A brainstem-hypothalamus neuronal circuit reduces feeding upon heat exposure.

Empirical evidence suggests that heat exposure reduces food intake. However, the neurocircuit architecture and the signalling mechanisms that form an associative interface between sensory and metabolic modalities remain unknown, despite primary thermoceptive neurons in the pontine parabrachial nucleus becoming well characterized1. Tanycytes are a specialized cell type along the wall of the third ventricle2 that bidirectionally transport hormones and signalling molecules between the brain's parenchyma and ventricular system3-8. Here we show that tanycytes are activated upon acute thermal challenge and are necessary to reduce food intake afterwards. Virus-mediated gene manipulation and circuit mapping showed that thermosensing glutamatergic neurons of the parabrachial nucleus innervate tanycytes either directly or through second-order hypothalamic neurons. Heat-dependent Fos expression in tanycytes suggested their ability to produce signalling molecules, including vascular endothelial growth factor A (VEGFA). Instead of discharging VEGFA into the cerebrospinal fluid for a systemic effect, VEGFA was released along the parenchymal processes of tanycytes in the arcuate nucleus. VEGFA then increased the spike threshold of Flt1-expressing dopamine and agouti-related peptide (Agrp)-containing neurons, thus priming net anorexigenic output. Indeed, both acute heat and the chemogenetic activation of glutamatergic parabrachial neurons at thermoneutrality reduced food intake for hours, in a manner that is sensitive to both Vegfa loss-of-function and blockage of vesicle-associated membrane protein 2 (VAMP2)-dependent exocytosis from tanycytes. Overall, we define a multimodal neurocircuit in which tanycytes link parabrachial sensory relay to the long-term enforcement of a metabolic code.

Electrostimulation of the white matter of the posterior insula and medial operculum: perception of vibrations, heat, and pain.

ABSTRACT: This study aimed to characterize the sensory responses observed when electrically stimulating the white matter surrounding the posterior insula and medial operculum (PIMO). We reviewed patients operated on under awake conditions for a glioma located in the temporoparietal junction. Patients' perceptions were retrieved from operative reports. Stimulation points were registered in the Montreal Neurological Institute template. A total of 12 stimulation points in 8 patients were analyzed. Painful sensations in the contralateral leg were reported (5 sites in 5 patients) when stimulating the white matter close to the parcel OP2/3 of the Glasser atlas. Pain had diverse qualities: burning, tingling, crushing, or electric shock. More laterally, in the white matter of OP1, pain and heat sensations in the upper part of the body were described (5 sites in 2 patients). Intermingled with these sites, vibration sensations were also reported (3 sites in 2 patients). Based on the tractograms of 44 subjects from the Human Connectome Project data set, we built a template of the pathways linking the thalamus to OP2/3 and OP1. Pain sites were located in the thalamo-OP2/3 and thalamo-OP1 tracts. Heat sites were located in the thalamo-OP1 tract. In the 227 awake surgeries performed for a tumor located outside of the PIMO region, no patients ever reported pain or heat sensations when stimulating the white matter. Thus, we propose that the thalamo-PIMO connections constitute the main cortical inputs for nociception and thermoception and emphasize that preserving these fibers is of utmost importance to prevent the postoperative onset of a debilitating insulo-opercular pain syndrome.

Topical application of L-Menthol - Physiological and genetic considerations to assist in developing female athlete research: A narrative review.

L-menthol is a cyclic monoterpene derived from aromatic plants, which gives a cooling sensation upon application. With this in mind, L-menthol is beginning to be considered as a potential ergogenic aid for exercise and sporting competitions, particularly in hot environments, however female-specific research is lacking. The aim of this narrative review is to summarize available literature relating to topical application of L-menthol and provide commentary on avenues of consideration relating to future research developments of topical L-menthol in female athletes. From available studies in male participants, L-menthol topical application results in no endurance exercise performance improvements, however decreases in thermal sensation are observed. Mixed results are observed within strength performance parameters. Several genetic variations and single nucleotide polymorphisms have been identified in relation to sweat production, fluid loss and body mass changes - factors which may influence topical application of L-menthol. More specifically to female athletes, genetic variations relating to sweat responses and skin thickness, phases of the menstrual cycle, and body composition indices may affect the ergogenic effects of L-menthol topical application, via alterations in thermogenic responses, along with differing tissue distribution compared to their male counterparts. This narrative review concludes that further development of female athlete research and protocols for topical application of L-menthol is warranted due to physiological and genetic variations. Such developments would benefit research and practitioners alike with further personalized sport science strategies around phases of the menstrual cycle and body composition indices, with a view to optimize ergogenic effects of L-menthol.

Christmas article: Well-being in hot weather ­ a randomised crossover trial.

Introduction While some studies have investigated the cooling properties of warm beverages, no studies have examined thermal well-being in warm environments in relation to beverage temperature. Methods Thirty researchers were randomised in a 1:1 ratio in a double-blinded cross-over study. Participants were randomised to drink 10cl of 10°C and 50°C decaffeinated tea, 15 minutes apart while staying outside in the Turkish summer heat at noon. Well-being was assessed using the American Society of Heating, Refrigeration and Air-conditioning Engineers (ASHRAE) thermal sensation scale, Bedford thermal comfort scale, Brief Mood Introspection Scale (BMIS), and the last two domains of EuroQol 5-domain, 5-point scale: EQ-5D-5L. Results Neither clinically nor statistically significant differences were found in well-being between warm and cold tea. Moods soured significantly as the trial course passed (using BMIS, µ 1.9; P=0.03), but comfort in the heat bettered (using Bedford, µ -0.37; P less-than 0.001). These changes were not considered to be clinically significant. Conclusion We were unable to show any correlation between beverage temperature and comfort in a hot environment. The mood of participants did, however, deteriorate as time passed-a lesson to any future researchers conducting drawn-out experiments just before lunch. Funding none. Trial registration NCT05900960.

[Construction of theoretical framework, item pool and rating scale words of Moxibustion Sensory Transmission Evaluation Scale].

Literature investigation and expert consultation were adopted to construct the theoretical framework and item pool of Moxibustion Sensory Transmission Evaluation Scale. The moxibusion sensory transmission categories include 4 aspects, i.e. heat sensation, non-heat sensation, mixed sensation and others, including 25 items. Moxibustion sensory transmission strengthen is divided into 5 grades with rating scale words as very weak, weak, neither strong nor weak, strong and very strong. Finally, the preliminary version, Moxibustion Sensory Transmission Evaluation Scale was developed. This scale may provide a tool for the objectiveevaluation of moxibustion sensory transmission categories and strength.

Neural Representations in the Prefrontal Cortex Are Task Dependent for Scene Attributes But Not for Scene Categories.

Natural scenes deliver rich sensory information about the world. Decades of research has shown that the scene-selective network in the visual cortex represents various aspects of scenes. However, less is known about how such complex scene information is processed beyond the visual cortex, such as in the prefrontal cortex. It is also unknown how task context impacts the process of scene perception, modulating which scene content is represented in the brain. In this study, we investigate these questions using scene images from four natural scene categories, which also depict two types of scene attributes, temperature (warm or cold), and sound level (noisy or quiet). A group of healthy human subjects from both sexes participated in the present study using fMRI. In the study, participants viewed scene images under two different task conditions: temperature judgment and sound-level judgment. We analyzed how these scene attributes and categories are represented across the brain under these task conditions. Our findings show that scene attributes (temperature and sound level) are only represented in the brain when they are task relevant. However, scene categories are represented in the brain, in both the parahippocampal place area and the prefrontal cortex, regardless of task context. These findings suggest that the prefrontal cortex selectively represents scene content according to task demands, but this task selectivity depends on the types of scene content: task modulates neural representations of scene attributes but not of scene categories.SIGNIFICANCE STATEMENT Research has shown that visual scene information is processed in scene-selective regions in the occipital and temporal cortices. Here, we ask how scene content is processed and represented beyond the visual brain, in the prefrontal cortex (PFC). We show that both scene categories and scene attributes are represented in PFC, with interesting differences in task dependency: scene attributes are only represented in PFC when they are task relevant, but scene categories are represented in PFC regardless of the task context. Together, our work shows that scene information is processed beyond the visual cortex, and scene representation in PFC reflects how adaptively our minds extract relevant information from a scene.

Construction of theoretical framework, item pool and rating scale words of / 中国针灸

Literature investigation and expert consultation were adopted to construct the theoretical framework and item pool of

Cortex senses environmental temperature earlier than the hypothalamus in awake rats.

Simultaneous and direct recording of temperature from the body, hypothalamus, and cortex in animals exposed to acute thermal challenges lack evidence. This study was conducted to assess the usual concept, that brain temperature is rather stable when animals are exposed to different ambient temperatures. In this study, we report the characteristic changes in the body, hypothalamic, and cortical temperature, when the rats were acutely exposed to cold (6 °C) and hot (36 °C) ambient temperature. The results of our study show that the body temperature is robustly regulated while hypothalamic and cortical temperatures vary on challenges to ambient cold (6 °C) and warm (36 °C) exposure in awake rats. The onset of response was observed quickest in the cortex, indicating that the cortical thermal sensing may relay intracranial thermal input to the hypothalamus for the regulation of body temperature within narrow limits. The present findings contradict earlier evidence, which stated that the brain does not participate in thermal sensing.

Negative Modulation of TRPM8 Channel Function by Protein Kinase C in Trigeminal Cold Thermoreceptor Neurons.

TRPM8 is the main molecular entity responsible for cold sensing. This polymodal ion channel is activated by cold, cooling compounds such as menthol, voltage, and rises in osmolality. In corneal cold thermoreceptor neurons (CTNs), TRPM8 expression determines not only their sensitivity to cold, but also their role as neural detectors of ocular surface wetness. Several reports suggest that Protein Kinase C (PKC) activation impacts on TRPM8 function; however, the molecular bases of this functional modulation are still poorly understood. We explored PKC-dependent regulation of TRPM8 using Phorbol 12-Myristate 13-Acetate to activate this kinase. Consistently, recombinant TRPM8 channels, cultured trigeminal neurons, and free nerve endings of corneal CTNs revealed a robust reduction of TRPM8-dependent responses under PKC activation. In corneal CTNs, PKC activation decreased ongoing activity, a key parameter in the role of TRPM8-expressing neurons as humidity detectors, and also the maximal cold-evoked response, which were validated by mathematical modeling. Biophysical analysis indicated that PKC-dependent downregulation of TRPM8 is mainly due to a decreased maximal conductance value, and complementary noise analysis revealed a reduced number of functional channels at the cell surface, providing important clues to understanding the molecular mechanisms of how PKC activity modulates TRPM8 channels in CTNs.

Comparison of high tone therapy and transcutaneous electrical nerve stimulation therapy in chemotherapy-induced polyneuropathy.

INTRODUCTION: Chemotherapy-induced peripheral neuropathy (CIPN) is a worldwide concern in patients receiving neurotoxic agents for cancer therapy. High tone external muscle stimulation is a promising therapeutic approach to alleviate symptoms of CIPN. METHODS: This pilot study aims to investigate whether the application of home-based high-tone external muscle stimulation therapy (HTEMS) improves symptoms of CIPN. The trial is planned as a therapist- and assessor-blinded, 1:1 randomized controlled study. A total of 50 patients with chemotherapy-induced peripheral polyneuropathy will be included. All patients will perform therapy at home. Study participants will be allocated randomly to the HTEMS therapy (intervention group) or to the transcutaneous electrical nerve stimulation (TENS, control group), respectively, following a standardized therapy schedule. Compliance of participants can be verified by reading out the tool box. Outcomes will be evaluated at baseline and after 8 weeks of home-based therapy. The primary outcome includes improvement of CIPN according to the patient-reported EORTC QLQ-CIPN 20 questionnaire. Secondary outcomes are the patient-reported change in health-related quality of life and clinician-reported changes of vibration sensibility, tendon reflexes, temperature sensibility, perception of touch, and strength of the lower leg muscles. Further a safety- and process evaluation will be performed. DISCUSSION: This pilot RCT aims to evaluate the impact of home-based HTEMS as compared to TENS in CIPN. There is a need for an effective treatment for CIPN and the results of this study are expected to possibly identify a novel and effective treatment strategy in the future.

Revisiting the brain activity associated with innocuous and noxious cold exposure.

Humans have a sophisticated set of neural structures for cutaneous thermoception. Sufficiently cold temperatures are thought to evoke pain and motivation to resolve disturbed homeostasis, while cool but not painful temperatures are evaluated as cold but do not cause thermoregulatory behaviour. Brain networks for innocuous and noxious cold temperature have been proposed but a quantitative meta-analysis comparing the two has never been conducted. As a result, we sought to perform activation likelihood estimation analysis of the brain activity associated with innocuous and noxious cold exposure. Combining data from 33 data sets revealed that innocuous cold exposure activates the posterior insular, middle/orbital and posterior parietal cortices while noxious cold activates the thalamus, putamen, and right anterior insula cortex. Both conditions respectively show greater activation in these areas and no areas are common between conditions. Our results confirm the long-standing hypothesis that noxious cold is encoded in the right anterior insula, but contradicts the selective importance of the posterior insula for cool somatosensory processing.

Effects of severe whole-body hyperthermia on ovarian hormone and extracellular Hsp72 responses in young adult women.

Background: Although acute thermal stress appears to be one of the most effective stressors that increase the intra- and extracellular concentrations of heat shock protein 72 (Hsp72), 17ß-estradiol has been shown to inhibit heat-induced Hsp72 expression. Materials and Methods: To determine whether severe whole-body hyperthermia (increase in rectal temperature up to 39.5 °C) induced by lower-body heating is a sufficient stimulus to modulate hormonal (17ß-estradiol, progesterone, prolactin, epinephrine, and norepinephrine) and extracellular Hsp72 responses, we investigated young adult women (21 ± 1 yr). Results and Conclusions: In the present study, we show that a severe whole-body hyperthermia (increase in rectal temperature of approximately 2.6 °C and heart rate of approximately 80 bpm from baseline) was sufficient to increase 17ß-estradiol, progesterone, and prolactin and catecholamine norepinephrine concentration. Moreover, we show that the concentration of extracellular Hsp72 and catecholamine epinephrine were not affected by severe whole-body hyperthermia in young adult women. From the functional point of view, expression of ovarian hormones induced by passive heat stress may have therapeutic potential for young adult women in, for example, estrogen treatment and overall women's health.

Quantitative Sensory Testing (QST) Estimation of Regional Cutaneous Thermal Sensitivity During Waking State, Neutral Hypnosis, and Temperature Specific Suggestions.

This study aimed to determine the effects of neutral hypnosis and hypnotic temperature suggestions in thermal and pain thresholds compared to resting state. Sixteen healthy medium or high hypnotizable volunteers were enrolled. Hypnotizability was assessed with the Hypnotic Induction Profile (HIP); QST was checked in resting state, in neutral hypnosis, after suggestions of heat and cold, and after deinduction. A significant increase in heat threshold was recorded during hypnosis with both cold and heat suggestions compared to neutral hypnosis. HIP induction score showed a linear correlation with changes of temperature thresholds after heat and cold suggestions. Thermal suggestions may result in a significant increase of heat perception thresholds with respect to neutral hypnosis. HIP score is related to thermal threshold changes. QST is a valuable and manageable tool to measure temperature threshold change during hypnosis.

Predicting the onset of Betula pendula flowering in Poznan (Poland) using remote sensing thermal data.

Due to the urban heat island effect, the time of plant pollination might markedly vary within the area of a city. However, existing pollen forecasts do not reflect the spatial variations in the pollen release time within a heterogeneous urban environment. The main objective of this study was to model the spatial pattern of flowering onset (and thus the moment of pollen release) in silver birch (Betula pendula Roth.) in Poznan (Western Poland) using land surface temperature (LST) data and in situ phenological observations. The onset of silver birch flowering was observed at 34 urban and rural sites (973 trees) in Poznan from 2012 to 2014. Forty-four thermal variables were retrieved from MODerate Resolution Imaging Spectroradiometer (MODIS) data. To predict the spatio-temporal distribution of B. pendula flowering onset dates in a city, the ordinary and partial least squares, support vector machine and random forest regression models were applied. The models' performance was examined by an internal repeated k-fold cross-validation and external validation with archival phenological data (2010). Birch flowering began significantly earlier in the urban sites compared to the rural sites (from -1.4 days in 2013, to -4.1 days in 2012). The maximum March LST difference between the urban and rural sites reached 2.4 °C in 2013 and 4.5 °C in 2012. The random forest model performed best at validation stage, i.e. the root mean square error between the predicted and observed onset dates was 1.461 days, and the determination coefficient was 0.829. A calibrated model for predicting the timing of flowering in a heterogeneous city area is an important step in developing a fine-scale forecasting system that can directly estimate pollen exposure in places where allergy sufferers live. Importantly, by incorporating only pre-flowering thermal data into the model, location-specific allergy forecasts can be delivered to the public before the actual flowering time.

Oral thermosensing by murine trigeminal neurons: modulation by capsaicin, menthol and mustard oil.

KEY POINTS: Orosensory thermal trigeminal afferent neurons respond to cool, warm, and nociceptive hot temperatures with the majority activated in the cool range. Many of these thermosensitive trigeminal orosensory afferent neurons also respond to capsaicin, menthol, and/or mustard oil (allyl isothiocyanate) at concentrations found in foods and spices. There is significant but incomplete overlap between afferent trigeminal neurons that respond to oral thermal stimulation and to the above chemesthetic compounds. Capsaicin sensitizes warm trigeminal thermoreceptors and orosensory nociceptors; menthol attenuates cool thermoresponses. ABSTRACT: When consumed with foods, mint, mustard, and chili peppers generate pronounced oral thermosensations. Here we recorded responses in mouse trigeminal ganglion neurons to investigate interactions between thermal sensing and the active ingredients of these plants - menthol, allyl isothiocyanate (AITC), and capsaicin, respectively - at concentrations found in foods and commercial hygiene products. We carried out in vivo confocal calcium imaging of trigeminal ganglia in which neurons express GCaMP3 or GCAMP6s and recorded their responses to oral stimulation with thermal and the above chemesthetic stimuli. In the V3 (oral sensory) region of the ganglion, thermoreceptive neurons accounted for ∼10% of imaged neurons. We categorized them into three distinct classes: cool-responsive and warm-responsive thermosensors, and nociceptors (responsive only to temperatures ≥43-45 °C). Menthol, AITC, and capsaicin also elicited robust calcium responses that differed markedly in their latencies and durations. Most of the neurons that responded to these chemesthetic stimuli were also thermosensitive. Capsaicin and AITC increased the numbers of warm-responding neurons and shifted the nociceptor threshold to lower temperatures. Menthol attenuated the responses in all classes of thermoreceptors. Our data show that while individual neurons may respond to a narrow temperature range (or even bimodally), taken collectively, the population is able to report on graded changes of temperature. Our findings also substantiate an explanation for the thermal sensations experienced when one consumes pungent spices or mint.

Cooling Rates of Hyperthermic Humans Wearing American Football Uniforms When Cold-Water Immersion Is Delayed.

CONTEXT: Treatment delays can be contributing factors in the deaths of American football athletes from exertional heat stroke. Ideally, clinicians begin cold-water immersion (CWI) to reduce rectal temperature (Trec) to <38.9°C within 30 minutes of collapse. If delays occur, experts recommend Trec cooling rates that exceed 0.15°C/min. Whether treatment delays affect CWI cooling rates or perceptual variables when football uniforms are worn is unknown. OBJECTIVE: To answer 3 questions: (1) Does wearing a football uniform and delaying CWI by 5 minutes or 30 minutes affect Trec cooling rates? (2) Do Trec cooling rates exceed 0.15°C/min when treatment delays have occurred and individuals wear football uniforms during CWI? (3) How do treatment delays affect thermal sensation and Environmental Symptoms Questionnaire responses? DESIGN: Crossover study. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: Ten physically active men (age = 22 ± 2 y, height = 183.0 ± 6.9 cm, mass = 78.9 ± 6.0 kg). INTERVENTION(S): On 2 days, participants wore American football uniforms and exercised in the heat until Trec was 39.75°C. Then they sat in the heat, with equipment on, for either 5 or 30 minutes before undergoing CWI (10.6°C ± 0.1°C) until Trec reached 37.75°C. MAIN OUTCOME MEASURE(S): Rectal temperature and CWI duration were used to calculate cooling rates. Thermal sensation was measured pre-exercise, postexercise, postdelay, and post-CWI. Responses to the Environmental Symptoms Questionnaire were obtained pre-exercise, postdelay, and post-CWI. RESULTS: The Trec cooling rates exceeded recommendations and were unaffected by treatment delays (5-minute delay = 0.20°C/min ± 0.07°C/min, 30-minute delay = 0.19°C/min ± 0.05°C/min; P = .4). Thermal sensation differed between conditions only postdelay (5-minute delay = 6.5 ± 0.6, 30-minute delay = 5.5 ± 0.7; P < .05). Environmental Symptoms Questionnaire responses differed between conditions only postdelay (5-minute delay = 27 ± 15, 30-minute delay = 16 ± 12; P < .05). CONCLUSIONS: Treatment delays and football equipment did not impair CWI's effectiveness. Because participants felt cooler and better after the 30-minute delay despite still having elevated Trec, clinicians should use objective measurements (eg, Trec) to guide their decision making for patients with possible exertional heat stroke.

Research on electroencephalogram to measure thermal pleasure in thermal alliesthesia in temperature step-change environment.

Thermal pleasure is currently measured along psychological and physiological variables. However, in transient environments where temperatures change, it is hard to correlate psychological and physiological measures, because there is a delay in physiological changes. This study tests a method for correlating both measures using electroencephalogram (EEG), which can capture physiological feedback with a rapid response rate. In this experimental study, thermal pleasure was induced in a temperature step-change environment, one of non-uniform and transient environments. During the experiment, EEG was monitored and psychological responses of thermal sensation and thermal comfort votes were collected via survey questionnaire. A total of 50 males in their twenties participated in a climate chamber experiment. An experimental group of 25 men were exposed to temperature step-change between two different room conditions (32°C, 65% and 25°C, 50%), experiencing thermal pleasure. The control group of the remaining 25 men were exposed to an unchanging condition, experiencing thermal comfort close to thermal neutrality. The EEG spectral analysis demonstrated that EEG frequency band associated with pleasant emotional (theta) increased while frequency band related to pleasantness, satisfaction or relaxation (beta) decreased with thermal pleasure.

iTRAQ-Based Proteomics Analyses of Sterile/Fertile Anthers from a Thermo-Sensitive Cytoplasmic Male-Sterile Wheat with Aegilops kotschyi Cytoplasm.

A “two-line hybrid system” was developed, previously based on thermo-sensitive cytoplasmic male sterility in Aegilops kotschyi (K-TCMS), which can be used in wheat breeding. The K-TCMS line exhibits complete male sterility and it can be used to produce hybrid wheat seeds during the normal wheat-growing season; it propagates via self-pollination at high temperatures. Isobaric tags for relative and absolute quantification-based quantitative proteome and bioinformatics analyses of the TCMS line KTM3315A were conducted under different fertility conditions to understand the mechanisms of fertility conversion in the pollen development stages. In total, 4639 proteins were identified, the differentially abundant proteins that increased/decreased in plants with differences in fertility were mainly involved with energy metabolism, starch and sucrose metabolism, phenylpropanoid biosynthesis, protein synthesis, translation, folding, and degradation. Compared with the sterile condition, many of the proteins that related to energy and phenylpropanoid metabolism increased during the anther development stage. Thus, we suggest that energy and phenylpropanoid metabolism pathways are important for fertility conversion in K-TCMS wheat. These findings provide valuable insights into the proteins involved with anther and pollen development, thereby, helping to further understand the mechanism of TCMS in wheat.

Cellular populations and thermosensing mechanisms of the hypothalamic thermoregulatory center.

Temperature affects all aspects of life down to the diffusion rates of biologically active molecules and reaction rates of enzymes. The reciprocal argument holds true as well and every biological process down to enzymatic reactions influences temperature. In order to assure biological stability, mammalian organisms possess the remarkable ability to maintain internal body temperature within a narrow range, which in humans and mice is close to 37 °C, despite wide environmental temperature variations and different rates of internal heat production. Nevertheless, body temperature is not a static property but adaptively regulated upon physiological demands and in the context of pathological conditions. The brain region that has been primarily associated with internal temperature regulation is the preoptic area and the anterior portion of the hypothalamus. Similar to a thermostat, this brain area detects deep brain temperature, integrates temperature information from peripheral body sensors, and-based on these inputs--controls body temperature homeostasis. Discovered more than a century ago, we still know comparatively little about the molecular and cellular make-up of the hypothalamic thermoregulatory center. After a brief historic outline that led to the discovery of the thermoregulatory center, we here review recent studies that have considerably advanced our understanding of hypothalamic thermoregulation. We touch upon proposed mechanisms of intrinsic deep brain temperature detection and focus on newly identified hypothalamic cell populations that mediate thermoregulatory responses and that provide novel entry points not only to shed light on the mechanistic underpinnings of the thermoregulatory center but also to probe its therapeutic value.

[Development and initial evaluation of deqi sensation scale of heat-sensitive moxibustion].

Based on heat-sensitive moxibustion (HSM) theory, a widely applicable scale was developed to reflect the deqi (arrival of qi) sensation of HSM. By documentary method and interviewing method, the items of describing deqi sensation of HSM were collected to establish the pool of candidate items. With expert questionnaire, patient questionnaire and core expert discussion, the items were screened and quantified by method of subjective evaluation to develop the initial draft of the scale. A total of 121 patients were pre-surveyed with the initial draft, and the structural validity of the scale was examined by exploratory factor analysis (principal component) and its internal consistency was assessed by Cronbach's coefficient. As a result, the items in the scale was reduced from 36 to 9; 110 effective questionnaires were reclaimed for statistical analysis. Finally, the scale (Version 1.0) contained 9 items and 4 dimensions, of which, 3 items highlighted the comfort emotional experience, 3 items highlighted autonomic response, 2 items highlighted heat sensation, and 1 item highlighted non-heat sensation. In conclusion, the deqi sensation scale of HSM containes 9 items, which has fair content and structure validity. It is in line with the current clinical understanding of deqi sensation of HSM and has strong clinical operability and wide adaptability.