Pub Date : 2025-11-01Epub Date: 2025-09-29DOI: 10.1152/ajpregu.00074.2025
Takuro Washio, Sarah L Hissen, John D Akins, Ryosuke Takeda, Safia Khan, Andrew R Tomlinson, David B Nelson, Tony G Babb, Qi Fu
The time-course changes in the exercise pressor response throughout gestation remain unknown. As pregnancy is associated with altered hemodynamics and sympathetic activation, we hypothesized that neural responses to static handgrip (SHG) exercise would be augmented, especially during late pregnancy. Forty-six women (30 ± 6 yr [SD]) were studied longitudinally during early and late pregnancy and postpartum. Mean arterial pressure (MAP), cardiac output (Qc), total peripheral resistance (TPR = MAP/Qc), and muscle sympathetic nerve activity (MSNA) were measured during supine rest and SHG at 40% of maximal voluntary contraction force until fatigue, followed by 2-min postexercise circulatory occlusion (PECO) to isolate muscle metaboreflex activation. The peak increase (Δ) in MAP during fatiguing SHG did not differ among gestation stages (P = 0.669), but ΔMAP during PECO trended smaller in late pregnancy than postpartum (P = 0.054). ΔQc during SHG and PECO was larger in late pregnancy compared to early pregnancy and postpartum (P < 0.05), while ΔTPR was lower in late pregnancy (P < 0.05). ΔMSNA during SHG was not different (P = 0.740) but smaller during PECO in late pregnancy compared to early pregnancy and postpartum (P < 0.05). Confounding factors like obesity or pregnancy complications did not affect these responses (P > 0.05). Sympathetic activation elicited by the muscle metaboreflex was reduced in late pregnancy, which may be related to the blunted peripheral vasoconstriction. Conversely, the cardiac output response to exercise was augmented in late pregnancy. These results suggest that central and peripheral responses are impacted differently to maintain an adequate pressor response to exercise throughout pregnancy, regardless of obesity and complications.NEW & NOTEWORTHY To our knowledge, this is the first longitudinal study to assess sympathetic neural responses during fatiguing static handgrip exercise across pregnancy. Our findings indicate that cardiovascular and sympathetic neural adaptations to exercise occur throughout pregnancy, regardless of the presence of obesity or pregnancy complications. Notably, central and peripheral mechanisms appear to be regulated differently, ensuring that an adequate pressor response to exercise is maintained during pregnancy and into the postpartum period.
{"title":"Longitudinal changes in cardiovascular and sympathetic neural responses to static handgrip exercise throughout pregnancy.","authors":"Takuro Washio, Sarah L Hissen, John D Akins, Ryosuke Takeda, Safia Khan, Andrew R Tomlinson, David B Nelson, Tony G Babb, Qi Fu","doi":"10.1152/ajpregu.00074.2025","DOIUrl":"10.1152/ajpregu.00074.2025","url":null,"abstract":"<p><p>The time-course changes in the exercise pressor response throughout gestation remain unknown. As pregnancy is associated with altered hemodynamics and sympathetic activation, we hypothesized that neural responses to static handgrip (SHG) exercise would be augmented, especially during late pregnancy. Forty-six women (30 ± 6 yr [SD]) were studied longitudinally during early and late pregnancy and postpartum. Mean arterial pressure (MAP), cardiac output (Qc), total peripheral resistance (TPR = MAP/Qc), and muscle sympathetic nerve activity (MSNA) were measured during supine rest and SHG at 40% of maximal voluntary contraction force until fatigue, followed by 2-min postexercise circulatory occlusion (PECO) to isolate muscle metaboreflex activation. The peak increase (Δ) in MAP during fatiguing SHG did not differ among gestation stages (<i>P</i> = 0.669), but ΔMAP during PECO trended smaller in late pregnancy than postpartum (<i>P</i> = 0.054). ΔQc during SHG and PECO was larger in late pregnancy compared to early pregnancy and postpartum (<i>P</i> < 0.05), while ΔTPR was lower in late pregnancy (<i>P</i> < 0.05). ΔMSNA during SHG was not different (<i>P</i> = 0.740) but smaller during PECO in late pregnancy compared to early pregnancy and postpartum (<i>P</i> < 0.05). Confounding factors like obesity or pregnancy complications did not affect these responses (<i>P</i> > 0.05). Sympathetic activation elicited by the muscle metaboreflex was reduced in late pregnancy, which may be related to the blunted peripheral vasoconstriction. Conversely, the cardiac output response to exercise was augmented in late pregnancy. These results suggest that central and peripheral responses are impacted differently to maintain an adequate pressor response to exercise throughout pregnancy, regardless of obesity and complications.<b>NEW & NOTEWORTHY</b> To our knowledge, this is the first longitudinal study to assess sympathetic neural responses during fatiguing static handgrip exercise across pregnancy. Our findings indicate that cardiovascular and sympathetic neural adaptations to exercise occur throughout pregnancy, regardless of the presence of obesity or pregnancy complications. Notably, central and peripheral mechanisms appear to be regulated differently, ensuring that an adequate pressor response to exercise is maintained during pregnancy and into the postpartum period.</p>","PeriodicalId":7630,"journal":{"name":"American journal of physiology. Regulatory, integrative and comparative physiology","volume":" ","pages":"R661-R672"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-09-08DOI: 10.1152/ajpregu.00133.2025
Tooyib A Azeez, Clifford J Pierre, Colin M Ihrig, Stephen P Chelko, Judy M Muller-Delp, Justin D La Favor
Cystathionine γ-lyase (CSE) produces hydrogen sulfide (H2S), a vasodilator critical for vascular function. Although its systemic effects are well-documented, its role in erectile physiology remains unclear. This study investigated the impact of CSE deletion on vascular and erectile tissue reactivity. We hypothesized that CSE knockout (CSE-KO) mice would exhibit endothelial dysfunction. A total of 22 CSE-KO and 22 age-matched wild-type (WT) controls were studied at 1 yr of age. The internal iliac artery (IIA), internal pudendal artery (IPA), and corpus cavernosum (CC) were harvested for ex vivo functional assessments using tissue, wire, and pressure myography. Vasoconstriction was evaluated using phenylephrine, endothelin-1, U-46619, and electrical field stimulation (EFS). Endothelium-dependent relaxation was assessed using acetylcholine (ACh) and flow-mediated dilation, whereas endothelium-independent relaxation was evaluated using sodium nitroprusside (SNP). Sodium sulfide (Na2S) was used to assess H2S-mediated dilation. Nonadrenergic, noncholinergic (NANC) transmission was evaluated using EFS. No significant differences were observed in ACh-, SNP-, or flow-mediated relaxation, although CSE-KO mice demonstrated impaired NANC-nerve-mediated relaxation in the CC. Moreover, CSE-KO mice exhibited significantly enhanced CC contraction in response to U-46619 and EFS, suggesting increased vascular resistance in the end-organ CC rather than the prepenile arteries. Histological analysis revealed no significant structural or fibrotic remodeling in any tissue, although there was a trend toward increased collagen deposition in the IIA and IPA. These findings indicate that chronic CSE deficiency does not impair endothelial function but alters neurogenic control and increases vasoconstrictive sensitivity specifically in the CC, potentially predisposing to erectile dysfunction.NEW & NOTEWORTHY This study highlights the critical role of hydrogen sulfide (H2S) in erectile physiology by demonstrating that cystathionine γ-lyase (CSE) deletion does not impair endothelial function but significantly enhances neurogenic and thromboxane A2 receptor-induced vasoconstriction specifically in the corpus cavernosum (CC). These findings suggest that endogenous H2S modulates neurovascular control of erection. Its deficiency predisposes the erectile system to heightened vascular resistance predominantly in the end organ, providing novel insights into the vascular mechanisms underlying erectile dysfunction.
{"title":"Cystathionine γ lyase deletion enhances corpus cavernosum contraction via thromboxane A<sub>2</sub> and neurogenic pathways without affecting endothelial function.","authors":"Tooyib A Azeez, Clifford J Pierre, Colin M Ihrig, Stephen P Chelko, Judy M Muller-Delp, Justin D La Favor","doi":"10.1152/ajpregu.00133.2025","DOIUrl":"10.1152/ajpregu.00133.2025","url":null,"abstract":"<p><p>Cystathionine γ-lyase (CSE) produces hydrogen sulfide (H<sub>2</sub>S), a vasodilator critical for vascular function. Although its systemic effects are well-documented, its role in erectile physiology remains unclear. This study investigated the impact of CSE deletion on vascular and erectile tissue reactivity. We hypothesized that CSE knockout (CSE-KO) mice would exhibit endothelial dysfunction. A total of 22 CSE-KO and 22 age-matched wild-type (WT) controls were studied at 1 yr of age. The internal iliac artery (IIA), internal pudendal artery (IPA), and corpus cavernosum (CC) were harvested for ex vivo functional assessments using tissue, wire, and pressure myography. Vasoconstriction was evaluated using phenylephrine, endothelin-1, U-46619, and electrical field stimulation (EFS). Endothelium-dependent relaxation was assessed using acetylcholine (ACh) and flow-mediated dilation, whereas endothelium-independent relaxation was evaluated using sodium nitroprusside (SNP). Sodium sulfide (Na<sub>2</sub>S) was used to assess H<sub>2</sub>S-mediated dilation. Nonadrenergic, noncholinergic (NANC) transmission was evaluated using EFS. No significant differences were observed in ACh-, SNP-, or flow-mediated relaxation, although CSE-KO mice demonstrated impaired NANC-nerve-mediated relaxation in the CC. Moreover, CSE-KO mice exhibited significantly enhanced CC contraction in response to U-46619 and EFS, suggesting increased vascular resistance in the end-organ CC rather than the prepenile arteries. Histological analysis revealed no significant structural or fibrotic remodeling in any tissue, although there was a trend toward increased collagen deposition in the IIA and IPA. These findings indicate that chronic CSE deficiency does not impair endothelial function but alters neurogenic control and increases vasoconstrictive sensitivity specifically in the CC, potentially predisposing to erectile dysfunction.<b>NEW & NOTEWORTHY</b> This study highlights the critical role of hydrogen sulfide (H<sub>2</sub>S) in erectile physiology by demonstrating that cystathionine γ-lyase (CSE) deletion does not impair endothelial function but significantly enhances neurogenic and thromboxane A<sub>2</sub> receptor-induced vasoconstriction specifically in the corpus cavernosum (CC). These findings suggest that endogenous H<sub>2</sub>S modulates neurovascular control of erection. Its deficiency predisposes the erectile system to heightened vascular resistance predominantly in the end organ, providing novel insights into the vascular mechanisms underlying erectile dysfunction.</p>","PeriodicalId":7630,"journal":{"name":"American journal of physiology. Regulatory, integrative and comparative physiology","volume":" ","pages":"R715-R726"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-10-20DOI: 10.1152/ajpregu.00194.2025
Ren Y Sato, Yujiro Yamanaka
Environmental light-dark (LD) cycles serve as the primary zeitgeber for the mammalian circadian system, but scheduled physical activity such as voluntary wheel running can act as a potent nonphotic cue. Previous studies on nonphotic entrainment have predominantly used male animals, leaving sex-specific mechanisms largely unexplored. In this study, we investigated circadian behavioral entrainment and phase-shifting responses to scheduled wheel-running activity in female C57BL/6J mice under constant darkness (DD). Mice underwent scheduled daily exposure to a novel cage with a running wheel (NCRW) for 3 h, and spontaneous locomotor rhythms were analyzed before, during, and after exposure. Fifteen of 16 female mice achieved steady-state entrainment when the NCRW schedule coincided with activity onset. However, they lacked both anticipatory behavior and behavioral aftereffects of entrainment-defined as persistent changes in circadian period and activity timing following entrainment-unlike what has been previously reported in males. To interpret entrainment dynamics, we constructed phase response curve (PRC) for a single 3-h pulse of exposure to NCRW in both sexes. Female PRC displayed prominent delay portions in the late subjective day and early subjective night, contrasting with male profiles showing minor advances in the same windows. These findings reveal a sex difference in nonphotic circadian entrainment and suggest that underlying mechanisms, including oscillator coupling or differential sensitivity to nonphotic stimuli, may vary between males and females. The results emphasize the importance of considering biological sex in circadian research and provide a basis for further investigation into sex-specific regulation of behavioral rhythms.NEW & NOTEWORTHY This study reveals sex-specific differences in nonphotic circadian entrainment induced by scheduled wheel-running activity in mice. Female mice exhibited distinct phase response curves and lacked behavioral aftereffects, contrasting with previously reported male patterns. These findings highlight the importance of biological sex in circadian regulation and suggest that nonphotic entrainment mechanisms may differ fundamentally between sexes.
{"title":"Nonphotic entrainment and phase shifting of circadian rhythms by novelty-induced wheel running in female mice.","authors":"Ren Y Sato, Yujiro Yamanaka","doi":"10.1152/ajpregu.00194.2025","DOIUrl":"10.1152/ajpregu.00194.2025","url":null,"abstract":"<p><p>Environmental light-dark (LD) cycles serve as the primary zeitgeber for the mammalian circadian system, but scheduled physical activity such as voluntary wheel running can act as a potent nonphotic cue. Previous studies on nonphotic entrainment have predominantly used male animals, leaving sex-specific mechanisms largely unexplored. In this study, we investigated circadian behavioral entrainment and phase-shifting responses to scheduled wheel-running activity in female C57BL/6J mice under constant darkness (DD). Mice underwent scheduled daily exposure to a novel cage with a running wheel (NCRW) for 3 h, and spontaneous locomotor rhythms were analyzed before, during, and after exposure. Fifteen of 16 female mice achieved steady-state entrainment when the NCRW schedule coincided with activity onset. However, they lacked both anticipatory behavior and behavioral aftereffects of entrainment-defined as persistent changes in circadian period and activity timing following entrainment-unlike what has been previously reported in males. To interpret entrainment dynamics, we constructed phase response curve (PRC) for a single 3-h pulse of exposure to NCRW in both sexes. Female PRC displayed prominent delay portions in the late subjective day and early subjective night, contrasting with male profiles showing minor advances in the same windows. These findings reveal a sex difference in nonphotic circadian entrainment and suggest that underlying mechanisms, including oscillator coupling or differential sensitivity to nonphotic stimuli, may vary between males and females. The results emphasize the importance of considering biological sex in circadian research and provide a basis for further investigation into sex-specific regulation of behavioral rhythms.<b>NEW & NOTEWORTHY</b> This study reveals sex-specific differences in nonphotic circadian entrainment induced by scheduled wheel-running activity in mice. Female mice exhibited distinct phase response curves and lacked behavioral aftereffects, contrasting with previously reported male patterns. These findings highlight the importance of biological sex in circadian regulation and suggest that nonphotic entrainment mechanisms may differ fundamentally between sexes.</p>","PeriodicalId":7630,"journal":{"name":"American journal of physiology. Regulatory, integrative and comparative physiology","volume":" ","pages":"R796-R804"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-09-30DOI: 10.1152/ajpregu.00151.2025
Shahrzad Soleimani Dehnavi, Jonathan D Smirl, Marc-Antoine Roy, Lawrence Labrecque, François Billaut, Kurt J Smith, Samuel J E Lucas, Philip N Ainslie, Patrice Brassard
Whether cerebral pressure-flow relationship directional sensitivity, which represents the attenuated changes in cerebral blood velocity in response to transient increases, compared with decreases, in mean arterial pressure (MAP), is altered in lowlanders at high altitude or differs between lowlanders and Sherpa (a well-adapted highlander population of the Nepalese Khumbu region) is unknown. Both MAP and middle cerebral artery mean blood velocity (MCAv) were recorded continuously during 5-min repeated squat-stands (RSS) at 0.05 Hz and 0.10 Hz at sea level (n = 10), initial exposure to high-altitude (n = 8), after 2 wk of partial acclimatization to high-altitude (n = 9), and in Sherpa (n = 16). For each transition, we calculated absolute and relative MCAv and MAP changes with respect to the transition time intervals of both variables indexing time adjusted ratios when MAP increases (ΔMCAvT/ΔMAPTINCREASE and %MCAvT/%MAPTINCREASE) and decreases (ΔMCAvT/ΔMAPTDECREASE and %MCAvT/%MAPTDECREASE). Regardless of altitude conditions, %MCAvT/%MAPTINCREASE was lower than %MCAvT/%MAPTDECREASE [0.05 Hz RSS: (P = 0.007); 0.10 Hz RSS (P = 0.003)] in lowlanders. Partially acclimatized lowlanders and Sherpa had lower %MCAvT/%MAPTINCREASE than %MCAvT/%MAPTDECREASE at 0.05 Hz (P = 0.007), but comparable metrics at 0.10 Hz RSS (P = 0.971). These findings indicate acute exposure and partial acclimatization to high altitude do not alter the cerebral pressure-flow relationship directional sensitivity compared with sea level measures in lowlanders. In addition, the hysteresis-like pattern in Sherpa is not different when compared with partially acclimatized lowlanders.NEW & NOTEWORTHY Cerebral blood flow changes are buffered when blood pressure increases versus decreases. The current findings suggest that acute exposure and partial acclimatization to high altitude do not influence the presence of this phenomenon in lowlanders. Preservation of this hysteresis-like pattern across all altitude conditions may protect the cerebral microvasculature from hypoxia-induced increases in blood pressure. However, cerebral pressure-flow directional sensitivity is absent in Sherpa, a well-adapted highlander population, when blood pressure oscillates at higher frequency.
{"title":"Cerebral pressure-flow relationship directional sensitivity in healthy lowlanders and natives at high altitude.","authors":"Shahrzad Soleimani Dehnavi, Jonathan D Smirl, Marc-Antoine Roy, Lawrence Labrecque, François Billaut, Kurt J Smith, Samuel J E Lucas, Philip N Ainslie, Patrice Brassard","doi":"10.1152/ajpregu.00151.2025","DOIUrl":"10.1152/ajpregu.00151.2025","url":null,"abstract":"<p><p>Whether cerebral pressure-flow relationship directional sensitivity, which represents the attenuated changes in cerebral blood velocity in response to transient increases, compared with decreases, in mean arterial pressure (MAP), is altered in lowlanders at high altitude or differs between lowlanders and Sherpa (a well-adapted highlander population of the Nepalese Khumbu region) is unknown. Both MAP and middle cerebral artery mean blood velocity (MCAv) were recorded continuously during 5-min repeated squat-stands (RSS) at 0.05 Hz and 0.10 Hz at sea level (<i>n</i> = 10), initial exposure to high-altitude (<i>n</i> = 8), after 2 wk of partial acclimatization to high-altitude (<i>n</i> = 9), and in Sherpa (<i>n</i> = 16). For each transition, we calculated absolute and relative MCAv and MAP changes with respect to the transition time intervals of both variables indexing time adjusted ratios when MAP increases (ΔMCAv<sub>T</sub>/ΔMAP<sub>T</sub><sup>INCREASE</sup> and %MCAv<sub>T</sub>/%MAP<sub>T</sub><sup>INCREASE</sup>) and decreases (ΔMCAv<sub>T</sub>/ΔMAP<sub>T</sub><sup>DECREASE</sup> and %MCAv<sub>T</sub>/%MAP<sub>T</sub><sup>DECREASE</sup>). Regardless of altitude conditions, %MCAv<sub>T</sub>/%MAP<sub>T</sub><sup>INCREASE</sup> was lower than %MCAv<sub>T</sub>/%MAP<sub>T</sub><sup>DECREASE</sup> [0.05 Hz RSS: (<i>P</i> = 0.007); 0.10 Hz RSS (<i>P</i> = 0.003)] in lowlanders. Partially acclimatized lowlanders and Sherpa had lower %MCAv<sub>T</sub>/%MAP<sub>T</sub><sup>INCREASE</sup> than %MCAv<sub>T</sub>/%MAP<sub>T</sub><sup>DECREASE</sup> at 0.05 Hz (<i>P</i> = 0.007), but comparable metrics at 0.10 Hz RSS (<i>P</i> = 0.971). These findings indicate acute exposure and partial acclimatization to high altitude do not alter the cerebral pressure-flow relationship directional sensitivity compared with sea level measures in lowlanders. In addition, the hysteresis-like pattern in Sherpa is not different when compared with partially acclimatized lowlanders.<b>NEW & NOTEWORTHY</b> Cerebral blood flow changes are buffered when blood pressure increases versus decreases. The current findings suggest that acute exposure and partial acclimatization to high altitude do not influence the presence of this phenomenon in lowlanders. Preservation of this hysteresis-like pattern across all altitude conditions may protect the cerebral microvasculature from hypoxia-induced increases in blood pressure. However, cerebral pressure-flow directional sensitivity is absent in Sherpa, a well-adapted highlander population, when blood pressure oscillates at higher frequency.</p>","PeriodicalId":7630,"journal":{"name":"American journal of physiology. Regulatory, integrative and comparative physiology","volume":" ","pages":"R727-R741"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-08-27DOI: 10.1152/ajpregu.00108.2025
Faming Wang, Huijuan Xu, Tze-Huan Lei, Yi Xu, Haojian Wang, Lijuan Wang
The core temperature inflection point (CTIP) method (also known as humidity-ramp protocol) and biophysical modeling are widely used to determine human thermoregulation limits, yet their validity under prolonged heat exposure remains unverified. This study evaluated the predictive accuracy by exposing 36 healthy young adults (20 males and 16 females) to five counterbalanced 8-h indoor heat trials in a controlled chamber (36°C/74.5%RH, 40°C/55.0%RH, 44°C/29.2%RH, 47°C/35.6%RH, and 50°C/24.5%RH). These conditions were selected based on prior CTIP and biophysical model predictions of human thermoregulation limits. Participants engaged in sedentary office tasks (1.29-1.67 METs), wore standardized summer clothing (0.39-0.40 clo), and had ad libitum access to an electrolyte drink, with a 500-kcal sandwich provided at midday. Rectal temperature (Trec) was continuously monitored. Contrary to model predictions, all five conditions remained compensable (Trec rise rate ≤ 0.1°C/h), with mean peak Trec well below heatstroke thresholds (38.2 ± 0.4°C). At 44°C/29.2%RH, females exhibited significantly lower Trec than males (P < 0.05); however, no sex differences in steady-state Trec responses were observed across other conditions (all P > 0.10). All exposures were compensable, aligning with the broader literature indicating minimal sex-based variability under such conditions. Collectively, CTIP and biophysical models substantially underestimated human thermoregulation limits, leading to overpredicted heat risk across all trials. These findings challenge the reliability of current predictive methods, suggesting human tolerance may exceed existing estimates. Refining these models is essential for improving heat risk assessment and informing public and occupational health guidelines in a warming climate.NEW & NOTEWORTHY This study reveals that widely used methods-core temperature inflection point and biophysical models-substantially underestimate human thermoregulation limits during prolonged heat exposure. Despite predictions of uncompensable heat stress, all five 8-h trials remained compensable, with core temperatures well below critical thresholds. These findings challenge the accuracy of current predictive tools and highlight the need to refine models to better assess heat risk in real-world, prolonged exposure scenarios.
{"title":"Defining human thermoregulation limits: a critical evaluation of predictive models using healthy young adults.","authors":"Faming Wang, Huijuan Xu, Tze-Huan Lei, Yi Xu, Haojian Wang, Lijuan Wang","doi":"10.1152/ajpregu.00108.2025","DOIUrl":"10.1152/ajpregu.00108.2025","url":null,"abstract":"<p><p>The core temperature inflection point (CTIP) method (also known as humidity-ramp protocol) and biophysical modeling are widely used to determine human thermoregulation limits, yet their validity under prolonged heat exposure remains unverified. This study evaluated the predictive accuracy by exposing 36 healthy young adults (20 males and 16 females) to five counterbalanced 8-h indoor heat trials in a controlled chamber (36°C/74.5%RH, 40°C/55.0%RH, 44°C/29.2%RH, 47°C/35.6%RH, and 50°C/24.5%RH). These conditions were selected based on prior CTIP and biophysical model predictions of human thermoregulation limits. Participants engaged in sedentary office tasks (1.29-1.67 METs), wore standardized summer clothing (0.39-0.40 clo), and had ad libitum access to an electrolyte drink, with a 500-kcal sandwich provided at midday. Rectal temperature (<i>T</i><sub>rec</sub>) was continuously monitored. Contrary to model predictions, all five conditions remained compensable (<i>T</i><sub>rec</sub> rise rate ≤ 0.1°C/h), with mean peak <i>T</i><sub>rec</sub> well below heatstroke thresholds (38.2 ± 0.4°C). At 44°C/29.2%RH, females exhibited significantly lower <i>T</i><sub>rec</sub> than males (<i>P</i> < 0.05); however, no sex differences in steady-state <i>T</i><sub>rec</sub> responses were observed across other conditions (all <i>P</i> > 0.10). All exposures were compensable, aligning with the broader literature indicating minimal sex-based variability under such conditions. Collectively, CTIP and biophysical models substantially underestimated human thermoregulation limits, leading to overpredicted heat risk across all trials. These findings challenge the reliability of current predictive methods, suggesting human tolerance may exceed existing estimates. Refining these models is essential for improving heat risk assessment and informing public and occupational health guidelines in a warming climate.<b>NEW & NOTEWORTHY</b> This study reveals that widely used methods-core temperature inflection point and biophysical models-substantially underestimate human thermoregulation limits during prolonged heat exposure. Despite predictions of uncompensable heat stress, all five 8-h trials remained compensable, with core temperatures well below critical thresholds. These findings challenge the accuracy of current predictive tools and highlight the need to refine models to better assess heat risk in real-world, prolonged exposure scenarios.</p>","PeriodicalId":7630,"journal":{"name":"American journal of physiology. Regulatory, integrative and comparative physiology","volume":" ","pages":"R524-R533"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-18DOI: 10.1152/ajpregu.00204.2025
Gopala Koneru, Lama Noureddine, Mohamad Mokadem
{"title":"Unraveling the enterohepatic paradigm in sleeve gastrectomy: bile acids lead, microbiome follows.","authors":"Gopala Koneru, Lama Noureddine, Mohamad Mokadem","doi":"10.1152/ajpregu.00204.2025","DOIUrl":"10.1152/ajpregu.00204.2025","url":null,"abstract":"","PeriodicalId":7630,"journal":{"name":"American journal of physiology. Regulatory, integrative and comparative physiology","volume":" ","pages":"R586-R588"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12633759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-09DOI: 10.1152/ajpregu.00162.2025
Simon Green
{"title":"Perfusion-dependent modulation of muscle contractility: an alternative perspective on fatigue and blood flow.","authors":"Simon Green","doi":"10.1152/ajpregu.00162.2025","DOIUrl":"10.1152/ajpregu.00162.2025","url":null,"abstract":"","PeriodicalId":7630,"journal":{"name":"American journal of physiology. Regulatory, integrative and comparative physiology","volume":" ","pages":"R550-R554"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-04-18DOI: 10.1152/ajpregu.00220.2024
Evan M Paules, Melissa VerHague, Anju A Lulla, Katie A Meyer, Michael F Coleman, Jody Albright, Brian J Bennett, Kari E North, Annie Green Howard, Penny Gordon-Larsen, Isis Trujillo-Gonzalez, John E French, Stephen D Hursting
Calorie restriction (CR) is a well-established weight loss strategy, albeit with variation in response. Using genetically heterogeneous mice, we sought to identify metabolic predictors of resistance to CR-induced weight loss. Diversity outbred (DO) mice (150 males and 150 females) were fed a high-fat diet for 12 wk to generate diet-induced obesity (DIO), then underwent CR for 8 wk. Body weight and composition, blood glucose, and plasma levels of nine metabolic hormones were assessed at baseline, following DIO, and following CR. In response to each dietary intervention, the mice displayed substantial heterogeneity across all outcomes, often with sexual dimorphism. Among the metabolic markers, leptin changed the most in response to each dietary intervention. Logistic regression found that resistance to CR-induced weight loss in obese mice was associated with lower glucose levels in males, and with lower levels of insulin, resistin, homeostatic model assessment for insulin resistance (HOMA-IR), and plasminogen activator inhibitor-1 and higher levels of ghrelin in females. Moreover, lower leptin levels predicted resistance to CR-induced weight loss in obese mice, regardless of sex. These preclinical findings provide proof-of-principle that the genetic and phenotypic heterogeneity of DO mice can be leveraged to identify mechanistic predictors that may enhance the personalization of weight loss interventions.NEW & NOTEWORTHY Using a population of obese diversity outbred (DO) mice, we interrogated plasma predictors of resistance to calorie restriction-induced weight loss in nonresponders versus responders to the diet intervention. Lower leptin levels significantly predicted resistance in both sexes. Sexually dimorphic predictors included lower levels of glucose in males and insulin, resistin, and plasminogen activator inhibitor-1 (PAI-1) in females. Hence, genetically and phenotypically heterogeneous diversity outbred mice may be useful for identifying metabolic predictors for personalizing weight loss interventions.
{"title":"Sex-specific systemic metabolic predictors of resistance to calorie restriction-induced weight loss in obese diversity outbred mice.","authors":"Evan M Paules, Melissa VerHague, Anju A Lulla, Katie A Meyer, Michael F Coleman, Jody Albright, Brian J Bennett, Kari E North, Annie Green Howard, Penny Gordon-Larsen, Isis Trujillo-Gonzalez, John E French, Stephen D Hursting","doi":"10.1152/ajpregu.00220.2024","DOIUrl":"10.1152/ajpregu.00220.2024","url":null,"abstract":"<p><p>Calorie restriction (CR) is a well-established weight loss strategy, albeit with variation in response. Using genetically heterogeneous mice, we sought to identify metabolic predictors of resistance to CR-induced weight loss. Diversity outbred (DO) mice (150 males and 150 females) were fed a high-fat diet for 12 wk to generate diet-induced obesity (DIO), then underwent CR for 8 wk. Body weight and composition, blood glucose, and plasma levels of nine metabolic hormones were assessed at baseline, following DIO, and following CR. In response to each dietary intervention, the mice displayed substantial heterogeneity across all outcomes, often with sexual dimorphism. Among the metabolic markers, leptin changed the most in response to each dietary intervention. Logistic regression found that resistance to CR-induced weight loss in obese mice was associated with lower glucose levels in males, and with lower levels of insulin, resistin, homeostatic model assessment for insulin resistance (HOMA-IR), and plasminogen activator inhibitor-1 and higher levels of ghrelin in females. Moreover, lower leptin levels predicted resistance to CR-induced weight loss in obese mice, regardless of sex. These preclinical findings provide proof-of-principle that the genetic and phenotypic heterogeneity of DO mice can be leveraged to identify mechanistic predictors that may enhance the personalization of weight loss interventions.<b>NEW & NOTEWORTHY</b> Using a population of obese diversity outbred (DO) mice, we interrogated plasma predictors of resistance to calorie restriction-induced weight loss in nonresponders versus responders to the diet intervention. Lower leptin levels significantly predicted resistance in both sexes. Sexually dimorphic predictors included lower levels of glucose in males and insulin, resistin, and plasminogen activator inhibitor-1 (PAI-1) in females. Hence, genetically and phenotypically heterogeneous diversity outbred mice may be useful for identifying metabolic predictors for personalizing weight loss interventions.</p>","PeriodicalId":7630,"journal":{"name":"American journal of physiology. Regulatory, integrative and comparative physiology","volume":" ","pages":"R576-R585"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12724622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-08-21DOI: 10.1152/ajpregu.00146.2025
Christian S DeSouza, Kelly A Stockelman, Jamie G Hijmans, Tyler D Bammert, Grace M Lincenburg, Jared J Greiner, Vinicius P Garcia, Brian L Stauffer, Christopher A DeSouza
Aging is associated with a progressive increase in risk and prevalence of cardiovascular disease (CVD). Circulating extracellular vesicles, particularly endothelial cell-derived microvesicles (EMVs), have been linked to the development and progression of endothelial dysfunction and CVD. The purpose of this study was to determine 1) if circulating EMV levels increase with age, independent of other cardiometabolic risk factors; and if so, 2) whether circulating EMVs are associated with age-related endothelial vasodilator dysfunction. Forty healthy, nonobese, normotensive, sedentary males were studied: 12 young (age: 27 ± 5 yr), 14 midlife (51 ± 5 yr), and 14 older (67 ± 5 yr). EMV identification (CD31+/42b-) and concentration in peripheral blood were determined by flow cytometry. Forearm blood flow (FBF: via plethysmography) was assessed in response to intra-arterial infusions of acetylcholine and sodium nitroprusside. Circulating EMV levels were significantly and progressively higher across the young, midlife, and older groups (54 ± 14 vs. 101 ± 30 vs. 132 ± 54 EMV/µL, respectively). FBF response to acetylcholine was significantly lower (∼30%) in the midlife (4.5 ± 0.8 to 13.5 ± 3.3 mL/100 mL tissue/min) and older (4.2 ± 1.0 to 11.5 ± 2.8 mL/100 mL tissue/min) vs. young (from 5.2 ± 1.1 to 17.2 ± 4.9 mL/100 mL tissue/min) group. Circulating EMVs were positively associated with age (r = 0.69; P < 0.001) and inversely associated with endothelial vasodilation (peak FBF to acetylcholine: r = -0.51; and total FBF to acetylcholine: r = -0.48; P = 0.02). Aging, independent of other cardiometabolic risk factors, is associated with progressively elevated circulating levels of EMVs in healthy males. Circulating EMVs may serve as a biomarker of, and potential contributor to, age-related endothelial dysfunction and vascular disease risk.NEW & NOTEWORTHY Aging is associated with progressive decline in endothelium-dependent vasodilation. Mechanisms underlying this decline in endothelial function are not fully understood. Circulating endothelial cell-derived extracellular vesicles (EMVs) have been linked to endothelial dysfunction. The results of the study demonstrate that circulating EMVs increase with age in healthy males and are associated with endothelial vasodilator dysfunction. Circulating EMVs represent a novel systemic biomarker, and potential mediator, of age-related decline in endothelium-dependent vasodilation.
衰老与心血管疾病(CVD)的风险和患病率的逐渐增加有关。循环细胞外囊泡,特别是内皮细胞来源的微囊泡(emv),与内皮功能障碍和心血管疾病的发生和进展有关。本研究的目的是确定:1)循环EMV水平是否随年龄增长而增加,独立于其他心脏代谢危险因素;2)循环emv是否与年龄相关的内皮血管扩张剂功能障碍有关。40名健康、非肥胖、血压正常、久坐不动的男性被研究:12名年轻男性(年龄:27+5岁);14名中年人(51+5岁)和14名老年人(67+5岁)。流式细胞术检测EMV (CD31+/42b-)及外周血浓度。动脉内输注乙酰胆碱和硝普钠后评估前臂血流量(FBF:通过体积描记术)。青年、中年和老年组的循环EMV水平显著且逐渐升高(分别为54+14 vs 101+30 vs 132+54 EMV/μL)。中年组(4.5±0.8 ~ 13.5±3.3 mL/ 100ml组织/min)和老年组(4.2±1.0 ~ 11.5±2.8 mL/ 100ml组织/min)对乙酰胆碱的FBF反应明显低于年轻组(5.2±1.1 ~ 17.2±4.9 mL/ 100ml组织/min)(约30%)。循环emv与年龄呈正相关(r=0.68
{"title":"Circulating endothelial extracellular vesicles progressively increase with age and are associated with endothelial vasodilator dysfunction.","authors":"Christian S DeSouza, Kelly A Stockelman, Jamie G Hijmans, Tyler D Bammert, Grace M Lincenburg, Jared J Greiner, Vinicius P Garcia, Brian L Stauffer, Christopher A DeSouza","doi":"10.1152/ajpregu.00146.2025","DOIUrl":"10.1152/ajpregu.00146.2025","url":null,"abstract":"<p><p>Aging is associated with a progressive increase in risk and prevalence of cardiovascular disease (CVD). Circulating extracellular vesicles, particularly endothelial cell-derived microvesicles (EMVs), have been linked to the development and progression of endothelial dysfunction and CVD. The purpose of this study was to determine <i>1</i>) if circulating EMV levels increase with age, independent of other cardiometabolic risk factors; and if so, <i>2</i>) whether circulating EMVs are associated with age-related endothelial vasodilator dysfunction. Forty healthy, nonobese, normotensive, sedentary males were studied: 12 young (age: 27 ± 5 yr), 14 midlife (51 ± 5 yr), and 14 older (67 ± 5 yr). EMV identification (CD31<sup>+</sup>/42b<sup>-</sup>) and concentration in peripheral blood were determined by flow cytometry. Forearm blood flow (FBF: via plethysmography) was assessed in response to intra-arterial infusions of acetylcholine and sodium nitroprusside. Circulating EMV levels were significantly and progressively higher across the young, midlife, and older groups (54 ± 14 vs. 101 ± 30 vs. 132 ± 54 EMV/µL, respectively). FBF response to acetylcholine was significantly lower (∼30%) in the midlife (4.5 ± 0.8 to 13.5 ± 3.3 mL/100 mL tissue/min) and older (4.2 ± 1.0 to 11.5 ± 2.8 mL/100 mL tissue/min) vs. young (from 5.2 ± 1.1 to 17.2 ± 4.9 mL/100 mL tissue/min) group. Circulating EMVs were positively associated with age (<i>r</i> = 0.69; <i>P</i> < 0.001) and inversely associated with endothelial vasodilation (peak FBF to acetylcholine: <i>r</i> = -0.51; and total FBF to acetylcholine: <i>r</i> = -0.48; <i>P</i> = 0.02). Aging, independent of other cardiometabolic risk factors, is associated with progressively elevated circulating levels of EMVs in healthy males. Circulating EMVs may serve as a biomarker of, and potential contributor to, age-related endothelial dysfunction and vascular disease risk.<b>NEW & NOTEWORTHY</b> Aging is associated with progressive decline in endothelium-dependent vasodilation. Mechanisms underlying this decline in endothelial function are not fully understood. Circulating endothelial cell-derived extracellular vesicles (EMVs) have been linked to endothelial dysfunction. The results of the study demonstrate that circulating EMVs increase with age in healthy males and are associated with endothelial vasodilator dysfunction. Circulating EMVs represent a novel systemic biomarker, and potential mediator, of age-related decline in endothelium-dependent vasodilation.</p>","PeriodicalId":7630,"journal":{"name":"American journal of physiology. Regulatory, integrative and comparative physiology","volume":" ","pages":"R509-R514"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-10DOI: 10.1152/ajpregu.00167.2025
Gregory W McGarr, Caroline Li-Maloney, Ashley P Akerman, Naoto Fujii, Tatsuro Amano, Glen P Kenny
The objective of this study was to explore sex and heating rate effects on frequency-domain indicators of the mechanisms modulating cutaneous vasodilation during local heating. In 30 young adults (21 ± 3 yr, 15 females), wavelet analysis of skin blood flux was assessed from laser-Doppler flux signals at the chest, abdomen, arm, forearm, thigh, and calf during rapid (33-42°C; 1°C·20 s-1) and gradual (33-42°C; 1°C·5 min-1) local skin heating. A wavelet transform using a Morlet mother wavelet was computed over the entire signal for each heating protocol (minimum 90 min), and 5-min time windows were subsequently isolated to determine responses during baseline and the 42°C heating plateau. Wavelet data were decomposed into metabolic, neurogenic, myogenic, respiratory, and cardiac frequency bands and presented as absolute and relative (normalized) amplitudes. There was a significant sex by heating rate interaction for relative wavelet amplitude in the metabolic frequency band (P = 0.003), which was 0.89-fold [0.82, 0.98] lower (P = 0.006) during rapid heating compared with gradual heating for females only. There were no significant interactions for the other frequency bands (all P ≥ 0.054). Males showed greater absolute and relative amplitudes for neurogenic and myogenic bands compared with females (all P ≤ 0.022). Rapid heating resulted in significantly lower absolute amplitudes for metabolic, neurogenic, and cardiac bands compared with gradual heating (all P ≤ 0.004). However, there was a significantly greater relative amplitude for the respiratory band during rapid heating compared with gradual (P = 0.030). These exploratory findings highlight important sex and heating rate effects on wavelet-based indicators of the mechanisms modulating cutaneous vasodilation during local heating.NEW & NOTEWORTHY Wavelet analysis showed males relied more on neurogenic and myogenic mechanisms than females to modulate skin blood flow during local heating. Rapid heating produced lower absolute wavelet amplitudes for metabolic, neurogenic, and cardiac frequency bands compared with gradual heating. Frequency-domain responses showed weak discrimination between skin sites across the torso and limbs. Our findings highlight sex and heating rate effects on cutaneous vasodilator mechanisms during local heating using noninvasive wavelet-based approaches for understanding microvascular control.
{"title":"Effects of sex and heating rate on skin blood flow oscillations during local heating in young adults.","authors":"Gregory W McGarr, Caroline Li-Maloney, Ashley P Akerman, Naoto Fujii, Tatsuro Amano, Glen P Kenny","doi":"10.1152/ajpregu.00167.2025","DOIUrl":"10.1152/ajpregu.00167.2025","url":null,"abstract":"<p><p>The objective of this study was to explore sex and heating rate effects on frequency-domain indicators of the mechanisms modulating cutaneous vasodilation during local heating. In 30 young adults (21 ± 3 yr, 15 females), wavelet analysis of skin blood flux was assessed from laser-Doppler flux signals at the chest, abdomen, arm, forearm, thigh, and calf during rapid (33-42°C; 1°C·20 s<sup>-1</sup>) and gradual (33-42°C; 1°C·5 min<sup>-1</sup>) local skin heating. A wavelet transform using a Morlet mother wavelet was computed over the entire signal for each heating protocol (minimum 90 min), and 5-min time windows were subsequently isolated to determine responses during baseline and the 42°C heating plateau. Wavelet data were decomposed into metabolic, neurogenic, myogenic, respiratory, and cardiac frequency bands and presented as absolute and relative (normalized) amplitudes. There was a significant sex by heating rate interaction for relative wavelet amplitude in the metabolic frequency band (<i>P</i> = 0.003), which was 0.89-fold [0.82, 0.98] lower (<i>P</i> = 0.006) during rapid heating compared with gradual heating for females only. There were no significant interactions for the other frequency bands (all <i>P</i> ≥ 0.054). Males showed greater absolute and relative amplitudes for neurogenic and myogenic bands compared with females (all <i>P</i> ≤ 0.022). Rapid heating resulted in significantly lower absolute amplitudes for metabolic, neurogenic, and cardiac bands compared with gradual heating (all <i>P</i> ≤ 0.004). However, there was a significantly greater relative amplitude for the respiratory band during rapid heating compared with gradual (<i>P</i> = 0.030). These exploratory findings highlight important sex and heating rate effects on wavelet-based indicators of the mechanisms modulating cutaneous vasodilation during local heating.<b>NEW & NOTEWORTHY</b> Wavelet analysis showed males relied more on neurogenic and myogenic mechanisms than females to modulate skin blood flow during local heating. Rapid heating produced lower absolute wavelet amplitudes for metabolic, neurogenic, and cardiac frequency bands compared with gradual heating. Frequency-domain responses showed weak discrimination between skin sites across the torso and limbs. Our findings highlight sex and heating rate effects on cutaneous vasodilator mechanisms during local heating using noninvasive wavelet-based approaches for understanding microvascular control.</p>","PeriodicalId":7630,"journal":{"name":"American journal of physiology. Regulatory, integrative and comparative physiology","volume":" ","pages":"R589-R597"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}