OBJECTIVE: To assess health status and heat preparation of cyclists at the 2019 Tour Down Under and determine the alignment of heat mitigation strategies with current recommendations.
METHODS: Cohort study.
METHODS: Twenty-three (17 % participation rate) male World Tour cyclists from five teams and 10 countries completed a pre-competition questionnaire evaluating exertional heat illness (EHI) history, pre-race health status, and heat mitigation and recovery strategies use. Associations between arrival days pre-competition, years as professional, nationality, team, history of EHI symptoms and diagnosis on heat mitigation and recovery strategy utilisation were assessed.
RESULTS: 65 % of cyclists reported previously experiencing one or more EHI symptom (cramping: 48 %) and 22 % a diagnosis of heat stroke. In the 10 days preceding the race, 26 % experienced one or more illness symptoms. 65 % trained in the heat (acclimatisation 8-25 days; acclimation: 3-7 days), which was associated with team (P = 0.047, ϕc = 0.61), nationality (P = 0.009, ϕc = 0.86) and EHI symptoms history (P = 0.058, ϕ = 0.43). All cyclists had a hydration plan, with links to team (0.5-1.0 L·h-1, P = 0.043, ϕc = 0.68) and EHI symptom history (1.0-1.5 L·h-1, P = 0.048, ϕ = 0.476). Most had pre-cooling (87 %) and mid-cooling (83 %) strategies, most commonly cold beverages (75 %) and neck collars (78 %), respectively. All cyclists planned on using at least one recovery strategy (massage: 87 %).
CONCLUSIONS: Our data indicate good alignment with current recommendations for competing in the heat, particularly for hydration, cooling and recovery strategies. Whilst the proportion of cyclists engaging in heat acclimation/acclimatisation is encouraging, greater awareness on adapting and implementing heat training is required.

BACKGROUND: Individuals with Multiple Sclerosis (MS) experience impairments in heat dissipation, compromising core temperature regulation during exercise.
OBJECTIVE: To examine the efficacy of combined head-and-neck cooling as administered via a commercially available cooling cap and neck wrap in mitigating increases in core temperature during exercise.
METHODS: On separate days, ten (7 females) adults (46.1 ± 11.6 years) with relapsing-remitting MS performed semi-recumbent cycling consisting of an incremental exercise bout to volitional fatigue in a temperate environment (23 °C, 50 % relative humidity) while undergoing head-and-neck cooling using a cooling cap and neck wrap maintained at 10 °C (COLD) or 24-26 °C (NEUTRAL). Prior to and following a 30-minute post-exercise recovery, functional capacity was assessed by a battery of tests consisting of a 2-minute walk test, Timed 25-Foot Walk test, sit-to-stand test, and Berg Balance Scale. Core (ingestible pill) and skin temperatures were recorded continuously. The level of fatigue was measured with questionnaires.
RESULTS: The duration of the incremental exercise test increased with the application of COLD (28.4 ± 5.1 min) versus NEUTRAL water (vs 20.8 ± 5.1 min) (p = 0.001) and was paralleled by a significant reduction in body temperatures (∼1 °C, p < 0.05). The distance covered during the 2-min walk test performed after the incremental exercise test increased with the COLD (176.5 ± 0.6 m), relative to the NEUTRAL condition (147.7 ± 43.5 m) (p = 0.01). Fatigue levels did not change between conditions.
CONCLUSIONS: We show that head-and-neck cooling with cold water effectively enhances exercise tolerance and mitigates increases in core temperature during exercise in individuals with MS.

Past climate changes have had large impacts on modern ecological patterns. Understanding if legacies are distinguishable in the climatic niches of extant and locally extinct taxa can provide insight into the importance of climate in extinction events. To better understand mid- to late-Cenozoic New Zealand plant extinctions, which are often attributed to Cenozoic climate cooling, we identify 13 con-familial extinct and extant New Zealand genus pairs, which have modern distributions in Australia. Using climatic niches derived from current geographic distributions in Australia, we compared (i) total niche breadth, (ii) niche overlap, and (iii) individual climate parameters, to investigate potential climate drivers of intrafamilial extinction and persistence patterns in New Zealand. A majority of New Zealand extinct genera (9 out of 13 pairs) do not indicate climate niche legacies consistent with susceptibility to extinction from changing climates, while the remaining four extinct/extant pairs show slight climatic niche legacies. Three extinct genera have warmer niches than their extant counterpart, which is consistent with extinction reflecting intolerance of cooling Cenozoic climates. The other genus pair with a climatic niche legacy has an extinct genus that is distinguished by a niche with smaller precipitation seasonality than its extant counterpart, suggesting that climate metrics other than temperature may also be important extinction drivers in some taxa. Our results show that the mechanisms of Cenozoic extinctions of New Zealand genera are likely more complex than taxa reaching environmental tolerances due to cooling climates. Comparisons of current climatic niches between extant and extinct sister taxa can provide useful insights into large-scale, long-term climatic legacies but more analyses, including trait and phylogeographic patterns, would lead to additional insights into alternative pathways of extinction.

Exercise performed under hot/humid conditions can hinder endurance performance. The Omius™ headband (OH) is purported to reduce the perception of heat and improve performance. We examined the impact of OH on selected thermal and cardiovascular functions, subjective perceptions and running performance. Using a randomized crossover protocol, 10 trained male athletes (28 ± 4 years) completed two trials (OH and sham headband (SH), 35.0 ± 0.3 °C, 56 ± 3% relative humidity) comprising 70 min of running (60% V˙ O2max) followed by a 5-km running time-trial (TT). Heart rate, perceived exertion and whole-body thermal comfort did not significantly differ between conditions during the submaximal running effort and TT. Rectal temperature was higher with OH (0.11 ± 0.16 °C, p = 0.052) than SH prior to the submaximal running effort, however, no significant differences were observed between conditions regarding the changes in rectal temperature from baseline during the submaximal running effort and TT. Forehead temperature was significantly lower with OH than SH during the submaximal running effort, but no significant differences were observed at the end of the TT. Scores of perceived forehead thermal comfort was only significantly lower with OH than SH during the submaximal running effort. TT performance did not significantly differ between OH (19.8 ± 1.2 min) and SH (20.2 ± 1.0 min). In conclusion, OH improves forehead thermal comfort and reduces forehead temperature but not rectal temperature, heart rate and perceived exertion during, nor 5-km TT performance following, 70 min of submaximal running in the heat.

BACKGROUND: Recent guidelines for post-cardiac arrest (CA) management have undergone significant changes regarding targeted therapeutic management (TTM), transitioning from hypothermia to temperature control. We aimed to assess changes in post-CA management in French intensive care units following the new recommendations.
METHODS: Two declarative web surveys were conducted from March to August 2023. We compared the doctors\' survey to that previously published in 2015. We contacted 389 departments from 276 French centers.
RESULTS: Three hundred thirty-four physicians from 189 distinct ICUs departments participated in the survey. TTM was used by 95.5 % of respondents. TTM with temperature feedback device was used by 64 % of respondents. In multivariate analysis, use of TTM with temperature feedback was associated with university hospital responder [OR 1.99 (1.19-3.34, p = 0.009)], high CA admissions rate [OR 2.25 (1.13-4.78, p = 0.026)], use of a written CA procedure [OR 1.76 (1.07-2.92, p = 0.027)] and presence of a cath-lab performing coronary angiography [OR 2.42 (1.33-4.44, p = 0.004)]. The targeted temperature rose from 32 to 34 °C in 2015, to 35-36 °C in 2023 (p < 0.001). Proportions of TTM with temperature feedback devices switched from 45 % to 65 % (p < 0.001). 660 nurses responses from 150 ICUs were analyzed. According to TTM users, gel-coated water circulating pads and intravascular cooling were considered the most effective devices and were found to be easily adjustable.
CONCLUSIONS: These surveys provide insights into post-resuscitation care and TTM practice in France. One year after their publication, the latest recommendations concerning TTM have not been fully implemented, as the majority of ICUs continue to use moderate hypothermia. They widely reported employing specific TTM, with the use of TTM with temperature feedback devices increasing significantly. Heterogeneity exists regarding the TTM systems used, with a significant proportion lacking temperature feedback. This aspect requires specific attention, depending on local constraints and devices costs.

In Korea, greenhouses are traditionally used for crop cultivation in the winter. However, due to diverse consumer demands, climate change, and advancements in agricultural technology, more farms are aiming for year-round production. Nonetheless, summer cropping poses challenges such as high temperatures, humidity from the monsoon season, and low light conditions, which make it difficult to grow crops. Therefore, this study aimed to determine the best planting time for summer tomato cultivation in a Korean semi-closed greenhouse that can be both air-conditioned and heated. The experiment was conducted in the Advanced Digital Greenhouse, built by the National Institute of Agricultural Sciences. The tomato seedlings were planted in April, May, and June 2022. Growth parameters such as stem diameter, flowering position, stem growth rate, and leaf shape index were measured, and harvesting was carried out once or twice weekly per treatment from 65 days to 265 days after planting. The light use efficiency and yield per unit area at each planting time was measured. Tomatoes planted in April showed a maximum of 42.9% higher light use efficiency for fruit production and a maximum of 33.3% higher yield. Furthermore, the growth form of the crops was closest to the reproductive growth type. Therefore, among April, May, and June, April is considered the most suitable planting time for summer cultivation, which is expected to contribute to reducing labor costs due to decreased workload and increasing farm income through increased yields. Future research should explore optimizing greenhouse microclimates and developing crop varieties tailored for summer cultivation to further enhance productivity and sustainability in year-round agricultural practices.

OBJECTIVE: To determine the effectiveness of phase-change-material mattress (PCM) during transportation of newborns with hypoxic ischemic encephalopathy (HIE).
METHODS: Randomized controlled trial of newborns with HIE from June 2016 to December 2019. Patients were randomized to transport with PCM or without PCM (control) when transferred to a cooling center in northern Vietnam. Primary outcome measure was mortality rate, secondary outcomes including temperature control and adverse effects.
RESULTS: Fifty-Two patients in PCM-group and 61 in control group. Median rectal temperature upon arrival was 34.5 °C (IQR 33.5-34.8) in PCM-group and 35.1 °C (IQR 34.5-35.9) in control group (p = 0.023). Median time from birth to reach target temperature was 5.0 ± 1.4 h and 5.5 ± 1.2 h in the respective groups (p = 0.065). 81% of those transported with PCM versus 62% of infants transported without (p = 0.049) had reached target temperature within the 6-h timeframe. There was no record of overcooling (< 32 °C) in any of the groups. The was no difference in mortality rate between the two groups (33% and 34% respectively (p > 0.05)).
CONCLUSIONS: Phase-change-material can be used as a safe and effective cooling method during transportation of newborns with HIE in low-resource settings.
BACKGROUND: The study was retro-prospectively registered in Clinical Trials (04/05/2022, NCT05361473).

Passive daytime radiative cooling is a zero-energy consumption cooling technology, which can dissipate heat to outer space via infrared radiation. Recently, coupling radiative cooling technology and thermoelectric devices to generate electricity has attracted much attention. However, existing radiative cooling integrated thermoelectric devices still suffer from low-temperature gradient and output voltage. Here, based on the Mie scattering and internal reflection enhancing principle, an impact-inducing geometry reconstruction approach was proposed to fabricate hierarchical nanostructured cellulosic coatings with good daytime cooling performance to achieve stable electricity generation function, which can be realized by using a scalable and facile wet ball milling technology. Guided by the theoretical simulations of the finite difference time domain method (FDTD), the cellulose and TiO2 nanoparticles can assemble into spherical envelope structured coatings drying by the shear, impact, and friction interaction in the ball milling process, dramatically enhancing the Mie scattering and internal reflection of coatings. The cellulosic coatings exhibit sunlight reflectivity of 0.962 and infrared emissivity of 0.94, resulting in a daytime radiative cooling efficiency of 5.9 °C under direct sunlight. Energy Plus stimulation demonstrated 35 % cooling energy and 468.9 kWh of cooling energy can be saved annually in China. Meanwhile, this cellulosic coating-based thermoelectric device can deliver a high voltage output of 150 mV under 1 Sun due to the strong bonding and high-temperature gradient formation (30 °C), which is higher than previous reports. This study will facilitate the development of sustainable power generation device for the goal of green future.

Various topical interventions have been described to minimize botulinum neurotoxin-A (BoNT)-induced pain. The purpose of this study is to conduct a systematic review of relevant randomized controlled trials (RCTs) to compare the efficacy of pain relief methods during BoNT injection. PubMed, Scopus, and Web of Science were searched using \"Botox,\" \"Botulinum,\" or \"BTX.\" We identified RCTs in which BoNT were injected to eliminate wrinkles. The pain score was the study outcome, and pain reduction method was compared with routine one. The meta-analysis was reported using the PRISMA checklist. The Higgins I(I2) statistical model assessed results heterogeneity. Two thousand one hundred and twenty-three articles were identified, thirteen articles eligible. Two hundred and sixty-two healthy volunteers were performed on these RCTs. Meta-analysis evaluated different methods to ease BoNT injection pain, and these methods significantly improved outcomes by 0.23% (95%CI, 0.11-0.46, p = .000). Subgroup analysis based on injection area showed no significant heterogeneity, but heterogeneity decreased when subgroup analysis based on other methods was done (Cochran\'s Q test = 115.52, p = .0001, I2 = 87.9%). This meta-analysis confirms the effectiveness of pain relief methods during BoNT injection. Evaluation of different methods showed their effectiveness, but finding the best method requires comparative studies, although the role of pH and EMLA has been proven.

Post-exercise hot (HWI) and cold (CWI) water immersion are popular strategies used by athletes in a range of sporting contexts, such as enhancing recovery or adaptation. However, prolonged heating bouts increase neuroendocrine responses that are associated with perceptions of fatigue. Fourteen endurance-trained runners performed three trials consisting of two 45-min runs at 95% lactate threshold on a treadmill separated by 6 h of recovery. Following the first run, participants completed one of HWI (30 min, 40°C), CWI (15 min, 14°C) or control (CON, 30 min rest in ambient conditions) in a randomised order. Perceived effort and recovery were measured using ratings of perceived exertion (RPE) and the Acute Recovery and Stress Scale (ARSS), whilst physiological responses including venous concentrations of a range of neuroendocrine markers, superficial femoral blood flow, heart rate and rectal temperature were measured. Exercise increased neuroendocrine responses of interleukin-6, adrenaline and noradrenaline (all P < 0.001). Additionally, perceptions of overall recovery (P < 0.001), mental performance capacity (P = 0.02), physical performance capability (P = 0.01) and emotional balance (P = 0.03) were reduced prior to the second run. However, there was no effect of condition on these variables (P > 0.05), nor RPE (P = 0.68), despite differences in rectal temperature, superficial femoral blood flow following the first run, and participants\' expected recovery prior to the intervention (all P < 0.001). Therefore, athletes may engage in post-exercise hot or cold-water immersion without negatively impacting moderate-intensity training sessions performed later the same day.