{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:38:44Z","timestamp":1791322724757,"version":"4.3.1"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","award":["RGPIN\u20102019\u201004053"],"award-info":[{"award-number":["RGPIN\u20102019\u201004053"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","award":["PGSD3\u2010519199\u20102018"],"award-info":[{"award-number":["PGSD3\u2010519199\u20102018"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>\n                      Sex differences in respiratory responses to ventilatory stress may contribute to exercise tolerance and dyspnoea perception, with potential implications across health and respiratory disease. We hypothesized that dead space loading (DSL) normalized to 15% of forced vital capacity would increase exertional dyspnoea, exacerbate inherent sex\u2010based differences in the respiratory system's response to exercise, and elicit higher diaphragmatic and extra\u2010diaphragmatic respiratory muscle activity in females than in males. Forty healthy, non\u2010smokers (20 males, 20 females; 24\u00a0\u00b1\u00a05\u00a0years old; maximal O\n                      <jats:sub>2<\/jats:sub>\n                      uptake: 96\u00a0\u00b1\u00a020% predicted) completed familiarization followed by two maximal incremental cycling tests on separate days with and without DSL in a randomized, single\u2010blinded and counter\u2010balanced order. Diaphragm activity was recorded using a multi\u2010pair electrode oesophageal catheter, while extra\u2010diaphragmatic inspiratory muscle activity was recorded with bipolar surface electrodes. DSL was 797\u00a0\u00b1\u00a0114\u00a0mL in males and 585\u00a0\u00b1\u00a071\u00a0mL in females (\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      &lt;\u00a00.001). Dyspnoea ratings increased similarly in both sexes with DSL, with no sex differences during or after exercise. Minute ventilation was increased with DSL throughout exercise [peak\u2010males: \u039416\u00a0L\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7%peak work\n                      <jats:sup>\u22121<\/jats:sup>\n                      , CI: (12,19),\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      &lt;\u00a00.001; females: \u039411\u00a0L\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7%peak work\n                      <jats:sup>\u22121<\/jats:sup>\n                      , CI: (8,15),\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      &lt;\u00a00.001], as well as indices of mechanical ventilatory constraints (e.g. tidal volume, power of breathing) at peak exercise in both sexes, where males had a greater increase with DSL for most variables than females. Diaphragm and extra\u2010diaphragmatic activity were increased with DSL in both sexes, with a greater increase in extra\u2010diaphragmatic activity in females near maximal exercise. These findings suggest that while sex differences in respiratory function and respiratory muscle activation exist, they do not necessarily translate to sex differences in dyspnoea perception during maximal incremental cycling.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tjp70212-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Sex differences in respiratory anatomy and function are known to influence dyspnoea perception during exercise; however, the effects of higher ventilatory demand and mechanical ventilatory constraints on these differences remain poorly understood.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Using a simple\u2010randomization, single\u2010blinded and counter\u2010balanced study design, we stimulated minute ventilation () and increased mechanical ventilatory constraints during maximal incremental cycling using dead space loading (DSL) customized to 15% of each individual's forced vital capacity. Dyspnoea was assessed using a multidimensional approach during and immediately after exercise.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Despite increases in the sensations of breathing work\/effort, unsatisfied inspiration and unsatisfied expiration with DSL in both sexes, there were no sex differences in dyspnoea perception during exercise with DSL.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>DSL increased  and indicators of mechanical ventilatory constraints in both sexes compared to control exercise.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Both sexes experienced an increase in diaphragmatic and extra\u2010diaphragmatic muscle activity, where females had a greater increase in extra\u2010diaphragmatic activity with DSL than males.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1113\/jp289764","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T05:12:32Z","timestamp":1762924352000},"page":"605-625","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Ventilatory stimulation with relative external dead space loading does not impact sex differences in exertional dyspnoea"],"prefix":"10.1113","volume":"604","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7583-8981","authenticated-orcid":false,"given":"Reid A.","family":"Mitchell","sequence":"first","affiliation":[{"name":"Centre for Heart Lung Innovation, Providence Research The University of British Columbia, St. Paul's Hospital Vancouver British Columbia Canada"},{"name":"Department of Physical Therapy, Faculty of Medicine The University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia N.","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, Providence Research The University of British Columbia, St. Paul's Hospital Vancouver British Columbia Canada"},{"name":"Department of Physical Therapy, Faculty of Medicine The University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alanna S.","family":"Hind","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, Providence Research The University of British Columbia, St. Paul's Hospital Vancouver British Columbia Canada"},{"name":"Department of Physical Therapy, Faculty of Medicine The University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Flynn","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, Providence Research The University of British Columbia, St. Paul's Hospital Vancouver British Columbia Canada"},{"name":"Department of Physical Therapy, Faculty of Medicine The University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3908-9447","authenticated-orcid":false,"given":"Jem I.","family":"Arnold","sequence":"additional","affiliation":[{"name":"School of Kinesiology, Faculty of Education The University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9232-9361","authenticated-orcid":false,"given":"Michele R.","family":"Schaeffer","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, Providence Research The University of British Columbia, St. Paul's Hospital Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satvir S.","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, Providence Research The University of British Columbia, St. Paul's Hospital Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil D.","family":"Eves","sequence":"additional","affiliation":[{"name":"Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences The University of British Columbia  Kelowna British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5779-5014","authenticated-orcid":false,"given":"A. 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