and 1.328 (1.218, 1.447). Heat exposure during the third trimester and entire pregnancy increased FHR in the third trimester by 0.24 bpm and 0.14 bpm. The proportion of heat exposure mediated by FHR elevation on PTB and its subtype ranged from 3.68 % to 24.06 %, with the significant mediation effect found for both medically indicated PTB and spontaneous PTB. CONCLUSIONS This study suggests that heat exposure during pregnancy has an important impact on fetal health, and FHR, as a surrogate marker of fetal physiology, may mediate the increased risk of PTB caused by extreme heat. Monitoring and managing physiological changes in the fetus would constitute a promising avenue to reduce adverse birth outcomes associated with maternal heat exposure.
Collapse
Affiliation(s)
- Liyun Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chunying Zhang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiangli Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Aiqun Huang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sidi Chen
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Zhao
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huanqing Hu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ailing Wang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China.
| |
Collapse
|
10
|
Kenny GP, Tetzlaff EJ, Journeay WS, Henderson SB, O’Connor FK. Indoor overheating: A review of vulnerabilities, causes, and strategies to prevent adverse human health outcomes during extreme heat events. Temperature (Austin) 2024; 11:203-246. [PMID: 39193048 PMCID: PMC11346563 DOI: 10.1080/23328940.2024.2361223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/07/2024] [Accepted: 05/20/2024] [Indexed: 08/29/2024] Open
Abstract
The likelihood of exposure to overheated indoor environments is increasing as climate change is exacerbating the frequency and severity of hot weather and extreme heat events (EHE). Consequently, vulnerable populations will face serious health risks from indoor overheating. While the relationship between EHE and human health has been assessed in relation to outdoor temperature, indoor temperature patterns can vary markedly from those measured outside. This is because the built environment and building characteristics can act as an important modifier of indoor temperatures. In this narrative review, we examine the physiological and behavioral determinants that influence a person's susceptibility to indoor overheating. Further, we explore how the built environment, neighborhood-level factors, and building characteristics can impact exposure to excess heat and we overview how strategies to mitigate building overheating can help reduce heat-related mortality in heat-vulnerable occupants. Finally, we discuss the effectiveness of commonly recommended personal cooling strategies that aim to mitigate dangerous increases in physiological strain during exposure to high indoor temperatures during hot weather or an EHE. As global temperatures continue to rise, the need for a research agenda specifically directed at reducing the likelihood and impact of indoor overheating on human health is paramount. This includes conducting EHE simulation studies to support the development of consensus-based heat mitigation solutions and public health messaging that provides equitable protection to heat-vulnerable people exposed to high indoor temperatures.
Collapse
Affiliation(s)
- Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Emily J. Tetzlaff
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - W. Shane Journeay
- Departments of Medicine and Community Health and Epidemiology, Dalhousie Medicine New Brunswick and Dalhousie University, Saint John, NB, Canada
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
- Department of Rehabilitative Care, Providence Healthcare-Unity Health Toronto, Toronto, ON, Canada
| | - Sarah B. Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
- National Collaborating Centre for Environmental Health, Vancouver, BC, Canada
| | - Fergus K. O’Connor
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
11
|
Xu Z, Yi W, Bach A, Tong S, Ebi KL, Su H, Cheng J, Rutherford S. Multimorbidity and emergency hospitalisations during hot weather. EBioMedicine 2024; 104:105148. [PMID: 38705102 PMCID: PMC11087953 DOI: 10.1016/j.ebiom.2024.105148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND People with chronic diseases are a commonly listed heat-vulnerable group in heat-health action plans. While prior research identifies multiple health conditions that may increase vulnerability to ambient heat, there is minimal evidence regarding the implications of multimorbidity (two or more chronic diseases). METHODS From the statewide hospital registry of Queensland, Australia, we identified people aged ≥15 years who had emergency hospitalisation(s) between March 2004 and April 2016 and previously had 0, 1, 2, or ≥3 of five chronic diseases: cardiovascular disease, diabetes, mental disorders, asthma/COPD, and chronic kidney disease. We conducted time-stratified case-crossover analyses to estimate the odds ratio of hospitalisations associated with ambient heat exposure in people with different numbers, types, and combinations of chronic diseases. Ambient heat exposure was defined as a 5 °C increase in daily mean temperature above the median. FINDINGS There were 2,263,427 emergency hospitalisations recorded (48.7% in males and 51.3% in females). When the mean temperature increased, hospitalisation odds increased with chronic disease number, particularly in older persons (≥65 years), males, and non-indigenous people. For instance, in older persons with 0, 1, 2, or ≥3 chronic diseases, the odds ratios associated with ambient heat exposure were 1.00 (95% confidence interval: 0.96, 1.04), 1.06 (1.02, 1.09), 1.08 (1.02, 1.14), and 1.13 (1.07, 1.19), respectively. Among the chronic diseases, chronic kidney disease, and asthma/COPD, either existing alone, together, or in combination with other diseases, were associated with the highest odds of hospitalisations under ambient heat exposure. INTERPRETATION While individuals with multimorbidity are considered in heat-health action plans, this study suggests the need to consider specifically examining them as a distinct and vulnerable subgroup. FUNDING Wellcome.
Collapse
Affiliation(s)
- Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Cities Research Institute, Griffith University, Gold Coast, Australia.
| | - Weizhuo Yi
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; School of Public Health, Anhui Medical University, Hefei, China
| | - Aaron Bach
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Cities Research Institute, Griffith University, Gold Coast, Australia
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, USA
| | - Hong Su
- School of Public Health, Anhui Medical University, Hefei, China
| | - Jian Cheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Cities Research Institute, Griffith University, Gold Coast, Australia
| |
Collapse
|
12
|
McCormick JJ, Meade RD, King KE, Akerman AP, Notley SR, Kirby NV, Sigal RJ, Kenny GP. Effect of daylong exposure to indoor overheating on autophagy and the cellular stress response in older adults. Appl Physiol Nutr Metab 2024; 49:855-867. [PMID: 38394645 DOI: 10.1139/apnm-2023-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
To protect vulnerable populations during heat waves, public health agencies recommend maintaining indoor air temperature below ∼24-28 °C. While we recently demonstrated that maintaining indoor temperatures ≤26 °C mitigates the development of hyperthermia and cardiovascular strain in older adults, the cellular consequences of prolonged indoor heat stress are poorly understood. We therefore evaluated the cellular stress response in 16 adults (six females) aged 66-78 years during 8 h rest in ambient conditions simulating homes maintained at 22 °C (control) and 26 °C (indoor temperature upper limit proposed by health agencies), as well as non-air-conditioned domiciles during hot weather and heat waves (31 and 36 °C, respectively; all 45% relative humidity). Western blot analysis was used to assess changes in proteins associated with the cellular stress response (autophagy, apoptosis, acute inflammation, and heat shock proteins) in peripheral blood mononuclear cells harvested prior to and following exposure. Following 8 h exposure, no cellular stress response-related proteins differed significantly between the 26 and 22 °C conditions (all, P ≥ 0.056). By contrast, autophagy-related proteins were elevated following exposure to 31 °C (p62: 1.5-fold; P = 0.003) and 36 °C (LC3-II, LC3-II/I, p62; all ≥2.0-fold; P ≤ 0.002) compared to 22 °C. These responses were accompanied by elevations in apoptotic signaling in the 31 and 36 °C conditions (cleaved-caspase-3: 1.8-fold and 3.7-fold, respectively; P ≤ 0.002). Furthermore, HSP90 was significantly reduced in the 36 °C compared to 22 °C condition (0.7-fold; P = 0.014). Our findings show that older adults experience considerable cellular stress during prolonged exposure to elevated ambient temperatures and support recommendations to maintain indoor temperatures ≤26 °C to prevent physiological strain in heat-vulnerable persons.
Collapse
Affiliation(s)
- James J McCormick
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Robert D Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kelli E King
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Ashley P Akerman
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Nathalie V Kirby
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Ronald J Sigal
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
- Departments of Medicine, Cardiac Sciences and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, AB, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| |
Collapse
|
13
|
McLeod KJ. Reversal of Soleus Muscle Atrophy in Older Adults: A Non-Volitional Exercise Intervention for a Changing Climate. Clin Interv Aging 2024; 19:795-806. [PMID: 38745745 PMCID: PMC11093118 DOI: 10.2147/cia.s447665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/27/2024] [Indexed: 05/16/2024] Open
Abstract
The World Health Organization recommends that older adults undertake at least 150 minutes of moderate intensity physical activity over the course of each week in order to maintain physical, mental, and social health. This goal turns out to be very difficult for most community dwelling older adults to achieve, due to both actual and perceived barriers. These barriers include personal health limitations, confinement issues, and self-imposed restrictions such as fear of injury. Climate change exacerbates the confinement issues and injury fears among the elderly. To assist older adults in obtaining the benefits of increased physical activity under increasingly challenging climate conditions, we propose a targeted non-volitional intervention which could serve as a complement to volitional physical activity. Exogenous neuro-muscular stimulation of the soleus muscles is a non-invasive intervention capable of significantly increasing cardiac output in sedentary individuals. Long-term daily use has been shown to improve sleep, reduce bone loss, and reverse age-related cognitive decline, all of which are significant health concerns for older adults. These outcomes support the potential benefit of exogenous neuro-muscular stimulation as a complementary form of physical activity which older adults may find convenient to incorporate into their daily life when traditional forms of exercise are difficult to achieve due to barriers to completing traditional physical activities as a result of in-home or in-bed confinement, perceptual risks, or real environmental risks such as those arising from climate change.
Collapse
|
14
|
Fischer S, Naegeli K, Cardone D, Filippini C, Merla A, Hanusch KU, Ehlert U. Emerging effects of temperature on human cognition, affect, and behaviour. Biol Psychol 2024; 189:108791. [PMID: 38599369 DOI: 10.1016/j.biopsycho.2024.108791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/26/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024]
Abstract
Human body core temperature is tightly regulated within approximately 37 °C. Global near surface temperature has increased by over 1.2 °C between 1850 and 2020. In light of the challenge this poses to human thermoregulation, the present perspective article sought to provide an overview on the effects of varying ambient and body temperature on cognitive, affective, and behavioural domains of functioning. To this end, an overview of observational and experimental studies in healthy individuals and individuals with mental disorders was provided. Within body core temperature at approximately 37 °C, relatively lower ambient and skin temperatures appear to evoke a need for social connection, whereas comparably higher temperatures appear to facilitate notions of other as closer and more sociable. Above-average ambient temperatures are associated with increased conflicts as well as incident psychotic and depressive symptoms, mental disorders, and suicide. With mild hypo- and hyperthermia, paradoxical effects are observed: whereas the acute states are generally characterised by impairments in cognitive performance, anxiety, and irritability, individuals with depression experience longer-term symptom improvements with treatments deliberately inducing these states for brief amounts of time. When taken together, it has thus become clear that temperature is inexorably associated with human cognition, affect, and (potentially) behaviour. Given the projected increase in global warming, further research into the affective and behavioural sequelae of heat and the mechanisms translating it into mental health outcomes is urgently warranted.
Collapse
Affiliation(s)
- Susanne Fischer
- University of Zurich, Institute of Psychology, Zurich, Switzerland.
| | - Kathrin Naegeli
- University of Zurich, Department of Geography, Zurich, Switzerland
| | - Daniela Cardone
- University G. d'Annunzio of Chieti-Pescara, Department of Engineering and Geology, Chieti, Italy
| | - Chiara Filippini
- University G. d'Annunzio of Chieti-Pescara, Department of Engineering and Geology, Chieti, Italy
| | - Arcangelo Merla
- University G. d'Annunzio of Chieti-Pescara, Department of Engineering and Geology, Chieti, Italy
| | - Kay-Uwe Hanusch
- Bern University of Applied Sciences, Department of Health Sciences, Berne, Switzerland
| | - Ulrike Ehlert
- University of Zurich, Institute of Psychology, Zurich, Switzerland
| |
Collapse
|
15
|
Choi YJ, Choi WC, Jeon GR, Kim JH, Kim MS, Kim JH. Characteristics of Far-Infrared Ray Emitted from Functional Loess Bio-Balls and Its Effect on Improving Blood Flow. Bioengineering (Basel) 2024; 11:380. [PMID: 38671801 PMCID: PMC11048564 DOI: 10.3390/bioengineering11040380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/06/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
XRD diffraction and IR absorption were investigated for raw loess powder and heat-treated loess powder. Raw loess retains its useful minerals, but loses their beneficial properties when calcined at 850 °C and 1050 °C. To utilize the useful minerals, loess balls were made using a low-temperature wet-drying method. The radiant energy and transmittance were measured for the loess balls. Far-infrared ray (FIR) emitted from loess bio-balls is selectively absorbed as higher vibrational energy by water molecules. FIR can raise the body's core temperature, thereby improving blood flow through the body's thermoregulatory mechanism. In an exploratory study with 40 participants, when the set temperature of the loess ball mat was increased from 25 °C to 50 °C, blood flow increased by 39.01%, from 37.48 mL/min to 52.11 mL/min, in the left middle finger; in addition, it increased by 39.62%, from 37.15 mL/min to 51.87 mL/min, in the right middle finger. The FIR emitted from loess balls can be widely applied, in various forms, to diseases related to blood flow, such as cold hands and feet, diabetic foot, muscle pain, and menstrual pain.
Collapse
Affiliation(s)
- Yeon Jin Choi
- R&D Center, Hanwool Bio, Yangsan 50561, Republic of Korea; (Y.J.C.); (W.C.C.)
| | - Woo Cheol Choi
- R&D Center, Hanwool Bio, Yangsan 50561, Republic of Korea; (Y.J.C.); (W.C.C.)
| | - Gye Rok Jeon
- R&D Center, eXsolit, Yangsan 50611, Republic of Korea; (G.R.J.); (J.H.K.)
| | - Jae Ho Kim
- R&D Center, eXsolit, Yangsan 50611, Republic of Korea; (G.R.J.); (J.H.K.)
| | | | - Jae Hyung Kim
- R&D Center, Hanwool Bio, Yangsan 50561, Republic of Korea; (Y.J.C.); (W.C.C.)
| |
Collapse
|
16
|
Iba T, Maier CL, Levi M, Levy JH. Thromboinflammation and microcirculation damage in heatstroke. Minerva Med 2024; 115:191-202. [PMID: 38240696 DOI: 10.23736/s0026-4806.23.08919-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Rising temperatures associated with climate change have significantly increased the risk of heatstroke. Unfortunately, the trend is anticipated to persist and increasingly threaten vulnerable populations, particularly older adults. According to Japan's environment ministry, over 1000 people died from heatstroke in 2021, and 86% of deaths occurred in those above 65. Since the precise mechanism of heatstroke is not fully understood, we examined the pathophysiology by focusing on the microcirculatory derangement. Online search of published medical literature through MEDLINE and Web of Science using the term "heatstroke," "heat-related illness," "inflammation," "thrombosis," "coagulation," "fibrinolysis," "endothelial cell," and "circulation." Articles were chosen for inclusion based on their relevance to heatstroke, inflammation, and thrombosis. Reference lists were reviewed to identify additional relevant articles. Other than preexisting conditions (genetic background, age, etc.), factors such as hydration status, acclimatization, dysregulated coagulation, and inflammation are the additional major factors that promote tissue malcirculation in heatstroke. The fundamental pathophysiologic mechanisms significantly overlap with those seen in the systemic inflammatory response to sepsis, and as a result, coagulation-predominant coagulopathy develops during heat stress. Although a bleeding tendency is not common, bleeding frequently occurs in the microcirculation, causing additional injury. Sterile inflammation is mediated by proinflammatory cytokines, chemokines, and other humoral mediators in concert with cellular factors, including monocytes, neutrophils, platelets, and endothelial cells. Excess inflammation results in inflammatory cell death, including pyroptosis and necroptosis, and the release of danger signals that further propagate systemic inflammation and coagulopathy. Consequently, thromboinflammation is the critical factor that induces microcirculatory disturbance in heatstroke.
Collapse
Affiliation(s)
- Toshiaki Iba
- Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan -
| | - Cheryl L Maier
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Marcel Levi
- Department of Vascular Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Department of Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jerrold H Levy
- Department of Anesthesiology, Critical Care and Surgery, Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
17
|
Deshayes TA, Hsouna H, Braham MAA, Arvisais D, Pageaux B, Ouellet C, Jay O, Maso FD, Begon M, Saidi A, Gendron P, Gagnon D. Work-rest regimens for work in hot environments: A scoping review. Am J Ind Med 2024; 67:304-320. [PMID: 38345435 DOI: 10.1002/ajim.23569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/08/2024] [Accepted: 01/23/2024] [Indexed: 03/16/2024]
Abstract
BACKGROUND To limit exposures to occupational heat stress, leading occupational health and safety organizations recommend work-rest regimens to prevent core temperature from exceeding 38°C or increasing by ≥1°C. This scoping review aims to map existing knowledge of the effects of work-rest regimens in hot environments and to propose recommendations for future research based on identified gaps. METHODS We performed a search of 10 databases to retrieve studies focused on work-rest regimens under hot conditions. RESULTS Forty-nine articles were included, of which 35 were experimental studies. Most studies were conducted in laboratory settings, in North America (71%), on healthy young adults, with 94% of the 642 participants being males. Most studies (66%) employed a protocol duration ≤240 min (222 ± 162 min, range: 37-660) and the time-weighted average wet-bulb globe temperature was 27 ± 4°C (range: 18-34). The work-rest regimens implemented were those proposed by the American Conference of Governmental and Industrial Hygiene (20%), National Institute of Occupational Safety and Health (11%), or the Australian Army (3%). The remaining studies (66%) did not mention how the work-rest regimens were derived. Most studies (89%) focused on physical tasks only. Most studies (94%) reported core temperature, whereas only 22% reported physical and/or mental performance outcomes, respectively. Of the 35 experimental studies included, 77% indicated that core temperature exceeded 38°C. CONCLUSIONS Although work-rest regimens are widely used, few studies have investigated their physiological effectiveness. These studies were mainly short in duration, involved mostly healthy young males, and rarely considered the effect of work-rest regimens beyond heat strain during physical exertion.
Collapse
Affiliation(s)
- Thomas A Deshayes
- Montreal Heart Institute, Montréal, Québec, Canada
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Hsen Hsouna
- Montreal Heart Institute, Montréal, Québec, Canada
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Mounir A A Braham
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
- Département d'anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Denis Arvisais
- Bibliothèque des sciences de la santé, Université de Montréal, Montréal, Québec, Canada
| | - Benjamin Pageaux
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
- Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Montréal, Québec, Canada
| | - Capucine Ouellet
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada
| | - Ollie Jay
- Heat and Health Research Incubator, University of Sydney, Sydney, New South Wales, Australia
| | - Fabien D Maso
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
- Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Montréal, Québec, Canada
| | - Mickael Begon
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada
| | - Alireza Saidi
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada
| | - Philippe Gendron
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Daniel Gagnon
- Montreal Heart Institute, Montréal, Québec, Canada
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| |
Collapse
|
18
|
Reis J, Buguet A, Radomski M, Stella AB, Vásquez TC, Spencer PS. Neurological patients confronting climate change: A potential role for the glymphatic system and sleep. J Neurol Sci 2024; 458:122900. [PMID: 38310733 DOI: 10.1016/j.jns.2024.122900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/06/2024]
Abstract
Interest in the health consequences of climate change (global warming, heatwaves) has increased in the neurological community. This review addresses the impact of elevated ambient temperatures and heatwaves on patients with neurological and mental health disorders, including multiple sclerosis, synucleinopathies, dementia, epilepsies, mental health, and stroke. Patients with such conditions are highly vulnerable during heatwaves because of functional disorders affecting sleep, thermoregulation, autonomic system reactivity, mood, and cognitive ability. Several medications may also increase the risk of heatstroke. Special attention is devoted to the involvement of common underlying mechanisms, such as sleep and the glymphatic system. Disease prevention and patient care during heatwaves are major issues for caregivers. Beyond the usual recommendations for individuals, we favor artificially induced acclimation to heat, which provides preventive benefits with proven efficacy for healthy adults.
Collapse
Affiliation(s)
- Jacques Reis
- Department of Neurology, University Hospital of Strasbourg, 67000 Strasbourg, France; Association RISE, 3 rue du Loir, 67205 Oberhausbergen, France.
| | - Alain Buguet
- Malaria Research Unit, UMR 5246 CNRS, Claude-Bernard Lyon-1 University, 69622 Villeurbanne, France; 21 rue de Champfranc, 38630 Les Avenières Veyrins-Thuellin, France
| | - Manny Radomski
- Emeritus at the University of Toronto, Apt n° 2501, 2010 Islington Avenue, Toronto, ON M9P3S8, Canada
| | - Alex Buoite Stella
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital, University of Trieste, Trieste, Italy
| | - Teresa Corona Vásquez
- División de Estudios de Posgrado, Universidad Nacional Autónoma de México, Mexico City, Mexico; Clinical Neurodegenerative Diseases Laboratory, Instituto Nacional de Neurología y Neurocirugía, Manuel Velasco Suárez, Mexico City, Mexico
| | - Peter S Spencer
- Department of Neurology, School of Medicine, Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR 97239, USA
| |
Collapse
|
19
|
Liu Z, Nguyen TTT, Ding F. Protocol for building a user-friendly temperature control system to support microscopes, microfluidic chambers, and custom incubators. STAR Protoc 2024; 5:102862. [PMID: 38294908 PMCID: PMC10846474 DOI: 10.1016/j.xpro.2024.102862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/07/2023] [Accepted: 01/16/2024] [Indexed: 02/02/2024] Open
Abstract
Biological experiments require precise temperature control, necessitating an integrated adjustable temperature system for instruments such as microscopes, microfluidic chambers, or custom incubators. We present a protocol for building a user-friendly temperature control system suitable for both in vitro and in vivo assays. We describe steps for preparing materials, assembling the printed circuit board and enclosure, and fine-tuning the heating algorithm for accuracy. This system can maintain a stable temperature of up to 60°C with stabilities under 0.06°C.
Collapse
Affiliation(s)
- Ziteng Liu
- Department of Electrical Engineering and Computer Science, University of California Irvine, Irvine, CA 92697, USA.
| | - Thao Thi Thu Nguyen
- Center for Complex Biological Systems, University of California Irvine, Irvine, CA 92697, USA
| | - Fangyuan Ding
- Center for Complex Biological Systems, University of California Irvine, Irvine, CA 92697, USA; Department of Biomedical Engineering, Center for Synthetic Biology, Chao Family Comprehensive Cancer Center, Department of Developmental and Cell Biology, and Department of Pharmaceutical Sciences, University of California Irvine, Irvine, CA 92697, USA.
| |
Collapse
|
20
|
Hou T, Zhang J, Wang Y, Zhang G, Li S, Fan W, Li R, Sun Q, Liu C. Early Pulmonary Fibrosis-like Changes in the Setting of Heat Exposure: DNA Damage and Cell Senescence. Int J Mol Sci 2024; 25:2992. [PMID: 38474239 DOI: 10.3390/ijms25052992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/22/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
It is well known that extreme heat events happen frequently due to climate change. However, studies examining the direct health impacts of increased temperature and heat waves are lacking. Previous reports revealed that heatstroke induced acute lung injury and pulmonary dysfunction. This study aimed to investigate whether heat exposure induced lung fibrosis and to explore the underlying mechanisms. Male C57BL/6 mice were exposed to an ambient temperature of 39.5 ± 0.5 °C until their core temperature reached the maximum or heat exhaustion state. Lung fibrosis was observed in the lungs of heat-exposed mice, with extensive collagen deposition and the elevated expression of fibrosis molecules, including transforming growth factor-β1 (TGF-β1) and Fibronectin (Fn1) (p < 0.05). Moreover, epithelial-mesenchymal transition (EMT) occurred in response to heat exposure, evidenced by E-cadherin, an epithelial marker, which was downregulated, whereas markers of EMT, such as connective tissue growth factor (CTGF) and the zinc finger transcriptional repressor protein Slug, were upregulated in the heat-exposed lung tissues of mice (p < 0.05). Subsequently, cell senescence examination revealed that the levels of both senescence-associated β-galactosidase (SA-β-gal) staining and the cell cycle protein kinase inhibitor p21 were significantly elevated (p < 0.05). Mechanistically, the cGAS-STING signaling pathway evoked by DNA damage was activated in response to heat exposure (p < 0.05). In summary, we reported a new finding that heat exposure contributed to the development of early pulmonary fibrosis-like changes through the DNA damage-activated cGAS-STING pathway followed by cellular senescence.
Collapse
Affiliation(s)
- Tong Hou
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou 310053, China
| | - Jiyang Zhang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou 310053, China
| | - Yindan Wang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou 310053, China
| | - Guoqing Zhang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou 310053, China
| | - Sanduo Li
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou 310053, China
| | - Wenjun Fan
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou 310053, China
| | - Ran Li
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou 310053, China
| | - Qinghua Sun
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou 310053, China
| | - Cuiqing Liu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou 310053, China
| |
Collapse
|
21
|
Rosales AM, Moler JL, Engellant AC, Held AL, Slivka DR. Impact of Topical Capsaicin Cream on Thermoregulation and Perception While Walking in the Cold. Wilderness Environ Med 2024; 35:36-43. [PMID: 38379484 DOI: 10.1177/10806032231223757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Capsaicin, a chili pepper extract, can stimulate increased skin blood flow (SkBF) with a perceived warming sensation on application areas. Larger surface area application may exert a more systemic thermoregulatory response. Capsaicin could assist with maintaining heat transport to the distal extremities, minimizing cold weather injury risk. However, the thermoregulatory and perceptual impact of topical capsaicin cream application prior to exercise in the cold is unknown. METHODS Following application of either a 0.1% capsaicin or control cream to the upper and lower extremities (10 g total, ∼40-50% body surface area), 11 participants in shorts and a t-shirt were exposed to 30 min of cold (0 °C, 40% relative humidity). Exposures comprised of 5 min seated rest, 20 min walking (1.6 m·s-1, 5% grade), and 5 min seated rest. Temperature (skin, core), SkBF, skin conductivity, heart rate, thermal sensation, and thermal comfort were measured throughout. RESULTS The capsaicin treatment did not differ from the control treatment in skin temperature (treatment mean: 30.0 ± 2.5, 30.1 ± 2.4 °C, respectively, p = 0.655), core temperature (treatment mean: 37.3 ± 0.5, 37.4 ± 0.4 °C, respectively, p = 0.113), SkBF (treatment mean: -8.4 ± 10.0, -11.1 ± 10.7 A.U., respectively, p = 0.492), skin conductivity (treatment mean: -0.7 ± 5.1, 0.4 ± 6.4 µS, respectively, p = 0.651), or heart rate (treatment mean: 83 ± 29, 85 ± 28 beats·minute-1, respectively, p = 0.234). The capsaicin and control treatments also did not differ in thermal sensation (p = 0.521) and thermal comfort (p = 0.982), with perceptual outcomes corresponding with feeling "cool" and "just uncomfortable," respectively. CONCLUSIONS 0.1% topical capsaicin application to exposed limbs prior to walking in a cold environment does not alter whole-body thermoregulation or thermal perception.
Collapse
Affiliation(s)
- Alejandro M Rosales
- School of Integrative Physiology and Athletic Training, Montana Center for Work Physiology and Exercise Metabolism, University of Montana, Missoula, MT, USA
| | - Jessica L Moler
- School of Integrative Physiology and Athletic Training, Montana Center for Work Physiology and Exercise Metabolism, University of Montana, Missoula, MT, USA
| | - Andrew C Engellant
- School of Integrative Physiology and Athletic Training, Montana Center for Work Physiology and Exercise Metabolism, University of Montana, Missoula, MT, USA
| | - Alice L Held
- School of Integrative Physiology and Athletic Training, Montana Center for Work Physiology and Exercise Metabolism, University of Montana, Missoula, MT, USA
| | - Dustin R Slivka
- School of Integrative Physiology and Athletic Training, Montana Center for Work Physiology and Exercise Metabolism, University of Montana, Missoula, MT, USA
| |
Collapse
|
22
|
Mota CMD, Madden CJ. Neural circuits of long-term thermoregulatory adaptations to cold temperatures and metabolic demands. Nat Rev Neurosci 2024; 25:143-158. [PMID: 38316956 DOI: 10.1038/s41583-023-00785-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 02/07/2024]
Abstract
The mammalian brain controls heat generation and heat loss mechanisms that regulate body temperature and energy metabolism. Thermoeffectors include brown adipose tissue, cutaneous blood flow and skeletal muscle, and metabolic energy sources include white adipose tissue. Neural and metabolic pathways modulating the activity and functional plasticity of these mechanisms contribute not only to the optimization of function during acute challenges, such as ambient temperature changes, infection and stress, but also to longitudinal adaptations to environmental and internal changes. Exposure of humans to repeated and seasonal cold ambient conditions leads to adaptations in thermoeffectors such as habituation of cutaneous vasoconstriction and shivering. In animals that undergo hibernation and torpor, neurally regulated metabolic and thermoregulatory adaptations enable survival during periods of significant reduction in metabolic rate. In addition, changes in diet can activate accessory neural pathways that alter thermoeffector activity. This knowledge may be harnessed for therapeutic purposes, including treatments for obesity and improved means of therapeutic hypothermia.
Collapse
Affiliation(s)
- Clarissa M D Mota
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Christopher J Madden
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, USA.
| |
Collapse
|
23
|
Deshayes TA, Sodabi DGA, Dubord M, Gagnon D. Shifting focus: Time to look beyond the classic physiological adaptations associated with human heat acclimation. Exp Physiol 2024; 109:335-349. [PMID: 37885125 PMCID: PMC10988689 DOI: 10.1113/ep091207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Planet Earth is warming at an unprecedented rate and our future is now assured to be shaped by the consequences of more frequent hot days and extreme heat. Humans will need to adapt both behaviorally and physiologically to thrive in a hotter climate. From a physiological perspective, countless studies have shown that human heat acclimation increases thermoeffector output (i.e., sweating and skin blood flow) and lowers cardiovascular strain (i.e., heart rate) during heat stress. However, the mechanisms mediating these adaptations remain understudied. Furthermore, several possible benefits of heat acclimation for other systems and functions involved in maintaining health and performance during heat stress remain to be elucidated. This review summarizes recent advances in human heat acclimation, with emphasis on recent studies that (1) advanced our understanding of the mechanisms mediating improved thermoeffector output and (2) investigated adaptations that go beyond those classically associated with heat acclimation. We highlight that these studies have contributed to a better understanding of the integrated physiological responses underlying human heat acclimation while leaving key unanswered questions that will need to be addressed in the future.
Collapse
Affiliation(s)
- Thomas A. Deshayes
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Dèwanou Gilles Arnaud Sodabi
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Marianne Dubord
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Daniel Gagnon
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| |
Collapse
|
24
|
Bhattacharya S, Sahay R, Afsana F, Sheikh A, Widanage NM, Maskey R, Naseri MW, Murad M, Harikumar KVS, Selim S, Aamir AH, Muthukuda D, Parajuli N, Baheer MD, Latheef A, Nagendra L, Mondal S, Kamrul-Hasan ABM, Raza SA, Somasundaram N, Shrestha D, Anne B, Ramakrishnan S, Kalra S. Global Warming and Endocrinology: The Hyderabad Declaration of the South Asian Federation of Endocrine Societies. Indian J Endocrinol Metab 2024; 28:129-136. [PMID: 38911103 PMCID: PMC11189284 DOI: 10.4103/ijem.ijem_473_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/19/2024] [Accepted: 03/18/2024] [Indexed: 06/25/2024] Open
Abstract
Global warming and endocrine disorders are intertwined issues posing significant challenges. Greenhouse gases emanating from human activities drive global warming, leading to temperature rise and altered weather patterns. South Asia has experienced a noticeable temperature surge over the past century. The sizable population residing in the region heightens the susceptibility to the impact of global warming. In addition to affecting agriculture, water resources, and livelihood, environmental changes interfere with endocrine functioning. Resulting lifestyle changes increase the risk of metabolic and endocrine disorders. Individuals with diabetes face heightened vulnerability to extreme weather due to impaired thermoregulation. A high ambient temperature predisposes to heat-related illnesses, infertility, and nephropathy. Additionally, essential endocrine drugs and medical devices are susceptible to temperature fluctuations. The South Asian Federation of Endocrine Societies (SAFES) calls for collaboration among stakeholders to combat climate change and promote healthy living. Comprehensive approaches, including the establishment of sustainable food systems, promotion of physical activity, and raising awareness about environmental impacts, are imperative. SAFES recommends strategies such as prioritizing plant-based diets, reducing meat consumption, optimizing medical device usage, and enhancing accessibility to endocrine care. Raising awareness and educating caregivers and people living with diabetes on necessary precautions during extreme weather conditions are paramount. The heat sensitivity of insulin, blood glucose monitoring devices, and insulin pumps necessitates proper storage and consideration of environmental conditions for optimal efficacy. The inter-connectedness of global warming and endocrine disorders underscores the necessity of international collaboration guided by national endocrine societies. SAFES urges all stakeholders to actively implement sustainable practices to improve endocrine health in the face of climate change.
Collapse
Affiliation(s)
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India
| | - Faria Afsana
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes (BIRDEM), Dhaka, Bangladesh
| | - Aisha Sheikh
- Department of Endocrinology, Agha Khan University Hospital and MIDEM, Karachi, Pakistan
| | | | - Robin Maskey
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | | | - Moosa Murad
- Department of Internal Medicine, Indira Gandhi Memorial Hospital, Male, Maldives
| | - K. V. S. Harikumar
- Department of Endocrinology, Magna Centres for Obesity Diabetes and Endocrinology, Hyderabad, Telangana, India
| | - Shahjada Selim
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Azizul Hasan Aamir
- Department of Diabetes, Endocrine and Metabolic diseases. Khyber Girls Medical College, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Dimuthu Muthukuda
- Endocrine and Diabetes Center, Sri Jayawardenepura General Hospital, Nugegoda, Sri Lanka
| | - Naresh Parajuli
- Department of Endocrinology, Institute of Medicine, Kathmandu, Nepal
| | - Mohammed Daud Baheer
- Department of Endocrinology, Kabul University of Medical Sciences (KUMS), Kabul, Afghanistan
| | - Ali Latheef
- Department of Internal Medicine, Indira Gandhi Memorial Hospital, Male, Maldives
| | - Lakshmi Nagendra
- Department of Endocrinology, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Sunetra Mondal
- Department of Endocrinology, Nil Ratan Sarkar Medical College, Kolkata, West Bengal, India
| | | | - Syed Abbas Raza
- Department of Medicine, Shaukat Khanum Cancer Hospital and Research Center, Lahore, Pakistan
| | - Noel Somasundaram
- Department of Endocrinology, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Dina Shrestha
- Department of Endocrinology, Norvic International Hospital, Kathmandu, Nepal
| | - Beatrice Anne
- Department of Endocrinology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Santosh Ramakrishnan
- Department of Endocrinology, Magna Centres for Obesity, Diabetes and Endocrinology, Hyderabad, Telangana, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| |
Collapse
|
25
|
Xiong M, Li X, Zhang C, Shen S. Effects of weather and air pollution on outpatient visits for insect-and-mite-caused dermatitis: an empirical and predictive analysis. BMC Public Health 2024; 24:633. [PMID: 38419007 PMCID: PMC11218201 DOI: 10.1186/s12889-024-18067-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/11/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Dermatitis caused by insects and mites, diagnosed as papular urticaria or scabies, is a common skin disease. However, there is still a lack of studies about the effects of weather and air pollution on outpatient visits for this disease. This study aims to explore the impacts of meteorological and environmental factors on daily visits of dermatitis outpatients. METHODS Analyses are conducted on a total of 43,101 outpatient visiting records during the years 2015-2020 from the largest dermatology specialist hospital in Guangzhou, China. Hierarchical cluster models based on Pearson correlation between risk factors are utilized to select regression variables. Linear regression models are fitted to identify the statistically significant associations between the risk factors and daily visits, taking into account the short-term effects of temperatures. Permutation importance is adopted to evaluate the predictive ability of these factors. RESULTS Short-term temperatures have positive associations with daily visits and exhibit strong predictive abilities. In terms of total outpatients, the one-day lagged temperature not only has a significant impact on daily visits, but also has the highest median value of permutation importance. This conclusion is robust across most subgroups except for subgroups of summer and scabies, wherein the three-day lagged temperature has a negative effect. By contrast, air pollution has insignificant associations with daily visits and exhibits weak predictive abilities. Moreover, weekdays, holidays and trends have significant impacts on daily visits, but with weak predictive abilities. CONCLUSIONS Our study suggests that short-term temperatures have positive associations with daily visits and exhibit strong predictive abilities. Nevertheless, air pollution has insignificant associations with daily visits and exhibits weak predictive abilities. The results of this study provide a reference for local authorities to formulate intervention measures and establish an environment-based disease early warning system.
Collapse
Affiliation(s)
- Minghua Xiong
- Business School, Foshan University, Foshan, 528000, China
- Research Centre for Innovation & Economic Transformation, Research Institute of Social Sciences in Guangdong Province, Guangzhou, 510000, China
| | - Xiaoping Li
- Business School, Sichuan University, Chengdu, 610065, China
| | - Chao Zhang
- School of Business, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Shuqun Shen
- Dermatology Hospital, Southern Medical University, Guangzhou, 510515, China.
| |
Collapse
|
26
|
Chen Z, Xie C, Chen K, Hu Y, Xu F, Pan L. Multimode adaptive logic gates based on temperature-responsive DNA strand displacement. NANOSCALE 2024; 16:3107-3112. [PMID: 38250822 DOI: 10.1039/d3nr05980d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Living organisms switch their intrinsic biological states to survive environmental turbulence, in which temperature changes are prevalent in nature. Most artificial temperature-responsive DNA nanosystems work as switch modules that transit between "ON-OFF" states, making it difficult to construct nanosystems with diverse functions. In this study, we present a general strategy to build multimode nanosystems based on a temperature-responsive DNA strand displacement reaction. The temperature-responsive DNA strand displacement was controlled by tuning the sequence of the substrate hairpin strands and the invading strands. The nanosystems were demonstrated as logic gates that performed a set of Boolean logical functions at specific temperatures. In addition, an adaptive logic gate was fabricated that could exhibit different logic functions when placed in different temperatures. Specifically, upon the same input strands, the logic gate worked as an XOR gate at 10 °C, an OR gate at 35 °C, an AND gate at 46 °C, and was reset at 55 °C. The design and fabrication of the multifunctional nanosystems would help construct advanced temperature-responsive systems that may be used for temperature-controlled multi-stage drug delivery and thermally-controlled multi-step assembly of nanostructures.
Collapse
Affiliation(s)
- Zhekun Chen
- Key Laboratory of Image Information Processing and Intelligent Control of Education Ministry of China, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Chun Xie
- Key Laboratory of Image Information Processing and Intelligent Control of Education Ministry of China, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Kuiting Chen
- Key Laboratory of Image Information Processing and Intelligent Control of Education Ministry of China, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Yingxin Hu
- College of Information Science and Technology, Shijiazhuang Tiedao University, Shijiazhuang 050043, China
| | - Fei Xu
- Key Laboratory of Image Information Processing and Intelligent Control of Education Ministry of China, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Linqiang Pan
- Key Laboratory of Image Information Processing and Intelligent Control of Education Ministry of China, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China.
| |
Collapse
|
27
|
Liang H, Wang JY, Liang Y, Shao XF, Ding YL, Jia HQ. Agreement of zero-heat-flux thermometry with the oesophageal and tympanic core temperature measurement in patient receiving major surgery. J Clin Monit Comput 2024; 38:197-203. [PMID: 37792140 PMCID: PMC10879315 DOI: 10.1007/s10877-023-01078-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/12/2023] [Indexed: 10/05/2023]
Abstract
To identify and prevent perioperative hypothermia, most surgical patients require a non-invasive, accurate, convenient, and continuous core temperature method, especially for patients undergoing major surgery. This study validated the precision and accuracy of a cutaneous zero-heat-flux thermometer and its performance in detecting intraoperative hypothermia. Adults undergoing major non-cardiac surgeries with general anaesthesia were enrolled in the study. Core temperatures were measured with a zero-heat-flux thermometer, infrared tympanic membrane thermometer, and oesophagal monitoring at 15-minute intervals. Taking the average value of temperature measured in the tympanic membrane and oesophagus as a reference, we assessed the agreement using the Bland-Altman analysis and linear regression methods. Sensitivity, specificity, and predictive values of detecting hypothermia were estimated. 103 patients and one thousand sixty-eight sets of paired temperatures were analyzed. The mean difference between zero-heat-flux and the referenced measurements was -0.03 ± 0.25 °C, with 95% limits of agreement (-0.52 °C, 0.47 °C) was narrow, with 94.5% of the differences within 0.5 °C. Lin's concordance correlation coefficient was 0.90 (95%CI 0.89-0.92). The zero-heat-flux thermometry detected hypothermia with a sensitivity of 82% and a specificity of 90%. The zero-heat-flux thermometer is in good agreement with the reference core temperature based on tympanic and oesophagal temperature monitoring in patients undergoing major surgeries, and appears high performance in detecting hypothermia.
Collapse
Affiliation(s)
- Hao Liang
- Department of Anesthesiology, The Fourth Hospital Of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jing-Yan Wang
- Department of ENT, Affiliated Hospital Of Hebei University, Baoding, Hebei, China
| | - Yan Liang
- Department of Obstetrics, The NO.1 Central Hospital Of Baoding City, Baoding, Hebei, China
| | - Xin-Feng Shao
- Department of Anesthesiology, The NO.1 Central Hospital Of Baoding City, Baoding, Hebei, China
| | - Yan-Ling Ding
- Department of Anesthesiology, The NO.1 Central Hospital Of Baoding City, Baoding, Hebei, China
| | - Hui-Qun Jia
- Department of Anesthesiology, The Fourth Hospital Of Hebei Medical University, Shijiazhuang, Hebei, China.
| |
Collapse
|
28
|
McGarr GW, Meade RD, Notley SR, Akerman AP, Richards BJ, McCourt ER, King KE, McCormick JJ, Boulay P, Sigal RJ, Kenny GP. Physiological responses to 9 hours of heat exposure in young and older adults. Part III: Association with self-reported symptoms and mood state. J Appl Physiol (1985) 2024; 136:408-420. [PMID: 38153847 DOI: 10.1152/japplphysiol.00740.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/13/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023] Open
Abstract
Older adults are at greater risk of heat-related morbidity and mortality during heat waves, which is commonly linked to impaired thermoregulation. However, little is known about the influence of increasing age on the relation between thermal strain and perceptual responses during daylong heat exposure. We evaluated thermal and perceptual responses in 20 young (19-31 yr) and 39 older adults (20 with hypertension and/or type 2 diabetes; 61-78 yr) resting in the heat for 9 h (heat index: 37°C). Body core and mean skin temperature areas under the curve (AUC, hours 0-9) were assessed as indicators of cumulative thermal strain. Self-reported symptoms (68-item environmental symptoms questionnaire) and mood disturbance (40-item profile of mood states questionnaire) were assessed at end-heating (adjusted for prescores). Body core temperature AUC was 2.4°C·h [1.0, 3.7] higher in older relative to young adults (P < 0.001), whereas mean skin temperature AUC was not different (-0.5°C·h [-4.1, 3.2] P = 0.799). At end-heating, self-reported symptoms were not different between age groups (0.99-fold [0.80, 1.23], P = 0.923), with or without adjustment for body core or mean skin temperature AUC (both P ≥ 0.824). Mood disturbance was 0.93-fold [0.88, 0.99] lower in older, relative to young adults (P = 0.031). Older adults with and without chronic health conditions experienced similar thermal strain, yet those with these conditions reported lower symptom scores and mood disturbance compared with young adults and their age-matched counterparts (all P ≤ 0.026). Although older adults experienced heightened thermal strain during the 9-h heat exposure, they did not experience greater self-reported symptoms or mood disturbance relative to young adults.NEW & NOTEWORTHY Despite experiencing greater cumulative thermal strain during 9 h of passive heat exposure, older adults reported similar heat-related symptoms and lower mood disturbance than young adults. Furthermore, self-reported symptoms and mood disturbance were lower in older adults with common age-associated health conditions than young adults and healthy age-matched counterparts. Perceptual responses to heat in older adults can underestimate their level of thermal strain compared with young adults, which may contribute to their increased heat vulnerability.
Collapse
Affiliation(s)
- Gregory W McGarr
- Consumer and Clinical Radiation Protection Bureau, Health Canada, Ottawa, Ontario, Canada
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Robert D Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ashley P Akerman
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Brodie J Richards
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Emma R McCourt
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Kelli E King
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - James J McCormick
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Pierre Boulay
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Ronald J Sigal
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| |
Collapse
|
29
|
Yang S, Bekö G, Wargocki P, Zhang M, Merizak M, Nenes A, Williams J, Licina D. Physiology or Psychology: What Drives Human Emissions of Carbon Dioxide and Ammonia? ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:1986-1997. [PMID: 38237915 PMCID: PMC10832055 DOI: 10.1021/acs.est.3c07659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/26/2023] [Accepted: 12/20/2023] [Indexed: 01/31/2024]
Abstract
Humans are the primary sources of CO2 and NH3 indoors. Their emission rates may be influenced by human physiological and psychological status. This study investigated the impact of physiological and psychological engagements on the human emissions of CO2 and NH3. In a climate chamber, we measured CO2 and NH3 emissions from participants performing physical activities (walking and running at metabolic rates of 2.5 and 5 met, respectively) and psychological stimuli (meditation and cognitive tasks). Participants' physiological responses were recorded, including the skin temperature, electrodermal activity (EDA), and heart rate, and then analyzed for their relationship with CO2 and NH3 emissions. The results showed that physiological engagement considerably elevated per-person CO2 emission rates from 19.6 (seated) to 46.9 (2.5 met) and 115.4 L/h (5 met) and NH3 emission rates from 2.7 to 5.1 and 8.3 mg/h, respectively. CO2 emissions reduced when participants stopped running, whereas NH3 emissions continued to increase owing to their distinct emission mechanisms. Psychological engagement did not significantly alter participants' emissions of CO2 and NH3. Regression analysis revealed that CO2 emissions were predominantly correlated with heart rate, whereas NH3 emissions were mainly associated with skin temperature and EDA. These findings contribute to a deeper understanding of human metabolic emissions of CO2 and NH3.
Collapse
Affiliation(s)
- Shen Yang
- Human-Oriented
Built Environment Lab, School of Architecture, Civil and Environmental
Engineering, École Polytechnique
Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Gabriel Bekö
- International
Centre for Indoor Environment and Energy, Department of Environmental
and Resource Engineering, Technical University
of Denmark, Kongens Lyngby, 2800 Copenhagen, Denmark
| | - Pawel Wargocki
- International
Centre for Indoor Environment and Energy, Department of Environmental
and Resource Engineering, Technical University
of Denmark, Kongens Lyngby, 2800 Copenhagen, Denmark
| | - Meixia Zhang
- Human-Oriented
Built Environment Lab, School of Architecture, Civil and Environmental
Engineering, École Polytechnique
Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Marouane Merizak
- Human-Oriented
Built Environment Lab, School of Architecture, Civil and Environmental
Engineering, École Polytechnique
Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Athanasios Nenes
- Laboratory
of Atmospheric Processes and Their Impacts, School of Architecture,
Civil & Environmental Engineering, École
Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Jonathan Williams
- Max
Planck Institute for Chemistry, Hahn-Meitner Weg 1, 55128 Mainz, Germany
- Energy,
Environment and Water Research Center, The
Cyprus Institute, 2121 Nicosia, Cyprus
| | - Dusan Licina
- Human-Oriented
Built Environment Lab, School of Architecture, Civil and Environmental
Engineering, École Polytechnique
Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| |
Collapse
|
30
|
Sisodiya SM. Hot brain: practical climate change advice for neurologists. Pract Neurol 2024; 24:28-36. [PMID: 37949657 DOI: 10.1136/pn-2023-003777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/12/2023]
Abstract
'We are called to be architects of the future, not its victims'-Buckminster Fuller People with chronic neurological conditions may be vulnerable to change and less able to manage its demands: neurological diseases are among the most burdensome. Whether climate change has particular effects on specific neurological diseases or not, the known impaired resilience to change affecting people with neurological diseases requires neurologists to have awareness of potential climate impacts and their management. Preparedness should include understanding of general national and local alerts and action systems, and the ability to advise patients about managing extreme weather events, particularly heatwaves, but also floods and cold snaps. At the same time, we need more research into the particular consequences of climate change on specific neurological diseases. Climate change is a serious healthcare issue, requiring the neurological community to respond as it would, or did, to other serious challenges, such as COVID-19. As disease experts, we all have a role to play.
Collapse
Affiliation(s)
- Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| |
Collapse
|
31
|
Xia R, Sun M, Li Y, Yin J, Liu H, Yang J, Liu J, He Y, Wu B, Yang G, Li J. The pathogenesis and therapeutic strategies of heat stroke-induced myocardial injury. Front Pharmacol 2024; 14:1286556. [PMID: 38259273 PMCID: PMC10800451 DOI: 10.3389/fphar.2023.1286556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Heat stroke (HS) is a febrile illness characterized by an elevation in the core body temperature to over 40°C, accompanied by central nervous system impairment and subsequent multi-organ dysfunction syndrome. In recent years, the mortality rate from HS has been increasing as ambient temperatures continue to rise each year. The cardiovascular system plays an important role in the pathogenesis process of HS, as it functions as one of the key system for thermoregulation and its stability is associated with the severity of HS. Systemic inflammatory response and endothelial cell damage constitute pivotal attributes of HS, other factors such as ferroptosis, disturbances in myocardial metabolism and heat shock protein dysregulation are also involved in the damage to myocardial tissue in HS. In this review, a comprehensively detailed description of the pathogenesis of HS-induced myocardial injury is provided. The current treatment strategies and the promising therapeutic targets for HS are also discussed.
Collapse
Affiliation(s)
- Rui Xia
- Department of Critical Care Medicine, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Meng Sun
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuling Li
- Emergency Department, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jing Yin
- Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Huan Liu
- Department of Critical Care Medicine, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Jun Yang
- Department of Critical Care Medicine, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Jing Liu
- Department of Critical Care Medicine, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Yanyu He
- Department of Critical Care Medicine, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Bing Wu
- Department of Critical Care Medicine, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Guixiang Yang
- Department of Critical Care Medicine, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Jianhua Li
- Department of Critical Care Medicine, Chongqing University Jiangjin Hospital, Chongqing, China
| |
Collapse
|
32
|
Bach AJE, Cunningham SJK, Morris NR, Xu Z, Rutherford S, Binnewies S, Meade RD. Experimental research in environmentally induced hyperthermic older persons: A systematic quantitative literature review mapping the available evidence. Temperature (Austin) 2024; 11:4-26. [PMID: 38567267 PMCID: PMC7615797 DOI: 10.1080/23328940.2023.2242062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/21/2023] [Indexed: 04/04/2024] Open
Abstract
The heat-related health burden is expected to persist and worsen in the coming years due to an aging global population and climate change. Defining the breadth and depth of our understanding of age-related changes in thermoregulation can identify underlying causes and strategies to protect vulnerable individuals from heat. We conducted the first systematic quantitative literature review to provide context to the historical experimental research of healthy older adults - compared to younger adults or unhealthy age matched cases - during exogenous heat strain, focusing on factors that influence thermoregulatory function (e.g. co-morbidities). We identified 4,455 articles, with 147 meeting eligibility criteria. Most studies were conducted in the US (39%), Canada (29%), or Japan (12%), with 71% of the 3,411 participants being male. About 71% of the studies compared younger and older adults, while 34% compared two groups of older adults with and without factors influencing thermoregulation. Key factors included age combined with another factor (23%), underlying biological mechanisms (18%), age independently (15%), influencing health conditions (15%), adaptation potential (12%), environmental conditions (9%), and therapeutic/pharmacological interventions (7%). Our results suggest that controlled experimental research should focus on the age-related changes in thermoregulation in the very old, females, those with overlooked chronic heat-sensitive health conditions (e.g. pulmonary, renal, mental disorders), the impact of multimorbidity, prolonged and cumulative effects of extreme heat, evidence-based policy of control measures (e.g. personal cooling strategies), pharmaceutical interactions, and interventions stimulating protective physiological adaptation. These controlled studies will inform the directions and use of limited resources in ecologically valid fieldwork studies.
Collapse
Affiliation(s)
- Aaron J. E. Bach
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Cities Research Institute, Griffith University, Gold Coast, QLD, Australia
| | - Sarah J. K. Cunningham
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Cities Research Institute, Griffith University, Gold Coast, QLD, Australia
| | - Norman R. Morris
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
- Metro North Hospital and Health Service, The Prince Charles Hospital. Allied Health Research Collaborative, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Cities Research Institute, Griffith University, Gold Coast, QLD, Australia
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Cities Research Institute, Griffith University, Gold Coast, QLD, Australia
| | - Sebastian Binnewies
- School of Information and Communication Technology, Griffith University, Gold Coast, QLD, Australia
| | - Robert D. Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| |
Collapse
|
33
|
Notley SR, Mitchell D, Taylor NAS. A century of exercise physiology: concepts that ignited the study of human thermoregulation. Part 3: Heat and cold tolerance during exercise. Eur J Appl Physiol 2024; 124:1-145. [PMID: 37796292 DOI: 10.1007/s00421-023-05276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/04/2023] [Indexed: 10/06/2023]
Abstract
In this third installment of our four-part historical series, we evaluate contributions that shaped our understanding of heat and cold stress during occupational and athletic pursuits. Our first topic concerns how we tolerate, and sometimes fail to tolerate, exercise-heat stress. By 1900, physical activity with clothing- and climate-induced evaporative impediments led to an extraordinarily high incidence of heat stroke within the military. Fortunately, deep-body temperatures > 40 °C were not always fatal. Thirty years later, water immersion and patient treatments mimicking sweat evaporation were found to be effective, with the adage of cool first, transport later being adopted. We gradually acquired an understanding of thermoeffector function during heat storage, and learned about challenges to other regulatory mechanisms. In our second topic, we explore cold tolerance and intolerance. By the 1930s, hypothermia was known to reduce cutaneous circulation, particularly at the extremities, conserving body heat. Cold-induced vasodilatation hindered heat conservation, but it was protective. Increased metabolic heat production followed, driven by shivering and non-shivering thermogenesis, even during exercise and work. Physical endurance and shivering could both be compromised by hypoglycaemia. Later, treatments for hypothermia and cold injuries were refined, and the thermal after-drop was explained. In our final topic, we critique the numerous indices developed in attempts to numerically rate hot and cold stresses. The criteria for an effective thermal stress index were established by the 1930s. However, few indices satisfied those requirements, either then or now, and the surviving indices, including the unvalidated Wet-Bulb Globe-Thermometer index, do not fully predict thermal strain.
Collapse
Affiliation(s)
- Sean R Notley
- Defence Science and Technology Group, Department of Defence, Melbourne, Australia
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Duncan Mitchell
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Sciences, University of Western Australia, Crawley, Australia
| | - Nigel A S Taylor
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
| |
Collapse
|
34
|
AlSahow A. The Impact of Hot Ambient Temperature and Prolonged Fasting Duration during Ramadan on Patients with Chronic Kidney Disease: A Literature Review. Int J Nephrol 2023; 2023:2636507. [PMID: 38106546 PMCID: PMC10725313 DOI: 10.1155/2023/2636507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 12/19/2023] Open
Abstract
The Islamic (lunar) calendar has 11 fewer days each year than the Gregorian (solar) calendar. Consequently, ambient temperatures during the month of Ramadan and the duration of the presunrise-to-sunset fast will change each year. At some point, individuals observing Ramadan will experience prolonged periods of fasting during the hot summer months. In this manuscript, findings published in the English-language medical literature that address the impact of prolonged fasting during the warmer summer months on patients with chronic kidney disease, including dialysis and transplantation patients, are reviewed. This is of particular concern given the accelerated pace of global warming. The limitations of the evidence that is currently available are also discussed, and an approach that might be used to standardize future evaluations of the impact of fasting on kidney health is suggested.
Collapse
Affiliation(s)
- Ali AlSahow
- Division of Nephrology, Jahra Hospital, Jahra, Kuwait
| |
Collapse
|
35
|
Chiang MH, Lin YC, Wu T, Wu CL. Thermosensation and Temperature Preference: From Molecules to Neuronal Circuits in Drosophila. Cells 2023; 12:2792. [PMID: 38132112 PMCID: PMC10741703 DOI: 10.3390/cells12242792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Temperature has a significant effect on all physiological processes of animals. Suitable temperatures promote responsiveness, movement, metabolism, growth, and reproduction in animals, whereas extreme temperatures can cause injury or even death. Thus, thermosensation is important for survival in all animals. However, mechanisms regulating thermosensation remain unexplored, mostly because of the complexity of mammalian neural circuits. The fruit fly Drosophila melanogaster achieves a desirable body temperature through ambient temperature fluctuations, sunlight exposure, and behavioral strategies. The availability of extensive genetic tools and resources for studying Drosophila have enabled scientists to unravel the mechanisms underlying their temperature preference. Over the past 20 years, Drosophila has become an ideal model for studying temperature-related genes and circuits. This review provides a comprehensive overview of our current understanding of thermosensation and temperature preference in Drosophila. It encompasses various aspects, such as the mechanisms by which flies sense temperature, the effects of internal and external factors on temperature preference, and the adaptive strategies employed by flies in extreme-temperature environments. Understanding the regulating mechanisms of thermosensation and temperature preference in Drosophila can provide fundamental insights into the underlying molecular and neural mechanisms that control body temperature and temperature-related behavioral changes in other animals.
Collapse
Affiliation(s)
- Meng-Hsuan Chiang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (M.-H.C.); (Y.-C.L.)
| | - Yu-Chun Lin
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (M.-H.C.); (Y.-C.L.)
| | - Tony Wu
- Department of Neurology, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei City 23652, Taiwan;
| | - Chia-Lin Wu
- Department of Neurology, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei City 23652, Taiwan;
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Brain Research Center, National Tsing Hua University, Hsinchu 30013, Taiwan
| |
Collapse
|
36
|
Yang Y, Zhang Y, Sheng S. Residential greenness for mitigating impacts of extreme heat events on depression and supporting mental health. Front Public Health 2023; 11:1310410. [PMID: 38145084 PMCID: PMC10740180 DOI: 10.3389/fpubh.2023.1310410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/15/2023] [Indexed: 12/26/2023] Open
Abstract
Background Residential green spaces (RGS) are a crucial aspect of urban life, which provide residents with a positive living environment both for mental and physical well-being. However, extreme heat events caused by global warming and local urban heat island effects are threatening the public health of rapidly growing populations. This is especially true for mental health. Depression is a mental illness that can be impacted by extreme heat events, i.e., heatwaves. Objective This study aimed to investigate the potential for residential green spaces (RGS) to alleviate depression by reducing heat stress sensitivity during extreme heat events. Methods We conducted a literature review using scientometric analysis with CiteSpace to summarize existing research on the relationships between RGS, depression, and heatwaves. We proposed a conceptual framework for the relationship between RGS and depression, and that extreme heat events may be an important contributor to depression. Results Our review found that RGS can provide ecosystem services that lower ambient temperatures through evaporative cooling, radiation reflection, humidity regulation, and shading. Different types of RGS, i.e., small green spaces, green roofs, green walls, and street trees, have varying cooling capacities. The mechanisms by which RGS alleviate depression during heatwaves involve green space composition, exposure, physical activity, social contacts, and cohesion. And we proposed a conceptual framework for the relationship between RGS and depression, and that extreme heat events may be an important contributor to depression. Conclusion We present a multidimensional RGS evaluation roadmap to inform green space design for reducing depression during heatwaves. Establishing RGS multidimensional evaluation can guide future research on leveraging RGS to build resilience against extreme heat and improve public mental health.
Collapse
Affiliation(s)
- Ying Yang
- Department of Landscape Architecture, Gold Mantis School of Architecture, Soochow University, Suzhou, China
| | - Yixin Zhang
- Department of Landscape Architecture, Gold Mantis School of Architecture, Soochow University, Suzhou, China
- Research Center of Landscape Heritage Protection and Ecological Restoration, China-Portugal Joint Laboratory of Cultural Heritage Conservation Science, Suzhou, China
| | - Shaojie Sheng
- Department of Landscape Architecture, Gold Mantis School of Architecture, Soochow University, Suzhou, China
| |
Collapse
|
37
|
Hu B, Shi Y, Zhang P, Fan Y, Feng J, Hou L. Global, regional, and national burdens of hypertensive heart disease from 1990 to 2019 :A multilevel analysis based on the global burden of Disease Study 2019. Heliyon 2023; 9:e22671. [PMID: 38213586 PMCID: PMC10782162 DOI: 10.1016/j.heliyon.2023.e22671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 01/13/2024] Open
Abstract
Aim This study aimed to describe the prevalence, deaths, and disability-adjusted life-years (DALYs) of hypertensive heart disease (HHD) at the global, regional, and national levels and analyze epidemiological trends. Method We extracted global estimates of prevalence, deaths, and DALYs related to HHD in 204 countries and regions from the 2019 Global Burden of Diseases Study. Average annual percent change (AAPC) was calculated to represent temporal trends. Joinpoint regression models were used to analyze time trends from 1990 to 2019. Finally, the decomposition analysis showed the driving factors of burden changes. Results From 1990 to 2019, the global prevalence of HHD cases increased by 138 %, reaching 18,598,025 cases (95 % uncertainty interval [UI]: 13,544,365-24,898,411). DALYs also rose by 154 %, reaching 21,508,002 (95 % UI, 16,400,051-23,899,879). The death rate increased to 14.95 (95 % UI, 11.11-16.52) per 100,000 people. Of the five sociodemographic index (SDI) regions, the prevalence rate related to HHD was the highest in the high-middle SDI region. In contrast, the death and DALY rate related to HHD were the highest in the middle SDI region. In other regions, the prevalence rate was the highest in East Asia (548.87 per 100,000 people; 95 % UI, 395.40-747.83), and the death rate was the highest in Central Europe (42.64 per 100,000 people; 95 % UI, 30.58-49.38). At the national level, the Cook Islands had the highest prevalence rate for HHD (703.08 per 100,000 people; 95 % UI, 532.87-920.72), Bulgaria had the highest death rate (75.08 per 100,000 people; 95 % UI, 46.38-92.81), and Afghanistan had the highest DALY rate (1374.12 per 100,000 people; 95 % UI, 467.17-2020.70). High body mass index, a diet high in sodium, alcohol use, lead exposure, high temperature, and low temperature were identified as risk factors for death and DALYs related to HHD in 2019. Aging and population growth were the major drivers of prevalence, death, and DALYs. Finally, over the past 30 years, the global age-standardized prevalence rate (ASPR) of HHD has significantly risen (AAPC = 0.21 %, 95 % confidence interval [CI]: 0.17-0.24; P < 0.001), while the age-standardized deaths rate (ASDR) has shown significant declining trends (AAPC = -0.86 %, 95 % CI: 1.00 to -0.71; P < 0.001), and age-standardized DALY rates (AAPC = -1.08 %, 95 % CI: 1.23 to -0.93; P < 0.001). Conclusion Despite a significant decline in the global ASDR and age-standardized DALY rate of HHD over the past 30 years, the ASPR continues to rise. The burden of HHD is more heavily skewed towards non-high-income economies. Active prevention, control of risk factors, and improvement of medical protection levels to address the disease burden caused by population growth and aging are needed.
Collapse
Affiliation(s)
- Ben Hu
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, 230000, Anhui, China
| | - Yihang Shi
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Pengcheng Zhang
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230000, Anhui, China
| | - Jun Feng
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Linlin Hou
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, 230000, Anhui, China
| |
Collapse
|
38
|
Kalhoff H, Sinningen K, Belgardt A, Kersting M, Luecke T. Climate change and fluid status in children: early education as one response to an emerging public health problem. Public Health Nutr 2023; 26:2891-2894. [PMID: 37981836 PMCID: PMC10755392 DOI: 10.1017/s1368980023002562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/27/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVE As global warming intensifies, residents of temperate regions will also face heat waves in the near future. Food habits are one component in addressing the global challenge of climate change. However, water, the most important food for humans, has not been adequately addressed. DESIGN For this commentary, on the one hand, publications on the increasing heat stress of children were consulted. On the other hand, publications on the special demands of children's temperature regulation in hot environments on fluid balance were analysed. SETTING The situation of young children in care facilities on days with heat stress is presented as a scenario. In this way, the effects of climatic changes on fluid balance can be estimated and measures to reduce heat stress and stabilise the fluid balance of children can be developed. PARTICIPANTS For this analysis, first, infants will be considered in order to identify their specific fluid needs. Second, the possibilities for caregivers to improve fluid intake and train appropriate drinking habits already in infancy will be highlighted. RESULTS Climate change should be included in recommendations on hydration for children. The need to adapt drinking habits requires educational approaches to weather and water - starting in early childhood care. CONCLUSIONS In the face of rapid climate change, countries must act now by protecting, preparing and prioritising the high-risk group of children. Particular focus should be placed on supporting adequate hydration.
Collapse
Affiliation(s)
- Hermann Kalhoff
- Pediatric Clinic Dortmund, Beurhausstrasse 40, D-44137 Dortmund, Germany
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Alexandrinenstrasse 5, D-44791 Bochum, Germany
| | - Kathrin Sinningen
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Alexandrinenstrasse 5, D-44791 Bochum, Germany
| | - Aziza Belgardt
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Alexandrinenstrasse 5, D-44791 Bochum, Germany
| | - Mathilde Kersting
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Alexandrinenstrasse 5, D-44791 Bochum, Germany
| | - Thomas Luecke
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Alexandrinenstrasse 5, D-44791 Bochum, Germany
| |
Collapse
|
39
|
Gong J, Sun P, Li L, Zou Z, Wu Q, Sun L, Li H, Gu Z, Su L. Heat stress suppresses MnSOD expression via p53-Sp1 interaction and induces oxidative stress damage in endothelial cells: Protective effects of MitoQ10 and Pifithrin-α. Heliyon 2023; 9:e22805. [PMID: 38125505 PMCID: PMC10730713 DOI: 10.1016/j.heliyon.2023.e22805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Aim To investigate the mechanism of p53-mediated suppression of heat stress-induced oxidative stress damage by manganese superoxide dismutase (MnSOD) in endothelial cells (ECs). Methods Primary ECs isolated from mouse aortas were used to examine the effects of heat stress on vascular ECs viability and apoptosis. We measured MnSOD expression, reactive oxygen species (ROS) production, p53 expression, viability, and apoptosis of heat stress-induced ECs. We also tested the protective effects of MitoQ10, a mitochondrial-targeted antioxidant, and Pifithrin-α, a p53 inhibitor, in ECs from a mouse model of heat stroke. Results Heat stress increased cellular apoptosis, ROS production, and p53 expression, while reducing cellular viability and MnSOD expression in ECs. We also showed that the suppression of MnSOD expression by heat stress in ECs was mediated by interactions between p53 and Sp1. Furthermore, MitoQ10 and Pifithrin-α alleviated heat stress-induced oxidative stress and apoptosis in ECs. Conclusion Our results revealed that p53-mediated MnSOD downregulation is a key mechanism for heat stress-induced oxidative stress damage in ECs and indicated that MitoQ10 and Pifithrin-α could be potential therapeutic agents for heat stroke.
Collapse
Affiliation(s)
- Jian Gong
- Department of Critical Care Medicine, The First School of Clinical Medicine, Southern Medical University (General Hospital of Southern Theater Command of PLA), Guangzhou, 510515, China
- Department of Intensive Care Medicine, The Third People's Hospital of Longgang District, Shenzhen, 518115, China
| | - Peipei Sun
- Department of Intensive Care Medicine, The Third People's Hospital of Longgang District, Shenzhen, 518115, China
| | - Li Li
- Department of Treatment Center for Traumatic Injuries, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
- Academy of Orthopedics, Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Zhimin Zou
- Department of Treatment Center for Traumatic Injuries, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
- Academy of Orthopedics, Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Qihua Wu
- Department of Intensive Care Medicine, The Third People's Hospital of Longgang District, Shenzhen, 518115, China
| | - Liyun Sun
- Department of Intensive Care Medicine, The Third People's Hospital of Longgang District, Shenzhen, 518115, China
| | - Hui Li
- Department of Critical Care Medicine, The First School of Clinical Medicine, Southern Medical University (General Hospital of Southern Theater Command of PLA), Guangzhou, 510515, China
- Key Laboratory of Hot Zone Trauma Care and Tissue Repair of PLA, Guangzhou, 510515, China
| | - Zhengtao Gu
- Department of Treatment Center for Traumatic Injuries, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
- Academy of Orthopedics, Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Lei Su
- Department of Critical Care Medicine, The First School of Clinical Medicine, Southern Medical University (General Hospital of Southern Theater Command of PLA), Guangzhou, 510515, China
- Key Laboratory of Hot Zone Trauma Care and Tissue Repair of PLA, Guangzhou, 510515, China
| |
Collapse
|
40
|
Hu P, Chang J, Huang Y, Guo M, Lu F, Long Y, Liu H, Yang X, Qi Y, Sun J, Yang Z, Deng Q, Liu J. Nonoptimum Temperatures Are More Closely Associated With Fatal Myocardial Infarction Than With Nonfatal Events. Can J Cardiol 2023; 39:1974-1983. [PMID: 37924969 PMCID: PMC10715678 DOI: 10.1016/j.cjca.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/10/2023] [Accepted: 08/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Ambient temperatures trigger hospitalisation, mortality, and emergency department visits for myocardial infarction (MI). However, nonoptimum temperature-related risks of fatal and nonfatal MI have not yet been compared. METHODS From 2007 to 2019, 416,894 MI events (233,071 fatal and 183,823 nonfatal) were identified in Beijing, China. A time-series analysis with a distributed-lag nonlinear model was used to compare the relative and population-attributable risks of fatal and nonfatal MI associated with nonoptimum temperatures. RESULTS The reference was the optimum temperature of 24.3°C. For single-lag effects, cold (-5.2°C) and heat (29.6°C) effects had associations that persisted for more days for fatal MI than for nonfatal MI. For cumulative-lag effects over 0 to 21 days, cold effects were higher for fatal MI (relative risk [RR] 1.99, 95% confidence interval [CI] 1.68-2.35) than for nonfatal MI (RR 1.60, 95% CI 1.32-1.94) with a P value for difference in effect sizes of 0.048. In addition, heat effects were higher for fatal MI (RR 1.33, 95% CI 1.24-1.44) than for nonfatal MI (RR 0.99, 95% CI 0.91-1.08) with a P value for difference in effect sizes of 0.002. The attributable fraction of nonoptimum temperatures was higher for fatal MI (25.6%, 95% CI 19.7%-30.6%) than for nonfatal MI (19.1%, 95% CI 12.1%-25.0%). CONCLUSIONS Fatal MI was more closely associated with nonoptimum temperatures than nonfatal MI, as evidenced by single-lag effects that have associations which persisted for more days, higher cumulative-lag effects, and higher attributable risks for fatal MI. Strategies are needed to mitigate the adverse effects of nonoptimum temperatures.
Collapse
Affiliation(s)
- Piaopiao Hu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jie Chang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yulin Huang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Moning Guo
- Beijing Municipal Health Big Data and Policy Research Center, Beijing, China; Beijing Institute of Hospital Management, Beijing, China
| | - Feng Lu
- Beijing Municipal Health Big Data and Policy Research Center, Beijing, China; Beijing Institute of Hospital Management, Beijing, China
| | - Ying Long
- School of Architecture, Tsinghua University, Beijing, China
| | - Huan Liu
- State Key Joint Laboratory of ESPC, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing, China
| | - Xudong Yang
- Departments of Building Science and Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yue Qi
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jiayi Sun
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Zhao Yang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qiuju Deng
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - Jing Liu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| |
Collapse
|
41
|
Chen L, Lu L, Fang Y, Ren J, Yang X, Gong Z, Zhang Y, Feng X. Glasgow Coma Scale on admission as predictor of neurological sequelae at discharge and acute respiratory failure in patients with heatstroke. Postgrad Med J 2023; 99:1237-1245. [PMID: 37650372 DOI: 10.1093/postmj/qgad071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/15/2023] [Accepted: 08/03/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Transient neuronal dysfunction may occur in most brain regions with heatstroke (HS). This study aimed to explore the prognostic significance of initial Glasgow Coma Scale (GCS) scores in HS. METHODS Retrospective data regarding HS were obtained from six hospitals. The primary outcome was neurological sequelae at discharge. Secondary outcomes included acute respiratory failure (ARF) and intensive care unit (ICU) admission. Logistic regression models and random forest imputation were used to assess the independent association between GCS score and outcomes. Interaction and stratified analyses of body temperature (BT) at 0.5 hours were also conducted. Receiver operating characteristic curves and decision curve analysis were used to estimate prognostic values. RESULTS Of 206 patients, 44 (21.36%) had neurological sequelae at discharge. The mean ± standard deviation initial GCS score was 8.17 ± 4.05. After adjustment for confounders, GCS, as a continuous variable, was significantly related to neurological sequelae at discharge [odds ratio (OR): 0.65; 95% confidence interval (CI): 0.50-0.85; P = 0.002], ARF (OR: 0.76; 95% CI: 0.66-0.87; P = 0.001), and ICU admission (OR: 0.68; 95% CI: 0.53-0.87; P = 0.003). These relationships were consistent in the random forest imputation cohort. The OR between GCS and neurological sequelae at discharge was much lower (P = 0.048) in participants with BT at 0.5 hours ≤39°C than in those with BT at 0.5 hours >39°C. The GCS and National Early Warning Score (NEWS) had similar prognostic ability for all outcomes, whereas the net benefits were greater with the GCS compared with the NEWS. CONCLUSIONS Initial GCS score was an independent prognostic factor for neurological sequelae at discharge in HS. Rapid cooling played a positive role in this relationship. Key messages What is already known on this topic Brain damage caused by heatstroke (HS) can be transient or result in irreversible injury. Early recognition of those at risk of death or developing neurological complications is very important for improving the outcomes of HS. What this study adds Initial Glasgow Coma Scale (GCS) score was an independent prognostic factor for neurological sequelae at discharge, acute respiratory failure, and intensive care unit (ICU) admission in HS. Rapid cooling played a positive role in this relationship. How this study might affect research, practice, or policy The GCS upon emergency department admission can be a useful predictor of prognosis in patients with HS.
Collapse
Affiliation(s)
- Lan Chen
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Liyun Lu
- Emergency Department, Jinhua People's Hospital, Jinhua, 321099, China
| | - Yuan Fang
- Emergency Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua Municipal Central Hospital, Jinhua, 321000, China
| | - Jingnan Ren
- Emergency Department, Dongyang People's Hospital, Dongyang, 322103, China
| | - Xiaoling Yang
- Emergency Department, Lanxi People's Hospital, Lanxi, 321102, China
| | - Zhumei Gong
- Emergency Department, Yiwu Central Hospital, Yiwu, 322099, China
| | - Yuping Zhang
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Xiuqin Feng
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| |
Collapse
|
42
|
Rivas E, Foster J, Crandall CG, Finnerty CC, Suman-Vejas OE. Key Exercise Concepts in the Rehabilitation from Severe Burns. Phys Med Rehabil Clin N Am 2023; 34:811-824. [PMID: 37806699 PMCID: PMC10731385 DOI: 10.1016/j.pmr.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
This article presents information on the benefits of exercise in counteracting the detrimental effects of bed rest, and/or severe burns. Exercise is key for maintaining physical function, lean body mass, metabolic recovery, and psychosocial health after major burn injuries. The details of an exercise training program conducted in severely burned persons are presented, as well as information on the importance of proper regulation of body temperature during exercise or physical activity. The sections on exercise and thermoregulation are followed by a section on the role of exercise in scarring and contractures. Finally, gaps in the current knowledge of exercise, thermoregulation, and contractures are presented.
Collapse
Affiliation(s)
- Eric Rivas
- Microgravity Research, In-Space Solutions, Axiom Space Headquarters, 1290 Hercules Avenue, Houston, TX 77058, USA
| | - Josh Foster
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Institute for Exercise and Environmental Medicine (IEEM), Texas Health Presbyterian Hospital Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Craig G Crandall
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Institute for Exercise and Environmental Medicine (IEEM), Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Suite 435, Dallas, TX 75231, USA
| | - Celeste C Finnerty
- Department of Surgery, Division of Surgical Sciences, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1220, USA
| | - Oscar E Suman-Vejas
- Department of Surgery, Division of Surgical Sciences, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1220, USA.
| |
Collapse
|
43
|
Wee J, Tan XR, Gunther SH, Ihsan M, Leow MKS, Tan DSY, Eriksson JG, Lee JKW. Effects of Medications on Heat Loss Capacity in Chronic Disease Patients: Health Implications Amidst Global Warming. Pharmacol Rev 2023; 75:1140-1166. [PMID: 37328294 DOI: 10.1124/pharmrev.122.000782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/20/2023] [Accepted: 05/31/2023] [Indexed: 06/18/2023] Open
Abstract
Pharmacological agents used to treat or manage diseases can modify the level of heat strain experienced by chronically ill and elderly patients via different mechanistic pathways. Human thermoregulation is a crucial homeostatic process that maintains body temperature within a narrow range during heat stress through dry (i.e., increasing skin blood flow) and evaporative (i.e., sweating) heat loss, as well as active inhibition of thermogenesis, which is crucial to avoid overheating. Medications can independently and synergistically interact with aging and chronic disease to alter homeostatic responses to rising body temperature during heat stress. This review focuses on the physiologic changes, with specific emphasis on thermolytic processes, associated with medication use during heat stress. The review begins by providing readers with a background of the global chronic disease burden. Human thermoregulation and aging effects are then summarized to give an understanding of the unique physiologic changes faced by older adults. The effects of common chronic diseases on temperature regulation are outlined in the main sections. Physiologic impacts of common medications used to treat these diseases are reviewed in detail, with emphasis on the mechanisms by which these medications alter thermolysis during heat stress. The review concludes by providing perspectives on the need to understand the effects of medication use in hot environments, as well as a summary table of all clinical considerations and research needs of the medications included in this review. SIGNIFICANCE STATEMENT: Long-term medications modulate thermoregulatory function, resulting in excess physiological strain and predisposing patients to adverse health outcomes during prolonged exposures to extreme heat during rest and physical work (e.g., exercise). Understanding the medication-specific mechanisms of altered thermoregulation has importance in both clinical and research settings, paving the way for work toward refining current medication prescription recommendations and formulating mitigation strategies for adverse drug effects in the heat in chronically ill patients.
Collapse
Affiliation(s)
- Jericho Wee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Xiang Ren Tan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Samuel H Gunther
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Mohammed Ihsan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Melvin Khee Shing Leow
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Doreen Su-Yin Tan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Johan G Eriksson
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Jason Kai Wei Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| |
Collapse
|
44
|
Al-Kindi S, Motairek I, Khraishah H, Rajagopalan S. Cardiovascular disease burden attributable to non-optimal temperature: analysis of the 1990-2019 global burden of disease. Eur J Prev Cardiol 2023; 30:1623-1631. [PMID: 37115593 DOI: 10.1093/eurjpc/zwad130] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 04/29/2023]
Abstract
AIMS Extreme temperatures are increasingly experienced as a result of climate change. Both high and low temperatures, impacted by climate change, have been linked with cardiovascular disease (CVD). Global estimates on non-optimal temperature-related CVD are not known. The authors investigated global trends of temperature-related CVD burden over the last three decades. METHODS AND RESULTS The authors utilized the 1990-2019 global burden of disease methodology to investigate non-optimal temperature, low temperature- and high temperature-related CVD deaths, and disability-adjusted life years (DALYs) globally. Non-optimal temperatures were defined as above (high temperature) or below (low temperature) the location-specific theoretical minimum-risk exposure level or the temperature associated with the lowest mortality rates. Analyses were later stratified by sociodemographic index (SDI) and world regions. In 2019, non-optimal temperature contributed to 1 194 196 (95% uncertainty interval [UI]: 963 816-1 425 090) CVD deaths and 21 799 370 (95% UI: 17 395 761-25 947 499) DALYs. Low temperature contributed to 1 104 200 (95% UI: 897 783-1 326 965) CVD deaths and 19 768 986 (95% UI: 16 039 594-23 925 945) DALYs. High temperature contributed to 93 095 (95% UI: 10 827-158 386) CVD deaths and 2 098 989 (95% UI: 146 158-3 625 564) DALYs. Between 1990 and 2019, CVD deaths related to non-optimal temperature increased by 45% (95% UI: 32-63%), low temperature by 36% (95% UI: 25-48%), and high temperature by 600% (95% UI: -1879-2027%). Non-optimal temperature- and high temperature-related CVD deaths increased more in countries with low income than countries with high income. CONCLUSION Non-optimal temperatures are significantly associated with global CVD deaths and DALYs, underscoring the significant impact of temperature on public health.
Collapse
Affiliation(s)
- Sadeer Al-Kindi
- Harrington Heart and Vascular Institute, University Hospitals, 11100 Euclid Avenue Cleveland, OH 44106, USA
- Cardiovascular Research Institute, Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106, USA
| | - Issam Motairek
- Harrington Heart and Vascular Institute, University Hospitals, 11100 Euclid Avenue Cleveland, OH 44106, USA
| | - Haitham Khraishah
- Division of Cardiovascular Medicine, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201, USA
| | - Sanjay Rajagopalan
- Harrington Heart and Vascular Institute, University Hospitals, 11100 Euclid Avenue Cleveland, OH 44106, USA
- Cardiovascular Research Institute, Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106, USA
| |
Collapse
|
45
|
Goulet EDB, Claveau P, Simoneau IL, Deshayes TA, Jolicoeur-Desroches A, Aloui F, Hoffman MD. Repeatability of Ad Libitum Water Intake during Repeated 1 h Walking/Jogging Exercise Sessions Conducted under Hot Ambient Conditions. Nutrients 2023; 15:4500. [PMID: 37960153 PMCID: PMC10650651 DOI: 10.3390/nu15214500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
A drinking strategy aiming to replace a given percentage of the sweat losses incurred during exercise should result in reproducible fluid intake volume and, hence, fluid balance from one exercise session to the other performed under similar scenarios. Whether this may also be the case with ad libitum drinking during exercise is unclear. We characterized the repeatability of ad libitum water intake during repeated 1 h exercise sessions and examined its effect over time on fluid balance and selected physiological functions and perceptual sensations. Twelve (3 women) healthy individuals participated in this study. At weekly intervals, they completed four 2 × 30 min walking/jogging exercise bouts (55% V˙O2max, 40 °C, 20-30% relative humidity) interspersed by a 3 min recovery period. During exercise, participants consumed water (20 °C) ad libitum. There were no significant differences among the four exercise sessions for absolute water intake volume (~1000 mL·h-1), percent body mass loss (~0.4%), sweat rate (~1300 mL·h-1) and percent of sweat loss replaced by water intake (~80%). Heart rate, rectal temperature, and perceived thirst and heat stress did not differ significantly between the first and fourth exercise sessions. Perceived exertion was significantly lower during the fourth vs. the first exercise session, but the difference was trivial (<1 arbitrary unit). In conclusion, ad libitum water intake during four successive identical 1 h walking/jogging sessions conducted in the heat will result in similar water intake volumes and perturbations in fluid balance, heart rate, rectal temperature, and perceived thirst, heat stress and exertion.
Collapse
Affiliation(s)
- Eric D. B. Goulet
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, PQ J1K 2R1, Canada; (P.C.); (T.A.D.); (A.J.-D.); (F.A.)
- Research Center on Aging, University of Sherbrooke, Sherbrooke, PQ J1H 4C4, Canada
| | - Pascale Claveau
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, PQ J1K 2R1, Canada; (P.C.); (T.A.D.); (A.J.-D.); (F.A.)
| | - Ivan L. Simoneau
- Centre de Recherche et de Formation par Simulation, Cégep of Sherbrooke, Sherbrooke, PQ J1E 4K1, Canada;
| | - Thomas A. Deshayes
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, PQ J1K 2R1, Canada; (P.C.); (T.A.D.); (A.J.-D.); (F.A.)
- Research Center on Aging, University of Sherbrooke, Sherbrooke, PQ J1H 4C4, Canada
| | - Antoine Jolicoeur-Desroches
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, PQ J1K 2R1, Canada; (P.C.); (T.A.D.); (A.J.-D.); (F.A.)
| | - Fedi Aloui
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, PQ J1K 2R1, Canada; (P.C.); (T.A.D.); (A.J.-D.); (F.A.)
| | | |
Collapse
|
46
|
Guo Y, Luo C, Cao F, Liu J, Yan J. Short-term environmental triggers of hemorrhagic stroke. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 265:115508. [PMID: 37774546 DOI: 10.1016/j.ecoenv.2023.115508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/01/2023]
Abstract
Hemorrhagic stroke (HS) is associated with severe morbidity and high mortality. Identifying the trigger factors for HS is critical for disease prevention. This study aimed to assess the associations between short-term environmental triggers (STETs) and HS risk. We systematically searched six databases for articles published up to September 9, 2022. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using random-effect models to evaluate the associations between STETs and the risk of HS. Heterogeneity was assessed using Cochran Q and I2 tests. A total of 63 studies were included for analysis. Of these, 40 focused on air pollutants and 23 on meteorological factors. Pooling results showed that exposure to particulate matter 2.5 (PM2.5; OR, 1.003 per 10 μg/m3; 95% CI, 1.001-1.007), sulfur dioxide (SO2; OR, 1.022 per 10 ppb; 95% CI, 1.005-1.040), and nitrogen dioxide (NO2; OR, 1.026 per 10 ppb; 95% CI, 1.004-1.047) was associated with an increase in HS risk. Moreover, exposure to PM2.5 (OR, 1.018 per 10 μg/m3; 95% CI, 1.009-1.027) and SO2 (OR, 1.102 per 10 ppb; 95% CI, 1.010-1.204) was positively associated with the risk of intracerebral hemorrhage. In addition, extreme temperature, high pressures, high and low relative humidity were potentially associated with HS risk. Targeted preventive measures to limit the effect of these air pollutants and extreme meteorological factors should be taken to reduce the HS disease burden. Further studies are warranted to verify these findings.
Collapse
Affiliation(s)
- Yuxin Guo
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Chun Luo
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Fang Cao
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Junyu Liu
- Department of Neurosurgery, XiangYa Hospital, Central South University, Changsha 410008, China; Department of Pharmacology, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan.
| | - Junxia Yan
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan 410078, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, XiangYa School of Public Health, Central South University, Changsha 410078, China.
| |
Collapse
|
47
|
Yuan J, Zhang Y, Wei C, Zhu R. A Fully Self-Powered Wearable Leg Movement Sensing System for Human Health Monitoring. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2303114. [PMID: 37590377 PMCID: PMC10582417 DOI: 10.1002/advs.202303114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/18/2023] [Indexed: 08/19/2023]
Abstract
Energy-autonomous wearable human activity monitoring is imperative for daily healthcare, benefiting from long-term sustainable uses. Herein, a fully self-powered wearable system, enabling real-time monitoring and assessments of human multimodal health parameters including knee joint movement, metabolic energy, locomotion speed, and skin temperature, which are fully self-powered by highly-efficient flexible thermoelectric generators (f-TEGs) is proposed and developed. The wearable system is composed of f-TEGs, fabric strain sensors, ultra-low-power edge computing, and Bluetooth. The f-TEGs worn on the leg not only harvest energy from body heat and supply power sustainably for the whole monitoring system, but also serve as zero-power motion sensors to detect limb movement and skin temperature. The fabric strain sensor made by printing PEDOT: PSS on pre-stretched nylon fiber-wrapped rubber band enables high-fidelity and ultralow-power measurements on highly-dynamic knee movements. Edge computing is elaborately designed to estimate multimodal health parameters including time-varying metabolic energy in real-time, which are wirelessly transmitted via Bluetooth. The whole monitoring system is operated automatically and intelligently, works sustainably in both static and dynamic states, and is fully self-powered by the f-TEGs.
Collapse
Affiliation(s)
- Jinfeng Yuan
- State Key Laboratory of Precision Measurement Technology and InstrumentsDepartment of Precision InstrumentTsinghua UniversityBeijing100084China
| | - Yuzhong Zhang
- State Key Laboratory of Precision Measurement Technology and InstrumentsDepartment of Precision InstrumentTsinghua UniversityBeijing100084China
| | - Caise Wei
- State Key Laboratory of Precision Measurement Technology and InstrumentsDepartment of Precision InstrumentTsinghua UniversityBeijing100084China
| | - Rong Zhu
- State Key Laboratory of Precision Measurement Technology and InstrumentsDepartment of Precision InstrumentTsinghua UniversityBeijing100084China
| |
Collapse
|
48
|
Deshayes TA, Périard JD. Regular physical activity across the lifespan to build resilience against rising global temperatures. EBioMedicine 2023; 96:104793. [PMID: 37689024 PMCID: PMC10498184 DOI: 10.1016/j.ebiom.2023.104793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023] Open
Abstract
Population aging, high prevalence of non-communicable diseases, physical inactivity, and rising global temperatures are some of the most pressing issues in public health of the current century. Such trends suggest that individuals increasingly less equipped to tolerate heat will be increasingly exposed to it, which from a public health perspective is alarming. Nonetheless, future impacts of extreme heat events will depend not only on the magnitude of climate change, but on our ability to adapt by becoming less sensitive and vulnerable. Although physical activity's role in mitigating climate change has received attention, its potential contribution to climate change adaptation and resilience remains largely unaddressed. Accordingly, in this viewpoint, we discuss how regular physical activity throughout life could have an important contribution to adapting to rising global temperatures, allowing to be better equipped to cope with heat-related health hazards and increasing individual and community resilience. This viewpoint constitutes a call for more research into the contribution that physical activity can have in adapting to rising global temperatures and, more broadly, to climate change.
Collapse
Affiliation(s)
- Thomas A Deshayes
- Montreal Heart Institute, Montréal, Canada; School of Kinesiology and Exercise Science, Université de Montréal, Montréal, Canada.
| | - Julien D Périard
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| |
Collapse
|
49
|
Wu H, Chen J, Zhao P, Liu M, Xie F, Ma X. Development and Prospective Applications of 3D Membranes as a Sensor for Monitoring and Inducing Tissue Regeneration. MEMBRANES 2023; 13:802. [PMID: 37755224 PMCID: PMC10535523 DOI: 10.3390/membranes13090802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/10/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023]
Abstract
For decades, tissue regeneration has been a challenging issue in scientific modeling and human practices. Although many conventional therapies are already used to treat burns, muscle injuries, bone defects, and hair follicle injuries, there remains an urgent need for better healing effects in skin, bone, and other unique tissues. Recent advances in three-dimensional (3D) printing and real-time monitoring technologies have enabled the creation of tissue-like membranes and the provision of an appropriate microenvironment. Using tissue engineering methods incorporating 3D printing technologies and biomaterials for the extracellular matrix (ECM) containing scaffolds can be used to construct a precisely distributed artificial membrane. Moreover, advances in smart sensors have facilitated the development of tissue regeneration. Various smart sensors may monitor the recovery of the wound process in different aspects, and some may spontaneously give feedback to the wound sites by releasing biological factors. The combination of the detection of smart sensors and individualized membrane design in the healing process shows enormous potential for wound dressings. Here, we provide an overview of the advantages of 3D printing and conventional therapies in tissue engineering. We also shed light on different types of 3D printing technology, biomaterials, and sensors to describe effective methods for use in skin and other tissue regeneration, highlighting their strengths and limitations. Finally, we highlight the value of 3D bioengineered membranes in various fields, including the modeling of disease, organ-on-a-chip, and drug development.
Collapse
Affiliation(s)
| | | | - Pengxiang Zhao
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China (F.X.); (X.M.)
| | | | | | | |
Collapse
|
50
|
McCormick JJ, Meade RD, King KE, Notley SR, Akerman AP, McGarr GW, Richards BJ, McCourt ER, Boulay P, Sigal RJ, Kenny GP. Physiological responses to 9 hours of heat exposure in young and older adults. Part II: Autophagy and the acute cellular stress response. J Appl Physiol (1985) 2023; 135:688-695. [PMID: 37471211 DOI: 10.1152/japplphysiol.00411.2023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023] Open
Abstract
With rising global temperatures, heat-related mortality is increasing, particularly among older adults. Although this is often attributed to declines in thermoregulatory function, little is known regarding the effect of age on the cellular processes associated with mitigating heat-induced cytotoxicity. We compared key components of the cellular stress response in 19 young (19-31 yr; 10 female) and 37 older adults (61-78 yr; 10 female) during 9 h of heat exposure (40°C, 9% relative humidity). Mean body temperature (Tbody) was calculated from core and skin temperatures. Changes in proteins associated with autophagy, apoptotic signaling, acute inflammation, and the heat shock response were assessed via Western blot in peripheral blood mononuclear cells harvested before and after exposure. Tbody increased by 1.5 (SD 0.3)°C and 1.7 (0.3)°C in the young and older adults, respectively. We observed similar elevations in autophagy-related proteins (LC3-II and LC3-II/I) in young and older adults (both P ≥ 0.121). However, the older adults displayed signs of autophagic dysfunction, evidenced by a 3.7-fold [95% CI: 2.4, 5.6] greater elevation in the selective autophagy receptor p62 (P < 0.001). This was paired with elevations in apoptotic responses, with a 1.7-fold [1.3, 2.3] increase in cleaved caspase-3 in the older relative to young adults (P < 0.001). Older adults also exhibited diminished heat shock protein 90 responses (0.7-fold [0.5, 0.9] vs. young, P = 0.011) and, at any given level of thermal strain (Tbody area under the curve), elevated tumor necrosis factor-α (1.5-fold [1.0, 2.5] vs. young, P = 0.008). Attenuated autophagic responses may underlie greater vulnerability to heat-induced cellular injury in older adults.NEW & NOTEWORTHY We demonstrate for the first time that peripheral blood mononuclear cells from older adults exhibit signs of autophagic impairments during daylong (9 h) heat exposure relative to their younger counterparts. This was paired with greater apoptotic signaling and inflammatory responses, and an inability to stimulate components of the heat shock response. Thus, autophagic dysregulation during prolonged heat exposure may contribute to age-related heat vulnerability during hot weather and heat waves.
Collapse
Affiliation(s)
- James J McCormick
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ontario, Canada
| | - Robert D Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ontario, Canada
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States
| | - Kelli E King
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ontario, Canada
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ontario, Canada
| | - Ashley P Akerman
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ontario, Canada
| | - Gregory W McGarr
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ontario, Canada
| | - Brodie J Richards
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ontario, Canada
| | - Emma R McCourt
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ontario, Canada
| | - Pierre Boulay
- Faculty of Physical Activity Sciences, University of Sherbrooke, Quebec, Canada
| | - Ronald J Sigal
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ontario, Canada
- Departments of Medicine, Cardiac Sciences and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Alberta, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| |
Collapse
|