Heavy Sweating Research Articles

Self-Healing and Shear-Stiffening Electrodes for Wearable Biopotential Sensing and Gesture Recognition.

The achievement of flexible skin electrodes for dynamic monitoring of biopotential is one of the challenging issues in flexible electronics due to the interference of large acceleration and heavy sweat that influence the stability of skin-electrode interfaces. This work presents materials and techniques to achieve self-healing and shear-stiffening electrodes and an associated flexible system that can be used for multichannel biopotential measurement on the skin. The electrode that is based on a composite of silver (Ag) flakes, Ag nanowires, and polyborosiloxane offers an electrical conductivity of 9.71 × 104 S/m and a rheological characteristic that ensures stable and fully conformal contact with skin and easy removal under different shear rates. The electrode can maintain its conductivity even after being stretched by more than 60% and becomes self-healed after mechanical damage. The combination of the electrodes with a screen-printed multichannel flexible sensor allows stable monitoring of both static and dynamic electromyography signals, leading to the acquisition of high-quality multilead biopotential signals that can be readily extracted to yield gesture recognition results with over 97.42% accuracy. The conductive self-healing materials and flexible sensors may be utilized in various daily biopotential sensing applications, allowing highly stable dynamic measurement to facilitate artificial intelligence-enabled health condition diagnosis and human-computer interface.

Extremes of Weather Conditions and Child Health

Background: The number of people exposed to extreme heat is growing exponentially due to climate change worldwide. Heat-related mortality for people over 65 years of age and young children has increased by 85% between 2000–2004 and 2017–2021. World Meteorological Organization announced that there’s an 80% chance that the world will exceed the 1.5 °C temperature limit in at least one of the next 5 years. Aim: To review the impact of extremes of climate changes on Children’s health based on cases managed and reported in media. Methods: Material & Methods: This article is a review of the impact of extremes of heat & Cold weather on children, based on personal handling of cases and media reports of the adverse effects of heat this summer, exercising /punishing children in hot and cold weather. Key findings: Most children experience increased thirst, weakness, headache, dizziness or fainting, muscle cramps, nausea and/or vomiting, irritability, prickly heat & heavy sweating. Dehydration in children is more than just being thirsty, as it is a condition where there isn’t enough fluid in the body because children lose more water than they take in. High heat stress also reduces physical work capacity and motor-cognitive performances, with consequences for school attendance for children. The cold weather itself doesn’t cause illness, but it weakens the immune system, making it a lot harder for the child to fight off infections. Conclusion: Temperatures above long-term averages during summer months and heatwaves are associated with cardiorespiratory and other diseases and mental health issues. Very young children are particularly vulnerable to the effects of heat, irrespective of income level or geographical region. Most heat-related mortality and morbidities are preventable with individual efforts like avoidance of exposure, improved community preparedness, and Public Health Advisory.

The influence of extreme thermal stress on the physiological and psychological characteristics of young women who sporadically use the sauna: practical implications for the safe use of the sauna.

Many individuals who use the sauna at a temperature of 120°C of higher are not aware of the negative consequences of extreme thermal stress. Despite extensive research into sauna use, the impact of extreme thermal stress on the physiological and psychological characteristics of sauna users have not been examined to date. The aim was to determine the effect of 20 min sauna sessions with a temperature of 80°C and 120°C on the physiological and psychological characteristics of women who sporadically visit the sauna. The study was conducted on 22 full-time female university students. Physical activity (PA) levels were evaluated with the Polish short version of the International Physical Activity Questionnaire (IPAQ). Anthropometric characteristics were measured before the first sauna session by the InBody270 body composition analyzer. Physiological parameters, including heart, energy expenditure, physical effort, and blood pressure (systolic blood pressure - SBP, and diastolic blood pressure - DBP), were assessed indirectly using Polar V800 heart rate monitors and the Omron M6 Comfort blood pressure monitor. The participants' wellbeing was assessed with the Profile of Mood States (POMS) questionnaire. The presence of significant correlations between heat exhaustion and heat stress variables and syncope during the second sauna session was examined with the use of classification and regression trees (CRT) and the cross-validation technique. Twenty-minute sauna sessions with a temperature of 80°C and 120°C induced a significant (p < 0.001) decrease in the values of SBP (excluding the temperature of 120°C), DBP, and body mass, as well as a significant increase in HR and forehead temperature. Exposure to a temperature of 80°C led to a significant (p < 0.001) increase in vigor with a simultaneous decrease in tension, depression, anger, fatigue, and confusion. In turn, sauna bathing at a temperature of 120°C had an opposite effect on the above mood parameters. Vomiting and confusion were the main predictors of syncope that occurred in some of the surveyed women. Excessive air temperature can induce symptoms characteristic of heat exhaustion and heat stress nausea, heavy sweating, fast weak or strong HR, high body temperature, and confusion. Therefore, sauna bathing at a temperature of 80°C can be recommended to women who sporadically use the sauna, whereas exposure to a temperature of 120°C is not advised in this group of sauna users. The present findings provide highly valuable inputs for managing wellness and SPA centers.

Trading greens for heated surfaces: Land surface temperature and perceived health risk in Greater Accra Metropolitan Area, Ghana

The unsustainable expansion of cities is generating urban heat islands(UHIs) by exchanging (trading) vegetation cover (green) for built impervious surfaces which is associated with heat-related health risks, globally. This phenomenon is exacerbated by climate change and anthropogenic activities like urban population growth, particularly in African cities. This study explores the spatio-temporal trends of land surface temperature (LST), land use land cover (LULC) and their economic and health risks in the Greater Accra Metropolitan Area (GAMA) of Ghana, from 1991 to 2021. We extracted LST/LULC information from Landsat datasets to perform change analysis, alongside an online survey across 56 communities on how LST relatesto economic and human health risks perceptions of residents. The results show urbanization of GAMA is trading greens for heated surfaces, impacting communities’ health risks. While the built environment grew (8.6%), the vegetation cover declined (2.5%) and the mean LST rose (0.8⁰C) in 25 years. A 30⁰C LST corresponds to the point of inflexion of exchanging green vegetative cover for heated built surfaces. The forest community of Kisseman, the populous community of Dansoman and the harbour city of Tema corresponded to the first, fourth and fifth LST quintiles, changing at −0.05⁰C, 0.06⁰C and 0.164⁰C per year. The common health risks include discomfort from heavy sweating, headaches, dehydration, thirst and skin rashes. These results call for climate action and green spatial planning through urban forestry and environmentalism in GAMA. For urban resilience and sustainable cities, we advocate green-cooling multi-purpose housing, roads, and industrial infrastructure.

Structural design of single functional jersey with moisture comfort based on yarn combination

Yarn property and structure design play a decisive role in the sweat, evaporation and heat dissipation comfort of single jersey. However, single jerseys also tend to exhibit limited moisture comfort properties, even with the use of high-performance fibers or specific structures. They also have some common phenomena such as backflow and the poor isolation of sweat, making the garment feel uncomfortable when worn. To enhance the moisture comfortable feeling of single jersey, the fabric is formed from a yarn combination of 75 dtex/288 f and 50 dtex/14 f polyesters, and the fabric structure with rapid moisture conduction is formed through the structural design. Through the research method of this paper, the single jersey ensures an excellent capillarity effect, and the outer surface of the fabric shows a large loop structure. In contrast, the inner surface is supported by yarn without contact with the skin. Furthermore, the fabric contains three pathways to transfer sweat outward, including a multistage bifurcated transmission system, which aids in the improvement of fabric moisture conduction, penetration and prevention. In the various tests, compared with plain structure, the single jersey of this design scheme exhibits a 1.98-fold larger loop size. It contains an effective sweat transmission pathway, which improves fabric air permeability and water permeability. In addition, the water repellent effect of the fabric is improved by 26.56%, with the inner surface of the fabric remaining dry within 3 s, even in the presence of heavy sweating. It is expected that the structural and material optimization designs of the single jersey can provide a promising method for functional textiles.

In Situ Formation of Conductive Epidermal Electrodes Using a Fully Integrated Flexible System and Injectable Photocurable Ink.

In situ fabrication of wearable devices through coating approaches is a promising solution for the fast deployment of wearable devices and more adaptable devices for different sensing demands. However, heat, solvent, and mechanical sensitivity of biological tissues, along with personal compliance, pose strict requirements for coating materials and methods. To address this, a biocompatible and biodegradable light-curable conductive ink and an all-in-one flexible system that conducts in situ injection and photonic curing of the ink as well as monitoring of biophysiological information have been developed. The ink can be solidified through spontaneous phase changes and photonic cured to achieve a high mechanical strength of 7.48 MPa and an excellent electrical conductivity of 3.57 × 105 S/m. The flexible system contains elastic injection chambers embedded with specially designed optical waveguides to uniformly dissipate visible LED light throughout the chambers and rapidly cure the ink in 5 min. The resulting conductive electrodes offer intimate skin contact even with the existence of hair and work stably even under an acceleration of 8 g, leading to a robust wearable system capable of working under intense motion, heavy sweating, and varied surface morphology. Similar concepts may lead to various rapidly deployable wearable systems that offer excellent adaptability to different monitoring demands for the health tracking of large populations.

ODP306 Diplopia as Presenting Manifestation of Acromegaly

Abstract Introduction Acromegaly is a chronic disorder characterized by excess growth hormone production, withclinical manifestations ranging from subtle signs to significant systemic complications. We describe a patient who presented with diplopia as initial symptom of acromegaly. Clinical case: A 72-year-old female patient was referred for diplopia. Upon questioning, she reported headache, muscle aches and heavy sweating. On physical assessment, she had coarse facial features, thickened tongue and hand enlargement. Orbital CT images revealed a mild to moderate symmetric enlargement of the extraocular muscle which spared myotendinous junction. MRI sella showed a 12 mm pituitary adenoma. The diagnosis of acromegaly was confirmed with high IGF-1 and oral glucose tolerance test. The patient underwent endoscopic debulking of the pituitary tumor and pathology showed a densely granulated GH producing adenoma. Upon follow up, she reported improvement of the diplopia which was completely corrected with prism glasses. Remission of acromegaly was confirmed biochemically and repeated MRI sella showed no residual tumor. Conclusion Acromegaly is the most likely cause of extraocular muscle enlargement with subsequent diplopia in this patient. Ocular manifestations in patients with acromegaly include visual field defect, excessive lacrimation, proptosis and double vision. This case adds to previous literature that diplopia could be the presenting manifestation of acromegaly. This is the first case reporting of improvement of diplopia following remission of acromegaly. Comprehensive ophthalmic assessment of patients presenting with eye symptoms and features suggestive of acromegaly is of value as it helps with early diagnosis as well as improving the outcome of this condition. Presentation: No date and time listed

Difficulties in diagnosing involvement of the lungs and other internal organs using CT in a patient with Kaposi’s sarcoma and generalized tuberculosis during the COVID-19 pandemic: a case report

Kaposi’s sarcoma in association with generalized tuberculosis is a rare combination of two opportunistic HIV-associated diseases, and the difficulties of their detection are especially relevant in the context of the COVID-19 pandemic. To demonstrate a clinical case of multisystem involvement by Kaposi’s sarcoma and pulmonary tuberculosis in a patient admitted to an infectious diseases hospital with suspected viral pneumonia caused by a new coronavirus infection COVID-19. The patient complained of general weakness, shortness of breath with minimal physical exertion, heavy sweating, cough with yellow-green sputum, fever up to 37–39°С, lack of appetite and weight loss of 13 kg over the past six months. The analysis of clinical data, laboratory, instrumental and pathoanatomical studies performed in a St. Petersburg’s infectious diseases hospitals was carried out. CT findings of generalized lymphadenopathy combined with lung infiltrates in a patient with a positive PCR test for a new coronavirus infection (COVID-19) led to the overdiagnosis of a lymphoproliferative disease and did not allow for Kaposi’s sarcoma to be detected in vivo due to the absence of typical CT findings of disseminated tuberculosis in the presence of bilateral pneumonia. Radiologists should be aware of the clinical picture and signs of Kaposi’s sarcoma, it must be included in the differential diagnosis if a patient has an atypical clinical presentation and course of the disease, in the presence of skin rashes, even with a positive PCR for COVID-19.

PRELIMINARY STUDY ON INVESTIGATION OF THE HEAT STRESS AFFECTING THE LABOR PRODUCTIVITY, A CASE STUDY: GARMENT FACTORY IN PHNOM PENH

This paper aims to investigate low labor productivity affected by heat stress; focusing on various parameters including outdoor and indoor temperatures and humidity, indoor air quality, and the outfit used. Survey of 130 questionnaires together with measurements of indoor and outdoor air temperatures and humidity were carried out in a garment factory in Phnom Penh, Cambodia during May 2019, which is one of the hottest months of the year. The indoor wet bulb globe temperature, WBGTid, with the evaporative cooling system in operation was ranging from 26 to 34oC; while the outdoor air dry-bulb temperature was around 25 to 41oC. The survey results show that the participants experienced all types of heat-stress symptoms, including heavy sweating, muscle cramps, tiredness/weakness, dizziness, headache, nausea or vomiting, and fainting. Even though the majority of respondents found the workplace temperature comfortable and around 65% could manage bad feelings due to heat stress, about 80% of respondents reported feeling hot and uncomfortable at working place within the period of 1 to 3 months in a year. During the hot months, some 39.6% had feeling thirsty, more than 22% felt exhaustion and had excessive sweating; and around 9% want to move and stay in a comfortable place. To cope with the heat stress, workers mostly drink water, but some also need to move away for a while or remove extra layer of outfit. Finally, noticeable number of workers, 41.3% and 33.7%, respectively, acknowledged heat stress negatively impact their productivity and cause irritation in working together.

PREVALENCE OF HEAT-RELATED SYMPTOMS UNDER HEAT STRESS AMONG THAI TIRE MANUFACTURER WORKERS

Tire manufacturer workers who work in hot environments in the workplace may suffer a variety of heat-related symptoms. The purpose of this study was to investigate the prevalence of heat-related symptoms under heat stress. The cross-sectional study was carried out in a tire plant in Nakonpathom province, Thailand. A total of 343 workers (n = 343) were interviewed using a modified questionnaire. The body temperature and wet bulk globe temperature (WBGT) were measured. The mean, Adjust Relative Risk Ratio (Adjust RRR), and 95 % Confidence Interval (CIs) for the association between chosen factors were estimated using multinomial logistic regression. As a result, the most prevalent heat-related symptoms in workers who were exposed to heat in production plants were heavy sweating (70.71%), red rashes (54.55%), and weakness/fatigue (52.02%). The Adjust RRR heat-exposed was three times higher experienced minor symptoms (Adjust RRR = 2.87, 95%CI = 1.43-5.76) and five times higher experienced moderate symptoms (Adjust RRR = 5.00, 95% CI = 2.25-10.82). Females were found six times more likely to experience minor symptoms (Adjust RRR = 6.11, 95%CI = 2.02-18.48) and ten times more likely to experience moderate symptoms (Adjust RRR = 9.57, 95%CI = 2.94-31.19) than the control group. The mean ear temperature did not exceed 38.0°C for safety reasons. Tire workers reported a high burden of heat-related symptoms. On-site care, training programs, and health monitoring strategies are necessary, especially for workers who intake high antihistamines to reduce the risk of heat strain, not only during the summer season but also during the rainy season.

Risk factors associated with heat-related illness among sugarcane farmers in Thailand.

Heatstroke is defined as severe symptoms of heat-related illness, which could lead to death. Sugarcane farmers are at high risk of heatstroke under extremely hot outdoor working conditions. We explored the prevalence of heat-related illness symptoms and risk factors related to heat-related illness among sugarcane farmers working in the summer. We conducted a cross-sectional study using questionnaire interviews among 200 sugarcane farmers in Kamphaeng Phet Province, Thailand. The questionnaire addressed demographics, heat-related symptoms experienced during summer at work, and occupational factors. Bioelectrical impedance analysis was used to assess body mass index and body fat percentage. Watson formula equations were used to estimate total body water. The prevalence of heat-related illness symptoms was 48%; symptoms included heavy sweating, weakness/fatigue, dizziness, muscle cramps, headache, and vertigo. Factors associated with heat-related illness included women and clothing. Sugarcane farmers wearing two-layer shirts had a higher risk of heat-related illness. Farmers with fluid intake 3.1–5.0 liters per day had a 79% lower risk of heat-related illness. Our findings demonstrated that sugarcane farmers are at risk of heat-related illness. We confirmed that working conditions, including wearing proper clothing and water-drinking habits, can reduce this risk.

Vitamin D Deficiency Manifested by Premature Ventricular Complexes from RVOT: A Report on Two Twins

Vitamin D receptor is present in almost every cell of the body. Although some studies have suggested that values &gt;30ng/ml would be sufficient, there is no consensus on the optimal values of serum vitamin D. Vitamin D deficiency can lead to “benign” manifestations, such as back pain, joint pain, fatigue, and heavy sweating. Premature ventricular contractions (PVCs) originating from the right ventricular outflow tract (RVOT) are considered “benign,” as they occur in patients without structural heart disease and their exact cause remains unknown. We describe the case of a 10-year-old boy with frequent PVCs and vitamin D deficiency that was corrected after vitamin D supplementation. On the contrary, his twin brother had normal serum vitamin D and no PVCs. The disappearance of PVCs occurred after treatment with vitamin D 2000 IU/day.

The sun is here! What will you recommend?

Spring and summer are just around the corner, and most areas accustomed to clouds and cooler temperatures will begin to experience a warming trend. This means folks will be spending more time in the sun. Pharmacists should be prepared to answer questions and make recommendations about sunscreen. Here's some important information to consider as you counsel patients on sun safety and the benefits of using sunscreen. The ultraviolet (UV) spectrum is divided into three major bands—ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC)—all of which may cause or exacerbate sun-induced skin disorders. UVA and UVB primarily are responsible for photodamage, as all UVC radiation is removed by the ozone layer. UVA and UVB both play a role in causing skin cancer. The only true therapeutic effect of UVB exposure is synthesis of vitamin D3 in the skin. Sun protection factor (SPF) is one parameter for determining a sunscreen's effectiveness for UV protection. Another parameter, minimal erythema dose, is used to calculate a sunscreen's SPF. SPF is calculated based on the time to skin burning with sunscreen compared with time to skin burning without sunscreen. For example, by using SPF 10, a person who usually stays in the sun for 10 minutes before starting to burn can prolong that time to approximately 100 minutes. Many dermatologists recommend using a product with SPF 30 or higher. Topical sunscreens can be divided into two major subgroups: chemical and physical. Chemical sunscreens absorb and thus block the transmission of UV radiation to the epidermis. Physical sunscreens are generally opaque; instead of absorbing UVR, they reflect and scatter it. Broad-spectrum sunscreens are designed to protect against both UVA and UVB rays. Many medications are associated with photosensitivity reactions. Review your patient's medication list and counsel patients to prevent any negative reactions. ▪For maximum effectiveness, apply sunscreens liberally to all sun-exposed areas of the body and reapply at least as often as the label recommends.▪Apply to dry skin at least 15 to 30 minutes before sun exposure if expecting to spend more than 20 minutes in the sun.▪Reapply every 2 hours at minimum, even on cloudy days.▪Reapply after heavy sweating, swimming, and toweling off. Reapplying doesn’t extend the length of time a person is protected from sunburn.▪When using sunscreen sprays, spray and rub into skin to ensure uniform coverage.▪If using insect repellent and sunscreen, apply sunscreen before insect repellent.▪Do not use on children younger than 6 months. Lotions are the preferred dosage form for children.▪For sufficient protection, the average adult in a bathing suit should apply nine portions of sunscreen of approximately ½ teaspoon each, or approximately 4.5 teaspoons (22.5 mL) total. Distribute the sunscreen as follows:–Face and neck (including ears): ½ teaspoon–Arms and shoulders: ½ teaspoon to each side of body–Torso: ½ teaspoon each to front and back–Legs and tops of feet: 1 teaspoon to each side of body As we consider the opportunities to counsel patients on appropriate sunscreen use, we shouldn’t assume they’re getting this advice elsewhere. Many people believe they’re knowledgeable about sunscreens and protection from the sun's harmful rays—until they get a sunburn. Because of the cost of sunscreen products and the need to apply them often and in sufficient amounts, users may apply substantially less sunscreen than is required to provide adequate protection. Find ways to educate your patients on optimal ways to protect against the potential dangers of the sun's UVA and UVB rays while still enjoying outdoor fun and activities. Shelf talkers and signage in the appropriate OTC sections of the pharmacy can facilitate dialogue. And don’t forget to practice what you preach!

Song, and: Connecticut, and: My Brother Does Not Return for My Mother’s Fiftieth

Song, and: Connecticut, and: My Brother Does Not Return for My Mother’s Fiftieth Tawanda Mulalu (bio) Song Forgive myself for breath and I should die.Self-love an excuse but for that exit: this daydreamof me ended. Of feet parched with weight beyondthe hurt of pale bathroom scale. Or love thisitch between thighs as slower metabolism giftsslower moods, these dull penetrations of faceinto pillowcase. So die then, says another countryor lover; splits me long through thoughts of this spine.And a dream of nerve cells copying beneath this glass.How inexact to possess skin. Like a flailing sacktoo stuffed with consciousness. I feel as a piñataand you are peckish. Not just the promise of guns shotbut allergic itch draws blood in late summer. I’m sorryother Black men died. I’m sorry I keep thinking,I look like him. I’m sorry my life feels as easyas these leaves failing to defend themselves againsttheir too-soon shifting colors. But I want myself.I want to want myself as much as I want your shadowsflickering against the walls of this cave, fooling meof presences beyond myself. And this music: I want thisfoolishness of my mouth transmuted into woodwindand brass. As if this could salve. As if this grass betweenmy lips epistles this gray sky as any virtue but failed rain.As if peaches. Forgive myself for breath and this songshould die. I am as new as the paintings in this cave.Am the same burrowing of grain into body and loss.Am the same ochre and hematite, inevitable and sorry. [End Page 18] Connecticut Mornings, his wife could not remember who my face was.Her face stared at me with a mushy smile while Henry ate the same corn flakes with bananas. I watched the yellow flakesuncrisping in his bowl of milk, his gums too soft to bear them. Henry then put me to work on his “fields.” I don’t know whofirst said it. Probably, his teeth cackled “fields” to his friend who visited him—limping gently—as Henry rolled around in hisred tractor. It roared through his backyard, funneling narrow lanes into the black, hot soil. Waddling after him in my white sneakers,I held blue seeds of grass that pricked my fingers. I tossed them over the soil like a flower girl. “Why are they blue?” I asked him.“Fertilizer coating,” he said. “Dry, mutant rice,” said my fizzy mind. Nights—they opened with heavy sweat—he would sit and watchFox News blare. Me next to him, reading a long novel on suffering. But he shouldn’t have paid me as a gardener. I dug about as wellas a child in a sandbox—shallow, amazed by my skinny handling of that spade. Its crusted rust as dark as my dry skin. No, Henry paidmy hands to hold his loneliness. To hear him. I needed a place to stay. He liked to hear me singing off-key in the mornings, taking longcold showers. And walk down these stairs to him: aging, waiting to plant more blue seeds. [End Page 19] My Brother Does Not Return for My Mother’s Fiftieth Egg that could but did not quite, I see you in theirmuseums, the coal-dark African masks, your blank face. To not find you walking with me with thesestolen faces, to not find you crawling up from dust— I left you landlocked with our parents, heard tidesbefore my body, wet axes carving shore to noise, and who has ever rescued the drive home? Washedmy crusted hands and what—stubborn grains. Dried my hands with a cold towel, your little hands driedbut could not hold their shores—though other grains now live between your fingers. This world will nothold little hands but turned to dust. At this party, I sip on bitter-dark drink, bearing warm speecheswhile your body turns to airlessness. My thoughts on this glass, roundedness of your once new skullI never saw. My flight returns to their shores. Your face escapes me...

Perceived Partner Responsiveness Attenuate the Link Between Menopausal Symptoms and Depressed Affect

The years around menopause are the time that associates not only with hormonal changes but with psychological and social transitions, and previous studies have consistently revealed the relationship between menopause and depression. The present study examined the moderating effect of perceived partner responsiveness (PPR) on the association between menopausal symptoms (MS) and depressed affect (DA). The sample was middle-aged climacteric women (N = 754, Age=49-60) from the second wave of Midlife in the United States (MIDUSⅡ). Measurement for MS consisted of the frequency of five symptoms in the past 30 days (insomnia, heavy sweating, painful intercourse, hot flashes, and irritability). PPR was assessed using three items matched the core components of responsiveness (understanding, validating, and caring). Results revealed that there were significant interactions between menopausal symptoms and PPR (b = 0.05, p < 0.039). Specifically, the level of elevation of DA in response to MS was smaller in women with higher levels of PPR (b = 2.93, p < 0.001) than in those with lower levels of PPR (b =3.05, p < 0.001). According to the region of significance analysis, the coefficients of MS on DA were significant within the -2SD to +2SD range of PPR, but it decreased as the PPR increased. Findings suggest that partners’ careful responsiveness may mitigate the detrimental effects of MS on DA among climacteric women.

Gastrointestinal hemorrhage from a duodenal varix rupture: a case report

: A 77-year-old male with background of antithrombin-III deficiency, SMV thrombosis and duodenal ulcer was transferred to our clinic with a sudden onset, russet diarrhoea and a concomitant episode of heavy sweating. Later on, he developed severe hematemesis and haematochezia. Ultimately, he was diagnosed on CT-angiography with a hemorrhage from extensive, isolated duodenal (D3) varices. Emergency surgical ligation was performed after endoscopy could not reveal an active bleeding site and the patient had become hemodynamically unstable. Duodenotomy confirmed three protruding veins, one of which was bleeding. After the ligation, the patient stabilised and further recovery was uneventful. He was discharged from ICU on the third day after surgery and left the hospital seven days later. In a second stage, a selective endovenous embolization of the duodenal varices (DV) with cyanoacrylate (Glubran®, 3×1 mL) was performed. DV are a rare cause of gastro-intestinal bleeding but should be considered in all patients with a history of splanchnic venous thrombosis. Endoscopy plays a pivotal role in the diagnosis and acute management of DV and should be carried out with the possibility of distal DV in mind. We advise that urgent endoscopic interventions are to be carried out by experienced clinicians as this might avoid open surgery. However, surgical ligation remains a valid therapy as endoscopic diagnosis and treatment is not always possible. Guidelines, meta-analyses and high-quality reviews that compare different therapies are still lacking and therefore further research is necessary.

Heat Stress, Physiological Response, and Heat-Related Symptoms among Thai Sugarcane Workers.

Prolonged or intense exposure to heat can lead to a range of health effects. This study investigated heat exposure and heat-related symptoms which sugarcane workers (90 sugarcane cutters and 93 factory workers) experienced during a harvesting season in Thailand. During the hottest month of harvesting season, wet bulb globe temperature was collected in the work environment, and workloads observed, to assess heat stress. Urine samples for dehydration test, blood pressure, heart rate, and body temperature were measured pre- and post-shift to measure heat strain. Fluid intake and heat-related symptoms which subjects had experienced during the harvesting season were gathered via interviews at the end of the season. From the results, sugarcane cutters showed high risk for heat stress and strain, unlike factory workers who had low risk based on the American Conference of Governmental Industrial Hygiene (ACGIH) threshold limit values (TLVs) for heat stress. Dehydration was observed among sugarcane cutters and significant physiological changes including heart rate, body temperature, and systolic blood pressure occurred across the work shift. Significantly more sugarcane cutters reported experiencing heat-related symptoms including weakness/fatigue, heavy sweating, headache, rash, muscle cramp, dry mouth, dizziness, fever, dry/cracking skin, and swelling, compared to sugarcane factory workers. We conclude that the heat stress experienced by sugarcane cutters working in extremely hot environments, with high workloads, is associated with acute health effects. Preventive and control measures for heat stress are needed to reduce the risk of heat strain.

Knowledge of Heat-Related Illness First Aid and Self-Reported Hydration and Heat-Related Illness Symptoms in Migrant Farmworkers.

Background: Outdoor workers are exposed to hot work environments and are at risk of heat-related morbidity and mortality. The purpose of this study was to evaluate the knowledge of migrant farmworkers about first aid for heat-related illness (HRI) symptoms. Methods: The authors recruited 60 migrant farmworkers out of 66 who were approached from vegetable farms in Georgia. They were workers who participated in the 2018 Farmworker Family Health Program (FWFHP). The authors surveyed the workers to assess demographics, prevalence of HRI symptoms, hydration practices, and knowledge of HRI first aid. Descriptive statistics for worker demographics, HRI symptoms, and hydration data were calculated, as were the percentages of correctly answered pilot questions. Findings: Of the 60 workers who chose to participate in this study, more than 50% incorrectly answered pilot questions related to their knowledge of HRI first aid. The two most common HRI symptoms reported were heavy sweating and muscle cramps. More than two thirds reported experiencing at least one HRI symptom during the workday. Mean liquid consumption within this sample was 72.95 oz per day, which is much less than the recommended 32 oz per hour. Conclusion/Application to Practice: Until larger structural change can occur to protect farmworkers, farm owners can prevent morbidity and mortality from inadequate hydration practices and working in high-heat conditions by providing migrant farmworkers with training in heat-related first aid. Appropriate heat-illness interventions should focus on first aid measures to reduce morbidity and mortality related to heat illness in farmworkers.

Renal Stress Responses To Work In The Heat Comparing Different Hydration Regimens

Workplace safety organizations recommend that workers predicted to incur heavy sweat loss should consume a ‘sport drink’ during work. These sugar-sweetened beverages (SSB) often include fructose, which can lead to acute kidney injury (AKI), especially when combined with hypohydration. PURPOSE: Investigate the effect of SSB on renal stress in response to simulated industrial work in the heat, while maintaining euhydration. METHODS: Twenty male participants (24 ± 2y, 179 ± 6cm, 24.7 ± 9.0% body fat) completed two randomized, matched trials of simulated industrial work (2-hr total; two 45-min work and two 15-min rest bouts) in the heat (30oC, 55% RH). Equal amounts of SSB or placebo were provided during rest and within 2-hr of completing work. Urine specific gravity (USG), heart rate (HR), and rectal temperature (Trec) were monitored throughout trials. Serum [Na+], hemoglobin, and hematocrit levels were measured at baseline, pre- and post-work, and 16-hr post-work. Urinary kidney injury molecule-1 (uKIM-1) and urinary neutrophil gelatinase-associated lipocalin (uNGAL) were measured pre- and post-work, 3-hr and 16-hr post-work. Total urine volume was measured for 16-hrs following work. Change in plasma volume (ΔPV) was calculated using the Dill & Costill equation. RESULTS: There was no significant trial difference in USG (p=.277) or HR (p=.209), but post-work (p≤.011) and 16-hr post-work USG were elevated compared to baseline (p=.043) and 3-hr post-work (p=.001). There was no difference in maximum Trec achieved between trials (SSB 38.84 ± 0.52oC; placebo 38.68 ± 0.40oC; p=.330). Serum [Na+] was elevated post-work compared to baseline and 16-hr post-work (p=.006), but there was no trial difference (p=.612). There was no trial difference in hemoglobin (p=.650) or hematocrit (p=.637). uKIM-1 was elevated post-work and 16-hr post-work compared to baseline (p≤.028) and 3-hr post-work (p≤.009), but showed no trial difference (p=.126). uNGAL 3-hr post-work was significantly lower than baseline (p=.011), but showed no trial difference (p=.992). There was no significant trial difference in total urine volume (p=.277) or ΔPV (p=.098). CONCLUSION: These findings indicate that beverage type did not affect renal stress biomarkers following simulated industrial work in the heat when euhydration was maintained.

The Impact of Heat on Health and Productivity among Maize Farmers in a Tropical Climate Area.

Background Heat stress disorders may cause negative health outcome and subsequent productivity reduction especially in those who work under direct sunlight for an extended number of hours. Objective This study assessed the impact of heat on the health and productivity among maize farmers in a hot tropical country. Methods A cross-sectional study was conducted among 396 maize farmers, randomly selected across Gombe province, Nigeria. The wet bulb globe temperature monitor (WBGT) Model QuesTemp036 was used in determining the heat index. Health was determined using a validated questionnaire, while productivity was determined by recording work output based on the number of ridges cultivated during the working hours. Results The farms recorded mean heat index with standard deviation (SD) of 31.56 (2.19) and 34.08 (1.54) in the hours of 9 am to 12 pm and 12–3 pm respectively, which exceeded the threshold level set by the ACGIH. Heavy sweating (93.2%), tiredness (48.5%), dizziness (34.1%), and headache (40.4%) were experienced by the respondents almost on daily basis. The finding further showed a significant difference in the farmers' productivity during the three time duration of the work day (p < 0.001). The productivity was significantly higher between the hours of 6–9 am (p < 0.001) and 12–3 pm (p < 0.001), compared to the hours of 9 am to 12 pm (p < 0.001). The factors that significantly predict the productivity outcome include temperature (p < 0.001), gender (p < 0.001), age (p=0.033), and BMI (p=0.008). Conclusion The farmers were frequently experiencing heat exhaustion which decreased their productivity.