2026-04-02
Shufang Wu, Guiying Zeng, Saisai Chen, Hongbin Chen, Senpei Xie, Jiabao Zhang, Yingchun Xiao, Nan Liu, Hui Chen, Ronghua Chen
BackgroundTo investigate the efficacy and underlying mechanisms of a combined therapy of estradiol/dydrogesterone and escitalopram in treating perimenopausal anxiety and depression.MethodsA total of 195 patients were randomized to receive escitalopram, estradiol/dydrogesterone, or combination therapy for 12 weeks. The primary efficacy endpoints were the changes in scores of the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) at week 12 compared with the baseline.ResultsCompared with the baseline, all groups reported a gradual decrease in Patient Health Questionnaire Somatic Symptom Scale (PHQ-15), the Patient Health Questionnaire Depression Scale (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), HAMD, and HAMA scores (P<0.001 for all), and a gradual increase in serum estradiol (E2) and 5-Hydroxytryptamine (5-HT) (P<0.001 for both), with the most pronounced changes in the Combined group (Comb group). In intergroup comparison, at weeks 4, 8, 12, the scores of PHQ-15, GAD-7, PHQ-9, HAMA, and HAMD were most reduced in the Comb group; At weeks 2, 4, 8, 12, E2 level was significantly higher in the Comb group and estradiol/dydrogesterone group (E/D group) than in the escitalopram group (ESC group); at weeks 4, 8, and 12, 5-HT level was significantly higher in the Comb group than in the E/D group; and at week 4 and 12, 5-HT level was significantly higher in the Comb group than in the ESC group.ConclusionsEstradiol/dydrogesterone plus escitalopram significantly improves anxiety, depression, and somatic symptoms in perimenopausal women. These findings provide clinical evidence of estradiol/dydrogesterone plus escitalopram regimen for the treatment of patients with perimenopausal anxiety and depression.
DOI: 10.3389/fphys.2026.17287362026-04-02
Lijuan Fu, Zhengbin Li, Na Liu
IntroductionTo investigate the immediate effects of different cold environments on heart rate variability (HRV), surface electromyography (sEMG), and balance in older adults Yangko dance (a traditional Chinese folk dance) participants, and to elucidate the mechanisms underlying increased injury risks during the early exercise phase (10–20 minutes) in cold conditions. This study aims to provide scientific evidence for targeted protective measures.MethodsA randomized controlled trial was conducted with 120 regular Yangko dancers (age>60 years) from Changchun, China. Participants were stratified into four temperature groups (15 °C, -5 °C, -10 °C, -15 °C; 30 cases in each group) using computer-generated randomization. All participants completed Yangko dance sessions under their assigned temperature conditions. HRV time-domain and frequency-domain indices (SDNN, RMSSD, PNN500, LogLF, LogHF, LF/HF), sEMG signals of the biceps femoris, rectus femoris, and medial gastrocnemius (RMS, IEMG), and balance parameters (RT, MVL, EPE) were measured using heart rate monitors, surface EMG devices, and a balance testing system. The impacts of different cold environments on cardiovascular and motor functions were analyzed.ResultsCompared to 15 °C, the cold groups (-5 °C, -10 °C, -15 °C) showed significant reductions in SDNN, RMSSD, PNN500, LogLF, and LogHF (P<0.05) after the experiment, while LF/HF increased significantly (P<0.05). Progressive hypothermia induced dose-dependent decreases in SDNN (15 °C: 65.4 ± 1.47 vs. -15 °C: 51.21 ± 13.41, P<0.001) and RMSSD, alongside increased LF/HF ratios (P<0.05). sEMG analysis demonstrated temperature-dependent neuromuscular adaptations, with -15 °C exposure eliciting 23.6% RMS elevation but 29.4% IEMG reduction versus controls (P<0.05), indicating enhanced muscle activation but decreased output efficiency. The conclusion of the balance ability test shows that RT is prolonged and DCL is reduced.DiscussionCold environments reduce HRV, increase muscle stiffness, and impair balance in the older adults, significantly raise injury risks during the early exercise phase. Recommendations include adequate warm-up, wearing thermal protective gear, and performing joint mobility exercises to enhance exercise safety in cold conditions.
DOI: 10.3389/fphys.2026.17854062026-04-01
Song Ee Park, Jin Hwa Choi, Du Hwan Kim, Don-Kyu Kim, Yongsoon Park, Yong Chan Ha, In Gyu Hwang
BackgroundAgeing and cancer are associated with accelerated skeletal muscle catabolism, leading to sarcopenia, adverse body composition changes, and functional decline. Exercise and nutritional support are established physiological countermeasures against muscle loss; however, their feasibility and physiological effects in older adults exposed to profound catabolic stress remain insufficiently characterized.MethodsBetween 2021 and 2023, adults aged ≥65 years with advanced cancer undergoing systemic therapy participated in a 12-week combined exercise and nutritional intervention program. Participants were assigned to an intervention group (exercise plus nutrition, n=20) or a usual-care control group (n=40). The primary endpoint was feasibility, defined as ≥50% adherence to both exercise and nutritional components during the first 6 weeks. Secondary endpoints included changes in skeletal muscle index (SMI), subcutaneous and visceral fat compartments, safety, and patient-reported quality of life.ResultsThe median age was 72 years, 65% were men, and 41.7% had baseline sarcopenia. Adherence rates were 65% for exercise and 75% for nutritional support, with an overall attrition rate of 5% and no intervention-related adverse events. At 6 weeks, SMI declined significantly in the control group, whereas no statistically significant change in SMI was observed in the intervention group. Subcutaneous fat decreased significantly in the intervention group, with a reduction in visceral fat observed among men. At 12 weeks, body composition parameters remained relatively stable in both groups. Modest improvements were noted in fatigue, appetite loss, and nausea.ConclusionsA combined exercise and nutritional intervention was feasible, safe, and well tolerated in older adults exposed to severe catabolic stress. The preservation of skeletal muscle mass and favorable body composition changes observed suggest meaningful physiological adaptation, supporting exercise and nutritional support as viable physiological countermeasures in vulnerable ageing populations.
DOI: 10.3389/fphys.2026.17795592026-03-31
S.A Sanduni Samudika De Alwis, Xueying Zhang, Huihui Mei, Xinyi Bi, Xinyue Ma, Ying Liu, Li Xue, Dehuang Kong, Lu Wang, Hongbo Wang, John R Speakman
IntroductionPhysical activity (PA) costs energy. However, recent theory suggests the relationship of increasing PA to total energy expenditure (TEE) is non-linear because high levels of activity suppress resting metabolism mediated via changes in thyroid hormones (THs; T3- triiodothyronine, T4- thyroxine, fT3- free triiodothyronine, fT4 - free thyroxine, TSH - thyroid stimulating hormone).MethodWe conducted a cross-sectional study on 38 euthyroid females (NCT06377943) to examine the relationship between PA, resting metabolic rate (RMR), and TEE. Multiple linear regression and Bootstrapped structural equation model were used to assessed whether THs statistically accounted for the association between PA and RMR.ResultsBootstrapped structural equation models indicated that PA was significantly associated with lower TH levels (β = –4.33, 95% CI [–8.51, –1.70], p = 0.011), while the association between THs and RMR was small and non-significant (β = 0.043, 95% CI [–0.02, 0.10], p = 0.16), resulting in a non-significant indirect effect (β = –0.19, 95% CI [–0.67, 0.08], p = 0.31). In multiple regression plots, physical activity energy expenditure (PAEE) and PA showed a trend toward significance (p = 0.07) when THs were added.ConclusionOverall, although PA was associated with modest changes in THs, these changes did not correspond to any detectable decrease in RMR.
DOI: 10.3389/fphys.2026.17161402026-03-31
Yu Zeng, Xinzhi Wang, Kim Geok Soh, Shuzhen Ma, Yue Zhao, Wenchao Rong, Xinrui Zhang, Ningfei Wei
BackgroundWith the continuous advancement of sports training methodologies, high-intensity interval training (HIIT) and small-sided games (SSG) have emerged as crucial strategies for enhancing players’ physical fitness. However, the comparative effects of these training modalities on various fitness components and their underlying physiological adaptation mechanisms remain insufficiently explored.ObjectivesThis systematic review and meta-analysis aim to compare the overall impact of HIIT and SSG on players’ physical fitness and examine the moderating effects of different training parameters, including training frequency, intervention duration, players’ training experience, age, and gender. The findings seek to provide theoretical insights for optimising training protocols.MethodsA systematic search was conducted in databases including PubMed, Web of Science, Scopus, and EBSCOhost to identify relevant English-language randomised controlled trials that met predefined eligibility criteria. Hedges’ g was used as the effect size metric, and a random-effects model was applied for meta-analyses of power, speed, endurance, and agility. Subgroup analyses were performed to assess the influence of potential moderators.ResultsThe meta-analysis revealed that, compared to SSG, HIIT produced a small but statistically significant improvement in speed (ES = 0.564) and a moderate and statistically significant improvement in endurance (ES = 0.706). In contrast, gains in power (ES = −0.144) and agility (ES = −0.159) were trivial in magnitude and not statistically significant. Subgroup analyses indicated that lower training frequency (<3 sessions per week) and shorter intervention duration (<6 weeks) yielded significant improvements. Furthermore, players across different age groups benefited from HIIT, while sex did not exhibit a significant moderating effect.ConclusionThis systematic review and meta-analysis confirm that both HIIT and SSG effectively enhance players’ physical fitness, with HIIT demonstrating a distinct advantage in improving speed and endurance. Although HIIT showed relatively limited improvements in power and agility compared to SSG, both training modalities exert their effects through distinct physiological adaptation mechanisms. Subgroup analysis findings suggest that appropriately balancing training frequency and intervention duration is crucial for achieving optimal training outcomes. Future research should further investigate the long-term effects of these interventions to provide a more robust theoretical foundation for personalised training program design.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024555633.
DOI: 10.3389/fphys.2026.17548252026-03-30
Mulin Yang, Yuqiang Guo, Feng Yang, Kewei Zhao
BackgroundVisual skills are increasingly recognized as key contributors to performance in team sports, yet the strength and consistency of their associations with sport-specific outcomes remain uncertain. To address this gap, the present review systematically synthesized empirical evidence examining how different domains of visual skill relate to sport-specific performance among team-sport athletes.MethodsPubMed, Web of Science™, MEDLINE, and SPORTDiscus databases were systematically searched from inception to October 2025 to identify studies relating visual skills to sport-specific performance in team-sport athletes. Risk of bias was conducted using a modified and validated tool for observational and correlational studies, and certainty of evidence was evaluated using the GRADE approach.ResultsOf 4,118 records identified, 22 studies (n = 1,113, male = 954, female = 159) were included, encompassing basketball, soccer, baseball, volleyball, handball, and other team sports. The relationship between multiple object tracking and sport-specific performance was large (r = 0.54; 95% CI: 0.30–0.71; p = 0.00), while visual attention (r = 0.39; 95% CI: 0.16–0.53; p = 0.00), and visual search (r = 0.36; 95% CI: 0.16–0.48; p = 0.00), demonstrated moderate associations. Simple reaction time (r = −0.31; 95% CI: −0.42 to −0.19; p = 0.00) and choice reaction time (r = −0.37; 95% CI: −0.58 to −0.11; p = 0.01) showed moderate negative correlations with performance, indicating faster reaction speeds were associated with better performance. Visual working memory, eye-hand coordination, and inhibitory control exhibited small effect sizes. In contrast, depth perception, the only visual-perceptual skill analyzed, showed trivial and non-significant associations (r = 0.09; 95% CI: −0.20–0.36; p = 0.56).ConclusionVisual-cognitive skills appear to show stronger links with team-sport performance, whereas basic perceptual skills contribute little. Evidence quality remains limited, and more robust, ecologically valid studies are needed to clarify causality and guide training applications.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251171665, identifier CRD420251171665.
DOI: 10.3389/fphys.2026.17973472026-03-27
John Jong-Jin Kim, Ramy Kirollos
The current generation of fighter aircraft (e.g., F-35) move at supersonic speeds. Fighter pilots undergo rigorous simulation-based training to adapt and learn to operate these high-speed aircraft. On a simulator’s display of a cockpit view of a moving aircraft, a fast-moving scene or objects seen by the pilot is presented as a series of computer-generated images. Due to the computing time for each image frame to be rendered, there are gaps between each frame which may present as visual artifacts in the virtual scene. This problem becomes amplified the faster objects move on the display. The missing visual information between frames presented can be detrimental for fast-paced high-intensity tasks, especially at low frame rates. Therefore, the effect of frame rate of the flight training simulator needs to be carefully evaluated to avoid negative transfer of training and ensure pilot safety. This paper reviews the current literature related to frame rate on viewer preference, its influence on task performance, simulator sickness and training. The aim of this paper was to identify gaps in scientific knowledge on the impact of simulator frame rate and provide future research directions to investigate pilot learning and transfer of complex tasks with extremely fast-moving scenes or objects across simulated and real fighter aircraft.
DOI: 10.3389/fphys.2026.17634852026-03-27
Marwin Jafari, Yann Stehly, Daniela M. Pampanin
IntroductionSelective serotonin reuptake inhibitors (SSRIs) are currently the highest prescribed class of antidepressants and are frequently detected in aquatic ecosystems. They act by increasing synaptic concentrations of serotonin, a neurotransmitter which is also involved in neuronal development. A knowledge gap remains regarding the effects of SSRIs on visual function, a process heavily relying on the neuronal system.MethodsTo close this knowledge gap, zebrafish (Danio rerio) embryos were exposed to the SSRI sertraline (SER) at sublethal concentrations of 1, 10, 100 and 1000 µg/L. Effects on the visual system were assessed at multiple levels of biological organisation in larvae exposed for 96 h, and measurements included visual function, retinal structure, and expression of genes involved in visual function and eye development.ResultsVisual function was affected after exposure to 100 and 1000 µg/L of SER, while retinal structure was significantly affected after exposure to 1000 µg/L of SER. To study the molecular processes behind these effects, gene expression was assessed, pointing out dysregulation of multiple opsin genes, as well as genes involved in retinoic acid metabolism and eye development, namely rho, opn1sw1, opn1mw1, rlbp1b, gnat2, and crx. While expression of these genes was significantly downregulated at 48 hrs post fertilisation (hpf), no significant effects were detected at 96 hpf.DiscussionThe present study points out the ability of SER to cause adverse effects to visual function, a key process for early life stage fish survival. However, these effects were detected at exposure concentrations exceeding the environmental one, thus not representing an environmental threat.
DOI: 10.3389/fphys.2026.17361102026-03-27
Ruihong Zhang, Hang Du, Tingting Bai, Jie Wang, Yanbin Shi, Xiaoguang Shao, Zhen Huang, Jie Zhang
Ovarian tissue cryopreservation (OTC) is essential for fertility preservation in cancer survivors, prepubertal girls, and individuals at high risk of premature ovarian insufficiency (POI). Yet conventional evaluation methods, such as histology and follicle counting, provide limited insight into tissue viability, microenvironmental integrity, molecular injury, and oncologic safety. Recent advances in multi-omics, including transcriptomics, single-cell sequencing, proteomics, and spatial transcriptomics, enable high-resolution characterization of follicular heterogeneity, stromal status, and potential malignant contamination. Concurrently, artificial intelligence (AI) offers automated follicle detection, quantitative tissue assessment, and multimodal prediction models that can support individualized clinical decisions. This review summarizes emerging applications of multi-omics and AI in ovarian tissue quality assessment and highlights their potential to transform fertility preservation strategies. Integrating molecular profiling with AI-based prediction may establish a more precise and intelligent framework for tissue selection, transplantation planning, and reproductive outcome prediction.
DOI: 10.3389/fphys.2026.17892522026-03-27
Leiming Jiang, Chaoqun Feng, Kaipeng Chen, Hongjie Yang, Zhen Chen
Background and purposeTranexamic acid (TXA) demonstrates anti-inflammatory effects during surgery. However, the clinical value of the TXA in intertrochanteric fractures patients has not been further investigated. This study aimed to investigate the effects of intraoperative tranexamic acid (TXA) administration on early postoperative inflammatory markers and clinical outcomes in elderly patients with intertrochanteric fractures.Patients and methodsA total of 136 patients (59 males and 77 females) aged 62–96 years were enrolled. Patients were divided into two groups: 68 received TXA [TXA group, intravenous drip (15 mg/kg)] and 68 did not receive TXA (control group). We compared surgical duration, total blood loss (TBL), hidden blood loss (HBL), transfusion rates, incidence of deep vein thrombosis (DVT), length of hospital stay, serum interleukin-6 (IL-6) levels on postoperative days 1, 3, 5, and 7, and visual analog scale (VAS) scores.ResultsThe TXA group exhibited significantly lower TBL (981.74 ± 451.14 mL vs. 1206.27 ± 408.22 mL, p = 0.002), HBL (890.94 ± 409.99 mL vs. 1104.39 ± 412.06 mL, p = 0.003), and transfusion rates (32.3% vs. 51.4%, p = 0.037) compared with the control group. Serum IL-6 levels and VAS scores were significantly lower in the TXA group on postoperative days 1 and 3 (p 0.05).ConclusionIntraoperative TXA administration appears to effectively reduce blood loss, attenuate the inflammatory response, and lower complication rates in elderly patients undergoing surgery for intertrochanteric fractures.
DOI: 10.3389/fphys.2026.1801500