Nitrogen Oxides and Ozones from B-747 Measurements (NOXAR) during POLINAT 2 and SONEX: Overview and Case-Studies on Continental and Marine Convection

In the framework of the project POLINAT 2 (Pollution in the North Atlantic Flight Corridor) we measured NO(x) (NO and NO2) and ozone on 98 flights through the North Atlantic Flight Corridor (NAFC) with a fully automated system permanently installed aboard an in-service Swissair B-747 airliner in the period of August to November 1997. The averaged NO, concentrations both in the NAFC and at the U.S. east coast were similar to that measured in autumn 1995 with the same system. The patchy occurrence of NO(x), enhancements up to 3000 pptv over several hundred kilometers (plumes), predominately found over the U.S. east coast lead to a log-normal NO(x) probability density function. In three case-studies we examine the origins of such plumes by combining back-trajectories with brightness temperature enhanced (IR) satellite imagery, with lightning observations from the U.S. National Lightning Detection Network (NLDN) or with the Optical Transient Detector (OTD) satellite. For frontal activity above the continental U.S., we demonstrate that the location of NO(x) plumes can be well explained with maps of convective influence. For another case we show that the number of lightning flashes in a cluster of marine thunderstorms is proportional to the NO(x) concentrations observed several hundred kilometers downwind of the anvil outflows and suggest that lightning was the dominant source. From the fact that in autumn the NO, maximum was found several hundred kilometers off the U.S. east coast, it can be inferred that thunderstorms triggered over the warm Gulf Stream current are an important source for the regional upper tropospheric NO(x) budget in autumn

Promotion of physical activity and sport in adolescents - first experiences of the Internet programme www.feelok.ch

The physical activity programme of feelok makes use of the multidimensionality of this health-related Internet platform for adolescents. It consists of an “energy test” providing individualised feedback on physical activity behaviour, a section for physically inactive individuals, one for physically active youths, and other tools. In 2008, feelok had 100 840 visits of more than three minutes duration, of which 12.0% concerned the physical activity programme. There are indications that feelok and its physical activity programme reach a broad range of adolescents and that its tools and elements are well accepted and appreciated. Further research, development and implementation strategies will be needed to maintain the attractiveness of the programme and to improve its reach and impact on physical activity behaviour

Effect of Thirst-Driven Fluid Intake on 1 H Cycling Time-Trial Performance in Trained Endurance Athletes

A meta-analysis demonstrated that programmed fluid intake (PFI) aimed at fully replacing sweat losses during a 1 h high-intensity cycling exercise impairs performance compared with no fluid intake (NFI). It was reported that thirst-driven fluid intake (TDFI) may optimize cycling performance, compared with when fluid is consumed more than thirst dictates. However, how TDFI, compared with PFI and NFI, impacts performance during a 1 h cycling time-trial performance remains unknown. The aim of this study was to compare the effect of NFI, TDFI and PFI on 1 h cycling time-trial performance. Using a randomized, crossover and counterbalanced protocol, 9 (7 males and 2 females) trained endurance athletes (30 ± 9 years; Peak V · O2∶ 59 ± 8 mL·kg−1·min−1) completed three 1 h cycling time-trials (30 °C, 50% RH) with either NFI, TDFI or PFI designed to maintain body mass (BM) at ~0.5% of pre-exercise BM. Body mass loss reached 2.9 ± 0.4, 2.2 ± 0.3 and 0.6 ± 0.2% with NFI, TDFI and PFI, respectively. Heart rate, rectal and mean skin temperatures and ratings of perceived exertion and of abdominal discomfort diverged marginally among trials. Mean distance completed (NFI: 35.6 ± 1.9 km; TDFI: 35.8 ± 2.0; PFI: 35.7 ± 2.0) and, hence, average power output maintained during the time-trials did not significantly differ among trials, and the impact of both PFI and TDFI vs. NFI was deemed trivial or unclear. These findings indicate that neither PFI nor TDFI are likely to offer any advantage over NFI during a 1 h cycling time-trial

Effect of pre-exercise caffeine intake on endurance performance and core temperature regulation during exercise in the heat : A systematic review with meta-analysis

Background Heat is associated with physiological strain and endurance performance (EP) impairments. Studies have investigated the impact of caffeine intake upon EP and core temperature (CT) in the heat, but results are conflicting. There is a need to systematically determine the impact of pre-exercise caffeine intake in the heat. Objective To use a meta-analytical approach to determine the effect of pre-exercise caffeine intake on EP and CT in the heat. Design Systematic review with meta-analysis. Data Sources Four databases and cross-referencing. Data Analysis Weighted mean effect summaries using robust variance random-effects models for EP and CT, as well as robust variance meta-regressions to explore confounders. Study Selection Placebo-controlled, randomized studies in adults (≥ 18 years old) with caffeine intake at least 30 min before endurance exercise ≥ 30 min, performed in ambient conditions ≥ 27 °C. Results Respectively six and 12 studies examined caffeine’s impact on EP and CT, representing 52 and 205 endurance-trained individuals. On average, 6 mg/kg body mass of caffeine were taken 1 h before exercises of ~ 70 min conducted at 34 °C and 47% relative humidity. Caffeine supplementation non-significantly improved EP by 2.1 ± 0.8% (95% CI − 0.7 to 4.8) and significantly increased the rate of change in CT by 0.10 ± 0.03 °C/h (95% CI 0.02 to 0.19), compared with the ingestion of a placebo. Conclusion Caffeine ingestion of 6 mg/kg body mass ~ 1 h before exercise in the heat may provide a worthwhile improvement in EP, is unlikely to be deleterious to EP, and trivially increases the rate of change in CT

High incidence of reversible renal toxicity of dose-intensified bendamustine-based high-dose chemotherapy in lymphoma and myeloma patients

INTRODUCTION High-dose chemotherapy (HDCT)/autologous stem cell transplantation (ASCT) is the standard for patients with relapsed/refractory lymphomas and multiple myeloma (MM), thereby improving DFS and OS. Relapse after HDCT/ASCT remains the major cause of death in patients with lymphomas or MM after melphalan-based HDCT. Dose-intensified bendamustine by replacing carmustine in the BEAM regimen (BeEAM) or by combining it with melphalan (BenMel) is a promising strategy to lower the relapse rates.Renal toxicity after BeEAM emerges as a major concern. METHODS We investigated renal toxicity in consecutive lymphoma patients treated with BeEAM and in consecutive MM patients treated with the same dose of 400 mg/m2 bendamustine (split into 200 mg/m2 on two consecutive days) together with full-dosed (200 mg/m2) melphalan. Patients with a history of renal impairment before HDCT were included. We assessed renal damage summarized as acute kidney injury (AKI) by measuring renal parameters on a daily basis starting from the first day of HDCT until the last day of hospitalization for HDCT/ASCT. AKI: rise of s-creatinine 6526.5 \u3bcmol/L in 48 hours or increase to more than or equal to twofold compared to baseline s-creatinine within 7 days (Kidney Disease International Global Organization, KDIGO, criteria). Grading of AKI: KDIGO. Treatment-related AKI (rAKI): occurred within 10 days from the last administration of bendamustine; no relation to sepsis. Consequently, we defined as treatment-unrelated AKI (uAKI) all renal damage occurring because of sepsis or later than 10 days since the last administration of bendamustine. Statistical Analysis Subgroup differences: Chi-squared test, Fisher Exact test. IBM SPSS software version 21. RESULTS Patient characteristics and therapy regimen: 122 consecutive patients with lymphomas or MM who underwent high- dose bendamustine regimen before ASCT in 01/2013-06/2016. Factors related to rAKIOccurrence of rAKI: correlated (p<0.05) with age >60 years, previous AKI, cardiovascular comorbidities and concomitant nephrotoxic drugs. In addition, rAKI correlated (p=0.004) with cardiovascular complications during hospitalization; details of subgroups analysis: Table 2.No differences in the incidence of rAKI MM (n=7/15; 46.7%) and lymphoma patients (n=44/107; 41.1%), p=0.683. Acute kidney Injury related to High Dose Bendamustine is reversible and manageable \u2022 Acute kidney injury related to bendamustine (rAKI): in 51 patients (41.8%); completely reversible in n=50/51 (98.0%). \u2022 rAKI: mild to moderate in 90% of affected patients; did not increase TRM after ASCT. \u2022 3/51 patients (5.9%) with rAKI required transient renal dialysis to enable recovery from renal damage, whereas approaches such as additional hydration were sufficient in the vast majority (n=48 with rAKI; 94.1% of this subgroup). \u2022 The median duration of rAKI was 7 days (range, 1-22). \uad According to Cox ZL et al., Adverse Drug Events during AKI and its recovery, Clin J Am Soc Nephrol 2013; 8:1070-1078. CONCLUSION \u2022 Our data suggest that treatment-related acute renal toxicity is common in lymphoma and MM patients receiving dose-intensified bendamustine HDCT before ASCT. \u2022 However, renal impairment is reversible and manageable. \u2022 Our data identify a subgroup of patients at increased risk for the development of renal damage following bendamustine-based HDCT. \u2022 Such patients should be strictly monitored during hospitalization, and a generous hydration strategy before, during and after administration of bendamustine is recommended. \u2022 Assessing the pre-transplant renal risk profile may help to identify those patients, which may not be candidates for bendamustine-based HDCT thereby avoiding prolonged hospitalization due to rAKI and eventual transient dialysis treatment. \u2022 Our results may contribute to design appropriate selection criteria for dose-intensified bendamustine as part of the conditioning regimens preceding HDCT/ASCT in lymphoma and MM patients

Programmed vs. Thirst-Driven Drinking during Prolonged Cycling in a Warm Environment

We compared the effect of programmed (PFI) and thirst-driven (TDFI) fluid intake on prolonged cycling performance and exercise associated muscle cramps (EAMC). Eight male endurance athletes (26 ± 6 years) completed two trials consisting of 5 h of cycling at 61% V˙O2peak followed by a 20 km time-trial (TT) in a randomized crossover sequence at 30 °C, 35% relative humidity. EAMC was assessed after the TT with maximal voluntary isometric contractions of the shortened right plantar flexors. Water intake was either programmed to limit body mass loss to 1% (PFI) or consumed based on perceived thirst (TDFI). Body mass loss reached 1.5 ± 1.0% for PFI and 2.5 ± 0.9% for TDFI (p = 0.10). Power output during the 20 km TT was higher (p < 0.05) for PFI (278 ± 41 W) than TDFI (263 ± 39 W), but the total performance time, including the breaks to urinate, was similar (p = 0.48) between conditions. The prevalence of EAMC of the plantar flexors was similar between the drinking conditions. Cyclists competing in the heat for over 5 h may benefit from PFI aiming to limit body mass loss to <2% when a high intensity effort is required in the later phase of the race and when time lost for urination is not a consideration