Skin Areas Research Articles

All-Fiber Flexible Electrochemical Sensor for Wearable Glucose Monitoring.

Wearable sensors, specifically microneedle sensors based on electrochemical methods, have expanded extensively with recent technological advances. Today's wearable electrochemical sensors present specific challenges: they show significant modulus disparities with skin tissue, implying possible discomfort in vivo, especially over extended wear periods or on sensitive skin areas. The sensors, primarily based on polyethylene terephthalate (PET) or polyimide (PI) substrates, might also cause pressure or unease during insertion due to the skin's irregular deformation. To address these constraints, we developed an innovative, wearable, all-fiber-structured electrochemical sensor. Our composite sensor incorporates polyurethane (PU) fibers prepared via electrospinning as electrode substrates to achieve excellent adaptability. Electrospun PU nanofiber films with gold layers shaped via thermal evaporation are used as base electrodes with exemplary conductivity and electrochemical catalytic attributes. To achieve glucose monitoring, gold nanofibers functionalized by gold nanoflakes (AuNFs) and glucose oxidase (GOx) serve as the working electrode, while Pt nanofibers and Ag/AgCl nanofibers serve as the counter and reference electrode. The acrylamide-sodium alginate double-network hydrogel synthesized on electrospun PU fibers serves as the adhesive and substance-transferring layer between the electrodes. The all-fiber electrochemical sensor is assembled layer-by-layer to form a robust structure. Given the stretchability of PU nanofibers coupled with a high specific surface area, the manufactured porous microneedle glucose sensor exhibits enhanced stretchability, superior sensitivity at 31.94 μA (lg(mM))-1 cm-2, a broad detection range (1-30 mM), and a significantly low detection limit (1 mM, S/N = 3), as well as satisfactory biocompatibility. Therefore, the novel electrochemical microneedle design is well-suited for wearable or even implantable continuous monitoring applications, thereby showing promising significant potential within the global arena of wearable medical technology.

Measurement and observation of the first web space based on morphology and clinical applications

PurposeTo describe and evaluate the anatomical skin shape of the first web space in cadavers, and to guide flap design for this area. Methods12 cadavers (24 hands on both sides) were selected. Marker points were chosen based on the characteristics of the first web for morphological measurement and observation. The morphological characteristics of the first web under the radial or palmar abduction position of the thumb were measured and compared. The best morphologic feature and parameters of the first web repairing flap were obtained. ResultsWhen the thumb is in the palmar abduction position, the maximum distance a(p) is 6.78±0.72cm, and the skin area s(p) is 20.09±2.63cm2, both of which are significantly greater than the distance a(r) of 5.86±0.74cm and the skin area s(r) of 17.39±2.15cm2 when the thumb is in the radial abduction position (P<0.05). There was no significant difference in the length b(r) and b(p) of the long axis of the flap between two different abduction positions (P>0.05). It is found that the shape of the first web area is not a symmetrical spindle, but an irregular quadrilateral inclined to the index finger side. ConclusionThe flap design and measurement for the first web space covering should take the maximum palmar abduction position of the thumb as a reference. The asymmetric quadrilateral flap design is more in line with the anatomical and morphological characteristics of the region.

Hidradenitis suppurativa: review of international clinical guidelines for the diagnosis and treatment of the disease

Background. Hidradenitis suppurativa hidradenitis is a chronic recurrent inflammatory skin disease that develops after puberty and is characterized by the appearance of recurrent painful nodes, abscesses, the formation of fistula passages and scars on skin areas rich in apocrine sweat glands. Treatment of purulent hidradenitis is aimed at suppressing inflammation, relieving pain, preventing the formation of fistulas and scars. The objectives of this review. Summarize the information in the published international clinical guidelines for the diagnosis and treatment of purulent hidradenitis, their comprehensive assessment and comparison with each other. Methods. In the period from December 2022 to February 2023, scientific articles were searched in the PubMed database of the National Center for Biotechnological Information. Inclusion criteria: scientific articles in English, without date restrictions; interdisciplinary publications of specialists in which dermatovenereologists participated. Results. The analysis of the existing relevant international clinical recommendations for the diagnosis and treatment of purulent hidradenitis indicates the absence of specific treatment schemes and algorithms, criteria for evaluating the effectiveness of therapy. In the treatment of purulent hidradenitis, the use of external keratolytics, antiseptics and antibiotics is recommended. Among systemic drugs, antibiotics, retinoids, immunosuppressive agents, hormonal drugs are used. The highest therapeutic efficacy in patients with purulent hidradenitis was shown by genetically engineered drugs that inhibit TNF-α and IL-17A. Conclusions. Patients with purulent hidradenitis require various treatment approaches, including a variety of surgical interventions, depending on the stage, severity, prescription of the disease and the general condition of the patient. The basic principle is the individual selection of the treatment method for a particular patient. In this regard, there is a need to develop domestic clinical guidelines for the management of patients with purulent hidradenitis.

Congenital melanocytic nevi – a literature review

Introduction: Congenital melanocytic nevi (CMN) are small, congenital pigmented moles on the skin that may appear after or shortly after the birth of a child (up to 12–24 months of age). CMN usually increases proportionately with the baby's physical development and occupies the same area of skin as at birth. The incidence of CMN among newborns is relatively low and ranges from 0.2% to 6%. Purpose of work: To collect information on the congenital melanocytic nevi. Summary: The initial step in caring for a patient with CMN involves obtaining a history and conducting a physical examination. We are able to examine the CMN using dermatoscopy, confocal microscopy, and histopathological examination. Melanoma is not common in people with CMN, but it can develop, so it is worth maintaining oncological vigilance and checking them regularly. In our literature review, we reviewed the clinical presentation of CMN and the dermatoscopic image, as well as the light microscopic and confocal microscopic picture of congenital melanocytic nevi.

Skin Ultrasound Assessment of Patients with Systemic Scleroderma-An Observational Study.

This study aims to analyze the changes in dermal thickness in patients with systemic scleroderma (SSc) in comparison with normal skin and also compare clinical forms with diffuse and limited cutaneous involvement. The study group consisted of female patients diagnosed with SSc with a disease history not exceeding 5 years. The areas of interest for ultrasound examination included the proximal phalanx of the third finger, the second intermetacarpal space, and the extension surface of the lower third of the forearm. The study included 20 patients diagnosed with SSc and 14 controls. SSc patients were subdivided into two subgroups based on the clinical form. Compared to the control group, patients with SSc had higher mean measurements in all three skin areas, with statistically significant differences in the hand and forearm areas. Patients with diffuse SSc displayed, on average, higher skin thickness compared to limited SSc in all skin areas examined, with a statistically significant difference only in the forearm area. Based on disease manifestations, significant differences were observed only with regard to the presence of pulmonary hypertension in the diffuse SSc group. In conclusion, skin ultrasound is a useful and accessible imaging method for diagnosing and quantifying dermal fibrosis in systemic scleroderma.

Assessment of Skin by High Frequency Musculoskeletal Ultrasound in Egyptian Patients with Systemic Sclerosis

Abstract Background Fibrotic involvement of the skin is a cardinal feature of systemic sclerosis (SSc). The extent of skin involvement is associated with internal organ involvement with severe disease course and poor prognosis. SSc skin involvement is characterized by three phases in temporal sequence: edematous, fibrotic, and atrophic. A palpation-based semi- quantitative score, the modified Rodnan skin score (mRSS) is widely used for the assessment of skin involvement. It is a quick, noninvasive clinical assessment that correlates with histological grading of skin fibrosis. However, it lacks the sensitivity to differentiate between clinically indistinguishable pathological phases such as inflammatory edema vs. established fibrosis. More objective approaches to measure skin involvement imaging have been developed in the past decades.In our study, we review the use of ultrasound for the assessment of early changes in skin thickness and echogenicity in patients with SSc, focusing. mainly on high frequency ultrasound. Aim of the Work to evaluate the role of high frequency ultrasound (HFUS) of skin in assessment of early changes in skin thickness and echogenicity in patients with SSc. Patients and Methods Our study is a cross-sectional, observational study involving homogenous groups consisting of 23 SSc patients and 21 healthy age and sex matched controls. Patients who fulfilled the 2013 ACR/EULAR Classification Criteria for SSc. Results DT was evaluated by both mRSS and HFUS at 5 skin areas in both patients and control. We found statistically significant difference between the two studied groups as regards in area 1 longitudinal (P = 0.017) and area 1 in transverse (P = 0.038), tendency to significance in area 2 (P = 0.054). Subclinical dermal involvement was detected by HFUS even in the skin areas in patients who had a normal local MRSS ( These areas were not planned to be assessed by high frequency ultrasound but added to the five areas to be assessed to evaluate for ultrasound detected subclinical involvement of skin in SSc patients ). In particular, DT was highly significantly greater in patients with area with Rodnan zero score at dorsum of hand than in healthy subjects (longitudinal and transverse) (P &amp;lt; 0.001, 0.005 ) respectively. Similar changes at the level of echogenicity occurred in determination of the stage of the disease, with increased skin thickness and decreased echogenicity occurring early and during skin disease activity due to edema; and decrease skin thickness and increased echogenicity occurring late with skin atrophy Conclusion that high frequency ultrasound is a useful tool in assessment of skin pathologic changes (even subclinical changes) in terms of thickness and echogenicity in patients with SSc both at disease onset and during follow up of response to therapy and disease stage. Moreover, it could be a useful screening tool with definite cutoff values at certain areas that differentiate normal from pathologic skin thickness.

Hair Shaft Abnormalities as a Dermoscopic Feature of Mycosis Fungoides: Pilot Results.

Diagnosis of persistent erythematous, scaly patches, or plaques can be complex since psoriasis (Ps), eczematous dermatitis (ED), and mycosis fungoides (MF) can be considered. Dermoscopy, which is a noninvasive diagnostic tool, is commonly used to examine blood vessels, scales, and background color; however, research on hair shaft evaluation in inflammatory dermatoses remains scarce. The aim of the study was dermoscopic evaluation of hair shafts in skin lesions localizedon thenon-scalp skin areas in patients diagnosed with MF, Ps, and ED. This was a retrospective evaluation of 55 patients diagnosed with MF, Ps, and ED. Photographic anddermoscopic documentation of these patients and detailed medical history were evaluated. A total of 21 patients with MF, 21 patients with Ps, and 13 patients with ED were evaluated. The examination revealed the presence of various abnormalities of hair shafts (e.g., numerouspili torti, singlepili torti, 8-shaped hairs, pigtail hairs, broken hairs, hair shafts rapidly tapered over long sections, hair shafts irregular in thickness, angulated hairs, branched hairs,the presence of trichorrhexis nodosa,and monilethrix-like hairs), yellow dots, and black dots. The presence ofpili tortiwas found in 80% of patients with MF, compared with 16% of patients with Ps and 8% of patients with ED (p < 0.005), with multiplepili tortifound only in MF patients (67%) (p < 0.005). Statistically significant differences also applied to hair shafts rapidly tapering over long sections and 8-shaped hairs, which occurred only in MF patients (p < 0.005 and p = 0.035, respectively). The presence of hair shaft abnormalities such as numerous pili torti, 8-shaped hairs, and hair shafts rapidly tapering over long sections is an important criterion that should be considered in the dermoscopic differentiation of the patchy/plaque mycosis fungoides and inflammatory dermatoses, such as psoriasis and eczematous dermatitis localizedon thenon-scalp skin areas.

Recent Advances in Understanding and Management of Arteriovenous Malformations of the Temporal Skin Area

Context: Arteriovenous malformations (AVMs) of the temporal skin area, though less common than cerebral AVMs, pose significant challenges in terms of cosmetic and functional outcomes. Over the past decade, substantial advancements have been made in the understanding and management of these lesions. This paper aims to review the latest developments in the pathophysiology, diagnosis, and treatment of temporal skin AVMs, and to explore ongoing challenges and emerging research directions. Evidence Acquisition: A comprehensive literature search was conducted using databases such as PubMed, Scopus, and Google Scholar. The focus was on research published in the past ten years related to temporal skin AVMs, including reviews, clinical studies, and advancements in treatment techniques. Results: The review discusses the evolution in understanding the pathophysiology of temporal skin AVMs, improvements in diagnostic imaging techniques, and the refinement of surgical and non-surgical treatment approaches. The outcomes, including cosmetic and functional results, and complications associated with various treatments, are also presented. Conclusions: The management of temporal skin AVMs has benefited from multidisciplinary approaches, combining surgery, interventional radiology, and dermatology. However, challenges remain in achieving optimal cosmetic and functional outcomes, necessitating ongoing research and innovation.

Intralesional hyaluronidase injection to relieve non-hyaluronic acid filler-induced vascular adverse events.

Vascular adverse events (VAEs) occurring during injections of soft-tissue fillers are still considered a challenging issue for both patients and practitioners. Hyaluronidase can dissolve hyaluronic acid (HA)-based soft-tissue fillers during a VAE. For VAEs induced by non-HA fillers, the absence of an "antidote" is regarded as exceptionally challenging. This multicenter study describes a case series of three VAEs induced by non-HA fillers, for which ultrasound-guided hyaluronidase injections were incorporated into the treatment approach. Two cases of calcium hydroxylapatite and one case of poly-L-lactic acid-induced VAEs are described, all of which were resolved without necrosis or scarring using a treatment approach with ultrasound-guided hyaluronidase injections. Unlike the mechanical hypothesis, which assumes filler particles travel antegrade to block arterioles in a large skin area, we hypothesize vasoconstriction as the pivot in VAEs. Filler injection-induced spasms could lead to long-lasting vasoconstriction of the perforator arteries stemming from the central facial arteries. Our results underscore that perforasome vasoconstriction might be the leading cause of the ischemia and subsequent necrosis in VAEs and that relaxation of these perforasomes, rather than dissolving the filler material, resolves the clinical symptoms associated with VAEs.

Mechanical properties analysis of bending-torsion coupled blades with different skin area angles

Mechanical properties analysis of bending-torsion coupled blades with different skin area angles

Effects of a mattress cover with special airflow technology on the structure and function of the sacral and heel skin during loading: A two-arm exploratory crossover trial.

Prolonged mechanical loading of the skin and underlying soft tissue cause pressure ulceration. The use of special support surfaces are key interventions in pressure ulcer prevention. They modify the degree and duration of soft tissue deformation and have an impact on the skin microclimate. The objective of this randomized cross-over trial was to compare skin responses and comfort after lying for 2.5 h supine on a support surface with and without a coverlet that was intended to assist with heat and moisture removal at the patient/surface interface. In addition, physiological saline solution was administered to simulate an incontinence episode on the mattress next to the participants' skin surface. In total, 12 volunteers (mean age 69 years) with diabetes mellitus participated. After loading, skin surface temperature, stratum corneum hydration and skin surface pH increased, whereas erythema and structural stiffness decreased at the sacral area. At the heel skin area, temperature, erythema, and stratum corneum hydration increased. These results indicate occlusion and soft tissue deformation which was aggravated by the saline solution. The differences in skin response showed only minor differences between the support surface with or without the coverlet.

Skin Homeostasis is Impaired in Hidradenitis Suppurativa Lesions: A Comparative Study

IntroductionHidradenitis suppurativa (HS) is a chronic skin disease whose impact on skin homeostasis has not been adequately studied at present. Knowledge about how skin function changes in these patients, and could be of interest not only to improve the topical management of the disease, but also as an objective measure of disease activity. The aim of this study was to compare skin homeostasis and the epidermal barrier function in lesional and healthy skin areas of patients with HS. MethodsWe conducted a cross-sectional study. Skin homeostasis and the epidermal barrier function of lesions were assessed in HS patients using validated tools. A healthy perilesional skin control was assigned to each lesion to compare skin homeostasis parameters. ResultsA total of 43 patients were included: 22 nodules, 10 abscesses and 25 draining tunnels were measured. The male-to-female ratio was 20:23, and the mean age, 35.95 years (SD, 14.82). Increased transepidermal water loss (TEWL) and erythema were found in nodules, abscesses and draining tunnel vs healthy skin. A direct association was observed between inflammatory nodules TEWL and IHS4 stage. In draining tunnels, a direct association was observed between TEWL and smoking. A trend of increasing TEWL values was observed as a function of Hurley stage. ConclusionHS lesions exhibit epidermal barrier dysfunction that depends on the severity of inflammatory activity. These results could be useful to develop objective classification systems for the severity and degree of involvement of HS or help in the development of vehicles for specific drugs, antiseptics and dressings for the management of this disease.

Incidence Rates of Pediculosis Capitis and Helminthiasis in Children in Danukusuman Surakarta

Pediculosis capitis and helminthiasis It is categorized as a neglected disease but is still an important health problem, especially for children. These two diseases each cause clinical disorders on the surface and internal organs of the body. Danukusuman is one of the most densely populated areas in the city of Surakarta, where in previous years many cases of gastrointestinal disorders affected local residents. The aim of this study to determine the incidence of pediculosis capitis and helminthiasis in elementary school children in the city of Surakarta. This research uses a descriptive analysis research design. The population in the study were children aged 6-8 years in Danukusuman Surakarta totaling 100 respondents. Samples were taken using total sampling technique. The diagnosis of pediculosis capitis is made on the skin and hair area of the head and intensity helminth enforced use method Kato katz from fecal samples by calculating the number of worm parasite eggs per gram of feces (EPG). Based on research conducted on 100 respondents, the results showed that 29 (29%) respondents had pediculosis capitis and cases of helminthiasis showed that 2 respondents (2%) had Ascari lumbricoides and Trichuris trichiura with a total of 24 epg of parasites each with a light infection intensity. From the results of this study, it was reported that the incidence of pediculosis capitis in children in Danukusuman was 29% and helminth infections were 2% of cases with a mild degree of infection.

Posidonia oceanica (L.) Delile Is a Promising Marine Source Able to Alleviate Imiquimod-Induced Psoriatic Skin Inflammation.

Psoriasis is a chronic immune-mediated inflammatory cutaneous disease characterized by elevated levels of inflammatory cytokines and adipokine Lipocalin-2 (LCN-2). Recently, natural plant-based products have been studied as new antipsoriatic compounds. We investigate the ability of a leaf extract of the marine plant Posidonia oceanica (POE) to inhibit psoriatic dermatitis in C57BL/6 mice treated with Imiquimod (IMQ). One group of mice was topically treated with IMQ (IMQ mice) for 5 days, and a second group received POE orally before each topical IMQ treatment (IMQ-POE mice). Psoriasis Area Severity Index (PASI) score, thickness, and temperature of the skin area treated with IMQ were measured in both groups. Upon sacrifice, the organs were weighed, and skin biopsies and blood samples were collected. Plasma and lesional skin protein expression of IL-17, IL-23, IFN-γ, IL-2, and TNF-α and plasma LCN-2 concentration were evaluated by ELISA. PASI score, thickness, and temperature of lesional skin were reduced in IMQ-POE mice, as were histological features of psoriatic dermatitis and expression of inflammatory cytokines and LCN-2 levels. This preliminary study aims to propose P. oceanica as a promising naturopathic anti-inflammatory treatment that could be introduced in Complementary Medicine for psoriasis.

Tattoo in patients undergoing lumbar and thoracic subarachnoid puncture. Prevention behaviors

The number of patients with tattoos and which are operated is increasing significantly in recent years. Some complications, mainly in neuraxial anesthesia, have been reported are unconvincing due to the lack of real evidence-based material. Tissue coring and deposition of epithelial cells in the CSF is a known entity. However, the theoretical risk exists and the anesthesiologist questions whether to puncture the neuraxial in patients with a tattoo at the puncture site. More organic pigments are being used and the precise composition of tattoo inks remains unknown. As a conduct for asepsis and antisepsis during spinal puncture (lumbar and thoracic), 14 steps were described to avoid neurological complications during spinal anesthesia. This approach during anesthesia in the neuraxial area meant that I never had a neurological complication, nor the appearance of an epidermoid tumor. Thus, a total of 17 steps that must be followed exactly when performing the puncture on the back of tattoo patients. If there is no pigment-free skin area available, a superficial skin incision is the method of choice.

Exploratory multi-omics analysis reveals host-microbe interactions associated with disease severity in psoriatic skin

Psoriasis (Pso) is a chronic inflammatory skin disease that poses both physical and psychological challenges. Dysbiosis of the skin microbiome has been implicated in Pso, yet a comprehensive multi-omics analysis of host-microbe interactions is still lacking. To bridge this gap, we conducted an exploratory study by adopting the integrated approach that combines whole metagenomic shotgun sequencing with skin transcriptomics. This was a cross-sectional study, adult patients with plaque-type Psoriasis (Pso) and healthy volunteers were included. Skin microbiota samples and biopsies were collected from both lesional and non-lesional skin areas on the lower back. Weighted Gene Correlation Network Analysis (WGCNA) was employed for co-expression network analysis, and cell deconvolution was conducted to estimate cell fractions. Taxonomic and functional features of the microbiome were identified using whole metagenomic shotgun sequencing. Association between host genes and microbes was analyzed using Spearman correlation. Host anti-viral responses and interferon-related networks were identified and correlated with the severity of psoriasis. The skin microbiome showed a greater prevalence of Corynebacterium simulans in the PASI severe-moderate groups, which correlated with interferon-induced host genes. Two distinct psoriatic clusters with varying disease severities were identified. Variations in the expression of cell apoptosis-associated antimicrobial peptides (AMPs) and microbial aerobic respiration I pathway may partly account for these differences in disease severity. Our multi-omics analysis revealed for the first time anti-viral responses and the presence of C.simulans associated with psoriasis severity. It also identified two psoriatic subtypes with distinct AMP and metabolic pathway expression. Our study provides new insights into understanding the host-microbe interaction in psoriasis and lays the groundwork for developing subtype-specific strategies for managing this chronic skin disease. The research has received funding from the FP7 (MAARS-Grant 261366) and the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 821511 (BIOMAP). The JU receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA. This publication reflects only the author's view and the JU is not responsible for any use that may be made of the information it contains. GAM was supported by a scholarship provided by CAPES-PRINT, financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES (Brazilian Government Agency). The authors thank all patients who participated in our study.

EB Naevi-like Lesion in Infant Bullous Pemphigoid

Epidermolysis Bullosa Naevi (EBN) is a subset of melanocytic nevi with atypical features arising at sites of blistering in patients with congenital EB. It may be clinically misdiagnosed as melanoma and may represent a challenge for the dermatologist. Bullous Pemphigoid (BP) consists of an autoimmune condition presenting with subepidermal blisters, usually affecting the elderly and rarely observed in children The case is reported of an infant who presented with pruritic erythematous bullous lesions, initially appearing over the trunk and legs with progression to arms and face. Clinical and immunopathological features were consistent with the diagnosis of infant BP. In the course of the disease, he developed a pigmented heterogeneous macule with irregular contour and satellite-dotted lesions, located on the right flank. Dermoscopy revealed a regular pigmented network distributed in an agminated manner interspersed with areas of healthy skin. Due to its similarity to EBN, an expectant approach was carried out. The lesion regressed during the 24-month follow-up. To our knowledge, there is only one literature case report of a child who presented with EBN-like in a previous BP lesion. Our case reinforces the presence of atypical melanocytic nevi in bullous diseases. Knowing this type of lesion clinically and dermatoscopically in patients with bullous dermatoses may prevent unnecessary surgical procedures in children.

RWHO: A hybrid of CNN architecture and optimization algorithm to predict basal cell carcinoma skin cancer in dermoscopic images

Basal cell carcinoma (BCC) is a type of skin cancer that initiates from the epithelial cells of our skin. Compared to other forms of cancer, BCC infrequently spreads to other parts of the body. It has a risk of local attack and demolition of surrounding tissues. Typically, BCC shows as one or numerous small, glowing nodules exhibiting central depressions. These knots are commonly found on the sun-exposed skin areas of older adults. Many dermatoscopic methods are available for diagnosing and predicting such kinds of skin cancers. But, medical professionals find it difficult to diagnose at some kind of images at the early stages. An automated methodology to predict such types of skin lesions would be better for such a diagnosis. In the present work, a new computer-assisted algorithm called RESNET50-WHO (RWHO) has been introduced to predict and diagnose BCC skin cancer. The method uses a combination of deep learning algorithm RESNET 50 and a metaheuristic algorithm, called wildebeest herd optimization (WHO) Algorithm to do prediction. The initial features from the images are extracted using RESNET 50. The output is given to the WHO algorithm to extract the beneficial features to reduce the time complexity. The method is tested using the PH2 dataset. The results obtained using the proposed algorithm is compared with the state-of-art optimization algorithms and evaluated. The conclusive findings specify that the proposed algorithm beats the comparative methods, yielding superior results

Effectiveness of cooling interventions on heat-stressed dairy cows based on a mechanistic thermoregulatory model

Addressing heat stress in dairy farming is a substantial challenge, and there is an increasing need for efficient cooling systems, even in regions with moderate climates. Accurately predicting the efficacy of diverse cooling options under different climatic conditions is crucial for reducing heat stress in modern high-producing dairy cows, aligning with sustainability goals. This study assessed the effectiveness and feasibility of different cooling measures, including fans, sprinklers with fans, and evaporative air cooling, using a dynamic thermoregulatory model. This 3-node dynamic model was developed based on recent animal data simulating the processes of dairy cows' physiological regulation and heat dissipation under various environmental conditions. The cooling methods were based on two principles: enhancing heat loss from cows using fans with/without sprinklers; lowering the ambient temperature by evaporative air cooling. The predicted results were discussed and partly validated using the experimental data from the literature. The predictions indicated that fan cooling alone was effective in ambient temperatures below 26 °C, while higher temperatures required a combination of fans and sprinklers for effective heat stress alleviation. Consideration of individual cow characteristics and environmental factors, including fan speed and wetting area, is crucial for optimal cooling. In regions with high relative humidity, evaporative air cooling could be counterproductive to some extent. The model's predictions largely aligned with experimental data, demonstrating its capability to forecast cooling effects under various climatic conditions. Future model improvements included refining calculations for water holding capacity, wetted skin area, and dry time, depending on the influence of spraying time and rate.

Skin Pigmentation Affects ViOptix T.Ox Performance in Variably Pigmented Preclinical Model of Flap Ischemia and Congestion.

Free flap monitoring is more difficult in patients with dark skin because ischemia and congestion can be masked by pigmentation. For this reason, adjunct methods such as cutaneous near-infrared spectroscopy are of elevated importance in patients with highly pigmented skin. The purpose of this experiment is to determine if ViOpitx T.Ox performance is affected by cutaneous pigmentation. Swine with naturally occurring areas of nonpigmented and pigmented skin were used. Pigmentation of each animal was assessed using spectrophotometry and histopathology. During normoxemia, tissue oxygenation (StO2) measurements were taken of nonpigmented and pigmented skin using the T.Ox device. A bicolor pedicled rectus abdominis myocutaneous flap was raised, and T.Ox probe was adhered to adjacent areas of opposite coloration on the same flap. StO2 was measured continuously during reversible episodes of flap ischemia and congestion (n = 4 swine, n = 6 flaps). There was not a significant difference between baseline StO2 values of nonpigmented (49% ± 7.9%) and pigmented skin (47% ± 6.2%). The absolute change in StO2 was significantly larger during both ischemia (6%) and congestion (16%) in nonpigmented skin compared with adjacent pigmented skin. T.Ox detects flap ischemia and congestion in both highly pigmented and nonpigmented skin. However, surgeons need to be aware that StO2 changes related to complete flap ischemia or congestion may be much more subtle than what is seen in nonpigmented skin. This study establishes a novel internally controlled porcine model that isolates the impact of skin pigmentation when assessing cutaneous devices measuring tissue oxygenation.