Skin Heating Research Articles

Symmetrical peripheral gangrene caused by urosepsis: Case reports and literature review.

Symmetrical peripheral gangrene (SPG) is a serious and rare complication in patients with urosepsis, characterized by distal limb symmetry impairment. In this study, 3 cases of SPG caused by urosepsis were reported, and the Chinese and English literature on SPG caused by urosepsis was reviewed. The demographic, clinicopathological, treatment, and follow-up data of the patients were summarized and analyzed. SPG was diagnosed with clinical symptoms. We conducted urological invasive surgery, administered anti-infective therapy, implemented fluid resuscitation and blood product transfusion, provided mechanical ventilation support, optimized myocardial contractility, administered heparin and B vitamins, utilized papaverine for vasodilation, performed hemodialysis and plasma exchange, peripheral skin warming along with other treatment modalities. Two patients died and 1 patient underwent autoamputation. Our cases and literature review demonstrate that timely and accurate diagnosis, effective infection control, correction of hypoperfusion, organ function support, early management of disseminated intravascular coagulation, avoidance of premature amputation, and multidisciplinary comprehensive treatment are crucial for the successful treatment of SPG caused by urosepsis.

Computational influences of convection micropolar fluid influx and permeability on characteristics of heating rate and skin friction over vertical plate

This manuscript merits at examining of an embedded orthogonal plate inside porous domain exposed to uniform heat influx to elaborate on how micro polar fluid factors and permeability characteristic affect the local skin friction, heating rate, and angular velocity inside boundary layer. The plate is subjected to forced convective micro polar fluid influx under steady, incompressible, and viscous circumstances. To facilitate dependable numerical solution, similarity approach is implemented to mutate set of coupled governing equations relevant to the adopted study into a constrained dimensionless differential equations. Computational analysis has been executed hiring Runge-Kutta scheme by Matlab function bvp4c to settle the governing equations. Study's results are highlighted graphically the impact of micro polar fluid factors on the local skin friction, heating rate, and angular velocity curves. High degree of acceptability of present findings compare with prior research results. It is found that the rising of Darcy parameter drives to decrease linearly both heating rate and local skin friction. Among the examined factors, the benchmark parameter of decreasing skin friction is the porosity. Additionally, it is found that an increasing of Prandtl number and micro rotation element lead to enhance Nusselt number. Once curves of micro rotation are interfered at certain distance from the plate due to increase in porosity, Darcy, Forchheimer's, and microelement rotation, the micro rotation curves are inverted.

The effect of regular periocular skin warming before bedtime on sleep and anxiety: a randomised clinical trial.

A randomised, placebo-controlled, parallel-group study was conducted to examine the effect of periocular skin warming before bedtime on sleep and anxiety in female workers with mild sleep difficulty. A total of 64 participants were included in the study, which consisted of a 1-week baseline period and a 4-week intervention period. They were randomly assigned to either the Warm group (N = 32) or the Sham group (N = 32) and were instructed to wear eye masks (warming or sham) before their habitual bedtime during the intervention period. The study found that the Athens Insomnia Scale score after the intervention was significantly lower in the Warm group compared to the Sham group. Additionally, participants in the warm condition showed a decrease in subjective sleep onset latency, better restorative sleep, and improved subjective anxiety before bedtime. A significant reduction in wake after sleep onset was observed in the Warm group at 4 weeks, and this decrease was significantly associated with the degree of improvement in subjective anxiety before bedtime. Furthermore, regular periocular skin warming before bedtime decreased sleep reactivity and improved well-being. In conclusion, the study suggests that periocular skin warming may be an effective approach for female workers with sleep problems, as it can easily be incorporated into daily life.

Skin heating during simulated hemorrhage lowers arterial blood pressure but not tolerance following exercise in a cold environment.

Skin heating helps avoid hypothermia in trauma victims but may influence the systolic (SBP) and mean arterial blood pressures (MAP) helping to guide resuscitation. We examined the effect of skin heating on tolerance and arterial blood pressure during lower body negative pressure (LBNP) across four trials. Nine participants completed 15 exercise intervals [60 s 88% peak power output (PPO) and 60 s 10% PPO] in a cold environment (0°C, 70% RH) lowering mean skin temperature (Tsk) before undergoing LBNP to pre syncope where Tsk remained low (Cold Trial: 27.6 ± 1.1°C) or was increased via a water-perfused suit 60 s into LBNP to 32.3 ± 0.7°C (Normothermic Trial), 34.8 ± 0.4°C (Warm Trial), or 36.1 ± 0.8°C (Hot Trial). Tsk was different between trials (P = 0.001). Core temperature was not different between trials, increasing with exercise (36.9 ± 0.3°C to 37.9 ± 0.4°C) and remaining elevated during LBNP (37.7 ± 0.4°C). During LBNP, MAP was greatest in the Cold Trial (88 ± 7 mmHg) and relatively lowered in the Normothermic (83 ± 5 mmHg), Warm (82 ± 5 mmHg), and Hot Trials (79 ± 7 mmHg; all P ≤ 0.017 vs. Cold). SBP was greatest in the Cold (111 ± 9 mmHg) and Normothermic Trials (110 ± 10 mmHg) and relatively lowered in the Warm (105 ± 7 mmHg) and Hot Trials (103 ± 11 mmHg; both P ≤ 0.037). LBNP tolerance was not different between trials (P = 0.746). Following exercise in a cold environment, skin heating during simulated hemorrhage lowers arterial blood pressures and has implications for prehospital care of trauma victims.NEW & NOTEWORTHY Skin heating helps avoid hypothermia in trauma victims but may influence arterial blood pressures, thus helping to guide resuscitation depending on the type of injury. Following exercise in a cold environment, arterial blood pressure was elevated during LBNP with cold skin but lowered with skin heating without changing LBNP tolerance. These findings are important for understanding the effect of skin heating on arterial blood pressure control in the prehospital and combat casualty care of trauma victims.

Magnetic Induction Heating in a Conducting Polymer for Biomedical Applications.

In this study, we investigate the magnetic induction heating induced in a conducting polymer (CP) under alternative magnetic fields (AMFs). Experimental results and numerical simulations have proved that the magneto-thermal conversion of the CP is caused by the induced eddy current, which is related to the shape and intensity of the applied external AMF, and the intrinsic electrical conductivity, macrostructure and microstructure of the CP. By employing various fabrication methods, specific temperature distribution and control of thermal field within conducting polymer films and aerogels could be achieved. To exploit the potential of magnetic induction heating in CP for biomedical applications, we designed a conducting polymer aerogel-based self-adaptive heat patch and demonstrated its AMF-enabled localized heating of skin. In addition to the thermal ablation of tumor cells via magneto-thermal conversion of the CP, the promotion of neuronal differentiation at mild temperature by noninvasive magneto-electrical stimulation has also been demonstrated to be an effective strategy for tissue engineering.

Millimeter wave radiation to measure blood flow in healthy human subjects

Objective.Peripheral Artery Disease (PAD) is a progressive cardiovascular condition affecting 8-10 million adults in the United States. PAD elevates the risk of cardiovascular events, but up to 50% of people with PAD are asymptomatic and undiagnosed. In this study, we tested the ability of a device, REFLO (Rapid Electromagnetic FLOw), to identify low blood flow using electromagnetic radiation and dynamic thermography toward a non-invasive PAD diagnostic.Approach.During REFLO radio frequency (RF) irradiation, the rate of temperature increase is a function of the rate of energy absorption and blood flow to the irradiated tissue. For a given rate of RF energy absorption, a slow rate of temperature increase implies a large blood flow rate to the tissue. This is due to the cooling effect of the blood. Post-irradiation, a slow rate of temperature decrease is associated with a low rate of blood flow to the tissue. Here, we performed two cohorts of controlled flow experiments on human calves during baseline, occluded, and post-occluded conditions. Nonlinear regression was used to fit temperature data and obtain the rate constant, which was used as a metric for blood flow.Main results.In the pilot study, (N= 7) REFLO distinguished between baseline and post-occlusion during the irradiation phase, and between baseline and occlusion in the post-irradiation phase. In the reliability study, (N= 5 with 3 visits each), two-way ANOVA revealed that flow and subject significantly affected skin heating and cooling rates, while visit did not.Significance.Results suggest that MMW irradiation can be used to distinguish between blood flow rates in humans. Utilizing the rate of skin cooling rather than heating is more consistent for distinguishing flow. Future modifications and clinical testing will aim to improve REFLO's ability to distinguish between flow rates and evaluate its ability to accurately identify PAD.

Chronic endothelial dopamine receptor stimulation improves endothelial function and hemodynamics in autosomal dominant polycystic kidney disease

Altered polycystin-mediated endothelial flow mechanosensitivity contributes to the development of hypertension and cardiovascular complications in patients with autosomal dominant polycystic kidney disease (ADPKD). Stimulation of endothelial type 5 dopamine receptors (DR5) can acutely compensate for the endothelial consequences of polycystin deficiency, but the chronic impact of this approach must be evaluated in ADPKD. Nineteen patients with ADPKD on standard of care therapy were randomized to receive a 2-month treatment with the DR agonist rotigotine using transdermal patches, nine at 2 mg/24hours and ten at 4 mg/24hours or while ten were untreated. Rotigotine at the dose of 4 mg/24hours significantly increased nitric oxide release (nitrite levels from 10±30 to 46±34 nmol/L) and radial artery endothelium-dependent flow-mediated dilatation (from 16.4±6.3 to 22.5±7.3%) in response to hand skin heating. Systemic hemodynamics were not significantly modified but aplanation tonometry showed that rotigotine at 4 mg/24hours reduced aortic augmentation index and pulse pressure without affecting carotid-to femoral pulse wave velocity. Plasma creatinine and urea, urinary cyclic AMP, which contributes to cyst growth in ADPKD and copeptin, a surrogate marker of vasopressin, were not affected by rotigotine. In mice with a specific deletion of polycystin-1 in endothelial cells, chronic infusion of the peripheral DR5 agonist fenoldopam also improved mesenteric artery flow-mediated dilatation and reduced blood pressure. Thus, our study demonstrates that in patients with ADPKD, chronic administration of rotigotine improves conduit artery endothelial function through the restoration of flow-induced nitric oxide release as well as hemodynamics suggesting that endothelial DR5 activation may represent a promising pharmacological approach to prevent cardiovascular complications of ADPKD.

Dietary NO3− does not enhance endothelial dependent cutaneous vascular conductance in older women

Prior work has yet to determine whether the reduction of dietary nitrate (NO3−) to NO, via the enterosalivary pathway, may modify cutaneous vascular conductance (CVC) responses to local heating in older women. Changes occurring with the transition to menopause related to hormonal flux, increased adiposity, and/or decreased physical activity may further compound the negative influence of aging on nitric oxide (NO)-dependent CVC. Herein, we characterized changes in NO-dependent CVC following acute ingestion of 140 mL of NO3−-rich beetroot juice in 24 older women (age: 65 ± 5 y, BMI: 31.2 ± 3.7 kg/m2). Red blood cell (RBC) flux was measured continuously via laser-Doppler flowmetry on the dorsal aspect of the forearm during local skin heating to 39 °C/44 °C before and 3 h after NO3− ingestion. NO-dependent changes in CVC were calculated as RBC flux/mean arterial blood pressure at 39 °C and normalized as a proportion of maximal CVC at 44 °C (%CVCmax). Changes (Δ) in fractional exhaled NO (FeNO) following NO3− ingestion were used an index of NO bioavailability. Despite increased FeNO (+81 ± 70 %, P < 0.001), %CVCmax at 39 °C was reduced (−16 ± 10 %, P < 0.001) following NO3− ingestion. A greater reduction in %CVCmax was weakly to moderately associated with higher body fat% (r = 0.45 [0.05–0.72], P = 0.029), central adiposity% (r = 0.50 [0.13–0.75], P = 0.012), neutrophil% (r = 0.42 [0.02–0.70], P = 0.041), and higher neutrophil to lymphocyte ratio (r = 0.49 [0.11–0.75], P = 0.016). These findings demonstrate a single dose of dietary NO3− does not promote CVC responses to local heating in sedentary older women with overweight and obesity. Correlation with multiple biomarkers suggest systemic inflammation may be involved.

Influence of progressive skin heating upon arterial blood pressure and tolerance to a simulated hemorrhage challenge following exercise in a cold environment

Purpose: Our aim was to examine the role of graded skin heating on blood pressure and tolerance to a simulated hemorrhage (lower body negative pressure, LBNP) in individuals who have exercised in a cold environment. We hypothesized that arterial blood pressure and tolerance would be lower during LBNP at higher skin temperatures. Methods: Following completion of a maximal exercise test, 7 participants (181±7 cm, 88.7±14 kg and 25±6 yrs) four exercise cold stress trials, comprising high intensity interval exercise on a cycle ergometer: 5 min at 60% VO2 max (1.9±0.4 L.O2.min) followed by 15 intervals of 60 sec at 88% peak power output (Wmax) (239±51 W) and 60 sec at 10% Wmax (27±6 W) in an environmental chamber (0°C 70% RH, Can-Trol International). Upon completion participants remained in the environmental chamber and underwent LBNP to pre syncope. Rectal (Tcore; °C) and mean skin (8 site average, Tskin; °C) temperatures, arterial blood pressure (Brachial Artery Auscultation, Suntech Tango; MAP; mmHg) and cutaneous vascular conductance (Laser Doppler Flowmetry, Perimed, CVC; AU/mmHg) were measured throughout. After the onset of LBNP, skin temperature was either kept cold (Cold), increased back to baseline (Normothermic), mildly heated (Warm) or severely heated (Hot) using a water perfused suit. LBNP tolerance was calculated via cumulative strain index (CSI). MAP, CVC, Tcore and Tskin were analyzed using a two-way ANOVA with repeated measures. CSI was compared between trials using a one-way ANOVA with repeated measures. Results: After exercise and immediately prior to LBNP, Tcore had increased from baseline 1.0±0.2°C and was not different between trials (P = 0.67), while Tskin was reduced from 33.2±0.5°C to 28.3±1.9°C (P = 0.001). MAP was elevated following exercise and immediately prior to LBNP in all trials relative to baseline, from 82±6 to 89±8mmHg. During LBNP, Tskin remained low in the Cold trial (27.6±1.2 °C) but was increased in all other trials (Normothermic: 32.3±0.8°C, Warm: 34.8±0.5°C and Hot: 36.4±0.7°C, all P &lt; 0.05). MAP was different between trials (Trial Effect P = 0.022). MAP was lowest in the Hot trial whether expressed 3 min after the onset of LBNP or at 60% CSI (81±9mmHg and 78±7 mmHg, respectively) relative to the Cold (89±10 and 84±9 mmHg) Normothermic (86±8 and 82±6 mmHg) and Warm trials (86±7 and 80±6 mmHg), respectively. MAP was reduced at pre syncope in all trials (59±9mmHg). CVC was different between trials (Trial Effect, P &lt; 0.0001). At 60% CSI, CVC was lowest in the Cold trial (0.17±0.11 AU/mmHg) but increased in the Normothermic (0.27±0.08 AU/mmHg) Warm (0.43±0.40 AU/mmHg) and Hot trials (0.60±0.43 AU/mmHg). LBNP tolerance was different between trials (Main Effect: P &lt; 0.01). LBNP tolerance was lowest in the Cold trial (700 ± 346 mmHg*min) and was increased in Normothermic (856±399 mmHg*min) Warm (821±345 mmHg*min) and Hot trials (990±328mmHg*min). Conclusion: These preliminary findings suggest that skin warming &gt;32°C increases tolerance to a simulated hemorrhagic challenge while further heating to ~36°C lowers arterial blood pressure without compromising LBNP tolerance in exercise cold stressed individuals. Supported by a RMACSM Grant. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Skin temperature influence on transcutaneous carbon dioxide (CO2) conductivity and skin blood flow in healthy human subjects at the arm and wrist.

Objective: present transcutaneous carbon dioxide (CO2)-tcpCO2-monitors suffer from limitations which hamper their widespread use, and call for a new tcpCO2 measurement technique. However, the progress in this area is hindered by the lack of knowledge in transcutaneous CO2 diffusion. To address this knowledge gap, this study focuses on investigating the influence of skin temperature on two key skin properties: CO2 permeability and skin blood flow. Methods: a monocentric prospective exploratory study including 40 healthy adults was undertaken. Each subject experienced a 90 min visit split into five 18 min sessions at different skin temperatures-Non-Heated (NH), 35, 38, 41, and 44°C. At each temperature, custom sensors measured transcutaneous CO2 conductivity and exhalation rate at the arm and wrist, while Laser Doppler Flowmetry (LDF) assessed skin blood flow at the arm. Results: the three studied metrics sharply increased with rising skin temperature. Mean values increased from the NH situation up to 44°C from 4.03 up to 8.88 and from 2.94 up to 8.11 m·s-1 for skin conductivity, and from 80.4 up to 177.5 and from 58.7 up to 162.3 cm3·m-2·h-1 for exhalation rate at the arm and wrist, respectively. Likewise, skin blood flow increased elevenfold for the same temperature increase. Of note, all metrics already augmented significantly in the 35-38°C skin temperature range, which may be reached without active heating-i.e. only using a warm clothing. Conclusion: these results are extremely encouraging for the development of next-generation tcpCO2 sensors. Indeed, the moderate increase (× 2) in skin conductivity from NH to 44°C tends to indicate that heating the skin is not critical from a response time point of view, i.e. little to no skin heating would only result in a doubled sensor response time in the worst case, compared to a maximal heating at 44°C. Crucially, a skin temperature within the 35-38°C range already sharply increases the skin blood flow, suggesting that tcpCO2 correlates well with the arterial paCO2 even at such low skin temperatures. These two conclusions further strengthen the viability of non-heated tcpCO2 sensors, thereby paving the way for the development of wearable transcutaneous capnometers.

Vitrification and ultra-rapid warming of mouse skin

Vitrification and ultra-rapid warming of mouse skin

Impaired microvascular reactivity in patients treated with 5-fluorouracil chemotherapy regimens: Potential role of endothelial dysfunction

Background5-fluorouracil (5-FU) is the second most common cancer chemotherapy associated with short- and long-term cardiotoxicity. Although the mechanisms mediating these toxicities are not well understood, patients often present with symptoms suggestive of microvascular dysfunction. We tested the hypotheses that patients undergoing cancer treatment with 5-FU based chemotherapy regimens would present with impaired microvascular reactivity and that these findings would be substantiated by decrements in endothelial nitric oxide synthase (eNOS) gene expression in 5-FU treated human coronary artery endothelial cells (HCAEC). MethodsWe first performed a cross-sectional analysis of 30 patients undergoing 5-FU based chemotherapy treatment for cancer (5-FU) and 32 controls (CON) matched for age, sex, body mass index, and prior health history (excluding cancer). Cutaneous microvascular reactivity was evaluated by laser Doppler flowmetry in response to endothelium-dependent (local skin heating; acetylcholine iontophoresis, ACh) and -independent (sodium nitroprusside iontophoresis, SNP) stimuli. In vitro experiments in HCAEC were completed to assess the effects of 5-FU on eNOS gene expression. Results5-FU presented with diminished microvascular reactivity following eNOS-dependent local heating compared to CON (P = 0.001). Iontophoresis of the eNOS inhibitor L-NAME failed to alter the heating response in 5-FU (P = 0.95), despite significant reductions in CON (P = 0.03). These findings were corroborated by lower eNOS gene expression in 5-FU treated HCAEC (P < 0.01) compared to control. Peak vasodilation to ACh (P = 0.58) nor SNP (P = 0.39) were different between groups. ConclusionsThe present findings suggest diminished microvascular function along the eNOS-NO vasodilatory pathway in patients with cancer undergoing treatment with 5-FU-based chemotherapy regimens and thus, may provide insight into the underlying mechanisms of 5-FU cardiotoxicity.

Severity of depressive symptoms moderates the sympathoinhibitory effect of local skin warming following exposure to a social stressor

Depression is the leading cause of disease burden globally. Existing antidepressant treatments that target the central nervous system have limited efficacy and come at the cost of significant side effects. Thus, there is growing interest in novel therapeutic interventions for the prevention and treatment of depression, including interventions that target interoceptive signaling. The thermosensory system may hold particular promise, given evidence that depression is associated with impairments in thermosensory functioning, and that whole-body hyperthermia produces an antidepressant effect in patients with major depressive disorder. In this study, we investigated whether the severity of depressive symptoms in a non-clinical population moderated the effect of local skin warming on subjective and physiological stress responses following exposure to an acute social stressor. Following exposure to the stressor, participants (N = 90) rested their arm on a heat blanket that was either turned on (local skin warming condition) or left off (control condition). We demonstrate that local skin warming increased fingertip temperature, a marker of reduced sympathetic nervous system activity, but only for participants with high levels of depressive symptoms. While local skin warming also inhibited salivary alpha amylase, severity of depressive symptoms did not moderate this effect, and no effect was found for electrodermal activity. These data highlight the importance of incorporating peripheral physiology in our conceptualization of the pathophysiology of depression and show that changes in sympathetic nervous system activity may underpin the antidepressant effect of warm stimuli.

Effect of geometric parameters of electrodes on skin heating for the design of non-ablative radiofrequency device.

Non-ablative radiofrequency (RF) has been widely used in clinical and at-home cosmetics devices. RF electrode geometry can influence the heat distribution in the tissue. This study analyzes the influence of geometric parameters of the electrode on the heat distribution in the layered tissue. The finite element simulation of the electrothermal coupling field was performed to obtain the three-dimensional (3D) temperature distribution of the four-layer tissue. The electrode geometric parameters including the inter-electrode spacing (5-12mm), width (1-3mm), length (3-10mm), shapes (bar, dot and circle), and the coupling gel's electrical conductivity (0.2-1.5 S/m) were simulated. The maximum temperature at 2mm depth (T-2mm ) and the temperature difference (Tdiff ) between the maximum skin surface temperature and T-2mm were obtained to evaluate the effectiveness and safety. The effect of geometric parameters on the effectiveness and safety was mixed. The maximum T-2mm occurred with the 5mm inter-electrode spacing, 3mm width, 10mm length, the circle-shaped electrode, and the 1.5 S/m coupling gel's electrical conductivity. The ratio of inter-electrode spacing to width at around four can achieve rapid temperature rise and skin surface temperature protection. The electrode shape influenced the area of temperature rise in the tissue's cross-section. The coupling gel's electrical conductivity should be close to that of the skin to avoid energy accumulation on the skin surface. The electrode's geometric parameters affect the effectiveness and safety of the RF product. This study has provided the simulation procedure for the electrode design.

Contactless photoplethysmography for assessment of small fiber neuropathy.

Chronic pain is a prevalent condition affecting approximately one-fifth of the global population, with significant impacts on quality of life and work productivity. Small fiber neuropathies are a common cause of chronic pain, and current diagnostic methods rely on subjective self-assessment or invasive skin biopsies, highlighting the need for objective noninvasive assessment methods. The study aims to develop a modular prototype of a contactless photoplethysmography system with three spectral bands (420, 540, and 800nm) and evaluate its potential for assessing peripheral neuropathy patients via a skin topical heating test and spectral analyses of cutaneous flowmotions. The foot topical skin heating test was conducted on thirty volunteers, including fifteen healthy subjects and fifteen neuropathic patients. Four cutaneous nerve fiber characterizing parameters were evaluated at different wavelengths, including vasomotor response trend, flare area, flare intensity index, and the spectral power of cutaneous flowmotions. The results show that neuropathic patients had significantly lower vasomotor response (50%), flare area (63%), flare intensity index (19%), and neurogenic component (54%) of cutaneous flowmotions compared to the control group, independent of photoplethysmography spectral band. An absolute value of perfusion was 20%-30% higher in the 420nm band. Imaging photoplethysmography shows potential as a cost-effective alternative for objective and non-invasive assessment of neuropathic patients, but further research is needed to enhance photoplethysmography signal quality and establish diagnostic criteria.

Mechanisms of Cardiovascular Changes of Phototherapy in Newborns with Hyperbilirubinemia.

During phototherapy of jaundiced newborns, vasodilation occurs in the skin circulation compensated by vasoconstriction in the renal and mesenteric circulation. Furthermore, there is a slight decrease in cardiac systolic volume, and blood pressure, as well as an increase in heart rate and discrete changes in the heart rate variability (HRV). The primary change during phototherapy is the skin vasodilation mediated by multiple mechanisms: 1) Passive vasodilation induced by direct skin heating effect of the body surface and subcutaneous blood vessels, modified by myogenic autoregulation. 2) Active vasodilation mediated via the mechanism provided by axon reflexes through nerve C-fibers and humoral mechanism via nitric oxide (NO) and endothelin 1 (ET-1). During and after phototherapy is a rise in the NO:ET-1 ratio. 3) Regulation of the skin circulation through the sympathetic nerves is unique, but their role in skin vasodilation during phototherapy was not studied. 4) Special mechanism is a photorelaxation independent of the skin heating. Melanopsin (opsin 4) - is thought to play a major role in systemic vascular photorelaxation. Signalling cascade of the photorelaxation is specific, independent of endothelium and NO. The increased skin blood flow during phototherapy is enabled by the restriction of blood flow in the renal and mesenteric circulation. An increase in heart rate indicates activation of the sympathetic system as is seen in the measures of the HRV. High-pressure, as well as low-pressure baroreflexes, may play important role in these adaptation responses. The integrated complex and specific mechanism responsible for the hemodynamic changes during phototherapy confirm adequate and functioning regulation of the neonatal cardiovascular system, including baroreflexes.

No impact of biological sex on nitric oxide contribution to cutaneous vascular response to 39ºC local heating

Purpose: The contribution of endothelial nitric oxide (NO) to vasodilation (%NO contribution) is a significant indicator of risk of cardiovascular disease development. Local skin heating to either 42 ºC or 39 ºC is used to determine mechanisms of vasodilation in health and disease, specifically to investigate %NO contribution. Women have lower %NO contribution in the cutaneous vasculature than men in the early follicular phase of the menstrual cycle, when the circulating vasoactive reproductive hormones are at their lowest concentration. However, this phase represents only a brief portion of the menstrual cycle. We aimed to determine the overall impact of biological sex on %NO contribution to cutaneous vasodilation utilizing a 39ºC local heating protocol, which better isolates the endothelial NO-synthase pathway. We tested women randomly during any phase of the menstrual cycle. We hypothesized that women would demonstrate greater NO-dependent cutaneous vasodilation than men in response to 39ºC local heating. Methods: Data are represented as mean(SD). An intradermal microdialysis fiber was placed in the ventral forearms of 12 men and 13 women [24.2(4.6) years]. Local heaters and laser-Doppler flowmetry probes were used to measure red blood cell flux (perfusion units, PU). Cutaneous vascular conductance (CVC) was calculated as laser-Doppler PU/mean arterial pressure. A standard 39ºC local heating protocol was conducted wherein PU was continuously collected at rest (10 minutes), then the local temperature was increased to 39ºC. After PU reached a steady plateau (~40 minutes), the NO synthase inhibitor 15 mM NG-nitro-L-arginine methyl ester (L-NAME) was perfused. Maximal vasodilation was induced by heating to 43ºC and perfusing 28 mM sodium nitroprusside and normalized to %CVCmax. %NO contribution was calculated as the absolute percentage difference between %CVCmax of 39ºC plateau and %CVCmax of L-NAME steady-state. We compared both CVC and %CVCmax between groups with two-way ANOVA and the %NO contribution with unpaired t-tests. Results: The %NO contribution was not different between sexes [men 48(23)%, women 39(17)%; P = 0.26]. There was no effect of sex on either absolute CVC [men 0.717(0.29) PU, women 0.73(0.48) PU at 39ºC phase] or %CVCmax [men 69(31)%, women 54(20)% at 39ºC phase] at any stage of the 39ºC local heating protocol (main effects P ≥ 0.08). Conclusion: These data indicate there is no impact of biological sex on the vasodilatory response of the cutaneous vasculature to 39ºC local heating in young healthy adults when women are tested at random across the menstrual cycle. Funding: National Institutes of Health Grant T-32-5T32AG049676 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Reliability of laser-Doppler flowmetry derived measurements of forearm and calf cutaneous vasodilation during gradual local heating in young adults.

Evaluate reliability of laser-Doppler flowmetry derived cutaneous vasodilation on the upper and lower limbs during gradual local heating. In twenty-eight young adults (21 (SD 3) years, 14 females), absolute cutaneous vascular conductance (CVCabs) and CVC normalized to maximum vasodilation at 44 °C (%CVCmax) were assessed at two adjacent sites on each of the forearm and calf during gradual local skin heating (33-42 °C at 1 °C·5 min-1) for two identical trials (~1 week apart). Responses were assessed for baseline, the steady-state heating plateau at 42 °C and the span (i.e. plateau-baseline). Between-day reliability was characterized as measurement consistency across trials. Within-day reliability was characterized as within-limb measurement consistency across adjacent skin sites. Between- and within-day absolute reliability (coefficient of variation) generally improved with heating, from poor (>25 %) at baseline to good (<10 %) for %CVCmax and moderate (10-25 %) for CVCabs for plateau and span. However, relative reliability (intraclass correlation coefficient) was generally not acceptable (≤0.70) for any condition. Responses were generally consistent for females and males and there were no major forearm and calf differences. Consistency of CVC estimates improved during gradual local heating with negligible limb and sex differences, which are important considerations for experimental design and interpretation.

Acute impact of aerobic exercise on local cutaneous thermal hyperaemia.

Little is known about the acute changes in cutaneous microvascular function that occur in response to exercise, the accumulation of which may provide the basis for beneficial chronic cutaneous vascular adaptations. Therefore, we examined the effects of acute exercise on cutaneous thermal hyperaemia. Twelve healthy, recreationally active participants (11 male, 1 female) performed 30-minute cycling at 50% (low-intensity exercise, LOW) or 75% (high-intensity exercise, HIGH) maximum heart rate. Laser Doppler flowmetry (LDF) and rapid local skin heating were used to quantify cutaneous thermal hyperaemia before (PRE), immediately following (IMM) and 1-h (1HR) after exercise. Baseline, axon reflex peak, axon reflex nadir, plateau, maximum skin blood flow responses to rapid local heating (42°C for 30-min followed by 44°C for 15-min) at each stage were assessed and indexed as cutaneous vascular conductance [CVC=flux/mean arterial blood pressure (MAP), PU·mmHg-1], and expressed as a percentage of maximum (%CVCmax). Exercise increased heart rate (HR), MAP and skin blood flow (all P<0.001), and to a greater extent during HIGH (all P<0.001). The axon reflex peak and nadir were increased immediately and 1-h after exercise (all comparisons P<0.01 vs. PRE), which did not differ between intensities (peak: P=0.34, axon reflex nadir: P=0.91). The endothelium-dependent plateau response was slightly elevated after exercise (P=0.06), with no effect of intensity (P=0.58) nor any interaction effect (P=0.55). CONCLUSION: Exercise increases cutaneous microvascular axonal responses to local heating for up to 1-h, suggesting an augmented sensory afferent function post-exercise. Acute exercise may only modestly affect endothelial function in cutaneous microcirculation.

Investigating sensor location on the effectiveness of continuous glucose monitoring during exercise in a non-diabetic population

ABSTRACT The purpose of this investigation was to evaluate whether continuous glucose monitoring (CGM) sensors worn on the active muscle may provide enhanced insight into glucose control in non-diabetic participants during cycling exercise compared to traditional sensor placement on the arm. Data from 9 healthy participants (F:3) was recorded using CGM sensors on the arm (triceps brachii) and leg (vastus medialis) following 100 g glucose ingestion during 30 min experimental visits of: resting control, graded cycling, electrically stimulated quadriceps contractions, and passive whole-body heating. Finger capillary glucose was used to assess sensor accuracy. Under control conditions, the traditional arm sensor better reflected capillary glucose, with a mean absolute relative difference (MARD) of 12.4 ± 9.3% versus 18.3 ± 11.4% in the leg (P = 0.02). For the intended use during exercise, the sensor-site difference was attenuated, with similar MARDs during cycling (arm:15.5 ± 12% versus leg:16.7 ± 10.8%, P = 0.96) and quadriceps stimulation (arm:15.5 ± 14.8% versus leg:13.9 ± 9.5%, P = 0.9). At rest, glucose at the leg was consistently lower than the arm (P = 0.01); whereas, during graded cycling, the leg-glucose was lower only after maximal intensity exercise (P = 0.02). There was no difference between sensors during quadriceps stimulation (P = 0.8). Passive heating caused leg-skin temperature to increase by 3.1 ± 1.8°C versus 1.1 ± 0.72°C at the arm (P = 0.002), elevating MARD in the leg (23.5 ± 16.2%) and lowering glucose in the leg (P < 0.001). At rest, traditional placement of CGM sensors on the arm may best reflect blood glucose; however, during cycling, placement on the leg may offer greater insight to working muscle glucose concentrations, and this is likely due to greater blood-flow rather than muscle contractions. Highlights Wearing a continuous glucose monitoring (CGM) sensor on the arm may better reflect capillary glucose concentrations compared to wearing a sensor on the inner thigh at rest. With passive or active leg-muscle contractions, site-specific differences compared to capillary samples are attenuated; therefore, wearing a CGM sensor on the active-muscle during exercise may provide greater information to non-diabetic athletes regarding glucose flux at the active muscle. Discrepancies in CGM sensors worn at different sites likely primarily reflects differences in blood flow, as passive skin heating caused the largest magnitude difference between arm and leg sensor readings compared to the other experimental conditions (control, electric muscle stimulation, and cycling exercise).