BACKGROUND: For persons with multiple sclerosis (pwMS), exercise is known to be safe and effective at treating several symptoms and it may even be disease-modifying. However, exercise can trigger heat intolerance, exercise-induced heat sensitivity (EIHS), which may cause some pwMS to refrain from exercise. No review has yet summarized the existing knowledge on EIHS in pwMS. Therefore, the purpose of the present review was to clarify the terminology, summarize both the prevalence of EIHS and the current knowledge of underlying mechanisms, and provide an overview of existing treatment options and clinical management of EIHS in pwMS.
METHODS: A scoping review was performed.
RESULTS: As no clear definition could be identified in the literature, we propose a definition of EIHS. Aspects related to EIHS are reported in 29-80 % of all pwMS. The mechanisms underlying EIHS are not well understood but seem to include axon demyelination, CNS lesions, abnormal sudomotor function and sweating, abnormal afferent thermosensory function, disease stability, and abnormal neuropsychological responses. The severity of EIHS depends on the applied exercise modality, intensity, and format, and can be further reduced when applying different cooling interventions or garments before and/or during exercise.
CONCLUSIONS: EIHS appears frequently in pwMS, but the underlying mechanisms are still only sparsely understood. EIHS severity depends on exercise-related factors and can be reduced by cooling interventions.

Examining how heat affects people with Parkinson\'s disease is essential for informing clinical decision-making, safety, well-being, and healthcare planning. While there is evidence that the neuropathology associated with Parkinson\'s disease affects thermoregulatory mechanisms, little attention has been given to the association of heat sensitivity to worsening symptoms and restricted daily activities in people with this progressive disease. Using a cross-sectional study design, we examined the experiences of people diagnosed with Parkinson\'s disease in the heat. Two-hundred and forty-seven people completed an online survey (age: 66.0 ± 9.2 years; sex: male = 102 (41.3%), female = 145 (58.7%)), of which 195 (78.9%) reported becoming more sensitive to heat with Parkinson\'s disease. Motor and nonmotor symptoms worsened with heat in 182 (73.7%) and 203 (82.2%) respondents, respectively. The most commonly reported symptoms to worsen included walking difficulties, balance impairment, stiffness, tremor, fatigue, sleep disturbances, excess sweating, difficulty concentrating, and light-headedness when standing. Concerningly, over half indicated an inability to work effectively in the heat, and nearly half reported that heat impacted their ability to perform household tasks and social activities. Overall, heat sensitivity was common in people with Parkinson\'s disease and had a significant impact on symptomology, day-to-day activities and quality of life.

OBJECTIVE: Following heat illness, a return to activity may require passing a heat tolerance test (HTT). However, there are several logistical limitations to the widespread use of the HTT. Thus, it would be advantageous to develop a test that could be conducted in a thermoneutral (~22°C) environment to predict heat tolerance status. The purpose of the current study was to determine the sensitivity and specificity of using the criteria of a heart rate (HR) ≥130 bpm following 30 min of thermoneutral exercise in detecting heat-intolerant and heat-tolerant individuals.
METHODS: Sixty-five subjects visited the lab on 3 separate days. The first visit consisted of completing a maximal oxygen uptake (VO2 max) test to assess cardiovascular fitness. For lab visits 2 and 3, subjects randomly completed a 2-hour walking treadmill test in either a hot (40°C, 40% relative humidity [RH]) or thermoneutral (22°C, 40% RH) environment.
RESULTS: Forty-eight subjects were classified as heat-intolerant and 17 subjects as heat-tolerant. Using the criterion of a HR ≥130 bpm at 30 min of exercise in the thermoneutral environment, specificity (54%) and sensitivity (100%) of passing the HTT was calculated. Secondary analysis using multiple regression revealed 3 significant variables for predicting ending HR during the HTT. They were: 1) absolute VO2 max (l/min), 2) age, and 3) HR at 30 min of exercise during thermoneutral exercise.
CONCLUSIONS: Exercise in a thermoneutral environment had a positive predictive value of 100%, thus, if a subject has a HR ≥130 bpm at 30 min of exercise in a thermoneutral environment, they are very likely to fail a subsequent 2-hour HTT in the heat and be classified as heat-intolerant. Therefore, prior screening has the potential to save time and money, along with providing safety to a heat-intolerant subject. Int J Occup Med Environ Health. 2023;36(2):192-200.

Lifespan and time of death of dogs died in Switzerland between 2016 and 2020 were evaluated in order to increase the awareness of the public to animal welfare-related consequences of extreme brachycephalic breeding and to clarify the torture breeding problem of dogs suffering from brachycephalic obstructive airway syndrome (BOAS). Skull shape, body size, country of origin and altitude of the registered place of residence at the time of death were analysed in a set of anonymized data from the national animal database Amicus as potential factors influencing the life expectancy. Death rate during summer months and the altitude of the reported place of residence at death were analysed in relation to the skull shape to demonstrate the heat intolerance of brachycephalic dog breeds. The final dataset included 137 469 dogs. The average age of death of the study population was 11,8 years, mixed breeds reaching a higher average age of 12,4 years than purebred dogs with 11,5 years. Bodyweight classification, skull shape and the origin of the dogs had a significant effect on the average lifespan. Giant breeds reached with 9,0 years the lowest mean age compared to the other bodyweight categories. The mean life expectancy of brachycephalic dogs was 9,8 years, i.e., 2,1 and 1,7 years less than mesocephalic and dolichocephalic dogs, respectively. Brachycephalic dogs and dogs imported from abroad showed increased mortality at a young age.
Um die Sensibilität der Schweizer Bevölkerung gegenüber tierschutzrelevanten Folgen der Extremzucht Brachyzephalie zu erhöhen und dabei insbesondere die Qualzuchtproblematik unter BOAS (Brachyzephales Obstruktives Atemwegssyndrom) leidender Hunde zu verdeutlichen, evaluierten wir die Lebensdauer und den Todeszeitpunkt von in der Schweiz zwischen 2016 und 2020 verstorbenen Hunden. Neben Kopfform wurden Körpergrösse, das Herkunftsland sowie die Höhenlage des gemeldeten Wohnorts zum Todeszeitpunkt als potenzielle Einflussfaktoren auf die Zielgrösse, das erreichte Lebensalter, in einem Satz anonymisierter Daten der nationalen Tierdatenbank Amicus ausgewertet. Um die Hitzeintoleranz brachyzephaler Hunderassen aufzuzeigen, untersuchten wir die Todesrate in den Sommermonaten sowie die Höhenlage des gemeldeten Wohnorts zum Zeitpunkt des Todes der Hunde in Abhängigkeit von ihrer Kopfform. Der endgültige Datensatz enthielt 137 469 Hunde. Das durchschnittlich erreichte Lebensalter aller Hunde betrug 11,8 Jahre, dabei wiesen Mischlingshunde mit 12,4 Jahren ein höheres durchschnittliches Lebensalter auf als die reinrassigen Hunde mit 11,5 Jahren. Die Gewichtskategorie, die Kopfform sowie die Herkunft der Hunde hatten einen deutlichen Effekt auf das durchschnittlich erreichte Lebensalter. Riesenrassen erreichten mit 9,0 Jahren im Vergleich zu den übrigen Gewichtskategorien das geringste mittlere Lebensalter. Die mittlere Lebenserwartung brachyzephaler Hunde war mit 9,8 Jahren im Mittel 2,1 und 1,7 Jahre geringer als die von Hunden mit meso- bzw. dolichozephaler Kopfform. Sowohl Hunde mit einer brachyzephalen Kopfform als auch Hunde, die aus dem Ausland importiert wurden, zeigten eine erhöhte Sterblichkeit in jungen Jahren.
La durée de vie et le moment du décès des chiens morts en Suisse entre 2016 et 2020 ont été évalués afin de sensibiliser le public aux conséquences sur le bien-être animal de l’élevage brachycéphale extrême et de clarifier le problème des pratiques d’élevage cruelles des chiens souffrant du syndrome obstructif respiratoire brachycéphale (SORB). Outre la forme du crâne, la taille du corps, le pays d’origine et l’altitude du lieu de résidence enregistré au moment de la mort ont été analysés dans un ensemble de données anonymisées provenant de la base de données nationale sur les animaux Amicus, en tant que facteurs potentiels influençant la taille et le vieillissement. Le taux de mortalité pendant les mois d’été et l’altitude du lieu de résidence déclaré au moment du décès ont été analysés pour démontrer l’intolérance à la chaleur des races de chiens brachycéphales. L’ensemble de données final comprenait 137 469 chiens. L’âge moyen du décès de la population étudiée était de 11,8 ans, les chiens croisés atteignant un âge moyen plus élevé de 12,4 ans que les chiens de race pure avec 11,5 ans. La catégorie de poids, la forme du crâne et l’origine des chiens ont eu un effet significatif sur la durée de vie moyenne. Les races géantes ont atteint avec 9,0 ans l’âge moyen le plus bas par rapport aux autres catégories de poids. L’espérance de vie moyenne des chiens brachycéphales était de 9,8 ans, soit 2,1 et 1,7 ans de moins que celle des chiens mésocéphales et dolichocéphales. Les chiens brachycéphales et les chiens importés de l’étranger présentaient une mortalité accrue dans leur jeune âge.
La speranza di vita e l’ora del decesso di cani brachicefali morti in Svizzera tra il 2016 e il 2020 sono state valutate alfine di aumentare la sensibilità dell’opinione pubblica svizzera sulle conseguenze relative al benessere degli animali nell’allevamento intensivo delle razze brachicefalie e, in particolare, per evidenziare il problema dell’allevamento abusivo di cani affetti dalla sindrome brachicefalica ostruttiva delle vie aeree (BOAS). La forma del cranio, le dimensioni del corpo, il luogo di origine e l’altitudine del luogo di residenza registrato al momento del decesso sono stati analizzati in una serie di dati anonimizzati provenienti dalla banca dati nazionale degli animali Amicus come potenziali fattori che influenzerebbero le dimensioni del corpo e l’invecchiamento. Il tasso di mortalità durante i mesi estivi e l’altitudine del luogo di residenza dichiarato al momento del decesso sono stati analizzati per dimostrare l’intolleranza al calore delle razze canine brachicefale. Il set di dati finale comprendeva 137 469 cani. L’età media al decesso di tutta la popolazione inclusa nello studio era di 11,8 anni e le razze miste hanno raggiunto un’età media più alta di 12,4 anni rispetto ai cani di razza pura con 11,5 anni. La categoria del peso corporeo, la forma del cranio e l’origine dei cani hanno avuto un effetto significativo sulla durata media della vita. Con 9,0 anni, le razze giganti hanno raggiunto l’età media più bassa rispetto alle altre categorie di peso corporeo. L’aspettativa di vita media dei cani brachicefali era di 9,8 anni, 2,1 e 1,7 anni in meno rispetto ai cani mesocefali e dolicocefali. I cani brachicefali e quelli importati dall’estero hanno mostrato una maggiore mortalità in giovane età.

Thermal intolerance may limit activity in hostile environments. After heat illness, two physiologically distinct phenotypes evolve: heat tolerant (HT) and heat intolerant (HI). The recognition that heat illness alters gene expression justified revisiting the established physiological concept of HI. We used a DNA microarray to examine the global transcriptional response in peripheral blood mononuclear cells (PMBCs) from HI and HT phenotypes, categorized 2-mo postheat injury using a functional physiological heat-tolerance test (HTT, 40°C)-Recovery (R, 24°C) protocol. The impact of recurrent heat stress was studied in vitro using peripheral blood mononuclear cells (PBMCs) from controls (participants with no history of heat injury), HI, and HT (categorized by functional HTT) with a customized NanoString array. There were significant differences under basal conditions between the HI and HT. HI were more immunological alerted. Almost no shared genes were found between end-HTT and recovery phases, suggesting vast cellular plasticity. In HI, mitochondrial function was dysregulated, canonical pathways associated with exercise endurance-NRF2 and insulin were downregulated, whereas AMPK and peroxisome proliferator-activated receptor (PPAR) were upregulated. HT exhibited reciprocal responses, suggesting that energy dysregulation found in HI interfered with performance in the heat. The endoplasmic-reticulum stress response was also suppressed in HI. In vitro HTT (43°C) abolished differences between HI and HT PBMCs including the HSPs genes, whereas controls showed profound HSPs upregulation.

Ectodermal dysplasias (EDs) encompass a large group of inherited disorders that affects two or more ectodermally derived structures. Hair, sweat glands, teeth, and nails are the most common ectodermal derivates affected. Other ectodermal structures that may be affected are ears, eyes, lips, and mucous membranes of the mouth or nose. During embryonic development, the ectoderm forms the outermost layer of the primary germ layers that give rise to the several structures that are commonly affected in ED. Therefore, ED manifests differently among patients, depending on the abnormality\'s combination and severity. Out of 150 distinctive syndromes, the most common syndromes within this group are hypohidrotic (defective sweat glands) and hidrotic (normal sweat glands). In addition, different types of inheritance patterns are found in ED; X-linked inheritance is by far the most common mode of inheritance. We present here the clinical case of hypohidrotic (anhidrotic) ED in a seven-year-old boy.

Heat tolerance testing (HTT) has been developed to assess readiness for work or exercise in the heat based on thermoregulation during exertion. Although the Israeli Defense Forces protocol has been the most widely used and referenced, other protocols and variables considered in the interpretation of the testing are emerging. Our purpose was to summarize the role of HTT after exertional heat stroke; assess the validity of HTT; and provide a review of best-practice recommendations to guide clinicians, coaches, and researchers in the performance, interpretation, and future direction of HTT. We also offer the strength of evidence for these recommendations using the Strength of Recommendation Taxonomy system.

UNASSIGNED: Signs of dysautonomia were frequently observed in calves that died during foot-and-mouth disease (FMD) virus (FMDV) outbreaks in Egypt from 2015 to 2018. This study aimed to describe the clinical and histopathological features of the central nervous system in malignant cases of FMD and excluding possible concurrent bacterial, and bovine herpes virus 4 (BHV4) infections or both.
UNASSIGNED: In this study, 335 FMDV-infected buffalo calves aged 1-22 months were clinically examined and followed until recovery or death. Of the 335 calves, 134 died (malignant group) and 201 recovered after exhibiting classic symptoms of FMD (recover group). The calves were subjected to clinical examination. For the malignant group, several laboratory trials were conducted to assess the possible cause/s of dysautonomia-related viral, bacterial, or concurrent infections. Koch\'s postulates and polymerase chain reaction were employed. Postmortem and histopathological examinations of nervous tissue were performed.
UNASSIGNED: In the malignant group, signs of dysautonomia were observed before death, including partial or complete gut dysfunction, loss of anal sphincter tone, rapid breathing sounds, fluctuating body temperature, and cardiac arrhythmias. In the malignant group, histopathological examination of the spinal cord, pons, medulla oblongata, hypothalamus, cerebellum, and cerebrum revealed demyelination, neuronal degeneration, and focal areas of malacia and gliosis. The nervous tissue and heart samples from malignant cases were positive for serotype O FMDV.
UNASSIGNED: Findings revealed in this study support the existence of neurodegeneration induced by FMDV infection in buffalo calves.

A basal heat stress test (HST) to predict the magnitude of adaptive responses during heat acclimatization (HA) would be highly useful for the armed forces. The aim was to identify physiological markers assessed during a HST (three 8-min running sets at 50% of the speed at VO2max) performed just before a 14-day HA period that would identify participants still at \"risk\" at the end of HA. Individuals that responded poorly (large increases in rectal temperature [Trec] and heart rate [HR]) during the initial HST were more likely to respond favorably to HA (large reductions in Trec and HR). However, they were also more likely to exhibit lower tolerance to HST at D15. Basal Trec was found to efficiently discriminate participants showing a Trec > 38.5°C after HA, who are considered to be \"at risk\". Finally, participants were classified by quartiles based on basal Trec and HR at the end of the HST and physiological strain index (PSI). Most of the participants \"at risk\" were among the upper quartile (i.e. the least tolerant) of Trec and PSI (p = 0.011 for both). Overall, these results show that the individuals who are less tolerant to a basal HST are very likely to benefit the most from HA but they also remain less tolerant to heat at the end of HA than those who better tolerated the basal HST. A basal HST could therefore theoretically help the command to select the most-ready personnel in hot conditions while retaining those who are less tolerant 6.

OBJECTIVE: Researchers have produced a hypothesis of transient heat intolerance (HI) after exertional heat stroke (EHS). Based on this hypothesis, heat-tolerance testing (HTT) has been postponed until weeks 6 to 8 after EHS and other types of exertional heat illness (EHI). We compared the HTT results of participants after either EHS or other EHI who were tested earlier (≤6-week group) versus those who were tested later (>6-week group) to verify the hypothesis.
METHODS: Cohort study.
METHODS: Data obtained from records of military athletes who experienced EHS or EHI.
METHODS: All participants who underwent HTT after EHI or EHS experienced between 2014 and 2018 and for whom complete data regarding the severity of the event (rectal temperature, neurologic symptoms, and laboratory results) and HTT results were available were included. Participants with suspected EHS and those with other EHIs were evaluated separately.
METHODS: The percentages of participants with HI and mean probability of heat tolerance were compared between those tested within 6 weeks of the event and those tested later.
RESULTS: A total of 186 participants were included in this study (EHS: 12 in the <6-week group, 9 in the >6-week group; EHI: 94 in the <6-week group, 71 in the >6-week group). In the EHS group, the percentages with HI (33% versus 44%, P = .67) and mean probability of heat tolerance (0.82 versus 0.82, P = .98) did not differ. In the EHI group, participants who were tested after 6 weeks had a greater chance of being diagnosed with HI (38% versus 21.3%, P < .02).
CONCLUSIONS: The HTT results were similar between participants with EHS who were tested early (<6 weeks) and those tested late (>6 weeks). Further investigation of heat-tolerance changes in larger cohorts of patients after EHS is required to verify the theory of transient HI.