Differences In Skin Temperature Research Articles

A prospective study comparing the FLIR ONE with laser Doppler imaging in the assessment of burn depth by a tertiary burns unit in the United Kingdom.

Introduction:Laser Doppler imaging (LDI) is the ‘gold standard’ tool for the assessment of burn depth. However, it is costly. The FLIR ONE is a novel, mobile-attached, thermal imaging camera used to assess burn wound temperature. This study compares the FLIR ONE and LDI in assessing burn depth and predicting healing times.Methods:Forty-five adult patients with burn wounds, presenting at 1–5 days, were imaged with the FLIR ONE and LDI. Infected, chemical and electrical burns were excluded. Healing potential was determined by comparing wound and normal skin temperature for the FLIR ONE and blood flow changes with the LDI. Healing potential was categorised into wounds healing in less than and over 21 days. Pearson’s test was used to determine the correlation between changes in wound temperature and healing potential.Results:Percent total body surface area (%TBSA) was in the range of 0.5–45. FLIR demonstrated a sensitivity of 66.67% and specificity of 76.67% in predicting healing within 21 days, while LDI demonstrated a sensitivity of 93.33% and specificity of 40%. The FLIR ONE showed a significant difference in the mean temperature changes between burns that healed in less than (0.1933 ± 0.3554) and over 21 days (–1 ± 0.4329) (P = 0.04904). Pearson’s test showed a significant correlation between the difference in wound and normal skin temperature with healing times (P = 0.04517).Conclusion:The inexpensive FLIR ONE shows a significant correlation between changes in wound temperature and healing times. It is useful in predicting healing within 21 days. However, evaporative cooling at the wound surface can lead to overprediction of healing times and overtreatment.Lay Summary Background Laser Doppler imaging is currently the main tool for burn depth assessment. It works by analysing the blood flow in a burn wound. Based on these findings, it can predict the depth of the burn injury and predict if it will heal in less than or over 21 days. The main problem is that it is costly. The FLIR ONE is a novel, mobile-attached, thermal imaging camera. It can be used to assess burn depth by comparing the temperature of the burn wound to the surrounding normal skin. This information can then be used to predict healing times into less than and over 21 days. The issue being explored The usefulness of the FLIR ONE in assessing burn depth and predicting healing time when compared to the LDI. How was the work conducted? Forty-five adult patients who sustained a burn injury within the last five days were imaged with both the FLIR ONE and LDI. Those with infected, electrical or chemical burns were excluded. Healing potential was determined by comparing the temperature of the burn wound with normal skin for the FLIR ONE and by changes in wound blood flow with the LDI. Healing potential was categorised into wounds healing in less than and over 21 days. The correlation between the temperature changes of the burn wound and healing time was evaluated for the FLIR ONE. What we learned from the study This study was able to demonstrate that the FLIR ONE showed a significant correlation between the temperature difference between the burn wound and normal skin with healing times. When compared with the LDI, the FLIR ONE was useful in predicting if a burn wound will heal in less than 21 days. The FLIR ONE has advantages over the LDI, it is low cost, portable and produces instantaneous images. Ultimately, this developing technology may increase access to higher standard burn care in centres where LDI is not affordable.

An in vivo and in silico analysis of novel variation in TMBIM6 gene affecting cardiopulmonary traits of Indian goats.

Transmembrane Bax Inhibitor Motif-containing 6 (TMBIM6) gene acts as calcium leak channel and negatively regulates autophagy and autophagosome formation. The TMBIM6 gene was amplified and searched for variation in three different goat populations (i.e. Black Bengal, Ganjam and Raighar) of Odisha state of the India. The result indicated two substitutions i.e. 55th position (C55T) and 95th position (C95A) in the amplified region of the gene resulting in change of amino acids (Leu>Phe and Thr>Asn). The identified SNPs were combined to form haplotypes and animals were grouped accordingly. Structural analysis showed minor changes (5%) in between mutant and wild TMBIM6 protein structures. However, any functional variation could not be identified with respect to the calcium ligand and open pore state. But an alteration of calcium binding site was found. The binding interaction of calcium with the TMBIM6 protein was hydrophobic in nature in closed state whereas hydrophilic in open pore stage. The stress releasing function was the result of calcium leakage controlled by amino acids coded by exon 4 and exon 5 regions of TMBIM6 gene. The effect of breed and haplotype on cardiopulmonary traits was studied. The data on cardiopulmonary traits of body i.e. rectal temperature, skin temperature, heart rate and respiration rate were recorded when ambient temperature usually remained the highest. The statistical analysis showed, significant difference in rectal temperature, skin temperature and respiration rate among these goat populations. The haplotypes (CC and TA) were found to have a significant (P<0.05) effect on rectal temperature, skin temperature and respiration rate. However, any such significant effect could not be identified in recorded heart rate. The objective of the present study to identify the genetic variations in TMBIM6 gene having significant effect on cardiopulmonary traits which can be further uses as the molecular markers to improve heat tolerance mechanism in goats.

Contribution of thermal imaging in determining the depth of pediatric acute burns.

Early burn wound assessment is a major problem in pediatrics. It involves regular clinical evaluations, and may be helped by objective tools, such as thermal imagers. Because of the skin temperature difference between partial and full thickness burns, due to injured vascular perfusion of the dermis in the latter, it could precisely identify areas with superficial burns which could heal from controlled wound healing, and those with deep burns which would need skin graft, at an early stage. The objective of this study was to assess the validity of the Flir one thermal imager® for this purpose. Thermal images were obtained by a single observer three times after burn: day 1-3 (T1); day 4-7 (T2); day 8-10 (T3). ΔT (temperature difference between burned area and healthy skin) was calculated on a tablet with Flir One application. Validity was assessed by comparing ΔT obtained at each time between two groups at day 15 depending on the healing time of the burn wounds : before or after day 15. Primary outcome was the AUC (area under curve) of the ROC (Receiver operating characteristic) curve for ΔT at T1, T2 and T3, representing the ability of the Flir One Thermal Imager® to discriminate between a healing time <15 days and >15 days. 40 patients were included (13 months to 13 years old). AUC at T1 and T2 are 0.700 (95% CI: 0.649; 0.925) and 0.787 (95% CI: 0.523; 0.877), respectively. AUC at T3 is 0.968 (95% CI: 0.918; 1.00). A ΔT threshold of -1.2°C at T3 is associated with a specificity of 100% allowing to diagnose as of day 8 all the patients having deep burns which heal after 15 days. The Flir One Thermal Imager® is an inexpensive, non-invasive, and easy-to-use device. It measures indirectly but with an excellent specificity the dermis perfusion reflecting the burns depth in children. However its low sensitivity calls for additional research to allow skin grafts earlier in common practice and decrease the length of stay.

Evaluation of infrared technology to detect category I and suspected deep tissue injury in hospitalised patients.

To evaluate the use of an infrared thermography device in assessing skin temperature among category I pressure ulcer (PU) and/or suspected deep tissue injuries (SDTI) with intact skin. An observational cross-sectional study design was used. Adult inpatients (cases) who had a category I PU or suspected deep tissue injury (skin intact) on the sacral or heel during the study period (March to April 2018) were recruited. Patients without a PU were also recruited to act as control. Thermal images of the patient's PU site and non-PU site were taken within 24 hours of PU occurrence. Thermal images of the control patients (no PU) were also taken. Each PU case was matched to three control patients in terms of age, gender, race and anatomical sites. All thermal images were taken using a portable CAT S60 Thermal Imaging Rugged Smartphone (Caterpillar Inc., US) that provided readings of the skin temperature in degrees Celsius. A total of 17 cases and 51 controls were recruited. Among the cases, the mean difference in skin temperature between the PU site (mean: 31.14°C; standard deviation [SD]: 1.54) and control site within the cases (mean: 28.93°C; SD: 3.47) was significant (difference: 2.21±3.66°C; p=0·024). When comparing between all cases and controls, the mean temperature difference was non-significant. When comparing between the category I PU and suspected deep pressure injury cases, the mean difference was also non-significant. Using infrared thermography technology at the bedside to measure skin temperature will support the clinical diagnosis of patients with skin types I to III. However, there is a need for a more accurate and objective measurement to identify and diagnose early category I PU or suspected deep tissue injury in adult patients with darker skin types 4 and above, enabling early initiation of preventive measures in the hospital acute care setting.

Sacral Skin Temperature and Pressure Ulcer Development: A Descriptive Study

The purpose of this prospective, descriptive study was to examine the relationship between sacral skin temperature and PU development. Using convenience sampling methods, patients who were hospitalized in the tertiary intensive care unit (ICU) of the internal medicine department of a university hospital in İzmir, Turkey, between April and December 2015 were eligible to participate if they were ⟩18 years of age, had an expected hospital stay of at least 5 days, a Braden score ≤12, and were admitted without a PU. Demographic and clinical data collected included age, gender, body mass index, diagnosis, mattress type, length of follow-up (days), systolic and diastolic blood pressure, body temperature, hemoglobin level, sacral skin temperatures in the supine and lateral positions, room temperature, PU stage and duration, and Braden score. Temperature was measured the day of hospitalization as a baseline measurement (day 1) and once every day thereafter up to 22 days, until the patient did or did not develop a PU, died, was no longer undergoing position change, or was discharged. Sacral skin temperature was taken immediately after the patient was moved to a lateral position following 120 minutes of supine position (referred to as supine position sacral skin temperature measurement) and after 30 minutes in lateral position (referred to as lateral position sacral skin temperature measurement). Data were collected using paper-and-pencil questionnaires and entered into a software program for analysis. Descriptive statistics, Student's t test, one-way analysis of variance test, Pearson product-moment correlation analysis, and Spearman's rank-order correlation analysis were used for data analysis. Of the 37 patients who met the inclusion criteria and were monitored for at least 5 days, 21 (56.8%) developed PUs. No statistically significant difference in supine position sacral skin temperature on day 1 or day 5 was found between patients who did and did not develop a PU (36.90° C ± 0.29° C and 37.15° C ± 0.53° C, respectively, on day 1; t = -1.656, P = .112; and 37.37° C ± 0.53° C and 37.30° C ± 0.79° C, respectively, on day 5; t = 0.259, P = .798). Day 5 lateral position skin temperatures also did not differ significantly between the 2 groups (37.44° C ± 0.44° C and 37.31° C ± 0.75° C, respectively; t = 1.306, P = .621). A statistically significant difference was noted between mean sacral skin temperature in the supine position among patients ages 75 to 90 years compared with patients 38 to 64 years and 65 to 74 years (36.93° C ± 0.39° C; F = 13.221, P = .000) and with use of a viscoelastic mattress compared with an alternating pressure air mattress and continuous lateral rotation alternating pressure air mattress (37.85° C ± 0.54° C; F = 14.039, P = .000). No statistically significant differences in sacral skin temperatures were found for any of the of the other variables assessed. Sacral skin temperatures were not statistically different between ICU patients who did and did not develop a PU. Additional research may help increase understanding of the relationship between skin temperature and PU development.

Effect of carotid artery stenosis on neck skin tissue heat transfer

The buildup of plaque in the carotid artery leads to the narrowing of the arterial lumen, known as stenosis. Arterial stenosis affects the supply of blood to the brain and may result in stroke if the plaque is dislodged. This study aims to evaluate stenosis influenced hemodynamics of the carotid artery and its effect on the bio-heat transfer to the external neck skin surface. Systolic and Diastolic carotid artery flow inlet conditions, using a finite volume numerical scheme, are simulated with the inclusion of varied stenosis degree in the carotid model (25%–90%). A 3-dimensional (3D) conjugate heat transfer study is performed on an idealized carotid artery geometry, encapsulated in a tissue model resembling the human neck. With no significant difference in the average external neck skin temperature, variation in the temperature contours is observed between stenosed and non-stenosed cases. With the increase in the carotid artery stenosis, a quantitative change, the presence of a colder region called ‘cold feature’, in external neck skin temperature features is reported. This numerical study will prove to be a strong basis for future patient-specific evaluations.

A Comparison of the Effects of Lung Protective Ventilation and Conventional Ventilation on Thermoregulation During Anaesthesia.

During prolonged surgery, hypothermia is an unwanted condition that frequently develops and increases complication rates. It has been shown that positive end-expiratory pressure (PEEP) during mechanical ventilation reduces hypothermia development by providing earlier peripheral vasoconstriction. In the present study, an investigation was made of the effect of two different ventilation models on perioperative hypothermia development. A total of 40 patients undergoing elective lumbar disc surgery were randomised to either the conventional group (Group C, n=20, tidal volume=10 mL kg-1, PEEP=0 cm H2O) or the lung protective ventilation group (Group P, n=20, tidal volume=6 mL kg-1, PEEP=5 cm H2O). Demographic data on gender, age, weight, height, preoperative-postoperative temperatures and haemodynamic values were recorded. The point where the forearm to fingertip skin temperature difference reached 0°C was determined as the peripheral vasoconstriction development. At this point, the core temperature was recorded as the thermoregulatory vasoconstriction threshold. Demographic characteristics of the patients and haemodynamic variables were similar between the groups. Preoperative and postoperative temperature gradients were not significantly different between the two groups (p=0.827). There was also no significant difference between the two groups in respect of the vasoconstriction threshold of the patients (p=0.432). The study results showed that lung protective ventilation has no advantage in preserving the perioperative core temperature compared to conventional ventilation.

Thermographic evaluation of occlusal splint and low level laser therapy in myofascial pain syndrome

ObjectiveThe purpose of this study was to compare and evaluate the effects of occlusal splint and low dose laser treatments clinically and thermographically in patients with myofascial pain syndrome. MethodsTwenty patients aged 18–45 with myofascial pain syndrome were involved into this study. Patients were examined by clinically and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used for the diagnosis of TMD. Patients divided into two groups. First group treated with stabilisation splint, while the other one with low level laser therapy (LLLT). Pre- and post-treatment pain intensity, muscle sensitivity and the superficial skin temperature differences over the masseter and anterior temporal muscle were assessed, and comparison was made within and between the groups pre- and post-operatively. ResultsIn both groups, there was a significant decrease in temperature values, especially in the masseter region (p < 0.05) and post-treatment pain intensity and muscle sensitivity values were lower than the pre-treatment values (p < 0.05). In addition, the heat values in certain regions of the masseter were lower in the LLLT group than in the splint group and there was a statistical difference in these regions between two groups (p < 0.05). However, there was no statistical difference in the pain intensity and muscle sensitivity between both groups (p > 0.05). ConclusionIt was concluded that both occlusal splint therapy and low level laser therapy were effective in the treatment of MPS, and when thermographic data were taken into account, LLLT treatments could provide more advantageous results in these patients.

Effect of three-layer close suture and Allgöwer-Donati suture on incision healing after calcaneal fracture surgery

Objective To compare the efficacy between three-layer suture and Allgower-Donati suture on wound healing. Methods From September 2016 to June 2018, patients with Sanders type III calcaneal fracture were randomly divided into two groups: three-layer close suture group (26 cases, 18 males and 8 females, aged 19-48 years, with an average age of 33.69±8.84 years) and Allgower-Donati group (26 cases, 19 males and 7 females, aged 19-49 years, with an average age of 32.38±8.45 years). The traditional L-shaped incision was used in all patients. The inflammatory reaction area of incision, skin temperature change at the corner of L-shaped incision line and the healing grade of incision were compared between the two groups. Results 52 pa-tients were followed up for 6 months. At 2 weeks after operation, the inflammatory reaction area of incision skin in the three-layer close skin suture group (26.46±9.37 mm2) was smaller than that in Allgower-Donati suture group (33.16±9.33 mm2). There was a significant difference between the two groups (t=2.584, P=0.013). There was no difference in skin temperature at the corner of L-shaped incision between the two groups before and on the first day after operation. However, the incision skin temperature of the three-layer close suture group on the 2nd and 3rd day after operation[ (36.47±0.33) ℃ and (36.54±0.22) ℃]was higher than that of Allgower-Donati group[ (36.20±0.42) ℃ and (36.22±0.43) ℃]. The difference was statistically significant (t=2.61, P=0.01; t= 3.48, P=0.001). There were 25 cases of Class A healing and 1 case of Class B healing in three-layer close suture group, with Class A healing rate of 96.15% (25/26). In Allgower-Donati group, there were 22 cases of Class A healing, 1 case of Class B healing, and 3 cases of Class C healing, with Class A healing rate of 84.62% (22/26). Among all grade B healing incisions, 1 case had a small amount of local hemorrhagic exudation in the three-layer close suture group, while 1 case had a black necrosis at the edge of the in-cision, 3 cases had a purulent incision and exposed steel plate in the Allgower-Donati group. Conclusion In the treatment of L-shaped incision of calcaneal fracture, three-layer close suture is a better method than Allgower-Donati suture because of smaller in-flammatory reaction area of incision, higher skin temperature change at the corner of L-shaped incision on the 2nd and 3rd day af-ter operation, higher rate of first-degree healing of incision and slighter incision complications. Key words: Calcaneus; Fractures, bone; Wound closure techniques; Wound healing

Establishment of Research Model on the Correlation Between Psychological Stress Intensity and Personality in Nursing Students Under Different Pressure Sources

Introduction:In recent years, sudden disasters are occurring frequently, resulting in inestimable casualties and losses. Hence, knowing what personality traits are suitable for stressful works is of vital importance for selecting applicable nurses for disaster relief operation, and helping the nursing students to have a clearer career orientation when choosing the specialty direction. Stress response is divided into psychological response and physiological response. This study focused on the process of physiological response and evaluated the psychological stress intensity through monitoring physiological indexes related to the autonomic nervous system during the stress process.Method: The experimental subjects were 16 nursing students. In the monitoring experiment, three kinds of pressures were set, including time limitation, threat assessment, and task- interference. The physiological indexes under the resting state of the experimental subjects were recorded as the resting period group (RT). Then, the nursing students performed the operation without setting the pressure condition, called the baseline period group (BL). The experimenter would record all important time nodes. The physiological indexes recorded under the three pressures were the time stress group (TS), the assessment stress group (AS), and the task-interference stress group (INS).Results:There was no statistically significant difference in heart rate and skin temperature between RT and BL, but there was a statistically significant difference in skin resistance. The heart rate and skin temperature in the stress phase were significantly higher than those in RT and BL. According to the analysis of HRV, the difference between RT and BL has no statistical significance.Discussion:Models can eliminate the interference of the operation itself to the recording of physiological signals. The time-stress condition caused a more psychological-stress response in nursing students than assessment and task interference. The pressure source was set up effectively and the stress model was established successfully.

The effectiveness of Korean herbal medicine in infertile men with poor semen quality: A prospective observational pilot study.

We examined the effects and safety of Korean herbal medicine (MYOMI-14) to treat infertile men with low semen quality. This study included 17 patients who received MYOMI-14 for 10weeks. The primary outcomes were the mean differences between sperm test values. The secondary outcomes were changes in the Fertility Quality of Life and the difference in skin temperature between the thigh and scrotum. Adverse events were also monitored. The average values of sperm concentration, sperm progressive motility and total motile sperm count significantly improved after MYOMI-14 treatment (36.2%, 51.7% and 55.5%, respectively; p<0.05). The core Fertility Quality of Life and the difference in skin temperature between the thigh and scrotum did not change significantly. No adverse events were observed. MYOMI-14 improved the semen quality of infertile men without adverse effects. Additional studies in a larger population and longer prospective randomised clinical trials are needed to confirm these results.

Thermal Manikin of Infant

Compared to an adult, an infant requires more consideration regarding the thermal environment so it is necessary to evaluate the thermal environment as it affects infants. However, experiments on infant subjects regarding their thermal environment based on the different heat balance of their body cannot ethically be conducted. We could instead consider using a thermal model for the human body, but thermal manikins based on heat transfer per unit area are rare. Therefore, this study aims to develop a thermal manikin to model the heat transfer per unit area and the body form of an infant in order to evaluate the infant’s thermal environment. When evaluating the thermal environment or heat balance of the body in the outside environment, it is essential to consider the asymmetry and unevenness of the temperature of the skin, as an element of the human body, and not just the unevenness and asymmetry of physical factors in the environment. Moreover, when receiving short wavelength direct solar radiation, light and shaded areas have significant differences in skin temperature. The following 20 body parts were investigated in the study: anterior head, posterior head, ventral trunk, dorsal trunk (including buttocks), right medial arm, right lateral arm, left medial arm, left lateral arm, right dorsal hand, right palmar hand, left dorsal hand, left palmar hand, right anterior leg, right posterior leg, left anterior leg, left posterior leg, right dorsal foot, right plantar foot, left dorsal foot, and left plantar foot. This paper measured the body surface area for each part of an infant’s body in order to establish the form of an infant model from the view of the heat transfer area, and verified the validity of the model.

Effects of Short-term Temperature Change in the Innocuous Range on Histaminergic and Non-histaminergic Acute Itch

While temperatures in the noxious range are well-known to inhibit acute itch, the impact of temperature in the innocuous temperature range is less well understood. We investigated the effect of alternating short-term temperature changes in the innocuous range on histamine and cowhage-induced acute itch, taking into account individual differences in baseline skin temperature and sensory thresholds. Results indicate that cooling the skin to the cold threshold causes a temporary increase in the intensity of histamine-induced itch, in line with previous findings. Skin warming increased cowhage-induced itch intensity. Potential mecha-nisms of this interaction between thermosensation and pruritoception could involve cold-sensitive channels such as TRPM8, TREK-1 or TRPC5 in the case of histamine. The rapid modulation of cowhage induced itch - but not histamine-induced itch - by transient skin warming could be related to the lower temperature threshold of pruriceptive polymodal C-fibres (cowhage) as compared to the higher temperature threshold of the mechanoinsensitive C-fibres conveying histaminergic itch.

Relationships between the changes of skin temperature and radiation skin injury

Background: Radiation skin injury (RSI) causes changes in skin temperature, but detailed information on the thermographic responses is currently lacking. We investigated thermographic patterns after radiotherapy. We hypothesized that skin temperature may be used as a diagnostic and early predictor of RSI severity.Method: All breast cancer patients received radiotherapy after unilateral postmastectomy. The contralateral supraclavicular area served as control, and the frontal thermal image of torso was taken by a thermal infrared imager weekly. We defined areas of interest on bilateral symmetrical supraclavicular area, and analyzed the difference of average and maximum skin temperature (DSTaverage and DSTmax) between them. The extent of the weekly variation in DST (DSTW) was calculated using a mathematical formula to represent a trend of skin temperature change. RSI and symptoms related to RSI were scored from baseline to 2 weeks after the end of radiotherapy.Results: Forty-one patients were enrolled in this study. In comparison to the baseline, the DSTaverage and DSTmax increased significantly over time during radiotherapy (p < .05). The onset of DST increase was accompanied by the onset of radiation dermatitis, and the maximal DST also appeared at the peak of Radiation Therapy Oncology Group (RTOG) and symptom scores. Radiation dose, DSTaverage, burning-feeling and pulling were the independent variables affecting RTOG score according to multivariate analysis (p < .001, p < .034, p < .001, p < .001). Patients with DSTWaverage >1.223 or DSTWmax >1.114 in second week showed a late higher dermatitis score (RTOG score ≥2).Conclusion: This study confirmed that RSI was associated with thermographic response. Our results suggested that the follow-up observations of skin temperature during radiotherapy could provide the objective evaluation criteria and prediction methods for RSI.

Effects of alternating exposure to cold and heat for 14 days on cold tolerance in winter

People are exposed to heat regularly due to their jobs or daily habits in cold winter, but few studies have reported whether parallel heat and cold exposure and diminish cold acclimation. This study was conducted to investigate the effects of alternating exposure to cold and heat on cold tolerance in eight young males. A daily acclimation program to cold and heat, which consisted of 2-h sitting at 10 °C air in the morning and 2-h running and rest at 30 °C air in the afternoon, was conducted for 14 consecutive days. Eight male subjects participated in a cold tolerance test (10 °C [ ± 0.3], 40%RH[ ± 3]) before (PRE) and after (POST) completing the alternating exposure program. During the cold tolerance test, subjects remained sitting upright on a chair for 60 min. Rectal temperature (Tre) was lower in POST than in PRE during the 60-min cold tolerance test (P = 0.027). During the cold tolerance test, systolic, diastolic, and mean arterial blood pressures in POST were lower than those in PRE (P = 0.006, P = 0.005, and P = 0.004). No significant differences in skin temperatures between PRE and POST were found for the cold tolerance test. There were no significant differences in energy expenditure during cold exposure between PRE and POST. Subjects felt less cold in POST than in PRE (P = 0.013) whereas there was no significant difference in overall thermal comfort between PRE and POST. These results suggest that cold adaptation can still occur in the presence of heat stress.

Evaluation on the performance of quilts based on young people's sleep quality and thermal comfort in winter

This study evaluated the performance of three different quilts (white duck down quilt, white goose down quilt and cotton quilt) based on sleep quality and thermal comfort of young people in non-heating bedroom in winter. Thermal comfort and sleep quality were subjectively evaluated before and after sleep. Electroencephalograms (EEG), skin temperatures and bed climate were measured throughout the all-night sleep. Both subjective and physiological results showed that quilt materials had a significant effect on sleep quality and thermal comfort. The goose down quilt was evaluated the most comfortable in overall sleep comfort and sleep thermal sensation. The duration of slow wave sleep as calculated by EEG signal was longer, the skin temperatures and bed climate were higher when the goose down quilt was used. The results also show that there are gender differences in skin temperatures. Compared with males, the mean skin temperature (MST) of females was higher, while their foot temperature was significantly lower, which suggest that for females more attention should be paid to maintain warmth of extremity during sleep in winter. Our results suggest that sleep quality and thermal comfort is the most desirable when using goose down quilt and undesirable when using cotton quilt. Duvet could guarantee a comfortable bed climate in non-heating bedroom in winter of East China. Results also showed that lighter quilts would have a higher degree of satisfactions, indicating that young people in East China may have a preference for light quilt.

The effectiveness of Ilizarov technique-based transverse tibial bone transport on treatment of severe diabetic foots complicated with systemic inflammation response syndrome

To evaluate the effectiveness of Ilizarov technique-based transverse tibial bone transport on the treatment of severe diabetic foot ulcer (Wagner grades 3 to 5) complicated with systemic inflammatory response syndrome (SIRS). Between August 2014 and December 2017, 33 patients with severe diabetic foot and SIRS were treated with Ilizarov technique-based transverse tibial bone transport. There were 27 males and 6 females, with a mean age of 60.6 years (range, 34-79 years). All of them suffered from type 2 diabetes mellitus. The duration of diabetes was 1-28 years (mean, 10 years) and the duration of diabetic foot was 1-12 months (mean, 2.7 months). According to Wagner classification, there were 8 cases in grade 3, 23 cases in grade 4, and 2 cases in grade 5. The wound healing condition was observed after operation, and the limb salvage rate was calculated. The changes in body temperature, heart rate, respiratory rate, white blood cell count, erythrocyte sedimentation rate, and C-reactive protein concentration were assessed. The skin temperature of the dorsum of the foot was measured, and the visual analogue scale (VAS) score was used to evaluate the improvement of foot pain. All 33 patients were followed up 3-30 months (mean, 14.1 months). All ulcers healed and the healing time was 3-12 months (mean, 5.3 months); the limb salvage rate was 100%. Postoperative body temperature, heart rate, respiratory rate, white blood cell count, erythrocyte sedimentation rate, and C-reactive protein concentration were significantly lower than those before operation ( P<0.05). The skin temperature of the dorsum of the foot was (32.64±2.17)℃ at 1 month after operation, which was significantly improved when compared with preoperative value [(31.28±1.99)℃] ( t=0.05, P=0.00); but there was no significant difference in skin temperature compared with healthy side [(32.46±2.10)℃] ( t=2.04, P=0.41). The VAS score was 2.4±0.7 at 1 month after operation, which was significantly improved when compared with preoperative score (4.3±0.8) ( t=3.10, P=0.00). Ilizarov technique-based transverse tibial bone transport is an effective way to treat severe diabetic foot complicated with SIRS. It can promote foot ulcer healing and avoid amputations.

Observing neck movements evokes an excitatory response in the sympathetic nervous system associated with fear of movement in patients with chronic neck pain

The objective of this study was to evaluate the response of the sympathetic-excitatory nervous system in patients with chronic neck pain compared with a control group of asymptomatic subjects who underwent an intervention of watching activities involving movements in the neck region. Thirty participants were divided into two groups: patients with chronic neck pain (n = 15) and the control group (n = 15). The patients’ neck disability, fear of movement and catastrophism were assessed with a self-report. The recorded variables related to the autonomic nervous system were skin conductance and skin temperature. The ANOVA test revealed significant differences in the increase in skin conductance in the chronic neck pain group after observing the activities (both in the photographs and video) at the end of the observation and 5 minutes after the intervention (p < .01; d > 0.80). There were no significant differences in skin temperature. Ultimately, the correlation analysis revealed a moderate positive correlation between kinesiophobia and skin conductance at 30 seconds (r = 0.53) and at 60 seconds (r = 0.52) of observing the activities in the video for the chronic neck pain group. Based on the results of the present study, we suggest that observing activities involving neck movements causes an activation of the sympathetic-excitatory nervous system in patients with chronic neck pain. These changes could be related to a fear of movement when faced with visual exposure to neck movements that could be interpreted as ‘harmful’ or ‘dangerous’.

Continuous and intermittent heat acclimation and decay in team sport athletes

The aim of this study was to compare the impact of continuous (CON) and intermittent (INT) heat acclimation protocols on repeat-sprint performance, and to also assess the degree of performance decay following acclimation. Using a pair-matched, between subjects design, 16 trained male team sport athletes were allocated to either INT (8 sessions over 15 days) or CON acclimation (8 sessions over 8 days) groups. Participants performed a heat tolerance test (HTT) involving 60-min of repeat-sprint cycling with a 10-min half time break (in 35.3 ± 0.7°C, 60.1 ± 4.0%; RH) two days pre- (pre-HTT) and post-acclimation (post-HTT1). Decay was investigated with two further HTT's completed over the next two weeks (post-HTT2 and post-HTT3). Results showed the post-HTT1 performance variables [mean power (pre-HTT; INT = 1002.07 ± 173.74, CON = 1057.10 ± 180.07 / post-HTT1; INT = 1097.11 ± 186.85, CON = 1163.77 ± 184.65 W), mean power (W.kg−1), total work (kJ) and work (J.kg−1)] were greater than pre-HHT (p < 0.001) after acclimation, with no differences between INT and CON. No differences in final core and mean skin temperatures or heart rate existed after INT or CON acclimation, however 30 min measures for thermal sensation, perceived thirst and ratings of perceived exertion (as well as the final measure) were lower in post-HTT1 (p < 0.05) in CON. Performance and thermoregulatory responses in post-HTT2 and 3 were similar to post-HTT1 in both INT and CON. These results indicate that prolonged repeat-sprint exercise in the heat is improved after acclimation involving short, high-intensity cycling sessions using either CON or INT protocols, with performance well-maintained over the subsequent 2 weeks, despite removal of the heat stimulus.

Effect of Humidified Noninvasive Ventilation on the Development of Facial Skin Breakdown.

The use of noninvasive ventilation masks is known to cause damage to facial skin tissue, which affects both the efficacy of the intervention and the patient's quality of life. The use of humidification with noninvasive ventilation is a common practice, but its relative role in the development of facial pressure ulcers has not been fully studied. A crossover cohort design was used in this study, with 15 healthy volunteers. Each volunteer randomly received both 10 cm H2O of CPAP with and without humidification through an oronasal mask. Skin integrity was evaluated by measuring transepidermal water loss, skin hydration, and skin pH at the bridge of the nose. Device-skin interface conditions (pressure and microclimate) were recorded at the bridge of the nose and both cheeks. The pro-inflammatory cytokine interleukin-1α was collected from the nose bridge before and after CPAP application by using a skin analysis tape. Nasal symptoms were collected by using a validated 6-point score. Humidified CPAP significantly increased transepidermal water loss (P < .001) and skin humidity (P = .02) compared with non-humidified CPAP. There were no significant differences in skin hydration, skin pH, skin temperature, and cytokine expression between both conditions. However, there was a trend of increased median ratios of interleukin-1α concentrations in the humidified CPAP. There was a significant increase in the interface pressure at the bridge of the nose after CPAP application (P = .02), with higher interface pressure values at the nose bridge compared with both left (P = .002) and right (P = .003) cheeks. The participants reported elevated nasal discomfort during non-humidified CPAP. These findings indicated that noninvasive ventilation with humidification had a potential disrupting effect on the barrier function of facial skin, associated with changes in skin microclimate and function. Further research is required to establish the cause of mask-related skin damage and to evaluate the effects of mask design, application techniques, and air flow and humidity settings.