Effective execution of military missions in cold environments requires highly trained, well-equipped, and operationally ready service members. Understanding the metabolic energetic demands of performing physical work in extreme cold conditions is critical for individual medical readiness of service members. In this narrative review, we describe 1) the extreme energy costs of performing militarily relevant physical work in cold environments, 2) key factors specific to cold environments that explain these additional energy costs, 3) additional environmental factors that modulate the metabolic burden, 4) medical readiness consequences associated with these circumstances, and 5) potential countermeasures to be developed to aid future military personnel. Key characteristics of the cold operational environment that cause excessive energy expenditure in military personnel include thermoregulatory mechanisms, winter apparel, inspiration of cold air, inclement weather, and activities specific to cold weather. The combination of cold temperatures with other environmental stressors, including altitude, wind, and wet environments exacerbates the overall metabolic strain on military service members. The high energy cost of working in these environments increases the risk of undesirable consequences, including negative energy balance, dehydration, and subsequent decrements in physical and cognitive performance. Such consequences may be mitigated by the application of enhanced clothing and equipment design, wearable technologies for biomechanical assistance and localized heating, thermogenic pharmaceuticals, and cold habituation and training guidance. Altogether, the reduction in energy expenditure of modern military personnel during physical work in cold environments would promote desirable operational outcomes and optimize the health and performance of service members.

Kettlebell as a sport has gained recognition worldwide. We characterized the physiological responses induced by a simulated kettlebell competition routine in experienced kettlebell athletes (n = 26) in a two-group, pre-post plus short-term follow-up, non-randomized experiment. The experimental group (EXP) included 13 kettlebell athletes, while the control group (CON) consisted of 13 individuals with prior recreational exposure to kettlebell activities. EXP performed a 10-minute-long, long-cycle kettlebell routine, whereas CON engaged in seated rest. Cardiovascular and neuromuscular outcomes were measured at rest, after warm-up, during exercise, at 0 (immediately post), 5 and 15 min into recovery. Group-by-time interactions revealed that the 10-minute-long, long-cycle kettlebell routine increased (P < 0.05) the levels of all outcomes (e.g. heart rate, blood pressure, blood lactate) (range of effect sizes: -0.9-8.9) with many outcomes remaining well above baseline at 5 and 15 min into recovery. A notable exception was a lack of change in maximal squat strength. Kettlebell experience and mass correlated with changes in oxygen uptake (ΔVO2) and in ventilation (ΔVT) (r = -0.70, 0.64, -0.87, and 0.73, respectively, P < 0.05) in EXP. Kettlebell routine evoked significant changes in all physiological variables (respiratory and cardiovascular), out of which the heart rate (HR), diastolic blood pressure (DBP), rate pressure product (RPP), and blood lactate (BL) outlasted the routine for at least 15 min. Future studies should longitudinally examine physiological responses to kettlebell training throughout a season. Long-cycle kettlebell routine adds to the repertoire of evidence-based exercise options for high-intensity exercise.

During some trail running races, athletes have to carry hydration support, food, and technical and safety equipment, which generates an additional load that must be mobilized during the race. The aim of the present study was to determine the physiological responses to overload running and the effect they may have on metabolic zones. Seventeen well-trained male trail runners (n = 17) completed three maximal treadmill tests with weighted vests at 0%, 5%, and 10% of their body mass (L0, L5, and L10). Their gas exchange was monitored to assess their ventilatory thresholds 1 (VT1) and 2 (VT2), maximal fat oxidation zone (FatMax), and peak oxygen consumption (VO2peak). Their heart rate (HR), power, and velocity (V) were tracked to compare their behavior. One-way ANOVA showed significant differences in the V (p < 0.001; ηp2 = 0.4620) as a limitation for reaching the peak velocity (Vpeak), with a significant decrease in the Vpeak with the L10 compared to the L0 (p = 0.002) and L5 (p = 0.004). In addition, one-way ANOVA showed significant differences in the peak absolute power (p < 0.001; ηp2 = 0.468) among the groups, detecting higher power production between the L10 and L0 (p < 0.001) and between the L10 and L5 (p = 0.015). Loads higher than L5 could generated important physiological and mechanical modifications, while a load of L5 managed to maintain the working conditions without overloading. These insights shed light on nuanced strategies for optimizing performance and endurance, offering valuable considerations for athletes seeking to enhance their training regimens during overload conditions.

The aim of this retrospective analysis was to provide a more comprehensive understanding of the cardiorespiratory profile of world-class ILCA-7 sailors (n = 3, all males), through a longitudinal evaluation offering real-world data on physiological profile and exercise intensity domains. The cardiopulmonary exercise testing (CPET) was performed by the same researchers using the same equipment during the study. Assessments took place twice a year, aligning with major international competition preparations. Participants trained and competed at the same sailing club in Split, Croatia, under consistent supervision from the same team throughout the study, winning a total of 21 medals at major international competitions. The recorded V ̇ O 2 peak ${{\\dot{V}}_{{{{\\mathrm{O}}}_{\\mathrm{2}}}{\\mathrm{peak}}}}$ ranged from 51.7 ± 1.6 to 61.9 ± 3.0 mL min-1 kg-1, respectively. Similarly, peak power output varied from 352 ± 10 to 426 ± 34 W. The changes in physiological responses at the ventilatory thresholds were proportional to the changes in peak cardiorespiratory fitness capacity. Interestingly, the oxygen pulse measured in 2015 was 25 ± 1 mL O2 beat-1. Over the subsequent 6 years, the O2 pulse marginally increased and appeared to stabilize at 27 ± 1 mL O2 beat-1 in 2020, when these athletes were 32 ± 3 years old. This work offers a broader understanding of world-class Olympic sailors\' cardiorespiratory fitness, going beyond the standard assessment of peak V ̇ O 2 ${{\\dot{V}}_{{{{\\mathrm{O}}}_{\\mathrm{2}}}}}$ to incorporate an analysis of ventilatory thresholds. While a direct link between cardiorespiratory fitness and competitive success remains ambiguous, the importance of a well-rounded aerobic capacity for excellence in ILCA-7 sailing class is evident. HIGHLIGHTS: What is the central question of this study? What are the temporal changes in the physiological profiles of three world-class ILCA-7 sailors? What is the main finding and its importance? Data on oxygen pulse adjustments suggest the involvement of compensatory cardiovascular mechanisms, likely associated with the isometric and quasi-isometric contractions inherent in ILCA-7 sailing. This is evidenced by the absence of an age-related increase in oxygen pulse, a phenomenon often observed in endurance athletes throughout their competitive careers.

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UNASSIGNED: To evaluate cardiorespiratory fitness in patients with early to mid-stage Parkinson\'s disease by cardiopulmonary exercise test (CPET) on a stationary cycle ergometer.
UNASSIGNED: To compare the differences in each index of the cardiopulmonary exercise test between the two groups of subjects; general data such as disease duration, medication use and exercise habits were also collected.
UNASSIGNED: (1) Finally, 36 Parkinson\'s disease patients and 12 healthy controls successfully completed the cardiopulmonary exercise test without any adverse events. (2) The V\'O2peak, Metspeak, RERpeak, MVVpeak, Wpeak, HRpeak, HRpeak/pre, percentage of HRR-1 min decay > 12 bpm, SBPpeak in the Parkinson\'s disease group were lower than those in the control group (p < .05, each). Detailed data: V\'O2peak (15.7 ± 4.5vs21.5 ± 3.6 ml/kg/min, p < .01), Metspeak (4.5 ± 1.3 vs 6.1 ± 1.0, p < .01), RERpeak (1.04 ± 0.10 vs 1.15 ± 0.10, p = .001), MVVpeak (37.22 ± 11.58 vs 53.00 ± 16.85L/min, p = .009), Wpeak (49.17 ± 29.72 vs 49.17 ± 29.72W, p < .01), HRpeak (111.08 ± 16.67 vs 111.08 ± 16.67bpm, p < .01), HRpeak/pre (71.19 ± 10.06 vs 96.00 ± 21.13, p = .002), percentage of HRR-1min decay > 12bpm (33.3% vs 100%, p < .01), systolic blood pressure (155.81 ± 31.83 vs 175.83 ± 17.84 mmHg, p = .01). (3) Divided Parkinson\'s disease patients into high V\'O2peak group (V\'O2peak ≥ 15 mL/kg/min) and low V\'O2peak group (V\'O2peak < 15 mL/kg/min). The age of patients, Hoehn-Yahr grade and incidence of symptom fluctuation in high V\'O2peak group were lower (p < .05, respectively), percentage of males and percentage of HRR-1 min decay > 12 bpm were higher (p < .05, respectively); p < .05 is considered a statistically significant difference. Detailed data: age of patients(61.05 ± 6.93 vs 68.57 ± 7.99 years, p = .005), Hoehn-Yahr grade(1.75 ± 0.48 vs 2.18 ± 0.64, p = .028), incidence of symptom fluctuation (59.1 vs 92.9%, p = .03), percentage of males (77.7 vs 42.9%, p = .041), percentage of HRR-1 min decay > 12 bpm (50 vs 7.1%, p = .008).
UNASSIGNED: Cardiopulmonary exercise test was safe to perform and the cardiorespiratory fitness is significantly reduced in patients with early and middle stage Parkinson\'s disease. Patients with Parkinson\'s disease presented blunted heart rate and systolic blood pressure responses to exercise test. Females, older age, fluctuating symptoms, high H-Y staging and higher activities of daily living may be associated with lower oxygen uptake.

Regulatory authorities in biopharmaceutical industry emphasize process design by process understanding but applicable tools that are easy to implement are still missing. Soft sensors are a promising tool for the implementation of the Quality by Design (QbD) approach and Process Analytical Technology (PAT). In particular, the correlation between viable cell counting and oxygen consumption was investigated, but problems remained: Either the process had to be modified for excluding CO2 in pH control, or complex kLa models had to be set up for specific processes. In this work, a non-invasive soft sensor for simplified on-line cell counting based on dynamic oxygen uptake rate was developed with no need of special equipment. The dynamic oxygen uptake rates were determined by automated and periodic interruptions of gas supply in DASGIP® bioreactor systems, realized by a programmed Visual Basic script in the DASware® control software. With off-line cell counting, the two parameters were correlated based on linear regression and led to a robust model with a correlation coefficient of 0.92. Avoidance of oxygen starvation was achieved by gas flow reactivation at a certain minimum dissolved oxygen concentration. The soft sensor model was established in the exponential growth phase of a Chinese Hamster Ovary fed-batch process. Control studies showed no impact on cell growth by the discontinuous gas supply. This soft sensor is the first to be presented that does not require any specialized additional equipment as the methodology relies solely on the direct measurement of oxygen consumed by the cells in the bioreactor.

Thermogenesis is well understood, but the relationships between cold water immersion (CWI), the post-CWI rewarming and the associated physiological changes are not. This study investigated muscle and systemic oxygenation, cardiorespiratory and hemodynamic responses, and gastrointestinal temperature during and after CWI. 21 healthy men completed randomly 2 protocols. Both protocols consisted of a 48 minutes heating cycling exercise followed by 3 recovery periods (R1-R3), but they differed in R2. R1 lasted 20 minutes in a passive semi-seated position on a physiotherapy table at ambient room temperature. Depending on the protocol, R2 lasted 15 minutes at either ambient condition (R2_AMB) or in a CWI condition at 10°C up to the iliac crest (R2_CWI). R3 lasted 40 minutes at AMB while favoring rewarming after R2_CWI. This was followed by 10 minutes of cycling. Compared to R2_AMB, R2_CWI ended at higher V ˙ O2 in the non-immersed body part due to thermogenesis (7.16(2.15) vs. 4.83(1.62) ml.min-1.kg-1) and lower femoral artery blood flow (475(165) vs. 704(257) ml.min-1) (p < 0.001). Only after CWI, R3 showed a progressive decrease in vastus and gastrocnemius medialis O2 saturation, significant after 34 minutes (p < 0.001). As blood flow did not differ from the AMB protocol, this indicated local thermogenesis in the immersed part of the body. After CWI, a lower gastrointestinal temperature on resumption of cycling compared to AMB (36.31(0.45) vs. 37.30(0.49) °C, p < 0.001) indicated incomplete muscle thermogenesis. In conclusion, the rewarming period after CWI was non-linear and metabolically costly. Immersion and rewarming should be considered as a continuum rather than separate events.

Given that there are both sex-based structural differences in the respiratory system and age-associated declines in pulmonary function, the purpose of this study was to assess the effects of age and sex on the metabolic cost of breathing (V̇o2RM) for exercise ventilations in healthy younger and older males and females. Forty healthy participants (10 young males 24 ± 3 yr; 10 young females 24 ± 3 yr; 10 older males 63 ± 3 yr, 10 older females 63 ± 6 yr) mimicked their exercise breathing patterns (voluntary hyperpnea) in the absence of exercise across a range of exercise intensities. At peak exercise, V̇o2RM represented a significantly greater fraction of peak oxygen consumption (V̇o2peak) in young females, 12.7 ± 4.0%, compared with young males, 10.7 ± 3.0% (P = 0.027), whereas V̇o2RM represented 13.5 ± 2.3% of V̇o2peak in older females and 13.2 ± 3.3% in older males. At relative ventilations, there was a main effect of age, with older males consuming a significantly greater fraction of V̇o2RM (6.6 ± 1.9%) than the younger males (4.4 ± 1.3%; P = 0.012), and older females consuming a significantly greater fraction of V̇o2RM (6.9 ± 2.5%) than the younger females (5.1 ± 1.4%; P = 0.004) at 65% V̇emax. Furthermore, both younger and older males had significantly better respiratory muscle efficiency than their female counterparts at peak exercise (P = 0.011; P = 0.015). Similarly, younger participants were significantly more efficient than older participants (6.5 ± 1.5% vs. 5.5 ± 2.0%; P = 0.001). Normal age-related changes in respiratory function, in addition to sex-based differences in airway anatomy, appear to influence the ventilatory responses and the cost incurred to breathe during exercise.NEW & NOTEWORTHY Here we show that at moderate and high-intensity exercise, older individuals incur a higher cost to breathe than their younger counterparts. However, as individuals age, the sex difference in the cost of breathing narrows. Collectively, our findings suggest that the normative age-related changes in respiratory structure and function, and sex differences in airway anatomy, appear to influence the ventilatory responses to exercise and the oxygen cost to breathe.

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