Body Surface Research Articles

Comparative early effectiveness across 14 PsA drugs and 5 classes of PsA treatment: 3-month results from the PRO-SPIRIT study

BackgroundThe psoriatic arthritis (PsA) Observational Study of Persistence of Treatment (PRO-SPIRIT) assesses effectiveness and persistence of real-world PsA treatments. Ixekizumab (IXE) is an interleukin (IL)-17A inhibitor (i) (IL-17Ai), approved for...

Sex Differences in Biomarkers of End-Organ Damage following Exertional Heat Stroke in Humans

Women are participating in military and athletic activities in the heat in increasing numbers, but potential sex differences in sequelae from exertional heat illness remain poorly understood. We tested the hypothesis that women suffering from exertional heat stroke (EHS) would have similar severity of organ damage biomarkers compared to men, as measured in a hospital setting. We studied women and men presenting with EHS to the emergency department at Fort Moore, GA. We measured creatinine (CR), creatine kinase (CK), alanine-transaminase (ALT), aspartate aminotransferase (AST), and estimated glomerular filtration rate (eGFR). Core temperature was also assessed by medical personnel. Biomarker data were obtained for 62 EHS cases (11 women). Men were significantly taller, and heavier, had larger BMI and body surface area (p<0.05 for all). Highest recorded body core temperature was not different between groups (women: 41.11°C (40.06,41.67); men: 41.11°C (40.28,41.72), p=0.57). Women had significantly lower peak CR (women: 1.39 (1.2,1.48) mgꞏdL-1; men: 1.75 (1.53,2.16) mgꞏdL-1, p<0.01) and peak CK (women: 584 (268,2412) UꞏL-1; men: 2183 (724,5856) U•L-1, p=0.02). Peak ALT and AST were not different between groups; during recovery time points, ALT and AST were either similar or lower in women. Women spent approximately half as much time in the hospital following admittance compared to men. Our findings suggest that women may be less susceptible to organ injury resulting from EHS. Further research is necessary to understand the pathophysiology underlying these differences and how biomarkers of end-organ damage severity can differ between women and men following EHS.

Left Atrial Volume versus Coronary Artery Calcium Score in Patients on Peritoneal Dialysis: An Observational Study

Background: The coronary artery calcium score and left atrial volume have been shown to predict the incidence of acute myocardial infarction and death from cardiovascular disease in patients undergoing peritoneal dialysis. However, the association between these factors has not been well-established. Methods: This cross-sectional, prospective, single-center study was conducted on patients undergoing outpatient peritoneal dialysis, who were followed up at a university hospital between March 2018 and August 2019. The coronary artery calcium score was calculated based on cardiovascular computed tomography findings. The score was “positive” when it was ≥100 Agatston and “negative” when it was <100 Agatston. The left atrial volume was obtained using the biplane disc method at the end of the left ventricular systole, and then it was indexed to the body surface. Results: Forty-four patients were evaluated. They had an age [mean (range)] of 56 (43–65) years and had been on dialysis therapy for 11.7 (6.8–25.4) months. Univariate analysis revealed a relationship between the coronary artery calcium score and left atrial volume index and the following variables: age, diabetes, overhydration, pulse wave velocity, E/A ratio, and left ventricular mass index. In multivariate logistic regression analysis, only the left atrial volume index was independently associated with a positive coronary artery calcium score. Conclusions: The left atrial volume index was associated with a positive coronary artery calcium score in patients on peritoneal dialysis, regardless of other factors. It may be a useful risk marker for coronary artery disease in this population.

Roflumilast Cream, 0.15%, for Atopic Dermatitis in Adults and Children

Safe, effective, and well-tolerated topical treatment options available for long-term use in patients with atopic dermatitis (AD) are limited and associated with low adherence rates. To evaluate efficacy and safety of once-daily roflumilast cream, 0.15%, vs vehicle cream in patients with AD. Two phase 3, randomized, double-blind, vehicle-controlled trials (Interventional Trial Evaluating Roflumilast Cream for the Treatment of Atopic Dermatitis 1 and 2 [INTEGUMENT-1 and INTEGUMENT-2]), included patients from sites in the US, Canada, and Poland. Participants were 6 years or older with mild to moderate AD based on Validated Global Assessment for Atopic Dermatitis (assessed on a 5-point scale ranging from 0 [clear] to 4 [severe]). Patients were randomized 2:1 to receive roflumilast cream, 0.15%, or vehicle cream once daily for 4 weeks. The primary efficacy end point was Validated Investigator Global Assessment for Atopic Dermatitis success at week 4, defined as a score of 0 or 1 plus at least a 2-grade improvement from baseline. Secondary end points included Eczema Area and Severity Index and Worst Itch Numeric Rating Scale. Safety and local tolerability were also evaluated. Among 1337 patients (654 patients in INTEGUMENT-1 and 683 patients in INTEGUMENT-2), the mean (SD) age was 27.7 (19.2) years, and 761 participants (56.9%) were female. The mean body surface area involved was 13.6% (SD = 11.6%; range, 3.0% to 88.0%). Significantly more patients treated with roflumilast than vehicle achieved the primary end point (INTEGUMENT-1: 32.0% vs 15.2%, respectively; P < .001; INTEGUMENT-2: 28.9% vs 12.0%, respectively; P < .001). At week 4, statistically significant differences favoring roflumilast also occurred for the achievement of at least 75% reduction in the Eczema Area and Severity Index (INTEGUMENT-1: 43.2% vs 22.0%, respectively; P < .001; INTEGUMENT-2: 42.0% vs 19.7%, respectively; P < .001). Roflumilast was well tolerated with low rates of treatment-emergent adverse events. At each time point, investigators noted no signs of irritation at the application site in 885 patients who were treated with roflumilast (≥95%), and 885 patients who were treated with roflumilast (90%) reported no or mild sensation at the application site. In 2 phase 3 trials enrolling adults and children, once-daily roflumilast cream, 0.15%, improved AD relative to vehicle cream, based on multiple efficacy end points, with favorable safety and tolerability. ClinicalTrials.gov Identifiers: NCT04773587, NCT04773600.

Improving electrocardiographic imaging solutions: A comprehensive study on regularization parameter selection in L-curve optimization in the Atria

BackgroundIn electrocardiographic imaging (ECGI), selecting an optimal regularization parameter (λ) is crucial for obtaining accurate inverse electrograms. The effects of signal and geometry uncertainties on the inverse problem regularization have not been thoroughly quantified, and there is no established methodology to identify when λ is sub-optimal due to these uncertainties. This study introduces a novel approach to λ selection using Tikhonov regularization and L-curve optimization, specifically addressing the impact of electrical noise in body surface potential map (BSPM) signals and geometrical inaccuracies in the cardiac mesh. MethodsNineteen atrial simulations (5 of regular rhythms and 14 of atrial fibrillation) ensuring variability in substrate complexity and activation patterns were used for computing the ECGI with added white Gaussian noise from 40 dB to -3dB. Cardiac mesh displacements (1–3 cm) were applied to simulate the uncertainty of atrial positioning and study its impact on the L-curve shape. The regularization parameter, the maximum curvature, and the most horizontal angle of the L-curve (β) were quantified. In addition, BSPM signals from real patients were used to validate our findings. ResultsThe maximum curvature of the L-curve was found to be inversely related to signal-to-noise ratio and atrial positioning errors. In contrast, the β angle is directly related to electrical noise and remains unaffected by geometrical errors. Our proposed adjustment of λ, based on the β angle, provides a more reliable ECGI solution than traditional corner-based methods. Our findings have been validated with simulations and real patient data, demonstrating practical applicability. ConclusionAdjusting λ based on the amount of noise in the data (or on the β angle) allows finding optimal ECGI solutions than a λ purely found at the corner of the L-curve. It was observed that the relevant information in ECGI activation maps is preserved even under the presence of uncertainties when the regularization parameter is correctly selected. The proposed criteria for regularization parameter selection have the potential to enhance the accuracy and reliability of ECGI solutions.

COMPARISON OF EFFICACY OF TAZAROTENE/BETAMETHASONE VERSUS CALCIPOTRIOL/BETAMETHASONE IN PATIENTS WITH MILD TO MODERATE PLAQUE PSORIASIS

Plaque psoriasis is a chronic inflammatory skin disorder that significantly impacts patients' quality of life. Combination therapies, such as Tazarotene/Betamethasone and Calcipotriol/Betamethasone, are widely used for its management. Evaluating the efficacy of these combination therapies is essential for optimizing treatment outcomes. Objective: To evaluate the efficacy of Tazarotene/Betamethasone compared to Calcipotriol/Betamethasone in patients with mild to moderate plaque psoriasis. Methods: Following ethical committee approval, this randomized comparative study was conducted in the Department of Dermatology, PIMS, Islamabad, from January 2024 to June 2024. One hundred seventy patients with mild to moderate plaque psoriasis were enrolled and randomly assigned to two groups. Group A received Tazarotene 0.045% cream combined with Betamethasone dipropionate 0.05% ointment, while Group B was treated with Calcipotriol 0.005% combined with Betamethasone dipropionate 0.05% ointment. Both therapies were applied once daily for 12 weeks. The treatment response was assessed by evaluating changes in the Psoriasis Area and Severity Index (PASI) scores and Body Surface Area (BSA) affected. Data were analyzed using SPSS Version 26, and comparisons between the groups were made using t-tests, with significance set at p &lt; 0.05. Results: The mean age of participants was 39.52±11.07 years. In Group A, 35.3% were male and 64.7% were female, while in Group B, 41.2% were male and 58.8% were female. Baseline PASI scores and BSA affected were comparable between the groups. After 12 weeks, Group A showed a more significant reduction in PASI scores (4.72±1.01 vs. 5.20±0.93, p=0.00) and BSA affected (3.49±0.86% vs. 4.21±0.86%, p=0.00) compared to Group B. Conclusion: Both combination therapies resulted in significant improvements in PASI scores and reductions in BSA affected. However, Tazarotene/Betamethasone was more effective than Calcipotriol/Betamethasone, likely due to the keratolytic properties of Tazarotene. These findings suggest that Tazarotene/Betamethasone may offer superior efficacy in managing mild to moderate plaque psoriasis.

Burns During Pregnancy: Is the outcome still Gloomy? A follow-up case series.

Despite the incidence of burns in pregnancy not being high, its occurrence leads to high morbidity and mortality for both mother and fetus.In 1997, we published a series of 27 cases of pregnant women who were managed and followed up for fetal and maternal outcomes at Ain Shams University's burn unit and Maternity Hospital during the period from October 1995 to September 1996. Now, two decades later, we report on seven cases of burns admitted to the Burn unit and the Maternity Hospital at Ain Shams University, during the period from January 2019 through June 2022. Pregnant patients admitted to the Burn unit and the Maternity Hospital at Ain Shams University during the period from January 2019 through June 2022 were included in this case series.Demographic data and obstetric history were documented for each patient as well as total body surface area burned, degree, cause and type of burn, maternal mortalities, fetal mortalities, obstetric interventions, and surgical interventions. The total burned surface area ranged from 12-40%; No maternal mortalities occurred in this series, three miscarriages, one preterm labor and three term pregnancies with four surviving neonates.

Neonatal reference values and nomograms of systemic vascular resistances estimated with electrical cardiometry.

Scanty data are available about neonatal systemic vascular resistances (SVR). We aim to provide reference values and nomograms for neonatal SVR. Multicenter, cross-sectional,descriptive study performed in France and Italy. Neonates with complete hemodynamic stability were enrolled. Non-invasive measurements of SVR by electrical cardiometry performed once, after the first 72 h and before the 7th day of postnatal age. We studied 1094 neonates: SVR was correlated with gestational age (ρ = -0.55, adj-r = -0.46, p < 0.001) and birth weight (ρ = -0.59, adj-r = -0.45, p < 0.001) irrespective of newborn sex. The relationships between SVR, gestational age and birth weight were represented by power equations and SVR was decreasing with increasing age and weight. Age- and weight-based SVR nomograms had optimal goodness-of-fit (non-linear R2 ≥0.74). Similar results were obtained for body surface indexed-SVR. In hemodynamically stable neonates, SVR decrease with increasing gestational age and birth weight. Specific gestational age and birth weight-based nomograms are provided for the clinical interpretation.

Mask R-CNN and Centroid Tracking Algorithm to Process UAV Based Thermal-RGB Video for Drylot Cattle Heat Stress Monitoring

This study developed and evaluated an algorithm for processing thermal-RGB video feeds captured by an unmanned aerial vehicle (UAV) to automate heat stress monitoring in cattle housed in the drylots. The body surface temperature (BST) of individual cows was used as an indicator of heat stress. UAV data were collected using RGB and thermal infrared imagers, respectively, at 2 and 6.67 cm per pixel spatial resolution in Spring 2023 (dataset-1) and Summer 2024 (dataset-2). Study sites were two commercial drylots in Washington State. The custom algorithms were developed to: (1) detect and localize individual cows using a Mask R-CNN-based instance segmentation model combined with centroid tracking; and (2) extract BST by averaging the thermal-imagery pixels for each of the segmented cows. The algorithm showed higher detection accuracy with RGB images as input (F1 score: 0.89) compared to thermal (F1 score: 0.64). BST extraction with combined RGB and thermal imaging approach required corrections for alignment problems associated with differences in optics, imaging field of view, resolution, and lens properties. Consequently, thermal imaging-only approach was adopted for assessing real-time cow localization and BST estimation. Operating at one frame per second, algorithm successfully detected 72.4% and 81.65% of total cows in video frames from dataset-1 (38 s) and -2 (48 s), respectively. The mean absolute difference between algorithm output and ground truth (BSTGT) was 2.1 °C (dataset-1) and 3.3 °C (dataset-2), demonstrating satisfactory performance. With further refinements, this approach could be a viable tool for real-time heat stress monitoring in large-scale drylot production systems.

Factors affecting intraperitoneal pressure (IPP) and its prognostic value in predicting leak risk and gastrointestinal symptoms in adult peritoneal dialysis patients: a systematic review and meta-analysis.

Intraperitoneal pressure measurementoffers therapeutic and prognostic benefits in predicting leak risks and gastrointestinal symptoms in Peritoneal Dialysis (PD) patients. This systematic review aims to evaluate the prognostic utility of intraperitoneal pressure measurements and different estimated intraperitoneal pressure equations in predicting the risk of non-infectious complications in PD patients. Databases including MEDLINE, EMBASE and Cochrane were searched up to July 2023. Randomised and non-randomised trials were included, focusing on End-Stage Kidney Disease (ESKD) patients undergoing PD. Primary outcomes were variables associated with intraperitoneal pressure, while secondary outcomes included PD-related non-infectious complications and gastrointestinal symptoms. Data synthesis combined meta-analysis with narrative synthesis.This review has been registered on PROSPERO (CRD42023475138). Out of 1828 identified studies, 12 were included for systematic review and 10 for meta-analysis. Body Mass Index (BMI) and Body Surface Area (BSA) showed a consistent positive correlation with intraperitoneal pressure (BMI: r = 0.49, 95% CI 0.35-0.61, I2 = 67.39%, p = 0.003; BSA: r = 0.2, 95% CI 0.08-0.31, I2 = 14.10%, p = 0.324). Conversely, the association between intraperitoneal pressure and age, intraperitoneal volume, and Charlson Comorbidity Index were less consistent. Subgroup analysis demonstrated an association between higher intraperitoneal pressure in patients with increased BMI and BSA. However, the relationship between intraperitoneal pressure and non-infectious mechanical complications remained inconclusive. This review underscores a significant association between intraperitoneal pressure and anthropometric measures (BMI and BSA). The majority of the studies identified included a small sample and considerable bias. However, the association between intraperitoneal pressure and clinically relevant outcomes was not clear. While increasing body mass index and body surface areas are associated with increasing intraperitoneal pressure, the clinical relevance of measuring intraperitoneal pressure in an adult population remains unclear, particularly given the absence of an association with clinically relevant non-infectious outcomes.

Impact of Disease Burden of Patients with Psoriasis on Biologic Therapy Switching: Real-World Evidence from the CorEvitas Psoriasis Registry.

Due to variable psoriasis symptoms, disease progression, and individual responses to therapy, patients may start, stop, or switch biologic therapies. Real-world data on the associated disease burden of patients with psoriasis who do and do not switch biologics are incomplete. This study compared disease burden among patients from the CorEvitas Psoriasis Registry (July 2017-December 2021) who switched biologics and those who did not within 4-12months following initiation. Disease-related patient-reported outcomes (PROs) were recorded, including skin pain, itching, activity impairment, and effects on health-related quality of life (HRQoL). Disease severity was measured by body surface area (BSA) and Psoriasis Area and Severity Index (PASI). Unadjusted and adjusted regression models were used to compare study outcome measures between the two groups. This study included 2145 patients, with 159 classified as switchers and 1986 as non-switchers. The most common reason for switching therapy was failure to maintain initial response (51.7%; n = 78). Moderate-to-severe disease (BSA ≥ 3) was found among 83.0% (n = 132) of switchers versus 26.1% (n = 516) of non-switchers. PASI > 5 was reported among 49.7% (n = 79) of switchers versus 8.6% (n = 171) of non-switchers. Differences in skin pain, itching, and effects on HRQoL between switchers and non-switchers were larger in magnitude for bio-experienced patients. Patients who switched biologic therapy experienced a greater disease burden of psoriasis across PROs than non-switchers. Patient-centered factors may be important drivers of biologic switching. Our findings suggest the association between switching and disease burden may be stronger among patients with prior biologic therapy experience.

Development of a 3D-printed phantom for total skin electron therapy dose assessment.

Total skin electron therapy (TSET) is a complex radiotherapy technique, posing challenges in commissioning and quality assurance (QA), especially due to significant variability in patient body shapes. Previous studies have correlated dose with factors such as obesity index, height, and gender. However, current treatment planning systems cannot simulate TSET plans, necessitating heavy reliance on QA methods using standardized anthropomorphic phantoms and in-vivo dosimetry. Given the relatively few studies on rotational techniques, comprehensive data in commissioning could streamline the process. Developing a full-body phantom would enable a more thorough TSET commissioning process, including testing for position-specific dose distributions and comprehensive measurements across all body surfaces, unlike the typical torso-only phantoms. This was created using digital modeling software, fabricated using 3D-printing FDM technology, and filled with tissue-equivalent gelatine. The phantom was positioned at an SSD of 340cm and irradiated with a standard rotational TSET plan using the 6E HDTSE mode on a Varian TrueBeam linac at gantry angles of±18° from the horizontal. The dose was measured at over 50 points across the surface using Gafchromic EBT3 film. Dose distributions were generally consistent with existing literature values from in-vivo dosimetry, with several position-specific differences identified, including the hands and scalp compared to conventional positions. Hotspots were observed for the mid-dorsum of the foot and nose, with areas under 80% of the dose identified as the soles of the feet, perineum, vertex of the scalp, top of the shoulder, and palm of the hand. Additionally, analysis using an interpolated dose heatmap found that 90% of the pixel area received a dose within 10% of the prescribed dose, indicating good uniformity with the commissioned technique. With high agreement with the current literature, a 3D-printed phantom proves effective for measuring doses in areas typically unmeasurable in TSET commissioning.

Exercise and Heat Stress in Well-Healed Burn Survivors: Effects of Cooling Modalities on Thermal and Perceptual Responses.

Burn injuries that require grafting impair thermoregulation, which may dissuade individuals with such injuries from being physically active. We tested the hypothesis that cooling modalities attenuate core temperature elevations and perceptions of heat stress during physical activity in the heat among adults with well-healed burn injuries. Adults with no burn injuries (non-burned), 20-40% body surface area burn injuries (moderate burn), and > 40% body surface area burn injuries (large burn) performed 1 hour of moderate intensity exercise (2.5 ± 0.2 mph and 2% grade) on four different occasions in two environmental conditions (30 °C & 39 °C, 40% relative humidity). Within each environmental condition, we applied one of the following cooling modalities, random assigned, for each visit: no cooling (control), fan at 4 m/s (fan), water spray every 5 min (water spray; scaled to burn area size), or a combination of water spray + fan. In 30 °C, perceptual strain index (PeSI) was reduced in the non-burned and moderate burn groups with water spray + fan, whereas PeSI was reduced with all cooling modalities in the large burn group. The cooling modalities did not affect core temperature responses. In the 39 °C environment, water spray and water spray + fan attenuated the elevation in core temperature (p ≤ 0.007) only in the large burn group. In the moderate burn group, PeSI was decreased with water spray + fan (p = 0.017). In the large burn group, both water spray alone and water spray + fan (p ≤ 0.041) lowered PeSI. For both environments across burn groups, the applied cooling modalities were generally more effective at reducing indices of perceptual strain relative to indices of thermal strain (e.g., core temperature).

Highly efficient multi-layer flexible heatsink for wearable thermoelectric cooling

Flexible thermoelectric cooler (fTEC), which interfaces well with curved human body surface and provides cooling functions, is an emerging candidate for personal thermal management and non-hospitalized medical treatment. Achieving efficient and long-term cooling performance of TEC requires high thermal conductivity and heat diffusion of the hot side, which has yet to achieve. In this study, we design and fabricate a highly thermally conductive and flexible heatsink with a multi-layered structure especially for wearable TEC wristband, which obtains a large temperature drop (8.8 °C) for imitated on-body test and the maxim 13.1 °C temperature decrease in air. Here, we demonstrate that a well-designed functional composite layer, including phase change material, thermally conductive fillers and metal foam, can establish an effective equilibration among cooling performance, thermal management capacity and mechanical property. Particularly, the heatsink with highly thermal conductive skeleton (k ∼ 2.7 W/mK) and effective heat dissipating fins can significantly improve heat conduction and dissipation, which improve the cooling performance by more than 55 %. With the help of theoretical simulation, we propose a promising strategy for heat management on thermoelectric device through a flexible multi-layered structure, paving the way for achieving practical applications of wearable thermoelectric coolers for personal thermal regulation or cooling therapy.

Geometric target margin strategy of proton craniospinal irradiation for pediatric medulloblastoma.

In proton craniospinal irradiation (CSI) for skeletally immature pediatric patients, a treatment plan should be developed to ensure that the dose is uniformly delivered to all vertebrae, considering the effects on bone growth balance. The technical (t) clinical target volume (CTV) is conventionally set by manually expanding the CTV from the entire intracranial space and thecal sac, based on the physician's experience. However, there are differences in contouring methods among physicians. Therefore, we aimed to propose a new geometric target margin strategy. Nine pediatric patients with medulloblastoma who underwent proton CSI were enrolled. We measured the following water equivalent lengths for each vertebra in each patient: body surface to the dorsal spinal canal, vertebral limbus, ventral spinal canal and spinous processes. A simulated tCTV (stCTV) was created by assigning geometric margins to the spinal canal using the measurement results such that the vertebral limb and dose distribution coincided with a margin assigned to account for the uncertainty of the proton beam range. The stCTV with a growth factor (correlation between body surface area and age) and tCTV were compared and evaluated. The median values of each index for cervical, thoracic and lumber spine were: the Hausdorff distance, 9.14, 9.84 and 9.77mm; mean distance-to-agreement, 3.26, 2.65 and 2.64mm; Dice coefficient, 0.84, 0.81 and 0.82 and Jaccard coefficient, 0.50, 0.60 and 0.62, respectively. The geometric target margin setting method used in this study was useful for creating an stCTV to ensure consistent and uniform planning.

A Resonant Lyapunov Centre Theorem with an Application to Doubly Periodic Travelling Hydroelastic Waves

We present a Lyapunov centre theorem for an antisymplectically reversible Hamiltonian system exhibiting a nondegenerate 1 : 1 or 1:-1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$1:-1$$\\end{document} semisimple resonance as a detuning parameter is varied. The system can be finite- or infinite-dimensional (and quasilinear) and have a non-constant symplectic structure. We allow the origin to be a ‘trivial’ eigenvalue arising from a translational symmetry or, in an infinite-dimensional setting, to lie in the continuous spectrum of the linearised Hamiltonian vector field provided a compatibility condition on its range is satisfied. As an application, we show how Kirchgässner’s spatial dynamics approach can be used to construct doubly periodic travelling waves on the surface of a three-dimensional body of water (of finite or infinite depth) beneath a thin ice sheet (‘hydroelastic waves’). The hydrodynamic problem is formulated as a reversible Hamiltonian system in which an arbitrary horizontal spatial direction is the time-like variable, and the infinite-dimensional phase space consists of wave profiles which are periodic (with fixed period) in a second, different horizontal direction. Applying our Lyapunov centre theorem at a point in parameter space associated with a 1 : 1 or 1:-1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$1:-1$$\\end{document} semisimple resonance yields a periodic solution of the spatial Hamiltonian system corresponding to a doubly periodic hydroelastic wave.

Pericardiocentesis: History, Current Practice, and Future Directions.

To discuss the evolution in the approach to pericardial effusions and drainage from a historical perspective, the present state, and pathways for future innovative therapies. Incorporation of advanced imaging tools has dramatically improved the safety profile of pericardial interventions. Outcome data allow for refined approaches to management of pericardial disease in special populations, such as pulmonary arterial hypertension. Consideration of intrapericardial interventions and pharmacotherapy represent novel and promising approaches to management of pericardial effusions moving forward. Although the impact of excess or rapidly accumulating pericardial fluid on hemodynamics has been recognized for centuries, the therapeutic approaches have only recently become more refined with the routine incorporation of such tools as echocardiography and fluoroscopy. The most utilized approaches for pericardiocentesis include the apical, subxiphoid, and parasternal, and the most favorable approach is that in which the pericardial fluid is closest to the body surface, where intervening vital structures are least likely to be damaged. With the notable exception of patients with pre-existing pulmonary hypertension, complete decompression of pericardial fluid with careful drain management reduces likelihood of pericardial effusion recurrence. In addition, percutaneous balloon pericardiotomies have been demonstrated to reduce recurrence in nonmalignant effusions.

67 Precision identification and weight assessment of cattle using supervised machine learning on body surface keypoints

Abstract Computer vision systems (CVS) offer identification solutions for animals with distinct coat patterns, but are less effective for solid-colored herds. In addition, they can be used to measure critical phenotypes, such as body weight (BW). Providing both BW and identification for solid-colored animals can help farmers make decisions. This study aimed to 1) develop an automatic CVS capable of identifying using the Euclidean distance between keypoints located at specific anatomical landmarks (e.g., bony prominences), and 2) predict the BW using features extracted from these keypoints. The keypoint model was trained to identify seven keypoints per cow, located at the left and right hips, left and right pin bones, tail head, sacral, and cervical vertebrae. These locations remain constant as body condition score of a cow changes. The Euclidean distance between these keypoints was used to generate biometric features for each cow. The keypoint detection model was trained using 3,928 images over 900 epochs with a batch size of 14 and validated using 391 images. This trained model was used to predict keypoints on a different set of 41 cows over 5 d, resulting in a total of 6,944 images which correspond to the dataset for cow identification. The Random Forest (RF) algorithm for cow identification was trained with the first 4 d (5,376 images), and the last day served as the test set (1,568 images). For the cow identification, a RF algorithm was employed on the Euclidean distance of the keypoints. The hyperparameters were determined through a grid search on the training set, utilizing 5-fold cross-validation. The hyperparameters ‘mtry’ (which ranged from 1 to 10) and ‘ntree’ (which ranged from 250 to 500, in increments of 50) were optimized. For the second objective, due to the completely new environment, the keypoint model was fine-tuned using transfer learning for 240 epochs with a batch size of 14, utilizing 310 images. The model predicted keypoints in 1,593 images from different beef-on-dairy animals. This dataset was used to train the BW prediction model. The Euclidean distances from the predicted images and sex were used as features. A RF model was trained using a leave-one-animal-out cross-validation approach. The hyperparameters were determined through a grid search on the training set, using 10-fold cross-validation. The ‘mtry’ parameter ranged from 2 to 16, in increments of 2. For animal identification, the model achieved an accuracy, precision, recall, and F1-score of 92.7%, 89.0%, 90.2%, and 92.7%, respectively. To predict BW, the RF model achieved an R² of 0.86 and a root mean squared prediction error of 36.9 kg, representing 6.7% of the observed values average. These results suggest that keypoints located on the dorsal body surface can identify and weigh individual animals, even those lacking distinct coat color patterns.

Zero-shot image segmentation for monitoring thermal conditions of individual cage-free laying hens

Body temperature is a critical indicator of the health and productivity of egg-laying chickens and other domesticated animals. Recent advancements in thermography allow for precise surface temperature measurement without physical contact with animals, reducing animal stress from human handling. Gold standard temperature analysis via thermography requires manual selection of limited points for an object of interest, which could be time-consuming and inadequate for representing the comprehensive thermal profile of a chicken’s body. The objective of this study was to leverage and optimize a zero-shot artificial intelligence technology for the automatic segmentation of individual cage-free laying hens within thermal images, providing insights into their overall thermal conditions. A zero-shot image segmentation model (Segment Anything, “SAM”) was modified by replacing manual selections of target points with automatic selection of the initial point using pre-processing techniques (e.g., thresholding) in each thermal image. The model was also incorporated with post-processing techniques integrated with a machine learning classifier to improve segmentation accuracy. Three versions of modified SAM models (i.e., SAM, FastSAM, and MobileSAM), two common instance segmentation algorithms (i.e., YOLOv8 and Mask R-CNN), and two foundation segmentation models (i.e., U2-Net and ISNet) were comparatively evaluated to determine the optimal one for bird segmentation from thermal images. A total of 1,917 thermal images were collected from cage-free laying hens (Hy-Line W-36) at 77–80 weeks of age. The image dataset exhibited considerable variations such as feathers, bird movement, body gestures, and the specific conditions of cage-free facilities. The experimental results demonstrate that the modified SAM did not only surpass the six zero-shot models—YOLOv8, Mask R-CNN, FastSAM, MobileSAM, U2Net, and ISNet—but also outperformed other modified SAM-based models (Modified FastSAM and Modified MobileSAM) in terms of hen detection performance, achieving a success rate of 84.4 %, and in segmentation performance, with an intersection over union of 85.5 %, recall of 91.0 %, and an F1 score of 92.3 %. The optimal model, modified SAM, was pipelined to extract statistics including the averages (°C) of mean (27.03, 27.04, 28.53, 26.68), median (26.27, 26.84, 28.28, 26.78), 25th percentile (25.33, 25.61, 27.26, 25.53), and 75th percentile (28.04, 27.95, 29.22, 27.55) of surface body temperature of individual laying hens in thermal images for each week. More statistics of hen body surface temperature can be extracted based on the segmentation results. The developed pipeline is a useful tool for automatically evaluating the thermal conditions of individual birds.

143 Short- and long-term effects of heat stress in cow-calf pairs adapted to tropical and subtropical regions

Abstract Chronic exposure to high temperatures and humidity can limit beef cattle performance in tropical/subtropical environments, regardless of breed. Despite better heat adaptability compared with Bos taurus cattle, heat-stressed Bos indicus cattle also experience an increase in body temperature above the physiological limit. As body temperature increases, cascades of behavioral and physiological events are triggered to lessen heat load but often at the expense of productive outcomes. Contrary to other species and feedlot beef cattle, the effects of heat stress on physiology and performance of grazing cow-calf pairs have not been evaluated in detail, particularly for Bos indicus cattle. Preliminary data showed opposite outcomes to heat stress in Bos indicus vs. Bos taurus cattle, limiting the implications of the existing data generated from studies using beef and dairy Bos taurus cattle. This presentation will share some nutritional and management practices to mitigate heat stress in grazing beef cattle. Practices mentioned herein include altering the timing of body weight (BW) growth pattern (stair-step, SST) and immunomodulatory feed ingredient (IFI) supplementation for replacement beef heifers, and maternal access to shade to reduce heat load. For 100 d before the breeding season, Bos indicus-influenced beef heifers grazing warm-season grasses received a constant supplementation amount or SST strategy (50 d of low then 50 d of high supplementation), with or without IFI. Under severe heat stress conditions, IFI supplementation reduced heifer vaginal temperature but did not increase their growth and reproduction, whereas the SST strategy lowered internal body temperature, enhanced growth performance and pregnancy success compared with a conventional constant supplementation practice. Our group is also focused on the critical need to determine the specific effects of heat stress mitigation during pre- and postnatal phases on physiology and performance of Bos indicus-influenced cow-calf pairs. Study 1 evaluated the impacts of maternal access to artificial shade from 83 d prepartum until 50 d postpartum on body thermoregulation, performance, and physiology of beef heifers and their first offspring. Removing maternal access to shade led to greater maternal respiration rate, vaginal and body surface temperatures and reduced maternal body condition score and calf BW at birth. Nonetheless, offspring born from cows with no access to shade were remarkably heavier during a 60-d post-weaning period and had decreased plasma indicators of inflammation and positive effects to humoral immune response. Study 2 is a multi-year, USDA/NIFA-funded study designed to capitalize on the ability of cattle to reprogram physiological/immunological systems following exposure to stress during gestation. Study 2 combined gestational and postnatal heat abatement to enhance the overall growth/immune/reproductive performance of grazing Bos indicus-influenced cow-calf pairs. Partial data on long-term growth and reproductive performance, physiology, metabolome, and microbiome of both cows and their female offspring will be shared in this presentation.