{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:40:14Z","timestamp":1792460414729,"version":"4.5.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Leisure, work, and sports activities that involve ascending to high altitudes (HA) are growing in popularity, yet they also pose the risk of developing acute mountain sickness (AMS). Despite the dynamic nature of AMS, its prevalence, clinical manifestations, and associated risks have still not to be comprehensively characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 770 healthy males, ranging in age from 18 to 45\u2009years, were included in this study. The subjects were divided into two cohorts: a fast ascent cohort (<jats:italic>n<\/jats:italic>\u2009=\u2009424) who ascended to 3,650\u2009m by airplane, and a slow ascent cohort (<jats:italic>n<\/jats:italic>\u2009=\u2009346) who ascended to the same altitude by bus. Subsequently, they all further ascended to 4,400\u2009m. AMS was diagnosed using the Lake Louise Scoring system (LLS), with either the old or new version were employed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>As diagnosed by the old LLS and new LLS, the incidence of AMS was 37.9 and 32.4% at 3650\u2009m, respectively, which decreased to 35.7 and 32.4% after further ascending to 4,400\u2009m in the fast ascent cohort; the incidence of AMS was 26.5 and 23.2% at 3650\u2009m, which increased to 44.5 and 42.3% after further ascending to 4,400\u2009m in the slow ascent cohort. Furthermore, there were noticeable disparities in the occurrence and progression of AMS-related symptoms among cohorts adhering to different ascent protocols. Specifically, fast ascent protocol posed a risk during the initial phase of the ascent, but transformed into a protective effect upon further ascent to a higher altitude.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ascent protocol emerged as the pivotal influence on the prevalence of AMS and associated manifestations, demonstrating a transition from a risk factor during initial ascent to a protective factor following further ascent to higher altitudes. These findings suggest an innovative strategy for high-altitude expeditions and work endeavors, emphasizing the importance of a strategic plan for ascending to higher altitudes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1472935","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T06:24:18Z","timestamp":1732170258000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Dynamics in the prevalence and clinical manifestations of acute mountain sickness of different ascent protocols during high altitudes exposure"],"prefix":"10.3389","volume":"12","author":[{"given":"Caitong","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yupeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renzheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lide","family":"Sha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1886","DOI":"10.1097\/00005768-200212000-00005","article-title":"Acute mountain sickness: influence of susceptibility, preexposure, and ascent rate","volume":"34","author":"Schneider","year":"2002","journal-title":"Med Sci Sports Exerc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1038\/s41572-024-00526-w","article-title":"Altitude illnesses","volume":"10","author":"Gatterer","year":"2024","journal-title":"Nat Rev Dis Primers"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1515\/reveh-2021-0172","article-title":"High altitude pulmonary edema, high altitude cerebral edema, and Acute Mountain sickness: an enhanced opinion from the high Andes - La Paz, Bolivia 3,500 m","volume":"38","author":"Zubieta-Calleja","year":"2023","journal-title":"Rev Environ Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2294","DOI":"10.1056\/NEJMcp1214870","article-title":"Clinical practice: acute high-altitude illnesses","volume":"368","author":"B\u00e4rtsch","year":"2013","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1001\/jama.2017.16192","article-title":"Does this patient have Acute Mountain sickness?: the rational clinical examination systematic review","volume":"318","author":"Meier","year":"2017","journal-title":"JAMA"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1089\/ham.2017.0164","article-title":"The 2018 Lake Louise Acute Mountain sickness score","volume":"19","author":"Roach","year":"2018","journal-title":"High Alt Med Biol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1089\/ham.2021.0031","article-title":"Assessment of Acute Mountain sickness using 1993 and 2018 versions of the Lake Louise score in a large Chinese cohort","volume":"22","author":"Chen","year":"2021","journal-title":"High Alt Med Biol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1097\/JSM.0000000000000098","article-title":"Rate of ascent and acute mountain sickness at high altitude","volume":"25","author":"Hsu","year":"2015","journal-title":"Clin J Sport Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e0276901","DOI":"10.1371\/journal.pone.0276901","article-title":"Ascent rate and the Lake Louise scoring system: an analysis of one year of emergency ward entries for high-altitude sickness at the mustang district hospital, Nepal","volume":"17","author":"Poudel","year":"2022","journal-title":"PLoS One"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taad011","article-title":"Flying to high-altitude destinations: is the risk of acute mountain sickness greater?","volume":"30","author":"Burtscher","year":"2023","journal-title":"J Travel Med"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taab102","article-title":"Risk factors for acute mountain sickness in travellers to Cusco, Peru: coca leaves, obesity and sex","volume":"29","author":"Caravedo","year":"2022","journal-title":"J Travel Med"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taz104","article-title":"Does age have an impact on acute mountain sickness? 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