Maximum Skin Research Articles

Lower maximal skin wettedness in both warm-humid and hot-dry environments with advanced age (PSU HEAT project).

Maximum skin wettedness (ωmax) is the proportion of the body covered in sweat at the upper limit of compensable heat stress. It has yet to be determined how ωmax changes with aging. We examined variability in ωmax at the upper limit of compensable heat stress in warm-humid (WH) and hot-dry (HD) environments in young (Y, 18-29 yr), middle-aged (MA, 40-60 yr), and older (O, 65-89 yr) adults during minimal activity (MinAct; ∼1.8 METS) and in O subjects at rest. ωmax was calculated using partitional calorimetry for 27 Y (13 F), 27 MA (16 F), and 32 O (18 F) at the previously determined upper limits of compensable heat stress in WH and HD environments. In WH environments, ωmax was greater in Y (0.69 ± 0.12) and MA (0.64 ± 0.20) compared with O (0.47 ± 0.14; both P < 0.05), but not different between Y and MA (P = 0.85). In HD environments, ωmax was greater in Y (0.52 ± 0.05) compared with O adults (0.40 ± 0.07; P < 0.05), but not different between MA (0.48 ± 0.10) and Y or O (both P ≥ 0.15). In O participants at rest, ωmax was lower than MinAct in WH (P < 0.001) but not HD environments. These findings indicate that 1) ωmax is lower with advanced age across environments and 2) is lower at rest than during light activity in O in humid conditions. ωmax established herein for unacclimated adults during activities of daily living and older adults at rest may be used to model heat stress responses for these populations and environments.NEW & NOTEWORTHY This study is the first to identify 1) maximal skin wettedness values for unacclimated adults across the adult age span of 18 to 89 yr at a metabolic rate representative of minimal activities of daily living and 2) establish specific ωmax values for older adults during rest and activities of daily living. These findings provide empirical data for the modeling of physiological responses to heat stress across the adult age span.

Boron neutron capture therapy for cutaneous angiosarcoma and malignant melanoma: First in-human phase I clinical trial

Background and purposeDefinitive radiotherapy for patients with scalp angiosarcoma has a poor prognosis, often resulting in severe skin adverse events. Additionally, malignant melanoma is known for its radioresistant nature. Boron neutron capture therapy (BNCT) may address these challenges due to the high uptake capacity of boron drugs in these cancer types. We aimed to determine the treatment dose for BNCT and evaluate the incidence of acute adverse events AEs following BNCT in patients with primary or recurrent angiosarcoma/malignant melanoma of the skin. Materials and methodsThis was a single-center, non-randomized clinical trial with a three-step dose escalation plan, involving maximum skin doses of 12, 15, and 18 Gy-Eq following a 3 + 3 design. The patients underwent BNCT between November 2019 and April 2022. The primary endpoint was to evaluate the incidence of acute adverse events. ResultsTen patients (scalp angiosarcomanine, forefinger malignant melanoma: one) were included. The median target lesion size was 46.5 (range: 20–145) mm. A transient asymptomatic increase in serum amylase level was the only grade 3 adverse event. The best overall response rate within 180 days was 70 % (median tumor shrinkage rate: 77.5 % [4.9–100 %]). ConclusionsBNCT with a dose of 18 Gy-Eq is a feasible treatment option, demonstrating a favorable safety profile and a high response rate in patients with primary or recurrent angiosarcoma or malignant melanoma of the skin.

Reproducibility of Thermography for Measuring Skin Temperature of Upper Limbs in Breast Cancer Survivors.

Background/Objectives: Breast cancer-related lymphedema (BCRL) is a chronic condition that has early diagnosis as a critical component for proper treatment. Thermography, a non-invasive imaging method, is considered a promising complementary tool for the diagnosis and monitoring of BCRL, especially in subclinical stages. The present study aimed to evaluate the intra- and inter-examiner reproducibility of thermography for measuring the skin temperature of the upper limbs (UL) of women with and without BCRL. Methods: This study, conducted with women who underwent a unilateral mastectomy, assessed BCRL using indirect volumetry. Maximum, minimum, and mean skin temperatures were measured in five regions of interest (ROI) of each UL (C1, C2, C3, C4, and Cup) in four different postures. Reproducibility measures were assessed using an intraclass correlation coefficient, 95% confidence interval, and coefficient of variation. Results: The sample comprised 30 women; 14 were diagnosed with BCRL. A total of 120 thermograms were recorded in different postures, and 3600 ROI were analyzed in the UL with and without BRCL. The intraclass correlation coefficient of the analyses indicated intra- and inter-examiner reproducibility from good to excellent (0.82 to 1.00) for all skin temperatures evaluated (maximum, minimum, and mean). The coefficient of variation for all measures was below 10%, indicating low variability. Conclusions: Our findings demonstrate that thermography shows good-to-excellent reproducibility across multiple postures and regions of interest, reinforcing its potential as a non-invasive and reliable method for assessing lymphedema in breast cancer survivors. This study establishes a foundation for incorporating thermography into clinical practice for early BCRL detection, particularly in subclinical stages, thus improving patient management and outcomes.

Design and dynamic analysis of a spanwise morphing wing for Mars exploration

The application of spanwise morphing wings makes it possible to transport and launch large-size Mars exploration UAVs. This article proposes a modular variable spanwise morphing wing for high-aspect-ratio aircrafts, and analyses the characteristics of the morphing wing by theoretical analysis, numerical simulation and experimental verification. The novel spanwise morphing wing is based on the Sarrus-inspired deployable structure, which can increase the wing's lift by changing the spanwise length. The pre-strain torsion springs are assembled to provide the initial driving moment of the morphing mechanism. A regular triangle cross section is selected by evaluating the bending and torsional stiffness, and deployable triangular prism mechanisms are identified. Through releasing the pre-strain torsion springs to achieve expansion and implant Sarrus linkages along the straight motion paths. A lockable structure is designed, and the main factors affecting the self-locking property are analysed. A rigid origami skin is proposed, which maintains the airfoil's continuous smoothness after spanwise morphing. The kinematics of the spanwise morphing wing unit is developed using the Lagrange equation, and the theoretical models of morphing wings with different numbers of units are obtained. The unit numbers influence fully expanded time, and the time decreases gradually along the wingtip's direction. Finally, a one-way fluid-structure interaction analysis is performed to investigate the spanwise morphing mechanism and origami skin response under aerodynamic loads. Results show that the skeleton mechanism's maximum stress is below the material's yield strength, and the origami skin's maximum out-of-plane deformation is less than 0.5% of the wing chord, which provides a necessary theoretical basis for applying the spanwise morphing wing.

Assessment of alternative metrics in the application of infrared thermography to detect muscle damage in sports.

Objective.The association between muscle damage and skin temperature is controversial. We hypothesize that including metrics that are more sensitive to individual responses by considering variability and regions representative of higher temperature could influence skin temperature outcomes. Here, the objective of the study was to determine whether using alternative metrics (TMAX, entropy, and pixelgraphy) leads to different results than mean, maximum, minimum, and standard deviation (SD) skin temperature when addressing muscle damage using infrared thermography.Approach.Thermal images from four previous investigations measuring skin temperature before and after muscle damage in the anterior thigh and the posterior lower leg were used. The TMAX, entropy, and pixelgraphy (percentage of pixels above 33 °C) metrics were applied.Main results.On 48 h after running a marathon or half-marathon, no differences were found in skin temperature when applying any metric. Mean, minimum, maximum, TMAX, and pixelgraphy were lower 48 h after than at basal condition following quadriceps muscle damage (p< 0.05). Maximum skin temperature and pixelgraphy were lower 48 h after than the basal condition following muscle damage to the triceps sural (p< 0.05). Overall, TMAX strongly correlated with mean (r= 0.85) and maximum temperatures (r= 0.99) and moderately with minimum (r= 0.66) and pixelgraphy parameter (r= 0.64). Entropy strongly correlates with SD (r= 0.94) and inversely moderately with minimum temperature (r= -0.53). The pixelgraphy moderately correlated with mean (r= 0.68), maximum (r= 0.62), minimum (r= 0.58), and TMAX (r= 0.64).Significance.Using alternative metrics does not change skin temperature outcomes following muscle damage of lower extremity muscle groups.

Energy Localization and Topological Defect in Spherical Non‐Hermitian Topolectrical Circuits

AbstractThis work examines the energy localization in non‐Hermitian systems, with a particular focus on the influence of topological defects in spherical models. Alterations in the mode distribution are explored within non‐Hermitian Su‐Schrieffer‐Heeger (SSH) chains affected by these defects, utilizing the Maximum Skin Corner Weight (MaxWSC) metric. An innovative spherical model is introduced, created by segmenting spheres into 1D chain structures, to study the non‐Hermitian skin effect (NHSE) within a spherical geometric framework. Experimental validations conducted on Printed Circuit Boards (PCBs) corroborate the theoretical insights. These findings not only substantiate the theoretical approach but also illustrate the capability of engineered circuit systems to mimic complex non‐Hermitian phenomena, highlighting the utility of spherical geometries in exploring NHSE and topological phenomena in non‐Hermitian systems.

Telescoping the Dorsal Hood in Hypospadias Surgery: An Innovation to Preserve Maximal Penile Skin

To describe a new technique or adjunct-telescoping the dorsal hood-with a view to banking excess skin on the penile shaft in hypospadias surgery. This would help if redo surgery, not a rare occurrence, is required in the future. A review of a prospectively maintained database of hypospadias surgeries conducted between 1997 and 2023 by a single surgeon. After the hypospadias repair, instead of excising the dorsal hood and suturing the ventral penile skin in the usual way, a skin hook is applied on the ventral penile skin in the midline. As the skin hook is pulled down towards the scrotum, anywhere from 1 to 4cm, it telescopes the dorsal hood down the penile shaft and also pulls in dorsal skin ventrally. (Technique described more fully in the manuscript) RESULTS: Around 1084 patients were operated for hypospadias over these 27 years. Telescoping of the dorsal hood was used in all patients, and in the 126 with proximal hypospadias, none had any skin of the dorsal hood excised! Sixty-two patients presented later with 73 fistulae which were operated on. Of note, no patient needed more than 2 surgical attempts for a cure. The dorsal hood is a useful source of not only skin but also underlying vascularised soft tissue. In hypospadias surgery where redo-operations are a predictable reality, preserving any excess skin on the phallus seems sensible. Our innovation of telescoping the dorsal hood achieves this goal nicely and takes only a few minutes to perform.

The Immediate and Delayed Maximal Nonirritating Skin Testing Concentrations of β-Lactam Antibiotics

BackgroundMaximal skin testing (ST) nonirritant concentrations (NICs) are consistent for penicillin and aminopenicillin amongst guidelines. However, there is variability amongst guidelines for maximal ST NICs of cephalosporins. ObjectiveTo determine maximal immediate and delayed ST NICs of 15 β-lactams in β-lactam-tolerant and β-lactam-naïve participants. MethodsWe performed a single-center, nonrandomized prospective study between September 2019 and January 2022 in adult participants. Participants received skin prick testing (SPT) and intradermal test (IDT) injections at six increasing concentrations of 1 or more β-lactams. A concentration was considered irritant when more than 5% of participants had a positive test. A positive test was defined as a wheal ≥3 mm than negative control accompanied by a ≥5 mm flare for SPT/IDT and induration ≥5 mm with associated erythema at 48 hours for delayed readings (dIDT). Sensitivity analyses using 3 alternative IDT positive criteria were conducted. ResultsA total of 747 participants with a median age of 64 (IQR 54-72), 52% males, 85% White, and 92% Non-Hispanic underwent 20,858 skin tests. All undiluted SPT concentrations were nonirritant. We found the following maximal IDT/dIDT NICs (mg/ml): ampicillin (41.6/125), ampicillin-sulbactam (93.8/187.5), aztreonam (6.3/25), cefazolin (55/165), cefepime (35/140), cefoxitin (45/90), ceftaroline (7.5/15), ceftriaxone (58.3/175), cefuroxime (55/110), ertapenem (16.6/50), imipenem-cilastin (6.3/25), meropenem (8.3/25), nafcillin (31.3/62.5), oxacillin (20.9/83.5), and piperacillin-tazobactam (112.5/225). dIDTs were almost all completely non-irritant close or at undiluted concentrations. There were no differences when we applied 3 IDT positivity criteria to our raw data. ConclusionOur results suggest that SPTs with undiluted stock β-lactam antibiotic concentrations are nonirritant. Compared to previously published nonirritant concentrations, we propose a 2 to 50-fold increase to the maximal IDT and dIDT NICs of 15 β-lactam antibiotics. When performing dIDTs, a higher concentration should be used rather than the same IDT concentration.

A comprehensive approach to skin rejuvenation with Neauvia smart combination therapy

Aesthetic medicine extends beyond just correction, evolving into prevention strategies for aging. This case study highlights the revolutionary potential of Neauvia dermal fillers in skin rejuvenation and enhancement. Unlike conventional hyaluronic acid fillers, Neauvia uses PEG (polyethylene glycol), a biocompatible polymer, ensuring exceptional durability and longevity. Moreover, its PEG-based formulation offers thermal stability, enabling synergistic use with energy-based devices like LaserMe. Through the SCT (Smart Combination Therapy) Protocol, combining Neauvia dermal fillers, Hydro Deluxe skin booster, and LaserMe, a comprehensive treatment approach is achieved. Illustrated through a case study of a 74-year-old female, this protocol demonstrates remarkable results in addressing volume loss, fine lines, and skin quality over three sessions. Neauvia's mission to redefine medical aesthetics emphasises synergy between technology and clinical efficacy, creating natural rejuvenation with minimal intervention. This approach signifies a model shift towards holistic aesthetic solutions, optimising outcomes with minimal filler volume and maximal skin regeneration.

Utility of large V-Y advancement of the latissimus dorsi myocutaneous flap in the reconstruction of large thoracic defects: a case series and literature review

BackgroundTrunk reconstruction following sarcoma excision involves significant defects. Pedicled and free latissimus dorsi myocutaneous flap (LDMF) reconstruction is commonly employed for thoracic defects; however, skin paddle design is limited to 10-12 cm to achieve primary donor closure. Paucity of data exists regarding the utility of V-Y advancement of LDMF, previously described for moderately sized thoracic defects. Efficacy of the technique's application, axial reach, maximum skin paddle, and overall success or complications have not been defined in the literature. MethodsA retrospective review of records was conducted from 2015 to 2021 at our center to identify patients who underwent large, islanded V-Y LDMF reconstructions. Results were assessed by reviewing photographs and clinical notes. PubMed search of articles using the search terms “Latissimus Dorsi Flap Reconstruction” AND “V-Y” was conducted, abstracts were screened, and relevant articles were selected for review by the 2 author (NL/YS). We summarized the findings in our review and discussion. ResultsEleven patients underwent V-Y LDMF reconstruction with large skin paddles designed to close the donor site and oncological defect. Flaps were mobilized in superior (n = 7), anterior (n = 2), inferior (n = 1) and medial (n = 1) directions. Satisfactory coverage and patient recovery with few complications was achieved. Average length of hospital stay was 4.7 days and secondary surgery was not required. Discussion and conclusionV-Y advancement of LDMF is reliable up to 24 cm axially with a skin paddle width of 24 cm based superiorly, inferiorly, or anteriorly. The technique is safe and effective in comorbid patients following high-dose radiotherapy, without prolonged general anesthesia or microsurgery. It represents a versatile locoregional reconstructive option for large trunk defects.

Skin sympathetic nerve activity in symptomatic and asymptomatic paroxysmal atrial fibrillation

BackgroundThe causes of symptoms in patients with paroxysmal atrial fibrillation (AF) remains unclear. ObjectiveThe purpose of this study was to correlate the magnitudes of skin sympathetic nerve activity (SKNA) with symptoms in patients with AF. MethodsWe prospectively enrolled patients with symptomatic paroxysmal AF for ambulatory electrocardiography and SKNA recording. Heart rhythms at the time of symptoms were categorized as AF or normal sinus rhythm (NSR). Maximal and average skin sympathetic nerve activity (aSKNA) and heart rate (HR) were compared between symptomatic and asymptomatic AF and NSR episodes using mixed effects models to account for within-patient correlations. ResultsAmong the 31 enrolled patients, 16 (52%) had at least 1 episode of AF, and 24 (77%) endorsed symptoms during the monitoring period. Compared with asymptomatic AF episodes, symptomatic AF episodes had higher maximal aSKNA (1.260 [interquartile range (IQR) 1.114–1.723] μV vs 1.108 [IQR 0.974–1.312] μV; P <0.001) and higher maximal HR (152 ± 24 bpm vs 132 ± 19 bpm; P <.001). Symptomatic NSR episodes were associated with higher maximal aSKNA (1.612 [IQR 1.287–2.027] μV vs 1.332 [IQR 1.033–1.668] μV; P = .001) and higher maximal HR (152 ± 24 bpm vs 105 ± 16 bpm; P <.001) than asymptomatic NSR episodes. Of the symptomatic episodes, 66 (73%) occurred during NSR and 24 (27%) during AF. All P values were obtained from mixed effects models. ConclusionSymptomatic episodes in patients with paroxysmal AF were more frequently associated with NSR than AF. Symptomatic AF and NSR episodes were associated with higher aSKNA than asymptomatic episodes. In patients with paroxysmal AF, symptoms correlate better with SKNA than heart rhythm.

Bio-friendly oleic acid-based ufasomal topical gel of rosuvastatin for diabetic wound healing: In-vitro, ex-Vivo, and in-Vivo evaluation

This study aimed to develop bio-friendly and biodegradable oleic acid-based ufasomes coated with chitosan for topical delivery of rosuvastatin for diabetic wound healing. Rosuvastatin was chosen as a suitable candidate due to its wound healing properties. Thin film hydration technique was implemented for the preparation of ufasomes at various concentrations of oleic acid. The most promising formulation (UF 5) was coated with chitosan. The effect of oleic acid and chitosan concentrations on vesicle Size, zeta-potential, polydispersity index, entrapment efficiency, and in-vitro drug release study was assessed. Optimum chitosan-coated ufasomal dispersion (CUF 3) was subjected to further characterizations, such as FT-IR, TEM, in-vitro release, broth microdilution susceptibility test, the effect of storage, ex-vivo skin permeability study, and wound healing efficiency in rats. Finally, CUF 3 was incorporated into chitosan gel base and examined for wound healing efficiency in rats. Uncoated ufasomal dispersion (UF 5) possessed the smallest vesicle Size (149.6 nm), the highest entrapment efficiency (79.48 %), an optimum zeta-potential (−35.78 mv), with polydispersity index of 0.18. FT-IR of coated ufasomes (CUF 3) reflected the effective coating of chitosan on the surface of ufasomes which coincided with the TEM image. Similar release profiles of UF 5 and CUF 3 were observed after 4 h of dissolution due to chitosan coating surrounding ufasomes. The cumulative percent of drug permeated across rat skin after 24 h for CUF 3 dispersion, and CUF 3 in chitosan gel were 11.21 % and 10.48 %, respectively, in comparison to 2.97 % in case of control gel. This was confirmed from the results of flux and permeability coefficient. A maximum skin retention and a controlled release effect with a reduced risk of systemic absorption of rosuvastatin were attained by CUF 3 in chitosan gel. Rosuvastatin encapsulated in ufasomal vesicles augmented the antimicrobial activity against Gram-negative and Gram-positive bacteria. A remarkable wound healing of CUF 3 in chitosan gel was confirmed by morphological and histopathological studies. Oleic acid-based ufasomes coated with chitosan could be a promising bio-friendly carrier for rosuvastatin to obtain a triple effect formulation for diabetic wound healing.

204 Detecting subclinical mastitis in meat-breed ewes using infrared thermography

Abstract Mastitis, the inflammation of the mammary gland most commonly due to bacterial infection, is an important welfare concern in meat-breed sheep. The objective of our study was to evaluate udder surface temperature obtained from infrared thermography as a diagnostic tool for subclinical mastitis. We predicted that udder halves with subclinical mastitis would have greater surface temperatures than healthy udder halves. We enrolled 39 meat-breed ewes (10 Hampshire, 24 Polypay, 5 Targhee; 2 to 9 yr of age) at the University of Wisconsin-Madison sheep unit. All procedures were approved by the UW-Madison Institutional Animal Care and Use Committee. Milk samples from each udder half were collected in duplicate weekly beginning 2 to 4 d postpartum until 8 wk postpartum. Immediately before milk sampling, the udder was photographed from the rear using a thermal camera. A sample was considered a true infection if at least 100 CFU/mL of a bacterial species were isolated. From each photo, we obtained values for minimum, maximum, and mean skin surface temperature for the right and left udders. Three linear mixed models were fit using minimum, maximum, and mean temperatures as the response variables. Fixed effects were infection status (infected or not), weeks postpartum (wk 1-8), and ambient temperature, with a random effect of udder half nested within animal ID. Contrary to our predictions, infection status did not predict udder skin surface temperature (P &amp;gt; 0.12). Healthy udder halves had a mean temperature of 35.5 ± 0.1°C (mean ± SE), minimum temperature of 29.9 ± 0.3°C, and maximum temperature of 37.8 ± 0.1°C. Infected udder halves had a mean temperature of 35.4 ± 0.1°C, minimum temperature of 30.5 ± 0.3°C, and maximum temperature of 37.7 ± 0.1°C. Our results contradict findings in dairy cows, and suggest more research is needed to evaluate the relationship between udder surface temperature and subclinical mastitis in sheep.

Comparative study of copper nanoparticles over radially stretching sheet with water and silicone oil

Abstract Copper nanoparticles are widely used in many sectors and research endeavors owing to their unique properties, including a large surface area, catalytic capabilities, and high thermal and electrical conductivity. The selection of the base fluid for copper nanoparticles should be contingent upon the anticipated application requirements since various fluids exhibit distinct characteristics that could potentially impact the mobility of the nanoparticles. The present investigation analyzes heat transfer phenomena occurring across a radially stretched surface. The research explores the effects of different states of Cu nanoparticles when combined with base fluids, such as water and silicone oil, on the heat transfer process. The momentum and energy equations are transformed into nonlinear ordinary differential equations by applying the similarity transformation. The boundary value problem-fourth-order (BVP4C) method numerically solves the governing ordinary differential equation for the modeled problem. In addition, the influence of various factors such as the slip parameter, solid volume fraction, Eckert number, Prandtl number, and unsteadiness parameter are examined. It has been discovered that blade-shaped nanoparticles transfer heat as quickly as possible via silicone oil and water. However, for platelet-shaped nanoparticles, a minimum heat transfer rate has been noted. The maximum skin friction coefficient is observed in platelet-shaped nanoparticles, while blade-shaped nanoparticles have the lowest skin friction coefficient.

Benefits of Collaboration Between the Wound, Ostomy, and Continence Nurse and Orthopedic Surgeon When Treating Skin Defects After Soft Tissue Sarcoma Resection: A Retrospective Case-Control Study.

The purpose of this study was to evaluate the benefits of collaborative management between orthopedic surgery and WOC nurses in patients undergoing resection of subcutaneous sarcomas. Retrospective case-control study. The sample comprised 25 patients who underwent wide resection for soft tissue sarcoma, followed by 2-stage split-thickness skin grafting. Data collection occurred between January 2015 and April 2021 in a university hospital based in Kagoshima, Japan. For comparison, we categorized these patients into 2 groups: intervention group participants were managed by an orthopedic surgeon and a WOC nurse; nonintervention group members were managed without WOC nurse participation. Patient background and treatment-related information was retrospectively collected from medical records and compared between the WOC nurse intervention group and the nonintervention group, including maximum tumor diameter, surgical time, maximum skin defect diameter, length of hospital stay, and time from surgery to complete wound healing. The average length of hospital stay was significantly shorter in the WOC nurse intervention group compared with the nonintervention group (38.3 days, SD = 8.0 vs 47.1 days, SD = 10.2; P = .023). Collaborative wound management with a WOC nurse resulted in a shorter hospital length of stay when compared to traditional management with WOC nurse involvement. Based on these findings, we assert that WOC nurses provide an important bridge between postoperative wound management in patients undergoing resection of subcutaneous sarcomas.

Efficacy and Safety of an Autologous Micrografting Procedure for Management of Striae Distensae in Women.

Striae distensae (SD), or stretch marks, are a common skin problem having a psychological impact and cosmetic concern, especially for women, in whom the prevalence is higher than in men. This study assessed the efficacy and safety of a single autologous micrografting treatment (AMT®) using Rigenera® technology for the management of SD. This single-centre study included 10healthy women between 24 and 65years of age, with Fitzpatrick-Goldman skin typesI-IV, who had visible SD in glutes/thighs. Each subject acted as their own control. The treatment procedure (microneedling + AMT) and the control procedure (no treatment) were performed on contralateral sides of the glutes/thighs, targeting matched and paired SD. Microneedling was carried out using Dermapen®, equipped with 32 needle heads set at 1.5mm needle length. The AMT procedure involved extracting biopsies from the mastoid hair zone with a 2.5-mm dermal punch, followed by disaggregation of the biopsies in a physiological saline solution using the Rigeneracons. The disaggregated micrografts were then intradermally injected using 30G 4-mm needles, maintaining a distance of 1cm between injection points, covering the entire marked treatment region. In the treated area, at 3months post-procedure compared to pre-procedure, the following changes were observed, all with statistical significance (P ≤ 0.05): (a) significant reductions in skin roughness (Ra, - 15.9%; Rz, - 22.6%), skin luminance (- 2.0%), and blue-green color distribution (- 10.6%); (b) significant increases in skin microcirculation maximum value (+ 240.1%), skin hydration (+ 71.2%), skin elasticity (+ 216.5%), skin density (+ 34.3%), skin thickness (+ 26.0%), and hypodermis thickness (+ 29.9%). Furthermore, for each of the aforementioned parameters, there was a significantly greater improvement observed with the AMT procedure compared with microneedling at 3months (all P ≤ 0.05). The AMT procedure using Rigenera technology resulted in an noticeable improvement in the SD appearance after 3months in healthy women.

Blood pressure, pulse rate, and skin temperature during hot-water bathing in real-world settings among community-dwelling older adults: the HEIJO-KYO Study.

Home hot-tub bathing substantially increases drowning mortality rates among older adults in Japan. Previous laboratory studies on hemodynamic responses during hot-tub bathing have been inconsistent depending on the thermal conditions. Furthermore, real-world hemodynamic changes that occur during bathing remain poorly understood. This study investigated the association between individual thermal states and hemodynamic parameters during hot-tub bathing among community-dwelling older adults. In this cross-sectional study conducted between January 2016 and April 2019, which involved 1,479 older adults (median [range] age, 68 [40-90] years), skin temperature on the abdominal surface was measured every minute. Ambulatory blood pressure and pulse rate were recorded at 15-min intervals for 24 h. Participants underwent simultaneous living room temperature measurements in their homes, and the time and methods of bathing were recorded. Associations between skin temperature and hemodynamic parameters during bathing and between the pre-bath living room temperature and in-bath maximum proximal skin temperature were evaluated using mixed-effects and linear regression models, respectively. A 1 °C increase in skin temperature was significantly associated with a 2.41 mmHg (95% confidence interval [CI]: 2.03-2.79) increase in systolic blood pressure and a 2.99 bpm (95% CI: 2.66-3.32) increase in pulse rate, after adjusting for potential confounders, including age, sex, body mass index, antihypertensive medication use, dyslipidemia, diabetes, and living room and outdoor temperatures. Significant interactions were not observed between sex and skin temperature in relation to systolic blood pressure and pulse rate (P = 0.088 and 0.490, respectively). One standard deviation lower living room temperature before bathing was significantly associated with a 0.41 °C (95% CI: 0.35-0.47) higher maximum skin temperature during bathing. Our findings suggest that pre-bath cold exposure may increase the skin temperature during hot-tub bathing, possibly resulting in excessive hemodynamic changes. This provides a framework for future interventions that utilize pre-bath thermal conditions and bathing environments to prevent bath-related deaths.

Use of Machine Learning techniques on a database of breast cancer patients treated with the FAST-Forward adjuvant radiotherapy scheme

The FAST-Forward scheme is an adjuvant radiotherapy protocol for breast cancer treatment. In this study, we analyze a patient database treated with this scheme to demonstrate its non-inferiority to the standard protocol in terms of local tumor control and safety regarding toxicity. Our findings support the continued use of the FAST-Forward scheme in clinical practice. Additionally, we employ machine learning techniques to identify subgroups of patients with similar characteristics and uncover clinically relevant patterns. These algorithms have enabled us to define three distinct patient profiles based on treatment regimen, molecular subtype, and toxicity outcomes. Furthermore, we observed a correlation between maximum skin dose and long-term induration, as well as the impact of breast volume on short-term hyperpigmentation.

What are optimum cycles for immediate primary closure of large cutaneous defects?

In the reconstruction of large complex cutaneous wounds, a myriad of mechanical devices has been designed to facilitate primary wound closure. However, there is a dearth of studies elucidating how best to achieve optimum use and efficiency of skin stretching (SS) when using the device for immediate primary closure of defects. Skin defect wounds (7 × 7 cm) were prepared on the back of three Bama miniature pigs. A total of 15 cycles of SS (cycle loading) were subsequently performed on the skin edges of the wound by EASApprox® SS system. Then, the changes in equidistant points were recorded after each cycle. After the SS test, all wounds were sutured under low tension. Skin elongation was observed at all equidistant points on the back wounds of three Bama miniature pigs. Up to an additional 1.10 to 3.75 cm of tissue was garnered. The maximum skin elongation was typically achieved within eight cycles of stretching and relaxation. Beyond this range, additional stretching cycles did not result in further skin extension. There may be a close link between mobilization range and the times of acute cyclic stretching (cycle loading) during the process of primary wound closure. However, larger studies are required to further evaluate the accuracy and effectiveness.

Comparison of Mammographic Findings after Conventional Radiotherapy and forward Intensity-Modulated Radiation Therapy in Breast Conservative Therapy.

This study aimed to determine and compare mammographic findings after conventional radiotherapy and forward intensity-modulated radiation therapy for breast conservation. Eighty-six patients with BCT (373 mammograms) were included between 2010-2015 and had post-treatment mammograms available for review. All mammograms were taken with an 18 × 24 cm detector and 0.070 mm pixel size (Selenia Dimensions, Hologic, Marlborough, Massachusetts, US). We documented the radiation technique, dose, and mammographic findings (e.g., edema, thickening, scarring, and calcification). We tracked the stability duration for each patient and grouped mammographic findings into 1-, 2, and 3 years post-treatment. SPSS version 26 and Stata version 18 were used for analysis. The FIMRT group received a lower total radiation dose (p=0.030), a higher dose per fraction (p=0.030), and a lower maximum skin dose (p<0.001). The time to stable was shorter in the FIMRT group (975 days for CRT vs. 478 days for FIMRT; p=0.001). Among the 86 patients, the FIMRT group showed less breast parenchymal edema and noticeable scarring at 1, 2, and 3 years post-treatment than the CRT group, although the difference was not statistically significant. In the FIMRT group, post-BCT mammographic findings, including breast parenchymal edema and marked scar appearance, were fewer than those in the CRT group, and the duration to stable was significantly reduced.