Validity of a noninvasive estimation of deep body temperature when wearing personal protective equipment during exercise and recovery

Background:Deep body temperature is a critical indicator of heat strain.However,direct measures are often invasive,costly,and difficult to implement in the field.This study assessed the agreement between deep body temperature estimated from heart rate and that measured directly during repeated work bouts while wearing explosive ordnance disposal(EOD)protective clothing and during recovery.Methods:Eight males completed three work and recovery periods across two separate days.Work consisted of treadmill walking on a 1%incline at 2.5,4.0,or 5.5 km/h,in a random order,wearing EOD protective clothing.Ambient temperature and relative humidity were maintained at 24℃and 50%[Wet bulb globe temperature(WBGT)(20.9±1.2)℃]or 32℃and 60%[WBGT(29.0±0.2)℃]on the separate days,respectively.Heart rate and gastrointestinal temperature(TGI)were monitored continuously,and deep body temperature was also estimated from heart rate(ECTemp).Results:The overall systematic bias between TGI and ECTemp was 0.01℃with 95%limits of agreement(Lo A)of±0.64℃and a root mean square error of 0.32℃.The average error statistics among participants showed no significant differences in error between the exercise and recovery periods or the environmental conditions.At TGI levels of(37.0–37.5)℃,(37.5–38.0)℃,(38.0–38.5)℃,and>38.5℃,the systematic bias and±95%Lo A were(0.08±0.58)℃,(–0.02±0.69)℃,(–0.07±0.63)℃,and(–0.32±0.56)℃,respectively.Conclusions:The findings demonstrate acceptable validity of the ECTemp up to 38.5℃.Conducting work within an ECTemp limit of 38.4℃,in conditions similar to the present study,would protect the majority of personnel from an excessive elevation in deep body temperature(>39.0℃).

Involvement of A5/A7 noradrenergic neurons and B2 serotonergic neurons in nociceptive processing:a fiber photometry study

In the central nervous system,the A6 noradrenaline(NA)and the B3 serotonin(5-HT)cell groups are well-recognized players in the descending antinociceptive system,while other NA/5-HT cell groups are not well characterized.A5/A7 NA and B25-HT cells project to the spinal horn and form descending pathways.We recorded G-Ca MP6 green fluorescence signal intensities in the A5/A7 NA and the B25-HT cell groups of awake mice in response to acute tail pinch stimuli,acute heat stimuli,and in the context of a non-noxious control test,using fiber photometry with a calcium imaging system.We first introduced G-Ca MP6 in the A5/A7 NA or B25-HT neuronal soma,using transgenic mice carrying the tetracycline-controlled transactivator transgene under the control of either a dopamineβ-hydroxylase or a tryptophan hydroxylase-2 promoters and by the site-specific injection of adeno-associated virus(AAV-Tet O(3 G)-G-Ca MP6).After confirming the specific expression patterns of G-Ca MP6,we recorded G-Ca MP6 green fluorescence signals in these sites in awake mice in response to acute nociceptive stimuli.G-Ca MP6 fluorescence intensity in the A5,A7,and B2 cell groups was rapidly increased in response to acute nociceptive stimuli and soon after,it returned to baseline fluorescence intensity.This was not observed in the non-noxious control test.The results indicate that acute nociceptive stimuli rapidly increase the activities of A5/A7 NA or B25-HT neurons but the non-noxious stimuli do not.The present study suggests that A5/A7 NA or B25-HT neurons play important roles in nociceptive processing in the central nervous system.We suggest that A5/A7/B2 neurons may be new therapeutic targets.All performed procedures were approved by the Institutional Animal Use Committee of Kagoshima University(MD17105)on February 22,2018.

Impact loading in female runners with single and multiple bone stress injuries during fresh and exerted conditions

Background:Bone stress injuries(BSIs)are common in female runners,and recurrent BSI rates are high.Previous work suggests an association between higher impact loading during running and tibial BSI.However,it is unknown whether impact loading and fatigue-related loading changes discriminate women with a history of multiple BSIs.This study compared impact variables at the beginning of a treadmill run to exertion andthe changes in those variables with exertion among female runners with no history of BSI as well as among those with a history of single or multiple BSIs.Methods:We enrolled 45 female runners(aged 18-40 years)for this cross-sectional study:having no history of diagnosed lower extremity BSI(N-BSI,n=14);a history of 1 lower extremity BSI(1-BSI,n=16);and diagnosed by imaging,or a history of multiple(>3)lower extremity BSIs(M-BSI,n=15).Participants completed a 5-km race speed run on an instrumented treadmill while wearing an Inertial Measurement Unit.The vertical average loading rate(VALR),vertical instantaneous loading rate(VILR),vertical stiffness during impact via instrumented treadmill,and tibial shock determined as the peak po sitive tibial acceleration via Inertial Measurement Unit were measured at the beginning and the end of the run.Results:There were no differences between groups in VALR,VILR,vertical stiffness,or tibial shock in a fresh or exerted condition.However,compared to N-BSI,women with M-BSI had greater increase with exertion in VALR(-1.8%vs.6.1%,p=0.01)and VILR(1.5%vs.4.8%,p=0.03).Similarly,compared to N-BSI,vertical stiffness increased more with exertion among women with M-BSI(-0.9%vs.7.3%,p=0.006)and 1-BSI(-0.9%vs.1.8%,p=0.05).Finally,compared to N-BSI,the increase in tibial shock from fresh to exerted condition was greater among women with M-BSI(0.9%vs.5.5%,p=0.03)and 1-BSI(0.9%vs.11.2%,p=0.02).Conclusion:Women with 1-BSI or M-BSIs experience greater exertion-related increases in impact loading than women with N-BSI.These observations imply that exertion-related changes in gait biomechanics may contribute to risk of BSI.

Heat Related Illnesses

KEY POINTS Heat illnesses range in severity from mild(heat rash,heat syncope, cramps) to serious(heat exhaustion,heat injury,heat stroke).Although heat illness can occur in anyone,an increased risk is associated with a variety of environmental factors,personal characteristics,health conditions,and medications.The risk of serious heat illness can be markedly reduced by implementing a variety of countermeasures,including becoming acclimated to the heat,managing heat stress exposure,and maintaining hydration.Athletes,coaches,training staff,and medical personnel should be vigilant for signs and symptoms of heat related illnesses.If warning signs are acted upon and body cooling rapidly administered,serious heat illness can be avoided.If heat stroke is suspected,rapid body cooling by immersion or soaking in cold water or ice water should be initiated.

腰背疼痛病史对持续性体力活动中骨盆和躯干协调的影响（英文）

Purpose:The purpose of this study was to compare the coordination between the trunk and the pelvis during a sustained asymmetric repetitive lifting task between a group with a history of low back pain(LBP;HBP) and a group with no history of LBP(NBP).Methods:Volunteers lifted a 11-kg box from ankle height in front to a shelf 45° off-center at waist height,and lowered it to the start position at12 cycles/min for 10 min.Lifting side was alternated during the trial.Continuous relative phase was used to calculate coordination between the pelvis and trunk rotation at the beginning(Min 1),middle(Min 5),and end of the bout(Min 9).Results:While there were no main effects for group,a significant interaction between time and group indicated that,in the frontal plane,the NBP group coordination was more anti-phase toward the end of the bout,with no such differences for the HBP group.Analysis of sagittal-axial(bend and twist) coordination revealed the HBP group coordination was more in-phase at the end of the bout over the entire cycle and for the lifting phase alone,with no such differences for the NBP group.Conclusion:Differences between groups demonstrate residual consequences of LBP in an occupational scenario,even though the HBP group was pain-free for >6 months prior to data collection.More in-phase coordination in the HBP group may represent a coordination pattern analogous to'guarded gait' which has been observed in other studies,and may lend insight as to why these individuals are at increased risk for re-injury.

Correction to:Associations Between Two Measures of Trunk Muscular Endurance Among Male Law Enforcement Officers

The original version of this article,published on August 7,2020,contained a mistake.The affiliations were incorrect.The correct affiliations of the authors are given below.