Search

Background and Purpose: Cryotherapy is an affordable and popular treatment of soft tissue injuries, which can reduce inflammation and pain. Studies have specifically addressed young adults and athletes, and these findings have been extended to older adults in clinical practice. Aging is associated with changes in the skin, including collagen degradation, decreased fat layer thickness, and reduced blood flow, which can alter the skin response to stress. Because of age-related changes, there are concerns about the direct use of ice on the skin of older individuals. Skin injuries were also observed after cryotherapy. This study aimed to assess the most effective and safe cryotherapy for superficial skin cooling among older women. Methods: Eighteen older women were enrolled in this blinded, randomized, crossover, clinical trial. The mean values (SD) of their age, height, and weight were 70.0 years (6.0), 156.0 cm (9.1), and 72.8 kg (19.5), respectively. The participants underwent cryotherapy using bagged ice, bagged ice plus a wet towel, or gel pack for 20 minutes. The surface temperature of the skin was measured at the end ofa 20-minute cryotherapy session using an infrared thermometer. Repeated-measures analysis of variance was conducted to analyze the effect of cryotherapy modalities and time, as well as the interaction between these 2 factors. The secondary outcome wasthe presence ofcryotherapy-induced lesions. Results and Discussion: Cryotherapy modalities had significant effects on superficial skin temperature (P = .001). Time points after application also had an effect (P< .001) and no interaction was observed between cryotherapy modalities and time points (P = .051). Bonferroni post hoc evaluation showed that bagged ice (P = .008) and gel (P = .007) were more effective in decreasing the superficial skin temperature than bagged ice plus wet towel. No difference was observed between bagged ice and gel (P = .32). Three of the 18 patients experienced adverse effects with the gel pack. Conclusion: This study of older women found that ice and gel cooled the skin more effectively than ice wrapped in towels. However, the gel pack had some adverse effects. Therefore, bagged ice is recommended for cryotherapy in older women. [ABSTRACT FROM AUTHOR]

Abstract Background Accidental hypothermia with severe frostbite is a rare combination of injuries with a high risk for long-term sequelae. There are widely accepted recommendations for the management of avalanche victims and for frostbite treatment, but no recommendation exists for the treatment of frostbite in severe hypothermic patients, specifically for the management of hypothermic avalanche victims presenting with frostbite. Case presentation We present a case of a previously healthy, 53-year-old male skier who was critically buried by an avalanche at 2300 m of altitude at an ambient temperature of − 8 °C for nearly 23 h. The victim was found with the right hand out of the snow and an air connection to outside. He was somnolent with Glasgow Coma Scale 11 (Eye 4, Verbal 2, Motor 5) and spontaneously breathing, in a severely hypothermic state with an initial core temperature of 23.1 °C and signs of cold injuries in all four extremities. After rescue and active external forced air rewarming in the intensive care unit, the clinical signs of first-degree frostbite on both feet and the left hand vanished, while third- to fourth-degree frostbite injuries became apparent on all fingers of the right hand. After reaching a core body temperature of approximately 36 °C, aggressive frostbite treatment was started with peripheral arterial catheter-directed thrombolysis with alteplase, intravenous iloprost, ibuprofen, dexamethasone and regional sympathicolysis with a right-sided continuous axillary block. After ten months, the patient had no tissue loss but needed neuropathic pain treatment with pregabalin. Conclusion The combination of severe accidental hypothermia and severe frostbite is rare and challenging, as drug metabolism is unpredictable in a hypothermic patient and no recommendations for combined treatment exist. There is general agreement to give hypothermia treatment the priority and to begin frostbite treatment as early as possible after full rewarming of the patient. More evidence is needed to identify the optimal dosage and time point to initiate treatment of frostbite in severely hypothermic patients. This should be taken into consideration by future treatment recommendations.

Background: Accidental hypothermia with severe frostbite is a rare combination of injuries with a high risk for long-term sequelae. There are widely accepted recommendations for the management of avalanche victims and for frostbite treatment, but no recommendation exists for the treatment of frostbite in severe hypothermic patients, specifically for the management of hypothermic avalanche victims presenting with frostbite. Case presentation: We present a case of a previously healthy, 53-year-old male skier who was critically buried by an avalanche at 2300 m of altitude at an ambient temperature of − 8 °C for nearly 23 h. The victim was found with the right hand out of the snow and an air connection to outside. He was somnolent with Glasgow Coma Scale 11 (Eye 4, Verbal 2, Motor 5) and spontaneously breathing, in a severely hypothermic state with an initial core temperature of 23.1 °C and signs of cold injuries in all four extremities. After rescue and active external forced air rewarming in the intensive care unit, the clinical signs of first-degree frostbite on both feet and the left hand vanished, while third- to fourth-degree frostbite injuries became apparent on all fingers of the right hand. After reaching a core body temperature of approximately 36 °C, aggressive frostbite treatment was started with peripheral arterial catheter-directed thrombolysis with alteplase, intravenous iloprost, ibuprofen, dexamethasone and regional sympathicolysis with a right-sided continuous axillary block. After ten months, the patient had no tissue loss but needed neuropathic pain treatment with pregabalin. Conclusion: The combination of severe accidental hypothermia and severe frostbite is rare and challenging, as drug metabolism is unpredictable in a hypothermic patient and no recommendations for combined treatment exist. There is general agreement to give hypothermia treatment the priority and to begin frostbite treatment as early as possible after full rewarming of the patient. More evidence is needed to identify the optimal dosage and time point to initiate treatment of frostbite in severely hypothermic patients. This should be taken into consideration by future treatment recommendations. [ABSTRACT FROM AUTHOR]

Phalangeal microgeodic syndrome (PMS) is a rare osteolytic disorder of unknown etiology that typically affects children up to 15 years old during colder months. Transient peripheral circulatory impairment probably underlines its pathogenesis. Conservative treatment with eviction of cold exposure is often successful. We report the case of a young woman presenting with joint pain in her feet, along with toe discoloration and redness, where a diagnosis of PMS was established based on magnetic resonance imaging findings and exclusion of other differential diagnostic entities. Pharmacological treatment was deemed necessary for symptomatic relief, but a trial of calcium channel blocker (CCB) was not tolerated by the patient. The patient was then started on pentoxifylline, with significant clinical improvement. [ABSTRACT FROM AUTHOR]

Abstract Introduction Our objective was to perform a systematic review of the outcomes of various frostbite treatments to determine which treatments are effective. We also planned to perform meta-analyses of the outcomes of individual treatments for which suitable data were available. Main Body We performed a systematic review and meta-analyses in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched PubMed, Cochrane Trials, and EMBase to identify primary references from January 1, 1900, to June 18, 2022. After eliminating duplicates, we screened abstracts to identify eligible studies containing information on treatment and outcomes of Grade 2 to 4 frostbite. We performed meta-analyses of groups of articles that provided sufficient data. We registered our review in the prospective registry of systematic reviews PROSPERO (Nr. 293,693). We identified 4,835 potentially relevant studies. We excluded 4,610 studies after abstract screening. We evaluated the full text of the remaining 225 studies, excluding 154. Ultimately, we included 71 articles with 978 cases of frostbite originating from 1 randomized controlled trial, 20 cohort studies and 51 case reports. We found wide variations in classifications of treatments and outcomes. The two meta-analyses we performed both found that patients treated with thrombolytics within 24 h had better outcomes than patients treated with other modalities. The one randomized controlled trial found that the prostacyclin analog iloprost was beneficial in severe frostbite if administered within 48 h. Conclusions Iloprost and thrombolysis may be beneficial for treating frostbite. The effectiveness of other commonly used treatments has not been validated. More prospective data from clinical trials or an international registry may help to inform optimal treatment.

Rice cultivation in the low-lying basin-like wetlands, known as the Haor, is often affected by early flash floods during the first two weeks of April. The flooding is mainly caused by heavy rainfall and water surging downstream from the Meghalaya hills in India. This flash flood poses a significant threat to rice production, risking the country's food security. Dry winter (Boro) rice is the primary food source throughout the year in the Haor region. Flash floods are the most catastrophic, affecting about 80% or even the entire rice yield. In 2017, a loss of 0.88 million metric tons of Boro rice in Haor regions cost the nation USD 450 million. To escape flash floods, it is recommended to sow Boro rice earlier, between the last week of October and the first week of November, instead of around 15 November so rice may be harvested by the last week of March before the onset of flash floods. However, early sowing has a possibility of causing grain sterility due to cold spells when the booting and heading stages of rice inevitably coincide with the cold period between 15 January and 7 February. The minimum temperature in the Haor regions ranges from 11 to 15 °C during this time. Rice is especially susceptible to low average temperatures (<20 °C) during the reproductive stage, leading to pollen abortion and the malformation of immature microspores. Low temperatures mainly impact rice cultivation in Haor regions during the reproductive phase, resulting in the degeneration of the spikelets, partial panicle exertion, and increased spikelet sterility, leading to a decrease in grain yield. Over two million hectares of Boro rice have been damaged by extreme cold spells in recent years, resulting in partial or total yield loss. To overcome the threats of flash floods and cold injury, breeding short-duration and cold-tolerant rice varieties is crucial. We assume that an economic benefit of USD 230 million per year could be achieved through the development and adoption of short-duration and cold-tolerant high-yielding rice varieties in the Haor regions of the country. In this review article, the authors summarized the problems and outline a way forward to overcome the flash flood and cold injury of Boro rice cultivation in the Haor districts of the country. Furthermore, the authors discussed the various forms and scenarios of cold damage and the global existence of cold-tolerant rice cultivars. Based on the available data from earlier research, a potential way of mitigating flash floods and cold devastation was suggested. [ABSTRACT FROM AUTHOR]

Introduction: Our objective was to perform a systematic review of the outcomes of various frostbite treatments to determine which treatments are effective. We also planned to perform meta-analyses of the outcomes of individual treatments for which suitable data were available. Main Body: We performed a systematic review and meta-analyses in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched PubMed, Cochrane Trials, and EMBase to identify primary references from January 1, 1900, to June 18, 2022. After eliminating duplicates, we screened abstracts to identify eligible studies containing information on treatment and outcomes of Grade 2 to 4 frostbite. We performed meta-analyses of groups of articles that provided sufficient data. We registered our review in the prospective registry of systematic reviews PROSPERO (Nr. 293,693). We identified 4,835 potentially relevant studies. We excluded 4,610 studies after abstract screening. We evaluated the full text of the remaining 225 studies, excluding 154. Ultimately, we included 71 articles with 978 cases of frostbite originating from 1 randomized controlled trial, 20 cohort studies and 51 case reports. We found wide variations in classifications of treatments and outcomes. The two meta-analyses we performed both found that patients treated with thrombolytics within 24 h had better outcomes than patients treated with other modalities. The one randomized controlled trial found that the prostacyclin analog iloprost was beneficial in severe frostbite if administered within 48 h. Conclusions: Iloprost and thrombolysis may be beneficial for treating frostbite. The effectiveness of other commonly used treatments has not been validated. More prospective data from clinical trials or an international registry may help to inform optimal treatment. [ABSTRACT FROM AUTHOR]

Frostbite is an insidious disease that normally affects people of cold climates. Winter Storm Uri, which occurred from February 12–20, 2021, created unique metrological conditions for Texas. It caused prolonged sub-freezing temperatures and led to rolling blackouts, affecting 2.8 million Texans including 300,000 people in San Antonio. We report 13 frostbite patients admitted to one burn center during this event. We aimed to determine the at-risk population for frostbite, to categorize their injury severity, and to describe their treatment. A secondary aim was to describe the rehabilitation management of these patients. This is a single-center retrospective study. Each patient's injuries were assessed by a topographical grading system. Comparisons were made among those who were admitted to the intensive care unit (ICU), admitted to the progressive care unit (PCU), and treated as outpatients. Thirteen patients were identified. Ten (76.9 %) considered themselves homeless, and 9 (69.2 %) were directly exposed to the elements. The median delay between time of injury and presentation to a medical facility was 3 days (IQR 1–6). Only 3 patients presented to a medical facility within 24 h. Six (46 %) sustained grade 2 injuries, 2 (15 %) sustained grade 3 injuries, and 5 (38%) sustained grade 4 injuries. Only one patient met criteria to receive tissue plasminogen activator (tPA), which was discontinued due to hematochezia. Patients admitted to the ICU, when compared to patients admitted to the ward, had a longer length of stay (median 73 days v. 12 days, p = 0.0215), and required more amputations at below-the-knee or higher levels (3 v. 0, p-value 0.0442). In a region unaccustomed and perhaps unprepared to deal with winter storms, the population is particularly vulnerable to frostbite. Lack of awareness of frostbite injuries likely led to the delay in the presentation of patients, which prevented the timely use of tPA. Increasing public awareness may increase readiness. • The homeless population was particularly vulnerable to frostbite. • Lack of awareness of frostbite injuries likely led to the delay in presentation, limiting therapeutic interventions. • Due to the homeless nature of many patients, rehabilitation was modified to best meet the patients' needs. [ABSTRACT FROM AUTHOR]

Introduction: Cold Weather Injury (CWI) represents a spectrum of pathology, the two main divisions being Freezing Cold Injury (FCI) and Non-Freezing Cold Injury (NFCI). Both are disabling conditions associated with microvascular and nerve injury often treated hours after initial insult when presenting to a healthcarestablishment. Given that iloprost is used for the treatment of FCI, could it be used in a forward operating environment to mitigate treatment delay? Is there a role for its use in the forward treatment of NFCI? This review sought to evaluate the strength of evidence for the potential use of iloprost in a forward operating environment. Methods: Literature searches were undertaken using the following question for both FCI and NFCI: in [patients with FCI/NFCI] does [the use of iloprost] compared to [standard care] reduce the incidence of [long-term complications]. Medline, CINAHL and EMBASE databases were searched using the above question and relevant alternative terminology. Abstracts were reviewed before full articles were requested. Results: The FCI search yielded 17 articles that were found to refer to the use of iloprost and FCI. Of the 17, one referred to pre-hospital treatment of frostbite at K2 base camp; however, this was utilising tPA. No articles referred to pre-hospital use in either FCI or NFCI. Discussion: Although evidence exists to support the use of iloprost in the treatment of FCI, its use to date has been in hospital. A common theme is delayed treatment due to the challenges of evacuating casualties from a remote location. There may be a role for iloprost in the treatment of FCI; however, further study is required to better understand the risk of its use. [ABSTRACT FROM AUTHOR]

Introduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather operations. Although the risks have long been recognised, injury occurrences tend to be sparse and geographically distributed, with relatively few cases to study in a systematic way. The first challenge to improve FCI medical management is to develop a common nomenclature for FCI classification. This is critical for the development of meaningful epidemiological reports on the magnitude and severity of FCI, for the standardisation of patient inclusion criteria for treatment studies, and for the development of clinical diagnosis and treatment algorithms. Methodology: A scoping review of the literature using PubMed and cross-checked with Google Scholar, using search terms related to freezing cold injury and frostbite, highlighted a paucity of published clinical papers and little agreement on classification schemes. Results: A total of 74 papers were identified, and 28 were included in the review. Published reports and studies can be generally grouped into four different classification schemes that are based on (1) injury morphology; (2) signs and symptoms; (3) pathophysiology; and (4) clinical outcome. The nomenclature in the different classification systems is not coherent and the discrete classification limits are not evidence based. Conclusions: All the classification systems are necessary and relevant to FCI medical management for sustainment of soldier health and performance in cold weather operations and winter warfare. Future FCI reports should clearly characterise the nature of the FCI into existing classification schemes for surveillance (morphology, symptoms, and appearance), identifying risk-factors, clinical guidelines, and agreed inclusion/exclusion criteria for a future treatment trial. [ABSTRACT FROM AUTHOR]

For decades, the Wind Chill Temperature Index (WCT) and its various iterations have been used to assess the risk of frostbite on unclothed body parts. This paper presents an innovative knowledge-based Cold Weather Ensemble Decision Aid (CoWEDA) that can be used to guide the selection of the most appropriate cold weather ensemble(s) relative to anticipated mission physical activities and environmental conditions. CoWEDA consists of a validated six-cylinder thermoregulatory model, a database of clothing properties, algorithms for calculating the whole ensemble properties from individual garments and a graphical user interface. The user-friendly CoWEDA allows users to select from an inventory of clothing items to build an ensemble suitable for their needs. CoWEDA predicts the risks of both frostbite and hypothermia and ensures that a selected clothing ensemble will provide adequate protection to prevent cold injury. CoWEDA predictions provide not only estimates of frostbite risk similar to WCT tables but also hypothermia times and clothing required to prevent cold injuries. In addition, a CoWEDA model variant can predict survivability and clothing requirements during cold water immersion. Thus, CoWEDA represents a significant enhancement of the WCT-based guidance for cold weather safety and survival by providing greater individual fidelity in cold injury predictions. [ABSTRACT FROM AUTHOR]

We performed a scoping review to identify the extent of the literature describing the use of iloprost in the treatment of frostbite. Iloprost is a stable synthetic analog of prostaglandin I2. As a potent inhibitor of platelet aggregation and vasodilator, it has been used to address the post-rewarming reperfusion injury in frostbite. The search using iloprost and frostbite as key words and MeSH terms yielded 200 articles. We included in our review the literature examining iloprost for the treatment of frostbite in humans in the form of primary research, conference proceedings and abstracts. Twenty studies published from 1994 to 2022 were selected for analysis. The majority were retrospective case series consisting of a homogeneous population of mountain sport enthusiasts. A total of 254 patients and over 1000 frostbitten digits were included among the 20 studies. The larger case series demonstrated a decrease in amputation rates relative to untreated patients. Primary gaps in the literature include a paucity of randomised trials and relatively limited study populations to date. While the case evidence is promising, a multi-centre collaboration would be crucial to adequately power prospective randomised studies to definitively determine if iloprost has a role in the treatment of frostbite. [ABSTRACT FROM AUTHOR]

Today, it can be considered established that the thermal scheme of the human body consists of a "core", which includes the brain, internal organs of the chest and abdominal cavities, and a "shell" consisting of skin, hypodermic matrices, and superficial muscles. The goal of the work is to design a device for slow noncontact defrosting of a limb that has received a cold injury and previously was thermally insulated from the external environment. Measurements were made of the temperature of the muscle tissue of a biological object frostbitten under experimental conditions that was previously placed in a heat-insulating material with subsequent noncontact heating with low-power microwaves. Since the heat-insulating material is ratio transparent for the microwave range, the heating effect will act directly on the sample under study. [ABSTRACT FROM AUTHOR]

ABSTRACTIntroduction: Cold Weather Injury (CWI) represents a spectrum of pathology, the two main divisions being Freezing Cold Injury (FCI) and Non-Freezing Cold Injury (NFCI). Both are disabling conditions associated with microvascular and nerve injury often treated hours after initial insult when presenting to a healthcarestablishment. Given that iloprost is used for the treatment of FCI, could it be used in a forward operating environment to mitigate treatment delay? Is there a role for its use in the forward treatment of NFCI? This review sought to evaluate the strength of evidence for the potential use of iloprost in a forward operating environment.Methods: Literature searches were undertaken using the following question for both FCI and NFCI: in [patients with FCI/NFCI] does [the use of iloprost] compared to [standard care] reduce the incidence of [long-term complications]. Medline, CINAHL and EMBASE databases were searched using the above question and relevant alternative terminology. Abstracts were reviewed before full articles were requested.Results: The FCI search yielded 17 articles that were found to refer to the use of iloprost and FCI. Of the 17, one referred to pre-hospital treatment of frostbite at K2 base camp; however, this was utilising tPA. No articles referred to pre-hospital use in either FCI or NFCI.Discussion: Although evidence exists to support the use of iloprost in the treatment of FCI, its use to date has been in hospital. A common theme is delayed treatment due to the challenges of evacuating casualties from a remote location. There may be a role for iloprost in the treatment of FCI; however, further study is required to better understand the risk of its use.

ABSTRACTIntroduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather operations. Although the risks have long been recognised, injury occurrences tend to be sparse and geographically distributed, with relatively few cases to study in a systematic way. The first challenge to improve FCI medical management is to develop a common nomenclature for FCI classification. This is critical for the development of meaningful epidemiological reports on the magnitude and severity of FCI, for the standardisation of patient inclusion criteria for treatment studies, and for the development of clinical diagnosis and treatment algorithms.Methodology: A scoping review of the literature using PubMed and cross-checked with Google Scholar, using search terms related to freezing cold injury and frostbite, highlighted a paucity of published clinical papers and little agreement on classification schemes.Results: A total of 74 papers were identified, and 28 were included in the review. Published reports and studies can be generally grouped into four different classification schemes that are based on (1) injury morphology; (2) signs and symptoms; (3) pathophysiology; and (4) clinical outcome. The nomenclature in the different classification systems is not coherent and the discrete classification limits are not evidence based.Conclusions: All the classification systems are necessary and relevant to FCI medical management for sustainment of soldier health and performance in cold weather operations and winter warfare. Future FCI reports should clearly characterise the nature of the FCI into existing classification schemes for surveillance (morphology, symptoms, and appearance), identifying risk-factors, clinical guidelines, and agreed inclusion/exclusion criteria for a future treatment trial.

ABSTRACTWe performed a scoping review to identify the extent of the literature describing the use of iloprost in the treatment of frostbite. Iloprost is a stable synthetic analog of prostaglandin I2. As a potent inhibitor of platelet aggregation and vasodilator, it has been used to address the post-rewarming reperfusion injury in frostbite. The search using iloprost and frostbite as key words and MeSH terms yielded 200 articles. We included in our review the literature examining iloprost for the treatment of frostbite in humans in the form of primary research, conference proceedings and abstracts. Twenty studies published from 1994 to 2022 were selected for analysis. The majority were retrospective case series consisting of a homogeneous population of mountain sport enthusiasts. A total of 254 patients and over 1000 frostbitten digits were included among the 20 studies. The larger case series demonstrated a decrease in amputation rates relative to untreated patients. Primary gaps in the literature include a paucity of randomised trials and relatively limited study populations to date. While the case evidence is promising, a multi-centre collaboration would be crucial to adequately power prospective randomised studies to definitively determine if iloprost has a role in the treatment of frostbite.

ABSTRACTFor decades, the Wind Chill Temperature Index (WCT) and its various iterations have been used to assess the risk of frostbite on unclothed body parts. This paper presents an innovative knowledge-based Cold Weather Ensemble Decision Aid (CoWEDA) that can be used to guide the selection of the most appropriate cold weather ensemble(s) relative to anticipated mission physical activities and environmental conditions. CoWEDA consists of a validated six-cylinder thermoregulatory model, a database of clothing properties, algorithms for calculating the whole ensemble properties from individual garments and a graphical user interface. The user-friendly CoWEDA allows users to select from an inventory of clothing items to build an ensemble suitable for their needs. CoWEDA predicts the risks of both frostbite and hypothermia and ensures that a selected clothing ensemble will provide adequate protection to prevent cold injury. CoWEDA predictions provide not only estimates of frostbite risk similar to WCT tables but also hypothermia times and clothing required to prevent cold injuries. In addition, a CoWEDA model variant can predict survivability and clothing requirements during cold water immersion. Thus, CoWEDA represents a significant enhancement of the WCT-based guidance for cold weather safety and survival by providing greater individual fidelity in cold injury predictions.

Pawpaw or Northern banana (Asimina triloba L. Dunal), is part of the Annonaceae family, although it is a temperate fruit tree species. The pawpaw fruit is an exciting new food option for people looking for new, balanced food choices. One hundred grams of pawpaw pulp delivers 80 calories and contains 1.2 g of proteins and 1.2 g of total fat. Studies have shown that during ripening, loss of firmness is extremely rapid. This trait may be the biggest obstacle to developing a broader market, as handling without injury is difficult. Cold storage of pawpaw seems limited to four weeks at 4°C. Cold storage for longer than four weeks caused cold injury symptoms such as black discoloration, rapid loss of firmness, impaired respiration, tissue acidification, decreased antioxidant content, reduced volatile ester production, and development of off-flavor volatile compounds. This paper aims to review pawpaw ripening and postripening characteristics under local conditions. [ABSTRACT FROM AUTHOR]

Exposure to extreme environmental heat or cold during military activities can impose severe thermal strain, leading to impairments in task performance and increasing the risk of exertional heat (including heat stroke) and cold injuries that can be life-threatening. Substantial individual variability in physiological tolerance to thermal stress necessitates an individualized approach to mitigate the deleterious effects of thermal stress, such as physiological monitoring of individual thermal strain. During heat exposure, measurements of deep-body (T c) and skin temperatures and heart rate can provide some indication of thermal strain. Combining these physiological variables with biomechanical markers of gait (in)stability may provide further insight on central nervous system dysfunction – the key criterion of exertional heat stroke (EHS). Thermal strain in cold environments can be monitored with skin temperature (peripheral and proximal), shivering thermogenesis and T c. Non-invasive methods for real-time estimation of T c have been developed and some appear to be promising but require further validation. Decision-support tools provide useful information for planning activities and biomarkers can be used to improve their predictions, thus maximizing safety and performance during hot- and cold-weather operations. With better understanding on the etiology and pathophysiology of EHS, the microbiome and markers of the inflammatory responses have been identified as novel biomarkers of heat intolerance. This review aims to (i) discuss selected physiological and biomechanical markers of heat or cold strain, (ii) how biomarkers may be used to ensure operational readiness in hot and cold environments, and (iii) present novel molecular biomarkers (e.g., microbiome, inflammatory cytokines) for preventing EHS. [ABSTRACT FROM AUTHOR]

Cold injury (CI) causes irreversible damage to tea plants, which results in decline in the quality of famous teas and huge economic loss. A new, quick, non-destructive method is provided to assess the CI of tea leaf based on terahertz (THz) spectroscopy. Absorbance of the samples was measured with THz spectroscopy in frequency bands from 0.1 to 1.6 THz under low temperature treatments of 4.0, 0, −2.5, −5.0, −7.5, and −10.0 °C. Fast Fourier transformation was explored to decompose the endpoint signal to improve the ratio of signal to air and convert the time-domain spectra to the corresponding frequency-domain spectra. To improve the separation of overlap signals caused by substantial scattering of injured cells in the leaf, two-dimensional correlation spectroscopy (2DCOS) and average intensity (AI) were introduced into the partial least squares regression (PLSR) to build 2DCOS–PLSR and AI–PLSR models. Quantitative assessments of the 2DCOS–PLSR and AI–PLSR models were conducted to evaluate the three models. The assessment results showed that the correlation coefficients of the 2DCOS–PLSR model (R2D) were 0.7873, 0.8305, and 0.9103, respectively. The root mean square errors of the 2DCOS–PLSR model (RMSE2D) were 0.6032, 0.5763, and 0.5221, respectively. For the AI–PLSR model, RAI values were 0.7477, 0.7691, and 0.8974, respectively. RMSEAI values were 0.6038, 0.5962, and 0.5797. The combination of THz spectroscopy with the 2DCOS–PLSR model provided a better benchmark for the input interval selection and improved the accuracy of cold-injury detection results. [ABSTRACT FROM AUTHOR]

Cold storage is widely used to preserve an organ for transplantation; however, a long duration of cold storage negatively impacts graft function. Unfortunately, the mechanisms underlying cold exposure remain unclear. Based on the sphingosine-1-phosphate (S1P) signal involved in cold tolerance in hibernating mammals, we hypothesized that S1P signal blockage reduces damage from cold storage. We used an in vitro cold storage and rewarming model to evaluate cold injury and investigated the relationship between cold injury and S1P signal. Compounds affecting S1P receptors (S1PR) were screened for their protective effect in this model and its inhibitory effect on S1PRs was measured using the NanoLuc Binary Technology (NanoBiT)-β-arrestin recruitment assays. The effects of a potent antagonist were examined via heterotopic abdominal rat heart transplantation. The heart grafts were transplanted after 24-hour preservation and evaluated on day 7 after transplantation. Cold injury increased depending on the cold storage time and was induced by S1P. The most potent antagonist strongly suppressed cold injury consistent with the effect of S1P deprivation in vitro. In vivo, this antagonist enabled 24-hour preservation, and drastically improved the beating score, cardiac size, and serological markers. Pathological analysis revealed that it suppressed the interstitial edema, inflammatory cell infiltration, myocyte lesion, TUNEL-positive cell death, and fibrosis. In conclusion, S1PR3 antagonist reduced cold injury, extended the cold preservation time, and improved graft viability. Cold preservation strategies via S1P signaling may have clinical applications in organ preservation for transplantation and contribute to an increase in the donor pool. [ABSTRACT FROM AUTHOR]

In biological particles such as Fusarium species, ice nucleation activity (INA) has been observed. Fusarium strains isolated from apple declined trees in Korea were identified with a multilocus sequence analysis using the tef1 and rpb1 genes. Droplet-freezing and tube-freezing assays were used to determine the INA of the strains, using Pseudomonas syringae pv. syringae KACC 21200 as a positive control and resulting in seven INA+ fungal strains that were identified as F. tricinctum (KNUF-21-F17, KNUF-21-F18, KNUF-21-F29, KNUF-21-F32, KNUF-21-F38, KNUF-21-F43, and KNUF-21-F44). The effect of Fusarium INA+ KNUF-21-F29 was compared to that of INA– strains on Chrysanthemum morifolium cv. Shinma explants. A higher callus formation and no-shoot formation were observed, suggesting that fungal INA could play a role in cold injuries and be a factor to consider in rapid apple decline. To the best of our knowledge, this is the first report of INA fungal strains isolated in Korea.

New Findings: What is the central question of this study?Is peripheral sensory function impaired in the chronic phase of non‐freezing cold injury (NFCI)?What is the main finding and its importance?Warm and mechanical detection thresholds are elevated and intraepidermal nerve fibre density is reduced in individuals with NFCI in their feet when compared to matched controls. This indicates impaired sensory function in individuals with NFCI. Interindividual variation was observed in all groups, and therefore a diagnostic cut‐off for NFCI has yet to be established. Longitudinal studies are required to follow NFCI progression from formation to resolution The aim of this study was to compare peripheral sensory neural function of individuals with non‐freezing cold injury (NFCI) with matched controls (without NFCI) with either similar (COLD) or minimal previous cold exposure (CON). Thirteen individuals with chronic NFCI in their feet were matched with the control groups for sex, age, race, fitness, body mass index and foot volume. All undertook quantitative sensory testing (QST) on the foot. Intraepidermal nerve fibre density (IENFD) was assessed 10 cm above the lateral malleolus in nine NFCI and 12 COLD participants. Warm detection threshold was higher at the great toe in NFCI than COLD (NFCI 45.93 (4.71)°C vs. COLD 43.44 (2.72)°C, P = 0.046), but was non‐significantly different from CON (CON 43.92 (5.01)°C, P = 0.295). Mechanical detection threshold on the dorsum of the foot was higher in NFCI (23.61 (33.59) mN) than in CON (3.83 (3.69) mN, P = 0.003), but was non‐significantly different from COLD (10.49 (5.76) mN, P > 0.999). Remaining QST measures did not differ significantly between groups. IENFD was lower in NFCI than COLD (NFCI 8.47 (2.36) fibre/mm2 vs. COLD 11.93 (4.04) fibre/mm2, P = 0.020). Elevated warm and mechanical detection thresholds may indicate hyposensitivity to sensory stimuli in the injured foot for individuals with NFCI and may be due to reduced innervation given the reduction in IENFD. Longitudinal studies are required to identify the progression of sensory neuropathy from the formation of injury to its resolution, with appropriate control groups employed. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of this study?Does non‐freezing cold injury (NFCI) alter normal peripheral vascular function?What is the main finding and its importance?Individuals with NFCI were more cold sensitive (rewarmed more slowly and felt more discomfort) than controls. Vascular tests indicated that extremity endothelial function was preserved with NFCI and that sympathetic vasoconstrictor response might be reduced. The pathophysiology underpinning the cold sensitivity associated with NFCI thus remains to be identified. The impact of non‐freezing cold injury (NFCI) on peripheral vascular function was investigated. Individuals with NFCI (NFCI group) and closely matched controls with either similar (COLD group) or limited (CON group) previous cold exposure were compared (n = 16). Peripheral cutaneous vascular responses to deep inspiration (DI), occlusion (PORH), local cutaneous heating (LH) and iontophoresis of acetylcholine and sodium nitroprusside were investigated. The responses to a cold sensitivity test (CST) involving immersion of a foot in 15°C water for 2 min followed by spontaneous rewarming, and a foot cooling protocol (footplate cooled from 34°C to 15°C), were also examined. The vasoconstrictor response to DI was lower in NFCI compared to CON (toe: 73 (28)% vs. 91 (17)%; P = 0.003). The responses to PORH, LH and iontophoresis were not reduced compared to either COLD or CON. During the CST, toe skin temperature rewarmed more slowly in NFCI than COLD or CON (10 min: 27.4 (2.3)°C vs. 30.7 (3.7)°C and 31.7 (3.9)°C, P < 0.05, respectively); however, no differences were observed during the footplate cooling. NFCI were more cold‐intolerant (P < 0.0001) and reported colder and more uncomfortable feet during the CST and footplate cooling than COLD and CON (P < 0.05). NFCI showed a decreased sensitivity to sympathetic vasoconstrictor activation than CON and greater cold sensitivity (CST) compared to COLD and CON. None of the other vascular function tests indicated endothelial dysfunction. However, NFCI perceived their extremities to be colder and more uncomfortable/painful than the controls. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of this study?Are biomarkers of endothelial function, oxidative stress and inflammation altered by non‐freezing cold injury (NFCI)?What is the main finding and its importance?Baseline plasma [interleukin‐10] and [syndecan‐1] were elevated in individuals with NFCI and cold‐exposed control participants. Increased [endothelin‐1] following thermal challenges might explain, in part, the increased pain/discomfort experienced with NFCI. Mild to moderate chronic NFCI does not appear to be associated with either oxidative stress or a pro‐inflammatory state. Baseline [interleukin‐10] and [syndecan‐1] and post‐heating [endothelin‐1] are the most promising candidates for diagnosis of NFCI. Plasma biomarkers of inflammation, oxidative stress, endothelial function and damage were examined in 16 individuals with chronic NFCI (NFCI) and matched control participants with (COLD, n = 17) or without (CON, n = 14) previous cold exposure. Venous blood samples were collected at baseline to assess plasma biomarkers of endothelial function (nitrate, nitrite and endothelin‐1), inflammation [interleukin‐6 (IL‐6), interleukin‐10 (IL‐10), tumour necrosis factor alpha and E‐selectin], oxidative stress [protein carbonyl, 4‐hydroxy‐2‐nonenal (4‐HNE), superoxide dismutase and nitrotyrosine) and endothelial damage [von Willebrand factor, syndecan‐1 and tissue type plasminogen activator (TTPA)]. Immediately after whole‐body heating and separately, foot cooling, blood samples were taken for measurement of plasma [nitrate], [nitrite], [endothelin‐1], [IL‐6], [4‐HNE] and [TTPA]. At baseline, [IL‐10] and [syndecan‐1] were increased in NFCI (P < 0.001 and P = 0.015, respectively) and COLD (P = 0.033 and P = 0.030, respectively) compared with CON participants. The [4‐HNE] was elevated in CON compared with both NFCI (P = 0.002) and COLD (P < 0.001). [Endothelin‐1] was elevated in NFCI compared with COLD (P < 0.001) post‐heating. The [4‐HNE] was lower in NFCI compared with CON post‐heating (P = 0.032) and lower than both COLD (P = 0.02) and CON (P = 0.015) post‐cooling. No between‐group differences were seen for the other biomarkers. Mild to moderate chronic NFCI does not appear to be associated with a pro‐inflammatory state or oxidative stress. Baseline [IL‐10] and [syndecan‐1] and post‐heating [endothelin‐1] are the most promising candidates for diagnosing NFCI, but it is likely that a combination of tests will be required. [ABSTRACT FROM AUTHOR]

This paper describes a newly developed software tool to evaluate human thermal safety and thermal comfort in cold-weather activities aimed at guiding users to arrange activity plans and select appropriate clothing ensembles. The software inputs include conditions of activity, environment, human body, and clothing ensemble. It outputs physiological temperatures, cold injury risks, thermal sensations, and thermal comforts in intuitive ways like cloud maps and curves. The software tool is characterized by (1) integration of a thermoregulatory model that predicts human thermophysiological responses under exercise conditions in cold environments, (2) the functions of clothing ensemble database and individual parameter database, (3) the human centric outputs that directly reflect human physiological and mental status, and (4) the user-friendly operation interface and output interface, as well as a wide applicability. The software is validated with human test studies covering ambient temperatures from − 30.6 to 5 °C, clothing ensembles from 1.34 to 3.20 clo, and activity intensities from 2 to 9 Mets. The average prediction RMSEs of core temperature, mean skin temperature, thermal sensation, and thermal comfort are 0.16 °C, 0.45 °C, 0.58, and 1.41, respectively. The software is an advanced expansion to current standards and guidance of cold exposure assessment and a meaningful tool for the fields of occupational health care, cold protection, and environmental ergonomics. [ABSTRACT FROM AUTHOR]

Yield of sweet cherry (Prunus avium L.) is determined by fruit set, a developmental stage sensitive to variable spring environmental conditions. To sustain fruit production and enhance crop climate resilience, it is important to understand the impacts of abiotic stresses and the effectiveness of horticultural mitigations in the spring on the critical developmental processes during fruit set. In this study, flowering phenology, pistil browning and percent fruit set of 'Lapins' were monitored at five sites of different elevation and frost risk in the Okanagan Valley, British Columbia, Canada, in 2019 and 2022. At Site 1 in Summerland Research and Development Centre ("SuRDC1"), where a 'Lapins' on Krymsk 5 planting was located in a frost pocket where the crops were exposed to high risk of cold damage in the spring, a series of experiments were conducted to investigate the floral organ viability and percent fruit set under low temperatures, and under the effects of four spring horticultural mitigation measures. Installation of polyethylene sleeves and FAME spray (fatty acid methyl esters-based plant growth regulator, WAIKEN, SST Australia) were implemented in 2019; boric acid spray and postponed irrigation were tested in 2022. Low fruit set at SuRDC1 in both years was associated with severe pistil browning after night temperature dropped below −4 °C in late April. In 2019, the semi-enclosure of polyethylene sleeves led to an increase in the surface temperature (Tsurfae) of floral buds by 2–4 °C, which prolonged the stage of first bloom, delayed petal fall and prevented frost damage on pistils, but led to the decrease in percent fruit set by 77%, due to ovule abortion or cessation of fruitlet development. The early and late sprays of FAME had no significant influence on either abundance of germinated pollen tubes or percent fruit set; however, the potential of late spray in improving pollen abundance and reducing pistil browning requires further investigation. In 2022, the spray of 0.01% boric acid solution led to a decrease in fruit set by 6.95%. Six-week postponement of irrigation starting from full bloom decreased soil moisture, but increased soil temperature and improved fruit set by 7.61%. The results improved our understanding about the damages of adverse spring air temperatures on pistils and ovules, and suggested the potential of irrigation adjustment in regulating soil moisture and temperature and improving fruit set in the cool and moist spring. [ABSTRACT FROM AUTHOR]

Introduction and purpose Frostbite is a serious injury caused by cold, which is an inseparable element of human contact with nature. It can cause tissue damage and loss of function if not properly treated. It treatment consists of several stages that require the involvement of many people. The purpose of the article is to summarize information on epidemiology, pathophysiology, prehospital and hospital procedures and to draw attention to the complexity of patient care. Materials and methods A literature review based on PubMed and Google Scholar using the following keywords: frostbite, cold injury. Description of the state of knowledge: The literature review shows the breadth of the issue. The effectiveness of therapy depends on: knowledge of pathophysiology and risk factors, early diagnosis, discontinuation of exposure to cold, effective analgesic treatment, fluid therapy, transport of the victim to the appropriate center, rapid warming of frozen tissues, imaging diagnostics, initiation of thrombolytic treatment and, if necessary, surgery. It is also important to remember about long-term complications that worsen the quality of life of patients, such as chronic pain, hyperaesthesia or impairment or loss of limb functionality. Conclusions Frostbite is a relatively rare problem, but especially in winter, every medic will have to deal with it sooner or later. Considering the above information, the management of a patient with frostbite is a demanding and long-term process in which the cooperation and involvement of many medics is important, so it is worth having knowledge about them.

PurposeCorneal endothelial cell regeneration varies by species, with nonhuman primates (NHPs) and rabbits displaying low and high proliferative capacities, respectively. Recent studies report that topical application of rho-associated kinase (ROCK) inhibitors accelerates corneal endothelial wound healing in animal models and human patients with endothelial dysfunction. This study determines the regenerative capacity of canine corneal endothelial cells in vivo and their response to a topical ROCK inhibitor, Y27632, after transcorneal freezing.MethodsRight eyes of 6 beagles underwent transcorneal freezing; 10 mM ROCK inhibitor Y27632 or vehicle control was applied topically to both eyes at least 4 times daily for 56 days. Endothelial cell density was evaluated by in vivo confocal microscopy, and corneal thickness was measured by Fourier-domain optical coherence tomography (FD-OCT) and ultrasound pachymetry.ResultsTranscorneal freezing induced severe central corneal edema in dogs, with restoration of transparency occurring within 4 weeks. Y27632 significantly decreased corneal thickness by FD-OCT and ultrasound pachymetry in the acute phase and significantly increased endothelial cell density at days 28 and 42 post-cryoinjury, suggesting faster restoration of endothelial cell recovery.ConclusionsCanine corneal endothelial function recovers at a similar rate as NHPs but more slowly than rabbits after cryoinjury. Faster corneal endothelial wound healing was observed by in vivo confocal microscopy and FD-OCT in dogs treated with Y27632 versus vehicle controls. Thus, a canine cryoinjury model may be a useful alternative to NHPs in detecting a response to therapies directed at endothelial regeneration.

Background: Cold injury is one of the most important limiting factors for maize production in mid-high latitude regions in the world. A total of 314 QTLs for maize low temperature tolerance have been identified in different populations using different statistical methods. However, few identical QTLs have been identified in different research studies. Results: A consensus map of QTLs related to maize low temperature tolerance was constructed, based on the public genetic map, IBM2 2008 Neighbors as a reference map, along with a set of 314 QTLs reported in the literature over the past 20 years. A total of 187 QTLs were projected onto the IBM2 2008 Neighbors by software BioMercator. Forty-seven consensus QTLs were detected. The confidence interval at all sites ranged from 0.04 cM to 102.73 cM, and the proportion of the phenotypic variance associated with each of them ranged from 3.32% to 20.11%. Major chromosomal sites were identified on Chr.6 (MQTL29, MQTL30, and MQTL31). Conclusions: This study provides further insights into the genetic basis of maize low temperature tolerance. Moreover, the MQTLs reported here could be harnessed for functional marker development and candidate gene mining of maize low temperature tolerance.How to cite: Yu T, Zhang J, Cao J, et al. A meta-analysis of low temperature tolerance QTL in maize. Electron J Biotechnol 2022;58. https://doi.org/10.1016/j.ejbt.2022.05.002

Abstract Background Cold exposure is an underrecognized occupational hazard that may increase the risk of peripheral nerve entrapment. The aim of this study was to determine if self-reported occupational exposure to contact and ambient cooling was associated with symptoms of carpal tunnel syndrome (CTS). Methods In this mainly cross-sectional study, surveys were conducted on a population-based sample of men and women between 18 and 70 years of age, living in northern Sweden. Cold exposure and presence of symptoms suggestive of CTS were subjectively reported. Associations between exposure and outcome were evaluated using logistic regression. Results The study included 2,703 women and 2,314 men, with a median age of 60 years (interquartile range 19). Symptoms of CTS were reported by 453 (9.2%). Being highly occupationally exposed (almost always) to contact cooling of the hands was associated with reporting CTS (OR 3.20; 95% CI 1.62–6.33), as was ambient cooling (OR 2.00; 95% CI 1.03–3.88) and severe ambient cooling (OR 4.02 95% CI 2.09–7.71), after adjusting for age, gender, body mass index, current daily smoking, diabetes mellitus, joint disease, and hand-arm vibration exposure. The point estimates increased with longer daily exposure duration. For workers exposed to severe ambient cooling for more than half of their working hours, in addition to performing heavy manual handling every day, the OR for reporting CTS was 7.25 (95% CI 3.88–13.53), with a positive additive interaction effect (expressed as relative excess risk due to interaction) of 4.67. Conclusions Self-reported occupational exposure to contact and ambient cooling was associated with symptoms suggestive of CTS. There were statistically significant positive exposure–response patterns for time spent exposed to contact and ambient cooling at work in relation to reporting symptoms of CTS. Positive additive interaction effects between cold exposure and heavy manual handling were also found. Since there was important potential uncontrolled confounding regarding repetitive wrist movements and forceful gripping, the results need to be confirmed by other studies, preferably with longitudinal design and more detailed exposure assessment.

The study aimed to determine the prevalence and incidence proportion of local cold injuries in northern Sweden, and identify associated factors. It was based on prospective data from surveys in 2015 and 2021 sent to a population-based sample in northern Sweden. Multiple binary logistic regression was performed. The study included 5,017 subjects (response rate 44.4%). The prevalence of cold injuries in the hands was 11.4%, feet 12.6%, and face 19.9%, while the incidence proportion was 1.0%, 1.0%, and 0.9%, respectively. Male gender was associated with incident cold injuries in the hands (OR 1.69; 95% CI 1.31–1.28), feet (OR 1.34; 95% CI 1.04–1.73), and face (OR 1.53; 95% CI 1.15–2.03); mental stress with cold injuries in the hands (OR 1.55; 95% CI 1.16–2.05) and feet (OR 1.39; 95% CI 1.04–1.88); previous stroke with cold injuries in the hands (OR 2.64; 95% CI 1.09–6.40) and face (OR 3.09; 95% CI 1.26–7.56); and Raynaud’s phenomenon with cold injuries in the hands (OR 2.48; 95% CI 1.80–3.41) and feet (OR 2.07; 95% CI 1.50–2.87). We conclude that male gender, mental stress, previous stroke, and Raynaud’s phenomenon increased the probability of contracting local cold injuries. [ABSTRACT FROM AUTHOR]

This study investigated the optimum transport condition for heart tissue to recover single-cell cardiomyocytes for future in-vitro or in-vivo studies. The heart tissues were obtained from removing excessive myocardium discharged during the repair surgery of an excessive right atrial hypertrophy due to a congenital disease. The transportation temperature studied was the most used temperature (4 °C) or the conventional condition, compared to a physiological temperature(37 °C). The heart tissues were transported from the operating theatre to the lab maintained less than 30 min consistently. Single-cell isolation was enzymatically and mechanically performed using collagenase-V (160 U/mg) and proteinase-XXIV (7-14 U/mg) following the previously described protocol. The impact of temperature differences was observed by the density of cells harvested per mg tissue, cell viability, and the senescence signals, identified by the p21, p53 and caspase-9 mRNA expressions. Results the heart tissue transported at 37 °C yielded significantly higher viable cell density (p < 0.01) yielded viable cells significantly higher density (p < 0.01) than the 4 °C; 2,335 ± 849 cells per mg tissue, and 732 ± 425 cells per mg tissue, respectively. The percentage of viable cells in both groups showed no difference. Although the 37 °C group expressed the apoptosis genes such as p21, p53 and caspase9 by 2.5-, 5.41-, 5-fold respectively (p > 0.05). Nonetheless, the Nk×2.5 and MHC genes were expressed 1,7- and 3.56-fold higher than the 4 °C. and the c-Kit+ expression was 17.56-fold, however, statistically insignificant. Conclusion When needed for single-cell isolation, a heart tissue transported at 37 °C yielded higher cell density per mg tissue compared to at 4 °C, while other indicators of gene expressions for apoptosis, cardiac structural proteins, cardiac progenitor cells showed no difference. Further investigations of the isolated cells at different temperature conditions towards their proliferation and differentiation capacities in a 3-D scaffold would be essential. [ABSTRACT FROM AUTHOR]

The present review discusses the molecular mechanisms of injury caused by low temperatures and/or freezing. The review is intended mainly for insect environmental physiologists who focus on the effects of low temperatures. The review successively discusses (1) the effects of low temperatures on the structure and function of macromolecules; (2) the effects of freezing on cells and macromolecules and (3) the mechanisms of damage during thawing and post-thaw. The review shows that injury primarily occurs at the molecular level in terms of damage to proteins, nucleic acids and biological membranes. The damage to macromolecular structures occurs as a result of the interaction between the effects of temperature, ice formation and resulting secondary effects such as osmotic stress, increased concentration of solutes, cellular freeze dehydration, disruption of ionic balance and oxidative stress. The present review attempts to identify gaps in our knowledge on the mechanisms of cold injury in organisms and proposes possible future directions that could contribute to filling the gaps. [ABSTRACT FROM AUTHOR]

The spectrum of cold injuries ranges from frostnip, chilblains to severe frostbite. Cold injuries occur upon prolonged exposure to freezing temperature and are pathologically a combination of ice crystal formation in the tissue resulting in inflammation, thrombosis and ischemia in the extremities, often necessitating limb amputation in extreme cases due to tissue necrosis. Severe forms of frostbite are a cause of major concern to patients as well as the treating physician. Due to the lack of effective treatment modalities and paucity of research on prophylaxis and therapeutics of cold injuries, we developed a novel herbosomal-loaded PEG–poloxamer topical formulation (n-HPTF) employing quality-by-design (QBD) approach. Natural compounds exhibiting potent therapeutic potential for the management of cold injuries were incorporated in novel lipid vesicles (herbosomes) loaded in PEG–poloxamer polymers. The herbosomal formulation effectively creates an occlusion barrier that promotes epithelial regeneration, desmosome scale-up and angiogenesis and thus promotes rapid healing, indicating controlled release of herbosomes. Optimized novel herbosomes showed entrapment efficiency > 90% and < 300 nm mean particle size and in vitro drug permeation of about 2 µg/cm2 followed Higuchi's release kinetics. Skin irritancy study on female Sprague–Dawley rats showed no edema or erythema. In vivo bio-efficacy study revealed significant efficacy (p < 0.05) when compared to the standard treatment groups. Graphical abstract presenting the designing and optimization of novel herbosomal-loaded PEG–poloxamer topical formulation (n-HPTF) and predictive model for the in vivo study of the developed n-HPTF on cold injury rat skin model [ABSTRACT FROM AUTHOR]

The present review discusses the molecular mechanisms of injury caused by low temperatures and/or freezing. The review is intended mainly for insect environmental physiologists who focus on the effects of low temperatures. The review successively discusses (1) the effects of low temperatures on the structure and function of macromolecules; (2) the effects of freezing on cells and macromolecules and (3) the mechanisms of damage during thawing and post-thaw. The review shows that injury primarily occurs at the molecular level in terms of damage to proteins, nucleic acids and biological membranes. The damage to macromolecular structures occurs as a result of the interaction between the effects of temperature, ice formation and resulting secondary effects such as osmotic stress, increased concentration of solutes, cellular freeze dehydration, disruption of ionic balance and oxidative stress. The present review attempts to identify gaps in our knowledge on the mechanisms of cold injury in organisms and proposes possible future directions that could contribute to filling the gaps.

The study aimed to determine the prevalence and incidence proportion of local cold injuries in northern Sweden, and identify associated factors. It was based on prospective data from surveys in 2015 and 2021 sent to a population-based sample in northern Sweden. Multiple binary logistic regression was performed. The study included 5,017 subjects (response rate 44.4%). The prevalence of cold injuries in the hands was 11.4%, feet 12.6%, and face 19.9%, while the incidence proportion was 1.0%, 1.0%, and 0.9%, respectively. Male gender was associated with incident cold injuries in the hands (OR 1.69; 95% CI 1.31–1.28), feet (OR 1.34; 95% CI 1.04–1.73), and face (OR 1.53; 95% CI 1.15–2.03); mental stress with cold injuries in the hands (OR 1.55; 95% CI 1.16–2.05) and feet (OR 1.39; 95% CI 1.04–1.88); previous stroke with cold injuries in the hands (OR 2.64; 95% CI 1.09–6.40) and face (OR 3.09; 95% CI 1.26–7.56); and Raynaud’s phenomenon with cold injuries in the hands (OR 2.48; 95% CI 1.80–3.41) and feet (OR 2.07; 95% CI 1.50–2.87). We conclude that male gender, mental stress, previous stroke, and Raynaud’s phenomenon increased the probability of contracting local cold injuries.

The low temperature (LT) is detrimental to growth of rice seedling during boro season in Bangladesh. An experiment was conducted in growth chamber during June to October, 2021 using BRRI dhan29 as planting material. The aim of this experiment was to determine the effect of variable duration of LT on growth, physiological and biochemical traits of rice seedling and to determine the age of seedling that can tolerate cold effect. In this experiment 5, 10, 15 and 20 days old seedling (DOS) were exposed to 6 °C for 1, 2, 3 and 4 days. Seedlings were also grown under room temperature (25 °C, RT) which consider as control treatment. Seedlings were grown in plastic trays filled with mixture of soil and cowdung. The experiment was conducted following completely randomized design with 3 replications. Data on shoot length and weight, root length and weight, chlorophyll (Chl), carotenoids, malondialdehyde (MDA) and proline contain were determined after 5 days of temperature sock. The results revealed that the LT was injurious to younger rice seedling when they were exposed to LT for 1 to 2 days. The shoot and root length as well as their dry weight were reduced under low temperature. Further, the Chl and carotenoid content of younger rice seedlings degraded within 2 days of LT exposure. On the contrary, the proline and MDA content of rice seedlings increased to reduce the harmful effect of under LT. It could be concluded that the rice seedlings could tolerate the detrimental effect of LT when they attain at least 15 days. [ABSTRACT FROM AUTHOR]

Background: Frostbite is a severe thermal injury, which characterized by tissue necrosis with a high percentage of amputations, disability of patients.Methods: According to the databases Web of Science, Google Scholar, PubMed, E-library down to 2001-2021 the search for works related to the problem of diagnosis, treatment of frostbite of the upper extremities was made. Actual possibilities of diagnostics, the questions of classification, treatment of frostbite, including the features of plastic surgery operations used to close hand defects after excision of necrotic tissues have been analyzed.Results: Frostbite is more common in people with alcohol dependence, mental illness and in socially disadvantaged groups. The most informative instrumental methods of diagnosis: bone scintigraphy, magnetic resonance imaging, single-photon emission computed tomography. Thrombolytic therapy (tPA) and prostacyclin are most effective if used within the first day after tissue rewarming. With deep frostbite and late medical care surgical treatment is fundamental. Amputation and debridement are carried out after the formation of the demarcation line. To replace soft tissue defects that extend beyond the fingers, it is preferable to use fasciocutaneous flaps.Conclusion: The defining moments in the treatment of deep frostbite are timely diagnosis and complex treatment. With late admission surgical treatment, including reconstructive skin plastic surgery, becomes important. [ABSTRACT FROM AUTHOR]

Although hypothermia and cold injuries are rare in children and young people in the UK, the risk is persistent and requires urgent medical management when it does occur. This article outlines some considerations for professionals who may be caring for hypothermic patients or those at risk of becoming hypothermic. [ABSTRACT FROM AUTHOR]

In this study, we extended our previously developed anatomically detailed three-dimensional (3-D) thermoregulatory virtual human model for predicting heat stress to allow for predictions of heat and cold stress in one unified model. Starting with the modified Pennes bioheat transfer equation to estimate the spatiotemporal temperature distribution within the body as the underlying modeling structure, we developed a new formulation to characterize the spatial variation of blood temperature between body elements and within the limbs. We also implemented the means to represent heat generated from shivering and skin blood flow that apply to air exposure and water immersion. Then, we performed simulations and validated the model predictions with experimental data from nine studies, representing a wide range of heat- and cold-stress conditions in air and water and physical activities. We observed excellent agreement between model predictions and measured data, with average root mean squared errors of 0.2°C for core temperature, 0.9°C for mean skin temperature, and 27 W for heat from shivering. We found that a spatially varying blood temperature profile within the limbs was crucial to accurately predict core body temperature changes during very cold exposures. Our 3-D thermoregulatory virtual human model consistently predicted the body's thermal state accurately for each of the simulated hot and cold environmental conditions and exertional heat stress. As such, it serves as a reliable tool to assess whole body, localized tissue, and, potentially, organ-specific injury risks, helping develop injury prevention and mitigation strategies in a systematic and expeditious manner. [ABSTRACT FROM AUTHOR]

Brain injury develops from a complex series of pathophysiological phases, resulting in acute necrotic or delayed apoptotic cell death after traumatic brain injury (TBI). Inhibition of apoptotic cell death is critical for the treatment of acute neurodegenerative disorders, such as TBI. Here, we investigated the role of phosphodiesterase 10A (PDE10A) in the development of neuronal injury, particularly in apoptotic cell death. Using the PDE10A inhibitor TAK-063, we found that PDE10A inhibition is associated with decreased brain injury, brain swelling, and blood brain barrier disruption 48 h after cold-induced TBI. Furthermore, a particularly notable result was observed with 3 mg/kg TAK-063, which reduced disseminated neuronal injury. Protein abundance analysis revealed that PDE10A inhibition activates survival kinases AKT and ERK-1/-2, which were associated with the decreased activation of MMP-9 and PTEN. Additionally, iNOS and nNOS levels significantly reduced in the TAK-063 group, playing roles in inflammation and apoptosis. A planar surface immunoassay was performed for in-depth analyses of the apoptotic signaling pathways. We observed that inhibition of PDE10A resulted in the decreased expression of TNFRSF1A, TNFRSF10B, and TNFRSF6 receptors, particularly inducing apoptotic cell death. Moreover, these findings correlated with reduced levels of pro-apoptotic proteins, including PTEN, p27, Cytochrome-c, cleaved Caspase-3, Bad, and p53. Interestingly, TAK-063 treatment reduced levels of anti-apoptotic proteins or enzymes, including XIAP, Claspin, and HIF1α, without affecting Bcl-x, MCL-1, SMAC, HO-1, HO-2, HSP27, HSP60, and HSP70. The findings suggest that PDE10A regulates cellular signaling predominantly pro-apoptotic pathways, and inhibition of this protein is a promising approach for the treatment of acute brain injury., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ertugrul Kilic reports financial support was provided by Turkish Academy of Sciences. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Antarctic expeditions are exceptional challenges for the human body, and medical issues such as nutritional deficiencies, polar anemia, cold injuries, and even death have been reported. We prospectively investigated medical issues encountered by a 33-year-old female adventurer completing the longest solo unsupported one-way polar ski expedition in Antarctica, covering 1484.53 km in 70 days and 16 h from Hercules Inlet to the Ross Ice Shelf, in temperatures estimated from -12 to -50°C and wind speeds of up to 60 mi/h. The adventurer developed a debilitating overuse musculoskeletal neck injury due to poor environmental conditions (ie, poor visibility, wind, and soft snow) while pulling a heavy sled and continuously holding the neck in a flexed position for checking directions on a mounted compass. The adventurer further developed a cold injury on the left calf (polar thigh) that gradually worsened and became ulcerated and more painful throughout the expedition. Potential risk factors included cold ambient temperatures, exposure to windy conditions, and clothing. After the expedition, this injury was treated with a skin graft. Important changes in body mass were observed (ie, reduction of body mass by 26.7% after the expedition) as well as general fatigue, muscle soreness, and sleep deterioration. This case study contributes to the body of knowledge of medical issues during Antarctic expeditions and provides the first scientific account of an adventurer with polar thigh. Further research into this condition is recommended.

The cold-induced vasodilation (CIVD) response of the human body to Arctic-like environments helps delay or prevent cold injuries to peripheral regions, such as the hands and feet. To more comprehensively predict the thermal responses of these body regions to cold stress, here we extended our previously developed and validated anatomically accurate three-dimensional whole-body thermoregulatory human model by incorporating a new phenomenological formulation of the CIVD mechanism. In this formulation, we modulated the cyclic vasodilation and vasoconstriction flow of warm blood from the body core to the peripheral regions solely by determining the heat-transfer exchange between the skin and the surrounding environment, and deactivated it when the core body temperature decreased to 36.5 °C. In total, we calibrated and validated the model using eight distinct studies involving 153 unique male subjects exposed to 10 diverse experimental conditions, including cold-air exposure of the whole body as well as air exposure and cold-water immersion of the hand or the foot. With CIVD incorporated, the model predictions generally yielded root mean square errors (RMSEs) of <3.0 °C for skin temperature, which represented a reduction of up to 3.6 °C compared to when we did not consider CIVD. Similarly, the incorporation of CIVD increased the fraction of predictions within two standard errors of the measured data by up to 63 %. The model predictions yielded RMSEs for core body temperature of <0.2 °C. The model can be used to provide guidelines to reduce the risk of cold-related injuries during prolonged exposures to very-cold environments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could appear to have influenced the work reported in this paper., (Published by Elsevier Ltd.)

Cold injury (CI) causes irreversible damage to tea plants, which results in decline in the quality of famous teas and huge economic loss. A new, quick, non-destructive method is provided to assess the CI of tea leaf based on terahertz (THz) spectroscopy. Absorbance of the samples was measured with THz spectroscopy in frequency bands from 0.1 to 1.6 THz under low temperature treatments of 4.0, 0, −2.5, −5.0, −7.5, and −10.0 °C. Fast Fourier transformation was explored to decompose the endpoint signal to improve the ratio of signal to air and convert the time-domain spectra to the corresponding frequency-domain spectra. To improve the separation of overlap signals caused by substantial scattering of injured cells in the leaf, two-dimensional correlation spectroscopy (2DCOS) and average intensity (AI) were introduced into the partial least squares regression (PLSR) to build 2DCOS–PLSR and AI–PLSR models. Quantitative assessments of the 2DCOS–PLSR and AI–PLSR models were conducted to evaluate the three models. The assessment results showed that the correlation coefficients of the 2DCOS–PLSR model (R2D) were 0.7873, 0.8305, and 0.9103, respectively. The root mean square errors of the 2DCOS–PLSR model (RMSE2D) were 0.6032, 0.5763, and 0.5221, respectively. For the AI–PLSR model, RAI values were 0.7477, 0.7691, and 0.8974, respectively. RMSEAI values were 0.6038, 0.5962, and 0.5797. The combination of THz spectroscopy with the 2DCOS–PLSR model provided a better benchmark for the input interval selection and improved the accuracy of cold-injury detection results.

We sought to examine whether short-term, whole body cold acclimation would modulate finger vasoreactivity and thermosensitivity to localized cooling. Fourteen men were equally assigned to either the experimental (CA) or the control (CON) group. The CA group was immersed to the chest in 14°C water for ≤120 min daily over a 5-day period while the skin temperature of the right-hand fingers was clamped at ~35.5°C. The CON group was instructed to avoid any cold exposure during this period. Before and after the intervention, both groups performed, on two different consecutive days, a local cold provocation trial consisting of a 30-min hand immersion in 8°C water while immersed to the chest once in 21°C (mild-hypothermic trial; 0.5°C fall in rectal temperature from individual preimmersion values) and on the other occasion in 35.5°C (normothermic trial). In the CA group, the cold-induced reduction in finger temperature was less (mild-hypothermic trial: P = 0.05; normothermic trial: P = 0.02), and the incidence of the cold-induced vasodilation episodes was greater (in normothermic trials: P = 0.04) in the post-than in the preacclimation trials. The right-hand thermal discomfort was also attenuated (mild-hypothermic trial: P = 0.04; normothermic trial: P = 0.01). The finger temperature responses of the CON group did not vary between testing periods. Our findings suggest that repetitive whole body exposure to severe cold within a week may attenuate finger vasoreactivity and thermosensitivity to localized cooling. These regional thermo-adaptions were ascribed to central neural habituation produced by the iterative, generalized cold stimulation. [ABSTRACT FROM AUTHOR]

Background: Cold exposure is an underrecognized occupational hazard that may increase the risk of peripheral nerve entrapment. The aim of this study was to determine if self-reported occupational exposure to contact and ambient cooling was associated with symptoms of carpal tunnel syndrome (CTS).Methods: In this mainly cross-sectional study, surveys were conducted on a population-based sample of men and women between 18 and 70 years of age, living in northern Sweden. Cold exposure and presence of symptoms suggestive of CTS were subjectively reported. Associations between exposure and outcome were evaluated using logistic regression.Results: The study included 2,703 women and 2,314 men, with a median age of 60 years (interquartile range 19). Symptoms of CTS were reported by 453 (9.2%). Being highly occupationally exposed (almost always) to contact cooling of the hands was associated with reporting CTS (OR 3.20; 95% CI 1.62-6.33), as was ambient cooling (OR 2.00; 95% CI 1.03-3.88) and severe ambient cooling (OR 4.02 95% CI 2.09-7.71), after adjusting for age, gender, body mass index, current daily smoking, diabetes mellitus, joint disease, and hand-arm vibration exposure. The point estimates increased with longer daily exposure duration. For workers exposed to severe ambient cooling for more than half of their working hours, in addition to performing heavy manual handling every day, the OR for reporting CTS was 7.25 (95% CI 3.88-13.53), with a positive additive interaction effect (expressed as relative excess risk due to interaction) of 4.67.Conclusions: Self-reported occupational exposure to contact and ambient cooling was associated with symptoms suggestive of CTS. There were statistically significant positive exposure-response patterns for time spent exposed to contact and ambient cooling at work in relation to reporting symptoms of CTS. Positive additive interaction effects between cold exposure and heavy manual handling were also found. Since there was important potential uncontrolled confounding regarding repetitive wrist movements and forceful gripping, the results need to be confirmed by other studies, preferably with longitudinal design and more detailed exposure assessment. [ABSTRACT FROM AUTHOR]

Olive (Olea europaea L.) is an evergreen xerophytic tree characterizing vegetative landscape and historical-cultural identity of the Mediterranean Basin. More than 2600 cultivars constitute the rich genetic patrimony of the species cultivated in approximately 60 countries. As a subtropical species, the olive tree is quite sensitive to low temperatures, and air temperature is the most critical environmental factor limiting olive tree growth and production. In this present review, we explored the detrimental effects caused of low temperatures on olive cultivars, and analyzed the most frequently experimental procedures used to evaluate cold stress. Then, current findings freezing stress physiology and gene are summarized in olive tree, with an emphasis on adaptive mechanisms for cold tolerance. This review might clear the way for new research on adaptive mechanisms for cold acclimation and for improvement of olive growing management. [ABSTRACT FROM AUTHOR]

Knowledge of nutrients effect on freezing tolerance is vital for protecting tea plants against cold injury (CI). Freezing injury treatments on tea leaves with different low temperature and nitrogen (N) concentration was evaluated by hyperspectral imaging based on the reflectance as potential analytical tool. Subsequently, quantitative evaluation of the CI was improved by comparing analyzed results using partial least squares regression (PLSR), principle component regression (PCR) and linear model (LM) models. Reflectance of the CI was obtained by hyperspectral imaging system in the band between 871 and 1766 nm. The results showed that average reflectance increases with the rise of N concentration. A substantial portion of the leaf from the plant with 100% N dosage had the darkest image and resulted in the highest reflectance because the N weakened the negative effect of freezing stress. Out of the five spectral domains tested, the best predictive accuracy for the CI of the tea leaf was achieved by PCR (R2 = 0.9971, RMSE = 0.0609) in 1410–1766 nm wavelength, followed by LM (R2 = 0.9999, RMSE = 0.0805) in 871–1000 nm. The whole interval had the worse prediction accuracy which could be caused by large variations in the data for a specific treatment and high absorption peak occurring around 1450 nm in the reflectance curve. The averages, R2 and RMSE for all the three statistical models showed that the worse prediction accuracy occurred in 1410–1766 nm, followed by the whole interval 871–1766 nm. The prediction accuracy was low which could be due to the strong water absorption peaks that appeared in both range of wavelengths. The models without absorption bands had improved correlation coefficient and reduced RMSE values between the measured and the predicted CI (R2 = 0.9676; RMSE = 0.3067) compared to the model developed with the reflectance values in the entire waveband (R2 = 0.9504; RMSE = 0.6629). The reflectance values where absorption bands occurred had detrimental effect on the model performance, which resulted in the lower correlation values and larger errors. This study has demonstrated that the wavelength at which absorption bands occur can influence model performance significantly which is a step towards real-time implementation of the technique.

Abstract Cold injury refers to local or systemic injury caused by a rapid, massive loss of body heat in a cold environment. The incidence of cold injury is high. However, the current situation regarding the diagnosis and treatment of cold injury in our country is not ideal. To standardize and improve the level of clinical diagnosis and treatment of cold injury in China, it is necessary to make a consensus that is practical and adapted to the conditions in China. We used the latest population-level epidemiological and clinical research data, combined with relevant literature from China and foreign countries. The consensus was developed by a joint committee of multidisciplinary experts. This expert consensus addresses the epidemiology, diagnosis, on-site emergency procedures, in-hospital treatment, and prevention of cold injury.