Materials used to simulate physical properties of human skin

In vitro 3D skin culture and its sustainability in toxicology: a narrative review

In current toxicological research, 2D cell cultures and animal models are well- accepted and commonly employed methods. However, these approaches have many drawbacks and are distant from the actual environment in human. To embrace this, great efforts have been made to provide alternative methods for non-animal skin models in toxicology studies with the need for more mechanistically informative methods. This review focuses on the current state of knowledge regarding the in vitro 3D skin model methods, with different functional states that correspond to the sustainability in the field of toxicology testing. We discuss existing toxicology testing methods using in vitro 3D skin models which provide a better understanding of the testing requirements that are needed. The challenges and future landscape in using the in vitro 3D skin models in toxicology testing are also discussed. We are confident that the in vitro 3D skin models application may become an important tool in toxicology in the context of risk assessment.

mTG-Gelatin phantoms as standardized testbeds for skin biomechanical measurements with Myoton

Quantitative assessment of skin mechanical properties can play a pivotal role in diagnosing and tracking various dermatological conditions. Myoton is a promising tool that rapidly and noninvasively measures five skin biomechanical parameters. Accurate interpretation of these parameters requires systematic in vitro testing with easy-to-fabricate, cost-effective skin-mimicking phantoms with controllable properties. In this study, we assessed the ability of phantoms made with 5% and 10% gelatin crosslinked with microbial transglutaminase (mTG) to mimic the human skin for Myoton measurements. We discovered that each of the five Myoton parameters displayed moderate to high correlations with shear elastic modulus of the phantoms. Furthermore, Myoton effectively tracked changes in the mechanical properties of these models over time. Additionally, we designed bilayer phantoms incorporating both dermis and subcutaneous tissue-mimicking layers. Myoton successfully distinguished changes in the mechanical properties of the bilayer phantoms due to the introduction of a stiff 2 mm top layer. We also found that 5% mTG-gelatin phantoms mimic Myoton measurements from healthy subjects and 10% phantoms mimic patients with sclerotic chronic graft-versus-host disease (cGVHD). Therefore, multi-layered mTG-gelatin models for skin and soft tissues can serve as standardized testbeds to study different sclerotic skin conditions in a systematic manner.

From lab to wearables: Innovations in multifunctional hydrogel chemistry for next-generation bioelectronic devices

Functional hydrogels have emerged as foundational materials in diagnostics, therapy, and wearable devices, owing to their high stretchability, flexibility, sensing, and outstanding biocompatibility. Their significance stems from their resemblance to biological tissue and their exceptional versatility in electrical, mechanical, and biofunctional engineering, positioning themselves as a bridge between living organisms and electronic systems, paving the way for the development of highly compatible, efficient, and stable interfaces. These multifaceted capability revolutionizes the essence of hydrogel-based wearable devices, distinguishing them from conventional biomedical devices in real-world practical applications. In this comprehensive review, we first discuss the fundamental chemistry of hydrogels, elucidating their distinct properties and functionalities. Subsequently, we examine the applications of these bioelectronics within the human body, unveiling their transformative potential in diagnostics, therapy, and human-machine interfaces (HMI) in real wearable bioelectronics. This exploration serves as a scientific compass for researchers navigating the interdisciplinary landscape of chemistry, materials science, and bioelectronics.

Tape Stripping Method in Dermatological and Pharmacological Research: Evaluating Fresh and Frozen-Thawed Porcine Skin

Background The stratum corneum (SC) plays a crucial role in protecting the skin and regulating water loss. Tape stripping is a well-established method for studying skin barrier function and evaluating topical treatments. However, the behavior of fresh versus frozen-thawed skin during tape stripping has not been extensively compared. Objective This study aims to compare the removal of the stratum corneum from fresh and frozen-thawed porcine skin using tape stripping. It also aims to assess the reliability of tape weighing versus histological methods in quantifying SC removal. Methods Fresh and frozen-thawed porcine ears were obtained, cleaned, and subjected to tape stripping at varying numbers of strips from zero to 40. Tape weight and histological measurements were used to quantify SC removal. Statistical analyses were conducted to compare SC thickness and tape weight between the two types of skin. Results The study found that frozen-thawed skin exhibited a non-linear rate (r = 0.65) of SC removal per tape strip in the first five strips compared to a linear removal for fresh skin (r = 0.96). By the fifth tape strip, frozen-thawed samples had lost 80.6% of their SC, while fresh samples had only lost 33.5% (P < 0.03). Tape weighing and histological measurements showed strong correlations (r = 0.93 for fresh skin and r = 0.95 for frozen-thawed skin), indicating that tape weighing is a reliable alternative to histology for assessing SC removal on both sample types. Conclusions Fresh and frozen-thawed porcine skin respond differently to tape stripping, with frozen-thawed skin showing accelerated SC removal in the first five strips. The strong correlation between tape weighing and histological analysis supports the use of tape weighing as a practical tool for evaluating SC removal. These findings have implications for specimen selection and methodological standardization in dermatological and pharmacological research. Future research should explore alternative preservation and SC thickness measurement methods and their impact on tape stripping outcomes.

Engineered Bacteria as Living Biosensors in Dermal Tattoos

Dermal tattoo biosensors are promising platforms for real-time monitoring of biomarkers, with skin used as a diagnostic interface. Traditional tattoo sensors have utilized small molecules as biosensing elements. However, the rise of synthetic biology has enabled the potential employment of engineered bacteria as living analytical tools. Exploiting engineered bacterial sensors will allow for potentially more sensitive detection across a broad biomarker range, with advanced processing and sense/response functionalities using genetic circuits. Here, the interfacing of bacterial biosensors as living analytics in tattoos is shown. Engineered bacteria are encapsulated into micron-scale hydrogel beads prepared through scalable microfluidics. These biosensors can sense both biochemical cues (model biomarkers) and biophysical cues (temperature changes, using RNA thermometers), with fluorescent readouts. By tattooing beads into skin models and confirming sensor activity post-tattooing, our study establishes a foundation for integrating bacteria as living biosensing entities in tattoos.

Aquatic conditions & bacterial communities as drivers of the decomposition of submerged remains

Aquatic decomposition, as a forensic discipline, has been largely under-investigated as a consequence of the highly complex and influential variability of the water environment. The limitation to the adaptability of scenario specific results justifies the necessity for experimental research to increase our understanding of the aquatic environment and the development of post-mortem submersion interval (PMSI) methods of estimation. This preliminary research aims to address this contextual gap by assessing the variation in the bacterial composition of aquatic biofilms as explained by water parameter measurements over time, associated with clothed and bare decomposing remains. As part of three field investigations, a total of 9 still-born piglets (n = 3, per trial) were used as human analogues and were submerged bare or clothed in either natural cotton or synthetic nylon. Changes in the bacterial community composition of the water surrounding the submerged remains were assessed at 4 discrete time points post submersion (7, 14, 21 and 28 days) by 16 S rRNA gene Next Generation Sequencing analysis and compared to coinciding water parameter measurements (i.e. conductivity, total dissolved solids (TDS), salinity, pH, and dissolved oxygen (DO)). Bacterial diversity was found to change over time and relative to clothing type, where significant variation was observed between synthetic nylon samples and bare/cotton samples. Seasonality was a major driver of bacterial diversity, where substantial variation was found between samples collected in early winter to those collected in mid - late winter. Water parameter measures of pH, salinity and DO were identified to best explain the global bacterial community composition and their corresponding dynamic trajectory patterns overtime. Further investigation into bacterial community dynamics in accordance with varying environmental conditions could potentially lead to the determination of influential extrinsic factors that may drive bacterial activity in aquatic decomposition. Together with the identification of potential bacterial markers that complement the different stages of decomposition, this may provide a future approach to PMSI estimations.

Characterising Skin Electrical Impedance Using Tape Stripping Methods: A Bioelectrical Study of a Porcine Model

Background Recent advancements in ultra-low power electronics and wireless devices have facilitated the widespread adoption of wearable technology for fitness and health monitoring, paving the way for personalized medicine. Microneedle-based devices, comprising small epidermal patches that penetrate the skin's stratum corneum to potentially access biomarkers in the extracellular fluid of the viable epidermis, represent a promising innovation in this field. Objectives This project aimed to develop and validate a novel method to evaluate microneedle engagement in the skin in real-time. To our knowledge, there are no studies published to date that have characterized the electrical impedance of stratum corneum and epidermis using the tape stripping method to selectively remove cell layers. Additionally, no studies have been published comparing the electrical impedance of fresh to frozen-thawed porcine skin. The objective of this study was to develop and validate a novel method to evaluate microneedle engagement in skin, in real-time, that does not require processing of the tissue. Methods A tape stripping technique was employed to selectively remove the stratum corneum from fresh and frozen-thawed porcine skin samples which were then electrically characterized using an excitation frequency of 5 kHz with a peak Voltage of 1 V. Results This study demonstrated a mean impedance reduction of 97.08 ± 1.3 % for fresh porcine skin, and 98.04 ± 0.3 % for frozen-thawed porcine skin when transitioning from the surface stratum corneum to the viable epidermis. The correlation between the reduction of impedance and the number of tape strips across all 18 test sites was significant (r = 0.98, p < 0.00001). However, comparing the skin impedance of the fresh and frozen-thawed specimens showed poor equivalence, with the frozen-thawed sites approximately 5.5 times the impedance of the fresh sites before any tape stripping, and 4.19 times greater after 30 tape strips. Conclusions These findings suggest that monitoring for an interelectrode impedance decrease of greater than 95% between two projections of a microneedle device could provide a rapid and effective evaluation of skin engagement, crucial for advancing the development and clinical application of microneedle-based technologies in personalized medicine. The study also underscores the impact of the freeze-thaw process on the mechanical and electrical properties of skin, which is crucial for standardizing testing protocols.

Predicting tactile sensory attributes of personal care emulsions based on instrumental characterizations: A review

Emulsions in the form of creams, lotions, gels or foams are the most widely used personal care formulations to improve the condition and feel of the skin. Achieving an optimal balance between their performance, effectiveness and sensory profile is essential, with the sensory profile being a key factor in consumer satisfaction and the success of these products in the market. Well-established methods using highly trained and semi-trained panels (e.g. Spectrum descriptive analysis, Flash Profile method, Quantitative Descriptive Analysis method and 'Check-all-that-apply') are available and commonly used for the sensory assessment of personal care products. Nevertheless, a common drawback among all these methods is their inherent cost, both in terms of financial resources and time requirements. In recent years, research studies have emerged to address this limitation by investigating potential correlations between tactile sensory attributes and instrumental data associated with the physical characteristics of topical formulations. In other words, significant efforts have been invested in the development of robust instrumental methods specifically designed to accurately predict the sensory description that a panel of assessors could establish. These methods are not only faster, cheaper and more objective compared to traditional sensory testing, but they can also be applied to formulations that have not undergone extensive safety and toxicological testing. This review summarizes the most relevant findings, trends and current challenges in predicting tactile sensory attributes of personal care emulsions based on instrumental parameters.

3D MODEL of an anatomically inert human hand: feasibility study

OBJECTIVES

Surgery for congenital malformation of the hand is complex and protocols are not available. Simulation could help optimize results. The objective of the present study was to design, produce and assess a 3D-printed anatomical support, to improve success in rare and complex surgeries of the hand.

MATERIAL AND METHODS

We acquired MRI imaging of the right hand of a 30 year-old subject, then analyzed and split the various skin layers for segmentation. Thus we created the prototype of a healthy hand, using 3D multi-material and silicone printing devices, and drew up a printing protocol suitable for all patients. We printed a base comprising bones, muscles and tendons, with a multi-material 3D printer, then used a 3D silicone printer for skin and subcutaneous fatty cell tissues in a glove-like shape. To evaluate the characteristics of the prototype, we performed a series of dissections on the synthetic hand and on a cadaveric hand in the anatomy lab, comparing realism, ease of handling and the final result of the two supports, and evaluated their respective advantages in surgical and training contexts. A grading form was given to each surgeon to establish a global score.

RESULTS

This evaluation highlighted the positive and negative features of the model. The model avoided intrinsic problems of cadavers, such as muscle rigidity or tissue fragility and atrophy, and enables the anatomy of a specific patient to be rigorously respected. On the other hand, vascular and nervous networks, with their potential anatomical variants, are lacking. This preliminary phase highlighted the advantages and inconveniences of the prototype, to optimize the design and printing of future models. It is an indispensable prerequisite before performing studies in eligible pediatric patients with congenital hand malformation.

CONCLUSION

The validation of 3D-printed anatomical model of a human hand opens a large field of applications in the area of preoperative surgical planning. The postoperative esthetic and functional benefit of such pre-intervention supports in complex surgery needs assessing.

A Dynamic Ultrasound Phantom with Tissue-Mimicking Mechanical and Acoustic Properties

Tissue-mimicking phantoms are valuable tools that aid in improving the equipment and training available to medical professionals. However, current phantoms possess limited utility due to their inability to precisely simulate multiple physical properties simultaneously, which is crucial for achieving a system understanding of dynamic human tissues. In this work, novel materials design and fabrication processes to produce various tissue-mimicking materials (TMMs) for skin, adipose, muscle, and soft tissue at a human scale are developed. Target properties (Young's modulus, density, speed of sound, and acoustic attenuation) are first defined for each TMM based on literature. Each TMM recipe is developed, associated mechanical and acoustic properties are characterized, and the TMMs are confirmed to have comparable mechanical and acoustic properties with the corresponding human tissues. Furthermore, a novel sacrificial core to fabricate a hollow, ellipsoid-shaped bladder phantom complete with inlet and outlet tubes, which allow liquids to flow through and expand this phantom, is adopted. This dynamic bladder phantom with realistic mechanical and acoustic properties to human tissues in combination with the developed skin, soft tissue, and subcutaneous adipose tissue TMMs, culminates in a human scale torso tank and electro-mechanical system that can be systematically utilized for characterizing various medical imaging devices.

Toward Synthetic Physical Fingerprint Targets

Biometric fingerprint identification hinges on the reliability of its sensors; however, calibrating and standardizing these sensors poses significant challenges, particularly in regards to repeatability and data diversity. To tackle these issues, we propose methodologies for fabricating synthetic 3D fingerprint targets, or phantoms, that closely emulate real human fingerprints. These phantoms enable the precise evaluation and validation of fingerprint sensors under controlled and repeatable conditions. Our research employs laser engraving, 3D printing, and CNC machining techniques, utilizing different materials. We assess the phantoms' fidelity to synthetic fingerprint patterns, intra-class variability, and interoperability across different manufacturing methods. The findings demonstrate that a combination of laser engraving or CNC machining with silicone casting produces finger-like phantoms with high accuracy and consistency for rolled fingerprint recordings. For slap recordings, direct laser engraving of flat silicone targets excels, and in the contactless fingerprint sensor setting, 3D printing and silicone filling provide the most favorable attributes. Our work enables a comprehensive, method-independent comparison of various fabrication methodologies, offering a unique perspective on the strengths and weaknesses of each approach. This facilitates a broader understanding of fingerprint recognition system validation and performance assessment.

Proximity Sensing Electronic Skin: Principles, Characteristics, and Applications

The research on proximity sensing electronic skin has garnered significant attention. This electronic skin technology enables detection without physical contact and holds vast application prospects in areas such as human-robot collaboration, human-machine interfaces, and remote monitoring. Especially in the context of the spread of infectious diseases like COVID-19, there is a pressing need for non-contact detection to ensure safe and hygienic operations. This article comprehensively reviews the significant advancements in the field of proximity sensing electronic skin technology in recent years. It covers the principles, as well as single-type proximity sensors with characteristics such as a large area, multifunctionality, strain, and self-healing capabilities. Additionally, it delves into the research progress of dual-type proximity sensors. Furthermore, the article places a special emphasis on the widespread applications of flexible proximity sensors in human-robot collaboration, human-machine interfaces, and remote monitoring, highlighting their importance and potential value across various domains. Finally, the paper provides insights into future advancements in flexible proximity sensor technology.

Strategies in surface engineering for the regulation of microclimates in skin-medical product interactions

There is a growing number of personal healthcare devices that are in prolonged contact with the skin. The functionality of these products is linked to the interface formed by the contact between the medical apparatus and the skin. The interface can be characterised by its topology, compliance, and moisture and thermal regulating capabilities. Many devices are, however, described to have suboptimal and occlusive contacts, resulting in physiological unfavourable microclimates at the interface. The resulting poor management of moisture and temperature can impact the functionality and utility of the device and, in severe cases, lead to physical harm to the user. Being able to control the microclimate is therefore expected to limit medical-device related injuries and prevent associated skin complications. Surface engineering can modify and potentially enhance the regulation of the microclimate factors surrounding the interface between a product's surface and the skin. This review provides an overview of potential engineering solutions considering the needs for, and influences on, regulation of temperature and moisture by considering the skin-medical device interface as a system. These findings serve as a platform for the anticipated progress in the role of surface engineering for skin-device microclimate regulation.

Biomimetic Electronic Skin through Hierarchical Polymer Structural Design

Human skin comprises multiple hierarchical layers that perform various functions such as protection, sensing, and structural support. Developing electronic skin (E-skin) with similar properties has broad implications in health monitoring, prosthetics, and soft robotics. While previous efforts have predominantly concentrated on sensory capabilities, this study introduces a hierarchical polymer system that not only structurally resembles the epidermis-dermis bilayer structure of skin but also encompasses sensing functions. The system comprises a polymeric hydrogel, representing the "dermis", and a superimposed nanoporous polymer film, forming the "epidermis". Within the film, interconnected nanoparticles mimic the arrangement of interlocked corneocytes within the epidermis. The fabrication process employs a robust in situ interfacial precipitation polymerization of specific water-soluble monomers that become insoluble during polymerization. This process yields a hybrid layer establishing a durable interface between the film and hydrogel. Beyond the structural mimicry, this hierarchical structure offers functionalities resembling human skin, which includes (1) water loss protection of hydrogel by tailoring the hydrophobicity of the upper polymer film; (2) tactile sensing capability via self-powered triboelectric nanogenerators; (3) built-in gold nanowire-based resistive sensor toward temperature and pressure sensing. This hierarchical polymeric approach represents a potent strategy to replicate both the structure and functions of human skin in synthetic designs.

Silk fibroin-derived electrospun materials for biomedical applications: A review

Electrospinning is a versatile technique for fabricating polymeric fibers with diameters ranging from micro- to nanoscale, exhibiting multiple morphologies and arrangements. By combining silk fibroin (SF) with synthetic and/or natural polymers, electrospun materials with outstanding biological, chemical, electrical, physical, mechanical, and optical properties can be achieved, fulfilling the evolving biomedical demands. This review highlights the remarkable versatility of SF-derived electrospun materials, specifically focusing on their application in tissue regeneration (including cartilage, cornea, nerves, blood vessels, bones, and skin), disease treatment (such as cancer and diabetes), and the development of controlled drug delivery systems. Additionally, we explore the potential future trends in utilizing these nanofibrous materials for creating intelligent biomaterials, incorporating biosensors and wearable sensors for monitoring human health, and also discuss the bottlenecks for its widespread use. This comprehensive overview illuminates the significant impact and exciting prospects of SF-derived electrospun materials in advancing biomedical research and applications.

Dermal tissue penetration of in-plane silicon microneedles evaluated in skin-simulating hydrogel, rat skin and porcine skin

Recently, microneedle-based sensors have been introduced as novel strategy for in situ monitoring of biomarkers in the skin. Here, in-plane silicon microneedles with different dimensions and shapes are fabricated and their ability to penetrate skin is evaluated. Arrays with flat, triangular, hypodermic, lancet and pencil-shaped microneedles, with lengths of 500-1000 μm, widths of 200-400 μm and thickness of 180-500 μm are considered. Fracture force is higher than 20 N for all microneedle arrays (MNA) confirming a high mechanical stability of the microneedles. Penetration force in skin-simulating hydrogels, excised rat abdominal skin and porcine ear skin is at least five times lower than the fracture force for all MNA designs. The lowest force for skin penetration is required for triangular microneedles with a low width and thickness. Skin tissue staining and histological analysis of rat abdominal skin and porcine ear skin confirm successful penetration of the epidermis for all MNA designs. However, the penetration depth is between 100 and 300 μm, which is considerably lower than the microneedle length. Tissue damage estimated by visual analysis of the penetration hole is smallest for triangular microneedles. Penetration ability and tissue damage are compared to the skin prick test (SPT) needle applied in allergy testing.

Difficulties in using simulation to assess abdominal palpation skills

OBJECTIVES

Abdominal palpation is an essential examination to diagnose various digestive system diseases. This study aimed to develop an objective and standardized test based on abdominal palpation simulators, and establish a credible pass/fail standard of basic competency.

METHODS

Two tests were designed using the newly developed Jucheng abdominal palpation simulator (test 1) and the AbSim simulator (test 2), respectively. Validity evidence for both tests was gathered according to Messick's contemporary framework by using experts to define test content and then administering the tests in a highly standardized way to participants of different experience. Different simulator setups modified by the built-in software were selected from hepatomegaly, splenomegaly, positive McBurney's sign plus rebound tenderness, gallbladder tenderness (Murphy's sign), pancreas tenderness, and a normal setup without pathologies, with six sets used in test 1 and five sets used in test 2. Different novices and experienced were included in the tests, and test 1 was also administered to an intermediate group. Scores and test time were collected and analyzed statistically.

RESULTS

The internal consistency reliability of test 1 and test 2 showed low Cronbach's alphas of 0.35 and -0.41, respectively. Cronbach's alpha for palpation time across cases were 0.65 for test 1 and 0.76 for test 2. There was no statistical difference in total time spent and total scores among the three groups in test 1 (P-values (ANOVA) were 0.53 and 0.35 respectively), nor between novices and experienced groups in test 2 (P-values (t-test) were 0.13 and 1.0 respectively). It was not relevant to try to establish pass/fail standards due to the low reliability and lack of discriminatory ability of the tests.

CONCLUSIONS

It was not possible to measure abdominal palpation skills in a valid way using either of the two standardized, simulation-based tests in our study. Assessment of the patient's abdomen using palpation is a challenging clinical skill that is difficult to simulate as it highly relies on tactile sensations and adequate responsiveness from the patients.

Mechanical characterisation of commercial artificial skin models

Understanding of the mechanical properties of skin is crucial in evaluating the performance of skin-interfacing medical devices. Artificial skin models (ASMs) have rapidly gained attention as they are able to overcome the challenges in ethically sourcing consistent and representative ex vivo animal or human tissue models. Although some ASMs have become commercialised, a thorough understanding of the mechanical properties of the skin models is crucial to ensure that they are suitable for the purpose of the study. In the present study, skin and fat layers of ASMs (Simulab®, LifeLike®, SynDaver® and Parafilm®) were mechanically characterised through hardness, needle insertion, tensile and compression testing. Different boundary constraint conditions (minimally and highly constrained) were investigated for needle insertion testing, while anisotropic properties of the skin models were investigated through different specimen orientations during tensile testing. Analysis of variance (ANOVA) tests were performed to compare the mechanical properties between the skin models. Properties of the skin models were compared against literature to determine the suitability of the skin models based on the material property of interest. All skin models offer relatively consistent mechanical performance, providing a solid basis for benchtop evaluation of skin-interfacing medical device performance. Through prioritising models with mechanical properties that are consistent with human skin data, and with limited variance, researchers can use the data presented here as a toolbox to select the most appropriate ASM for their particular application.

A skin patch integrating swellable microneedles and electrochemical test strips for glucose and alcohol measurement in skin interstitial fluid

Microneedle (MN)-based diagnostic devices can efficiently access skin interstitial fluid (ISF) for accurate and minimally invasive detection of health-related biomarkers. This work reports a biomarker (i.e., glucose or alcohol) monitoring MN device that is composed of swellable MNs and electrochemical test strip. This device is constructed by adhering MN patch on the electrochemical strips using the chitosan as the connecting layer. The MNs penetrate the skin for extraction of ISF that flows to the backing layer of MNs and is analyzed by the test strip. In the in vitro skin models, this device accurately detects the glucose from 0 mM to 12 mM and alcohol from 0 mM to 20 mM. In vivo experiment shows this MN device is capable of minimally invasive sampling of ISF and analysis of glucose levels to determine the glycemic status of mice.

Skin and Artificial Skin Models in Electrical Sensing Applications

Skin electrical properties play a significant role in recording biopotentials by using electrophysiological sensors. To test and evaluate sensor systems, it is commonly accepted to employ artificial skin models due to complications associated with testing on living tissues. The first goal of this Review is to provide a systematic understanding of the relation between skin structure and skin electrochemical behavior at an appropriate depth for electrophysiological sensing applications through a focus on skin structure, electrochemical properties of skin, and theoretical models (equivalent circuits) representing skin electrochemical behavior. The second goal is to review artificial skin models mimicking the electrochemical properties of skin and to give suggestions for future studies on relevant skin models based on a comparison between the behavior of skin and that of artificial skin models. The Review aims to help the reader to analyze the relation between the structure, elements of the equivalent circuits, and the resulting impedance data for both skin and artificial skin models.

A Novel Robust Method Mimicking Human Substratum To Dissect the Heterogeneity of Candida auris Biofilm Formation

Candida auris is a pathogen of urgent threat level as marked by the CDC. The formation of biofilms is an essential property of this fungus to establish infection and escape drug treatment. However, our understanding of pathogenesis through biofilm is hampered by heterogeneity in C. auris biofilms observed in different studies. It is imperative to replicate in vivo conditions for studying C. auris biofilm formation in vitro. Different methods are standardized, but the surface used to form biofilms lacks consistency as well as the architecture of a typical biofilm. Here, we report an in vitro technique to grow C. auris biofilms on gelatin-coated coverslips. Interestingly, C. auris cells grown on gelatin-coated coverslips either on modified synthetic sweat media or RPMI 1640 resulted in similar multilayer biofilm formation with extracellular polymeric substances (EPS). This method is also consistent with the biofilm formation of other Candida species, such as Candida glabrata and Candida albicans. Biofilms of C. glabrata developed through this method show pseudohyphae and EPS. This method can be used to understand the molecular basis of biofilm formation, associated pathogenesis, and drug tolerance. The technique is cost-effective and would thus serve in rightful screening and repurposing drug libraries for designing new therapeutics against the less-studied high-alarm pathogen C. auris. IMPORTANCE Heterogeneity is seen when multidrug-resistant C. auris biofilm is cultured using different reported methods. Biofilm formed on the gelatin surface mimics the condition of a host environment that has multilayers and EPS. This method has feasibility for drug screening and analyzing biofilms through three-dimensional (3D) reconstruction. This in vitro biofilm formation technique is also exploited to study the formation of biofilm of other Candida species. The biofilms of C. glabrata and C. albicans can also be correctly mimicked using gelatin in the biofilm-forming environment. Thus, the novel in vitro method for biofilm formation reported here can be widely used to understand the mechanism of biofilm formation, related virulence properties, and drug tolerance of C. auris and other Candida species. This simple and low-cost technique is highly suitable for screening novel inhibitors and repurposed libraries and to design new therapeutics against Candida species.

Mechanical and contact characteristics of foam materials within wound dressings: Theoretical and practical considerations in treatment

In the treatment of acute and chronic wounds, the clinical performance of a given foam-based dressing, and, ultimately, the wound healing and cost of care outcomes are strongly influenced by the mechanical performance of the foam material/s within that dressing. Most aspects of the mechanical performance of foam materials, for example, their stiffness, frictional properties, conformability, swelling characteristics and durability, and the overall mechanical protection provided by a foam-based dressing to a wound strongly depend on the microstructure of the foam components, particularly on their microtopography, density and porosity. This article, therefore, provides, for the first time, a comprehensive, self-inclusive compilation of clinically relevant theoretical and practical considerations, based on published analytical and experimental research as well as clinical experience related to the mechanical performance of foams in foam-based wound dressings. The current bioengineering information is useful for establishing understanding of the importance of mechanical properties of foams in foam-based dressings among clinicians and researchers in industry and academia, and other potential stakeholders in the wound care field, for example, regulators and buyers. This information is also particularly important for the development of standardised test methods for the evaluation of foam-based wound dressings and resulting standard mechanical performance metrics for these dressings.

Bioinspired skin towards next-generation rehabilitation medicine

The rapid progress of interdisciplinary researches from materials science, biotechnologies, biomedical engineering, and medicine, have resulted in the emerging of bioinspired skins for various fantasticating applications. Bioinspired skin is highly promising in the application of rehabilitation medicine owing to their advantages, including personalization, excellent biocompatibility, multi-functionality, easy maintainability and wearability, and mass production. Therefore, this review presents the recent progress of bioinspired skin towards next-generation rehabilitation medicine. The classification is first briefly introduced. Then, various applications of bioinspired skins in the field of rehabilitation medicine at home and abroad are discussed in detail. Last, we provide the challenges we are facing now, and propose the next research directions.

Gelatin nanofibers: Recent insights in synthesis, bio-medical applications and limitations

The use of gelatin and gelatin-blend polymers as environmentally safe polymers to synthesis electrospun nanofibers, has caused a revolution in the biomedical field. The development of efficient nanofibers has played a significant role in drug delivery, and for use in advanced scaffolds in regenerative medicine. Gelatin is an exceptional biopolymer, which is highly versatile, despite variations in the processing technology. The electrospinning process is an efficient technique for the manufacture of gelatin electrospun nanofibers (GNFs), as it is simple, efficient, and cost-effective. GNFs have higher porosity with large surface area and biocompatibility, despite that there are some drawbacks. These drawbacks include rapid degradation, poor mechanical strength, and complete dissolution, which limits the use of gelatin electrospun nanofibers in this form for biomedicine. Thus, these fibers need to be cross-linked, in order to control its solubility. This modification caused an improvement in the biological properties of GNFs, which made them suitable candidates for various biomedical applications, such as wound healing, drug delivery, bone regeneration, tubular scaffolding, skin, nerve, kidney, and cardiac tissue engineering. In this review an outline of electrospinning is shown with critical summary of literature evaluated with respect to the various applications of nanofibers-derived gelatin.

Optimal skin simulant for ballistic testing

An extensive literature review, combined with practical experience of forensic testing, has identified several concerns regarding existing studies into skin simulants. These can be summarised as arising due to human skin being a highly complex, multi-layered and anisotropic material whose mechanical properties depend on many factors such as age and gender of the host. In many studies (and papers) essential information is missing. Although there is some parallelism between the studies, the reported energy density at perforation is very inconsistent (a function of the natural variation of skin properties alluded to above) and differs from 0,113 J/mm² [1] to 0,239 J/mm² [2]. Which is, in fact, a more than 100 % variation. Such a variation is arguably insufficient to enable accurate replication with a single simulant material. Combined with the missing common agreement about the energy density threshold between countries, laboratories and researchers, this analysis clearly identifies the need for an adjustable and / or customizable skin simulant. To-date, the most often used simulation material for human skin in ballistic testing is 'Chrome crusted cow hide' [3]. However, this is a natural material and, consequently therefore, inevitably physically variable in nature - both inter and intra hide. Ballistic tests on 10 chrome crusted cow hides using 4,5 mm BB's gave v50% ranging from 113 m/s to 200 m/s, an uncontrolled variability for forensic experiments. Hence, the authors examined a skin analogue that could be produced in-house, enabling tailoring to match the desired properties, and with improved consistency. To this end, a thin, 4 mm thick, layer of gelatine (30 - 45 wt%, increasing per 1 wt%) was studied. The ballistic resistance of the gelatine skin analogue was compared to the v50%'s published values in literature, with good agreement found as the gelatine concentration was varied. In comparison to the chrome crusted cow hides this suggests that this relatively simple and accessible approach has potential to provide a more consistent standard.

A mechatronic leg replica to benchmark human-exoskeleton physical interactions

Evaluating human-exoskeleton interaction typically requires experiments with human subjects, which raises safety issues and entails time-consuming testing procedures. This paper presents a mechatronic replica of a human leg, which was designed to quantify physical interaction dynamics between exoskeletons and human limbs without the need for human testing. In the first part of this work, we present the mechanical, electronic, sensory system and software solutions integrated in our leg replica prototype. In the second part, we used the leg replica to test its interaction with two types of commercially available wearable devices, i.e. an active full leg exoskeleton and a passive knee orthosis. We ran basic test examples to demonstrate the functioning and benchmarking potential of the leg replica to assess the effects of joint misalignments on force transmission. The integrated force sensors embedded in the leg replica detected higher interaction forces in the misaligned scenario in comparison to the aligned one, in both active and passive modalities. The small standard deviation of force measurements across cycles demonstrates the potential of the leg replica as a standard test method for reproducible studies of human-exoskeleton physical interaction.

Differences in prophylactic performance across wound dressing types used to protect from device-related pressure ulcers caused by a continuous positive airway pressure mask

Prolonged use of continuous positive airway pressure masks, as often required for non-invasive ventilation, involves a risk for facial tissue breakdown due to the sustained deformations caused by tightening of the stiff mask surfaces to the head and the moist environment. The risk of developing mask-related facial injuries can be reduced through suitable cushioning materials placed at the skin-mask interfaces to spread the localised contact forces and disperse the surface and internal tissue stresses. Using an integrated experimental-computational approach, we compared the biomechanical protective performance of three popular foam-based wound dressings to that of a market-lead hydrocolloid dressing when applied to protect the facial skin under a mask. We measured the compressive stiffness properties of the four commercial dressing types in dry and moist conditions, and then fed those to an anatomically realistic finite element model of an adult male head, with an applied simulated mask. Through this process, we calculated the protective efficacy index of each dressing type, indicating the relative contribution of the specified dressing to alleviating facial soft tissue loads with respect to the no-dressing case. The foam-based dressings generally performed substantially better than the hydrocolloid, but foam dressings were also demonstrated to vary by their protective performance.

Micro-pillar tunnel stamp for enhanced transdermal delivery of topical drug formulations

Dissolving microneedles (DMNs), despite their minimally invasive drug administration, face challenges in skin insertion and drug-loading capacity, which lead to less effective drug delivery. The micro-pillar tunnel stamp (MPTS) was designed to enhance the transdermal delivery efficacy of externally provided topical formulations via the creation of microchannels. The tunnel and canal of the MPTS enable the simultaneous application of DMNs and topical drugs. The application of micro-pillar-polycaprolactone (MP-PCL), which is a DMN made of a slowly dissolving polymer, exhibited a drug permeation rate 1.3-fold and 2.6-fold higher than that of micro-pillar-hyaluronic acid (MP-HA), a DMN made of a rapidly dissolving polymer, and the topical group, respectively. The base diameter of MP-PCL was set to 700 μm for maximized delivery efficacy, achieving 2.8-fold higher L-ascorbic acid accumulation than that of the topical group. In vivo analysis showed that, compared to topical administration, MPTS-delivered lidocaine had 5-fold greater permeation and the MPTS-delivered group showed 1.25-fold higher skin residual amount, confirming enhanced delivery. Thus, the optimized MPTS system can be presented as an attractive alternative to overcome the limitations of the existing MN systems such as incomplete insertion and limited drug-loading capacity, enhancing the delivery of topical formulations in the transdermal market. STATEMENT OF SIGNIFICANCE: We developed a micro-pillar tunnel stamp (MPTS) to enhance the delivery of externally provided topical formulations. The functional tunnel and canal of the MPTS enabled the simultaneous application of a dissolving microneedle (DMN) array insertion and administration of external topical drugs. Upon insertion, the DMNs created skin microchannels that allowed the externally administered drug to diffuse. DMNs were fabricated using polycaprolactone (PCL), a slowly dissolving polymer, to maintain their structure inside the skin and prolong the opening duration of the microchannels. This system achieved significantly improved delivery of topically administered external drugs via integration with slowly dissolving DMNs, while offering the possibility of its development as a universal delivery system for various topical pharmaceuticals.

Dissolvable Carboxymethylcellulose Microneedles for Noninvasive and Rapid Administration of Diclofenac Sodium

The aim of this study is to prepare dissolvable biopolymeric microneedle (MN) patches composed solely of sodium carboxymethylcellulose (CMC), a water-soluble cellulose derivative with good film-forming ability, by micromolding technology for the transdermal delivery of diclofenac sodium salt (DCF). The MNs with ≈456 µm in height displayed adequate morphology, thermal stability up to 200 °C, and the required mechanical strength for skin insertion (>0.15 N needle^-1 ). Experiments in ex vivo abdominal human skin demonstrate the insertion capability of the CMC_DCF MNs up to 401 µm in depth. The dissolution of the patches in saline buffer results in a maximum cumulative release of 98% of diclofenac after 40 min, and insertion in a skin simulant reveals that all MNs completely dissolve within 10 min. Moreover, the MN patches are noncytotoxic toward human keratinocytes. These results suggest that the MN patches produced with CMC are promising biopolymeric systems for the rapid administration of DCF in a minimally invasive manner.

Development and characterisation of hybrid composite skin simulants based on short polyethylene fibre and bioactive glass particle-reinforced silicone

Silicone elastomers are widely recognised as artificial skins for medical prosthesis and cranial injury assessment. Since silicone is not an ideal skin simulant due to the lack of mechanical stiffness and a fibrous structure, the present study aimed to tailor the mechanical and structural characteristics of silicone by integrating biocompatible reinforcements (namely, short polyethylene fibres and bioglass particles) to develop suitable bio-integrative skin simulant candidates. The influences of short polyethylene fibres and bioglass particles in the selected platinum silicone on the mechanical properties of silicone-based composite skin simulants were investigated with various factors, including filler concentration, KMnO4 surface treatment of the polyethylene fibre, and particle size. A comprehensive assessment of the tensile, compressive, and hardness properties of the examined composites was conducted, and they were compared with the properties of human biological skin. The results exhibited that the elastic moduli and the hardness of all composites increased with the concentration of both reinforcements. While integrating only the bioglass particles had the advantage of an insignificant effect on the hardness change of the silicone matrix, the composite with polyethylene fibres possessed superior tensile elastic modulus and tensile strength compared to those of the bioglass reinforced composite. The composites with 5% untreated polyethylene fibres, KMnO4 surface-treated fibres, and bioglass reinforcements enhanced the tensile elastic moduli from the pure silicone up to 32%, 44%, and 22%, respectively. It reflected that the surface treatment of the fibres promotes better interfacial adhesion between the silicone matrix and the fibres. Moreover, the smaller bioglass particle had a greater mechanical contribution than the larger glass particle. Systematically characterised for the first time, the developed composite skin simulants demonstrated essential mechanical properties within the range of the human skin and constituted better skin alternatives than pure silicone for various biomedical applications.

Optical Epidermal Mimicry from Ultraviolet to Infrared Wavelengths

Optical tissue phantoms present substantial value for medical imaging and therapeutic applications. We have developed an epidermal tissue phantom to mimic the optical properties of human skin from the ultraviolet to the infrared region, exceeding the breadth of existing studies. An epoxy matrix is combined with melanin-mimicking polydopamine via a cost-effective fabrication strategy. Reflectance and transmittance measurements enable calculation of the wavelength-dependent complex refractive index and absorption coefficient. Results are compared with literature data to establish agreement with a real human epidermis. By analyzing emissive power at a typical skin temperature, the epidermal tissue phantom is shown to accurately mimic the radiative properties of human skin. This simple, multifunctional material represents a promising substitute for human tissue for a variety of medical and bioengineering applications.

An Integrated 3D Hydrophilicity/Hydrophobicity Design for Artificial Sweating Skin (i-TRANS) Mimicking Human Body Perspiration

Artificial skins reproducing properties of human skin are emerging and significant for study in various areas, such as robotics, medicine, and textiles. Perspiration, as one of the most imperative thermoregulation functions of human skin, is gaining increasing attention, but how to realize ideal artificial skin for perspiration simulation remains challenging. Here, an integrated 3D hydrophilicity/hydrophobicity design is proposed for artificial sweating skin (i-TRANS). Based on normal fibrous wicking materials, the selective surface modification with gradient of poly(dimethylsiloxane) (PDMS) creates hydrophilicity/hydrophobicity contrast in both lateral and vertical directions. With the additional help of bottom hydrophilic Nylon 6 nanofibers, the constructed i-TRANS is able to transport "sweat" directionally without trapping undesired excess water and attain uniform "secretion" of sweat droplets on the top surface, decently mimicking human skin perspiration situation. This fairly comparable simulation not only presents new insights for replicating skin properties, but also provides proper in vitro testing platforms for perspiration-relevant research, greatly avoiding unwanted interference from the "skin" layer. In addition, the facile, fast, and cost-effective fabrication approach and versatile usage of i-TRANS can further facilitate its application.

Sweat analysis with a wearable sensing platform based on laser-induced graphene

The scientific community has shown increasing interest in laser scribing for the direct fabrication of conductive graphene-based tracks on different substrates. This can enable novel routes for the noninvasive analysis of biofluids (such as sweat or other noninvasive matrices), whose results can provide the rapid evaluation of a person's health status. Here, we present a wearable sensing platform based on laser induced graphene (LIG) porous electrodes scribed on a flexible polyimide sheet, which samples sweat through a paper sampler. The device is fully laser manufactured and features a two layer design with LIG-based vertical interconnect accesses. A detailed characterization of the LIG electrodes including pore size, surface groups, surface area in comparison to electroactive surface area, and the reduction behavior of different LIG types was performed. The bare LIG electrodes can detect the electrochemical oxidation of both uric acid and tyrosine. Further modification of the surface of the LIG working electrode with an indoaniline derivative [4-((4-aminophenyl)imino)-2,6-dimethoxycyclohexa-2,5-dien-1-one] enables the voltammetric measurement of pH with an almost ideal sensitivity and without interference from other analytes. Finally, electrochemical impedance spectroscopy was used to measure the concentrations of ions through the analysis of the sweat impedance. The device was successfully tested in a real case scenario, worn on the skin during a sports session. In vitro tests proved the non-cytotoxic effect of the device on the A549 cell line.

A Novel Method to Measure the Static Coefficient of Friction for Socks

Mechanical testers have commonly been used to measure the frictional properties of socks. However, the friction values may be susceptible to the level of stretchiness of tested fabrics or human variability. Thus, the aim of this study was to propose a novel method that enables friction measurement of socks in a sock-wearing condition with less human variability effects. Five socks with different frictional properties were chosen. Three experimental ramp tests were performed with an artificial structure shaped like the foot-ankle complex (last) and a ramp tester to quantify the static coefficient of friction (COF) at the foot against sock, at the sock against an insole, and the foot wearing socks against the insole, respectively. The angle where the last slipped while the ramp surface was gradually inclined was used to compute the static COF values for each sock. The reliability was 0.99, and COF values ranged from 0.271 to 0.861 at the foot-sock interface, 0.342 to 0.639 at the sock-insole interface, and 0.310 to 0.614 in the third test. Socks with different frictional properties were successfully distinguished each other. Thus, the suggested protocol could be a reliable option for measuring the static COF values in the tension similar with it found in a sock-waring condition with reduced effects of human variability.

Transfer of bacteria between fabric and surrogate skin

BACKGROUND

Contaminated textiles serve as fomites in healthcare settings. The extent of transfer of pathogens from fabrics depends on the surface properties of the 2 contact surfaces.

METHODS

In the current study, the effect of surface energy and surface roughness of fabrics on the transfer of Escherichia coli and Staphylococcus aureus to and from textiles to surrogate skin were determined. Three fabrics (100% cotton, 100% polyester, and 50-50 blend of cotton and polyester) having identical constructional parameters, were characterised on the basis of surface roughness, and energy. Assessment of transfer of bacteria was carried out by bringing the matrix seeded with inoculum in contact with the sterilized matrix for a predetermined period of time, followed by dislodging of cells from the recipient surface by vortexing, and plating.

RESULTS AND DISCUSSION

Results showed that 100% polyester attracted the highest number of bacterial cells compared to the others. It also released the maximum number of bacteria upon coming in contact with surrogate skin. Properties of fabrics like absorbency, surface energy, and surface roughness, simultaneously affected transfer.

CONCLUSIONS

It is advisable to minimize the use of 100% polyester in healthcare settings to curb the transfer load of bacteria from one surface to another.

Ciprofloxacin-loaded dissolving polymeric microneedles as a potential therapeutic for the treatment of S. aureus skin infections

Microneedles have been widely studied for many topical and transdermal therapeutics due to their ability to painlessly puncture the skin, thereby bypassing the stratum corneum, the main skin barrier. In this study, ciprofloxacin (CIP) was loaded into dissolving polymeric microneedles prepared by a two-layer centrifugation method as a potential treatment of skin infections such as cellulitis. The polymers used were polyvinyl alcohol (PVA) and polyvinylpyrrolidone (PVP). Two formulations were investigated, namely CIP_MN1, composed of 10 mg ciprofloxacin incorporated into a polymer matrix of PVA and PVP with a weight ratio of (9:1), and CIP_MN2, composed of 10 mg ciprofloxacin incorporated into PVA polymer. CIP_MN1 and CIP_MN2 showed a mean microneedle height of 188 and 179 µm, respectively. Since Parafilm has been proven as a model to examine the perforation of microneedles in skin, it was used to evaluate the ability of microneedles to perforate the skin. CIP_MN1 showed almost complete perforation of Parafilm, 190 pores, compared to CIP_MN2 which created only 85 pores in Parafilm, and therefore CIP_MN1 was used for subsequent studies. Examining CIP_MN1 on agarose gel as an in vitro model of human skin showed that the formula was able to fully perforate the agarose gel. Moreover, this formula showed significantly greater antimicrobial activity (p < 0.0001) compared to a free gel of ciprofloxacin against Staphylococcus aureus in an agarose gel-based model. This was evidenced by a zone of inhibition of 29 mm for the microneedle formulation of ciprofloxacin (CIP_MN1) compared to 2 mm for the free gel of ciprofloxacin. Furthermore, the CIP_MN1 showed complete dissolution in human skin after 60 min from application. Finally, the skin deposition of CIP_MN1 was investigated in ex vivo excised human skin. CIP_MN1 showed significantly more deposition of ciprofloxacin in deeper skin layers compared to the free gel of ciprofloxacin, and the released ciprofloxacin from the microneedles tends to migrate to deeper layers with time. Collectively, these results suggest that CIP_MN1 can be a potential delivery system for the treatment of S. aureus skin infections.

Parameter estimation in high-intensity focused ultrasound therapy

Hyperthermia using High-Intensity Focused Ultrasound (HIFU) is an acoustic therapy for cancer treatment. This technique consists of an increase in the temperature field of the tumor to achieve coagulative necrosis and immediate cell death. Therefore, for having a successful treatment, the physical problem requires to know several properties due to the high variability from individual to individual, or even for the same individual under different physiological conditions. This article presents a numerical simulation of hyperthermia therapy for cancer treatment using HIFU, as well as the estimation of parameters that influence the physical problem. Two mathematical models were considered to solve the forward problem. The acoustic model based on acoustic pressure performs a frequency-domain study, and the bioheat transfer model a time-dependent study. These models were solved using Comsol Multiphysics® software in a 2D-axisymmetric rectangular domain to determine the temperature field. Parameter estimation was coded in Matlab Mathworks® environment using a Bayesian approach. The Markov Chain Monte Carlo method by the Metropolis-Hastings algorithm was implemented, and the simulated temperature measurements were considered. Results suggest that specific HIFU therapy can be performed for each patient by estimating appropriate parameters for cancer treatment and provides the possibility to define procedures before and during the treatment.

Skin models for dermal exposure assessment of phthalates

Phthalates are a class of compounds that have found widespread use in industrial applications, in particular in the polymer, cosmetics and pharmaceutical industries. While ingestion, and to a lesser degree inhalation, have been considered as the major exposure routes, especially for higher molecular weight phthalates, dermal exposure is an important route for lower weight phthalates such as diethyl phthalate (DEP). Assessing the dermal permeability of such compounds is of great importance for evaluating the impact and toxicity of such compounds in humans. While human skin is still the best model for studying dermal permeation, availability, cost and ethical concerns may preclude or restrict its use. A range of alternative models has been developed over time to substitute for human skin, especially in the early phases of research. These include ex vivo animal skin, human reconstructed skin and artificial skin models. While the results obtained using such alternative models correlate to a lesser or greater degree with those from in vivo human studies, the use of such models is nevertheless vital in dermal permeation research. This review discusses the alternative skin models that are available, their use in phthalate permeation studies and possible new avenues of phthalate research using skin models that have not been used so far.

Influence of wall slip, thixotropy, and lubrication regime on the instrumental sensory evaluation of topical formulations

OBJECTIVE

Drawing parallels from rheo-tribology can be used to develop a robust instrumental protocol for non-subjective characterization, product development and design of topical dosage forms with desired sensory attributes. However, instrumental characterization of cosmetic products can be influenced by the measurement protocol, thixotropy, flow anomalies like shear banding or wall slip and nature of the film formed on the skin surface. In this study, we evaluated the influence of above parameters on the instrumental sensory evaluation of twelve topical formulations of different galenic forms.

METHODS

Oscillatory strain sweep measurements (SAOS and LAOS) were performed to investigate the influence of frequency and wall slip on the material parameters. The textural attributes at different consumer touch points were evaluated by accounting time dependent simulation of visco-elastic flow. Further, the influence of film thickness and sample drying on the tactile properties of the topical formulations were studied on a non-biological skin model using a sliding probe tribometer.

RESULTS

The study shows that the flow properties of the semi-solid formulations depend on the time scale of the problem. A few formulations exhibited wall slip to varying degrees in the linear visco-elastic regime where the behaviour was found not to be characteristic of a particular topical dosage form. The material functions obtained from the Lissajous plots suggest that the non-linear flow behavior of different galenic forms is least influenced by the boundary conditions imposed by the measurement geometry. The results were statistically analyzed using principal component analysis where the attributes used for discriminating skin creams during pick-up and rub out are found to be closely associated with non-linear rheology. The friction coefficient exhibited speed dependence where it formed different parametric group with rheological data depending on the lubrication regime.

CONCLUSION

The study highlights that correlations are possible among rheological, tribological, and instrumental textural analysis data, which can act an impetus for the development of models to predict attributes that drive perception at different consumer touch points. However, the choice of instrumental settings, anomalies associated with rheological measurements and friction dependence on a number of parameters can influence the model prediction.

Effect of β-Estradiol on Mono- and Mixed-Species Biofilms of Human Commensal Bacteria Lactobacillus paracasei AK508 and Micrococcus luteus C01 on Different Model Surfaces

The impact of steroid hormones, and particularly estradiol, on human microbiota could be recognized as a substantial part of human-microbiota interactions. However, an area that remains poorly investigated is that of the skin and vaginal microbial communities and biofilms, which contain non-pathogenic bacteria of phyla Firmicutes and Actinobacteria, especially probiotic bacteria of the genus Lactobacillus and the widespread, safe skin genus, Micrococcus. Experiments with Lactobacillus paracasei AK508 and Micrococcus luteus C01 biofilms on PTFE cubes showed dose-dependent effects of estradiol at concentrations of 0.22 nM and 22 nM. The hormone mostly inhibits L. paracasei growth and stimulates M. luteus. The presented studies of colony-forming unit (CFU) amountsand cell aggregation in biofilms on glass fiber filters showed the same general tendencies. Estradiol generally increased the aggregation of cells in monospecies communities and potentially changed the synthesis of antibacterial metabolites in L. paracasei. The balance between two bacteria in mixed-species biofilms depended on the initial adhesion stage, and when this stage was reduced, micrococci were more resistant to the antagonistic action of L. paracasei. Moreover, in mixed-species biofilms, the effect of estradiol on lactobacilli altered from inhibition to stimulation, potentially due to the presence of M. luteus. At the same time, ethanol as a solvent for estradiol at the concentration 0.6% acted mostly as an antagonist of the hormone and had an opposite effect on bacteria; nevertheless, the overlapping of ethanol and estradiol effects was shown to be minimal. The data obtained prove the complexity of microbial interactions and the regulatory effect of estradiol on commensal bacteria biofilms.

Continuous Glucose Monitoring System Based on Percutaneous Microneedle Array

A continuous blood glucose monitoring system (CGMS) which include a microneedle-array blood glucose sensor, a circuit module, and a transmission module placed in a wearable device is developed in this research. When in use, the wearable device is attached to the human body with the microneedle array inserted under the skin for continuous blood glucose sensing, and the measured signals are transmitted wirelessly to a mobile phone or computer for analysis. The purpose of this study is to replace the conventionally used method of puncture for blood collection and test strips are used to measure the blood glucose signals. The microneedle sensor of this CGMS uses a 1 mm length needle in a 3 mm × 3 mm microneedle array for percutaneous minimally invasive blood glucose measurement. This size of microneedle does not cause bleeding damage to the body when used. The microneedle sensor is placed under the skin and their solutions are discussed. The blood glucose sensor measured the in vitro simulant fluid with a glucose concentration range of 50~400 mg/dL. In addition, a micro-transfer method is developed to accurately deposit the enzyme onto the tip of the microneedle, after which cyclic voltammetry (CV) is used to measure the glucose simulation solution to verify whether the difference in the amount of enzyme on each microneedle is less than 10%. Finally, various experiments and analyses are carried out to reduce the size of the device, test effective durability (approximately 7 days), and the feasibility of minimally invasive CGMS is evaluated by tests on two persons.

A personalized FEM model for reproducible measurement of anti-inflammatory drugs in transdermal administration to knee

A personalized model of the human knee for enhancing the inter-individual reproducibility of a measurement method for monitoring Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) after transdermal delivery is proposed. The model is based on the solution of Maxwell Equations in the electric-quasi-stationary limit via Finite Element Analysis. The dimensions of the custom geometry are estimated on the basis of knee circumference at the patella, body mass index, and sex of each individual. An optimization algorithm allows to find out the electrical parameters of each subject by experimental impedance spectroscopy data. Muscular tissues were characterized anisotropically, by extracting Cole-Cole equation parameters from experimental data acquired with twofold excitation, both transversal and parallel to tissue fibers. A sensitivity and optimization analysis aiming at reducing computational burden in model customization achieved a worst-case reconstruction error lower than 5%. The personalized knee model and the optimization algorithm were validated in vivo by an experimental campaign on thirty volunteers, 67% healthy and 33% affected by knee osteoarthritis (Kellgren-Lawrence grade ranging in [1,4]), with an average error of 3%.

Topical and transdermal delivery with diseased human skin: passive and iontophoretic delivery of hydrocortisone into psoriatic and eczematous skin

Psoriasis and atopic dermatitis (eczema) are both common immune-mediated inflammatory skin diseases associated with changes in skin's stratum corneum lipid structure and barrier functionality. The present study aimed to investigate healthy, eczematous, and psoriatic excised human tissue for the effect of non-infectious skin diseases on skin characteristics (surface color, pH, transepidermal water loss, electrical resistance, and histology), as well as on permeation and retention profile of hydrocortisone. Further, differences in percutaneous absorption on application of iontophoresis on healthy and diseased skin were also investigated. Measurements of transepidermal water loss and electrical resistance showed a significant difference in psoriasis skin samples indicating a damaged barrier function. In vitro permeation studies on full-thickness human skin using vertical diffusion cells further confirmed these results as the drug amount retained in the psoriatic tissue was significantly higher when compared with the other groups. Despite no significant difference, the presence of the drug in the receptor chamber in both diseased groups can be concerning as it suggests the increased possibility of systemic absorption and adverse reactions associated with it in the use of topical corticosteroids. Application of anodal iontophoresis resulted in greater distribution of hydrocortisone into deeper layers of skin and the receptor chamber, in comparison to passive permeation. However, no significant differences were observed due to the healthy or diseased condition of skin.

Development of a Smartphone-Based Skin Simulation Model for Medical Education

INTRODUCTION

Teaching dermatology to medical students entails a series of lectures, pictures, and hands-on skin examinations to convey a sense of skin features and textures, often by use of simulated skin models. However, such methods can often lack accurate visual and tactile texture representation of skin lesions. To facilitate learning, we have developed a smartphone-based skin simulation model, which provides a configurable visual and tactile sense of a lesion by using the ubiquitous availability of smartphone-based mobile platforms.

METHODS

A polydimethylsiloxane (PDMS) overlay was used as a configurable translucent elastomer material to model the stiffness and texture of skin. A novel custom smartphone-based app was developed to capture images of various skin lesions, which were subsequently displayed on a tablet or second smartphone, over which the PDMS model skin elastomer was placed. Using the local Bluetooth connection between mobile devices, an iterative feedback algorithm corrected the visual distortion caused by the optical scattering of the translucent elastomer, enabling better virtual visualization of the lesion.

RESULTS

The developed smartphone-based app corrected the distortion of images projected through the simulated skin elastomer. Surface topography of the developed PDMS elastomer provided a more accurate representation of skin texture.

CONCLUSIONS

In this investigation, we developed a smartphone-based skin lesion visualization app with a simulated skin elastomer for training/education in not only dermatology but also all general medical specialties that examine the skin. This technique has the potential to advance the educational experience by giving students the ability to see, touch, and feel pragmatic skin textures and lesions.

A multifunctional electronic suture for continuous strain monitoring and on-demand drug release

Surgical sutures are widely used for closing wounds in skin. However, the monitoring of wound integrity and promoting tissue regeneration at the same time still remains a challenge. To address this, we developed a drug-releasing electronic suture system (DRESS) to monitor the suture integrity in real-time and enhance tissue regeneration by triggered drug release. DRESS was fabricated by using a single fiber with a core-shell structure consisting of a stretchable conductive fiber core and a thermoresponsive polymer shell containing drugs. The highly conductive fiber core acts as a strain sensor that enables continuous monitoring of suture strain with high sensitivity (a gauge factor of ∼686) and mechanical durability (being able to endure more than 3000 stretching cycles). The thermoresponsive shell layer composed of flexible poly(vinyl alcohol) (PVA) grafted onto poly(N-isopropylacrylamide) (PNIPAm) facilitates on-demand drug release via Joule heating. The results of an in vitro scratch assay showed a 66% decrease in wound area upon heat-activation after 48 hours demonstrating the stimuli-responsive therapeutic efficacy of DRESS by promoting cell migration. Moreover, ex vivo testing on porcine skin demonstrated the applicability of DRESS as a electronic suture. The approach used for DRESS provides insight into multifunctional sutures and offers additional therapeutic and diagnostic options for clinical applications.

Epinephrine affects gene expression levels and has a complex effect on biofilm formation in M icrococcus luteus strain C01 isolated from human skin

In this study, the effect of epinephrine on the biofilm formation of Micrococcus luteus C01 isolated from human skin was investigated in depth for the first time. This hormone has a complex effect on biofilms in various systems. In a system with polytetrafluoroethylene (PTFE) cubes, treatment with epinephrine at a physiological concentration of 4.9 × 10^-9 M increased the total amount of 72-h biofilm biomass stained with crystal violet and increased the metabolic activity of biofilms, but at higher and lower concentrations, the treatment had no significant effect. On glass fiber filters, treatment with the hormone decreased the number of colony forming units (CFUs) and changed the aggregation but did not affect the metabolic activity of biofilm cells. In glass bottom plates examined by confocal microscopy, epinephrine notably inhibited the growth of biofilms. RNA-seq analysis and RT-PCR demonstrated reproducible upregulation of genes encoding Fe-S cluster assembly factors and cyanide detoxification sulfurtransferase, whereas genes encoding the co-chaperone GroES, the LysE superfamily of lysine exporters, short-chain alcohol dehydrogenase and the potential c-di-GMP phosphotransferase were downregulated. Our results suggest that epinephrine may stimulate matrix synthesis in M. luteus biofilms, thereby increasing the activity of NAD(H) oxidoreductases. Potential c-di-GMP pathway proteins are essential in these processes.