Evidence map›Paper›PMID 41269435›Full record

ArticleSports medicine - open2025

Integrating Cognitive and Mood Assessments into the Heat Tolerance Test for Male Soldiers After Exertional Heat Injury: A Prospective Observational Study.

David Erez, Harris R Lieberman, Sharon Segev, Ziv Izhaki, Itay Ketko, Daniel S Moran

Abstract read
In one paragraph

Article in Sports medicine - open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

David ErezThe Department of Health Systems Management, Ariel University, Ariel, Israel. david.erez@msmail.ariel.ac.il.ORCID http://orcid.org/0009-0002-6038-853X
Harris R LiebermanMilitary Nutrition Division, U.S. Army Research Institute of Environmental Medicine (USARIEM), Natick, MA, USA.
Sharon SegevInstitute of Military Physiology, IDF Medical Corps, Tel Hashomer, Israel.
Ziv IzhakiInstitute of Military Physiology, IDF Medical Corps, Tel Hashomer, Israel.
Itay KetkoInstitute of Military Physiology, IDF Medical Corps, Tel Hashomer, Israel.
Daniel S MoranThe Department of Health Systems Management, Ariel University, Ariel, Israel.

Funding

Directorate of Defense Research & Development, Israeli Ministry of Defense #4440836612Israel Defense Forces (IDF) Medical Corps Israel Defense Forces (IDF) Medical Corps
6 · The paper itself

Abstract

backgroundThe Heat Tolerance Test (HTT) is widely used to evaluate physiological recovery following exertional heat injury (EHI). However, the current protocol does not assess neurocognitive or affective recovery, which may remain impaired despite normalization of core temperature and heart rate. This study examined whether brief, field-deployable assessments of sustained attention and mood state could discriminate between heat-intolerant (HI) and heat-tolerant (HT) individuals during the HTT.

resultsSeventy male combat soldiers (20.3 ± 1.2 years) with a history of EHI completed the HTT; 14 (20%) were classified as HI. Compared to HT counterparts, HI individuals exhibited significantly slower mean reaction times (MeanRT) on the Psychomotor Vigilance Test at 60 min (t (13) = - 8.13, p < 0.001, d = - 2.17) and 120 min (t (13) = - 12.31, p < 0.001, d = - 3.29). They also demonstrated fewer valid responses, more premature responses, and more timeouts (p < 0.01). Total Mood Disturbance (TMD) increased significantly in the HI group from baseline (6.7 ± 12.7) to 120 min (63.4 ± 6.5), with significant between-group differences (p < 0.001). ROC analyses showed that MeanRT (AUC = 0.807, 95% CI: 0.72-0.90) and TMD (AUC = 0.856, 95% CI: 0.79-0.93) effectively discriminated HI status. Additionally, baseline TMD significantly predicted MeanRT at 120 min (p < 0.001), suggesting that mood disturbance is associated with cognitive decline under thermal strain.

conclusionsHI individuals exhibited substantial impairments in vigilance and mood during the HTT, despite achieving physiological recovery. Incorporating brief cognitive and affective metrics into post-EHI assessments enhances the diagnostic sensitivity of the HTT and may inform return-to-duty decisions in both military and civilian contexts where thermal strain compromises operational performance.

Identifiers

PMID41269435
PMCPMC12638594

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.