Frontiers in Physiology

Irritable Bowel Syndrome (IBS) is a highly prevalent, commonly diagnosed gastrointestinal disorder of gut-brain interaction (DGBI) that causes substantial physical, psychological, and financial burden. The role of abnormal motility and altered autonomic nervous system function, and their interplay, remains to be fully understood. Here we present a non-invasive method using body surface electrical recordings to concurrently quantify meal-response colonic motility and heart rate variability (HRV). We demonstrate the practical utility of this new technique in a pilot study comparing colonic motility and autonomic nervous system (ANS) function in IBS patients (n=14) and healthy controls (HC; n = 22). The study protocol included a 2-3 hr body-surface electrical recording with 60-90 minutes each of pre- and post- meal epochs. Colonic motility was markedly increased in the subset of IBS patients experiencing moderate-to-severe symptoms during the study, compared to IBS no or mild symptom groups and healthy controls. HRV metrics in IBS patients showed substantial baseline shifts with decreased vagal and increased sympathetic input, with blunted autonomic meal responses compared to HC. Newly introduced dynamic trajectory maps revealed pronounced colon motility-vagal dysregulation in high symptom IBS patients but not mild or no symptom groups. These results indicate altered autonomic-motility interaction as a potential mechanism of symptom genesis in IBS patients. This technology platform offers an easy-to-apply, non-invasive tool for larger scale investigations of gut and autonomic nervous system function in healthy and gastrointestinal disease cohorts.

Regulation of water permeability in the collecting duct is important for osmoregulatory acclimation in teleost fish. In hyperosmotic environments such as seawater (SW), the teleost kidney functions as a site of divalent ion excretion. The collecting ducts reabsorb Na+, Cl-, and water, thereby reducing urine volume and producing small amounts of isotonic urine with high concentrations of divalent ions. In hypoosmotic environments such as freshwater (FW) or low-salinity brackish water (BW), the kidney produces large volumes of hypotonic urine and serves as a site of water excretion; under these conditions, the collecting ducts reabsorb Na+ and Cl- but not water. To identify aquaporins (Aqps) involved in regulating water permeability in the collecting ducts of teleosts, we analyzed renal Aqp expression in a euryhaline marine fish, the Japanese pufferfish (Takifugu rubripes), which possesses 16 Aqp genes in its genome, seven of which (Aqp1aa, 1ab, 3a, 4a, 7, 8bb, and 11a) are expressed in the kidney. Quantitative RT-PCR analysis showed that Aqp1aa and Aqp4a were highly expressed in collecting duct tissues, and that Aqp1aa expression was markedly reduced in fish acclimated to BW. Immunohistochemistry revealed apical localization of Aqp1aa and basolateral localization of Aqp4 in collecting duct cells, with apical Aqp1aa downregulated in BW. These results suggest that Aqp1aa and Aqp4 mediate water reabsorption in SW and that downregulation of Aqp1aa contributes to hypotonic urine production in BW. NEW & NOTEWORTHYRegulation of water permeability in the collecting duct is important for osmoregulation in teleost fish. Expression analyses of aquaporins (Aqps) in the marine pufferfish Takifugu rubripes showed that Aqp1aa and Aqp4a are highly expressed in the collecting duct and localized to the apical and basolateral membranes, respectively. Renal Aqp1aa expression was markedly reduced in fish acclimated to hypoosmotic brackish water. These results indicate that collecting duct water permeability is regulated by Aqp1aa expression.

Embryo implantation is early and complex stage of pregnancy begins when competent blastocyst makes a physiological attachment to receptive endometrium. Expression of numerous molecules are essential for initiation of pregnancy. leukemia inhibitory factor (LIF) is essential cytokines required for priming uterus to make it receptive for implantation. In mice, the ovarian estrogen regulated expression of LIF is absolutely required for implantation. Golden hamster showed ovarian estrogen independent process of embryo implantation. Hence, the regulation of LIF in uterus of golden hamster during early pregnancy is still ambiguous. In this study, we explored the possible regulation of LIF by uterine factor and their spatio-temporal localization and expression in the uterus of golden hamster during early pregnancy and pseudopregnancy. We further demonstrated their ability to activate prostaglandin synthesizing enzymes to achieve successful pregnancy. We used immunohistochemistry, quantitative and semiquantitative PCR to achieve the objectives. We observed the expression of LIF in all the day of early pregnancy and pseudopregnancy in the uterus of hamster. Their m-RNA was found to be upregulated around the day of implantation and decidualization. LIF showed high expression in D3 pseudopregnancy. LIF was found to be regulated by estrogen in ovariectomized uterus and significantly reduced expression of LIF was observed in letrozole treated uterine horn. Downregulated expression of prostaglandin synthesizing enzymes was observed in anti-LIF antibody treated uterus. Together, these findings highlights that uterine factor regulated LIF mediate their action via activating prostaglandin synthesizing enzymes to make uterus receptive for successful early pregnancy in hamster. HighlightO_LIExpression of LIF in uterus during pregnancy in golden hamster is independent from the presence of blastocyst C_LIO_LILIF is regulated by estrogen in ovariectomized hamster C_LIO_LIExpression of LIF mRNA is downregulated in letrozole treated uterine horn in day 5 of pregnancy indicating the possibility of their regulation by uterine estrogen in golden hamster C_LIO_LIProstaglandin synthesizing enzyme and LIF might be associated with the activation of inflammatory signals which are essential for successful establishment of early pregnancy in golden hamster. C_LI

Background and Aims: Clinical interpretation of the precordial leads V1-V6 assumes that Wilson's central terminal (WCT) has a fixed anatomical location. Consequently, a positive signal corresponds to electrical activation spreading from WCT towards the respective electrode, and vice versa. However, the location of WCT has never been systematically investigated. Yet, a better understanding of WCT location could improve the interpretation of the precordial leads. This work aims to characterize the spatial expansion and location of the physical WCT i.e., the electrical potential defined by the WCT, during the P-wave on the body surface. Methods: An intensive analysis of body surface potential maps (BSPMs) during atrial depolarization in an in silico patient cohort and clinical data was conducted. Results: During the P-wave, the location of WCT was not stationary but the spatial extent and location varied across time as well as across individuals. Four distinct spatial patterns of WCT distribution on the body surface were identified in silico, and three of these were found in the clinical cohort. WCT signals agreed with BSPM signals at commonly assumed positions of WCT only for a small fraction of the P-wave. Conclusion: The spatial extension and location of WCT changes during the P-wave and thus should be considered when interpreting the precordial leads.

BACKGROUNDIn addition to lethal ventricular arrhythmias, arrhythmogenic cardiomyopathy (ACM) is associated with conduction abnormalities, bradycardias, and reduced expression of the scaffolding junctional protein zonula occludens-1 (ZO-1). Reduced ZO-1 expression is also seen in dilated cardiomyopathy, which is far more common than ACM. Conduction abnormalities are likewise a feature of ZO-1 cardiac-specific knockout (ZO-1cKO) mice. However, the role of ZO-1 in sinoatrial node (SAN) automaticity has not been studied. OBJECTIVETo investigate the role of ZO-1 in SAN automaticity and elucidate the mechanisms by which ZO-1 deficiency leads to SAN dysfunction. METHODSZO-1 cardiac-specific knockout (ZO-1cKO) mice were generated by crossing ZO-1 floxed mice with MHC-nuclear Cre mice. SAN/atrial tissue and isolated SAN cells were examined using optical mapping, single-cell patch clamp, and quantitative PCR techniques to assess functional alterations caused by ZO-1 loss. RESULTSZO-1cKO mice exhibited enlarged atria and SAN area compared to control mice, with normal left ventricular function. Electrocardiograms showed sinus bradycardia, sinus pauses and atrioventricular block. Optical mapping revealed a caudal shift in the SAN leading region and reduced intra-atrial conduction velocity in ZO-1cKO mice. Patch-clamp recordings from isolated SAN cells showed reduced spontaneous action potential frequency and diastolic depolarization rate, while voltage-clamp revealed a marked reduction in pacemaker current (If). CONCLUSIONZO-1 expression is essential for SAN automaticity. Its loss impairs SAN impulse generation by reducing pacemaker current and hampering atrial conduction, leading to bradyarrhythmia, conduction delay and block. These findings help explain impulse generation and conduction abnormalities in ACM and other cardiomyopathies.

IntroductionVagus nerve stimulation modulates laryngeal, cardiac, pulmonary, and gastrointestinal functions. Knowledge of where along the vagal trunk organ-specific branches emerge may support alternative surgical placements of stimulation devices to engage targeted functions while avoiding off-target effects. However, no quantified map of how vagal branches emerge and how they relate to surgically relevant anatomical landmarks exists in humans. MethodsFifty-eight vagus nerves (29 left, 29 right) from 29 embalmed donor bodies (15 females) were dissected from the jugular foramen through the thoracic cavity. Branches were traced to end organs and allocated to seven groups -- sympathetic, muscular, vascular, cardiac, pulmonary, esophageal, and multiple targets -- and several sub-groups. Distances between branch emergence and the jugular foramen (JF) were normalized to three anatomical landmarks: carotid bifurcation, laryngeal prominence, and superior border of clavicle. ResultsBranch emergence follows a proximal-to-distal order: sympathetic (5.28 cm from JF), muscular (9.59 cm), vascular (10.70 cm), cardiac (19.65 cm), pulmonary (25.36 cm), and esophageal (26.57 cm). Vagal branches emerge into two embryological domains separated near the clavicle: pharyngeal arch-targeting branches cluster proximally (9.34 cm) and primitive mediastinum-targeting branches cluster distally (23.74 cm), with sympathetic, muscular, and vascular sub-groups occupying distinct zones within the proximal domain. The largest branch-free intervals occur above the left clavicle (2.33 {+/-} 2.80 cm) and below the left carotid bifurcation (2.58 {+/-} 3.17 cm). Alternate placement regions separating targeted organs from off-targets: sympathetic vs. cervical visceral at 6/8 cm (L/R), cardiac vs. carotid sinus/bifurcation at 14/10 cm, and recurrent laryngeal vs. other cervical visceral at 18/13 cm from JF. Overall, no differences were found between male and female donors. ConclusionsThis study provides a quantified, landmark-registered map of cervical and thoracic vagal branch emergence, offering a standardized anatomical template that may inform strategies for more function-selective vagal neuromodulation.

High intensity and unaccustomed physical activity can induce skeletal muscle damage, while even routine movements can cause similar alterations in patients with neuromuscular disease. However, reliable assessment of muscle damage using indirect markers such as muscle function evaluation, invasive measurements, or imaging techniques is difficult to implement in routine clinical follow-up and sport field settings. Bioimpedance spectroscopy appears as a promising non-invasive, easy-to-use and transportable tool to assess indirect markers of muscle damage. The aim of this study was to determine whether bioimpedance spectroscopy data are sensitive to eccentric exercise-induced muscle damage and if these potential changes mirror responses in muscle function and tissue mechanical properties. Changes in knee extensors maximal isometric contraction torque, muscle soreness, resting rigidity of the quadriceps femoris muscle tissue, and bioimpedance parameters at rest and during maximal isometric contraction were assessed in nine healthy males before, immediately after and in the three days following 120 maximal isokinetic eccentric contractions. Maximal contraction torque was significantly reduced during the three days following the eccentric exercise (up to -24.2%) while muscle soreness and rigidity of the quadriceps femoris were elevated until the second day (+494.4% and +7.6%). Changes in bioimpedance spectroscopy parameters were transiently observed at rest immediately after the damaging exercise, but not in the days that followed. Although the changes in bioimpedance parameters correlated with that of the indirect markers of muscle damage, they had already returned to baseline while functional and mechanical impairments persisted. Therefore, bioimpedance spectroscopy measurements may represent a suitable and cost-effective means of monitoring muscle fatigue.

Objective: Several endotypes contribute to the development of Obstructive Sleep Apnea (OSA). However, efforts to measure these endotypes have been challenging. In this paper, we propose a new method that overcomes some of these challenges. Methods: To test the feasibility of this new method, data from the Sleep Heart Health Study (SHHS) were analyzed and two oxygen-based endotypes were identified and plotted on a graphical model: the steady-state SpO2 and the SpO2 arousal threshold. The first is the oxygen saturation that would occur during sleep if there were no arousals, and it is a measure of upper airway collapsibility (a more collapsible airway produces a lower SpO2). The latter is the oxygen saturation that triggers arousals. These endotypes were validated by assessing their ability to detect positional and state-related changes in airway collapsibility and arousal threshold. Results: The study showed that it was feasible to measure oxygen-based endotypes in 95% of SHHS participants. As expected, steady-state SpO2 was lower during supine vs. non-supine sleep, as well as during REM vs. NREM sleep. Also, the SpO2 arousal threshold was similar between supine and non-supine sleep. However, SpO2 arousal threshold was not lower in REM sleep vs. NREM sleep. Therefore, in 3 of the 4 conditions, the oxygen-based endotypes moved in the expected direction due to positional or sleep state changes. Conclusion: Although further validation experiments are required, this study indicates that OSA endotyping using the pulse oximetry signal is feasible. The oxygen-based endotypes could be used to aid therapeutic decision making.

Normal urinary bladder function relies on afferent fibers that detect and integrate mechanical and chemical cues related to bladder distension. Though, the molecular identity and function of the various sensory neuron types involved in bladder function have yet to be fully elucidated. Here, we introduce a novel framework for the functional classification of mechanosensitive bladder afferents based on their differential responses to physiological (15 l/min) and noxious filling (30 s at intravesical pressures of 10, 20, 30, 40, 50, and 60 cmH2O). Our data reveal the presence of three distinct types of mechanosensitive bladder afferents, two that respond to physiological distension (type I and II) and one that is activated by noxious stimulation (type III). Of the two populations that respond to physiological filling, one displays a linear increase in firing with bladder filling (type I), while the firing of the other plateaus as intravesical pressure increases (type II). Fast filling (130 l/min) increases the discharge of all three afferent types, with the effect being most pronounced in those responding to noxious stimulation (type III). Corroborating the existence of three functionally distinct bladder afferent populations, Yoda1, a selective PIEZO1 channel activator, significantly increased the firing rate of types I and III during slow filling and of type III during noxious stimulation. In summary, we present a reliable and reproducible method for studying and classifying bladder afferents, while providing compelling evidence for the existence of functionally distinct populations of mechanosensitive afferents, each activated and regulated by distinct mechanisms. New & NoteworthyUsing a novel approach, we identify three types of mechanosensitive afferents innervating the urinary bladder, two that respond to slow filling and one that is activated only by noxious distension. The three afferent types display distinct firing patterns during rapid filling and in response to the PIEZO1 channel agonist Yoda1.

Postganglionic sympathetic neurons not only regulate target organs but also their own intrinsic activity and can be further modulated by parasympathetic neurons. This crosstalk and automodulatory signalling have been implicated in cardiovascular disorders, with the majority of earlier work employing rodent models. Here, we have used human sympathetic neurons derived from induced pluripotent stem cells (hiPSCs), as a scalable human in vitro system with the aim to investigate these pathways. Efficient differentiation of hiPSCs into sympathetic neurons was confirmed using molecular characterisation for the expression of PHOX2B, DBH, TH, PRPH. We employed Ca2+ imaging and whole-cell patch-clamp electrophysiology, to examine the neuronal functional properties and found that hiPSC-derived sympathetic neurons recapitulate key physiological features of the rodent native counterparts. Most cells responded to nicotine and expressed functional 2 adrenergic and muscarinic receptors, involved in sympathetic autoregulation and parasympathetic crosstalk. We further demonstrated that 2 adrenergic and muscarinic receptors inhibit membrane excitability (increased rheobase, hyperpolarisation, reduced input resistance) and that both types of receptors converge on inwardly rectifying K+ channels (GIRK) as effectors. The GIRK blocker Tertiapin-Q significantly reduced the 2 adrenergic and muscarinic responses, while the activator ML297 mimicked their action. Analysis of mouse stellate scRNA-seq confirmed that the receptors and GIRK subtypes studied here are prominently expressed in native sympathetic neurons. Overall, our data show that GIRK channels play an important role in the regulation of sympathetic neurons excitability and that hiPSC-derived neurons provide an attractive in vitro tool for drug discovery to study sympathetic autoregulation and parasympathetic-sympathetic crosstalk. KEY POINTSO_LIhiPSC-sympathetic neurons recapitulate key cellular pathways of native counterparts C_LIO_LIThey express relevant receptors and ion channels involved in the inhibitory autoregulatory feedback and parasympathetic-sympathetic crosstalk C_LIO_LIUsing a combination of RT-qPCR and functional recordings we identified inwardly rectifying K+ channels as downstream effectors of both 2 adrenergic and M2 muscarinic receptors. We cross-validated our findings with a mouse transcriptomic dataset from thoracic sympathetic ganglia. C_LIO_LIOverall, our data suggest that hiPSC-sympathetic neurons can be employed as a human in vitro platform to study cellular pathways and for drug discovery purposes. C_LI O_FIG O_LINKSMALLFIG WIDTH=119 HEIGHT=200 SRC="FIGDIR/small/727423v1_ufig1.gif" ALT="Figure 1"> View larger version (23K): org.highwire.dtl.DTLVardef@14e37ddorg.highwire.dtl.DTLVardef@35c534org.highwire.dtl.DTLVardef@260837org.highwire.dtl.DTLVardef@e57af6_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOGraphic abstract.C_FLOATNO Summary of proposed modulation of sympathetic neuron activity via 2ARs and muscarinic receptors via GIRK channels Functional recordings showed that muscarinic receptors and 2 adrenergic receptors reduce neuronal excitability, this effect was mimicked by activation of inwardly rectifying K+ channels (GIRK). Blockade of GIRK abolished the effects of both types of receptors, demonstrating that they converge on GIRK as a common effector. The muscarinic response was blocked by pertussis toxin, indicating an involvement of Gi/o downstream of the receptor, consistent with the high expression of CHRM2 by RT-qPCR. C_FIG

AIMS Cardiometabolic risk factors may impair health by altering the autonomic modulation of the cardiovascular system, a physiological process described by heart rate (HR) circadian oscillations. However, the impact of cardiometabolic health determinants on HR circadian oscillations remains scarcely characterized in real-world, population-based settings. To address this, we applied digital health technologies to investigate how cardiometabolic health determinants shape HR circadian oscillations in a real-world cohort of individuals free of cardiometabolic diseases. METHODS First, a 10-fold cross-validation of a model was performed, aiming at mitigating wearables measurement error caused by motion artifacts. This process was informed by 10,056 epochs of concurrent wearable-derived and polysomnographic HR assessment, yielding an average 1.3 bpm reduction in wearables measurement error. We subsequently applied this model to over 2 million 1-minute epochs of HR data, derived from 7-day continuous actigraphic recordings of 245 individuals free of cardiometabolic disorders. Functional-on-scalar regression modelling and both parametric and nonparametric analyses characterized HR circadian profiles and their relationships with demographics, lifestyle, chronotype, sleep health, and chronic insomnia diagnosis. A 6-dimension sleep health index was calculated. RESULTS Sex, chronotype, and sleep health predominantly shaped HR circadian oscillations. In detail, females consistently showed higher HR across the 24 hours. Moreover, chronotype was associated to a phase shift in HR circadian profiles, with later timings corresponding to eveningness. Notably, sleep health impacted HR circadian oscillations in a dose-dependent fashion: each additional impaired sleep dimension was associated with a 1.2 bpm HR increase during nighttime, alongside reduced circadian robustness and delayed oscillation timings. Finally, the earlier occurrence of morning HR peaks served as a digital biomarker of insomnia (80% specificity, 74% sensitivity). CONCLUSIONS This work provides a digital health framework to characterize HR circadian oscillations in free-living populations and supports its clinical utility in capturing the autonomic disruptions related to cardiometabolic health determinants.

Nuclear receptors, transcription factors essential for organism growth, development, and reproduction, are expressed in a variety of tissues, with some exhibiting differential expression between males and females. The Estrogen-related receptor (ERR) is a conserved metabolic nuclear receptor required for energy metabolism and lipid accumulation. While previous studies in Drosophila have identified potential ERR targets from mixed sex larval populations and adult males, it is unclear whether transcriptional targets and biological pathways downstream of ERR are altered in a sex-specific manner. Here, we took an RNA sequencing approach to identify candidate ERR targets specifically in adult females and compared differentially expressed genes to a published male-specific dataset. Whole body conditional knockout of ERR significantly downregulated transcription of enzymes associated with glycolysis and the pentose phosphate pathway. In contrast, components of the DNA replication machinery were selectively downregulated in adult females, whereas ribosome biogenesis transcription was increased. Our results have further defined the metabolic targets of ERR between males and females, as well as suggest that ERR regulates DNA replication and global translation in females. SUMMARYIn this manuscript, we used RNA sequencing to identify differential expression of transcripts dependent on the nuclear receptor ERR in Drosophila adult females. We find that ERR is required for activating transcription of glycolytic and pentose phosphate pathway enzymes, as observed in larvae and adult males. Furthermore, compared to males, loss of ERR in females specifically decreased DNA replication enzyme components while upregulating ribosomal components. Our results suggest that nuclear receptors have common and sex-specific targets, which will be of interest for those in the nuclear receptor and sexual dimorphism fields.

Optogenetic defibrillation uses light-gated ion channels to terminate cardiac arrhythmias through targeted illumination. Previous studies assessed the feasibility of using either cation (e.g. ChR2) or anion (e.g. GtACR1) non-selective channels, both of which depolarise resting cardiomyocytes upon photoactivation. In contrast, recently identified light-gated K+-channels (e.g. WiChR) suppress cardiomyocyte activity while maintaining the membrane potential near its resting state. Here, we use biophysically detailed simulations to compare the defibrillation potential of ChR2, GtACR1, and WiChR. Single-cell simulations show that activation of ChR2 and GtACR1 markedly increase diastolic intracellular Ca2+ concentration (by 42.6% and 52.6%, respectively), whereas WiChR induces only minimal changes (4.0% increase), suggesting a lower pro-arrhythmogenic risk. WiChR activation, however, slightly increases intracellular Na+ levels (by 15.1% compared to 0.1% and 3.4% for ChR2 and GtACR), consistent with the residual Na+ permeability of all currently available K+-selective channelrhodopsins. Simulations of human ventricles and atria demonstrate that GtACR1 most effectively terminates re-entrant arrhythmias at low light intensities, while WiChR achieves comparable efficacy at light levels [≥]5 mW/mm2. Complementary tissue-scale simulations reveal that defibrillation is either based on depolarisation within the excitable gap, followed by fast Na+ channel inactivation (depolarising variants ChR2 and GtACR1), or based on a reduction in membrane resistance supporting arrhythmia termination at sufficiently high light levels (large-conductance ion channels GtACR1 and WiChR). Overall, our findings identify channelrhodopsin ion selectivity as a key determinant of both arrhythmia termination success and mechanisms underlying defibrillation. Key points summaryO_LIWe use computational simulations to compare non-selective cation (ChR2), anion (GtACR1), and K+-selective channelrhodopsins (WiChR) for optogenetic termination of re-entrant arrhythmia. C_LIO_LISingle-cardiomyocyte simulations suggest that ChR2 and GtACR1 activation can cause progressive accumulation of intracellular Ca2+, which is minimised when using WiChR. C_LIO_LISimulations of human left ventricles and atria indicate that GtACR1 is most effective in terminating re-entrant arrhythmia at low light intensities, while WiChR becomes similarly effective at higher intensities. C_LIO_LITissue-scale simulations indicate distinct defibrillation mechanisms: Excitable gap extinction by de-novo action potential initiation followed by inactivation of fast Na+ channels for depolarising channelrhodopsins (ChR2, GtACR1), and reduction in membrane resistance for the large-conductance channels (GtACR1, WiChR), effectively clamping the membrane potential at each channels reversal potential at high light levels. C_LI

Background Atrial fibrillation (AF) is a leading cause of stroke, cardiovascular morbidity, and mortality. Atrial myopathy, characterized by progressive metabolic, electrical, and structural changes, creates the arrhythmogenic substrate that drives AF. Defining the key drivers of atrial myopathic processes is essential for targeted therapies that can mitigate AF progression. Here we explore how reduced ERBB4 expression contributes to the development of left atrial myopathy. Methods We analyzed the Cleveland Clinic Biobank to compare left atrial ERBB4 levels in patients grouped by AF diagnosis. To investigate the impact of reduced ERBB4 levels on atrial tissue substrate, we created mouse models of cardiac-specific Erbb4 deficiency using Mlc2a (myosin light chain 2a)-Cre. Comprehensive physiological assessments were performed. Transcriptomic analyses of the left atrium were performed in an Erbb4 haploinsufficient mouse model and compared with human atrial datasets. Molecular validation of key dysregulated pathways was performed. Results We found that left atrial ERBB4 levels are reduced in patients with AF. Adult cardiomyocyte-specific Erbb4 heterozygous (Erbb4fl/+;Mlc2a-Cre) mice exhibited prolonged P-wave duration in the absence of ventricular dysfunction. Left atrial transcriptomic analysis in Erbb4 haploinsufficient mice showed upregulation of pathways related to fibrosis, apoptosis, and coagulation, and downregulation of pathways related to fatty acid metabolism and mitochondrial function, mirroring changes observed in pressure overload mouse models. A cross-species transcriptomic comparison revealed significant overlap between ERBB4-correlated gene expression and functional pathways in adult human atria and mice with Erbb4 haploinsufficiency. Validating the transcriptomic data, protein and functional assays demonstrated increased fibrosis, apoptosis, and oxidative stress in the mutant left atrial tissue. Conclusion Left atrial ERBB4 levels are reduced in AF patients. A mouse model of Erbb4 deficiency and human atrial transcriptomic analyses highlight a role for ERBB4 in supporting normal atrial metabolism while protecting against inflammation, apoptosis, and fibrosis.

We examine the long-range temporal structure of forecasts produced by Time-Series Foundation Models (TSFMs) on heartbeat dynamics using the MIT-BIH Normal Sinus Rhythm Database (NSRDB). Our findings indicate that these models do not adequately capture long-range dependencies, as reflected in growing errors in RR-interval predictions over longer forecast horizons. Code is available at https://github.com/SubramanianLab/ecg-tsfm-benchmark.

Mental imagery is known to be accompanied by autonomic responses, traditionally viewed as merely downstream consequences of imagery. Recent theoretical work has challenged this view, proposing that mental imagery requires the integration of cortical sensory representations with ascending interoceptive signals supplied by the autonomic nervous system. These two views make opposite predictions: if autonomic activity is only a consequence of imagery, then the responsiveness of the autonomic nervous system should not predict imagery vividness. If instead autonomic input shapes the generation of mental images, individuals with greater autonomic responsiveness should experience more vivid imagery. The present study tested these competing predictions by examining whether individual differences in cardiac vagal reactivity (indexed by the magnitude of HRV change in response to a paced breathing manipulation) predict self-reported visual imagery vividness. Imagery vividness was assessed using the Vividness of Visual Imagery Questionnaire (VVIQ) at a separate time point from the paced breathing protocol, ensuring that any observed relationship between cardiac vagal capacity cannot reflect autonomic activation driven by imagery itself. The key result was that cardiac vagal reactivity (indexed by RMSSD change normalized by mean R-R interval), significantly predicted higher VVIQ scores (r = .30, p = .031). These findings demonstrate that vividness of mental imagery is not exclusively central in origin but also shaped by the capacity of the autonomic nervous system to enter a high-parasympathetic state. Imagery thus likely involves bidirectional autonomic-cortical interaction, with descending pathways triggering the intention to generate an image and ascending interoceptive signals contributing to its generation.

Objective To verify the reliability of a self developed bowel sound monitoring device under real biological tissue acoustic propagation conditions using a controllable sound source, and to establish quantitative evidence for its translational applicability. Methods Freshly euthanized six month old Bama miniature pigs were used as an experimental model. A high fidelity Bluetooth audio playback device was implanted into the abdominal cavity to deliver manually annotated bowel sound recordings as controllable acoustic stimuli. A self developed bowel sound monitoring device was fixed on the abdominal surface for continuous signal acquisition. Playback timestamps were defined as the ground truth, and event level matching was performed within a predefined temporal tolerance window. Four performance indicators were evaluated: (1) bowel sound acquisition and energy amplification, (2) event matching accuracy, (3) acoustic feature consistency, and (4) subjective agreement assessed by blinded auscultation from gastroenterologists with different levels of clinical experience. Results The monitoring device exhibited stable detection capability and effectively covered the full spectral range of the original signals. It significantly enhanced bowel sound energy while preserving temporal and spectral characteristics, demonstrating high consistency in time and frequency domain features. Blinded clinician assessments showed a subjective agreement rate of 88.9% between original and surface recorded bowel sound events. Conclusions Under real tissue acoustic propagation conditions, the self-developed bowel sound monitoring device reliably captures bowel sound events with high temporal accuracy, acoustic fidelity, and clinical perceptual consistency. This controllable sound source based validation provides robust technical evidence for subsequent in vivo studies and clinical translation, supporting the development of objective and continuous gastrointestinal function monitoring.

BackgroundNeonatal sepsis is a major cause of infant morbidity and mortality worldwide, particularly in preterm and very low birthweight babies. Fundamental differences between neonates and adults warrant clinically relevant models of neonatal sepsis. Here, we describe a preclinical fecal-slurry (FS)-induced peritonitis model of polymicrobial sepsis in neonatal rats, along with a novel neonatal rat sepsis score (nRSS) to monitor illness severity. MethodsPeritonitis was induced in 3-day-old Sprague Dawley rats by intraperitoneal injection of various doses (0.3-1.5mg/g body weight) of fecal slurry (FS); control pups received equivalent doses of vehicle. All pups received analgesics (buprenorphine), antibiotics (ampicillin and gentamicin), and fluids (saline) to model clinical standards of sepsis treatment. Time-dependent changes in circulating cytokines (IL-6, IL-1{beta}) and biomarkers of sepsis pathology (hemoglobin, glucose, alanine transaminase [ALT] levels) were assessed and correlated with nRSS scores. ResultsFS administration caused a dose-dependent increase in severity of sepsis over time, as indicated by increases in mortality rates (based on predefined criteria for euthanasia), nRSS scores, as well as time-dependent changes in circulating glucose, hemoglobin, IL-6, IL-1{beta}, and ALT activity levels. nRSS scores correlated with all quantitative measures of sepsis pathology. Notably, females showed higher mortality and higher early NRSS scores than males at moderate to high FS doses, yet biochemical markers and time of death did not differ between sexes, suggesting that the apparent female vulnerability may reflect more conspicuous behavioral manifestations of illness rather than greater underlying physiological severity. ConclusionInduction of peritonitis in rats at postnatal day 3 produced a consistent and reproducible model of polymicrobial neonatal sepsis. Illness severity was monitored using a newly developed nRSS. By minimizing distress and incorporating standards of care, this model and scoring system may serve as a platform for future investigations into the underlying mechanisms and potential therapeutic interventions for neonatal sepsis. ImpactO_LIA clinically relevant rat model of neonatal polymicrobial sepsis was developed, incorporating standards of care (analgesics, antibiotics, and fluid resuscitation) to better reflect the clinical context in which preclinical findings must ultimately translate. C_LIO_LIA novel neonatal rat sepsis scoring system (nRSS) was developed and validated, providing a sensitive, non-invasive measure of disease severity that correlates with biochemical markers and predicts mortality. C_LIO_LIFemale pups showed higher mortality and earlier behavioral signs of illness than males despite equivalent biochemistry, highlighting that clinical scores may capture sex-dependent vulnerability not apparent in standard biochemical measures. C_LIO_LITogether, this model and scoring system offer a refined platform for mechanistic and therapeutic studies of neonatal sepsis while advancing the welfare-conscious 3Rs principles essential to rigorous preclinical research C_LI

Introduction Obstructive lung diseases (OLDs) are responsible for high rates of illness and death worldwide. Inflammation, chronic airflow limitation, and bronchial remodeling occur in OLD and eventually result in the unique respiratory sounds. Despite its subjective and having low reproducibility, still traditional auscultation using a manual stethoscope is the main method used to identify the lung sounds. Nevertheless, the combination of recent advancements in digital stethoscopes and AI (Artificial Intelligence) has permitted the objective measurement of lung sounds. Nevertheless, there is a lack of standardized, region-specific databases for AI training and validation. Even though lung sound classification is an emerging aspect in research and telerehabilitation the lobar wise acoustic pattern is still novel due to lack of prevailing database to train AI models. Identifying this gap this study aims to develop an acoustic repository and analyze the data using segmental lung sounds from patients with OLDs and healthy controls through an electronic stethoscope. Methods and analysis This is a cross sectional observational study involving 120 participants (60 OLD patients and 60 healthy controls). Lobar wise acoustic signals will be captured using an electronic stethoscope in healthy and diseases population. The data will be analyzed using Audacity software for annotations and then it will be used for feature extraction and statistical analysis. The acoustic features extracted through Audacity, will include frequency, intensity, pitch, and root mean square (RMS) energy. Repeated measures ANOVA will be applied to compare mean sound intensities across lung segments while Pearson correlation will be used to assess associations with body composition parameters. The data will then be standardized for AI-based diagnostic applications. Ethics and dissemination The study is being reviewed from the Ethics Review Committee, Faculty of Medicine, University of Peradeniya (2025/EC/87) will be sought. Informed consent will be obtained in writing. The dissemination of results will take place through peer-reviewed publications and the creation of a public database containing lung sounds from the region.

The epidermal growth factor receptor (EGFR) family network comprises 4 receptors (EGFR, ERBB2, ERBB3, ERBB4) and numerous ligands, and is dysregulated in many cancers. Since anti-cancer drugs that target these receptors are cardiotoxic for some patients, it is important to understand the network in cardiac cells. Data from the Human Protein Atlas established that EGFR family members and their ligands are differentially expressed in cardiac cell types. Ligand expression was altered in human failing hearts and may contribute to disease. These ligands stimulated extracellular signal-regulated kinases 1/2 (ERK1/2) and Akt in rat cardiomyocytes but to different degrees. Afatinib (at a concentration to inhibit all EGF family receptors) was used to assess the role of the network in a mouse model of cardiac hypertrophy induced by angiotensin II (AngII). Echocardiography and segmental strain analysis demonstrated that afatinib reduced AngII-induced cardiac hypertrophy and caused cardiac dysfunction. This was associated with loss of cardiomyocyte hypertrophy, enhanced cardiac fibrosis, and reduced expression of Nrg1. NRG1 binds to ERBB4 in cardiomyocytes which homodimerizes or heterodimerises with ERBB2. The role of ERBB2 in the cardiomyocyte response to NRG1 compared with EGF was dissected using tucatinib (a selective ERBB2 inhibitor) and mRNA expression profiling. Most, but not necessarily all, of the response to NRG1 required ERBB2 signalling; most, but not all, of the response to EGF did not. Thus, the EGFR family network plays an important role in the heart. Understanding this network may identify therapeutic approaches to avoid cardiotoxicity associated with EGFR family anti-cancer drugs. Clinical perspectivesO_LIAnti-cancer drugs that target the epidermal growth factor receptor (EGFR) family are cardiotoxic for some patients; it is therefore important to understand the network in cardiac cells. C_LIO_LIThe EGFR family and their ligands are differentially expressed in cardiac cells with changes in ligand expression in heart failure; inhibition of all receptors in a mouse model of hypertrophy reduces cardiac hypertrophy and causes cardiac dysfunction with attenuation of cardiomyocyte hypertrophy and enhanced cardiac fibrosis and loss of neuregulin 1 (NRG1); in rat cardiomyocytes, NRG1 signalling to gene expression is largely mediated via ERBB2. C_LIO_LIThe EGFR family network plays an important role in the heart; understanding this network may identify therapeutic approaches to avoid cardiotoxicity associated with anti-cancer drugs targeted against it. C_LI