Thermoregulation and age

Electroacupuncture stimulation improves cognitive ability and regulates metabolic disorders in Alzheimer's disease model mice: new insights from brown adipose tissue thermogenesis

Background

Metabolic defects play a crucial role in Alzheimer's disease (AD) development. Brown adipose tissue (BAT) has been identified as a novel potential therapeutic target for AD due to its unique role in energy metabolism. Electroacupuncture (EA) shows promise in improving cognitive ability and brain glucose metabolism in AD, but its effects on peripheral and central metabolism are unclear.

Methods

In this study, SAMP8 mice (AD model) received EA stimulation at specific acupoints. Cognitive abilities were evaluated using the Morris water maze test, while neuronal morphology and tau pathology were assessed through Nissl staining and immunofluorescence staining, respectively. Metabolic variations and BAT thermogenesis were measured using ELISA, HE staining, Western blotting, and infrared thermal imaging.

Results

Compared to SAMR1 mice, SAMP8 mice showed impaired cognitive ability, neuronal damage, disrupted thermoregulation, and metabolic disorders with low BAT activity. Both the EA and DD groups improved cognitive ability and decreased tau phosphorylation (p<0.01 or p<0.05). However, only the EA group had a significant effect on metabolic disorders and BAT thermogenesis (p<0.01 or p<0.05), while the DD group did not.

Conclusion

These findings indicate that EA not only improves the cognitive ability of SAMP8 mice, but also effectively regulates peripheral and central metabolic disorders, with this effect being significantly related to the activation of BAT thermogenesis.

Optimal low-cost cooling strategies for infant strollers during hot weather

The current study aimed to identity the optimal low-cost stroller cooling strategies for use in hot and moderately humid summer weather. A commercially available stroller was instrumented to assess the key parameters of the thermal environment. The cooling efficacy of eight different stroller configurations was examined in a counterbalanced order across 16 hot summer days (air temperature (Ta) = 33.3 ± 4.1 °C; relative humidity = 36.7 ± 15%; black globe temperature = 43.9 ± 4.6 °C). Compared with a standard-practice stroller configuration, combining a moist muslin draping with a battery-operated clip-on fan provided optimal in-stroller cooling, reducing the end-trial air temperature by 4.7 °C and the wet bulb globe temperature (WBGT) by 1.4 °C. In contrast, in-stroller temperatures were substantially increased by draping a dry muslin (Ta = +2.6 °C; WBGT = +0.9 °C) or flannelette (Ta = +3.7 °C; WBGT = +1.4 °C) cloth over the stroller carriage. These findings provide empirical evidence which may inform guidance aimed at protecting infants during hot weather.Practitioner summary: This study examined the efficacy of traditional and novel stroller cooling strategies for use in hot and moderately humid weather. Covering the carriage with a dry muslin cloth substantially increased stroller temperatures and should be avoided. Evaporative cooling methods reduced in-stroller temperatures. A moist muslin cloth draping combined with a fan provided optimal stroller cooling.

The association between childhood adiposity in northeast China and anthropogenic heat flux: A new insight into the comprehensive impact of human activities

Anthropogenic heat has been reported to have significant health impacts, but research on its association with childhood adiposity is still lacking. In this study, we matched the 2008-2012 average anthropogenic heat flux, as simulated by a grid estimation model using inventory methods, with questionnaire and measurement data of 49,938 children randomly recruited from seven cities in Northeast China in 2012. After adjusting for social demographic and behavioral factors, we used generalized linear mixed-effect models to assess the association between anthropogenic heat flux and adiposity among children. We also examined the effect modification of various social demographic and behavioral confounders. We found that each 10 W/m2 increase in total anthropogenic heat flux and that from the industry source was associated with an increase of 5.82% (95% CI = 0.84%-11.05%) and 6.62% (95% CI = 0.87%-12.70%) in the odds of childhood adiposity. Similarly, the excess rate of adiposity among children were 5.26% (95% CI = -1.33%-12.29%) and 8.51% (95% CI = 2.24%-15.17%) per 1 W/m2 increase in the anthropogenic heat flux from transportation and buildings, and was 7.94% (95% CI = 2.28%-13.91%) per 0.001 W/m2 increase in the anthropogenic heat flux from human metabolism. We also found generally greater effect estimates among female children and children who were exposed to passive smoking during pregnancy, born by caesarean section, non-breastfed/mixed-fed, or lived within 20 m adjacent to the main road. The potential deleterious effect of anthropogenic heat exposure on adiposity among children may make it a new but major threat to be targeted by future mitigation strategies.

Value of the combination of a smartphone-compatible infrared camera and a hand-held doppler ultrasound in preoperative localization of perforators in flaps

This study was conducted to evaluate the effectiveness of the FLIR ONE PRO, a thermal imaging camera for smartphones, combined with handheld Doppler (HHD) in the localization of perforator arteries and to assess the efficacy of the FLIR ONE PRO in distinguishing perforators of the descending branch of the lateral circumflex femoral artery (LCFA) from other perforators of the anterolateral thigh perforator (ALTP) flap. We enrolled 29 free perforator flaps from 22 patients in our study. Before surgery, dynamic infrared thermography was performed using a FLIR ONE PRO to visualize hotspots on the flaps. Subsequently, HHD was used to further determine the perforators under the hotspots, which were ultimately identified and confirmed through intraoperative findings. Additionally, infrared images of the ALTP flap were analyzed using FLIR Tools. The performances of the FLIR ONE PRO and FLIR ONE PRO + HHD groups were evaluated by comparing the intraoperative findings. Using FLIR ONE PRO + HHD, 119 hotspots and 106 perforators were identified during surgery. Using FLIR ONE PRO + HHD, sensitivity and positive predictive value were 97.87% and 88.46%, respectively, in the young (age≤45 years). In the elderly group (age>45 years), these percentages were 93.22% and 82.09%, respectively. In addition, we found that the FLIR ONE PRO could be useful for differentiating perforators in the descending branch of the LCFA from other perforators within 5 min. The results showed a sensitivity of 96.15%, a specificity of 98.9%, a positive predictive value of 96.15%, and a negative predictive value of 98.9%. Compared to using FLIR ONE PRO alone, the combined application of HHD and FLIR ONE PRO had a higher value in perforator localization by increasing the positive predictive value. The FLIR ONE PRO may have significance in the rapid prediction of perforators deriving from the descending branch of the LCFA.

Seasonal patterns of body temperature in response to experimental photoperiod variation in a non-hibernating ground squirrel

Unlike numerous other members of the holarctic Tribe Marmotini of the squirrel family (Sciuridae) that typically exhibit spontaneous bouts of torpor that progress into an annual season of hibernation, members of the genus Ammospermophilus (antelope ground squirrels) do not enter torpor, and they remain active throughout the year in nature. We have experimentally evaluated seasonal patterns of variation in the circadian rhythm of body temperature in captive A. leucurus over a two-and-a-half-year period by exposing groups to either a constant daily photoperiod of 12 h light or a seasonally changing photoperiod that cycled between a summer maximum of 16 h per day and a winter minimum of 8 h; ambient air temperature was maintained at 26 °C. All squirrels showed continuous, year-round diurnal locomotor activity, and the group exposed to seasonally changing photoperiod adjusted onset and end of activity to changes in duration of the photoperiod. Animals in both groups showed a marked circadian rhythm of core body temperature with a typical daytime level of about 38 °C and nighttime level of about 35 °C for most of each year, but the group exposed to naturally changing daylength surprisingly reduced the level of its circadian oscillation by about 2 °C at the winter seasonal extreme of shortest daily illumination to a daytime level about 36 °C and a nocturnal level of about 33 °C. Despite this modest experimentally induced reduction in the level of the circadian rhythm of body temperature, we conclude that A. leucurus shows an overall stable annual pattern of circadian rhythmicity of its core body temperature that is consistent with a lack of any other evidence that the species engages in torpor or hibernation.

Gender differences in adaptation to heat in Spain (1983-2018)

In Spain the average temperature has increased by 1.7 °C since pre-industrial times. There has been an increase in heat waves both in terms of frequency and intensity, with a clear impact in terms of population health. The effect of heat waves on daily mortality presents important territorial differences. Gender also affects these impacts, as a determinant that conditions social inequalities in health. There is evidence that women may be more susceptible to extreme heat than men, although there are relatively few studies that analyze differences in the vulnerability and adaptation to heat by sex. This could be related to physiological causes. On the other hand, one of the indicators used to measure vulnerability to heat in a population and its adaptation is the minimum mortality temperature (MMT) and its temporal evolution. The aim of this study was to analyze the values of MMT in men and women and its temporal evolution during the 1983-2018 period in Spain's provinces. An ecological, longitudinal retrospective study was carried out of time series data, based on maximum daily temperature and daily mortality data corresponding to the study period. Using cubic and quadratic fits between daily mortality rates and the temperature, the minimum values of these functions were determined, which allowed for determining MMT values. Furthermore, we used an improved methodology that provided for the estimation of missing MMT values when polynomial fits were inexistent. This analysis was carried out for each year. Later, based on the annual values of MMT, a linear fit was carried out to determine the rate of evolution of MMT for men and for women at the province level. Average MMT for all of Spain's provinces was 29.4 °C in the case of men and 28.7 °C in the case of women. The MMT for men was greater than that of women in 86 percent of the total provinces analyzed, which indicates greater vulnerability among women. In terms of the rate of variation in MMT during the period analyzed, that of men was 0.39 °C/decade, compared to 0.53 °C/decade for women, indicating greater adaptation to heat among women, compared to men. The differences found between men and women were statistically significant. At the province level, the results show great heterogeneity. Studies carried out at the local level are needed to provide knowledge about those factors that can explain these differences at the province level, and to allow for incorporating a gender perspective in the implementation of measures for adaptation to high temperatures.

Thermographic of the Microcirculation in Healthy Children Aged 3-10 Months as an Objective and Noninvasive Method of Assessment

BACKGROUND

The aim of this study was to assess if thermography as an objective and non-invasive research tool is capable of identifying the changes in the surface temperature of the body as a response to muscle stimulation in Vojta therapy. The research group consisted of children aged 3-10 months with slight abnormalities of the motor pattern, subjected to individually selected stimulation elements according to Vojta.

METHODS

The Vojta method of spontaneous motor assessment and the thermovision method of assessing the microcirculation properties of muscles were used for the evaluation.

RESULTS

In the study group, changes in the microcirculation parameters of the extensor muscles of the back occurred immediately after the therapy at the first examination.

CONCLUSIONS

The analysis featuring an objective assessment allows physiotherapists to diagnose local temperature changes based on the effect of microcirculation parameters in the musculofascial structures.

TRIAL REGISTRATION

The research was conducted as a pilot study for a scientific project approved by the Commission for Scientific Research of the University of Health and Sport Sciences in Wroclaw No 24/2021. The study is currently in the registration process with the Australian New Zealand Clinical Trials Registry.

Anesthesia care in the interventional neuroradiology suite: an update

PURPOSE OF REVIEW

The scope of procedures conducted by neurointerventionalists is expanding quickly, with lacking consensus over the best anesthesia modality. Although the procedures involve all age groups, the interventions may be complex and lengthy and may be provided in hospitals currently not yet familiar with the field. Here we review current literature addressing elective outpatient neurointerventional procedures and aim to provide an update on the management of intervention-specific crises, address special patient populations, and provide key learning points for everyday use in the neurointerventional radiology suite.

RECENT FINDINGS

Various studies have compared the use of different anesthesia modalities and preinterventional and postinterventional care. Monitored anesthesia care is generally recommended for elderly patients, whereas children are preferably treated with general anesthesia. Additional local anesthesia is beneficial for procedures, such as percutaneous kyphoplasty and vascular access.

SUMMARY

Combining different anesthetic modalities is a valuable approach in the neurointerventional radiology suite. More interventional and patient population-specific studies are needed to improve evidence-based perioperative management.

Superficial temperature distribution patterns before and after physical activity in school children are indicative for personalized exercise coaching and disease prevention

Background

Thermoregulation is highly individual and predictive for potentially cascading pathologies. Altered and deficient thermoregulation is considered an important diagnostic indicator which can be of great clinical utility for specialized screening programs and individualized prediction and prevention of severe pathologies triggered early in life.

Working hypothesis

Individual thermoregulation can be objectively assessed by thermovision camera before and after exercises in school children stratified by age and gender that may be of great clinical utility for personalized training early in life in the framework of 3P medicine.

Study design

In this study, 60 female and male primary school children were exposed to physical exercises in the form of 45-min general fitness training. The subjects under examination were stratified by age: group 1 (7-year-olds), group 2 (9-year-olds), and group 3 (12-year-olds). Superficial body temperature patterns were measured by means of thermovision camera before and immediately after exercises, as well as after the 15-min recovery time. Temperature patterns were analyzed in 12 areas of the body front and back, covering trunk and upper and lower limbs.

Results

The obtained results revealed an individual and age-depended difference in response of the body to exercises. The first measurement prior to exercise (measurement 1) revealed no statistically significant differences in the mean surface temperature of all analyzed areas between 7- and 9-year-old children. Further, 7- and 9-year-old children did not differ significantly in the mean temperature recorded in the trunk compared to the 12-year-old children. However, in 12-year-old children, statistically significant higher values of the mean temperature of the upper and lower limbs, were observed compared to the group of 7-year-olds and significantly higher values of the mean temperature of the lower limbs compared to the group of 9-year-olds. Immediately after exercises (measurement 2), a statistically significant decrease in the temperature was noted in all groups and in all areas of the body. The greatest temperature change was observed in 12-year-olds, while the least one was measured in the youngest subjects. The statistically significant relation between the average trunk temperature of 7-year-old and 12-year-old children was observed: lower values of the mean temperature of the front and back of the trunk were noted in the group of 12-year-old children compared to the group of 7-year-olds. A significantly lower average temperature of the back of the trunk compared to the youngest group was also recorded in 9-year-old children. The study performed after the 15-min recovery time (measurement 3) showed an increase in the average temperature of all analyzed areas. In all subjects, the mean temperature recorded in measurement 3 did not differ significantly from the initial ones (measurement 1, prior to exercises). Only the mean temperature of the trunk back of 12-year-old children was significantly lower after the rest period compared to the initial examination. In all groups, the temperatures after exercises followed by a 15-min recovery returned to the initial ones, except of the trunk backs of 12-year-old children, where the temperature was lower than before exercises.

Conclusions and expert recommendations in the framework of 3PM

Thermovision analysis is an effective tool to assess individual thermoregulation and to stratify school children for personalized exercise coaching. Body exercise-based disease prevention early in life is effective when tailored to the person: multi-parametric guidance for prescribing exercises individually is needed. Contextually, proposed individualized training approach should be adapted to the age-dependent particularities and individual thermoregulation.

Metabolic determinants of Alzheimer's disease: A focus on thermoregulation

Alzheimer's disease (AD) is a complex age-related neurodegenerative disease, associated with central and peripheral metabolic anomalies, such as impaired glucose utilization and insulin resistance. These observations led to a considerable interest not only in lifestyle-related interventions, but also in repurposing insulin and other anti-diabetic drugs to prevent or treat dementia. Body temperature is the oldest known metabolic readout and mechanisms underlying its maintenance fail in the elderly, when the incidence of AD rises. This raises the possibility that an age-associated thermoregulatory deficit contributes to energy failure underlying AD pathogenesis. Brown adipose tissue (BAT) plays a central role in thermogenesis and maintenance of body temperature. In recent years, the modulation of BAT activity has been increasingly demonstrated to regulate energy expenditure, insulin sensitivity and glucose utilization, which could also provide benefits for AD. Here, we review the evidence linking thermoregulation, BAT and insulin-related metabolic defects with AD, and we propose mechanisms through which correcting thermoregulatory impairments could slow the progression and delay the onset of AD.

Factors Associated With Rebound Hyperthermia After Targeted Temperature Management in Out-of-Hospital Cardiac Arrest Patients: An Explorative Substudy of the Time-Differentiated Therapeutic Hypothermia in Out-of-Hospital Cardiac Arrest Survivors Trial

Supplemental Digital Content is available in the text.

OBJECTIVES:

To investigate rebound hyperthermia following targeted temperature management after cardiac arrest and its impact on functional outcome.

DESIGN:

Post hoc analysis.

SETTING:

Ten European ICUs.

PATIENTS:

Patients included in the time-differentiated therapeutic hypothermia in out-of-hospital cardiac arrest survivors trial treated with targeted temperature management at 33°C for 48 or 24 hours. Favorable functional outcome was defined as a Cerebral Performance Category of 1 or 2 at 6 months.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Of 338 included patients, 103 (30%) experienced rebound hyperthermia defined as a maximum temperature after targeted temperature management and rewarming exceeding 38.5°C. Using multivariate logistic regression analysis, increasing age (odds ratio, 0.97; 95% CI, 0.95–0.99; p = 0.02) and severe acute kidney injury within 72 hours of ICU admission (odds ratio, 0.35; 95% CI, 0.13–0.91; p = 0.03) were associated with less rebound hyperthermia, whereas male gender (odds ratio, 3.94; 95% CI, 1.34–11.57; p = 0.01), highest C-reactive protein value (odds ratio, 1.04; 95% CI, 1.01–1.07; p = 0.02), and use of mechanical chest compression during cardiopulmonary resuscitation (odds ratio, 2.00; 95% CI, 1.10–3.67; p = 0.02) were associated with more rebound hyperthermia. Patients with favorable functional outcome spent less time after rewarming over 38.5°C (2.5% vs 6.3%; p = 0.03), 39°C (0.14% vs 2.7%; p < 0.01), and 39.5°C (0.03% vs 0.71%; p < 0.01) when compared with others. Median time to rebound hyperthermia was longer in the unfavorable functional outcome group (33.2 hr; interquartile range, 14.3–53.0 hr vs 6.5 hr; interquartile range, 2.2–34.1; p < 0.01). In a predefined multivariate binary logistic regression model, rebound hyperthermia was associated with decreased odds of favorable functional outcome (odds ratio, 0.42; 95% CI, 0.22–0.79).

CONCLUSIONS:

One-third of targeted temperature management patients experience rebound hyperthermia, and it is more common in younger male patients with an aggravated inflammatory response and those treated with a mechanical chest compression device. Later onset of rebound hyperthermia and temperatures exceeding 38.5°C associate with unfavorable outcome.

The association of compound hot extreme with mortality risk and vulnerability assessment at fine-spatial scale

The frequency and intensity of compound hot extremes will be likely to increase in the context of global warming. Epidemiological studies have demonstrated the adverse effect of simple hot extreme events on mortality, but little is known about the effects of compound hot extremes on mortality. Daily meteorological, demographic, and mortality data during 2011-2017 were collected from 160 streets in Guangzhou City, China. We used distributed lag non-linear model (DLNM) to analyze the associations of different hot extremes with mortality risk in each street. Street-specific associations were then combined using a meta-analysis approach. To assess the spatial distribution of vulnerability to compound hot extremes, vulnerable characteristics at street level were selected using random forest model, and then we calculated and mapped spatial vulnerability index (SVI) at each street in Guangzhou. At street level, compared with normal day, compound hot extreme significantly increased mortality risk (relative risk(RR)=1.43, 95%CI:1.28-1.59) with higher risk for female (RR=1.54 [1.35-1.76]) and the elderly(RR for aged 65-74=1.41 [1.14-1.74]; RR for ≥75years=1.63 [1.45-1.84]) than male (RR=1.32 [1.15-1.52]) and population <65 years (RR=1.01 [0.83-1.22]). Areas with high vulnerability were in the urban center and the edge of suburban. High proportion of population over 64 years old in urban center, and high proportions of outdoor workers and population with illiteracy in suburban areas were the determinants of spatial vulnerability. We found that compound hot extreme significantly increased mortality risk at street level, which is modified by socio-economic and demographic factors. Our findings help allocate resources targeting vulnerable areas at fine-spatial scale.°.

Impact of postoperative hypothermia on outcomes after off-pump coronary artery bypass grafting

BACKGROUND

Even though the physiological derangements caused by hypothermia are well described, there is no consensus about its impact on postoperative outcomes. The aim of this study is to assess the effect of postoperative hypothermia on outcomes after off-pump coronary artery bypass surgery.

METHODS

A total of 1979 patients undergoing isolated off-pump coronary artery bypass surgery in a single center in the period 2007-2018 were classified according to their axillary temperature measurement at intensive care unit admission postoperatively to either hypothermic (<36°C) or normothermic (≥36°C). Between-group differences on baseline characteristics and postoperative outcomes were assessed before and after propensity score matching.

RESULTS

Data analysis showed that 582 patients (29.4%) were hypothermic (median temperature 35.5°C) and 1397 patients (70.6%) were normothermic (median temperature 36.4°C). Using propensity score matching, 567 patient pairs were created. Patients with hypothermia exhibited a higher rate of postoperative transfusion of at least three red cell concentrate units (14.3% vs 9%, p = 0.005), a longer intubation duration (median duration, 6 vs 5 h, p < 0.0001), and a longer intensive care unit stay (median stay, 1.6 vs 1.3 days, p = 0.008). There was no difference in reoperation for bleeding, renal replacement therapy, infections, and mortality between the two groups.

CONCLUSIONS

Even though associated with a higher blood transfusion requirement and a slightly longer intensive care unit stay, mild postoperative hypothermia was not associated with a higher morbidity and mortality.

Age-Related Changes in the Thermoregulatory Properties in Bank Voles From a Selection Experiment

As with many physiological performance traits, the capacity of endotherms to thermoregulate declines with age. Aging compromises both the capacity to conserve or dissipate heat and the thermogenesis, which is fueled by aerobic metabolism. The rate of metabolism, however, not only determines thermogenic capacity but can also affect the process of aging. Therefore, we hypothesized that selection for an increased aerobic exercise metabolism, which has presumably been a crucial factor in the evolution of endothermic physiology in the mammalian and avian lineages, affects not only the thermoregulatory traits but also the age-related changes of these traits. Here, we test this hypothesis on bank voles (Myodes glareolus) from an experimental evolution model system: four lines selected for high swim-induced aerobic metabolism (A lines), which have also increased the basal, average daily, and maximum cold-induced metabolic rates, and four unselected control (C) lines. We measured the resting metabolic rate (RMR), evaporative water loss (EWL), and body temperature in 72 young adult (4 months) and 65 old (22 months) voles at seven ambient temperatures (13-32°C). The RMR was 6% higher in the A than in the C lines, but, regardless of the selection group or temperature, it did not change with age. However, EWL was 12% higher in the old voles. An increased EWL/RMR ratio implies either a compromised efficiency of oxygen extraction in the lungs or increased skin permeability. This effect was more profound in the A lines, which may indicate their increased vulnerability to aging. Body temperature did not differ between the selection and age groups below 32°C, but at 32°C it was markedly higher in the old A-line voles than in those from other groups. As expected, the thermogenic capacity, measured as the maximum cold-induced oxygen consumption, was decreased by about 13% in the old voles from both selection groups, but the performance of old A-line voles was the same as that of the young C-line ones. Thus, the selection for high aerobic exercise metabolism attenuated the adverse effects of aging on cold tolerance, but this advantage has been traded off by a compromised coping with hot conditions by aged voles.

Thermal Sensation in Older People with and without Dementia Living in Residential Care: New Assessment Approaches to Thermal Comfort Using Infrared Thermography

The temperature of the indoor environment is important for health and wellbeing, especially at the extremes of age. The study aim was to understand the relationship between self-reported thermal sensation and extremity skin temperature in care home residents with and without dementia. The Abbreviated Mental Test (AMT) was used to discriminate residents to two categories, those with, and those without, dementia. After residents settled and further explanation of the study given (approximately 15 min), measurements included: tympanic membrane temperature, thermal sensation rating and infrared thermal mapping of non-dominant hand and forearm. Sixty-nine afebrile adults (60-101 years of age) were studied in groups of two to five, in mean ambient temperatures of 21.4-26.6 °C (median 23.6 °C). Significant differences were observed between groups; thermal sensation rating (p = 0.02), tympanic temperature (p = 0.01), fingertip skin temperature (p = 0.01) and temperature gradients; fingertip-wrist p = 0.001 and fingertip-distal forearm, p = 0.001. Residents with dementia were in significantly lower air temperatures (p = 0.001). Although equal numbers of residents per group rated the environment as 'neutral' (comfortable), resident ratings for 'cool/cold' were more frequent amongst those with dementia compared with no dementia. In parallel, extremity (hand) thermograms revealed visual temperature demarcation, variously across fingertip, wrist, and forearm commensurate with peripheral vasoconstriction. Infrared thermography provided a quantitative and qualitative method to measure and observe hand skin temperature across multiple regions of interest alongside thermal sensation self-report. As an imaging modality, infrared thermography has potential as an additional assessment technology with clinical utility to identify vulnerable residents who may be unable to communicate verbally, or reliably, their satisfaction with indoor environmental conditions.

Infrared thermography to prognose the venous leg ulcer healing process-preliminary results of a 12-week, prospective observational study

Venous leg ulcers are complex, and their multifactorial etiology make successful treatment a difficult and long process. Nonhealing ulcers are the greatest challenge because they are resistant to standard therapies. In this study, we analyzed whether monitoring the temperature of the ulcered limb wound area could benefit the diagnosis of the wound's tendency to heal (estimating the presence of a healing or nonhealing wound) in patients with two-sided venous leg ulcers. This prospective, 12-week observational study included 57 adult individuals with chronic venous leg ulcers. The dynamics of wound healing was assessed by planimetry and infrared thermography every two weeks. We analyzed temperatures measured at three marked areas-the wound, the periwound skin, and the reference area. An initial wound area larger than 1 cm² was associated with a temperature increase of 0.027 °C in the periwound skin. A 1-cm² decrease in the wound area was associated with a 0.04 °C decrease in the temperature difference between the periwound skin and wound. A strong positive relationship was identified for both the bacteriology variables (the presence of bacteria: temperature increase in the periwound skin of 0.4 °C, p < 0.001; the number of bacterial species in a wound, temperature increase of 0.95 °C, p < 0.001). The temperature in the reference area was significantly correlated with the failure of the superficial and perforating veins (temperature increase of 0.69 °C, p = 0.04). This study reports that the assessment of the temperature a limb may be beneficial in predicting whether an ulcer is a healing or a nonhealing ulcer. The decrease in the temperature differences between the areas referred to as healing wounds was the only beneficial prognostic marker. Other temperature differences in the periwound skin were caused by disorders, such as multibacterial wound infections and superficial venous inflammation.

Brain diseases in changing climate

Climate change is one of the biggest and most urgent challenges for the 21st century. Rising average temperatures and ocean levels, altered precipitation patterns and increased occurrence of extreme weather events affect not only the global landscape and ecosystem, but also human health. Multiple environmental factors influence the onset and severity of human diseases and changing climate may have a great impact on these factors. Climate shifts disrupt the quantity and quality of water, increase environmental pollution, change the distribution of pathogens and severely impacts food production - all of which are important regarding public health. This paper focuses on brain health and provides an overview of climate change impacts on risk factors specific to brain diseases and disorders. We also discuss emerging hazards in brain health due to mitigation and adaptation strategies in response to climate changes.

Love is a physiological motivation (like hunger, thirst, sleep or sex)

The multitude of terms associated with love has given rise to a false perception of love. In this paper, only maternal and romantic love are considered. Love is usually regarded as a feeling, motivation, addiction, passion, and, above all, an emotion. This confusion has consequences in the lives of human beings, leading not only to divorces, suicides, femicides but possibly also to a number of mental illnesses and suffering. Therefore, it is crucial to first clarify what is meant by emotion, motivation and love. This work aims to finally place love within the category of physiological motivations, such as hunger, thirst, sleep, or sex, on the basis that love is also essential for human survival, especially in childhood. Love is presented from an evolutionary perspective. Some other similarities between love and other physiological motivations are pointed out, such as its importance for appropriate human development, both its ontogeny and its permanence, and the long-lasting consequences of abuse and neglect. There are summarized reasons that account for this, such as the fact that physiological motivations are essential for survival and that love is an essential motivation for the survival of human offspring. Other reasons are that minimum changes in the quantity and quality of love alters development, that there can be a variety of neurophysiological and behavioural states within a motivation, and that motivations (also love) appear and change throughout development. Also, motivations and love sometimes may lead to an addictive behaviour. Finally, it is recognized that once physiological motivations (and love) appear, they become permanent. In a third section, some potential social, cultural, clinical and scientific consequences of the proposed consideration of love as a motivation are discussed. Accordingly, love's recognition as a motivation in the clinical field would imply a better understanding of its disorders and its inclusion in classifications manuals such as The Diagnostic and Statistical Manual of Mental Disorders (DSM), or in the International Classification of Diseases (ICD). Considering love as a motivation rather than an emotion could also impact the results of scientific research (an example is included). A comprehensive understanding of these questions could potentially allow for a new therapeutic approach in the treatment of mental illness, while offering an all-inclusive evolutionary explanation of cultural phenomena such as the origin and diffusion of both language and art. Love should be understood as a physiological motivation, like hunger, sleep or sex, and not as an emotion as it is commonly considered.