Elderly bioheat modeling: changes in physiology,thermoregulation, and blood flow circulation

A bioheat model for the elderly was developed focusing on blood flow circulatory changes that influence their thermal response in warm and cold environments to predict skin and core temperatures for different segments of the body especially the fingers. The young adult model of Karaki et al. (Int J Therm Sci 67:41–51, 2013) was modified by incorporation of the physiological thermoregulatory and vasomotor changes based on literature observations of physiological changes in the elderly compared to young adults such as lower metabolism and vasoconstriction diminished ability, skin blood flow and its minimum and maximum values, the sweating values, skin fat thickness, as well as the change in threshold parameter related to core or skin temperatures which triggers thermoregulatory action for sweating, maximum dilatation, and maximum constriction. The developed model was validated with published experimental data for elderly exposure to transient and steady hot and cold environments. Predicted finger skin temperature, mean skin temperature, and core temperature were in agreement with published experimental data at a maximum error less than 0.5 °C in the mean skin temperature. The elderly bioheat model showed an increase in finger skin temperature and a decrease in core temperature in cold exposure while it showed a decrease in finger skin temperature and an increase in core temperature in hot exposure.     

Reduction of cutaneous blood flow in cold fingers

Blood flow to fingers is reduced during cold exposure. This is generally attributed to vasoconstriction. We tested the hypothesis that increased blood viscosity, not vasoconstriction, accounts for reductions of cutaneous flow after fingers cool. Blood viscosity was higher at 10 degree C than at 27 degree C and independent of hematocrit at low shear rates. The increase of finger vascular resistance may be due to increased vascular hindrance early in cold exposure (< 15 min) and is more likely due to increased viscosity after 20-30 min, a factor that may dominate the peripheral microcirculaton during prolonged cold exposure.     

Quantification of conservative endurance times in thermally insulated cold-stressed digits.

The estimation of endurance times of the digits exposed to cold weather is performed by an analytical, one-dimensional cylindrical model. Blood perfusion effects are lumped into a volumetric heat-generation term. Cold-induced vasodilatation (CIVD) effects are not included in the present analysis. Endurance times, defined by a drop in cylinder tip temperature to 5 degrees C, were evaluated. Parameters included in this evaluation were 1) environmental temperatures, 2) thermal insulation applied on the cylinder, 3) length of the cylinder, and 4) diameter of the cylinder. It was found that the lower the ambient temperature, the longer the finger, and the smaller its diameter, then the shorter the endurance time for the same thermal insulation. Results of the model were compared with measured data for a subject not exhibiting CIVD response to cold stress. Conformity of results calculated for an adjusted value of the volumetric heat-generation term and measured data was very good, with a maximum deviation of less than 10% at only one particular point in time. This model facilitates the conservative estimation of lower bounds to thermally insulated fingers and toes exposed to cold stress.     

The effect of direct and indirect hand heating on finger blood flow and dexterity during cold exposure

1. The aim of this study was to investigate if finger temperature or finger blood flow is the critical factor for maintenance of finger dexterity during cold exposure.

2. Subjects were exposed twice to −25°C air for 3 h by using a Torso Heating Test (THT) where the torso was maintained to 42°C with a heating vest while the hands were bare, and a Hand Heating Test (HHT) where the hands were heated with heated gloves.

3. Despite similar finger temperatures, finger blood flow was eight times lower and finger dexterity was decreased in HHT as compared to THT.

4. It is concluded that finger blood flow is the critical factor to maintain finger dexterity in the cold.

Thermal behavior of biological tissues—A general analysis

A general analysis is presented for the thermal behavior of a biological tissue. Energy transport by the circulatory system is assumed to be represented by a modified Fick's law. General boundary conditions are assumed for the two-dimensional model and solutions are obtained for rectangular, cylindrical, and spherical geometries. The effects of blood perfusion rate, metabolic rate, arterial temperature and heat exchange with the environment are considered. Results indicate a region of almost constant temperature in the deeper layers of the tissue and reaffirm the important role which blood flow plays in maintaining homeostasis.     

Effect of alterations in ambient temperature on blood flow in the skin.

The effect of changing ambient temperature on skin temperature was recorded in human subjects; also, its effect on blood flow was measured using venous occlusion and optical plethysmography. When cold stimulus was removed in stages using a heating cabinet, it was found that a biphasic flow response occurred in the fingers with each step change in temperature. There was a rapid transient rise followed by a decline to an equilibrium flow level. The transient rise occurred even when the temperature rose from 37 to 40 degrees C, although at this level the equilibrium remained unchanged. It is suggested that the transient rise was due to stimulation of Hensel's dynamic warmth receptors, whereas the rise in equilibrium temperature was due to removal of cold stimulus, which at low ambient temperatures maintains reflex vasoconstriction through activation of static cold receptors. Upper arm skin responded to removal of cold stimulus by a fall in temperature. Immersion of a different limb in cold water produced vasoconstriction in fingers but vasodilatation in the upper arm skin. It is suggested that this may be due to neurogenic vasodilatation, though the present work gives no indication as to pathways.     

Coordinated force production in multi-finger tasks: finger interaction and neural network modeling

During maximal voluntary contraction (MVC) with several fingers, the following three phenomena are observed: (1) the total force produced by all the involved fingers is shared among the fingers in a specific manner (sharing); (2) the force produced by a given finger in a multi-finger task is smaller than the force generated by this finger in a single-finger task (force deficit); (3) the fingers that are not required to produce any force by instruction are involuntary activated (enslaving). We studied involuntary force production by individual fingers (enslaving effects, EE) during tasks when (an)other finger(s) of the hand generated maximal voluntary pressing force in isometric conditions. The subjects (n = 10) were instructed to press as hard as possible on the force sensors with one, two, three and four fingers acting in parallel in all possible combinations. The EE were (A) large, the slave fingers always producing a force ranging from 10.9% to 54.7% of the maximal force produced by the finger in the single-finger task; (B) nearly symmetrical; (C) larger for the neighboring fingers; and (D) non-additive. In most cases, the EE from two or three fingers were smaller than the EE from at least one finger (this phenomenon was coined occlusion). The occlusion cannot be explained only by anatomical musculo-tendinous connections. Therefore, neural factors contribute substantially to the EE. A neural network model that accounts for all the three effects has been developed. The model consists of three layers: the input layer that models a central neural drive; the hidden layer modeling transformation of the central drive into an input signal to the muscles serving several fingers simultaneously (multi-digit muscles); and the output layer representing finger force output. The output of the hidden layer is set inversely proportional to the number of fingers involved. In addition, direct connections between the input and output layers represent signals to the hand muscles serving individual fingers (uni-digit muscles). The network was validated using three different training sets. Single digit muscles contributed from 25% to 50% of the total finger force. The master matrix and the enslaving matrix were computed; they characterize the ability of a given finger to enslave other fingers and its ability to be enslaved. Overall, the neural network modeling suggests that no direct correspondence exists between neural command to an individual finger and finger force. To produce a desired finger force, a command sent to an intended finger should be scaled in accordance with the commands sent to the other fingers. Received: 17 October 1997 / Accepted in revised form: 12 May 1998     

Physiological mechanism of digital vasoconstriction training

Recent work in our laboratory has shown that vasodilation produced during temperature biofeedback training is mediated through a nonneural, beta-adrenergic mechanism. Here we sought to determine if the effects of feedback training for vasoconstriction are produced through a neural or nonneural pathway and whether other measures of physiological activity are correlated with these changes. Nine normal subjects received temperature feedback vasoconstriction training in which feedback was delivered only during periods of successful performance. In a subsequent session, the nerves to one finger were blocked with a local anesthetic while finger blood flow was recorded from this and other fingers. Vasoconstriction occurred during feedback in the intact fingers but not in the nerve-blocked finger and was accompanied by increased skin conductance and heart rate. These data demonstrate that temperature feedback vasoconstriction training is mediated through an efferent, sympathetic nervous pathway. In contrast, temperature feedback vasodilation training is mediated through a nonneural, beta-adrenergic mechanism.     

No effect of 85 mT permanent magnets on laser-Doppler measured blood flow response to inspiratory gasps

Although no effects of permanent magnets on resting skin blood flow (SBF) in humans have yet been demonstrated, the possibility that magnet related effects might modify dynamic SBF changes has not been previously studied. We hypothesized that magnets may alter local neurovascular mechanisms to cause changes in normal SBF vasoactive responses. To test this, we studied the effects of a magnet on SBF reductions induced by sympathetic reflexes associated with deep inspirations. SBF was continuously monitored by a dual channel laser-Doppler flowmeter with probes on the middle finger dorsum of both hands of 24 healthy subjects. In the first of two successive intervals, each of the fingers rested on sham ceramic magnets (control interval). Subsequently, one finger rested on an active magnet and the other finger on a sham (experimental interval). Skin temperatures were also measured. The magnet was a 37 mm diameter x 14 mm thick ceramic magnet with a surface field strength of 85 mT measured in the geometrical center of the magnet. Field strength at the finger dorsum, 13 mm above magnet, was 31.5 mT. During each interval, three deep breaths were used to elicit SBF reductions. Responses were calculated as the percent reduction in SBF from its prior 20 s average. Breaths in each interval were spaced 3 min apart to permit full recovery between responses. The experimental interval started after an active magnet was in place for 20 min. Results showed no significant difference in either vasoconstrictive responses or skin temperature due to the magnet. We conclude that magnets of the type, strength and duration used, have no significant effect on vasoconstrictive processes associated with this sympathetic reflex in this group of healthy subjects.     

Cold-induced vasodilation and vasoconstriction in the finger of tropical and temperate indigenes

While heat acclimatization reflects the development of heat tolerance, it may weaken an ability to tolerate cold. The purpose of this study was to explore cold-induced vasodilation (CIVD) responses in the finger of tropical indigenes during finger cold immersion, along with temperate indigenes. Thirteen tropical male indigenes (subjects born and raised in the tropics) and 11 temperate male indigenes (subjects born and raised in Japan and China) participated. Subjects immersed their middle finger at 4.3±0.8 °C water for 30 min. Rectal temperature, skin temperatures, finger skin blood flow, blood pressure and subjective sensations were recorded during the test. The results showed that: (1) the tropical group demonstrated a lower minimum (T_min), maximum (T_max) and mean finger temperature (T_mean) compared to those of the temperate group (P<0.05); (2) seven tropical indigenes demonstrated a late-plateau type of CIVD pattern, which is characterized by a pronounced 1st vasoconstriction and a single CIVD with a faint and weak 2nd vasoconstriction, whereas no temperate indigene demonstrated the late-plateau type; and (3) the hand temperature at the end of finger immersion was 3 °C lower in the tropical than the temperate group (P<0.05). These results indicate that tropical indigenes have less active responses of arterio-venous anastomoses in the finger and weaker vasoconstrictions after the first CIVD response during finger cold immersion, which can be considered as being more vulnerable to cold injury of the periphery in severe cold.     

Orientation and polarity in collectively migrating cell structures: statics and dynamics

Collective cell migration is often characterized by the spontaneous onset of multicellular protrusions (known as fingers) led by a single leader cell. Working with epithelial Madin-Darby canine kidney monolayers we show that cells within the fingers, as compared with the epithelium, are well oriented and polarized along the main finger direction, which suggests that these cells actively migrate. The cell orientation and polarity decrease continuously from the tip toward the epithelium over a penetration distance of typically two finger lengths. Furthermore, laser photoablation experiments at various locations along these fingers demonstrate that the cells in the fingers are submitted to a tensile stress whose value is larger close to the tip. From a dynamical point of view, cells entering a finger gradually polarize on timescales that depend upon their particular initial position. Selective laser nanosurgery of the leader lamellipodium shows not only that these structures need a leader to progress, but that this leader itself is the consequence of a prior self-organization of the cells forming the finger. These results highlight the complex interplay between the collective orientation within the fingers and the mechanical action of the leader.     

A 3D thermal model to analyze the temperature changes of digits during cold stress and predict the danger of frostbite in human fingers

The existing computational models of frostbite injury are limited to one and two dimensional schemes. In this study, a coupled thermo-fluid model is applied to simulate a finger exposed to cold weather. The spatial variability of finger-tip temperature is compared to experimental ones to validate the model. A semi-realistic 3D model for tissue and blood vessels is used to analyze the transient heat transfer through the finger. The effect of heat conduction, metabolic heat generation, heat transport by blood perfusion, heat exchange between tissues and large vessels are considered in energy balance equations. The current model was then tested in different temperatures and air speeds to predict the danger of frostbite in humans for different gloves. Two prevalent gloves which are commonly used in cold climate are considered for investigation. The endurance time and the fraction of necrotic tissues are two main factors suggested for obtaining the response of digit tissues to different environmental conditions.     

Differences in finger skin contact cooling response between an arterial occlusion and a vasodilated condition.

To assess the presence and magnitude of the effect of skin blood flow on finger skin cooling on contact with cold objects against the background of circulatory disorder risks in occupational exposures, this study investigates the effect of zero vs. close-to-maximal hand blood flow on short-term (< or =180 s) skin contact cooling response at a contact pressure that allows capillary perfusion of the distal pulp of the fingertip. Six male volunteers touched a block of aluminium with a finger contact force of 0.5 N at a temperature of -2 degrees C under a vasodilated and an occluded condition. Before both conditions, participants were required to exercise in a hot room for > or = 30 min for cutaneous vasodilation to occur (increase in rectal temperature of 1 degrees C). Under the vasodilated condition, forearm blood flow rate rose as high as 16.8 ml.100 ml(-1).min(-1). Under the occluded condition, the arm was exsanguinated, after which a blood pressure cuff was secured on the wrist inducing arterial occlusion. Contact temperature of the finger pad during the subsequent cold contact exposure was measured. No significant difference was found between the starting skin temperatures for the two blood flow conditions, but a distinct difference in shape of the contact cooling curve was apparent between the two blood flow conditions, with Newtonian cooling observed under the occluded condition, whereas a rewarming of the finger skin toward the end of the exposure occurred for the vasodilated condition. Blood flow was found to significantly increase contact temperature from 40 s onward (P < 0.01). It is concluded that, at a finger contact force compatible with capillary perfusion of the finger pad ( approximately 0.5 N), circulating blood provides a heat input source that significantly affects finger skin contact cooling during a vasodilated state.     

Physiological mechanism of digital vasoconstriction training

Recent work in our laboratory has shown that vasodilation produced during temperature biofeedback training is mediated through a nonneural, beta-adrenergic mechanism. Here we sought to determine if the effects of feedback training for vasoconstriction are produced through a neural or nonneural pathway and whether other measures of physiological activity are correlated with these changes. Nine normal subjects received temperature feedback vasoconstriction training in which feedback was delivered only during periods of successful performance. In a subsequent session, the nerves to one finger were blocked with a local anesthetic while finger blood flow was recorded from this and other fingers. Vasoconstriction occurred during feedback in the intact fingers but not in the nerve-blocked finger and was accompanied by increased skin conductance and heart rate. These data demonstrate that temperature feedback vasoconstriction training is mediated through an efferent, sympathetic nervous pathway. In contrast, temperature feedback vasodilation training is mediated through a nonneural, beta-adrenergic mechanism.This work was supported by research grant HL-30604 from the National Heart, Lung, and Blood Institute.     

激光多普勒血流仪在断指再植术后血运监测应用的效果研究

目的:为了提高临床断指再植手术效果,分析断指再植术后彩色多普勒血流成像仪的临床应用效果价值。方法:从2016年9月至2017年9月在我院接受断指再植术治疗的60例患者中,采用随机数表法随机将其分为实验组和对照组各30例。实验组:采用激光多普勒血流成像仪监测再植肢体血运;对照组:采用传统方法监测再植肢体血运。探讨断指再植术后彩色多普勒血流成像仪的临床应用价值。结果:研究结果显示,和对照组相比观察组患者断指再植术后血管栓塞率、血管危象发生率明显降低,而断指成活率以及成活再植指术后功能恢复情况则明显增加(P0.05)。结论:将彩色多普勒血流监测应用于断指再植术后,能够无创、实时、灵敏的反应再植指术后的血运情况,有助于及时发现各种不良事件的,提高再植成功率,效果显著,值得推广。     

Responses to whole body and finger cooling before and after an Antarctic expedition

Eight subjects, who were indoor workers and not habitually exposed to cold, spent 53 days in Antarctica. They did mainly geological field work often requiring the use of bare hands. The effects of the expedition on responses to a whole body cold exposure test, a finger blood flow test and a cold pressor test were studied. After the expedition, during whole-body cooling the time for the onset of shivering was delayed by 36 min (P<0.001) and forearm and thigh temperatures were 1.5°C higher (P<0.05) at the end of exposure. During local cooling of the finger with 10°C perfusion, finger vascular resistance was 14.9 (SEM 6.6) mmHg · ml^–1 · min · 100 ml (P<0.05) lower and finger temperature 3.9 (SEM 0.8) °C higher (P< 0.01). However, the decrease in rectal temperature during wholebody cooling was unaltered and the response to a cold pressor test was unchanged. The data would indicate that partial acclimatization to cold had been developed. Changes in forearm temperature were correlated with the duration of cold exposure of the hands (P < 0.05) and finger vascular resistance and finger temperature were correlated with responses to cooling before the expedition (P<0.001 and P<0.01, respectively). Because the ambient temperature was not clearly lower in Antarctica in comparison to Finland, the reason for the changes developed seems to be the increased exposure to the outdoor climate in Antarctica.     

The C-terminal zinc finger domain of Arabidopsis cold shock domain proteins is important for RNA chaperone activity during cold adaptation

Among the four cold shock domain proteins (CSDPs) identified in Arabidopsis thaliana, it has recently been shown that CSDP1 harboring seven CCHC-type zinc fingers, but not CSDP2 harboring two CCHC-type zinc fingers, function as a RNA chaperone during cold adaptation. However, the structural features relevant to this differing RNA chaperone activity between CSDP1 and CSDP2 remain largely unknown. To determine which structural features are necessary for the RNA chaperone activity of the CSDPs, the importance of the N-terminal cold shock domain (CSD) and the C-terminal zinc finger glycine-rich domains of CSDP1 and CSDP2 were assessed. The results of sequence motif-swapping and deletion experiments showed that, although the CSD itself harbored RNA chaperone activity, the number and length of the zinc finger glycine-rich domains of CSDPs were crucial to the full activity of the RNA chaperones. The C-terminal domain itself of CSDP1, harboring seven CCHC-type zinc fingers, also has RNA chaperone activity. The RNA chaperone activity and nuclei acid-binding property of the native and chimeric proteins were closely correlated with each other. Collectively, these results indicate that a specific modular arrangement of the CSD and the zinc finger domain determines both the RNA chaperone activity and nucleic acid-binding property of CSDPs; this, in turn, contributes to enhanced cold tolerance in plants as well as in bacteria.     

A new mathematical model to simulate AVA cold-induced vasodilation reaction to local cooling

The purpose of this work was to integrate a new mathematical model with a bioheat model, based on physiology and first principles, to predict thermoregulatory arterio-venous anastomoses (AVA) and cold-induced vasodilation (CIVD) reaction to local cooling. The transient energy balance equations of body segments constrained by thermoregulatory controls were solved numerically to predict segmental core and skin temperatures, and arterial blood flow for given metabolic rate and environmental conditions. Two similar AVA–CIVD mechanisms were incorporated. The first was activated during drop in local skin temperature (<32 °C). The second mechanism was activated at a minimum finger skin temperature, T _{CIVD, min}, where the AVA flow is dilated and constricted once the skin temperature reached a maximum value. The value of T _CIVD,min was determined empirically from values reported in literature for hand immersions in cold fluid. When compared with published data, the model predicted accurately the onset time of CIVD at 25 min and T _CIVD,min at 10 °C for hand exposure to still air at 0 °C. Good agreement was also obtained between predicted finger skin temperature and experimentally published values for repeated immersion in cold water at environmental conditions of 30, 25, and 20 °C. The CIVD thermal response was found related to core body temperature, finger skin temperature, and initial finger sensible heat loss rate upon exposure to cold fluid. The model captured central and local stimulations of the CIVD and accommodated observed variability reported in literature of onset time of CIVD reaction and T _CIVD,min.     

Reductions in finger blood flow in men and women induced by 125-Hz vibration: association with vibration perception thresholds

Vibration of one hand reduces blood flow in the exposed hand and in the contralateral hand not exposed to vibration, but the mechanisms involved are not understood. This study investigated whether vibration-induced reductions in finger blood flow are associated with vibrotactile perception thresholds mediated by the Pacinian channel and considered sex differences in both vibration thresholds and vibration-induced changes in digital circulation. With force and vibration applied to the thenar eminence of the right hand, finger blood flow and finger skin temperature were measured in the middle fingers of both hands at 30-s intervals during seven successive 4-min periods: 1) pre-exposure with no force or vibration, 2) pre-exposure with force, 3) vibration 1, 4) rest with force, 5) vibration 2, 6) postexposure with force, and 7) recovery with no force or vibration. A 2-N force was applied during periods 2-6 and 125-Hz vibration at 0.5 and 1.5 ms(-2) root mean square (r.m.s.; unweighted) was applied during periods 3 and 5, respectively. Vibrotactile thresholds were measured at the thenar eminence of right hand using the same force, contact conditions, and vibration frequency. When the vibration magnitude was greater than individual vibration thresholds, changes in finger blood flow were correlated with thresholds (with both 0.5 and 1.5 ms(-2) r.m.s. vibration): subjects with lower thresholds showed greater reductions in finger blood flow. Women had lower vibrotactile thresholds and showed greater vibration-induced reductions in finger blood flow. It is concluded that mechanoreceptors responsible for mediating vibration perception are involved in the vascular response to vibration.